• Chest & lungs (primary motor centre of weakness): Profound weakness/emptiness in chest, exhausting cough, voice fatigue, must talk slowly or stop, descending stairs aggravates breathlessness; pressure with hands to sternum gives relief; better after expectoration though weakness remains [Kent], [Clarke], [Boericke], [Hering].
• Larynx/voice: Aphonia from speaking, voice breaks; readers/singers fail early; hoarseness with tough green or sweetish sputum; talking excites cough [Hering], [Allen], [Boericke].
• Bronchi/catarrh: Copious, often greenish, sweetish or saltish expectoration, rattling yet exhausting; cough worse talking, laughing, singing, after exertion, better lying on right side and after bringing something up [Clarke], [Boericke], [Nash].
• Abdomen/colic: Griping colic relieved by strong pressure or by bending double; emptiness at epigastrium; flatulence with weakness [Hering], [Allen].
• Rectum: Constipation with soft stool requiring great effort (paretic expulsion); rectal weakness; piles tender after straining [Hering], [Allen], [Clarke] (cf. Alum.).
• Female pelvic floor: Bearing-down as if everything would protrude, prolapse-tendency, must cross legs or press with hand, leucorrhoea like albumen with debility; labour-like pains with crescendo–decrescendo profile [Clarke], [Hering], [Kent].
• Neuralgia (face, intercostals, ovaries): Pains increase gradually to a peak, then subside slowly; pressure relieves; motion and talking aggravate; intercostal and trigeminal tracks common [Hering], [Allen], [Farrington], [Boger].
• General neuromuscular: Extreme fatigue from the least exertion, limbs feel powerless, drops things, knees give way; descending aggravates more than ascending—a keynote [Kent], [Clarke], [Tyler].
• Mind/nerve tone: Weary, despondent, anxious about health, cognitive slowness with muscular exhaustion; sensitive to music (aggravates by stirring emotions) [Kent], [Clarke], [Nash].

• Firm pressure on the painful part (abdomen, intercostals, sternum). [Hering], [Boger]
• After expectoration—breathing easier; cough abates, though weakness persists. [Boericke], [Clarke]
• Rest, silence, speaking little and slowly; avoidance of vocal effort. [Kent], [Hering]
• Lying on the right side or supporting the chest with pillows/hands. [Clarke]
• Leaning forward/bending double during colic or cough. [Hering]
• Warmth, wraps, warm drinks for chest soreness and neuralgia. [Boericke], [Allen]
• Gentle, steady pressure/bandaging over pelvic floor (bearing-down states). [Clarke]
• Open air that is mild and still (harsh wind aggravates, calm air soothes). [Tyler]
• Short naps or after a quiet sleep—temporary renewal of strength. [Nash]
• Support while descending (handrail); slow measured steps. [Clinical]
• Eating a little may relieve the hollow, sinking feeling. [Clarke]
• Massage of weak limbs and intercostals. [Clinical]

• Talking, reading aloud, singing, even a short conversation—evokes cough and prostration. [Hering], [Kent], [Boericke]
• Exertion, ascending then especially descending stairs, lifting; the descent notably exhausts and shakes the chest. [Kent], [Clarke]
• Motion, laughing, deep breathing, cold air, drafts—cough and pains flare. [Allen], [Clarke]
• Evening and after exertions; forenoon sinking in some provers. [Allen], [Hering]
• Touch (neuralgia), yet firm pressure relieves—paradox typical of Stann. [Hering], [Boger]
• Music/emotion—stirs and fatigues the nerves, renews cough/weakness. [Kent]
• Heat of bed at night for intercostal neuralgia; morning for cough on waking to speak. [Clarke], [Boericke]
• Stooping, talking while standing, and cold damp weather. [Clarke], [Tyler]
• Fasting—hollow, sinking, tremulous weakness worse when empty. [Clarke]
• Pregnancy/lochia exertions—bearing-down returns with effort. [Hering], [Clarke]
• Odours, smoke, dust in readers/singers—laryngeal fatigue rekindled. [Boericke]

A weary, despondent tone dominates; the patient feels unequal to tasks and shrinks from conversation because talking exhausts and provokes cough, a behaviour echoing the worse from speaking modality [Kent], [Hering]. Thinking is slow, with a sense of emptiness not only in chest but at the pit of stomach, and a timid anxiety that the strength will fail midway through any effort. Music and emotional talk aggravate by stirring the nerves; the Stann. subject often asks visitors to speak softly, then replies in short phrases to conserve breath—an economy of effort that is itself diagnostic [Clarke]. Irritability follows attempts to work or read aloud; after these abortive efforts a sighing, tearful sadness steals over them, relieved briefly by rest or a short nap [Nash]. Unlike Phosphorus, whose excitability and burning social openness precede collapse, Stann. is economical from the outset—husbanding breath, guarding voice, leaning on pressure and supports. The fear is practical: “If I speak much, I shall cough and sink.” When expectoration finally comes freely, mood and confidence lift, though the motor weakness remains—clear cross-link to Better after expectoration [Boericke], [Clarke]. Mini-case: A public reader, hoarse and despondent, could read only two paragraphs before cough and weakness forced him to stop; Stann. 30C restored the ability to read in short sessions, provided he paced speech and rested voice [Kent]. [Clinical]

Headache accompanies cough, especially frontal bursting after paroxysms; scalp tender to touch, yet pressure of the hand is soothing—typical Stann. paradox [Hering]. Dizziness on descending stairs is common, as if the brain “dropped” with each step; the symptom abates when the chest is supported and steps are taken slowly—again aligning with the descent modality [Clarke]. Mental work quickly produces heaviness and a hollow feeling at the epigastrium, driving the patient to rest. Neuralgic temporal and malar pains may creep up, climax, then fade gradually, the classical Stann. time-curve [Hering], [Allen].

Fatigue of ocular muscles on reading; letters blur when the patient reads aloud; lachrymation in cold air with hawking of thick mucus from the posterior nares. Photophobia is slight; the characteristic element is functional weakness, not inflammatory photophobia [Clarke]. Relief follows quiet reading without speaking, which spares the larynx and chest.

Ringing and humming during exhaustion; ear-ache of neuralgic type may follow the crescendo–decrescendo pattern; increased sensitivity to noise when cough is pending. No specific otic pathology; ear signs track the general nerve fatigue [Allen], [Hering].

Posterior catarrh with thick, tenacious mucus that must be hawked; nose dry in warm rooms, then fluent in cold damp; smell of smoke or dust at once provokes hoarseness and cough—the laryngeal affinity governs this region [Clarke], [Boericke].

Pale, sunken, with lines of fatigue; malar neuralgia of crescendo–decrescendo type, often left-sided, worse talking and motion, better pressure and warmth [Hering]. Lips dry; expression anxious before a bout of speech or coughing.

Taste often sweetish with morning expectoration; saliva increased during cough; tongue coated yellowish-white in chronic catarrh. Speaking dries the mouth; small warm sips are preferred. Teeth jar with coughing; maxillary neuralgia radiates to them during a pain-wave [Allen], [Hering].

Neuralgic odontalgia mapping the infraorbital track; worse cold air, touch, and talking, better firm pressure and warmth; pains mount slowly to a peak, then retire—the Stann. curve again [Hering].

Raw, tired larynx; voice husky or fails after a little use; reading aloud excites tickling and cough; mucus adheres behind manubrium with soreness on phonation [Boericke], [Clarke]. Swallowing is free, but the act of speaking fatigues the whole throat–chest organ. Warm drinks and steam moisten and comfort.

Hollow, sinking sensation at the epigastrium—the “all-gone” feeling—worse on talking or after slight effort; faintness compels a little food or rest [Clarke]. Nausea accompanies the worst coughing, but the gastric field is secondary to the motor exhaustion theme.

Griping colic around umbilicus, better pressure (hands or binders) and bending double; flatulence after slight fatigue; stitching in hypochondria when coughing. Abdominal walls ache from paroxysms; warmth soothes [Hering], [Allen].

Urging with weak stream in exhausted states; urine may be scant during severe cough days, freer as rest restores tone. No pathognomonic sediment or odour; signs are functional weakness, not renal disease [Clarke].

A keynote: constipation with soft stool that nevertheless requires great straining—rectal atony; stool slips back unless abdominal muscles are powerfully used [Hering], [Allen], [Clarke] (contrast Alumina: no desire, inactive rectum). Haemorrhoids sore from straining, relieved by local pressure and warm bathing.

Sexual desire reduced by exhaustion; emissions leave the chest emptier and the back weak; coitus aggravates cough-tendency next morning—again motion/use → weakness pattern [Clarke], [Kent].

Bearing-down in uterus with prolapse-tendency; must sit, cross legs, or press vulva to support parts; leucorrhoea like white of egg; menses early and profuse if over-fatigued, followed by extreme motor weakness [Hering], [Clarke], [Kent]. Labour-like back-to-front pains show the crescendo–decrescendo gradation. Voice-workers and nursing mothers break down in the Stann. way: speaking or household exertion triggers cough and sinking.

Short on slight exertion, talking, laughing, descending; better after expectoration and at rest with chest supported. Expiration may be prolonged with sighing; inspiration provokes the tickle. In emphysematous elders, the Stann. pattern (talking → cough → weakness, relief after mucus) is decisive [Boericke], [Nash].

Palpitation with weakness on descending or after coughing; systoles feel empty rather than forcible; the patient fears the heart will “stop” if he exerts or speaks much. Pulse soft, easily accelerated; cardiac signs retreat when the chest is supported and the voice spared—mechanical governance again [Kent], [Clarke].

This is the centre: the chest feels empty, weak, and hollow, as though the vital motor of breathing were run down; small exertions, especially talking, bring a racking cough with copious greenish or sweetish sputum; after expelling, there is momentary relief, yet extreme weakness ensues, forcing the patient to sit still with hands pressing the sternum [Hering], [Clarke], [Boericke]. Descending stairs peculiarly aggravates breathlessness and palpitation; the patient learns to support the chest and take stairs slowly, or to avoid descent altogether [Kent], [Tyler]. Intercostal neuralgia of the creeping-up/creeping-down type is frequent and accepts firm pressure for ease [Boger]. Compare Antimonium tart. (rattling with inability to raise, cyanosis), Phosphorus (burning, haemorrhagic tendency, thirst for cold, more open and sympathetic), Causticum (paretic larynx, aphonia without the greenish sweet sputum), Drosera (spasmodic barking, < after midnight), Kali carb. (stitching, lower-lobe weakness, oedematous faces).

Lumbo-dorsal weakness like a weight; bearing-down to sacrum in women; aching between scapulae after speech or effort; the back seeks a firm support. Spinal fatigue echoes the chest motor failure [Clarke], [Hering].

Limbs powerless, tremulous; drops things; knees knock on stairs, especially down; calves ache after small errands; arms tire from writing or reading aloud holding a book [Kent], [Tyler]. Neuralgic ulno-radial pains exhibit the crescendo–decrescendo signature and accept pressure.

Dry, pale; prone to herpes zoster along intercostal tracks, pains mounting and fading slowly; itching with exhaustion. Healing slow in the elderly with catarrhs [Clarke], [Boger].

Sleep is unrefreshing; the patient wakes tired, yawning, with the all-gone feeling in chest and epigastrium; first attempts to speak on rising provoke cough [Hering], [Clarke]. Talking in dreams starts a paroxysm; afternoon drowsiness is marked, a short nap improving the mental tone but not abolishing the chest weakness [Nash]. Propped posture is preferred to avoid cough on turning.

Of public speaking and inability to go on; of descending steps and sinking; of losing one’s voice; of falling through empty space—imagery mirroring voice-exhaustion, descent-worse, and emptiness.

Low fevers in chronic catarrh; heat of face and cold extremities after bouts; sweat after slight exertion without relief of weakness. Fever pattern lacks sharp definition; constitutional fatigue is central.

Chill on small exposure; flushes with speaking; sweat on minimal effort, easily exhausting; warmth generally soothes neuralgia, though heat of bed may irritate intercostals [Clarke], [Boger].

Desire for warm drinks; aversion to cold drinks that provoke laryngeal tickle; small feedings preferred; faint when empty—relieved by a little food. Sweet or sweetish taste of sputum is a clinical pointer [Boericke], [Clarke].

Stann. expresses motor exhaustion centred in the chest and larynx: talking or the least exertion brings racking cough and profound weakness; expectoration relieves the oppression yet leaves an emptiness behind. The peculiarities are descent-worse, pressure better, pains that wax and wane gradually, and constipation with soft stool needing great straining. Voice-workers, readers, the convalescent, and the elderly show it most; women with bearing-down find mechanical support indispensable while the remedy restores tone. Distinguish from Phosphorus (burning, open, haemorrhagic; thirst for cold), Ant-t. (drowning rales, cannot raise), Causticum (paretic cords without the sweet green sputum), Drosera (spasmodic midnight cough), Kali-c. (stitching and oedema), Alumina (constipation atony without the soft-yet-straining paradox of Stann.), and Sepia (pelvic bearing-down with chilliness and indifference, lacking Stann.’s voice-chest centre) [Hering], [Allen], [Clarke], [Kent], [Farrington], [Nash], [Boericke], [Boger].

• Exhausting cough with weakness/emptiness of chest; expectoration relieves
  • Phosphorus — Burning, haemorrhage, thirst for cold, emotional openness; less peculiar descent-worse and soft-stool-with-straining. [Clarke], [Kent]
  • Antimonium tart. — Rales with inability to raise, cyanosis, drowsiness; Stann. can raise after effort but is spent. [Hering], [Boericke]
  • Causticum — Aphonia/paresis; cough from tickle in larynx; expectoration not so greenish/sweetish; lacks descent-worse. [Clarke]
  • Drosera — Paroxysmal, spasmodic, after midnight; retching; little emptiness motif. [Boger], [Farrington]
  • Kali carbonicum — Stitching, lower-lobe weakness, oedema, 3–4 a.m. aggravation; Stann. marked voice-fatigue and pressure >. [Clarke]
  • Stann. vs. Stann-salts — Metallic Stann. shows voice/chest motor weakness and stool paradox; salts (e.g., Stann-iod.) shift toward glands/skin. [Clarke], [Boger]
• Pelvic bearing-down / prolapse-tendency
  • Sepia — Marked indifference, pelvic relaxation, ball-bearing-down, better exercise; Stann. worse exertion, needs mechanical support. [Kent], [Clarke]
  • Murex — Excited sexuality with bearing-down; Stann. lacks erotic hyperæsthesia. [Farrington]
  • Lilium tigrinum — Hysterical alternations; urgent bearing-down; more mental unrest. [Tyler]
• Neuralgia with gradual increase/decrease
  • Magnesia phosphorica — Cramping, lightning-like pains better pressure and heat, but lacks the staged crescendo–decrescendo emphasis. [Clarke]
  • Spigelia — Thread-like, left-sided ocular/heart stitches; posture rules (right-side), not the Stann. pressure-better colics. [Farrington]
  • Mezereum — Burning bone-pains with eruption; different terrain. [Hering]
• Constipation paradox: soft stool yet needs straining
  • Alumina — Atony without desire; stools hard, dry; no soft-yet-difficult peculiarity. [Allen], [Clarke]
  • Silicea — Ineffectual urging with spasm; stool recedes; Stann. marked soft stool with labour. [Hering]

• Complementary: Phosphorus—after Stann. frees mucus and steadies voice, Phos. may rebuild reactive weakness; reversed order when burning, haemorrhagic signs dominate. [Clarke], [Kent]
• Complementary: Calcarea—chronic catarrhal constitutions that collapse on exertion; Calc. builds base after Stann. has restored mechanics. [Farrington]
• Follows well: Antimonium tart. in bronchitis as power to raise returns; Causticum when paresis recedes to Stann.’s motor weakness. [Boericke], [Boger]
• Precedes well: Kali carb. or Carbo veg. if failure persists with oedema or flat collapse; Sepia if pelvic bearing-down dominates after the chest clears. [Clarke], [Nash]
• Inimical/antidotal notes: Over-use of voice, music, cold damp aggravate; counsel pacing speech, warmth, and supports while dosing. [Kent], [Tyler]

• Voice-worker’s bronchitic cough (greenish/sweetish sputum, voice fatigue, after expectoration relief yet prostration): Stann. 6C–30C every 4–6 hours acutely; taper as cough eases; enforce voice rationing and humid warmth. [Boericke], [Clarke], [Kent]
• Emptiness of chest with descent-worse in convalescence: single 30C–200C then observe; add sternal support training for stairs; compare Phos. if burning/thirst predominate. [Kent], [Tyler]
• Constipation: soft stool yet must strain (rectal atony): Stann. 6x–12x b.i.d. with abdominal support and warm fluids; distinguish from Alum. (dry hard stool, no desire). [Hering], [Allen], [Clarke]
• Pelvic bearing-down with chest weakness: Stann. 30C–200C; insist on mechanical support (crossing legs, pessary evaluation where appropriate) while tone returns; compare Sepia if mental indifference dominates. [Clarke], [Kent]
• Intercostal/trigeminal neuralgia with gradual rise/fall and pressure >: Stann. 6C–30C during waves; warm compression and stillness potentiate action. [Hering], [Boger], [Farrington]

Mind

• MIND — DESPONDENCY — weakness from the least effort — with. — Practical dread of exertion.
• MIND — AVERSION to conversation — speaking aggravates complaints. — Voice-economy.
• MIND — MUSIC — aggravates. — Nerve fatigue stirred by emotion.

Head / Face

• HEAD — DIZZINESS — descending stairs — aggravates. — Descent-worse keynote.
• HEAD — PAIN — temporal/malar — gradually increasing and decreasing. — Stann. time-curve.
• FACE — NEURALGIA — pressure — ameliorates — motion/talking — aggravates. — Neuralgic paradox.

Throat / Larynx / Voice

• VOICE — WEAK — reading aloud — aggravates — aphonia from exertion of voice. — Speaker’s failure.
• LARYNX — TICKLING — talking — aggravates — cough from. — Phonation-cough link.
• THROAT — RAWNESS — speaking — aggravates — warm drinks — ameliorate. — Warmth soothes use-fatigue.

Cough / Chest / Expectoration

• COUGH — TALKING — aggravates; LAUGHING — aggravates; DESCENDING — aggravates. — Use and descent triggers.
• EXPECTORATION — GREENISH — sweetish/saltish — copious — after coughing — relief. — Classic Stann. sputum/relief.
• CHEST — EMPTINESS — weakness — speaking — aggravates — pressure — ameliorates. — Motor centre failure.
• PAIN — INTERCOSTAL — pressure — ameliorates — motion — aggravates — gradual onset/decline. — Neuralgia signature.

Abdomen / Rectum

• ABDOMEN — COLIC — pressure — ameliorates — bending double — ameliorates. — Mechanical relief.
• RECTUM — CONSTIPATION — soft stool; yet must strain greatly. — Atony paradox.

Female

• GENITALIA — BEARING-DOWN — must cross legs/press vulva. — Mechanical support need.
• LEUCORRHOEA — albuminous — weakness — with. — Pelvic atony pattern.

Generalities

• GENERALITIES — DESCENDING — aggravates. — Stairs signature.
• GENERALITIES — PRESSURE — ameliorates — touch — aggravates. — Stann. paradox.
• GENERALITIES — EXERTION — from the least — aggravates — prostration. — Global fatigue.
• GENERALITIES — AFTER EXPECTORATION — amelioration. — Turning-point cue.
• GENERALITIES — MUSIC — aggravates. — Emotional stir costs energy.

Sleep

• SLEEP — UNREFRESHING — wakes tired — cough on speaking after waking. — Morning economy required.
• SLEEP — NAPS — short — ameliorate. — Brief reset of nerve tone.

Hahnemann — Materia Medica Pura / Chronic Diseases (early 19th c.): proving bedrock—emptiness of chest, stool paradox, crescendo–decrescendo pains.
Hering — The Guiding Symptoms of Our Materia Medica (1879): voice fatigue, greenish/sweet sputum, pressure > colic, pelvic bearing-down; modalities.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): cough/expectoration, rectal atony with soft stool, neuralgia time-curve, descent-worse notes.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): reader’s aphonia, descent-worse chest weakness, albuminous leucorrhoea; comparisons.
Kent, J. T. — Lectures on Homoeopathic Materia Medica (1905): “motor in the chest,” voice-exhaustion, economy of effort, stairs modality.
Boericke, W. — Pocket Manual of Homoeopathic Materia Medica (1901): greenish sweet sputum; pressure >; cough from talking; relationships.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): modality grid—pressure >, motion/touch <; intercostal neuralgia; sequencing.
Farrington, E. A. — Clinical Materia Medica (late 19th c.): neuralgia comparisons (Mag-phos., Spig., Mez.); pelvic vs. chest differentials.
Nash, E. B. — Leaders in Homoeopathic Therapeutics (1907): short naps restore mind, not power; cough–weakness relation.
Hughes, R. — A Manual of Pharmacodynamics (1870s): tin background; occupational notes; catarrhal rationale.
Tyler, M. L. — Homoeopathic Drug Pictures (1942): “descending-worse” portraits; teacher/reader cases; practical pacing.
Dewey, W. A. — Practical Homoeopathic Therapeutics (1901): chest catarrhs, voice-worker counsel; regimen adjuncts.
Phatak, S. R. — Concise Materia Medica (1977): keynotes—emptiness of chest, stool paradox, cough from speaking.