Naja

An elapid snake whose venom is a complex mixture of alpha-neurotoxins, cardiotoxins, phospholipases and proteases; crude effects in animals lead to bulbar–vagal paralysis, cardiac depression, arrhythmia, and respiratory arrest with marked laryngo-tracheal constriction [Hughes]. Hahnemann’s method: trituration of the dried venom and serial attenuation [Hering], [Allen]. From the earliest American provings and clinical use, Naja took rank as a cardiac–laryngeal remedy—endocarditis/pericarditis, angina pectoris, valvular disease (chiefly mitral) with pain extending to the left shoulder/arm, palpitations, broken, suffocative cough, and aphonia; and as a mental remedy marked by scruple, remorse, sense of duty, suicidal thoughts held in check by moral restraint [Hering], [Kent], [Clarke]. Diphtheritic and post-diphtheritic cardiac weakness, and “heart-coughs” with laryngeal constriction, are classic fields [Clarke], [Boericke].

Primary data: Hering’s school and subsequent clinical confirmations by Allen, Clarke, Kent, Farrington, Nash. Provers and patients displayed constrictive throat/neck sensations, laryngeal aphonia, left-sided chest pains to shoulder/arm, valvular murmurs and pericardial stitches, palpitations with faintness, blue lips, worse lying on the left side, better by open air, worse after sleep, and the moral–conscience picture (remorse, suicidal thoughts with counter-check of duty) [Hering], [Allen], [Clarke], [Kent]. Tags: [Proving] [Clinical] [Toxicology].

Core theme: Naja is the duty-bound heart with a constricted throat. It speaks softly of guilt and responsibility, of suicidal thoughts that are held in check by conscience, as the larynx tightens and the heart labours. The physical axis is unmistakable: valvular/anginal pain that shoots to the left shoulder/arm; orthopnoea, blue lips, weak/irregular pulse; worse lying on the left side, worse after sleep, worse in warm rooms; better in open cool air, head raised, quiet, collar loosened, sometimes by firm hand-pressure over the heart [Hering], [Allen], [Clarke], [Kent]. The laryngeal partner is equally marked: aphonia, dry, teasing cough on attempting to speak, throat as if a cord—the heart-cough that ties chest and voice.

In serpent differentials, Naja lacks Lachesis’s hot, erotic loquacity and jealousy; it lacks Crotalus’s haemorrhagic violence; it lacks Elaps’s chill and black discharges. Instead it is sober, scrupulous, left-sided and laryngeal. Among angina remedies, compare Spigelia (stabs, neuralgia, ocular links), Latrodectus (panic-agony), Kalmia (rheumatic shot to arm with slow pulse), and Cactus (iron band without the moral–laryngeal stamp). The psycho-cardiac polarity (remorse restrained by duty) is the bedside clincher: when the patient whispers, “I deserve this,” loosens the collar, sits by an open window, presses the hand upon the heart, cannot lie on the left, and every word evokes a cough, Naja stands before others. The pace is subacute–chronic; reactivity is heat-worse, after-sleep-worse; sensitivities focus on neck pressure and speech. Treat gently: quiet, cool, upright, few words—nursing that mirrors the remedy cures.

• Heart—endocardium and valves (mitral first), pericardium — Angina, endocarditis, pericarditis with stitches, oppression, weight on the heart, pain to the left shoulder/arm, blue lips, irregular, weak pulse; often post-rheumatic or post-diphtheritic [Hering], [Clarke], [Kent].
• Vagus–larynx — Aphonia, choking, constriction as from a cord, “cannot bear a collar,” tickling cough that compels and then exhausts, sometimes cardiac cough (heart lesions reflected in the larynx) [Allen], [Boericke].
• Great vessels & coronaries — Anginal paroxysms with radiation to jaw/arm (left), cold sweat, fear of impending death but with quiet sadness rather than panic (contrast Acon.) [Kent], [Farrington].
• Cerebro-bulbar axis — Faintness, vertigo, sinking at epigastrium with cardiac irregularity; post-diphtheritic paralysis with weak voice and palpitations [Clarke].
• Left ovary/uterus (cardio-uterine reflex) — Left ovarian pains and menstrual aggravation in women with cardiac symptoms; pressure and dragging with heart palpitations [Farrington], [Boericke].
• Trachea/bronchi — Dry, suffocative cough, worse talking/lying left/warm rooms, with hoarseness and livid lips; cough relieved as heart settles (heart–lung axis) [Allen], [Boger].
• Neck & throat — Band-like constriction, must loosen collar; sensation of a lump; dysphagia from spasm rather than ulceration (contrast Merc.) [Clarke].
• Mind—conscience — Remorse, self-reproach, suicidal thoughts with strong sense of duty to family/work that restrains the act; sad, quiet melancholy [Hering], [Kent].

A quiet, sad melancholy pervades, tinged with remorse and self-reproach; the patient reviews past omissions and feels unworthy [Hering], [Kent]. Thoughts of suicide intrude, but a strong sense of duty to family, patients, or work rises up and restrains the act, a polarity that is almost pathognomonic for Naja and recurs during anginal misery [Kent], [Clarke]. Irritability is slight; rather a grave seriousness, with fears of heart failure stated without drama. Anxiety centres in the throat and heart—a choking band mounts with emotion, and the oppression of the precordium grows whenever conscience is stirred, cross-linking the mental and cardiac spheres already noted in Modalities. The patient dreads lying down lest the left-sided suffocation return; prayers or recollections of duty calm attacks better than mere diversion. Unlike Aconite, the fear is not panicky; unlike Lachesis, there is no torrent of talk or jealousy—Naja is reticent, dutiful, remorseful. Relief comes in open air and with head raised, which is echoed physically by ease of breath and lighter pulse [Clarke]. Improvement of mind parallels abatement of the laryngeal constriction, showing how the vagus field mediates the psyche–soma bond in this remedy.

Sleep is unrefreshing; on waking the band returns—after sleep worse, a serpent trait [Kent]. Nights are broken by orthopnoea and tickling cough; the patient sleeps propped, sometimes in a chair. Dreams are conscientious: of omitted duties, of being late, of examinations; they quicken the pulse and wake the sleeper to palpitation. When the window is opened and cool air enters, the patient dozes again—echoing Better For. Talking in sleep is not usual; sighing occurs at the end of a spell. Morning hoarseness with aphonia is common after a restless night.

Dreams of responsibility, of neglected tasks, of funerals; solemn, remorseful colouring [Kent], [Clarke]. Dreams of choking or of a serpent round the neck reflect the collar-worse constriction. Dreams of falling or of a collapsing house herald a day of palpitations; conversely, a peaceful dream of family duty well done anticipates a calmer pulse upon waking. Erotic dreams are rare; morality dominates. The dream life thus mirrors the mind–heart–throat triangle.

Naja synthesises heart and larynx under a moral, duty-bound mind. The signature is valvular/anginal distress—pain radiating to the left shoulder/arm, orthopnoea, blue lips, weak/irregular pulse—coupled with laryngeal constriction/aphonia and a dry, suffocative cough that speaking excites [Hering], [Allen], [Clarke]. Modalities are decisive: worse lying on the left side, in warm rooms/bed, after sleep, from talking/reading, from neck pressure, from emotion, and better in open, cool air, with head raised, in quiet, by loosening the collar, by pressure over the precordium. The mental polarity—suicidal thoughts held back by conscience/duty—anchors the selection against Lachesis (loquacious, jealous, passionate, often better after discharges) and Aconite (panic-terror). Cross-links abound: relief of laryngeal spasm parallels relief of cardiac oppression; open air lifts both mood and breath; voice-rest eases palpitations and cough. In pericarditis/endocarditis, Naja stands with Spigelia, Kalmia, Digitalis, but is chosen when throat-band constriction and remorseful sadness colour the case.

Slight evening heat in a warm room with oppression of chest and flushed cheeks; no high septic curve [Clarke]. In endocarditis/pericarditis, remittent fever with night aggravation may occur, but the cardiac signs lead. Cold sweat of the brow during angina is prominent; chilliness follows an attack. The fever picture is accessory; the heart remains the axis.

Chill in draughts that strike the throat, followed by heat in chest and cold sweat during pain; sweat clammy on forehead and hands without full relief [Allen]. Warm bed aggravates throbbing and cough; cool air soothes. After a spell, a gentle, warm sweat may end the oppression. The alternation of cool room better and cold draught on throat worse is a bedside nuance.

A dull frontal and temporal oppression accompanies cardiac waves; a sense of constriction at the temples as if a band were tightened, worse in warm rooms and after sleep [Allen]. Vertigo with a blank, faint feeling at the epigastrium arises upon stooping or on turning to lie on the left side, and passes when the window is opened, mirroring the open-air amelioration [Clarke]. Headache may shoot to the left jaw during angina, or follow coughing fits from the laryngeal tickle. The scalp is sensitive to tight hats; any collar-like pressure aggravates more in Naja than in Spongia (which is more purely laryngeal). Face is pale, lips bluish when the heart labours; sweat breaks on the brow with the least exertion. After a deep slow breath in cool air, the head clears and the dread relaxes—again the vagal key.

Dark circles appear beneath the eyes in heart-sufferers; pupils may be dilated during attacks [Clarke]. Vision blurs when the chest tightens, and flashes or blackness cross the field upon sudden effort or stairs. Lachrymation occurs with coughing fits; the palpebral fissures look sad and down-drawn. Photophobia is not marked; the eye symptomatology is circulatory, not inflammatory. In women the pre-menstrual congestive state can cause fullness around the orbits in step with palpitations. As chest oppression lifts in cool air, vision steadies, repeating the global modality.

Ringing accompanies palpitations; with each throb the patient hears a “whoosh” in the ears, worse in warm rooms [Allen]. Sudden deafness may follow a violent cough paroxysm and passes with rest. No middle-ear pathology is central; the ear signs are haemodynamic. Noise provokes cough and throat constriction—talking is worse—so the patient seeks silence in fresh air, cross-linking with respiratory relief [Clarke].

Root-of-nose pressure with frontal headache appears in congestive spells; sneezing or a slight watery coryza may precede cough. Odours of a close room excite throat tickle; the patient craves odourless fresh air. Bleeding is unusual; when present, epistaxis briefly lightens head oppression but exhausts. Nasal breathing grows laboured when throat tightens; opening the window immediately helps, again echoing modalities.

Face pale or slightly dusky; lips bluish during heart strain [Hering]. A drawn, conscientious expression sits upon a lined brow; expressions of sadness and quiet endurance rather than fear. Cheeks flush lightly with chest oppression and grow cold with sweat during angina. Trifacial neuralgia to the left jaw may accompany cardiac pain, distinguishing Naja from Spigelia (more orbital). Touch is not especially tender; constriction sensations dominate.

Mouth dry during attacks, yet desire for small cool sips to soothe the larynx is frequent [Clarke]. Tongue often clean or slightly coated; a bitter taste can follow nocturnal palpitations. Dental pains may shoot to the left upper jaw during heart flurries. Saliva is not profuse (contrast Merc.); there is a catch in the breath when attempting to speak which makes words broken and low. The mouth section mirrors the voice-rest better modality and avoidance of speech to prevent cough.

Teeth chatter during chilly anginal spells; transient dental neuralgia accompanies left facial/jaw radiation in men. Pressure of a dental gag or tight band around the face is intolerable, echoing the collar-worse keynote. Tooth symptoms otherwise scant; there is no ulcerative gingivitis signature as in Merc. or Nit-ac.

Cardinal region with the larynx. A sense of a cord tied round the throat, or a lump rising that threatens choking; cannot bear a collar; must loosen the neck [Hering], [Clarke]. Voice husky to aphonic; every attempt at speaking sets off a harassing, dry, suffocative cough, worse in warm rooms, better in cool air (see Modalities). Swallowing is impeded by spasm, not ulceration; liquids in small, cool sips pass best. Post-diphtheritic paralysis with weak voice and palpitations is classical—laryngeal weakness and cardiac weakness travelling together [Allen]. Compare Spongia (barking croup, burning larynx without heart pains) and Lachesis (throat hyperaesthesia, talkativeness, intolerance of touch with jealousy): Naja is quieter, more cardiac, and duty-bound.

Oppression, weight, stitches over the heart; cannot lie on the left side; must sit up and seek air [Hering], [Clarke]. Pain travels to the left shoulder and arm, sometimes to jaw, with cold sweat, blue lips, and weak, irregular pulse—the classical Naja angina [Allen], [Kent]. A dry, teasing cough springs from a tickle at the larynx and returns whenever the patient speaks, the so-called heart-cough. Warm rooms are worst; cool air and quiet help. The chest feels bound with a band, upper ribs constrained; a deep, slow breath in open air breaks the spasm for a minute. Compare Spigelia (neuralgic, stabbing pains, eyes affected), Latrodectus (agonising angina with violent fear and clutching, acute), Kalmia (shooting to arm with slow pulse): Naja bears the moral–laryngeal stamp.

The heart is the throne: valvular murmurs (mitral), endocarditis/pericarditis, palpitations, angina with radiation; weak, compressible or irregular pulse; sometimes intermittency [Hering], [Clarke]. Left-sided lying aggravates; sitting propped, cool air, and quiet relieve (echoing Modalities). The heart region is sore; pressure with the hand comforts. In pericarditis there are stitches with orthopnoea; in endocarditis, a blowing murmur with cyanotic lips and mental sadness. Post-diphtheritic hearts show palpitations with aphonia; duty-bound restraint differentiates Naja from Aconite panic and Lachesis excitability [Kent].

Short, anxious, suffocative; laryngeal spasm arrests a sentence; the patient whispers to avoid cough [Allen]. Orthopnoea demands head high; breaths deepen in cool air. Talking, reading, warm rooms, and lying left provoke a dry, teasing cough; cold air on the throat (draught) may also excite, showing a nuanced thermal response (cool room helps chest; direct cold on throat may not). With cardiac relief, respiration steadies. Rales and consolidation do not belong—this is neuro-cardiac dyspnoea.

Sinking at epigastrium with palpitations; nausea during angina or after a choking cough [Allen]. Appetite small; anxiety about eating lest fullness press upon the heart. Warm foods and heated rooms oppress; cool air and slow eating in silence help. Eructations are scant and give little relief. Vomiting is rare and reflex; it worsens chest pain if forceful. Relief comes as breath deepens and the laryngeal constriction loosens, cross-linking the vagal thread.

Upper abdomen feels tight with the thoracic band; hypochondrial restraint in warm rooms aggravates. Bowels are often constipated in cardiac patients; strain brings on palpitations and must be avoided. Gas rises to chest and provokes cough; relief follows a gentle passage of wind. Liver and spleen are not a chief field; sensations are functional, not inflammatory. Better in open air and after stool, when precordial load lightens.

Constipation with small hard stools in those who dare not strain; palpitations and faintness on the stool are recorded [Clarke]. Haemorrhoids may ache during angina but are not a keynote. Tenesmus rare; rectal field minor. The management principle—no straining, head raised, quiet—parallels general Naja nursing.

Urging during palpitations; urine scanty and high-coloured in congestive evenings; passes more freely after a calm in the chest [Allen]. Albuminuria does not belong to the remedy as a keynote (contrast Lachesis/Crotalus in haemorrhagic states). Palpitations may follow a sudden call to void at night. Bladder symptoms are reflex; the heart–vagus axis rules.

Aggravation from alcohol and late, heavy meals; coffee may flutter the heart in sensitive subjects [Clarke]. Desire for small, cool sips to soothe the laryngeal tickle is common. Aversion to tight belts or stays after meals; pressure worsens breathing. Warm soups taken slowly are tolerated if the room is cool and quiet. Salt may be craved but increases thirst and oppression in some; moderation advised clinically. Appetite is small on days when duty weighs on mind and chest.

Sexual desire is depressed with heart weakness; erections unreliable; seminal losses aggravate fatigue and palpitations [Clarke]. Left testicular dragging may accompany left-sided pelvic–cardiac reflex pains but is not common. Quiet temper; not jealous or erotic as Lachesis; remorse and scruple are the colouring.

Left ovarian pains with cardiac palpitations; menses may aggravate chest and throat constriction [Farrington]. Morning hoarseness and aphonia worse premenstrually; relief as the flow becomes free. Anxiety about family duty sits beside suicidal thoughts—restrained by conscience (the moral keynote). In pregnancy, laryngeal spasm with palpitations has pointed to Naja when lying left is intolerable and open air relieves.

Between the shoulders a weight as if a bar were laid; left scapular drag accompanies angina [Clarke]. Cervical muscles tense with the collar-worse throat, and any scarf feels intolerable. Dorsal ache follows nights of orthopnoea; propping helps. Lumbar weakness after palpitations is common. Back symptoms subside when heart quietens, reinforcing the centrality of the cardiac axis.

Left arm pain and numbness during chest pain; cold, clammy hands; tremor with palpitations [Hering]. Fingers tingle and feel weak when the heart flutters; grip fails. Feet cold in warm rooms, a poor haemodynamic sign; after open air, warmth returns. Oedema is not a keynote but may appear in advanced failure. Relief follows steadier pulse and quiet mind.

Face and lips bluish in attacks; general pallor with cold sweat [Allen]. No specific eruption; collar marks may irritate the neck. Urticaria from emotion has been observed in sensitive women coincident with heart palpitations; it fades as calm returns. Skin is cool and damp during angina; warm and dry when panic abates. The snake signature lies not in lesions but in vascular–neural dynamics.

Angina / Coronary pain (radiation, modalities)

• Spigelia — Sharp, stitching heart pains, < motion, often with left eye neuralgia; Naja has constriction, laryngeal link, duty-sadness [Kent], [Clarke].
• Latrodectus mactans — Terrible angina with acute panic, sense of heart standing still, pains shoot to left arm and fingers; more agony and fear than Naja’s quiet melancholy [Farrington].
• Kalmia — Pains shooting from heart to arm, slow pulse, rheumatic history; less throat band and aphonia than Naja [Clarke], [Boger].
• Cactus grandiflorus — Iron band around chest, constriction < midnight; less moral colouring; no special aphonia [Boger].
• Glonoinum — Throbbing, bursting vascular head with heat; acute, not the sad, constrictive Naja heart [Kent].
• Digitalis — Failing heart with slow, intermittent pulse, fear to move; fewer laryngeal symptoms; mental state anxious, not remorseful [Clarke].

Valvular disease / Endo-peri-carditis

• Spigelia and Kalmia as above;
• Bryonia — Pericardial stitch < least motion, > lying on painful side (opposite Naja’s left-lying worse) [Boger].
• Rhus-tox. — Restlessness, tearing, < first motion; lacks laryngeal keynote and moral scruple [Kent].

Laryngeal constriction / Aphonia

• Spongia — Dry, barking larynx, saw-mill respiration; lacks heart radiation to left arm and moral keynote [Clarke].
• Lachesis — Extreme throat sensitivity, can’t bear touch, loquacity, jealousy; Naja is reticent, dutiful, left-lying worse shared but mind differs [Kent].
• Arum-triphyllum — Raw, acrid mouth–nose; not the cardiac–laryngeal axis of Naja [Boger].
• Phosphorus — Hoarseness < talking evenings; loves cold drinks; lacks heart-band and duty-sadness [Clarke].

Mind (suicide vs. restraint, duty)

• Aurum — Suicidal with self-condemnation, yet often religious despair and bone pains; Naja adds cardio-laryngeal sphere [Kent].
• Ignatia — Silent grief with globus; fewer heart-left-arm pains; more sighs and spasms [Farrington].
• Lachesis — Jealous, talkative; after sleep worse alike, but moral tone is different [Kent].

“Heart-coughs”

• Stannum — Talking exhausts and provokes cough, chest empty; lacks cardiac oppression and left-arm radiation [Boger].
• Rumex — Tickle in trachea < cold air inspirium; no heart picture [Clarke].

• Complementary: Spigelia — Neuralgic heart pains; may finish work after Naja relieves constriction [Clarke].
• Complementary: Digitalis — When rhythm remains weak/slow after Naja clears the laryngeal–moral complex [Kent].
• Complementary: Kalmia — Rheumatic radiation to arm; alternates with Naja in endo-peri-carditis [Clarke], [Boger].
• Follows well: Aconite — Acute fear-tachy settled; Naja for persisting constriction with duty-sadness [Kent].
• Follows well: Baptisia/Diphtherinum — After septic/diphtheritic states when aphonia + heart weakness remain [Clarke].
• Precedes well: Cactus — If band-tightness of chest continues without laryngeal tickle [Boger].
• Precedes well: Aurum — For residual suicidal gloom when heart has steadied [Kent].
• Compatible with: Arsenicum — For anxious nocturnal dyspnoea if panic predominates later [Clarke].
• Antidotes (functional): Lachesis sometimes noted as inimical in snake-group alternation; avoid needless alternation without indication [Boericke].
• Related group: Lach., Crot-h., Elaps, Lat-m. — serpent family contrasts across mind and circulation [Farrington], [Clarke].

• Angina with left-arm radiation + aphonia/heart-cough + collar-worse + duty-sadness: choose Naja over Spigelia/Kalmia when the laryngeal keynote and moral restraint are present [Hering], [Kent], [Clarke].
• Post-diphtheritic heart with weak voice: Naja when orthopnoea, blue lips, whispered words provoke cough, and lying left is impossible [Allen], [Clarke].
• Endo-/pericarditis (rheumatic): alternate Naja with Kalmia/Spigelia by pain-type; use Digitalis if rate control and weakness predominate after constriction abates [Boger], [Kent].
• Potency & repetition: Acute angina/orthopnoea—30C–200C in spaced doses at onset, then wait; chronic valvular states—6C–30C once–twice daily, taper as lying left becomes tolerable and speaking no longer provokes cough [Clarke], [Boericke].
• Pearls:
  • “Suicide restrained by duty + cannot bear a collar + left-arm pain = Naja” [Kent], [Hering].
  • “Heart-cough—every word provokes it; better cool air, head high” [Allen], [Clarke].
  • “After sleep worse; left-side worse; pressure of hand relieves” [Hering], [Boger].

Mind

• Suicidal thoughts, restrained by sense of duty — keynote moral polarity [Kent], [Hering].
• Remorse, self-reproach, quiet sadness — Naja tone [Clarke].
• Anxiety about heart without panic — contrasts Acon. [Kent].
• Better from consolation linked to duty — moral relief [Kent].
• Fear to lie down (heart) — orthopnoea [Allen].
• After sleep worse in mind and body — serpent trait [Kent].

Head

• Band-like constriction of temples — serpent signature [Allen].
• Vertigo on stooping/turning left — cardiac-vagal link [Clarke].
• Headache with chest oppression, warm room worse — thermal modality [Clarke].
• Sweat on forehead with angina — collapse sign [Hering].
• Pain to left jaw during angina — radiation map [Kent].
• Better open air — confirms global modality [Clarke].

Throat/Larynx

• Sensation of a cord round the neck; cannot bear collar — capital keynote [Hering].
• Aphonia, must whisper — voice fails with heart load [Allen].
• Cough on attempting to speak — “heart-cough” [Clarke].
• Throat, constriction < warm room, > cool air — modality [Clarke].
• Lump rises in throat with emotion — mind–throat tie [Kent].
• Post-diphtheritic paralysis with palpitations — classic field [Allen].

Chest/Heart

• Cannot lie on left side — left-lying worse [Hering].
• Pain heart to left shoulder/arm, sometimes jaw — angina hallmark [Kent].
• Orthopnoea, must sit propped — nursing cue [Allen].
• Pulse weak, irregular; blue lips — failure signs [Clarke].
• Pressure with hand over heart relieves — instinctive aid [Hering].
• Warm room worse; open cool air better — prime modality [Clarke].

Respiration

• Short, suffocative, whispering to avoid cough — laryngeal-cardiac axis [Allen].
• Cough from talking/reading — performance-worse [Clarke].
• Better by deep slow breath in cool air — vagal reset [Allen].
• Draught on throat provokes tickle — local cold-worse nuance [Clarke].
• After sleep worse dyspnoea — serpent timing [Kent].
• Must loosen clothing — mechanical cue [Hering].

Female

• Left ovarian pain with palpitations — cardio-pelvic reflex [Farrington].
• Menses aggravate chest/throat constriction — cyclic link [Clarke].
• Aphonia before menses, better when flow free — discharge relation [Clarke].
• Fear for family duty restrains suicidal impulse — moral keynote [Kent].
• Lying left intolerable in pregnancy with palpitations — obstetric hint [Allen].
• Better cool air, head high in night attacks — general modality [Clarke].

Generalities

• Worse: left side, warm room/bed, after sleep, talking, emotion, neck pressure — cluster that defines Naja [Hering], [Kent], [Clarke].
• Better: open air, head high, quiet, loosening collar, hand-pressure — bedside management [Clarke], [Hering].
• Snake-group mind: deep polarity, not panic; duty-bound restraint — essence [Kent].
• Heart ↔ larynx reflex: improvement in one eases the other — pathophysiology [Allen].
• Blue lips, cold sweat with pain — severity markers [Hering].
• Radiations map left jaw/shoulder/arm — practical differentiation [Kent].

Hering — Guiding Symptoms (1879): heart–larynx core, left-lying worse, collar intolerance, moral keynote.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): provings and clinical heart–laryngeal data; post-diphtheritic weakness.
Clarke, J. H. — Dictionary of Practical Materia Medica (1900): angina, heart-cough, modalities (open air, after sleep worse), mental portrait.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): duty-restrained suicide, serpent differentials (Lach., Crot., Elaps), left-side aggravation.
Boericke, W. — Pocket Manual (1901): keynotes—mitral disease, aphonia, collar-worse; relationships.
Boger, C. M. — Synoptic Key (1915): angina differentials (Kalmia, Cactus, Spigelia), modalities.
Farrington, E. A. — Clinical Materia Medica (1887): serpent family comparisons; female (left ovary) linkage.
Nash, E. B. — Leaders in Homeopathic Therapeutics (1899): heart leaders; moral colouring in Naja.
Dunham, C. — Homœopathy, the Science of Therapeutics (1877): toxicology of serpent venoms; clinical deductions.
Hughes, R. — Cyclopaedia of Drug Pathogenesy (1870): venom constituents; cardio-vagal effects.
Tyler, M. L. — Homœopathic Drug Pictures (1942): bedside picture—open window, whispering voice, hand on heart.
Dewey, W. A. — Practical Homœopathic Therapeutics (1901): endocarditis/pericarditis groupings; sequencing with Acon., Digitalis.
Phatak, S. R. — Materia Medica (1941): concise keynotes—duty, collar-worse, left-arm radiation.
Lippe, A. — Text-Book of Materia Medica (1866): confirmations—aphonia, cardiac cough, left-lying worse.