• Lungs—cavities and bronchiectasis. Large quantities of purulent, greenish, sometimes fetid sputum, with rattling and exhaustion; cough often looser in morning, oppressive at night; a “washing-out” expectoration after long tickling paroxysms is characteristic [Hering], [Clarke], [Boericke].
• Larynx and tracheal bifurcation. Tickling point at the supra-sternal notch or bifurcation that provokes cough on lying or talking; hoarse, fatigued voice in readers/speakers [Allen], [Clarke].
• Apices (tubercular field). Stitching, raw pains beneath clavicles; apical soreness with nocturnal cough, aligning to the tubercular miasm [Hering], [Boger].
• Sweat/thermoregulation. Night sweats with rank odour after cough paroxysms; desire for cool air though the chest feels tender [Clarke], [Boericke].
• Heart–lung strain. Palpitation and breathlessness from trivial exertion during chest disease; settles as expectoration becomes free [Clarke], [Allen].
• Ears/nose linkage. Post-nasal trickle sensitises the laryngeal tickle, prolonging cough when recumbent (micro-comparison with Kali-bi.) [Clarke].
• General debility from drainage. Prostration out of proportion to exertion—the sputum-loss picture; appetite capricious, craving cool drinks [Boericke], [Nash].
• Side-notes (lesser). Pleurodynia from cough; pectoral wall soreness and intercostal stitch after spells [Boger], [Clarke].

• Open air; cool room — eases tickle and oppression, though the patient may still be weak [Clarke], [Boericke].
• Sitting up propped; forward-bent — unloads apices and allows freer expectoration [Hering], [Boger].
• Morning, once sputum is freely raised — cough loosens, breathing easier; fatigue then follows [Allen].
• After expectorating large quantities — transient relief, chest feels “washed out” [Clarke].
• Gentle sipping of cool water — soothes laryngeal tickle and hoarseness (reader/speaker type) [Clarke].
• Slow walking in fresh air — quietens paroxysms; patient dislikes close rooms [Boericke].
• Humidified cool air — lowers irritant threshold at the bifurcation [Allen].
• Restfulness; silence — speech and laughter readily rekindle cough; quiet spares the larynx [Hering].

• Lying down, especially on first going to sleep — tickle at notch/bifurcation becomes insupportable; the paroxysm bursts forth [Hering], [Allen].
• Warm, crowded rooms; stove heat — cough drier, irritative; voice fails in readers [Clarke].
• Evening and night — oppression, apical stitch, night sweats; sleep broken [Boericke].
• Talking, laughing, reading aloud — immediate cough from laryngeal tickle and weakness [Allen], [Clarke].
• Turning in bed; lying on painful side — sets up pleurodynia/stitch, renews cough [Boger].
• After meals — fullness mounts to cough, sometimes retching of mucus [Clarke].
• Ascending — breath short, palpitation; must pause to expectorate [Clarke], [Nash].
• Damp fog — in some, increases rattling and weight on chest (phthisical terrain) [Clarke].

The mental picture is that of a patient worn by drainage: anxious at night from oppression, yet disposed to hope after a morning clearance; irritability attends interrupted sleep and the ceaseless tickle that renews as soon as he lies down—a direct echo of the modalities [Clarke], [Hering]. Speech fatigues him, producing cough and hoarseness, so he answers briefly and avoids long conversation (Mind ↔ Larynx cross-link). There may be a fear of suffocation on lying, prompting restlessness until the right propped posture is found; with cool air he calms and may even doze (Mind ↔ Respiration cross-link). The damped morale of chronic suppuration appears—discouragement after night-sweats; yet a surprisingly free morning revives confidence, only to ebb again in the evening (diurnal polarity). Some patients grow fastidious about sputum’s odour, cleaning compulsively; others feel shame at the quantity and avoid company, especially in warm rooms where cough betrays them (worse warm rooms, better open air). Children appear peevish at bedtime, dreading the tickling paroxysm that always comes when head touches the pillow, a classic guide to Phel. [Hering], [Allen]. A quiet, resigned tone replaces earlier fretfulness when expectoration flows, confirming the somatic driver of mood.

From night-waking and cough there arises a heavy head with frontal pressive ache and a hot vertex; cough-jars send stitches to the temples [Allen]. The supra-sternal tickling seems to radiate upward, making the mouth water and eyes smart before the first cough breaks (Head ↔ Throat ↔ Larynx cross-link). Warm rooms aggravate head oppression; open air cools both head and chest (modal echo). Vertigo appears on first rising in phthisical subjects, relieved after free expectoration. Unlike Kali-carb., which has rigid interscapular stitches with splitting head pain at 2–3 a.m., Phel. presents a lighter, tickle-driven head discomfort that yields to cool and air [Clarke], [Boger]. Children bang the pillow from irritation when the tickle mounts; the head symptom is secondary and reflects sleep-loss.