Marsdenia condurango

Condurango is the dried bark of an Andean climbing vine (Apocynaceae, subfamily Asclepiadoideae) native to Ecuador, Peru, and Colombia. The bark contains a bitter principle historically named “cundurangin,” with resins and allied constituents typical of Apocynaceous bitters; these explain much of the gastric stimulation and epithelial action seen clinically and in provings [Hughes], [Clarke]. In crude form it may provoke burning from the fauces to the epigastrium, nausea, and altered appetite [Toxicology—Hughes]. In homœopathy, the mother tincture is prepared from carefully dried, coarsely powdered bark macerated in strong alcohol; potencies are prepared by centesimal dilution and succussion per pharmacopœial standards [Clarke], [Boericke]. Classical writers repeatedly emphasise its affinity for mucocutaneous junctions (angles of mouth, nipples, anus), the oesophagus and cardia, and chronic indolent ulcers with callous edges—an epithelial signature that threads through its entire picture [Hering], [Allen].

Introduced to homœopathy in the United States (New York) soon after 1871; provings recorded by Dowling and colleagues appeared in American literature and were summarised by T. F. Allen and Hering [Proving—Allen], [Hering]. The proving shows burning along the oesophagus, constriction at the cardia with arrest of bolus (especially solids), bitter eructations, sallow cachectic facies, and characteristic fissures at mucocutaneous angles. Early clinical confirmations followed rapidly in gastric ulceration, oesophageal stricture, angular cheilitis, fissured nipples, and anal fissures [Clinical—Clarke], [Boericke].

Condurango is an epithelial remedy with a syphilitic hue. Its essence is a triad: fissure, burning track, and constriction. The tissues it “chooses” are borders—angles and orifices where skin meets mucosa—and the inner “borderland” of the cardia where oesophagus meets stomach. There the patient feels as though life itself sticks: solids halt, swallowing is fearful, and a sting of flame travels downward. This track burns whenever heat is applied—hot soups, hot drinks, hot poultices—yet eases under the governance of coolness: cool sips, cool rinses, cool applications. This stark thermal polarity (worse hot, better cold) is not an afterthought but a constitutional polarity running through mouth, throat, stomach, nipples, anus, and ulcer margins [Clarke], [Allen], [Hering]. Psychologically, the patient lives in the shadow of incurability; the word “cancer” haunts, not always because pathology proves it, but because the felt sense of constriction and slow destruction conveys that story to the mind [Kent], [Tyler]. Miasmatically, the syphilitic current explains fissures that will not heal, ulcers that granulate slowly with callous edges, and cicatricial tendencies that narrow passages; a psoric dryness adds cracking, and a sycotic recurrence ensures the problem returns each winter or under the wrong indoor climate [Sankaran], [Boger], [Kent].
The kingdom signature (plant, Apocynaceae) brings bitters and reflexes—stimulation of mucosa that, in oversensitive subjects, becomes irritation. Thus, Condurango sits among gastric bitters (Hydrastis, Gentiana) yet is distinguished by its border fixation and temperature profile. Micro-comparisons clarify: Arsenicum burns but seeks heat; Condurango burns and seeks cold. Ratanhia’s anal agony loves heat; Condurango’s fissure hates it. Graphites weeps honey; Condurango is dry and callous. Kali bichromicum punches out ulcers; Condurango smooths and seals edges. Phosphorus craves ice but bleeds; Condurango craves coolness without marked haemorrhage [Clarke], [Allen], [Boger], [Kent].
Pace is slow. Reactivity is moderate: pains burn and smart rather than shoot violently; constriction is the key sensation. Thermal state is mixed: the body tolerates warmth, but the affected epithelium rejects heat; hence the successful “mixed” tactic of keeping the back warm while the oesophageal track receives cool sips—an observation patients teach us and which the materia confirms [Clinical—Clarke]. The core polarity is heat versus cool at the surface; constriction versus flow at the passage; despair versus reassurance in the mind. Treatment unfolds as steady consolidation: easing spasm so solids pass; encouraging fissures to knit; curbing the mind’s fear as the body’s borders soften. When the case displays this triad with the repeating temperature law across several orifices (lips and anus or nipples and throat), Condurango becomes a first-line consideration.

• Oesophagus & Cardia — Sensation as if food sticks at the cardia; burning, constriction, dysphagia (especially to solids); palliative sphere in oesophageal stricture and suspected malignant disease [Allen], [Hering], see Throat/Respiration/Stomach.
  • Gastric Mucosa — Chronic gastric catarrh, ulcer tendency, bitter eructations, craving for cold drinks yet aggravation from hot; bitterness reflects its chemical bitter principle [Hughes], [Clarke], see Stomach.
  • Mucocutaneous Junctions — Angular fissures (lips), rhagades of nipples and anus; dry, callous edges that crack and bleed on motion [Hering], [Allen], see Mouth/Rectum/Female/Skin.
  • Skin & Ulceration — Indolent ulcers with hard margins; slow granulation; epithelial regeneration keynote [Clarke], [Boger], see Skin.
  • Liver & Portal Area — Epigastric and right hypochondrial soreness in dyspeptic states; sallow, earthy complexion suggests hepatic sluggishness [Hughes], [Farrington], see Abdomen/Face.
  • Rectum & Anus — Painful fissure, bleeding with stool, alternating constipation/diarrhoea in the cachectic; fissure edges dry and callous [Allen], [Boericke], see Rectum.
  • Mammary/Nipple — Ragades in nursing women, fissured and intensely painful, often with burning; a frequent clinical sphere [Clarke], see Female.
  • Respiratory Reflex Track — Tickling cough from oesophageal irritation; “oesophago-tracheal” reflex fits the vertical burning path [Hering], see Respiration/Chest.
  • Circulation & Cachexia — Wasting, night sweats, and low mood in chronic ulcerative or malignant-adjacent states (palliative) [Hughes], [Kent], see Generalities/Perspiration.
  • Mental Sphere of Illness — Fear of incurable disease, despair coloured by chronic burning pains and fissures; somatic-psychic loop typical of long dyspepsia and ulceration [Kent], [Tyler], see Mind.

The mental picture develops from bodily suffering: a settled fear that the illness is incurable, often naming “cancer,” coloured by the syphilitic miasm’s slow destructiveness [Kent], [Sankaran]. Patients brood at night, measure their sips, dread each swallow, and this anticipatory anxiety increases spasm at the cardia—an elegant mind–body loop already catalogued by Kent in digestive remedies [Kent]. Irritability alternates with despondency; a sullen, sallow visage mirrors the stomach’s condition [Hering], [Clarke]. They crave reassurance and feel better in quiet company, which tallies with the amelioration from gentle support noted under modalities (better reassurance) and often softens gastric constriction [Kent]. Concentration wavers due to persistent retrosternal burning; reading in bed aggravates reflux and triggers a tickling cough that further unsettles the mind [Hering]. Hypochondriacal dwelling on symptoms is common, yet with a curious resignation when fissures or ulcers are long-standing [Tyler]. The patient may be fastidious about food temperature (worse hot, prefers cool)—a behaviour born of experience with burning tracks—and this exact behavioural adaptation confirms the modality (better cold drinks; worse hot), reappearing in Stomach and Throat [Clarke]. Mini-case: “A pale, anxious man, counting each swallow; fears a fatal narrowing—small, cool sips give courage; Condurango 30 relieved the panic and eased the cardial spasm” [Clinical—Clarke]. Over months, despair may deepen into a grey melancholy with night sweats and weight loss, a cachectic psychology paralleling the physical picture [Hughes], [Kent].

Sleep is fractured by: fear of swallowing at night; retrosternal burning after hot evening drinks; and post-stool anal burning in fissure cases [Hering], [Clarke]. The first sleep comes readily from fatigue, yet waking at 2–3 a.m. brings anxiety about disease and light sweat—nocturnal aggravation that tallies with the modalities [Kent]. Reflux in recumbency provokes a tickling cough and a need to sit up; a few cool sips settle both cough and fear (better cold sips) [Hering]. Dreams are preoccupied with narrow passages, choking, or climbing constricted stairways—a mind-image of the cardial ring [Tyler]. The bed feels too hot for fissures; cool linen eases stinging, while hot bottles aggravate (temperature modalities replayed) [Clarke]. After small, plain evening meals sleep improves, confirming the “better small meals” modality [Allen]. Mini-case: “Waking nightly with sternum burn after tea; ceased on avoiding hot drinks and taking Condur. 30.” Over time, unrefreshing sleep contributes to daytime heaviness of head, better in open air, cross-linking Head [Hering]. The whole pattern is nocturnal, burning, anxious, and relieved by coolness and smallness (sips, meals, movements).

Dreams centre on constriction: narrow corridors, blocked doors, choking at table; waking with a start and hand to chest confirms the psychophysical bond [Tyler], [Kent]. Fear-laden medical dreams (“the doctor says it is hopeless”) mirror the syphilitic dread of irreversible damage [Kent]. After improvement in gastric symptoms the dreams abate and become merely busy or domestic, a barometer of cure [Clinical]. Dreams may also feature broken vessels or cracked earth—symbolic echoes of fissures [Tyler]. Hot drinks late intensify vivid dreams and night burning (worse hot, worse night) [Clarke]. Cool sips at bedside reduce both dream-intensity and cough [Hering].

Condurango synthesises an epithelial remedy whose keynote is fissure and slow-healing ulcer at borders—lips, nipples, anus—together with a “burning track” from mouth to cardia and a sensation of arrest when swallowing solids [Hering], [Allen], [Clarke]. The modalities are unusually coherent across systems: worse hot food/drinks and at night; better cold sips, small meals, rest after eating, open air for the head, and emollients locally. This very coherence is a prescribing compass that must be echoed in local symptoms (as repeatedly cross-linked) [Kent]. The constitutional tone is cachectic: sallow face, night sweats, worry about incurability—syphilitic in colouring with psoric dryness and a hint of sycotic recurrence [Sankaran], [Kent]. Pressure at the epigastrium aggravates; gentle post-prandial walking helps—mechanical facts aligning with physiology of cardial spasm [Hughes]. Weather sensitivity divides: cold damp delays healing of fissures, while dry, heated rooms provoke cracking—patients need balanced humidity and temperature [Clarke]. Finally, Condurango’s action is not explosive but steady: a slow, granular promotion of repair where tissues have hardened, cracked, or narrowed—hence its value as a palliative or consolidating remedy in stubborn epithelial lesions [Hering], [Clarke].

Low-grade evening heat appears in cachectic states with burning pains; face flushes while lips feel parched and fissured—an internal–external burning concordance [Hughes]. Febrile phases are modest; the “fire” is experienced along the oesophagus and at fissures rather than as high temperature [Allen]. Chilliness follows brief heats; the patient seeks cool drinks yet tolerates general body warmth, a nuanced temperature pattern already recorded under modalities [Clarke]. Night brings mild heat with anxiety and sweat, cross-linking to Perspiration [Hering]. Febrile episodes are provoked by dietary mistakes (hot, spicy soups), mapping to Food & Drink [Hughes]. Relief with rest after eating and avoidance of hot liquids confirms core modalities [Allen].

Chilliness in the evening with internal burning—an inversion that captures Condurango’s duality [Allen]. Heat is local (retrosternal, lip angles, fissures) rather than universal; hot applications aggravate the burning surfaces [Clarke]. Sweat arrives mostly at night—slight to moderate, sometimes offensive in the debilitated—and accompanies anxiety and palpitations in the small hours [Hering], [Hughes]. Cold damp prolongs the chill phase and impedes fissure healing (weather aggravation confirmed) [Clarke]. A cool drink cuts the retrosternal heat even while the back appreciates gentle warmth—mixed thermal tactics recorded under “Better For” [Clinical]. After regulating evening foods, the whole chill-heat-sweat pattern steadies [Allen].

Headache is dull, frontal, band-like, and indoor-aggravated; it lightens in open air, echoing the amelioration (better open air) already noted [Hering]. The heaviness tracks with post-prandial gastric oppression—head symptoms wax when the stomach is burdened and ease with smaller meals, cross-linking to the gastric affinity [Allen]. Vertigo may accompany sudden retrosternal burning, a reflex from abrupt cardial constriction [Hering]. The scalp and lips feel tight and dry in heated rooms; this dryness foreshadows the angular rhagades described under Mouth/Face and matches the modality (worse dry, heated rooms) [Clarke]. Some report a faint, sick headache after hot broths, mirroring the gastric aggravation from hot liquids [Hughes]. Morning clearness of head is typical, aligning with the general better morning noted under modalities [Hering]. Mini-case: “After soup, a band headache rose with heart-burn; cool water relieved both.”

The eyes are dry and smarting, lids feeling stiff; in chronic dyspeptics a faint subicteric hue is sometimes seen, linking hepatic sluggishness to the facial sallowness of Face/Abdomen [Hughes], [Farrington]. Burning of the tarsal margins may accompany burning of lips—an epithelial signature spanning mucocutaneous borders [Hering]. Vision may blur transiently during severe retrosternal burning or after hot drinks, a vasomotor echo of gastric irritation [Proving—Allen]. Dry rooms aggravate ocular rawness, syncing with the general skin dryness that invites fissure (worse heated rooms) [Clarke]. Relief comes with open air and brief eye rest, paralleling the general head amelioration in air [Hering]. In some, reading at night provokes ocular strain and triggers the tickling cough of Respiration, completing the reflux–eye–cough triangle [Hering].

Tinnitus or a distant humming may appear in debilitated, cachectic subjects; these noises intensify at night with restlessness and sweats, aligning with the nocturnal worse of the general state [Hughes]. Ear canals feel dry, occasionally itchy, reflecting the drying influence seen at other epitheliums [Hering]. Sudden cardial pain may momentarily dull hearing—an autonomic blip seen in marked oesophageal spasm [Allen]. Open air eases the congestive sense of the head and ears, in step with Head [Hering]. No constant ear pathology belongs to the core picture, yet ear sensations serve as minor barometers of venous and autonomic states in the cachectic patient [Boger].

Nasal alæ chap in harsh weather; tiny rhagades sting on facial motion, a miniature of the remedy’s larger fissures [Hering]. Chronic catarrh with thick, stringy mucus may complicate long dyspepsia, especially in dry rooms, paralleling Mouth/Throat dryness [Clarke]. Hot soups aggravate posterior burning and induce hawking of mucus, recalling the modality (worse hot drinks/foods) [Hughes]. Open air relieves a stuffy, heavy nose, as it does the frontal head heaviness [Hering]. Epistaxis is rare, but if present it accompanies great dryness and cracking [Allen]. The sense of smell may be blunted in sallow dyspepsia, improving when gastric symptoms abate with cooler, plain fare [Farrington].

A sallow, earthy tint is a frequent sign in chronic Condurango states, reflecting hepatic dyspepsia and weight loss [Hughes]. Corners of the mouth show deep cracks that bleed on opening, chewing, or laughing—textbook mucocutaneous fissures with callous borders; these worsen in dry, heated rooms and in cold damp weather, matching both aggravations [Hering], [Clarke]. The cheeks may flush with transient heat while lips feel as if scorched—a small echo of the “burning track” from fauces to epigastrium [Allen]. Emollients palliate yet do not cure; the recurrence of rhagades signals the constitutional sphere, aligning with the “better for emollients (transient)” modality [Clarke]. Mini-case: “Angular cheilitis two winters running; hot tea stung, cool water soothed; Condur. cleared fissures after Graphites failed” [Clinical—Clarke]. Expression is drawn and anxious before meals, softening after small cool sips and rest [Kent].

Lips are dry, thick, fissured—especially at the angles; when the mouth opens widely, the cracks split and bleed, with raw burning that tallies with “worse talking/laughing” and “worse heated rooms,” and “better mild pressure/emollients” [Hering], [Clarke]. Buccal mucosa feels as if scalded after hot soups; cool water gives prompt, if brief, comfort—precisely mirroring the modalities (worse hot; better cold drinks) [Clarke]. Taste may be metallic or bitter in the fasting state, correcting after a few cool swallows [Allen]. Salivation varies—often dry by day, sticky by night with thirst for small cool sips [Hughes]. Aphthous spots or superficial erosions on an irritable mucosa connect Condurango to the epithelial healing sphere later exploited in Skin [Clarke]. Speech is hesitant when cracks sting; patients develop guarded, small-mouth talking to avoid tearing, a behavioural adaptation that confirms the fissure keynote [Hering].

No prominent tooth pathology is recorded, yet chewing firm crusts is painful because the oral angles split and burn; soft, cool foods are preferred, confirming the remedy’s food-temperature modalities [Allen], [Clarke]. In long dyspepsia, a sour film accrues and teeth feel “long,” paralleling gastric acidity and bitter eructations [Hughes]. Gum margins may recede slightly with chronic dryness; astringents aggravate smarting [Hering]. Nightly grinding is occasional, coinciding with anxious dreams about illness and with retrosternal burning that interrupts sleep, cross-linking to Sleep [Kent]. Relief comes by avoiding hard crusts and hot meals in the evening [Clinical]. Teeth per se are not decisive; the perioral fissures are.

A defining sphere: burning from fauces to cardia with a sense of constriction; the bolus halts as if the oesophagus narrows—especially to solids [Allen], [Hering]. Hot drinks are intolerable, amplifying the “burning track,” whereas cold sips soothe—an exact echo of modalities [Clarke]. The cardial pinch or “ring” is worse at night, with small regurgitations and a reflex cough from tickling behind the sternum [Hering]. Swallowing anxiety anticipates spasm; reassurance and slow, small sips ease passage (better reassurance; better small, cool sips), cross-linking Mind and Modalities [Kent]. Mucosa feels dry and scalded in heated rooms; damp cold provokes prolonged chapping and delayed healing of any superficial erosions [Clarke]. Mini-case: “Oesophageal stricture palliated—cold milk sipped, Condur. in 6X and 30C alternated; solids still difficult but pain halved” [Clinical—Clarke].

A feeling of tightness behind the sternum accompanies oesophageal burning; swallowing solids can provoke substernal pain radiating to the interscapular region (oesophageal referral) [Allen], [Hering]. The patient guards deep breaths during severe cardial spasm; once the bolus passes, respiration eases—respiratory symptoms are thus reflex, not primary [Hering]. Hot drinks bring immediate substernal heat; cool sips calm—temperature modalities repeated [Clarke]. A fleeting stitch in the left chest appears in cachectic states but is not decisive [Hughes]. Nightly retrosternal discomfort drives the patient to sit up, linking Chest with Sleep [Kent]. Emaciated subjects show visible costal motion with shallow breaths during attacks, eased by rest after eating (better rest post-prandially) [Allen].

Palpitation arises from anxiety during swallowing or from nocturnal reflux irritation, not from structural heart disease [Hughes]. Cachectic weakness produces a soft, easily accelerated pulse; night sweats accompany it, tying Heart to Perspiration [Hering]. Hot meals hasten pulse and aggravate burning, mapping heart-rate changes to gastric inputs [Clarke]. Relief follows calming the cardial spasm (reassurance, small cool sips), mirroring Mind and Modality cross-links [Kent]. No constant valvular signature belongs here; the heart is a passenger in the digestive drama [Farrington]. Mini-case: “Palpitation only at mealtimes, with fear of choking; Condur. quieted both.”

Tickling cough follows reflux of acrid contents and oesophageal irritation; it arises particularly when reading late, recumbent after a hot drink (worse night; worse hot), and is eased by sitting up for a few cool sips [Hering], [Clarke]. The cough is dry, teasing, and retrosternal; scant mucus comes only after repeated irritation [Allen]. Deep inspiration provokes a substernal “sawing” sensation during spasm, but the lungs themselves are sound [Hering]. Cold damp air outdoors may paradoxically help if it lessens the room-heat dryness that cracks lips—consistent with “better open air” for head yet “worse cold damp” for fissure healing; patients learn to balance exposure and humidity [Clinical]. Breathing becomes freer once the bolus passes, reaffirming the reflex nature of symptoms [Hering]. Mini-case: “Night cough after hot cocoa; stopped on avoiding hot drinks and with Condur. 30.”

Gastric symptomatology is rich: bitter eructations, nausea after rich or very hot foods, and weight at the epigastrium with tenderness to pressure (worse pressure) [Hering], [Hughes]. Burning in the epigastrium climbs retrosternally after hot soups or spices, while cool water mitigates—a perfect restatement of temperature modalities [Clarke]. Appetite alternates—early satiety from cardial constriction one day; ravenous snacking on small, cool, bland foods the next; large or hot meals reliably provoke distress [Allen]. Patients discover that gentle walking after small meals enhances comfort (better gentle motion after eating), exactly as in modalities [Hughes]. Vomiting is not essential but may occur as regurgitation of mucus or recently swallowed food when the cardia spasms [Hering]. Mini-case: “Gastric ulcer suspicion; worse hot tea; Condur. 30 t.i.d.—less burning, resumed soft solids; later hydrogastric tenderness subsided” [Clinical—Clarke].

Fullness and bloating appear after very small quantities—an effect of proximal stasis at the cardia rather than true gastric dilatation; gentle walking helps, overeating hurts (cross-refer modalities) [Hughes]. Right hypochondrium is sore with a dragging sensation; the face turns sallow—liver–stomach linkage per Hughes and Farrington [Hughes], [Farrington]. Flatus is offensive in cachectic states and alternates with a sense of “hollow heat” inside [Boger]. Cold damp weather dulls peristalsis and leaves a bruised epigastrium, matching the weather aggravation for fissures [Clarke]. Pressure at the epigastrium is intolerable (worse pressure), yet a light, warm wrap with cool sips paradoxically comforts—a mixed strategy already described under “Better For” [Hering]. Constipation on travel or with anxiety alternates with loose, slimy stools in the debilitated [Allen].

The anal fissure keynote is striking: knife-like pain on stool with bright bleeding; the fissure has dry, callous edges and heals slowly, splitting anew with straining or weather changes [Allen], [Clarke]. Pain continues for hours after stool as burning and stinging, worse hot compresses, better cool irrigation or mild ointment (reinforces temperature and emollient modalities) [Clarke]. Constipation alternating with loose stools is typical; the patient dreads evacuation and delays it, worsening the tear—behaviour that mirrors fear of swallowing solids [Hering]. Mini-case: “Chronic fissure post-partum, worse in damp winter; Paeon. eased briefly; Condur. sustained healing and stopped bleeding” [Clinical—Clarke]. Gentle laxation and avoiding strain form crucial adjuncts, explicitly matching “better gentle laxation” [Boericke]. Night aggravation keeps the patient from sleep, cross-linking to Sleep [Hering].

Urinary symptoms are secondary and reflex: frequent small voids in anxious spells; burning in urethra may echo the general burning signature when mucosa is dry and irritated [Hughes]. At night, rising to void reawakens retrosternal burning from recumbency (reflux element), tying bladder restlessness to oesophageal symptoms [Hering]. Urine can be dark in the cachectic, with sediment when digestion is poor—non-specific but commonly observed [Clarke]. No fixed organic urinary lesion belongs to Condurango; rather, the urinary tract mirrors constitutional dryness and irritability [Boger]. Relief follows improvement of gastric symptoms and general state [Clinical].

Aversion to hot drinks and soups is marked; they aggravate burning and constriction from fauces to cardia [Clarke]. Desire for cool or cold drinks—sipped, not gulped—defines daily strategies and confirms “better cold drinks” [Allen]. Rich, greasy, or spicy foods bring bitter eructations and epigastric weight; small, plain, cool meals suit best (better small meals; better gentle walking after) [Hughes]. The patient learns to avoid late suppers to prevent nocturnal reflux and cough (worse night) [Hering]. Alcohol stings—especially spirits or mulled wine—whereas diluted, cool fluids are tolerated [Clarke]. Some crave bland milk cold, others prefer cool water only; temperature trumps content [Clinical]. Appetite is variable, alternating with early satiety when spasm threatens [Allen].

Specific male symptoms are sparse. In debilitated men with long dyspepsia there may be genital chill and decreased desire, tracking the general low vitality [Hughes]. Fissures at preputial frenum margins (rare) obey the same epithelial pattern and modalities—worse in cold damp, worse friction; better bland emollients [Hering]. Haemorrhoidal congestion coexists with anal fissure in the sedentary [Allen]. Mini-case: “Office worker with rhagades at preputial angle—healed under Condur., diet cooling, and avoidance of irritants” [Clinical]. No proving-anchored testicular or prostatic centre belongs to the core picture [Allen].

Fissured nipples (ragades) in nursing mothers are a prime clinical sphere: cracks sting and burn, bleed on suction, worse hot compresses, better cool applications—temperature modalities verified yet again [Clarke]. Local measures palliate, but recurrence indicates a constitutional need; Condurango has repeatedly helped where Graphites or Muriatic acid partially failed [Clinical—Clarke]. Some women report oesophageal burning worsened by hot drinks taken during night feeds; cool sips help them continue nursing (cross-links Throat/Stomach) [Hering]. Anal fissures post-partum or in the constipated pregnant woman also respond, provided straining is reduced (better gentle laxation) [Boericke]. Dyspeptic distension and sallow face are common in the late puerperium with poor sleep, tying Abdomen/Face/Sleep together [Hughes]. Menses per se are not a key sphere, though chronic debility may blunt the flow [Boger].

Pain or dragging between the scapulæ during difficult swallows is classic oesophageal referral [Allen]. The dorsal spine feels tired after meals; rest helps (better rest after eating), but pressure over the epigastrium aggravates [Hering]. Cold damp weather stiffens the dorsal muscles and delays fissure healing elsewhere, re-echoing the skin/anal weather aggravation [Clarke]. A hot bottle to the back sometimes eases dorsal ache while cool drinks soothe the front burning—a bidirectional temperature management noted under modalities [Clinical]. Lumbar weakness accompanies cachexia and night sweats, cross-linked to Perspiration [Hughes]. Posture becomes guarded in anticipation of the “sticking” bolus [Kent].

Generalised dryness of the dorsal hands with fine cracks around joints mirrors the mucocutaneous fissure pattern of the mouth and anus [Hering]. Fingertips split in winter or in heated rooms; emollients palliate but do not prevent recurrence—constitutional treatment is needed [Clarke]. The cachectic grow easily tired in forearms and thighs after meals (post-prandial asthenia) [Hughes]. Cold damp weather stiffens small joints and slows healing of skin splits, matching aggravations under Skin [Clinical]. Better open air for the head may contrast with worse damp cold for the hands, a nuanced Condurango balance patients often describe [Hering]. Night cramps are occasional, worsening with dehydration from fear-driven fluid restriction; encouraging small cool sips helps both cramps and cardial burning [Clinical].

Generalised dryness of the dorsal hands with fine cracks around joints mirrors the mucocutaneous fissure pattern of the mouth and anus [Hering]. Fingertips split in winter or in heated rooms; emollients palliate but do not prevent recurrence—constitutional treatment is needed [Clarke]. The cachectic grow easily tired in forearms and thighs after meals (post-prandial asthenia) [Hughes]. Cold damp weather stiffens small joints and slows healing of skin splits, matching aggravations under Skin [Clinical]. Better open air for the head may contrast with worse damp cold for the hands, a nuanced Condurango balance patients often describe [Hering]. Night cramps are occasional, worsening with dehydration from fear-driven fluid restriction; encouraging small cool sips helps both cramps and cardial burning [Clinical].

By Organ Affinity — Oesophagus/Stomach
• Carbo animalis — Cancerous cachexia with glandular induration and burning; more putrid eructations and profound weakness; Condur. is more “cardial ring” and fissure-linked [Clarke], [Kent].
• Hydrastis — Thick, ropy gastric catarrh with sinking at epigastrium; less of a temperature modality; Condur. has stronger worse-hot, better-cold and fissure keynote [Hughes], [Clarke].
• Bismuthum — Burning pains, vomiting immediately after water; desires company; in Condur. vomiting is not cardinal and the oesophageal constriction dominates [Allen], [Kent].
• Phosphorus — Burning, regurgitation, craves cold drinks but vomits when warm in stomach; more haemorrhagic tendency; Condur. has fissures and callous ulcers as anchors [Hering], [Clarke].
• Kali bichromicum — Round, punched-out gastric ulcers with stringy mucus; Condur. shows fissure/epithelial borders and temperature modalities [Allen], [Boger].

By Fissures/Rhagades (Mucocutaneous)
• Nitric acid — Splinter-like pains and bleeding fissures; offensive discharges; Condur. pains are burning/raw with callous edges and strong worse-hot/better-cold [Kent], [Allen].
• Graphites — Cracks with honey-like oozing in corpulent, chilly subjects; Condur. fissures are drier, callous, with burning; strong oesophageal link [Clarke], [Boericke].
• Causticum — Fissures with rawness and soreness, better warmth; Condur. is worse hot, better cold—opposite temperature profile [Kent].
• Petroleum — Winter cracks, especially hands; more itching and eczema history; Condur. centres on angles of mouth, nipples, anus and oesophagus [Boger], [Clarke].
• Pæonia — Painful anal fissures and ulcers with severe post-stool burning; Condur. adds epithelial callousness and systemic “burning track” [Allen], [Clarke].
• Ratanhia — Knife-like anal pain hours after stool, relieved by hot applications; Condur. is worse hot and better cool—useful temperature discriminator [Kent].

By Modalities/Cachexia
• Arsenicum album — Burning better heat; extreme restlessness and anguish; Condur. is burning worse hot, better cold; less restless but anxious about incurability [Kent], [Clarke].
• Carbo vegetabilis — Great flatulence, desire to be fanned; lacks the fissure keynote and the marked cardial “ring”; Condur. more epithelial [Hughes].
• Sulphur — Burning orifices and fissures with itching, unwashed look; Condur. burns without the Sulphur itch and leans to callous borders, fissured nipples/angles [Clarke], [Kent].

• Complementary: Nitric acid — Splinter-pains and bleeding fissures complement Condur.’s callous rhagades; sequence often consolidates healing [Kent].
  • Complementary: Graphites — Where oozing cracks predominate, Graph. may precede; Condur. consolidates epithelial repair [Clarke].
  • Complementary: Pæonia & Ratanhia — Anal fissure pains (hot relieves for Ratanh.) may require temperature-guided alternation; Condur. completes epithelial healing [Kent], [Allen].
  • Complementary: Hydrastis — Mucosal catarrh with sinking weakness; Hydr. prepares field; Condur. addresses fissure/stricture elements [Hughes].
  • Follows well: Kali bichromicum — After punched-out gastric ulcer phase, Condur. steadies borders and burning track [Boger].
  • Follows well: Carbo animalis — In malignant-adjacent cachexia when glands hard; Condur. palliates cardial constriction [Clarke].
  • Follows well: Silicea — When indolent ulcers finally granulate, Condur. maintains epithelial integrity [Boger].
  • Precedes well: Nux vomica — In irritable dyspeptics, Nux may clear hyperaesthesia before Condur.’s slower epithelial action [Kent].
  • Antidotes (functional): Nux vomica — For medicinal gastric aggravations or over-irritation during dosing [Kent].
  • Antidotes (emotional): Pulsatilla — For tearful anxiety with food aversions that hinder swallowing [Kent].
  • Related/Compare: Causticum — Opposite thermal modality in fissures; use as comparator [Kent].
  • Related/Compare: Phosphorus — Burning and cold drinks desire; haemorrhagic bent distinguishes Phos. [Clarke].

Condurango is invaluable for recurrent angular cheilitis, fissured nipples, and anal fissures that are dry, callous, and burn with heat but ease with cool applications; choose it especially when the same temperature law governs the oesophagus and stomach (worse hot drinks; better cold sips) [Clarke], [Allen]. In suspected oesophageal stricture or malignant-adjacent states it is palliative, reducing burning and spasm while aiding swallowing of soft solids (combine with diet and posture advice) [Hering], [Clarke]. Potencies: many classical authors employ tincture or low decimal/centesimal (Ø, 3X/6X) for local epithelial states, and 6C–30C constitutionally; higher (200C and above) have been used when the mental–modal pattern is clear and tissues are highly reactive [Boericke], [Kent]. Repetition: in acute fissure pain, low potencies can be given once to thrice daily until easing; in chronic epithelial repair, use infrequent doses (e.g., 30C weekly) and watch for steady granulation; avoid over-stimulation in the very irritable stomach [Kent], [Boger]. Adjuncts: cool rinses/sitz baths; emollients without heat; small, cool meals; avoid hot soups/drinks at night; gentle laxation to prevent straining—each adjunct mirrors the modality and speeds cure [Clarke], [Boericke].
Case pearls (one-liners):
• “Anal fissure worse hot, better cool irrigation; Condur. 30 closed a six-month wound after Ratanh. relieved pain only” [Clarke], [Kent].
• “Angular cheilitis splitting on laughter; worse heated rooms; Condur. 200 with humidity control prevented winter relapse” [Clinical—Clarke].
• “Cardial ‘ring’ with solids; cold milk sipped; Condur. 6X t.i.d. palliated enough to permit nutrition while work-up proceeded” [Hering].
• “Fissured nipples, stinging with hot compresses; cool rinses and Condur. 30 enabled continued nursing” [Clarke].

Mind
• Fear—disease, of being incurable. Keynote dread in cachexia; guides remedy choice when paired with burning track [Kent], [Tyler].
• Anxiety—health, about; worse at night. Night aggravation mirrors gastric burning and sweats [Hering].
• Hypochondriasis—dwells on symptoms. Sustained focus on swallowing and fissures [Kent].
• Despair—recovery, of. Syphilitic colouring of mind picture [Kent].
• Company—desires; better with reassurance. Calms spasm at meals [Kent].
• Fastidious about food temperature. Clinical hallmark—avoids hot, seeks cool [Clarke].
• Irritability from pain. Burning/fissure pains sour the temper [Hering].
Mouth
• Lips—cracks; angles of mouth. Angular cheilitis with callous edges; worse heat, better cool [Hering], [Clarke].
• Lips—fissures; bleeding on opening. Splits on talking/laughing; confirms modality [Allen].
• Mouth—burning; hot drinks aggravate. Thermal law central to case [Clarke].
• Stomatitis—aphthous; burning and raw. Epithelial signature [Clarke].
• Tongue—coated; bitter taste fasting. Gastric catarrh reflection [Hughes].
• Saliva—scanty by day, sticky at night. Nocturnal aggravation [Allen], [Hering].
Throat/Oesophagus
• Oesophagus—constriction at cardia; swallowing solids difficult. Pathognomonic sphere [Allen], [Hering].
• Oesophagus—burning; hot drinks aggravate. Confirms remedy law [Clarke].
• Swallowing—fear of choking; anticipatory spasm. Mind–body loop [Kent].
• Regurgitation—small amounts after hot food. Temperature-linked reflux [Hughes].
• Pain—retrosternal; radiating to back. Oesophageal referral [Allen].
• Better—cold drinks; sipped. Practical test in case [Clarke].
Stomach
• Eructations—bitter; after rich/hot foods. Bitter principle expression [Hughes].
• Pain—burning epigastrium; pressure aggravates. Matches epigastric tenderness [Hering].
• Appetite—variable; early satiety with spasm. Cardial “gate” symptom [Allen].
• Nausea—after hot soups. Thermal modality again [Clarke].
• Better—rest after eating; gentle walking. Post-prandial strategies [Allen], [Hughes].
• Vomiting—regurgitation of food/mucus. Secondary to spasm [Hering].
Rectum
• Fissure—anus; burning pain, bleeding. A chief clinical indication [Allen], [Clarke].
• Pain—after stool; hours. Knife-like, then burning [Allen].
• Constipation—alternating with diarrhœa. Debility pattern [Hughes].
• Straining—aggravates fissure. Avoid; confirm modality [Boericke].
• Better—cool applications/irrigation. Temperature law proves remedy [Clarke].
• Weather—cold damp aggravates healing. Seasonal relapse pattern [Clarke].
Skin
• Ulcers—indolent; callous edges. Slow granulation; epithelial sphere [Clarke], [Boger].
• Cracks—fingers; winter; heated rooms. Environmental modalities [Hering], [Clarke].
• Nipples—ragades; nursing. Stinging, burning; better cool [Clarke].
• Heat—local applications aggravate. Diagnostic for Condur. [Allen].
• Better—emollients (transient). Palliation signals constitutional need [Clarke].
• Weather—cold damp retards healing. Clinical management clue [Clarke].
Generalities
• Cancerous affections—epithelial; palliative sphere. Oesophagus/cardia focus [Clarke].
• Cachexia—night sweats; sallow face. Systemic tone [Hughes], [Kent].
• Food/drink—hot aggravates; cold ameliorates. Central modality [Clarke].
• Time—night aggravation. Nocturnal pattern across systems [Hering].
• Pressure—epigastrium aggravates. Exam finding [Hering].
• Motion—gentle after meals ameliorates. Practical advice [Hughes].
Sleep/Respiration (bridge rubrics)
• Cough—tickling; after hot drinks; night. Reflux-linked cough [Hering].
• Waking—2–3 a.m.; anxiety with burning. Nocturnal hallmark [Kent].
• Better—sitting up, cool sips. Postural/temperature relief [Clarke].
• Dreams—choking, narrow passages. Mind image of cardial ring [Tyler].
• Recumbency—aggravates retrosternal burning. Reflux physiology [Hering].
• Reading—evening aggravates cough. Lifestyle trigger [Hering].

Hering — The Guiding Symptoms of Our Materia Medica (1879): proving and clinical confirmations for oesophageal constriction, fissures, night aggravations.
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): compilation of American provings (Dowling et al.), gastric and oesophageal symptoms.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): clinical cases of fissures, nipples, oesophageal stricture, temperature modalities; preparation notes.
Hughes, R. — A Cyclopædia of Drug Pathogenesy (1895): toxicology of bitter principles, gastric catarrh, historical non-homœopathic uses.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1927): concise indications for fissures, epithelial ulcers; potency hints.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): miasmatic lens, mental states in digestive remedies; comparisons (Ars., Graph.).
Boger, C. M. — Synoptic Key of the Materia Medica (1915): keynotes for ulcer, fissure, modalities; differential pointers (Kali bi., Ratanh.).
Farrington, E. A. — Clinical Materia Medica (1887): organ affinities—hepatic–gastric axis and cachexia remarks.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1898): therapeutic emphasis on confirmatory clinical “leaders” (fissures, cachexia).
Dunham, C. — Homœopathy, the Science of Therapeutics (1879): observations on drug action in mucosa and constitutional indications.
Tyler, M. L. — Homœopathic Drug Pictures (1942): remedy portrait; dream imagery and psychological colouring in digestive remedies.
Boger, C. M. — Boenninghausen’s Characteristics & Repertory (1905): repertorial structure informing selected rubrics and relationships.