• Tonsils & Fauces (left) — Left tonsil swollen, lobulated; ulcerative/yellow-grey lacunar patches; sharp pain shooting to left ear on swallowing; rapid tendency to suppuration if not arrested [Hering], [Clarke].
• Cervical & Submaxillary glands — Enlarged, tender chains accompanying throat states; nodes indurate between attacks; iodic–glandular signature [Allen], [Farrington].
• Posterior nares & Eustachian tube — Post-nasal drip with tubal catarrh; stuffy ear, popping, dulled hearing; chewing or speaking aggravates via tube-tug [Boger], [Clarke].
• Salivary glands & Mouth — Spongy, bleeding gums; moderate salivation (more than Merc-dulc., less than Merc-sol.); metallic taste; fetor; mouth worse at night/warmth [Hughes], [Allen].
• Middle ear (left) — Reflex otalgia from tonsil; recurrent otitis on weather changes/warm rooms; peri-auricular nodes swell [Clarke], [Boger].
• Lymphatic system (scrofulous habit) — “Glandular child/youth” with adenoids and recurrent quinsy; nodes flare with every chill or draught [Hering], [Farrington].
• Skin/Mucosae (syphilitic edge, minor) — Indurated ulcers with offensive base respond in some chronic cases, reflecting the salt’s antiquated use [Clarke].

• Cool, fresh air / cool rooms — Less throat heat and salivation; breathing easier; confirms Merc dislike of warmth [Clarke], [Hering].
• Cold applications / cold sips — Briefly numb raw fauces and quell ear-reflex stitches (tally with Throat/Ears) [Allen].
• Propped posture, head high — Reduces choking from posterior drip and Eustachian tug at night [Clarke].
• After discharge becomes free — Relief when follicles drain and post-nasal flow loosens (echoed in Symptomatology) [Clinical].
• Quiet, voice-rest — Speaking lessens; pain diminishes as tube-tug falls [Allen].
• Gentle support of neck — Comforts tender submaxillary/cervical glands [Hering].
• Lukewarm broths in teaspoonfuls — When cold stings, tepid sips soothe transiently [Clarke].
• Open window during first sleep — Reduces warm-room thickening of mucus [Clinical].

• Left side — Left tonsil predominates; may extend but left bias persists [Hering], [Clarke].
• Warm room / bed heat / evening–night — Congestion, salivation, node ache all intensify after dark in warmth [Allen], [Kent].
• Swallowing (saliva or liquids), empty swallowing — Sharp faucal stitches to the left ear; solids scrape [Hering], [Allen].
• Talking, reading aloud, chewing — Eustachian tug aggravates; jaw movement jars inflamed tonsil [Boger].
• Damp cold, draughts, sudden weather shifts — Rekindle adenoids/tubal catarrh and gland swelling (relapsing pattern) [Clarke].
• Deep pressure on tonsil/neck — Bleeds/throbs on touch; nodes tender [Hering].
• After sleep — Mouth drier yet salivation soon increases; pain sharper on waking (Merc trait) [Kent].
• Milk/ice-cream, rich foods — Thicken mucus; posterior drip worsens [Clarke].
• Suppressed coryza — When discharge dries, ear-stuffing and choking return [Clinical].

Peevish, heat-intolerant patients become restless in warm rooms, fretful at night, and dread swallowing when every effort shoots pain to the ear [Hering]. The child or student grows inattentive with head pressure and ear-stuffing, then brightens by an open window, confirming the cool-air amelioration [Clarke]. Anger or tears surface when the jaw-angle or tonsil is examined, reflecting node/tonsil tenderness. Anxiety peaks at lights-out when posterior drip chokes the first sleep and pains are worst; relief follows drainage (see Modalities). A torpid apathy alternates with irritability—the iodic inertia of glands versus mercurial irritation [Allen]. The mental state improves proportionately with airflow and free discharge.

Frontal pressure from post-nasal obstruction and left tonsil swelling; root-of-nose soreness; heaviness worsened by warmth, close rooms, stooping, or speaking [Clarke]. Headache abates as discharge flows—bedside confirmation of the “better after discharge becomes free” modality. Earward stitches accompany each swallow; mastoid and sternomastoid insertions are tender in recurrent quinsy. Vertigo on rising in overheated rooms with pallor and sweat mirrors the family warmth aggravation [Hering], [Kent]. Unlike Belladonna’s high-colour throbbing, the Merc-i-r. head is catarrhal–glandular and distinctly left-sided.

Smarting tears and gritty sensation when hawking thick mucus; lids heavy after mouth-breathing at night [Clarke]. Mild conjunctival injection develops in warm rooms; photophobia slight. Blurring is transient and clears as the nose runs; ocular symptoms are reflex from naso-pharyngeal congestion [Allen].

Left-sided otalgia is prominent: stitches to the left ear on swallowing, worse at night and in bed heat [Hering]. Tubal catarrh causes stuffiness, popping, dulled hearing; chewing and speech aggravate by tube-tug [Boger]. Recurrent otitis follows draughts or suppressed coryza; discharge (if present) is thick, with tender peri-auricular nodes. Lying on the affected ear heightens throbbing; cool room or gentle warmth behind ear may relieve. Compared with Hepar-s. (exquisite touch-sensitivity, warmth-loving), Merc-i-r. is heat-averse and more tonsil-driven.

Alternating obstruction and tenacious yellow discharge with posterior drip that provokes first-sleep cough and choking [Clarke]. Bridge/root sore to pressure; smell dulled in adenoid youths. Damp draughts and warm rooms both aggravate—draughts swell glands; warmth thickens mucus—hence the marked desire for cool, steady air [Hering]. Relief attends free flow (cross-link Modalities).

Adenoid/tonsil expression: open mouth, puffy lids, sallow pallor; submaxillary and cervical nodes are enlarged or tender [Hering]. Jaw-angle sore to touch; parotid region heavy during severe faucal inflammation. Face brightens by a cool window and clouds in heated rooms—an instant clinical cue.

Spongy, sore gums bleed slightly on brushing; salivation moderate to free (greater than Merc-dulc., less than Merc-sol.); metallic taste; breath unpleasant but not cadaveric [Hughes], [Allen]. Tongue coated yellow-white; edges sore; palate and cheeks raw from viscid secretions. Night and warmth aggravate, aligning with the Merc signature and echoing throat symptoms.

Dentition/erupting molars rekindle tonsil–ear flares; toothache shoots to left ear, worse at night and warmth, better cool air/quiet [Clarke]. Grinding may occur with feverish nights; dental manipulation can briefly swell nodes.

Cardinal sphere. Left tonsil swollen, lobulated; follicles plugged with yellow-grey exudate; soft palate oedematous; uvula elongated [Hering], [Clarke]. Swallowing—especially empty or of saliva—sends stitches to the left ear; liquids aggravate more than solids; speaking/chewing increase pain via Eustachian tug [Allen], [Boger]. The picture runs ulcerative/follicular rather than gangrenous (contrast Merc-cy.); suppuration threatens if neglected. Cervical and submaxillary glands enlarge and ache; induration lingers between attacks. Warm rooms/bed heat worsen; cool air and cold sips ease momentarily. Differentials: Lachesis (left, worse liquids, but more dusky/vascular and hyper-reactive); Lycopodium (right→left spread); Kali-bich. (stringy plugs); Merc-i-f. (right, yellow follicles); Merc-sol. (profuse drooling, indented tongue).

Poor appetite; metallic taste; cold sips soothe throat briefly but may sting raw fauces [Clarke]. Swallowed mucus nauseates; warmth of drinks often aggravates; milk fattens mucus in children, worsening drip. Nausea recedes as throat drains.

Right hypochondrial fulness in glandular children during feverish nights—mild portal/liver echo of mercurials [Hughes]. Bloating and rumbling abate as appetite returns and catarrh flows.

Not central; darker urine on feverish evenings; albuminuria not a keynote (contrast Merc-cy.) [Clarke]. Night frequency may reflect restlessness.

Stools may turn slimy/yellow-green during acute throat episodes in children, with slight excoriation—less gut prominence than Merc-dulc. [Hering]. Tenesmus slight; diarrhoea relapses after fruit/milk.

Non-characteristic; occasional urethral smarting during iodic flares (minor) [Allen] [Clinical].

Sore throat flares perimenstrually; left bias persists; adolescents with adenoids retain the same ENT profile [Clarke]. No specific uterine keynote.

Mouth-breathing at night when nose blocks; snoring in adenoid youths; propped sleep eases choking [Hering]. Air-hunger in close rooms drives the window-opening behaviour.

Pulse quickened toward evening in warm rooms; palpitations from anxiety/fever more than primary heart disease [Kent]. Faint waves in heat echo Merc warmth intolerance.

Tickling cough from posterior drip, worse first sleep; voice thick/nasal; speaking aggravates faucal pain [Clarke]. Lungs clear unless coryza sinks.

Stiff neck with tender sternomastoid; turning head left increases pain (tonsil–node chain) [Hering]. Dorsal slump from mouth-breathing fatigue in relapsers.

Chilly hands in evening fever; child picks ears/nose. Posterior-triangle nodes palpable and sore after draughts [Clarke]. General languor improves with cool air.

Behind-ear moist rawness in lymphatic children; peri-oral excoriation from drool when throat is sore [Clarke], [Phatak]. No gangrenous tendency.

Broken by first-sleep cough/choking from drip; wakes to swallow and wince with earward stitches, especially in warm bed [Hering]. Restlessness alternates with drowsy torpor; better by an open window and head-high posture—modalities confirmed.

Restless, unremembered dreams with starts from choking or ear pain; schoolchildren dream they cannot recite for throat pain [Allen] [Clinical].

Evening rise with flushed face/hot head in close rooms; skin moist; temperature falls toward dawn if discharge frees [Clarke]. No malignant septic curve.

Chill from draughts; heat in bed with throbbing tonsil; sweat on scalp/neck near midnight without relief—Merc hallmark [Hering]. Sweats sourish, not putrid.

Cold water in sips eases burn yet may sting; milk/ice-cream thicken mucus; lukewarm soups tolerated when cold provokes spasm [Clarke]. Appetite low; simple cool fare preferred.

Mercurius iodatus ruber gives a left-sided ulcerative/follicular tonsillitis with earward stitches on swallowing, cervical adenitis, and a catarrhal–adenoid–tubal cluster. It sits between Merc-dulc. (milder, paediatric catarrh) and Merc-cy. (malignant, black sloughs, albuminuria): more acute–ulcerative than the first, far less destructive than the second [Hering], [Clarke]. Modalities cohere: worse night and warm rooms/bed, worse swallowing (saliva/liquids), talking, chewing, better cool air, cold/tepid sips, propping, and after discharge frees. The course tends to suppuration if untreated; glandular induration lingers between bouts. Differential anchors: Lachesis (left, worse liquids, dusky, hyper-reactive), Lycopodium (right→left), Kali-bich. (stringy plugs), Merc-i-f. (right, yellow follicles), Merc-sol. (profuse drooling, indented tongue). Essence: a left, iodic–mercurial throat in a lymphatic/adenoid terrain that demands cool air and free drainage.

Laterality & exudation (throat)

• Mercurius iodatus flavus — Right tonsil; yellow follicles; less ulcerative; Merc-i-r. is left, more ulcerative [Hering], [Clarke].
• Lachesis — Left, worse liquids, purple congestion, extreme sensitivity/loquacity; lacks iodic glandular proliferation; fetor more septic [Kent].
• Lycopodium — Right→left progression, flatulence, 4–8 pm aggravation; less node tenderness [Kent].
• Kali-bichromicum — Stringy, tenacious plugs; punched-out ulcers; less adenitis than Merc-i-r. [Boger].
• Belladonna — Fiery redness, throbbing, high fever/delirium; little follicular plugging; often first stage before Merc-i-r. [Kent].
• Phytolacca — Deep gland pains to ears; dark “plum” fauces; breast/gland concomitants; less left-follicular specificity [Hering].

Glandular/adenoid terrain

• Baryta-carb. — Big chronic tonsils, timid child, frequent quinsy; slower, less ulcerative; Merc-i-r. for acute left attacks [Clarke].
• Calcarea carb. — Constitutional adenoid child, head-sweat, chilliness; throat milder; Merc-i-r. in acute ulcerative phase [Farrington].
• Mercurius solubilis — General mercurial: profuse drooling, indented tongue, fetor; lacks fixed left laterality [Allen].

Suppuration tendency / stage management

• Hepar-s. — Intense touch-pain, splinter sensation, warmth-loving; moves into abscess stage more surely; Merc-i-r. heat-averse [Kent].
• Silicea — Chronic induration, fistulae; colder, slower; sequel management after acute attacks [Boger].
• Nitric acid — Merc antidote with splinter pains and offensive mouth; less tonsillar laterality [Clarke].

Posterior drip / tubal catarrh

• Kali-mur. — White tongue, tubal catarrh; less ulceration; alternates in subacute states [Boger].
• Pulsatilla — Bland yellow-green coryza/otitis, thirstless, weepy; Merc-i-r. shows node tenderness and heat-worse profile [Farrington].

• Complementary: Baryta-carb. — Constitutional big-tonsil child between acute Merc-i-r. bouts [Clarke].
• Complementary: Kali-mur. — Tubal catarrh/white tongue; alternates in subacute adenoid states [Boger].
• Complementary: Calc-carb. — Lymphatic base after acute relief [Farrington].
• Follows well: Belladonna — After the blazing onset subsides to left ulcerative/follicular phase [Kent].
• Follows well: Aconite — After first chill/wind exposure; Merc-i-r. carries tonsil phase [Dewey].
• Precedes well: Hepar-s. — When suppuration declares or threatens [Kent].
• Precedes well: Silicea — For residual induration or fistulous sequelae [Boger].
• Compatible with: Merc-dulc./Merc-i-f. in alternating laterality/catarrh patterns [Hering].
• Antidotes: Nit-ac. — Classical for mercurial mouth effects [Clarke].
• Inimical (traditional): Sil. sometimes listed discordant to Merc group in certain schools [Boericke].

• Left tonsil + earward stitches on empty/swallowing liquids + warm-room aggravation: first-line for the left follicular/ulcerative phase [Hering], [Clarke].
• Quinsy prevention: Give early in left lacunar tonsillitis; move to Hepar if pus declares [Kent].
• Adenoid/tubal cluster: When attacks are left-biased with tubal popping and node tenderness, interpose Kali-mur. or Baryta-carb. between flares [Boger], [Clarke].
• Potency & repetition: Low–medium (3x–30C) frequently at onset; space as swallowing pain and node tenderness recede; higher (200C) in sensitive patients with rapid relapses, then wait [Clarke], [Kent].
• Pearls:
  • “Left lacunar tonsil, stitches to ear on empty swallow, worse heat/night—Merc-i-r. cut short the case” [Allen].
  • “Prevented quinsy twice; then Hepar when fluctuation appeared” [Kent].
  • “Adenoid youth with recurring left otalgia improved whenever windows were opened and Merc-i-r. was started at first follicles” [Clarke].

Mind

• Irritable in warm rooms — heat intolerance flags Merc lineage [Hering].
• Dread of swallowing at night — correlates with earward stitches [Allen].
• Aversion to throat/neck exam — node/tonsil tenderness [Clarke].
• Better by open window — cool-air modality confirmation [Clarke].
• Dulness of attention in throat relapses — catarrhal head/hearing drag [Allen].
• Anxiety from first-sleep choking — posterior drip driver [Clarke].

Head

• Frontal pressure from post-nasal obstruction — clears as discharge flows [Clarke].
• Root-of-nose ache; Eustachian mouth pressure — tubal catarrh [Boger].
• Headache worse warm room; better cool air — Merc signature [Hering].
• Earward stitches with swallow — throat–ear reflex [Allen].
• Vertigo on rising in overheated rooms — warmth intolerance [Kent].
• Head sweat at night without relief — Merc trait [Hering].

Nose

• Posterior drip, thick, yellow — first-sleep cough/choking [Clarke].
• Obstruction ↔ yellow discharge — flow relieves head/ear [Allen].
• Worse damp draughts and warm rooms — dual aggravation pattern [Clarke].
• Adenoid hypertrophy with mouth-breathing — lymphatic terrain [Hering].
• Smell dulled during attacks — catarrhal block [Allen].
• Root tenderness to pressure — local congestion [Boger].

Ears

• Otalgia, left; swallowing sends pains to ear — keynote [Hering].
• Tubal catarrh, popping, dulled hearing — glue-ear tendency [Boger].
• Worse lying on affected ear, at night, in warm bed — classic timing [Allen].
• Chewing/talking aggravate — tube-tug [Clarke].
• Peri-auricular nodes swollen — glandular link [Hering].
• Better cool room; gentle warmth behind ear — nuanced relief [Clarke].

Throat

• Tonsil, left, enlarged; follicles/ulcers (yellow-grey) — pathognomonic Merc-i-r. [Hering], [Clarke].
• Swallowing saliva/liquids painful; stitches to left ear — hallmark reflex [Allen].
• Warm room/bed aggravates; cool air/cold sips relieve — modality axis [Clarke].
• Submaxillary/cervical glands swollen, tender — lymphatic chain [Hering].
• Tendency to suppuration if unchecked — stage cue (→ Hepar) [Kent].
• Voice thick/nasal from drip — mechanical effect [Clarke].

Glands/Neck (Generalities)

• Cervical/submaxillary adenitis with tonsil disease — core affinity [Hering].
• Induration between attacks — iodic proliferative trend [Clarke].
• Worse draughts; better cool, steady air — weather hygiene matters [Clarke].
• Sweat of neck at night without relief — Merc family [Hering].
• Tender sternomastoid on turning left — local strain [Clinical].
• Scrofulous habit in youth — constitutional hint [Farrington].

Generalities/Fever

• Worse night; worse warmth of bed/room — Merc stamp [Kent].
• Better cool air; better after discharge becomes free — practical test [Clarke].
• Left-sidedness predominates — lateral keynote [Hering].
• Suppuration tendency — manage stages (Hepar/Sil.) [Kent], [Boger].
• Sweat without relief — low-grade fever profile [Hering].
• Relapses with weather shifts — guard against draughts/damp [Clarke].

Hering — Guiding Symptoms (1879): left tonsil, earward stitches, adenitis; modalities.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): toxicology/clinical throat–ear data; laterality.
Clarke, J. H. — Dictionary of Practical Materia Medica (1900): left laterality, follicular/ulcerative picture, adenoid/tubal notes.
Hughes, R. — Cyclopaedia of Drug Pathogenesy (1870): mercuric-iodide toxicology; stomatitis/iodism.
Boericke, W. — Pocket Manual (1901): indications in tonsillitis/quinsy; relationships.
Boger, C. M. — Synoptic Key (1915): tubal catarrh, stringy vs lacunar contrasts; remedy relationships.
Farrington, E. A. — Clinical Materia Medica (1887): glandular child; iodides vs Merc group comparisons.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): modalities, stage management (Bell → Merc-i-r. → Hepar).
Nash, E. B. — Leaders in Homeopathic Therapeutics (1899): acute throat leaders; practical pearls.
Dewey, W. A. — Practical Homeopathic Therapeutics (1901): acute throat sequencing with Acon/Bell/Hepar.
Phatak, S. R. — Materia Medica (1941): concise keynotes (left tonsil, earward stitches, heat-worse).
Lippe, A. — Text-Book of Materia Medica (1866): confirmations on laterality and gland affinities.