Lobelia inflata

A North American annual in the Campanulaceae. The mother tincture is prepared from the fresh herb in flower and seed capsules, macerated in alcohol and potentised per pharmacopoeial directions [Hering], [Clarke]. The plant contains lobeline (a piperidine alkaloid) and related constituents with nicotinoid actions: stimulation then depression of autonomic ganglia and the medullary respiratory centre. Toxicology shows profuse salivation, deathly nausea, vomiting, cold sweat, tremor, faintness, dyspnoea and collapse, with bronchial secretion and spasm of larynx/bronchi—a blueprint for the remedy’s sphere in asthma, spasmodic cough, laryngeal spasm, sea-sickness/motion-sickness, gastric sinking, and tobacco intolerance [Hughes], [Allen], [Hale], [Clarke], [Boericke].

Pathogenesis from provings, toxicology, and abundant clinical confirmations in asthma with gastric sinking, laryngeal spasm, hiccough (drunkards, pregnancy), sea-sickness, spasmodic cough, and tobacco dyspepsia/palpitations with profuse salivation and deathly nausea; characteristic globus and epigastric emptiness with dyspnoea and weak, tremulous pulse recur through the literature [Hering], [Allen], [Hale], [Clarke], [Boericke], [Farrington], [Nash].

Essence: Autonomic spasm with gastric sinking. A banded epigastrium, deathly nausea with profuse salivation, yawning for air, tickling larynx, short cough, and air-hunger better for cool air, forward sitting, loosening clothes, eructation, and small cold sips; worse for tobacco, warm close rooms, motion of ship/car, after meals, emotion, and lying flat. In asthma with gastric element, sea-/car-sickness, hiccough (alcoholic/pregnancy), and tobacco intolerance, Lob. quietly rebalances the vago-sympathetic swing so breath and stomach settle together [Hering], [Allen], [Hale], [Clarke], [Boericke], [Farrington], [Nash], [Hughes].

• Respiratory tract (larynx–bronchi). Spasmodic asthma; sense of suffocation; frequent deep yawning breaths to “get air”; laryngeal spasm with choking and tickling cough [Hering], [Clarke], [Boericke].
• Gastro-duodenal axis. Deathly nausea, empty sinking at pit of stomach, excessive salivation; vomiting with cold sweat; sea-sickness and car-sickness [Allen], [Hale], [Clarke].
• Vago-sympathetic (autonomic). Alternation of spasm and collapse: tremor, faintness, cold surface, small soft pulse during attacks [Hughes], [Boger].
• Chest–epigastrium band. Constriction as of a cord around lower chest/epigastrium linking breathing and stomach states [Hering], [Clarke].
• Tobacco intolerance. Gastric and cardiac distress from smoking/chewing; nausea, vertigo, pallor, palpitations [Hale], [Clarke].
• Hiccough. Persistent hiccough—alcoholic, post-operative, pregnancy; reflex from diaphragmatic irritation [Allen], [Boericke].
• Mucous membranes. Irritative catarrh with profuse thin saliva, much hawking, and tickling spots that provoke cough [Hering], [Clarke].
• Pregnancy/Neonate. Vomiting of pregnancy with salivation and empty sinking; neonatal apnoea/asphyxial spells (historic clinical notes) [Hale], [Tyler].
• Cardio-respiratory drive. Irregularity of pulse and breathing under autonomic strain; precordial anxiety during dyspnoea [Hughes], [Clarke].

The mental picture oscillates with autonomic storms: a subdued anxiety rising to fear of suffocation during asthma, yet with a passive, faint demeanour rather than frantic restlessness (contrast Arsenicum) [Clarke], [Boericke]. The empty sinking at the pit of the stomach provokes a sense of imminent failure—they dread that the next wave of nausea will “end me,” especially when the chest feels banded and the throat catches (Stomach/Chest cross-link) [Hering], [Allen]. Odours of tobacco or hot, greasy kitchens set off revulsion—a mental aversion immediately mirrored by salivation and retching (Affinity: Tobacco intolerance) [Hale], [Clarke]. During paroxysms the patient seeks air and space, sits bent forward, asks for the window and speaks in short sentences, conserving breath; attempts at conversation or contradiction provoke cough (Respiration/Larynx) [Boericke], [Hering]. A hypochondriacal watchfulness centres on the epigastrium and breath; they count breaths, then yawn to pull in air, an automatised coping routine (Generalities) [Clarke]. Between attacks they are mild, low-spirited, with blunted initiative—a post-paroxysmal fatigue resembling that after sea-sickness (Sleep) [Allen]. Anticipatory anxiety before travel or a meal can precipitate a bout—mind and mucosa move together (Modalities worse emotions; Stomach) [Hughes], [Clarke]. In pregnancy they fear choking when lying down; reassurance plus posture instruction reduces panic (Female/Respiration) [Hale]. In short, the Mind is the barometer of the vago-sympathetic seesaw: sinking–spasm–sweat–faint, relieved by air, posture, eructation, and cooling [Clarke], [Hale], [Boericke].

Sleep is broken and unrefreshing; the patient dreads lying flat for fear of choking and chooses propped, forward-leaning postures (Respiration) [Boericke], [Clarke]. First sleep is interrupted by tickling cough, salivation pooling, and empty sinking that compels them to sit up and belch (Stomach/Throat cross-link) [Hering]. Dreams of suffocation, falling in waves, or being shut in hot rooms; they wake clammy and gasp for cool air (Dreams/Modalities) [Clarke]. After vomiting they may doze in a blank, spent sleep, but awake faint if the room is warm (Generalities) [Allen]. Sea-travel nights are worst—rocking re-triggers nausea on every light doze (Motion) [Allen]. Nocturnal hiccough jerks them awake repeatedly; a little cold water temporarily stills it (Hiccough/Modalities) [Boericke]. Towards morning, if the window is open and the air cool, sighing breaths deepen and a short refreshing nap appears—an omen that the spasm–sinking cycle is easing (Affinity logic) [Clarke]. Persistent insomnia leaves daytime heaviness with a fragile calm; they fear the next meal or journey (Mind) [Hale]. Over days on Lob., night wakings shorten, tickle-cough softens, and posture is less guarded (Relationships) [Boericke], [Clarke].

Of suffocating rooms, choking, waves and rolling decks, and searching for a window; wake gasping, salivating, and retching until cool air and belching relieve (Mind/Respiration/Stomach) [Clarke], [Allen].

Lobelia inflata centres on a stomach–chest axis where empty sinking at the pit and spasm of larynx/bronchi rise and fall together: nausea–salivation–retching–dyspnoea–cold sweat; then brief collapse and doze; then recurrence with the next trigger [Hering], [Clarke], [Hale]. Tobacco is the chief aggravator; even the smell can launch the cycle (keynote) [Hale], [Clarke]. The modal logic: worse in warm, close rooms, motion of ship/car, tobacco, fat foods, after meals, emotion, lying flat; better in cool, open air, sitting forward, loosening clothing, firm epigastric pressure, eructation, small cold sips, and sometimes slow walking once spasm breaks [Allen], [Clarke], [Boericke]. Compare Ipecac (constant nausea, clean tongue, little thirst, no relief from vomiting; fewer respiratory links) and Tabacum (icy coldness, deadly sinking, wants to be uncovered, better cold air, but with more extreme pallor and collapse); Nux-v. has irritable spasm and gastric cramp without classic salivation–tobacco nexus; Ant-t. shows rattling, drowsy dyspnoea with mucus overload rather than banded epigastrium [Farrington], [Boericke]. In asthma with gastric element, Lob. stands between Nux-v. and Ipecac, distinguished by profuse saliva, globus, need to yawn for air, and tobacco aggravation [Clarke], [Hale]. The autonomic signature explains the hiccough, sea-sickness, pregnancy vomiting, and post-paroxysmal lassitude that thread the case [Hughes], [Allen].

Not a fever remedy; during paroxysms there may be chilliness with sweat, subjective heat of face, and cold extremities—an autonomic picture rather than infection [Hughes], [Clarke]. As spasm collapses, temperature normalises without a classic cycle.

Chill with gooseflesh during nausea; heat of face and head in warm rooms; sweat cold and clammy on forehead, upper lip, palms (Loss-of-tone) [Allen], [Clarke]. Sweat does not relieve nausea fully (contrast Ipecac) [Boericke].

Light-headedness, faintness, and cold sweat accompany the deathly nausea; the scalp may prickle and the face turn pale or greenish (sea-sick look) [Allen], [Clarke]. Occipital weight follows long retching; head clearer in cool air (Modalities) [Hale]. Dizzy on rising from bed or seat during a bout; must steady and breathe first (Generalities) [Boericke]. Yawning is frequent, not from sleepiness but as a respiratory manoeuvre to catch air (Respiration link) [Clarke]. Warm rooms throb the head and increase salivation; open windows calm it (Modalities) [Clarke]. Headache is seldom primary; it reflects gastric–respiratory stress and abates as epigastric sinking and tickling cough ease [Hering].

Eyes look watery, dull, with half-closed lids; a tear film pools during nausea; pupils may be slightly dilated in pallor [Allen], [Hale]. Motion or reading while moving blurs vision; shutting eyes helps sea-sickness (Modalities) [Allen]. Photophobia minimal; they prefer dim light in nausea (Better dim) [Hale]. Blue rings under eyes appear with long asthma history (Respiration chronicity) [Clarke]. After vomiting, sparkles or dark spots pass before eyes briefly, then clear with deep breaths (Heart/Respiration) [Boericke].

Humming or ringing when the pulse is small and soft; worse in close warm rooms (Vaso-motor) [Clarke]. Ear fullness with yawning fits (Respiration link). Sea-sick subjects notice noise intolerance, preferring quiet [Allen].

Nasal tickle excites a short, hacking cough; the smell of tobacco or kitchen fat triggers nausea instantly (Tobacco intolerance) [Hale], [Clarke]. Coryza is thin with much hawking; sneezing may precede a laryngeal spasm [Hering]. No haemorrhagic tendency is typical of Lobelia.

Face pale, greenish, damp; lips cold; saliva ropy at mouth corners during nausea [Allen], [Clarke]. A drawn look during chest constriction; relief shows as colour returns after eructation (Stomach/Chest) [Hering]. Warm flush follows tobacco, quickly changing to pallor and sweat (Modalities) [Hale]. Subtle cyanosis at alae nasi in bad asthma is noted (Respiration) [Boericke].

Profuse salivation is a keynote; saliva is watery or ropy; mouth tastes flat or tobacco-sour [Allen], [Hering]. Tongue often clean, sometimes coated at base; nausea is disproportionate to tongue coat (contrast Nux-v.) [Clarke]. Hawking of thin mucus frequent; gagging follows (Larynx) [Hering]. Warm drinks aggravate retching; small cold sips palliate (Modalities) [Allen]. Fetor may be stale-tobacco-like in smokers (Tobacco link) [Hale].

Teeth chatter with chill and faintness during vomiting; jaw tired from retching (Generalities) [Allen]. No distinctive dental neuralgia; the oral sphere is salivary.

Globus—a lump in the throat that catches breath, worse swallowing saliva, better chewing/eructation (neuro-vegetative) [Hering], [Clarke]. Throat raw from hawking; tickle at sternal notch triggers spasm and short cough [Hering]. Tight collars intolerable; loosening relieves (Modalities) [Clarke]. Little true inflammation; function dominates.

Constriction as of a band around lower chest; must take deep breaths; cannot tolerate close room; dyspnoea with wheezing and rattling of scant mucus [Hering], [Clarke]. Short, teasing cough from a tickle at sternal notch or in larynx; talking renews it [Hering]. Expectoration scant, ropy; relief after raising a little [Boericke]. Palpitation accompanies breathlessness in tobacco users [Hale]. Asthma tends to midnight–early morning or after meals (gastric link) [Clarke].

Pulse small, soft, weak in attacks; precordial anxiety with cold sweat; palpitations from tobacco or emotion [Hughes], [Hale], [Clarke]. Cyanosis slight around lips; heart feels tired, not inflamed (contrast Aconite) [Boericke]. Recovery follows air, posture, eructation [Clarke].

Oppressed, sighing, yawning to drag air in; spasmodic closing of glottis with momentary choking (Larynx) [Hering]. Better leaning forward and cool air; worse warm, close room, tobacco smoke, motion [Clarke], [Boericke]. Orthopnoea in bad spells; must sit up (Modalities) [Boericke].

Cardinal. Deathly nausea with cold sweat, empty sinking at the pit, profuse saliva, retching sometimes ending in vomiting of food/mucus; relief partial and short-lived [Allen], [Hering], [Clarke]. Eructations (wind) bring momentary ease to both stomach and breath (chest–stomach band) [Hering]. Odour/taste of tobacco, warm rooms, fatty foods, and motion (ship, carriage) are classic triggers [Hale], [Allen]. Hiccough attends spells or follows alcohol; diaphragmatic irritability sits at the core (Hiccough affinity) [Allen], [Boericke]. Hunger may be present yet food repels at the sight; anticipation of a meal can start nausea (Mind link) [Clarke]. In pregnancy, morning salivation with sinking and air-hunger points strongly to Lob. [Hale], [Tyler].

Epigastric constriction radiates around lower ribs (“band”), tying breath to stomach; each attempt to breathe deep provokes nausea (Respiration cross-link) [Hering], [Clarke]. Abdomen feels empty and heavy at once; flatulence presses upward, relieved by belching [Allen]. Colic is not marked; it is the sinking and spasm that dominate. Coldness internally during collapse sensations (Generalities) [Boericke]. After vomiting, slack weakness replaces spasm for a time [Allen].

Ineffectual urging during autonomic storms; a relaxation follows vomiting (vagal) [Hughes]. Hiccough may force flatus; stool otherwise unremarkable (not a dysenteric remedy) [Allen].

During attacks scant urine, pale; after relief, copious flow as the vago-sympathetic balance resets [Clarke]. Urgency during sea-sickness episodes is noted (autonomic) [Allen].

Aversion to tobacco; worse from its odor/use; worse from fatty foods, warm drinks, alcohol (hiccough/nausea); better from small cold sips, ice, and eructation; worse from over-eating or empty stomach—the sinking is paradoxical (needs little but often) [Hale], [Allen], [Clarke].

Tobacco-heart with palpitation, nausea, sweat, faintness after smoking; sexual function slack when tobacco excess persists (Tobacco intolerance) [Hale], [Clarke]. No primary gonadal pathology.

Vomiting of pregnancy with salivation, empty sinking, and air-hunger; lying flat worsens; cool air, sips, and sitting forward help [Hale], [Tyler]. Dysmenorrhoea with nausea and faintness in close rooms (less characteristic than pregnancy picture) [Clarke]. Hiccough of pregnancy relieved by Lob. in several classical notes [Allen].

Between scapulae ache from stooping forward and laboured breathing; better when spasm abates (Chest link) [Clarke]. Lumbosacral weakness after long nausea bouts (Generalities) [Allen].

Trembling, coldness, weakness, and a sense of hollowness in knees during paroxysms; fingers cold, moist [Allen], [Boericke]. Cramping of diaphragm felt as jerks into epigastrium and lower ribs (Hiccough) [Allen].

Cold, clammy, pale/greenish hue; sweat beads on face during nausea and asthma [Clarke], [Allen]. No primary eruption; skin changes are vaso-motor.

• Ipecacuanha — Constant nausea not relieved by vomiting, clean tongue; less chest band. Lob.: salivation, empty sinking, tobacco aggravation, chest–stomach link [Clarke], [Farrington].
• Tabacum — Deathly nausea with icy coldness, desires cold air, must be uncovered; profound collapse. Lob.: similar nausea/sweat but more salivation, globus, yawning for air, and band at epigastrium [Allen], [Boericke].
• Antimonium tart. — Much rattling of mucus, drowsiness, cyanosis; little nausea. Lob.: less mucus, more spasm–sinking and salivation [Boericke].
• Nux vomica — Gastric spasm, irritable, chill; worse after excess, but lacks Lobelia’s tobacco intolerance and profuse salivation [Farrington].
• Arsenicum — Asthma with burning, great restlessness, thirst for hot sips. Lob.: passive faintness, cool air, salivation; nausea foreground [Clarke].
• Cuprum — Violent spasms, cramping, blue face; cough ends in spasm. Lob.: less cramp, more empty sinking and yawning for air [Boger].
• Kali bichromicum — Tough stringy mucus, metallic nausea; fixed “spot” of pain. Lob.: ropy saliva but not tough plugs; tobacco triggers [Clarke].
• Naphthalinum — Paroxysmal asthma (drug), less gastric sinking; Lob. adds nausea–salivation [Hale].
• Cocculus — Motion-sickness with vertigo, weakness; less chest spasm; Lob. has chest band and need to yawn deeply [Clarke], [Allen].
• Sepia — Nausea of pregnancy, empty feeling but better after eating; less salivation; Lob. marked salivation and tobacco aversion [Tyler].
• Bryonia — Irritable, dry, wants to lie still; nausea worse movement, but lacks Lobelia’s saliva and choking [Farrington].
• Grindelia — Cannot expectorate, must sit up; less gastric core; Lob. has stomach–breath axis [Boericke].
• Carbo veg. — Air-hunger collapse, wants to be fanned; gastric distension prominent. Lob.: spasm with salivation–nausea, not flatulent collapse [Clarke].
• Ignatia — Globus hystericus with sighing; less salivation/nausea; Lob. globus is autonomic, tied to retching [Kent].

• Complementary: Antimonium tart. (when mucus accumulation dominates late), Nux-v. (to regulate gastric irritability between attacks), Ipecac. (in violent nausea phases lacking relief), Cocculus (pure motion-sickness days), Ignatia (residual globus without nausea) [Clarke], [Boericke], [Farrington].
• Follows well: Tabacum (after collapse is lifted but salivation–nausea persist), Arsenicum (after restless toxic anxiety subsides leaving passive sinking), Carbo-veg. (post-asphyxial phase with persistent gastric sinking) [Allen], [Clarke].
• Precedes well: Ant-t. (rattling mucus stage), Grindelia (failure to raise mucus), Sepia (pregnancy nausea without saliva after acute Lobelia phase), Nux-v. (habit correction) [Boericke], [Clarke], [Tyler].
• Related: Ipec., Tab., Nux-v., Ant-t., Cocculus, Ars., Cupr., Ign., Carb-v., Grindelia, Bry., Kali-bi., Naphthalinum—see differentials.
• Antidotes/Notes: Tobacco aggravates; fresh air, posture, cold sips act as natural palliatives; crude Lobelia emetic effects are neutralised by warmth and rest, but homeopathic doses regulate the autonomic swing (historical observation) [Hale], [Hughes].
• Inimical: None classical; avoid indiscriminate alternation with multiple antiemetics without clear phase-indication [Clarke].

• Asthma — keynote remedy in paroxysmal asthma with sensation of fullness or constriction in chest, worse exertion, with much nausea and vomiting of mucus or food [Hering], [Clarke].
• Dyspnoea — great oppression of chest, feeling of suffocation, must have fresh air, yet anxiety and weakness prevail [Allen].
• Nausea and vomiting — intense, persistent nausea not relieved by vomiting; stomach feels faint, sinking, empty, with copious salivation [Boericke].
• Gastric irritability — “deathly nausea” with profuse saliva, cold sweat, and sense of collapse; often in tobacco or alcohol excess [Clarke].
• Collapse states — sudden sinking at stomach with cold sweat, weak pulse, faintness, much like poisoning pictures [Allen].
• Nervous and hysterical asthma — indicated in subjects who have attacks from emotional disturbance, fright, or over-exertion [Kent].
• Angina-like symptoms — præcordial distress with oppression and nausea; sometimes precedes fainting [Boericke].
• Tobacco antidote — neutralises ill effects of tobacco: nausea, vomiting, giddiness, trembling, oppression of chest [Clarke].
• Modalities — worse exertion, open air, warm room, tobacco; better rest, belching, and sometimes eating a little [Boericke].
• Dosing — low tincture doses (mother tincture, 2X, 3X) for asthma and gastric complaints; higher (30C, 200C) for nervous, hysterical presentations [Hering].
• Case Pearls

Mind

• Fear of suffocation during asthma; seeks air.
• Anxiety with empty sinking at epigastrium.
• Aversion to tobacco; odour excites nausea.
• Better open air, worse warm room.
• Hypochondriacal watchfulness of breath/epigastrium.
• Anticipatory nausea before travel or meals.

Head/Eyes/Ears

• Vertigo with nausea; must sit.
• Headache from warm, close room; better air.
• Yawning to draw breath.
• Watering eyes during nausea; dim vision with motion.
• Ringing when pulse small/soft.
• Greenish pallor of face in sea-sickness.

Throat/Larynx

• Globus—lump in throat; catches breath.
• Tickling at sternal notch induces cough/spasm.
• Talking aggravates cough.
• Loosening clothing about neck relieves.
• Hawking thin mucus with gagging.
• Laryngeal spasm with momentary choking.

Stomach/Abdomen

• Deathly nausea with profuse salivation.
• Empty sinking at pit; wants pressure.
• Vomiting with cold sweat; eructation relieves.
• Sea-sickness/car-sickness.
• Hiccough, especially after alcohol.
• Worse tobacco, fatty food, warm drinks; better small cold sips.

Respiration/Chest/Heart

• Asthma with epigastric band sensation.
• Must yawn/sigh for air; open window.
• Wheezing with scant ropy expectoration.
• Orthopnoea; sits bent forward.
• Palpitation after tobacco.
• Cough from a small tickling spot.

Female

• Vomiting of pregnancy with salivation and air-hunger.
• Hiccough of pregnancy.
• Nausea worse lying; better sitting forward.
• Anticipatory fear of choking at night.
• Dysmenorrhoea with nausea/faintness in close rooms.
• Odours of cooking provoke retching.

Generalities/Modalities

• Worse warm, close rooms; motion (ship/car); tobacco; after meals; lying flat; emotion.
• Better open cool air; sitting forward; loose clothing; eructations; small cold sips; slow walking after spasm.
• Cold, clammy sweat with faintness.
• Small, soft pulse in attacks.
• Paroxysms at midnight–morning.
• Alternation of spasm and collapse.

Hering — The Guiding Symptoms of Our Materia Medica (1879–91): asthma with gastric sinking; globus; salivation; banded chest; modalities.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): toxicology (lobeline), deathly nausea with cold sweat, hiccough, sea-sickness, laryngeal spasm.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): tobacco intolerance, stomach–chest axis, asthma modalities, travel sickness.
Boericke, W. — Pocket Manual of Homeopathic Materia Medica (1901): keynotes—salivation, empty sinking, asthma, sea-sickness, hiccough, posture relief.
Hale, E. M. — New Remedies (late 19th c.): lobelia pharmacology; tobacco withdrawal notes; motion-sickness; pregnancy nausea.
Hughes, R. — A Cyclopaedia of Drug Pathogenesy (1895): nicotinoid actions; medullary respiratory effects; autonomic seesaw.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): modalities (air vs warm room), autonomic polarity, comparisons.
Farrington, E. A. — Clinical Materia Medica (1887): differentials (Ipecac, Nux-v., Tabacum, Ant-t., Arsenicum).
Nash, E. B. — Leaders in Homeopathic Therapeutics (1899): clinical pearls for asthma with gastric element; passive faintness.
Tyler, M. L. — Homeopathic Drug Pictures (20th c.): pregnancy nausea, practical posture and air hints.
Dunham, C. — Homoeopathy, the Science of Therapeutics (1877): management of autonomic crises (contextual).
Hughes & Dake — Pharmacodynamics in Homoeopathy (late 19th c.): lobeline physiology; respiratory centre effects.
Cowperthwaite, A. C. — A Text-Book of Materia Medica and Therapeutics (late 19th c.): asthma–stomach linkage; modalities.