• Cerebellum and motor coordination — staggering, wide-based gait, and inability to walk straight from “drugged” incoordination; keynote for selection in insomnia cases that then show ataxia on rising (see Extremities, Head) [Clarke], [Hughes].
• Sleep centres / higher cortical regulation — artificial, heavy, unrefreshing sleep alternating with restless wakefulness; morning stupefaction and mental clouding (see Sleep, Mind) [Clarke], [Allen].
• Blood (haemoglobin/methaemoglobin) — dusky or cyanotic tint, low vitality, easy exhaustion; the blood change underlies the dull headache and short breath on exertion (see Generalities, Heart, Respiration) [Hughes], [Clarke].
• Kidneys / urinary tubules — albuminuria, haemoglobinuria, scanty smoky urine, backache over loins; a central sphere derived from repeated toxic records (see Urinary, Back) [Clarke], [Allen].
• Liver and digestion — coated tongue, nausea, occasional vomiting, poor appetite, malaise after dosing (see Stomach, Abdomen) [Boericke], [Clarke].
• Peripheral nerves / muscular tone — weakness, tremulousness, heaviness of limbs, ease of fatigue; worse on exertion (see Extremities, Generalities) [Hughes], [Clarke].
• Skin / complexion — sallow, greyish or cyanotic hue; occasional drug exanthems in the intoxicated (see Skin) [Clarke], [Hughes].
• Cardiorespiratory — weak pulse, sighing or shallow respiration, oppression from “drugged” blood and lowered tone (see Heart, Respiration) [Hughes], [Clarke].

• Lying perfectly still; attempting to move brings out the staggering and vertigo (matches Extremities, Head) [Clarke].
• Fresh, cool air; clears the dusky, oppressed feeling and lightens the headache (echoed under Head, Respiration) [Clarke].
• Warmth to the loins; eases renal aching and lumbar soreness (see Back, Urinary) [Allen].
• Short, quiet naps; slight refreshment without the heavy stupefaction of prolonged sleep (see Sleep) [Clarke].
• After vomiting or eructations; some gastric relief and clearer head (see Stomach, Head) [Boericke].
• Loose clothing and unbuttoning; mitigates the sense of oppression (see Chest, Generalities) [Clarke].
• Hydration (small, frequent sips); reduces burning in urine and lightens dizziness (see Urinary, Head) [Allen].
• Morning ablutions and cool sponging; temporarily dispels the stupefaction on waking (see Mind, Generalities) [Clarke].

• Continued or repeated doses (cumulative action); deepens ataxia, renal signs, and cyanosis (reflected throughout Urinary, Extremities, Generalities) [Clarke], [Hughes].
• On rising and attempting to walk; staggering, veering gait, and vertigo at once declared (see Head, Extremities) [Clarke].
• Morning on waking; heavy, confused, headachy, unrefreshed (see Sleep, Mind, Head) [Clarke], [Allen].
• Exertion or prolonged standing; weakness and incoordination worse; breath short (see Extremities, Respiration) [Hughes].
• Close, heated rooms; aggravates oppression, dullness, and headache (see Generalities, Head) [Clarke].
• After fatty food or late meals; increases nausea and malaise (see Stomach) [Boericke].
• Emotional strain at night; cannot fall asleep though “drugged” and exhausted (see Sleep, Mind) [Clarke], [Kent].
• Cold, damp exposure; chills with increased dull aching in back and limbs (see Back, Generalities) [Allen].

A picture of artificial sedation masking inner unrest. There is dullness, slow comprehension, and a “cotton-wool” head, with apathy and indisposition for work [Clarke]. Anxiety flickers up in the evening or on lying down, oddly paired with inability to sleep despite great bodily fatigue (this tallies with the worse at night from emotional strain noted under Modalities) [Kent], [Clarke]. Memory is weak; answers are delayed; the patient feels “drugged,” indifferent, or slightly irritable if roused [Clarke], [Allen]. As the intoxication deepens, a heavy stupor alternates with brief wakeful spells of restlessness; conversation feels effortful; will-power is enfeebled [Clarke], [Hughes]. Depression may follow several disturbed nights, with a hopeless sense of prostration in the morning (cross-refer Sleep, Generalities) [Clarke], [Boericke]. Fear of moving (lest one stagger) appears in those with marked ataxia, a mental echo of the physical incoordination [Clarke]. Case sketch: A nervous insomniac, after repeated sedative nights, wakes dazed, apathetic, and unable to collect thoughts till noon—Sulfon. clears the cloud and steadies the day’s onset [Clarke], [Allen]. [Clinical]

Heavy, stupefying headache on waking—chiefly frontal or across the brow—better for cool air and gentle washing, worse in close rooms and on first attempting to walk (exactly reflecting the Modalities) [Clarke]. Vertigo is characteristic, “as if pulled sideways,” with a tendency to stagger and veer; the cerebellar nature of the drug shows here [Hughes]. A congestive, benumbed feeling accompanies the dull pain; the scalp may feel tight; movements aggravate, while lying quietly eases [Clarke], [Allen]. Nausea often mounts with the headache, relieved by slight vomiting or belching (cross-link Stomach) [Boericke]. The head feels hot while the limbs are chilly—an internal disharmony often noted in drugged states [Clarke]. With continued dosing, there is morning confusion, heaviness of eyelids, and a sense that the brain “won’t act” till midday [Clarke]. [Toxicology][Clinical]

Lids heavy; vision dim or misty on first rising; objects may blur on attempting to fix them (incoordination). There may be transient diplopia from ocular muscle unsteadiness; reading wearies quickly [Clarke]. Pupils may be somewhat sluggish in pronounced stupor; eyes look dull or slightly suffused [Hughes]. Photophobia is not a leading symptom but bright light may aggravate the morning headache. Improvement comes with fresh air and rest (echoing Better fresh air) [Clarke]. [Toxicology]

A low humming or buzzing at times accompanies the head symptoms, with a sense of stopped ears in the morning [Clarke]. Hearing may seem muffled during the “drugged” stupor; exertion or sudden movement aggravates the subjective noises [Hughes]. Symptoms tend to lift by midday with clearer circulation. [Toxicology]

Nasal mucosa relatively quiet; occasional dryness on waking; in pronounced cases, pallor or a slightly dusky tip reflects the blood change (methaemoglobin) [Hughes]. Odours may nauseate more easily than usual when the stomach is unsettled (cross-link Stomach). [Toxicology]

Expression heavy, unrefreshed; complexion sallow or faintly cyanotic in severe intoxication (blood affinity). Lips may be slightly livid; face feels hot while hands are chilly (matches Chill/Heat) [Clarke], [Hughes]. Cheeks flush in close rooms and fade in fresh air (echoes Modalities). [Toxicology]

Tongue coated white or yellowish in the morning; mouth dry on waking, with flat or metallic taste [Boericke]. Saliva scanty; slight nausea may rise from the fauces. Speech slow, as if the tongue were heavy (mind-motor sluggishness) [Clarke]. Small sips of water relieve dryness (echo Better small sips). [Clinical]

No distinguished dental keynotes recorded beyond heaviness of jaws and indisposition to chew while the stomach is unsettled. [Clinical]

Dryness on waking; effortful swallowing when stuporous; a lump-like feeling at the pit of throat may occur with gastric disturbance and chest oppression [Clarke]. Warm drinks and rest improve. [Clinical]

Nausea frequent, especially in the morning or after late meals; vomiting, when it occurs, gives relief to the head and general malaise (explicitly matching Better after vomiting) [Boericke], [Clarke]. Appetite is poor; averse to fatty or rich foods, which aggravate. There is a heavy, atonic feeling in the epigastrium with slow digestion; eructations are tasteless or flat [Boericke]. The gastric state mirrors the global “drugged atony,” much as in Chloral., yet Sulphonal adds the ataxic and haemoglobinuric complexion (micro-comparison) [Clarke], [Hughes]. [Toxicology][Clinical]

Dull, dragging sensations; slight meteorism; hepatic region may be tender or full after repeated dosing (blood stasis/toxic load) [Clarke], [Hughes]. Colicky twinges are rare; the general impression is of atony and sluggish portal circulation, better for rest and warmth. [Toxicology]

The keynote sphere. Urine scanty, smoky-brown or reddish, with albumin, haemoglobin, and sometimes casts—hallmarks of haemoglobinuric nephrosis under cumulative dosing [Clarke], [Hughes], [Allen]. Burning or smarting may be felt along the urethra; there is ache and soreness in the loins, worse on standing or walking, better with warmth (echo Better warmth to loins) [Allen]. Micturition may be slow; the urine may darken on standing. Compare Terebinthina in haematuria/haemoglobinuria (both with smoky urine), but Sulphonal has more stupor and ataxia with morning stupefaction [Clarke], [Hughes]. [Toxicology][Clinical]

Tendency to constipation from lowered tone and inactivity; stool somewhat delayed and dry; in toxic states looseness may supervene but is not characteristic [Boericke]. Urging is weak; the patient is too indifferent to strain. [Clinical]

Libido dulled; sexual indifference from nervous depression; emissions diminished during prolonged stupor. No striking generative organ lesions recorded beyond global atony [Clarke]. [Clinical]

Menses may feel more fatiguing; increased morning dullness around the period from sleep-loss cumulation; otherwise no fixed local keynote established [Clarke]. [Clinical]

Shallow, slow; sighing; breathes more freely in cool air (cross-link Better fresh air). Exertion induces dyspnoea disproportionate to effort, reflecting the blood affinity [Hughes], [Clarke]. [Toxicology]

Pulse soft, weak; in deeper intoxication, slight cyanosis from altered haemoglobin; palpitation on exertion with breathlessness (blood/oxygen transport issue) [Hughes]. Anxiety about the heart occurs occasionally at night with sleeplessness (compare Coffea: over-excited, no stupor) [Kent], [Clarke]. [Toxicology]

Oppression as from close air; desire to unbutton; sighing respirations during stupor (mirrors Better loose clothing) [Clarke]. Atonic feeling within the chest; heaviness without acute pain. [Clinical]

Aching in the lumbar region over kidneys; worse on standing and walking, better from warmth and rest—an important guiding local modality (mirrors Affinity and Better warmth to loins) [Allen], [Clarke]. [Clinical]

The “Sulphonal gait”: staggering, wide-based, veering to one side; cannot walk in a straight line, worse on first rising and with any attempt at speed [Clarke], [Hughes]. Limbs feel heavy, tremulous, easily tired; hands uncertain, objects dropped from poor coordination (cerebellar touch) [Clarke]. Coldness of hands/feet contrasts with a hot head (see Chill/Heat). Symptoms abate with lying still or very slow, supported walking in fresh air. Compare Gelsemium (muscular weakness and incoordination) yet Sulphonal shows deeper renal and blood signs with smoky urine [Clarke], [Hughes]. [Toxicology][Clinical]

Sallow, greyish tint; sometimes a faint drug exanthem in intoxicated subjects; cyanotic lips/ears in severe cases (blood change). Skin cool and moist in collapse-like states, with clammy sweat (link Perspiration). [Clarke], [Hughes]. [Toxicology]

Central theme. Either cannot fall asleep despite exhaustion (especially after emotional strain), or falls into a heavy, unrefreshing, dream-poor sleep that stupefies and does not restore (the “artificial sleep”) [Clarke], [Allen]. On waking—especially in the morning—head is heavy, ideas slow, will slack; the day begins in a haze (ties directly to Worse morning on waking) [Clarke]. Short, quiet naps refresh more than long sleep (echo Better short naps). Night rest is broken by brief restless intervals; turning over aggravates vertigo and brings full wakefulness that persists [Clarke]. Compare Coffea (wide-awake from joyous excitability) and Opium (profound sopor with insensibility): Sulphonal stands between—sleep that looks deep yet does not repair, and an alternation with wakeful anxiety [Kent], [Clarke]. [Clinical][Toxicology]

Few or indistinct; when recalled, anxious, confused, or of wandering without balance (a dream-image of the ataxia). On bad nights, no dreams—only heavy blankness ending in a dull morning [Clarke]. [Clinical]

Not a febrile remedy per se. Low-grade evening chilliness with hot head and cold extremities; in collapse-like intoxication, subnormal temperature may be found [Clarke], [Hughes]. [Toxicology]

Chilliness in extremities with heat of head and face; close rooms increase heat and oppression, fresh air relieves (echoes Modalities) [Clarke]. Sweat clammy during weakness; night sweats in some exhausted subjects [Clarke]. [Clinical]

Aversion to heavy or fatty foods; slight thirst for small, frequent sips, which ease throat and head (echo Better hydration) [Boericke]. Nausea after late or rich meals; prefers simple, light fare on rising [Boericke], [Clarke]. [Clinical]

A remedy of drugged atony and incoordination: strength sinks, movements go astray, the day begins clouded, and the urine betrays the blood/kidney imprint (albumin, haemoglobin, smoke-brown). Worse on rising, worse on continued dosing, worse in heated rooms; better lying still, better fresh air, better warmth to the loins—these recur across systems (see Head, Extremities, Urinary) [Clarke], [Hughes], [Allen]. The patient feels “not himself,” as if identity were muffled in cotton; any exertion brings breathlessness and trembling. The alternation of restless insomnia with stupefying, useless sleep is hallmark (cross-link Sleep). Compared with Gelsemium (weakness, incoordination), Sulphonal adds the renal-haemoglobinuric signature; compared with Chloral. (drugged sleep), Sulphonal strikes deeper into motor control and kidneys [Clarke], [Hughes]. [Toxicology][Clinical]

Aetiology / Drug-states

• Chloral. — Drugged sleep with depression; less ataxia/urinary change than Sulphonal; Chloral. shows more cutaneous vaso-motor effects [Clarke], [Hughes].
• Op. — Profound sopor with insensibility and retention; Sulphonal has unrefreshing sleep alternating with wakefulness, plus ataxia and smoky urine [Kent], [Clarke].

Mind / Sleep

• Coffea — Wide-awake from mental excitation; no stupor or morning cloud; Sulphonal alternates insomnia with heavy, unrefreshing sleep [Kent], [Clarke].
• Passifl. — Soothing insomnia (herbal) without the toxic ataxia/urinary imprint; Sulphonal indicated where smoky urine and morning stupor co-exist [Boericke].

Organ Affinity — Neuromuscular / Ataxia

• Gels. — Tremulous weakness, incoordination, drooping eyelids; lacks haemoglobinuria and the dusky blood tone of Sulphonal [Kent], [Clarke].
• Pic-ac. — Spinal exhaustion and unsteady legs with mental fag; urine changes not a keynote as in Sulphonal [Hughes], [Clarke].

Urinary / Blood

• Tereb. — Haematuria/haemoglobinuria with smoky urine and backache; less mental cloud/ataxia than Sulphonal [Clarke], [Hughes].
• Canth. — Intense vesical tenesmus and burning; chemical urine changes secondary; Sulphonal: less tenesmus, more albumin/haemoglobin with stupor [Allen], [Clarke].
• Merc-cor. — Nephritic albuminuria with erosive dysuria; Sulphonal is blander locally, more “drugged” generally [Hughes], [Clarke].
• Ars. — Collapse, restlessness, prostration; urine may be scant; Sulphonal adds ataxia and characteristic unrefreshing sleep pattern [Kent], [Clarke].

Modalities / Generals

• Ph-ac. — Mental apathy, morning weakness after loss; sleep is light but not the drug-stupor of Sulphonal; urine changes not central [Nash], [Kent].
• Nux-v. — Sleepless from business worry with morning irritability; lacks ataxia and smoky urine; Nux more gastric spasmodic than atonic [Kent], [Clarke].

• Complementary: Gels. — Both share incoordination and tremulous weakness; Sulphonal adds renal/urine signs; may follow in drug-induced ataxia states [Kent], [Clarke].
• Complementary: Tereb. — Unites well where smoky urine with backache predominates; Sulphonal covers the drugged stupor element [Clarke], [Hughes].
• Follows well: Coffea — After over-excited sleeplessness subsides into heavy, unrefreshing slumber with morning cloud, urine smoky [Kent], [Clarke].
• Follows well: Nux-v. — In nervous, over-drugged patients where stomach irritability improves but atony/insomnia pattern persists [Kent].
• Precedes well: Passifl. — In convalescence when sleep needs gentle support without deep stupefaction [Boericke].
• Antidotes (drug state): Coffea, Nux-v. — Counteract some nervous and gastric facets of soporific overmedication [Kent], [Clarke].
• Related (drug picture): Chloral. — Similar “artificial sleep” theme; not usually compatible in alternation; use for differentiation [Clarke], [Hughes].
• Compare: Pic-ac., Ph-ac. — Exhaustion remedies for protracted mental/sexual drain where urine lacks Sulphonal’s smoky/albuminous stamp [Hughes], [Nash].

• Insomnia with heavy, unrefreshing sleep alternating with wakeful anxiety; morning stupefaction a keynote. Consider when ordinary “nervous” remedies (Coffea, Nux-v.) leave a drugged atony and incoordination behind [Clarke], [Kent].
• Smoky or brownish urine with albumin/haemoglobin and lumbar aching after sedative drugging or prolonged sleep cures; pair with renal modalities (better warmth/rest) [Clarke], [Allen].
• Ataxic staggering on first rising, especially after nights of broken, “useless” sleep; fresh air and lying still help [Clarke], [Hughes].
• Potency/use: older clinicians used 3x–6x for toxicologic spheres and urine changes; higher potencies (30C and upwards) may be selected for sleep pattern and mind-state, titrated to sensitivity [Boericke], [Clarke].
• Repetition: In acute drug-states, short series with close observation; in chronic insomnia patterns, dose sparingly and review after sleep quality stabilises [Clarke], [Dewey].

Mini-pearls

• Case: Insomnia of weeks; finally sleeps, but awakens more muddled than before; morning urine smoky—Sulfon. 3x cleared urine and head, then sleep normalised [Clarke].
• Case: Ataxic tottering on rising after nights of broken, heavy sleep; better in fresh air—Sulfon. 30C steadied gait and restored morning clarity [Hughes].
• Case: Albuminous urine with lumbar ache post-sedative; warmth to loins relieves—Sulfon. 6x with regimen improved both urine and back pain [Allen].

Mind

• Mind; dullness; morning; on waking — heavy, clouded onset to the day [Clarke].
• Mind; indifference; apathy — “drugged” unconcern [Clarke].
• Mind; anxiety; night; in bed — restlessness preventing onset of sleep [Kent], [Clarke].
• Mind; answers; slow; comprehension difficult — delayed response under stupor [Clarke].
• Mind; fear; to move; lest he fall — mental echo of ataxia [Clarke].
• Mind; weakness of will — effort to initiate tasks [Allen].

Head

• Head; pain; forehead; morning; on waking — dull frontal stupefaction [Clarke].
• Head; vertigo; on rising; staggering — veering gait, first steps worst [Clarke], [Hughes].
• Head; congestion; in close room; agg. — better in fresh air [Clarke].
• Head; heaviness; eyelids heavy — cannot think till midday [Clarke].
• Head; better; after vomiting — gastric relief clears head [Boericke], [Clarke].
• Head; motion; aggravates — must lie still [Clarke].

Stomach

• Stomach; nausea; morning — frequent with head symptoms [Boericke].
• Stomach; vomiting; relieves — removes gastric oppression and head pain [Boericke], [Clarke].
• Stomach; appetite; diminished — aversion to rich/fatty food [Boericke].
• Stomach; eructations; tasteless — atonic flatness [Boericke].
• Stomach; heaviness; after eating — slow digestion [Clarke].
• Stomach; food; fat; aggravates — late meals provoke nausea [Boericke].

Urinary

• Urine; albuminous — renal involvement [Clarke].
• Urine; haemoglobinuria (smoky, brown) — keynote toxic stamp [Hughes], [Clarke].
• Urination; scanty — diminished output with dark colour [Allen].
• Pain; kidneys; aching; standing agg.; warmth amel. — lumbar modalities [Allen], [Clarke].
• Urine; casts; presence of — tubular strain [Clarke].
• Urethra; burning; during micturition — irritative edge to drug state [Allen].

Sleep

• Sleep; unrefreshing — “useless” heavy sleep [Clarke].
• Sleep; sleeplessness; from mental activity; night — cannot switch off [Kent], [Clarke].
• Sleep; stupor; difficult arousing — drug-like torpor [Clarke].
• Sleep; daytime; short naps; amel. — brief naps help [Clarke].
• Waking; morning; stupefaction — slow start, ideas sluggish [Clarke].
• Dreams; anxious; indistinct — troubled or blank [Clarke].

Extremities

• Gait; staggering; veering; cannot walk straight — Sulphonal gait [Clarke], [Hughes].
• Weakness; lower limbs; on exertion — easily tired [Hughes].
• Trembling; hands; slight — uncertain grasp [Clarke].
• Coldness; hands, feet; with hot head — circulatory imbalance [Clarke].
• Better; lying still — motion aggravates incoordination [Clarke].
• Worse; on rising — first steps most uncertain [Clarke].

Generalities

• Generalities; weakness; morning; on waking — prostrated outset [Clarke].
• Generalities; worse; exertion — breathless, tremulous [Hughes].
• Generalities; room; warm, close; aggravates — oppression rises [Clarke].
• Generalities; open air; amel. — clears head and chest [Clarke].
• Generalities; drugging; after; complaints — classic post-sedative pattern [Clarke], [Hughes].
• Generalities; lying; amel. — stillness steadies [Clarke].

Clarke — A Dictionary of Practical Materia Medica (c. 1900): toxicology and clinical confirmations (ataxia, smoky urine, unrefreshing sleep).
Hughes — A Manual of Pharmacodynamics (late 19th c.) and related writings: pathophysiological notes (methaemoglobin, renal effects) and drug comparisons.
Hughes & Dake — Cyclopaedia of Drug Pathogenesy (1885–92): collated toxicology/clinical records for newer drugs.
T. F. Allen — Handbook of Materia Medica and Homeopathic Therapeutics (1892): clinical pointers and urinary sphere notes.
Boericke — Pocket Manual of Homeopathic Materia Medica (1901): concise remedy outline, dosage guidance, gastric/urinary notes.
Kent — Lectures on Homoeopathic Materia Medica (1905): comparative insights (Coffea, Opium, Gelsemium) used here for differentiation.
Nash — Leaders in Homoeopathic Therapeutics (1899): general comparative indications (Ph-ac., Nux-v.) applied in differentials.
Dewey — Practical Homoeopathic Therapeutics (early 20th c.): prescribing cautions and repetition strategies cited in Clinical Tips.
Farrington — Clinical Materia Medica (late 19th c.): broader comparative frames for drug-induced states (used in differentiation tone).
Boger — Synoptic Key of the Materia Medica (1915): general analysis framework applied to modalities and generals for drug states.