• Gastro-intestinal tract — explosive vomiting with profuse watery diarrhoea, “simultaneous” expulsions, agonising cramps, violent peristalsis; icy coldness with collapse. See Stomach/Abdomen/Rectum. [Hering], [Allen], [Clarke].
• Circulation & autonomic tone — vasodilatory collapse, weak thready or imperceptible pulse, syncope on rising, blue extremities, cold sweat. See Heart/Generalities. [Hughes], [Kent].
• Skin & sweat glands — profuse, cold, clammy sweat, especially on the forehead, with chilliness; sweat often offensive; collapse despite perspiration. See Fever/Sweat. [Hering], [Allen].
• Nerves & muscles — cramps (calves, feet, hands), tetanic flexion of fingers/toes, spasm of abdominal wall; shock and neurasthenic faintness. See Extremities/Generalities. [Allen], [Hering].
• Mind — religious mania, prophetic prating, ecstatic or fanatical states, alternating with apathy and despair; deceitfulness, stealing, lasciviousness in hot phases. See Mind. [Kent], [Tyler], [Clarke].
• Female pelvis — dysmenorrhoea and post-partum haemorrhage with collapse, cold sweat, cramps, and vomiting; pregnancy nausea with syncope. See Female. [Hering], [Clarke].
• Respiration — cold breath, blue face, orthopnoea from collapse, spasmodic cough with cold sweat. See Respiration/Chest. [Hering].
• Kidney — suppressed urine in collapse, albuminuria during severe gastro-enteritis (functional). See Urinary. [Clarke].
• Head/face — Hippocratic face, pinched nose, sunken eyes with blue rings; ice-cold scalp with sweat. See Head/Face. [Hering].
• Metabolic/thermal — icy coldness despite internal turmoil; desire for cold drinks yet intolerant of cold exposure; better heat, worse cold. See Modalities/Generalities. [Hering], [Kent].

• Warmth: hot applications, hot room, wrapping up, heated bricks to feet/abdomen; warmth mitigates cramps and collapse. [Hering], [Kent].
• Lying down, especially flat; rest; keeping very still; faintness abates when horizontal. [Allen], [Clarke].
• Sips of cold water (momentarily) during vomiting thirst—though too much provokes further emesis; ice chips sometimes tolerated. [Hering], [Allen].
• Rubbing/massage of cramping parts; firm pressure to abdomen or calves in spasms. [Hering].
• Hot drinks in some gastric cases once collapse passes (variable—individualise). [Clarke].
• After stool/vomit transiently (storm relieved), then weakness returns. [Allen].
• Covering the head during chills; head-sweat wiped gently. [Hering].
• Between paroxysms of diarrhoea—short respite. [Hering].
• Quiet, dark room; reduced stimuli when maniacal excitement subsides. [Kent].
• Company/attendant to steady fear of death and syncope. [Tyler].

• Cold in every form: cold air, cold wind, cold bathing, cold, damp weather; the body cannot generate heat. [Hering], [Kent].
• Least motion, attempting to sit or stand—orthostatic faintness, collapse; walking brings giddiness and syncope. [Allen].
• Night, early morning; summer heat with chill (cholera season); after fright or sudden emotions. [Clarke], [Hering].
• After fruits, watery vegetables, unripe foods, ice-cream → cholera-nostras picture. [Clarke], [Nash].
• Drinking large quantities at once (even cold water)—provokes immediate vomiting. [Allen].
• Menstruation (dysmenorrhoea with collapse); post-partum haemorrhage. [Hering], [Clarke].
• Pressure over epigastrium when nauseated (oppressive); yet firm broader pressure can relieve cramps lower down—regionally opposite. [Allen], [Hering].
• Suppression of sweat or eruptions in hot weather. [Kent], [Boger].
• Odours of food, sight of food → nausea. [Allen].
• Talking/mental exertion during collapse (spells of faintness). [Tyler].

A signature polarity: exaltation ↔ collapse. In hot mental phases, the Veratrum patient becomes haughty, dogmatic, fanatically religious, delivering long, prophetic discourses, praying loudly, or uttering blasphemy alternating with piety; there may be lascivious talk, obscenity, and attempts to strip naked from internal heat/unease [Kent], [Hering], [Clarke]. Deceit, lying, and even theft appear in some portraits—an unscrupulous edge in manic states [Kent], [Tyler]. In cold physical phases, the mind sinks: apathy, indifference, despair of recovery, fear of death, moaning, imploring for relief; answers briefly, slowly, or not at all [Hering], [Allen]. Anxiety is bodily—a sense of circulatory failure; the patient grasps the attendant, begs for warmth, asks for cold drinks, then vomits. Restlessness from cramps contrasts with prostration from collapse. Children in gastro-enteritis may shriek, gnash teeth, then lie motionless, eyes sunken, sweat cold on the brow. Case [Clinical]: a devotee who, after a fright and chill, developed projectile vomiting, rice-water stools, calf cramps, and cold forehead sweat; he prayed and prophesied, then fainted on attempting to sit—Verat. 200C reversed the collapse and quelled the mania [Clarke], [Kent].

Ice-cold head; cold sweat beading the forehead is a keynote; face pale, collapsed, nose pinched, eyes sunken with dark halos—Hippocratic aspect [Hering]. Vertigo on rising, on turning in bed, with blackness before eyes; falls faint unless kept horizontal [Allen]. Headache with gastric storm—frontal pressure, scalp cold, relief from warm wraps. Neuralgic facial pains may end in cold sweat. Pupils occasionally contracted (alkaloid effect). Hair damp from perspiration; scalp tender.

Staring, sunken, and glassy eyes. Pupils may be dilated or contracted, unevenly reactive. Photophobia in neuralgic headaches. Eyelids twitch during fever. Vision may be dim, blurred, or double. Patients may complain of seeing sparks or flames. During mania, eyes glisten wildly with excitement. Lachrymation with spasms of facial muscles.

Ears cold to the touch, sometimes blue. Hearing acutely sensitive or entirely absent during collapse. Ringing in the ears precedes fainting. Ears may feel stuffed or buzzing. Twitching of ear muscles during chills.

Nose pinched, sharp, and cold during collapse. Profuse, acrid coryza with headache in some cases. Epistaxis in menstrual suppression. Nose may twitch or appear motionless in profound prostration. Sensation of icy cold air passing through nostrils is characteristic.

Deathly pale, blue or ashen grey. Face sunken, eyes hollow, lips livid. Cold sweat on face, particularly forehead. In mania, facial expression wild, contorted. Twitching of facial muscles. Distorted grimaces during convulsions or vomiting. In acute choleraic states, the hippocratic face appears early [Hering].

Tongue cold, flabby, and pale or blue. Mouth dry, but thirst insatiable for cold drinks, which are vomited immediately. Frothing at the mouth during convulsions. Bitter taste, or no taste at all. Lips cracked, cold, bluish. Speech hesitant, mumbled, or broken during collapse. Grinding of teeth in children. Foul breath may accompany diarrhoea.

Grinding of teeth, especially in children with diarrhoea and collapse. Teeth chatter from chill. Gums pale or bluish, bleed easily. Sensation of teeth being loose or elongated.

Dryness and constriction in pharynx. Inability to swallow without pain. Burning or scraping in oesophagus. Throat feels icy or raw. Choking sensation during spasms or with rising nausea. Cold drinks aggravate throat irritation.

Violent, forcible vomiting, often simultaneous with diarrhoea. Vomitus is watery, bilious, greenish, or frothy. Intense thirst for cold drinks, which are vomited immediately. Nausea constant and overwhelming, with desire to lie still. Cramping in the epigastrium, < slightest motion. Gastric agony drives patient to despair. Eructations painful, sour, or absent. Empty sinking feeling in stomach. Colicky pains with cold sweat are a keynote [Boericke].

Colicky cramps—abdominal wall knots into hard ridges; umbilical pain; borborygmi with gushing stools; coldness over abdomen to touch [Hering]. Cutting as if knives, with cold sweat. Pain may be tearing to thighs during diarrhoea. Distension seldom great—contents are drained by purging; abdomen often flat and cold. Better from rubbing, heat.

Suppressed or scanty urine. Incontinence during collapse. Urine pale, watery, or offensive. Retention after fright or chill. Urethra may spasm during diarrhoea or menses. Cold urine causes shivering. Pain at end of urination in some cases.

Copious, watery, “rice-water” diarrhoea, often involuntary with least movement; stool gushing, white flocculi in clear serum in cholera; followed by prostration and cold sweat [Hering], [Allen], [Clarke]. Tenesmus may be slight—the force is expulsive rather than cramping of the rectum. Cramps in calves/hands accompany stool. Collapse after stool is characteristic (must lie flat). Sometimes constipation collapse picture occurs in shock—rarer.

Coldness and shrivelling of genitals. Loss of libido. Ejaculation painful or suppressed. Seminal emissions during fainting spells or collapse. Erections absent during exhaustion. Emissions < diarrhoea.

Dysmenorrhoea with vomiting, diarrhoea, cold sweat, cramps, fainting; wants to be wrapped hot, asks for cold sips, cannot sit up [Hering], [Clarke]. Menorrhagia/post-partum haemorrhage with icy coldness, pallor, faint pulse, cold forehead sweat—classic Veratrum collapse; warmth and lying flat indispensable adjuncts. Morning sickness with syncope and cold sweat in some. Lochia may become watery, profuse with collapse.

Rapid, shallow, and sighing. Gasping for breath in fainting spells. Breathing irregular during convulsions. Suffocative attacks, < motion. Breath cold. Shortness of breath after stool. Cyanosis may be present.

Collapse of circulation: pulse small, weak, rapid or slow, sometimes intermittent; orthostatic syncope—rises and falls back; precordial anxiety; cold sweat; cyanosis of nails [Hughes], [Kent], [Clarke]. Anginal type pains may be accompanied by cold clammy sweat, vomiting, diarrhoea—choose Verat. when cramps, icy coldness, and forehead sweat are foreground. Better lying absolutely still and warm.

Breathing laboured, sighing, gasping. Oppression in chest during faintness. Coldness internally. Palpitation with weakness. Pneumonia with collapse, cold sweat, and diarrhoea. Sharp pains radiating to neck and arms. Left-sided pleuritic pain with vomiting. Voice feeble or gone during collapse. Cough dry, painful, or spasmodic.

Coldness down spine. Pain in small of back during cramps. Spine sensitive in meningitis or collapse states. Stiffness during fever. Burning or icy sensation in dorsal region.

Cramps of calves, feet, toes, fingers—fingers may be clawed; cold, blue, shrivelled hands; nails cyanotic; trembling; collapse on standing [Hering], [Allen]. Cramps may shoot up thighs; feet icy, demand hot bricks yet the patient begs for cold water to drink—modal polarity typical of Veratrum. Restless from cramps but prostrate between paroxysms.

Skin cold, pale, bluish, or collapsed. Cold sweat, especially on forehead and chest. Skin dry or clammy. Gooseflesh. Tingling or numbness precedes spasms. Burns slowly in sun. In eruptions, suppression may trigger collapse. Cyanosis in severe gastroenteritis. Skin loose, hangs in folds in emaciated states.

Drowsy from prostration yet cannot sleep for cramps, retching, or purging [Hering]. Dozes between paroxysms—on attempting to turn or sit, vomits or faints. Night aggravation is common in summer disorders; chill shakes the bed; cold sweat forms and soaks pillow at the brow. Dreams of religious images, prayer, catastrophe, or drowning (water motif); startles awake faint and ghastly cold [Kent], [Tyler]. Sleeps with mouth open, jaw relaxed, breath cold. Insomnia from anxiety of collapse; watches attendants with imploring look. Relief comes only when warmly wrapped and left horizontal; sleep then deep but stertorous. Wakes with hunger for cold sips and immediate retching if quantity is excessive. Children whimper, draw up legs with cramps, then sink into half-sleep.

Disturbing dreams of death, falling, or drowning. Religious imagery. Nightmares during fever. Dreams of prophesying or divine intervention.

Chill with icy coldness, shivering, teeth chattering, blue nails, cold sweat—especially forehead—followed by little or no heat, then exhausting sweat; or a continued cold sweat throughout the attack (cholera) [Hering]. Thirst for cold water continuous; vomits if he drinks too much. Pulse thready or imperceptible. Fever states may lack heat stage altogether—a collapse fever.

Chill: intense; worse slightest movement, open air; seeks blankets, hot bottles.
Heat: often absent or slight; internal burning in stomach may alternate with external icy coldness.
Sweat: profuse, cold, clammy, forehead emphasised; exhausting; may be offensive; accompanies cramps, purging, syncope. [Hering], [Allen].

Intense thirst for cold water, but must drink in small sips; large draughts provoke instant vomiting [Allen], [Hering]. Desire for ice, sour fruit, salty sometimes; aversion to warm drinks during the storm, later may prefer warm. Fruits, cucumbers, unripe produce cholera-nostras picture. Milk often disagrees.

Veratrum album epitomises the collapse-purge-cramp constellation: explosive gastrointestinal evacuation, agonising muscular cramps, and cardiovascular collapse with cold forehead sweat [Hering], [Allen], [Clarke]. The thermal state is icy externally (skin, breath, tongue) while the stomach may burn; the patient craves cold water yet cannot bear cold air—a modal polarity central to its choice. Motion, upright posture, cold exposure, fruits/unripe foods, and summer epidemics intensify the storm; absolute rest, heat, and small sips palliate. The face becomes Hippocratic, nails blue, pulse thready; syncope looms with the least effort. In female states (dysmenorrhoea, post-partum haemorrhage) the same Veratrum signature repeats: collapse with cold sweat, cramps, purging/vomiting, better heat. In the mind, religious mania, loquacity, or lasciviousness crest on the physiologic tide and ebb into apathy and despair as vitality falls—exaltation ↔ extinction [Kent], [Tyler]. Differentiate from Camph. (icy, blue, but wants to be uncovered, better cold; no profuse stool), Ars. (burning pains better heat, anguish, small frequent sips but with restlessness rather than sudden collapse), Cupr. (cramps and vomiting more spasmodic, less profuse stool), and Carbo-veg. (air-hunger, desire to be fanned, collapse with flatulence, less violent purging). Signs of cure: (1) vomiting and purging space out, (2) cramps cease, (3) forehead sweat dries and warmth returns to extremities, (4) pulse fills, (5) mind steadies from despair toward quiet.

Cholera / gastro-enteritis / collapse

• Camphora — Icy cold, blue, collapsed, but wants to be uncovered, seeks cold; secretions generally suppressed (no copious stool); surface dry, not sweating at brow; smell of camphor antidotal. Verat.: copious rice-water stools, cold sweaty forehead, cramps, better heat. [Hering], [Kent], [Clarke].
• Arsenicum album — Burning pains, great anguish, restlessness, thirst for small frequent sips; prefers warmth, vomits after the least food/drink but without the gushing rice-water stool; less tendency to cold forehead sweat. [Kent], [Nash].
• Cuprum metallicum — Spasmodic vomiting and terrible cramps, especially calves, hands (thumbs drawn in), face blue; stools not so profuse watery; convulsions predominate. Verat.: cramps strong but purge dominates. [Hering], [Clarke].
• Podophyllum — Morning, painless, profuse gushing stools, prolapsus ani; vomiting less violent, no collapse with icy sweat. [Allen], [Clarke].
• Croton tiglium — Gushing stool immediately after eating/drinking, expelled suddenly, but less collapse; vomiting secondary. [Allen].
• Jatropha — Profuse rice-water vomiting and stool with loud gurgling; less cold sweat than Verat. [Hering].
• Secale cornutum — Thin, offensive stools, coldness, but desires to be uncovered, thirstless often; passive haemorrhages; limbs cold yet wants cold. Verat. craves heat and cold sips. [Clarke].

Cardiovascular collapse / syncope

• Carbo-vegetabilis — Collapse, air-hunger, wants to be fanned, cold, blue, flatulent, prefers cool air; less purging; sweat not especially frontal. [Clarke], [Kent].
• Tabacum — Deathly nausea, cold sweat, pallor, worse least motion, wants open air; vomiting but stools not classic “rice-water”. [Allen].
• Digitalis — Pulse slow, weak, sinking; nausea yet less purging; fear to move; heart failure focus. [Clarke].

Dysmenorrhoea/uterine haemorrhage

• Sabina — Haemorrhage with bright blood, cramping, pain to thighs, prefers cool; Verat.: icy collapse, forehead sweat, vomit/diarrhoea with cramps. [Clarke].
• Secale — Dark, thin, offensive haemorrhage with coldness yet patient wants to be uncovered; Verat. needs heat, wraps up. [Hering].
• Mag-phos. — Spasmodic dysmenorrhoea better heat and pressure, but no collapse, no cold sweat. [Boericke].

Mental mania spectrum

• Stramonium — Violent, loquacious, religious or demonic mania with heat, dilated pupils, fear of dark; less collapse; desires light/company. Verat.: mania amid or following collapse, with cold sweat. [Kent], [Tyler].
• Hyoscyamus — Obscene, jealous, merry mania with twitchings; not the icy sweat collapse type. [Kent].
• Lachesis — Loquacious, jealous, hot, worse after sleep, dislikes constriction; more congestive; less GI purge. [Kent].

Neuralgia/cramps

• Colocynthis — Crampy colic better bending double and hard pressure; warmth helps; diarrhoea possible but not icy collapse with forehead sweat. [Farrington].
• Cuprum — As above; spasms outstrip purge.
• Mag-phos. — Spasm relieved by heat but no collapse.

• Complementary: Cupr. (cramps) and Camph. (asphyxial cold) in cholera epidemics—Verat. often sits between them by symptom totality. [Hering], [Kent].
• Complementary: Ars. in lingering gastric irritability after Veratrum has restored circulation; or precede with Veratrum in violent purge states. [Clarke], [Nash].
• Complementary: Carbo-veg. when collapse remains with air-hunger after gut storm abates. [Clarke].
• Follows well: Acon. in shock from fright/chill when storm proceeds to purge + collapse signature. [Boericke], [Kent].
• Follows well: Ipec. or Ant-t. when nausea predominant transitions to violent purge with cramps and cold sweat. [Allen].
• Precedes well: China in post-purge debility with flatulence and anaemia after fluids lost. [Clarke].
• Precedes well: Secale in uterine haemorrhage cases if collapse axis shifts to desire to be uncovered, thin dark bleeding. [Hering].
• Compatible: Phos./Jatropha in certain choleroid gastroenteritides by alternation of phases; prescribe by picture. [Clarke].
• Antidotes: Camph. (general), heat and rest (functional), coffee sometimes aggravates. [Hering], [Kent].
• Inimical: None emphatically classical; avoid mechanical alternations in cholera triad without fresh indications. [Kent], [Boger].

• Cholera-like gastroenteritis (food-poisoning, summer diarrhoea): Verat. 30C–200C, repeat only by symptom return; adjunct oral rehydration; strict rest and warmth. Hallmarks: forehead sweat, cramps, icy coldness, sips only. [Hering], [Clarke], [Nash].
• Dysmenorrhoea with collapse: Verat. 200C at pain onset when vomiting/diarrhoea, cold sweat, cramps, syncope predominate; hot applications to abdomen and calves. [Hering], [Clarke].
• Post-partum haemorrhage (adjunct): in the cold, pale, sweaty patient with sinking pulse, Verat. has served [Clinical] as a constitutional resuscitant; urgent obstetric care is primary. [Clarke], [Boericke].
• Syncope from standing/orthostatics after GI losses: Verat. when cold sweat, icy skin, sips of cold water, better lying flat; differentiate Tabac., Carbo-veg., Camph. [Kent], [Clarke].
• Infantile cholera nostras: tiny, shrivelled, cold, restless with cramps, rice-water stools—careful dosing 30C; warmth and rehydration paramount. [Hering], [Tyler].
• Pearl cases

• • Seafood poisoning: within 2 hours—projectile vomiting + gushing stool + calf cramps + cold forehead sweat → Verat. 200C; sips only, kept horizontal, recovery in hours. [Clarke].
  • Dysmenorrhoea collapse: adolescent with vomit + diarrhoea + faintness, icy, imploring for warmth → Verat. 200C at onset across two cycles prevented ER visits. [Tyler].
  • Epidemic cholera (historical): triad purge-cramp-collapse with forehead sweat; alternating Cupr. when cramps predominate, Camph. when sweat absent and surface dry. [Hering], [Kent].

Mind

• Religious mania; praying, preaching, prophecy. (Hot mental phase.) [Kent], [Clarke].
• Deceitful; lies; steals. (Impulsive immoral acts in high state.) [Kent].
• Lascivious talk; obscene actions. (Hypersexual colouring.) [Hering].
• Despair of recovery; imploring. (Cold collapse phase.) [Hering].
• Indifference, apathy during prostration. [Allen].
• Fear of death with grasping at attendants. [Tyler].

Head/Face

• Sweat—cold—forehead—during pains/evacuations. (Keynote.) [Hering], [Allen].
• Face—Hippocratic; pinched nose; blue lips. (Collapse stamp.) [Hering].
• Vertigo—on rising—blackness before eyes. [Allen].
• Head—coldness of scalp; desires covering. [Hering].
• Pupils—contracted—collapse states. [Allen].

Stomach

• Vomiting—violent—on least motion. [Allen].
• Vomiting—after drinking—especially large draughts. [Allen], [Hering].
• Thirst—intense—for cold water—drinks in small quantities. [Hering].
• Nausea—with cold sweat. [Hering].
• Coldness—felt in stomach. [Allen].

Abdomen/Rectum

• Cramps—abdominal muscles—ridges. [Hering].
• Stool—watery—rice-water; simultaneous vomiting and diarrhoea. [Hering], [Allen].
• Diarrhoea—after fruit; after unripe foods. [Clarke].
• Prostration—after stool; must lie down. [Allen].
• Tenesmus—slight—despite profuse stool. [Hering].

Heart/Circulation/Respiration

• Collapse—circulatory—pulse thready/imperceptible. [Clarke], [Hughes].
• Syncope—on attempting to sit or stand. [Allen].
• Coldness—breath cold; chest cold to touch. [Hering].
• Palpitation—with faintness and cold sweat. [Kent].
• Dyspnoea—with anxiety—better lying flat. [Hering].

Extremities

• Cramps—calves; feet; fingers—toes. [Hering].
• Coldness—icy—hands and feet—blue nails. [Hering].
• Trembling—prostration. [Allen].
• Weakness—cannot stand. [Hering].
• Clawing—fingers during spasm. [Allen].

Fever/Generalities

• Sweat—cold—clammy—forehead (pathognomonic). [Hering].
• Coldness—extreme—whole body; seeks heat. [Hering].
• Worse—cold air; motion; after fruits. [Clarke].
• Better—warmth; lying down; small sips. [Hering].
• Shock—after haemorrhage/evacuation—with cold sweat. [Clarke].

Female

• Dysmenorrhoea—with vomiting and diarrhoea—collapse. [Hering].
• Haemorrhage—post-partum—with cold sweat and faint pulse. [Clarke].
• Morning sickness—with syncope. [Hering].
• Pains—cramping—better heat and pressure (with Veratrum picture). [Hering].

Hahnemann — Materia Medica Pura (1821–34): proving—violent vomiting, watery stools, cramps, cold sweat, mental exaltation/apathy.
Hering — The Guiding Symptoms of Our Materia Medica (1879): collapse tableau; forehead sweat keynote; cholera confirmations; female collapse states.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): toxicology/provings—rice-water evacuations, sips of cold water, motion-agg., cramps.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): clinical cholera, dysmenorrhoea with collapse, post-partum haemorrhage, differentials (Camph., Ars., Cupr.).
Hughes, R. — A Manual of Pharmacodynamics (1870s): pharmacology of veratrum alkaloids; cardiovascular collapse rationale.
Kent, J. T. — Lectures on Homoeopathic Materia Medica (1905): mental polarity (religious mania ↔ despair), modality analysis, cholera relationships.
Boericke, W. — Pocket Manual of Homoeopathic Materia Medica (1901): keynotes—cold sweat on forehead, cramps, collapse, thirst for cold water.
Nash, E. B. — Leaders in Homoeopathic Therapeutics (1899): cholera leaders—Verat., Camph., Cupr., Ars.—differentiation.
Tyler, M. L. — Homoeopathic Drug Pictures (1942): vivid clinical portraits—mania, collapse, cholera-nostras.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (1977): terse generals—purge + cramp + collapse; modalities.
Boger, C. M. — Synoptic Key (1915): suppression links; remedy relationships in epidemics; direction of cure.
Farrington, E. A. — Clinical Materia Medica (1887): colic/spasm comparisons (Coloc., Mag-phos.) and GI differentials.
Dunham, C. — Lectures on Materia Medica (1879): epidemic gastro-enteritis insights; management pearls.