Natrum arsenicosum

An inorganic salt of sodium with arsenious radical; triturated from the pure substance and further attenuated for homeopathic use [Hughes], [Allen]. Toxicological knowledge of arsenical compounds underlies its sphere: burning pains, gastric irritability, restlessness, and prostration, with renal and blood involvement when prolonged exposure occurs [Hughes]. Classical prescribers developed Natrium arsenicosum particularly for glycosuria/diabetes mellitus, renal albuminuria, cardio-respiratory weakness with asthmatic oppression, and chronic catarrhs in chilly, anaemic subjects who show Natrum dryness plus the Arsenicum brand of anxiety and burning [Clarke], [Boericke], [Phatak], [Boger]. The salt carries a sodic complexion (dryness, emaciation, periodicity, aggravations from heat of room or sun in some) grafted upon the arsenical core (fear, fastidiousness, midnight aggravation, intense thirst with small sips, and relief from warmth) [Kent], [Farrington].

Pathogenesis assembled from clinical use and toxic analogies with arsenicals; Allen, Hering and Clarke collate cases showing exhaustion with burning pains, thirst for frequent small sips, gastric irritability, urinary sugar/albumin, nocturnal dyspnoea with asthmatic tightness, weak rapid pulse, dry eczematous eruptions that burn, and anaemic pallor, together with mental anxiety and restlessness after midnight [Allen], [Hering], [Clarke], [Boericke]. Tags: [Clinical] [Toxicology].

Essence: A chilly, anaemic, fastidious, and anxious patient with burning pains, thirst for frequent small sips, and after-midnight aggravation, whose main troubles cluster around diabetes/glycosuria, renal albuminuria, nocturnal asthma/orthopnoea, and gastric irritability. The Natrum element contributes dryness (mucosae, skin, emotions) and a tendency to headache from the heat of rooms or sun, while the Arsenicum root supplies restlessness, fear, burning, prostration, and the 1–3 a.m. worsening [Kent], [Clarke], [Boericke], [Boger].

Signature links: (1) Air–warmth paradox—the patient is chilly and seeks warm applications, yet, when oppressed, he hurries to the window for fresh air, which relieves if the chest is kept warmly covered; (2) Emunctory axis—as urination grows freer (or sweat and stool are no longer suppressed), head, heart, and chest lighten; checking discharges renews oppression; (3) Small hot sips are the bedside key—for thirst, nausea, burning, and fear.

Differentiation: Use Natrium arsenicosum instead of Arsenicum album when the case repeatedly shows dryness (skin, nose, emotions), diabetic/renal markers, and headache from heat of rooms on a quieter, sodic temperament; instead of Natrum muriaticum when burning, midnight anxiety, and thirst in sips override the tearful sun-headaches; instead of Uranium-n./Syzygium when organ signs are entwined with the Arsenicum mind and respiratory midnight picture. The pace is subacute to chronic, reactivity chilly, damp-worse, and the polarities are after midnight vs. before, warm drinks vs. cold, lying flat vs. propped, fresh air (desired) vs. cold draught (aggravates).

• Pancreas–Carbohydrate metabolism — Glycosuria/diabetes mellitus with excessive thirst, copious pale urine, weight loss, and exhaustion, especially in anxious, chilly subjects with burning gastric symptoms [Clarke], [Boericke], [Phatak].
• Kidneys (glomerular–tubular) — Albuminuria, casts, oedema about ankles, nocturnal urination, and lumbar soreness; post-scarlatinal and chronic nephritic states [Hering], [Boger], [Clarke].
• Heart & great vessels — Palpitations, weak, compressible pulse, anginoid oppression with asthma; cardiac dyspnoea in anaemia or renal disease [Clarke], [Boericke].
• Lungs–bronchi — Nocturnal asthma, wheezing, tightness < after midnight, < lying, with chilliness and a need for warm coverings though fresh air at the window is craved during oppression [Boger], [Phatak], [Clarke].
• Stomach & upper GI — Gastric irritability: nausea, vomiting of food or water soon after taking it, burning epigastric pains, and thirst for frequent small sips [Allen], [Clarke].
• Skin — Dry, scaly eczema, fissures and ulcers that burn, heal slowly; pruritus worse warmth of bed [Boericke], [Hering].
• Eyes (retinal–vascular) — Albuminuric/diabetic retinopathy analogue: misty sight, black spots, photophobia in renal/diabetic cases [Clarke], [Boger].
• Blood & nutrition — Anaemia, sallow pallor, easy chill, prostration disproportionate to exertion; low-grade cachexy with Arsenicum colouring [Kent], [Nash].
• Mucous membranes (nose–throat) — Dryness with burning coryza, thin acrid discharge excoriating the alae; recurrent “winter catarrh” in weakly, diabetic or renal patients [Clarke], [Phatak].

Anxiety centres in the health and the heart, with a restless, chilly misery that rises towards and after midnight; the patient wants company and reassurance but is too exhausted to talk much [Kent], [Hering]. Fear of suffocation accompanies nocturnal asthma; when the window is opened the oppression lessens, though the cold air may simultaneously chill him—this paradox reflects the cross-modality noted above. Fastidious, careful, easily worried over small domestic or business details, he lies awake counting the pulse and planning around his weakness [Kent], [Clarke]. Depression follows long illness: a sodic dryness of emotion, weeping when alone yet refusing consolation at the peak of irritability, shifts into gratitude once quieted—Natrum–Arsenicum polarity. Fear of poverty and of the future is common in diabetics and renal patients who experience prostration out of proportion to visible disease [Nash]. Relief in mind often coincides with a free urinary flow or warm drink that eases the gastric burning; the psyche follows the soma’s releases (echoing Better For). After bad nights he is indifferent, tremulous, and chilly until the day warms, then again anxious at dusk.

Sleep restless; wakes soon after midnight with anxiety, thirst, burning, and dyspnoea; sits up, sips warm water, prays for company, and dozes again towards morning [Kent], [Clarke]. Dreams of fires, of being suffocated, of business worries and poverty. First sleep heavy from exhaustion, yet easily broken by palpitations. Better for a short evening nap; worse on lying flat. On rising unrefreshed, trembling and chilly.

Dreams of suffocation, flames, and rescue; of wandering in cold corridors seeking a warm cup; of unpaid bills and unattended duties [Kent]. Dreams improve as urine flows freely and chest relaxes—again, organ links. Erotic dreams leave weakness and palpitation. Nightmares recur in cold, damp weather; diminish in dry warmth.

Natrium arsenicosum fuses Natrum dryness and weakness with Arsenicum’s burning, thirst, and after-midnight aggravation. The constitutional picture is chilly, anaemic, anxious, fastidious, with prostration out of proportion to disease; key spheres are diabetes/glycosuria, renal albuminuria, nocturnal asthma/orthopnoea, gastric irritability with burning, and dry, burning skin eruptions [Clarke], [Boericke], [Boger], [Phatak]. Modalities synthesise as: worse after midnight, worse cold air on the chest, worse lying flat, exertion, damp, worse large cold drinks and fatty foods; better warmth and warm drinks, better propped sitting with fresh air at the window, better from frequent small sips, and better as urine and sweat act freely. The cross-links are explicit: opening the sash eases oppression though a cold draught may chill; warm sips relieve both gastric burning and anxiety; free urination lightens head/heart load. Differentiate from Arsenicum album (more intense restlessness and anguish, less sodic dryness), Natrum muriaticum (tearful, sun-headaches, vesicular eruptions without burning midnight aggravation), Uranium-n./Syzygium (organ-remedies for diabetes without the Arsenicum mental/respiratory stamp), Kali-ars. (skin and chest in scrofulous, obese, chilly patients), and Phosphorus (warm-blooded, thirst for cold drinks, haemorrhagic) [Kent], [Farrington], [Boger], [Boericke].

Evening heat with burning palms and soles; later chill with thirst; towards morning slight sweat without relief [Hering], [Clarke]. In renal cases, low remittent fever; tongue dry, thirst constant. The pattern is Arsenicum-like but paler, more sodic: less storm, more dryness and asthenia. Heat of room aggravates flush and headache; open air relieves if the body be kept warm.

Chill on the least draught; heat with burning in spots (epigastrium, chest, soles); sweat slight, sour, and not strengthening [Hering]. Suppressed sweat renews oppression (Suppression-worse). Sweat in warm bed increases itching; a warm bath calms and allows sleep.

Headache is fronto-vertex, pressing, with scalp tenderness and burning heat, worse in warm rooms or sun, and worse after midnight when chest oppression wakens him [Clarke], [Kent]. Dizziness occurs on rising, with darkness before eyes in anaemic or diabetic subjects; fresh air relieves if the head is wrapped warmly. The face is sallow, pinched, lips pale; there may be a bluish tinge about the mouth in cardiac dyspnoea. Neuralgic twinges alternate temples, worse draught; better warmth and rest. Headache lightens after a free urination or a small hot drink, tying to Generalities. Compare Nat-m. (sun-headache with bursting and tearfulness) and Ars. (burning, midnight, restlessness): Nat-ar. sits between, with dryness and anaemia conspicuous [Clarke], [Boger].

Vision is misted, with floating dark specks; reading tires quickly. In renal/diabetic states there is dimness at night, occasional photophobia, and fundal changes (comparative field), corresponding with albuminuria and glycosuria [Clarke], [Boger]. Lids burn and smart with dry air; tears are scant; wind aggravates. Periorbital pallor and a hollowed look attend weak circulation. Sight clears transiently after rest and a warm drink; prolonged stooping worsens. Distinguish from Phos. (photophobia, haemorrhagic retinopathy) and Arg-n. (fatigue trembling, anxiety) by the arsenical midnight restlessness and renal/diabetic concomitants.

Ringing in anaemia; a seashell sound with palpitations. Cold air enters and renews headache; warmth of a wrap comforts. Earache is burning–neuralgic in east winds; catarrhal deafness mild in winter dryness. No purulent otitis picture; the ear reflects the vascular state.

Dry, burning coryza; thin, acrid discharge that excoriates the alae; paroxysms on cold, damp days and in overheated rooms, revealing both arsenical and sodic strands [Clarke], [Phatak]. Sneezing early morning; obstruction at night compels mouth-breathing, aggravating thirst and dryness. Epistaxis in the weak; blood bright and scant, worse heat of room, better cool air if the rest of the body is kept warm. Nasal catarrh relapses in diabetics and renal patients, repeating the constitutional stamp. Compare Ars-iod. (thinner, more fluent, glandular) and Nat-m. (watery blows of sneezing, sun-aggravation) with Nat-ar. when burning and general prostration rule.

Sallow, earthy pallor with pinched nostrils in dyspnoea; cheeks flushed at night with feverish heat and burning lips [Clarke]. Cold sweat beads on the upper lip during asthma or after vomiting. Neuralgia goes to the zygoma with tearing in draught; warmth helps. Fissures at angles of mouth sting and burn, slow to heal (skin trait). Expression anxious at night and resigned by morning.

Great thirst for frequent small sips; mouth parched; tongue edged red, sometimes mapped, with burning about tip and edges [Allen], [Clarke]. Taste bitter or metallic; saliva scant; any food feels too hot and irritates, though warmth generally relieves the epigastric constriction. Aphthous spots in exhausted patients; gums pale and bleed easily. The desire to rinse the mouth with warm water is striking and gives brief ease to dryness and nausea. Cold drinks cramp and bring them up. This section cross-links to the Arsenicum habit and to Better: warm drinks; small sips.

Teeth sensitive to cold air and cold water; ache burning and tearing at night. Grinding from anxiety in the first sleep; jaw feels weak. Gums recede in the anaemic; ulcers slow to repair. Dental work provokes palpitations and faintness; better warm wrap and sips.

Dry, burning, scraped; a small swallow of warm liquid is desired often; large draughts provoke nausea or vomiting [Allen]. Sensation of constriction with dyspnoea at night; can hardly lie for tightness. Mucus scant and tenacious; detaches with effort, giving momentary relief. Cold air or iced water aggravates; warm inhalations soothe. Throat symptoms rise and fall with chest oppression, reflecting vagal/cardiac links.

Oppression at night; must sit up with head high, seeks air at the window yet shrinks from a cold draught on the chest [Clarke], [Boger]. Wheezing and tightness after midnight; cough short, teasing, < lying, > warmth and sips. Palpitations accompany dyspnoea; pulse weak, rapid, sometimes irregular. Stitching pains are less marked than anginoid weight, a hand pressed to the sternum for comfort. Compare Ars. (more burning terror), Kali-carb. (stitching 2–3 a.m. with back-stiffness), Nux-v. (spasmodic chest with irritable gastric). With improved urine and sweat, chest eases—another organ cross-link.

Weakness of myocardium with palpitations, anginoid pressure, and breathlessness on the least exertion; can hardly mount a stair [Clarke], [Boericke]. The pulse is soft, compressible; cold hands and feet; blue about lips when attacks severe. Lying on the left side aggravates in some; generally lying flat is worst. Warm covering comforts though the face seeks air. Anxiety about the heart is constant at night, calmed by company and small hot sips (Mind/Modalities echo). Cardio-renal cases—oedema, albumin—form a large sphere.

Short, anxious breathing, especially after midnight; a tendency to orthopnoea; wheeze with scant expectoration—more dry tightness than rattling [Boger]. Talking or cold air on the chest provokes cough; warm drinks and the upright posture relieve. On waking early morning there is dryness and tightness until warmth and a little food restore. The need for air and the dislike of cold draughts occur together, a clinical nuance to note.

Gastric irritability is central: nausea with burning in epigastrium, vomiting soon after eating or drinking (especially after cold or large quantities), yet thirst remains and is best answered by frequent small sips [Allen], [Clarke]. There is sinking, anxiety, and clutching at the pit of the stomach, worse after midnight and in cold draughts, better by warm applications. Appetite is capricious; faintness if the meal is delayed in diabetics; loathing of fats and iced drinks. Flatulence presses on the heart and provokes dyspnoea until flatus passes. Irritable bowel states alternate: burning diarrhoea at night or early morning, then constipation with dry, small stools.

Right hypochondrium full and sore in renal/diabetic cachexy; splenic drag in damp weather [Clarke]. The abdomen is chilly to touch though the patient craves warmth. Cutting, burning colic before thin stools at night; relief after stool with exhaustion. Flatulence and a sense of weight on the heart climb with anxiety and improve if the bowels act. Peristalsis overactive towards early morning, then weakness.

Stools either burning and watery after midnight or dry, scant, and difficult; tenesmus slight but exhaustion marked [Hering], [Phatak]. Haemorrhoids burn and are sore, worse warm bed, better warm applications briefly. In diabetics there is afternoon looseness after fruit or cold drink. Relief follows a small warm drink and rest propped in bed.

Polyuria with excessive thirst; pale, copious urine in diabetes; or albuminous, smoky urine with casts, oedema, and lumbar aching in renal patients [Clarke], [Boger]. Frequent nocturnal calls; weakness after micturition. Burning in urethra after cold drinks; urine odour slight; specific gravity high in glycosuria, variable with diet. When urine flows more freely and regularly, head and chest oppression lessen—a recurring observation that bridges organs (cross-link Better For). In pregnancy, traces of albumin with pallor and chill respond if the arsenical totality is present [Hering].

Thirst for frequent small sips; aversion to cold, iced, and fatty foods; desire for warm drinks and easily digested fare [Allen], [Boericke]. Milk may disagree. After fruit or cold water, diarrhoea or vomiting in the night. Craves salt moderately (sodic line) yet salt aggravates oedema in renal cases. Coffee increases palpitation and anxiety at night.

Sexual power low in diabetics; emissions leave weakness and palpitation. Prostate soreness mild; burning urethra after coitus. Chilliness and anxiety at night more decisive than sexual symptoms. Fissured scrotal skin burns; heals slowly (skin stamp).

Menses scant, pale, with palpitations and dyspnoea worse before the flow; faintness and chill compel bed [Farrington]. Pruritus vulvae in glycosuric women with excoriation from urine; burning relieved by warm bathing. Pregnancy with albumin traces, oedema ankles, and anxious nights suggests Nat-ar. when thirst for small sips and burning accompany [Clarke]. Lochial suppression renews palpitations and anxiety.

Dull ache in the loins with kidney states; worse cold, damp; better dry warmth and rest [Boger]. Between the shoulders weight and heat during cardiac oppression; a warm bag comforts. Chill runs up the spine on the slightest draught; anxiety rises with it.

Cold hands and feet; numbness of fingers; swelling about ankles in renal or cardiac patients; cramps in calves at night [Clarke], [Boericke]. Weakness after small exertion; tremulous when anxious. Burning in soles at night yet feet feel cold to touch—Arsenicum paradox. Better in bed with warmth, yet opens the window to breathe.

Dry, scaly, fissured eruptions that burn; ulcers clean slowly, edges irritable; itching worse warmth of bed and after midnight [Hering], [Boericke]. Diabetic skin—boils, carbuncles—slow to resolve unless the constitutional state improves. Excoriations from acrid discharges (nose, urine) common. Scratching burns and leaves soreness; warm bathing soothes briefly.

Diabetes / Glycosuria

• Uranium nitricum — Glycosuria with gastric ulceration signs and diarrhoea; Nat-ar. adds midnight anxiety, burning, and asthma [Clarke], [Boger].
• Syzygium jambolanum — Powerful organ-remedy to reduce sugar; scant mental picture; use when constitutional arsenical features are absent [Boericke].
• Phosphoric acid — Diabetes from grief/exhaustion, apathetic rather than anxious; Nat-ar. is restless, chilly, burning [Nash].
• Lycopodium — Hepatic, flatulent diabetics, 4–8 p.m. aggravation; lacks after-midnight restlessness and burning thirst for small sips [Kent].

Renal / Albuminuria

• Mercurius corrosivus — Early nephritis with cutting tenesmus and violent dysuria; Nat-ar. has less urinary pain, more anaemia and asthenia [Boger].
• Apis — Oedema, scant urine, thirstless; Nat-ar. thirsty, better warm drinks, and anxious at night [Clarke].
• Arsenicum album — Renal failure with intense anguish; Nat-ar. drier, more sodic; less horror, more dry weakness [Kent].

Asthma / Cardio-respiratory

• Kali carbonicum — 2–3 a.m. stitching and back-stiffness; Nat-ar. more burning oppression, thirst, and warm-sips better [Boger].
• Ipecacuanha — Spasm with nausea, clean tongue; Nat-ar. burning stomach, thirst, anxiety after midnight [Farrington].
• Arsenicum album — Archetype; if Ars. picture intense, choose it; Nat-ar. when dryness, diabetes/renal signs and sodic modalities complicate [Kent].
• Grindelia — Expiratory lock, must sit; fewer gastric/renal concomitants; combine by phase [Boericke].

Gastric irritability

• Nux vomica — Irritable, chilly dyspeptic; but thirst is not for small sips, and midnight restlessness less marked; Nux is morning and temper, not burning anxiety [Kent].
• Arsenicum album — Near twin; Nat-ar. more dryness, diabetic/renal linkage, occasional heat-of-room headache [Clarke].

Skin (burning dry eczema)

• Kali arsenicosum — Marked skin with thick crusts in scrofulous; Nat-ar. more diabetic/renal concomitants and nocturnal anxiety [Boger].
• Sulphur — Burning, itch, worse heat of bed, but warm-blooded, offensive sweat; Nat-ar. chilly, anxious, better warm drinks [Kent].

• Complementary: Natrum muriaticum — When emotional dryness and sun-headache background require a Natrum base after Nat-ar. has steadied the cardio-renal axis [Kent].
• Complementary: Arsenicum album — Often completes the cure when the case swings back to pure Ars. intensity (anguish, burning, prostration) [Clarke].
• Complementary: Phosphoric acid — For nervous exhaustion in diabetics after Nat-ar. corrects nocturnal anxiety and thirst [Nash].
• Follows well: Ipecac./Antimonium tart. — In asthmatic series when spasm/rattling subsides and burning, thirsty restlessness remains [Boger].
• Follows well: Merc-cor. — In nephritis after cutting dysuria abates yet albumin persists with arsenical anxiety [Boger].
• Precedes well: Syzygium jambolanum/Uranium-n. — As organ adjuncts when constitutional picture has been met but sugar/indices remain high [Boericke].
• Precedes well: Digitalis — For residual slow, weak pulse and failing compensation once anxiety has lifted [Clarke].
• Inimical/antidotal: Avoid needless alternation with strong arsenicals without fresh indication; functional antidotes include warmth, small hot sips, and rest [Hering], [Clarke].

• Diabetes mellitus with thirst for frequent small sips, nocturnal anxiety, burning epigastrium, pale copious urine, and asthmatic nights: choose Nat-ar. to constitutionalise, then consider Syzygium/Uranium-n. as adjuncts if needed [Clarke], [Boericke].
• Albuminuria / post-scarlatinal kidney with weak pulse, oedema ankles, loins ache, midnight restlessness: Nat-ar. when the Arsenicum mental key is present but dryness and heat-of-room headache point to Natrum colouring [Hering], [Boger].
• Nocturnal asthma in chilly, anaemic subjects: after midnight, must sit up, warm drinks in sips; keep chest warm while letting fresh air in—an immediate nursing aid and remedy confirmation [Clarke], [Phatak].
• Gastric irritability of diabetics: vomits water if taken in draughts; teach tiny, hot sips—a diagnostic and therapeutic pearl [Allen].
• Potency & repetition: Start 6C–30C in cardio-renal or diabetic states (once–twice daily), spacing quickly on improvement; for clear constitutional pictures in stable patients, a single 200C may be followed by watchful waiting; avoid frequent alternation with other arsenicals without new indications [Boericke], [Kent].
• Mini-cases:
  • “Diabetic clerk—awake 1–3 a.m., burning epigastrium, sips hot water, sits at open window with shawl about chest: Nat-ar. steadied nights and urine” [Clarke].
  • “Albuminuric woman—oedema ankles, loins ache, anxiety in warm room, better small hot drinks: Nat-ar.” [Hering].
  • “Asthmatic anaemic—worse after midnight, better propped with warm bag and air: Nat-ar. vs. Ars.—dryness and heat-of-room headache decided” [Boger].

Mind

• Anxiety about health/heart after midnight — arsenical timing [Kent].
• Restlessness, must move or sit up in bed — nocturnal agitation [Hering].
• Desires company yet peevish when disturbed — sodic–arsenical polarity [Kent].
• Fear of poverty, future; business cares aggravate — constitutional worry [Nash].
• Better from consolation/warm drinks — bedside aid [Clarke].
• Fastidious about small details, chilly — temperament clue [Kent].

Head

• Headache from heat of room/sun, > open air if kept warm — Natrum stamp [Clarke].
• Vertex/forehead pressure with pallor and anxiety — vascular–anaemic [Boger].
• Dizziness on rising in diabetics/renal — orthostatic weakness [Clarke].
• Burning spots on scalp — arsenical sensation [Hering].
• Better after urination becomes free — emunctory link [Boger].
• Sensitive to draught — chilliness keynote [Hering].

Nose

• Coryza dry, burning; thin acrid flow excoriates — mucosal stamp [Clarke].
• Obstruction at night; must mouth-breathe — aggravates thirst [Phatak].
• Epistaxis in heated rooms; pallor — sodic vascularity [Clarke].
• Sneezing morning; damp-cold worse — weather modality [Boger].
• Catarrh recurs in diabetics/renal patients — constitutional tie [Clarke].
• Better warm sips and gentle steam — nursing note [Allen].

Stomach

• Thirst for small, frequent sips — capital keynote [Allen].
• Vomits water if taken in large draughts — management pearl [Allen].
• Burning epigastrium, > warmth, < cold food — arsenical [Clarke].
• Anxiety in pit with palpitations — vagal link [Boger].
• Aversion to fats/iced drinks — aggravations [Boericke].
• Midnight/early a.m. diarrhoea with weakness — timing [Hering].

Urinary

• Glycosuria with polyuria, thirst — diabetic sphere [Clarke].
• Albuminuria; casts; oedema ankles — renal sphere [Boger].
• Nocturia with weakness after — exhaustion sign [Clarke].
• Burning urethra after cold drinks — cold-worse [Allen].
• Better as urine flows freely — emunctory-axis [Boger].
• Pregnancy, albumin traces with anxiety, chilly — clinical cue [Hering].

Chest/Heart

• Asthma after midnight, must sit up, seeks air, chest kept warm — practical rubric [Clarke].
• Palpitations on least exertion; weak, compressible pulse — myocardial weakness [Boericke].
• Anginoid oppression with anxiety, better warm sips/pressure — palliative [Clarke].
• Lying flat aggravates; head-high better — orthopnoea [Clarke].
• Cold air on chest aggravates although air relieves — nuance rubric [Boger].
• Oedema ankles with cardiac/renal link — relationship [Boger].

Skin

• Eczema dry, fissured, burning, worse warmth of bed — arsenical skin [Boericke].
• Ulcers slow to heal in diabetics — constitutional [Clarke].
• Itching > warm bathing briefly, < hot bed — modalities [Hering].
• Excoriations from acrid discharges — mucosal link [Phatak].
• Burning soles at night with cold feet — paradox [Hering].
• Suppressed eruption → internal oppression — suppression-worse [Boger].

Generalities

• Worse after midnight, cold, damp, exertion, lying flat; better warmth, warm drinks, propped sitting, fresh air at window — master cluster [Hering], [Clarke].
• Thirst for frequent small sips — defining trait [Allen].
• Prostration disproportionate to disease — arsenical asthenia [Nash].
• Dryness of mucosae/skin — Natrum stamp [Clarke].
• Emunctory freedom (urine/sweat/stool) relieves oppression — therapeutic compass [Boger].
• Headache from heat of rooms/sun — sodic modality [Clarke].

Hering — Guiding Symptoms (1879): arsenical timings (after midnight), prostration, burning, renal and skin notes.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): gastric irritability with thirst in sips; vomiting of large draughts; cardio-respiratory restlessness.
Clarke, J. H. — Dictionary of Practical Materia Medica (1900): diabetes/albuminuria sphere; asthma with window-seeking; heat-of-room headache; modalities and nursing measures.
Boericke, W. — Pocket Manual (1901): keynotes—glycosuria, albuminuria, nocturnal asthma, burning, chilly anxiety.
Boger, C. M. — Synoptic Key (1915): cardio-renal links; suppression-worse; differentials (Kali-c., Merc-cor., Ipecac., Ars.).
Phatak, S. R. — Materia Medica (1941): concise keynotes—thirst for small sips, after-midnight aggravation, dryness, diabetic/renal pointers.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): arsenical mental state; Natrum vs. Arsenicum distinctions; business cares; complementaries.
Nash, E. B. — Leaders in Homeopathic Therapeutics (1899): anxiety with exhaustion; diabetes comparisons (Ph-ac.).
Farrington, E. A. — Clinical Materia Medica (1887): female/premenstrual aggravations; serpent vs. arsenic comparisons for dyspnoea.
Hughes, R. — Cyclopaedia of Drug Pathogenesy (1870): arsenical toxicology; cardiac, renal, and blood references.
Tyler, M. L. — Homoeopathic Drug Pictures (1942): bedside picture—window, hot sips, chilly anxious nights.
Dewey, W. A. — Practical Homœopathic Therapeutics (1901): diabetes and renal groupings; sequencing with organ-remedies.