Sambucus nigra

Sambucus nigra is a deciduous shrub native to Europe, bearing small white flowers and deep purple-black berries. Its flowers and berries have long been used in herbal medicine for respiratory and febrile conditions. In homeopathy, the fresh leaves and flowers are potentised to yield a remedy especially active on the respiratory system, particularly in children. It has a powerful action on larynx, bronchi, and skin, often used in nightly asthma, laryngeal spasms, and suffocative coughs.

Proved by Hahnemann. Symptoms confirmed especially in infants and children through clinical application.

Sambucus nigra embodies the sudden, dramatic suffocative crisis of the sleeping child. It is the essence of night-time respiratory arrest, where breath fails at the very threshold of sleep, and panic reigns. The child, drenched in sweat, gasps awake, eyes wide in terror. The cough is dry, tight, unproductive, and painful. A remedy of spasm and obstruction, Sambucus stands out for those attacks that vanish by day and erupt like a storm at night, a ghost in the hours after midnight. It treats the fragile space between breath and no breath, often in infants, but also the elderly or frail.

• Respiratory system – larynx, bronchi, mucosa
• Skin – sweat glands, pores
• Throat – pharynx and larynx
• Nervous system – reflex irritation of vagus
• Infants and children – night suffocation, whooping cough, croup
• Muscles – asthenic weakness post-illness or fever

Fear of suffocation; dread of falling asleep due to breathlessness. Anxious and restless, especially children crying out during sleep. Apathy and drowsiness during the day but fearful awakening at night. Irritability from sleeplessness or coughing attacks. Clingy or frightened children. Dreams of choking or pressure.

Disturbed by paroxysmal attacks. Wakes up suddenly with a sense of suffocation. Cannot lie down again for fear of recurrence. Sleep is anxious, full of jerks or starts. Daytime drowsiness follows night attacks.

Dreams of choking or drowning. Nightmares in children who are prone to asthma or croup. Sleep disturbed by sudden cries or frightened waking.

Great remedy for children, especially plump, fair, sweaty, and congested types. Night aggravation, especially after falling asleep. Sudden onset of symptoms. Obstructed breathing with no expectoration. General chilliness and lack of vital heat. Sweats profusely during sleep. Suits acute onset of croup, asthma, or bronchitis. Children wake startled and gasping, with dry heat followed by sweat.

Violent dry heat without perspiration, followed by sudden, profuse sweating. Alternating hot face with cold extremities. Fever comes on at night, worsens toward morning. Accompanied by spasmodic breathing or cough. Suitable in early stages of respiratory infections in children.

Chilliness during early stage; later, hot dry skin. Then profuse sweat—especially on waking from sleep. Sweat relieves some symptoms but may also be suppressed, leading to respiratory aggravation.

Fullness or pressure in forehead during cough or obstructed breathing. Head feels congested during heat or fever. Sweat on forehead, especially during sleep. Sensation of heaviness, especially with suppressed perspiration.

Swollen lids; conjunctivae red during coughing episodes. Eyes wide open in fright during choking spells. Lachrymation during coughing. Puffy, blue-tinged skin under the eyes in infants with nightly suffocative attacks.

Stitching pain in ears during fever. Ears stopped up during catarrh. Ringing in ears from sinus congestion. Sensation of fullness in the ear, worse during colds.

Dryness and obstruction of nostrils, especially at night. Sudden stoppage of the nose during sleep—a characteristic keynote. Nasal obstruction leads to paroxysmal suffocation in children. Discharge scanty but acrid. Tickling in the nostrils may precede a spasm of cough.

Bluish, swollen face during asthma or cough attacks. Expression anxious or fearful. Sweat on forehead and upper lip. Children wake startled with flushed cheeks and mouth open. Lips may become cyanotic during dyspnoea. Twitching of facial muscles during cough.

Dry mouth during night coughing. Tongue coated white. Mucous membranes feel hot and dry. Frothy saliva may be observed in severe spasm. Infants often show difficulty sucking due to nasal obstruction.

Dryness and burning in pharynx. Sensation of constriction in larynx. Tickling in throat causing spasmodic cough. Hoarseness after exposure to cold air. Spasm of the glottis in children. Throat dry but not painful.

The primary seat of action. Paroxysmal, spasmodic, suffocative cough, occurring after midnight. Larynx feels constricted, as if closed. Attacks come on suddenly during sleep; child wakes up terrified, gasping for air, face bluish, eyes staring, nostrils flaring. Chest feels tight and dry. No expectoration initially, later becomes loose with frothy or scanty mucus. Better from sitting up, worse from lying down. Asthmatic attacks in children, especially those with a history of suppressed eruptions or sweat. Bronchial tubes filled with mucus but difficult to expel. Cough recurs with every attempt to sleep.

Palpitations during fever or respiratory distress. Irregular heartbeat with breathlessness. Cyanosis during severe dyspnoea. Tachycardia from oxygen deprivation in asthmatic children.

Extremely characteristic: sudden arrest of breathing during sleep. Difficult, gasping, rattling respiration. Laryngeal spasm, glottis closes suddenly. Inspiratory difficulty dominates—can breathe out but not in. Child becomes cyanotic, claws at air, and gasps. Crisis occurs after midnight. Rattling in chest with obstructed expiration. Respiration better after expectoration. Nasal obstruction compounds dyspnoea. In adults, may be used for post-viral asthma, especially when aggravated by lying down.

Nausea during or after coughing attacks. Aversion to food during fever. Vomiting of mucus after coughing in children. Poor appetite during illness. Sensation of weight in stomach during respiratory complaints.

Distended abdomen in children with respiratory affections. Abdominal muscles sore from constant coughing. Occasional colicky pain after coughing fits. Flatulence during febrile stages.

Constipation during dry febrile states. Diarrhoea rare but may occur after chills or fever. Involuntary stool during severe coughing.

Urination relieves breathlessness in some children. Increased frequency during night. Enuresis may occur due to spasm or coughing. Burning during urination in fever.

Thirstless despite fever. Aversion to milk in infants. Better from warm drinks when mucus is loosened. Appetite reduced during illness. Often refuses food when breathing is difficult.

Chilly sensations along spine. Back pain from strain of coughing. Stiffness during fever. Sweat along back during sleep.

Cold hands and feet during febrile or respiratory attacks. Cramping of calves in older children. Twitching in limbs during night suffocation. Weakness and heaviness post-coughing. Perspiration on soles.

Profuse, debilitating sweat, especially during sleep and fever. Sweat may be cold and clammy. Skin feels soft and cool. Suppressed perspiration may precede respiratory complaints. Tendency to dryness when sick.

• Spongia tosta – Dry, barking, croupy cough worse before midnight, but less about sweat or nasal blockage
• Hepar sulphuris – Later stages of croup, with yellow expectoration, extreme chilliness and sensitivity
• Aconitum napellus – Sudden onset croup after exposure to cold wind, but more fear and heat without sweat
• Antimonium tartaricum – Rattling chest with difficult expectoration, more weakness and cyanosis
• Ipecacuanha – Spasmodic cough with nausea and vomiting; less sweat and nasal blockage
• Drosera – Whooping cough remedy, but cough is deeper and more persistent through the day

• Complementary: Antimonium tart., Ipecacuanha
• Antidotes: Camphora, Nux vomica
• Follows well: Aconitum in early stages of croup or asthma
• Inimical: Spongia (in same acute phase—use with caution)

• Ideal for night-time croup in children, where child wakes gasping or choking
• Useful in asthmatic attacks that occur during sleep
• Helps with nasal obstruction in infants, especially when it disrupts nursing or sleeping
• Use in early febrile stages of bronchitis or influenza, especially when sweat is suppressed
• A good acute intercurrent for recurrent nightly spasmodic coughs

Respiration

• Arrested, during sleep
• Difficult, worse lying
• Suffocation, night, waking from
• Asthma in children

Cough

• Dry, paroxysmal, night
• Spasmodic, suffocative
• Cough, wakes child from sleep
• Cough, with nasal obstruction

Skin

• Perspiration, night, profuse
• Sweat, cold, clammy
• Suppressed sweat, followed by chest symptoms

Mind

• Anxiety, on waking
• Fear of suffocation
• Restlessness at night

Generalities

• Worse, night
• Worse, lying down
• Better, sitting up
• Sudden onset

• Samuel Hahnemann – Materia Medica Pura: Original proving, focusing on respiratory symptoms and night aggravations
• C. Hering – Guiding Symptoms: Emphasis on sudden respiratory crises in children and sweat suppression
• J.H. Clarke – Dictionary of Practical Materia Medica: Expanded applications in croup, asthma, and infantile obstruction
• William Boericke – Pocket Manual: Practical indications for croup, night coughs, and profuse sweat
• T.F. Allen – Encyclopaedia of Pure Materia Medica: Original pathogenetic effects, respiratory and systemic