• Large intestine / rectum — dysentery with tenesmus, copious white-to-yellow jelly-like mucus, burning and rawness post-stool (see Rectum, Abdomen) [Clarke], [Hering], [Allen].
• Umbilical region — cutting, griping colic focused round the navel; pressing the navel or bending double relieves (see Abdomen) [Clarke], [Allen].
• Sigmoid/left lower abdomen — crampy pain with frequent small stools; straining disproportionate to quantity (see Rectum) [Hering].
• Stomach — nausea with empty, sinking epigastrium; stool urging after slight food (see Stomach, Food & Drink) [Allen], [Boericke].
• Portal circulation — “bilious” headache with coated tongue around attacks (see Head, Mouth) [Clarke].
• Anus and perineum — burning, smarting, raw soreness after stool; itching margins (see Rectum, Skin) [Hering], [Clarke].
• General mucosae — catarrhal tendency with stringy mucus; less respiratory than intestinal, but pattern mirrors sycotic discharge state (see Generalities) [Clarke], [Hughes].

• Pressure on the abdomen (hand, band, or lying on the belly); relieves umbilical griping (see Abdomen) [Clarke], [Allen].
• Bending double / drawing up knees; eases colic and straining (see Abdomen, Rectum) [Hering].
• Warmth to the belly (hot applications, warm drink); soothes cramp and rectal burning (see Abdomen, Rectum) [Clarke].
• After copious passage of mucus; temporary relief of pain and tenesmus (see Rectum) [Allen].
• Rest and avoidance of food during acute attacks; reduces urging (see Stomach, Food & Drink) [Boericke].
• Sipping warm water; quiets nausea/colic (see Stomach) [Clarke].
• Open bowels in the morning; the day may go easier after early evacuation [Clarke].
• Gentle rubbing round the navel; palliative for the cutting pains [Allen].

• Night; after midnight toward early morning — stools and tenesmus recur in paroxysms (see Rectum, Sleep) [Clarke], [Hering].
• Before breakfast / after slight eating — the least food or drink provokes urging (see Stomach, Food & Drink) [Allen], [Boericke].
• Cold exposure / cold drinks — chills the bowel; increases cramp and mucus (see Abdomen) [Clarke].
• Autumnal weather / damp chill — seasonal dysentery picture (see Generalities) [Clarke], [Hughes].
• Motion and walking upright — jarring aggravates umbilical pains (see Abdomen) [Hering].
• After coffee or rich food — gastric irritability and urging (see Food & Drink) [Allen].
• During stool — burning, smarting at anus; straining with little result (see Rectum) [Clarke].
• Soon after the previous stool — fruitless re-tenesmus; repeated small passages (see Rectum) [Hering], [Allen].

Irritable, fretful, and anxious during paroxysms; the constant urging and burning soreness make the patient impatient of questioning and movement [Clarke]. There is a peculiar fear to eat or drink because “it will bring on the urging,” which produces a cautious, wary demeanour around mealtimes (cross-links Food & Drink, Stomach) [Allen], [Boericke]. During the night attacks the patient is restless, apprehensive, and preoccupied with the rectal spasm—sleep cannot be maintained (see Sleep). Relief after a free evacuation brings a short-lived calm and clearer head, returning to irritability as soon as re-tenesmus begins [Hering]. Children become peevish, draw up the knees, and cry before stool; they quiet if the belly is pressed or warmed (modalities reproduced) [Clarke]. A dull, depressed tone may persist through the day in autumnal cases, mirroring the mucosal catarrh; yet mental symptoms are secondary to the severe intestinal–rectal focus [Clarke], [Allen]. [Clinical]

A bilious, heavy headache may accompany the bowel disturbance, with a coated tongue and slight nausea [Clarke]. The head throbs during violent straining and quiets when the tenesmus intermits (cross-reference Rectum). Vertigo on rising too quickly is noted after a bad night. Occipital ache from bending double eases if the abdomen is supported (echo Better bending double). The face looks drawn and anxious during the worst colic; the expression brightens after a copious mucous discharge [Hering], [Clarke]. [Clinical]

Slight conjunctival injection in nocturnal paroxysms; lids feel heavy after broken sleep. Vision blurs transiently with straining; there is no distinctive ocular keynote beyond fatigue [Hering]. [Clinical]

Dull ringing during violent urging, from vascular strain; hearing otherwise normal and not a prescribing centre for this remedy [Clarke]. [Clinical]

Occasional watery coryza in damp, autumnal weather accompanying the gut catarrh; sneezing strains the umbilical region and is avoided (micro-comparison: Dulc. has autumnal catarrh but far less rectal tenesmus) [Clarke], [Hughes]. [Clinical]

Pallid or sallow with drawn features during colic; lips dry; perioral sweat during violent straining [Clarke]. Heat of face with chilly limbs (see Chill/Heat/Sweat). [Clinical]

Tongue coated white or yellowish; bitter or flat taste on waking after night attacks [Allen], [Clarke]. Much saliva before stool; thirst variable—often for small warm sips, which soothe the stomach (ties to Better warm drinks). [Clinical]

No special dental keynotes; children may grind teeth during abdominal pain from nervous irritation (colic-driven bruxism), settling when the belly is pressed warm [Hering]. [Clinical]

Sense of dryness or scraping when fasting from fear of stool; warm water relieves; swallowing cold fluids may chill the epigastrium (cross-link Food & Drink). [Allen]. [Clinical]

Nausea with empty, sinking sensation; the least food awakens urging to stool, so that patients dread breakfast (exactly echoing worse before breakfast / after slight eating) [Allen], [Boericke]. Eructations are tasteless, sometimes hot; vomiting is uncommon and, if present, is secondary to excessive straining. Epigastric tenderness is slight compared with umbilical pain; warm drinks and local heat comfort the stomach (see Modalities). Compare Ipecac. (nausea constant, clean tongue, little relief after stool) and Nux-v. (gastric spasm with irritability, but stool relieves less and rectal burning is milder than Trom.) [Hering], [Clarke]. [Clinical]

Centre of action. Griping, cutting, contractive pains about the umbilicus, often radiating in a ring, better by hard pressure, bending double, and warmth [Clarke], [Allen], [Hering]. The abdomen is sensitive to jarring; the patient walks bent, with the hand pressed over the navel. Much borborygmus and gurgling precede stool; flatus is difficult during tenesmus and passes afterwards with relief. The left iliac/sigmoid region is crampy; small, frequent stools afford partial ease then re-tenesmus returns. Cold drinks aggravate; warm applications (hot water bag) soothe. Compare Coloc. (colic better bending double but with green stool and less mucus), Merc-cor. (tenesmus with bloody shreddy stools, intense anal rawness and great prostration), and Aloe (sudden urging with jelly-like mucus but less umbilical focus) [Clarke], [Hering], [Allen]. [Clinical]

Irritative urging from pelvic congestion may attend rectal crises; urine otherwise not characteristically altered. Burning urine suggests intercurrent Canth. rather than Trom. when pronounced [Clarke]. [Clinical]

Dysenteric picture: frequent urgent urging with tenesmus before, during, and after stool; stool small, often composed chiefly of white-to-yellow, jelly-like mucus, sometimes streaked with blood [Clarke], [Hering], [Allen]. Burning, smarting, and raw soreness at the anus are marked; the margin may itch and feels swollen. Each evacuation brings brief relief, then renewed spasm compels another ineffectual effort—re-tenesmus. Passing a larger quantity of mucus gives the most relief (echo Better after copious mucus). The sphincter feels cramped; sitting exacerbates the sense of fullness and heat. Children cry, draw up the knees, and bore the fist upon the belly; adults pace, bend double, and seek warmth. Compare Nux-v. (straining with scanty stool, irascibility; less jelly-mucus), Ratanhia (knife-like fissure pain rather than mucous flux), Canth. (tense vesical/rectal burning with urine symptoms), Merc-cor. (bloody dysentery, intense sensorial depression) [Clarke], [Hering], [Allen], [Boericke]. [Clinical]

Tenesmus spills into perineal aching; scrotal itching from anal moisture; sexual symptoms not characteristic [Clarke]. [Clinical]

Dysenteric episodes around menses possible; pelvic dragging with rectal spasm; leucorrhoea not a keynote. Post-partum rectal catarrh with mucus may respond if the Trom. modalities are present [Hering]. [Clinical]

Quickened during colic; better after evacuation; desire for warm cover over the belly rather than overall heat [Clarke]. [Clinical]

Palpitations during straining in sensitive persons; soon pass when pain abates [Clarke]. [Clinical]

Sighing with colic; respiration shallow during spasms; there is no fixed pulmonary keynote [Clarke]. [Clinical]

Sacral ache with tenesmus; lumbar muscles tighten to aid bending double; warmth to the small of back eases pelvic spasm [Hering]. [Clinical]

Knees drawn up in bed; thighs pressed upon belly; weakness after repeated stools; cold feet with hot anus (thermal inversion) [Clarke]. [Clinical]

Anus and perineal skin excoriated by acrid mucus; itching margins with burning after scratching (modal rebound). Occasionally small urticarial papules round the buttocks and thighs during attacks—an extension of mucosal irritation to skin [Hering], [Clarke]. [Clinical]

Broken by urging; worst after midnight toward morning; patient dozes between paroxysms, starting when a new wave of umbilical colic rises (ties directly to Modalities) [Clarke], [Hering]. Children cry, toss, and curl up; adults dread sleep lest the next urge awaken them. After a freer morning stool, sleepiness by day from exhaustion follows. [Clinical]

Disturbing dreams of being pursued to a privy or of fruitless efforts; anxious dreams terminate in waking with cramp and urgent desire for stool [Clarke]. [Clinical]

In acute dysentery a slight evening rise with chills down the back; heat localised to face and anus; sweat after a freer stool brings transitory ease [Clarke]. [Clinical]

Chilly with abdominal pains, yet craves local warmth to the belly; heat aggravates anal burning but relieves cramp if applied over umbilicus; sweat clammy after efforts, non-offensive [Clarke], [Hering]. [Clinical]

Worse from the least food—especially breakfast; coffee and rich dishes provoke urging; cold drinks aggravate colic; better for warm drinks in sips and fasting lightly during the acute period [Allen], [Boericke], [Clarke]. [Clinical]

Signature of intestinal catarrh with umbilical colic and tenesmus, worse at night, worse after slight food, better bending double, pressure, and warmth. Discharges are mucous, jelly-like, sometimes blood-streaked. The patient is chilly, irritable, and weary from broken nights; the anus is burning and raw. Differentially, think between Merc-cor. (bloody shreddy stools, great prostration), Nux-v. (straining sans mucus keynote), Aloe (sudden urging with jelly-mucus but more rectal weakness/prolapsus), and Coloc. (colic better bending double, less tenesmus/mucus) [Clarke], [Hering], [Allen], [Boericke]. [Clinical]

Dysentery / Tenesmus

• Merc-cor. — Intense tenesmus with bloody, shreddy stools and great prostration; Trom. has more jelly-mucus, umbilical focus, and relief by warmth/pressure [Hering], [Clarke].
• Nux-v. — Straining with scanty stool, irritable, chilly; less jelly-mucus, more gastric spasm and rectal hyperaesthesia than Trom. [Allen], [Clarke].
• Ipec. — Constant nausea, clean tongue, stools greenish with mucus; tenesmus less marked; Trom. has umbilical cutting better pressure [Hering].
• Aloe — Sudden urging, jelly-like mucus, rectal weakness, involuntary stool/flatus; less umbilical ring-pain than Trom. [Clarke], [Allen].
• Ratanhia — Knife-like fissure pain and burning after stool with constipated habit; Trom. has frequent mucous passages [Clarke].
• Canth. — Burning from mouth to anus, urinary tenesmus; in Trom. urinary sphere is quiet, bowel mucus leads [Hering].

Umbilical Colic

• Coloc. — Colic better bending double; stools not especially mucous; Trom. ties colic to dysenteric mucus [Hering].
• Diosc. — Pain better bending backwards, not double; stool less tenesmic; helps to differentiate posture-modalities [Clarke].

Seasonal / Weather

• Dulc. — Autumnal catarrh (respiratory/urinary/skin); bowels less tenesmic; Trom. is intestinal-centric [Hughes], [Clarke].

• Complementary: Aloe — When Trom. clears the tenesmus + mucus yet residual rectal weakness/urgency persists [Clarke].
• Complementary: Ratanhia — Follows when fissural burning remains after mucous dysentery abates [Clarke].
• Follows well: Ipec., Nux-v. — After acute gastric/rectal spasm is reduced but umbilical colic with jelly-mucus continues [Allen], [Hering].
• Precedes well: Merc-cor. — If case turns frankly bloody with membrane shreds and collapse; shift shows change of state [Hering].
• Inimical/Compare: Canth. — Strong urinary/vesical overlap may mislead; reserve for urinary tenesmus pictures [Hering].
• Related (kingdom): Other arthropod remedies (Acarus, Pediculus, Apis) share burning/itching cutaneous themes, but Trom. is intestinally focused [Clarke], [Hughes].

• Dysentery/enterocolitis with jelly-like mucus, tenesmus before/during/after stool, and umbilical cutting better pressure and warmth: think Trom. early—especially in autumnal outbreaks [Clarke], [Hering].
• Meal-provoked urging: the least food brings on a stool; many cases improve by fasting lightly for a day and sipping warm fluids alongside Trom. (3x–6x or 12C–30C according to sensitivity) [Allen], [Boericke].
• When mucus and tenesmus subside yet fissural burning persists, interpose Ratanhia; if rectal weakness/prolapsus remains, consider Aloe (complementary sequence) [Clarke].
• Paediatric colic with mucous stools: child curls up, draws knees, cries before stool; warmth/pressure soothe—Trom. often shortens the course [Hering].
• Repetition: in acute dysentery, dose at short intervals until tenesmus eases; then lengthen intervals. Watch for a shift to bloody, shreddy stools—if so, re-evaluate towards Merc-cor. [Hering], [Dewey].

Mini-pearls

• Case: Autumn dysentery, stools like white jelly, violent umbilical cramps better pressure—Trom. 6x every 2 hours; by morning a freer stool and marked reduction of tenesmus [Clarke].
• Case: Child with night paroxysms, urging after sips of milk, knees drawn up—Trom. 12C; sleep returned, stools lost mucus in 24–36 h [Hering].
• Case: Adult with coffee-triggered urging and rectal burning—Trom. 30C cleared meal-provoked tenesmus; later Ratanhia for fissure-like soreness [Allen], [Clarke].

Mind

• Mind; irritability; during pains; abdominal — fretful under umbilical colic [Clarke].
• Mind; fear; to eat; from aggravation of complaints — least food brings urging [Allen].
• Mind; anxiety; night; during diarrhoea — nocturnal paroxysms [Clarke].
• Mind; restlessness; during tenesmus — cannot keep still between urges [Hering].
• Mind; peevishness; children; during colic — soothed by warmth/pressure [Hering].

Head

• Head; pain; bilious; with gastric/intestinal catarrh — coated tongue, malaise [Clarke].
• Head; heaviness; during straining — congestive effort [Clarke].
• Head; vertigo; on rising; after broken sleep — nocturnal disturbance [Hering].
• Face; expression; drawn; with abdominal colic — improves after stool [Clarke].
• Mouth; tongue; coated; yellowish; during enteritis — digestive catarrh [Allen].

Stomach

• Stomach; nausea; with empty, sinking feeling — dread of food [Allen].
• Stomach; aggravation; after the least food; breakfast; before — meal-triggered urging [Allen], [Boericke].
• Stomach; drinks; cold; aggravate — chills bowel and colic [Clarke].
• Stomach; drinks; warm; ameliorate — comfort from warmth [Clarke].
• Stomach; eructations; tasteless — catarrhal state [Allen].

Abdomen

• Abdomen; pain; umbilicus; around; cutting; cramping — central keynote [Clarke], [Hering].
• Abdomen; pressure; hard; ameliorates — presses with hand/band [Allen].
• Abdomen; bending double; ameliorates — posture relief [Hering].
• Abdomen; warmth; external; ameliorates — hot applications [Clarke].
• Abdomen; motion; aggravates — jarring increases pain [Hering].
• Abdomen; borborygmus; before stool — noisy precursor [Allen].

Rectum

• Rectum; tenesmus; before, during, after stool — persistent spasm [Hering], [Clarke].
• Stool; mucus; jelly-like; white or yellow; with blood streaks — hallmark discharge [Clarke], [Allen].
• Anus; burning; after stool; rawness — intense post-evacuation soreness [Hering].
• Rectum; urging; frequent; small stools — repeated paroxysms [Allen].
• Rectum; re-tenesmus; soon after stool — fruitless return [Hering].
• Anus; itching; margin; with moisture — excoriation from acrid mucus [Clarke].

Sleep

• Sleep; disturbed; after midnight; by urging to stool — nightly paroxysms [Clarke].
• Sleep; position; on abdomen; prefers — pressure eases pain [Allen].
• Sleep; restless; drawing up knees — posture relief in bed [Hering].
• Waking; frequent; with colic — cyclic urging [Clarke].
• Somnolence; day; after night diarrhoea — exhaustion [Clarke].

Generalities

• Generalities; food; least; aggravates complaints — meagre intake triggers stool [Allen].
• Generalities; pressure; ameliorates — hand/band over navel [Clarke].
• Generalities; warmth; external; ameliorates — hot applications help [Clarke].
• Generalities; cold; drinks; aggravate — chills bowel [Clarke].
• Generalities; season; autumn; aggravates — seasonal dysentery [Clarke], [Hughes].
• Generalities; night; after midnight; aggravates — timing hallmark [Clarke].

Clarke — A Dictionary of Practical Materia Medica (c. 1900): primary clinical portrait (dysentery, jelly-mucus, umbilical colic, modalities).
Hering — The Guiding Symptoms of Our Materia Medica (1879–91): rectal/umbilical keynotes, re-tenesmus, posture relief, paediatric notes.
T. F. Allen — Handbook of Materia Medica and Homoeopathic Therapeutics (1892): meal-provoked urging, mucus character, modalities, gastric–rectal axis.
Boericke — Pocket Manual of Homoeopathic Materia Medica (1901): concise indications for dysentery/enteritis with mucus, potency hints.
Hughes — A Manual of Pharmacodynamics (late 19th c.): toxicologic and seasonal catarrh correlations; arthropod remedy comparisons.
Boger — Synoptic Key of the Materia Medica (1915): generals and modalities framework applied to tenesmus–mucus states.
Farrington — Clinical Materia Medica (1890s): differentiations—Coloc., Aloe, Merc-cor., Nux-v.—in intestinal colic/dysentery.
Nash — Leaders in Homoeopathic Therapeutics (1899): practical contrasts for dysenteric remedies (tenesmus patterns).
Dewey — Practical Homoeopathic Therapeutics (early 20th c.): acute bowel therapeutics, repetition strategies.
Tyler — Homoeopathic Drug Pictures (early 20th c.): comparative portraits referenced for synthesis of small intestinal remedies.
Phatak — Concise Repertory of Homoeopathic Medicines (20th c.): modality indexing (pressure, warmth, night), rectal sphere cross-checks.
Boger–Boenninghausen — Therapeutic Pocket Book tradition: rubric style and modality weighting adapted to intestinal catarrh pictures.