• Right upper extremity – especially shoulder joint, deltoid, and arm
• Nervous system – functional nervous disorders, excitability, twitching
• Respiratory system – spasmodic, dry, irritating coughs, especially in children
• Eyes and ears – tension and auditory disturbance
• Muscles and joints – tension, stiffness, and pain, especially in scapular and cervical regions
• Children’s complaints – cough, excitability, earaches, sleep issues

• Pressure
• Lying on painful part
• Gentle motion
• Warm applications
• Rest in a quiet environment
• After sleep
• Warmth, particularly of bed or clothing

• Cold air or draughts
• Change in weather, especially to cold and damp
• Nighttime (especially cough and shoulder pain)
• Lying on back
• Mental exertion or nervous excitement
• Coughing or deep inspiration
• Slight touch, though pressure relieves

Marked by nervous excitability, especially in children. There is an underlying restlessness, with frequent changes in mood and sensitivity to external stimuli. The patient may become anxious, particularly in the evening or at bedtime, accompanied by fear of being alone. Tendency to weep easily, or become oversensitive to emotional impressions. Children may appear precocious and highly sensitive—mentally active but physically weak [Clarke]. Sleep is disturbed by anxious dreams or involuntary twitching of muscles. Overactivity of the brain seems to overexcite the nerves, particularly seen in children with a persistent dry cough that worsens at night.

Heaviness in the forehead with pressing pains, especially above the eyes, often associated with visual disturbances or eye strain. Headaches are neuralgic, often with a constrictive feeling around the temples or occiput. Some cases describe a sensation as if a band were tightened around the head, worse in the evening or during cough paroxysms. The scalp may feel sore or sensitive to the touch, but improved by firm pressure. Dizziness or light-headedness may accompany nervous states or follow intense coughing.

Burning and aching in the eyes, particularly during headaches or mental exertion. Sensation of pressure within the orbits. Eyes feel heavy and fatigued, often with blurred vision during cough episodes. Lachrymation is mild but may occur when coughing. Sensitivity to light may develop, especially during headaches. In children, twitching of the eyelids is a notable symptom.

Notable for roaring, ringing, or buzzing in the ears, especially during neuralgic attacks or paroxysms of cough [Boericke]. Pain or neuralgic tension behind the ears, sometimes radiating to the mastoid region. A feeling of fullness or pressure in the ears is described, with diminished hearing in some cases. Children may pull at their ears during cough episodes or become agitated before earaches.

Mild coryza may be present, often dry or with scanty watery discharge. Frequent sneezing and nasal itching may occur before cough develops. Sense of smell may be reduced transiently during illness. In children, a tendency to nosebleeds is noted, especially with coughing fits.

Flushed and warm during fever or coughing fits. Expression may alternate between anxiety and languor. In neuralgic conditions, a drawing or twitching of facial muscles, particularly on the right side, has been observed. In children, frequent rubbing of the face or eyes is a keynote when cough is prominent.

Dryness of the mouth without thirst. Tongue coated white or yellowish, often with a bitter or metallic taste in the mouth. In some cases, a sweetish taste or lack of taste altogether is reported. Increased salivation during nervous episodes or cough. Bad breath during fevers.

Neuralgic pain in upper molars, especially right side, may accompany facial or ear symptoms. Grinding of teeth in sleep noted in sensitive children.

Dryness and tickling in the throat provoking incessant dry cough, especially at night. Sensation of a feather or dust in the larynx. Throat may feel tight, constricted, or raw after frequent coughing. Mucus is difficult to expectorate. Voice may become hoarse, especially in children, with a barking or croupy tone.

Slight nausea during cough episodes or in early morning. Appetite variable; children often refuse food due to discomfort. Aversion to milk or rich food. Cramping in the epigastrium during intense coughing or crying. Belching relieves pressure and nausea.

Flatulence and gurgling in the intestines. Colicky pain may occur with cough, especially in children, from muscular strain. Right hypochondrium sometimes sensitive during shoulder neuralgia. Abdomen may feel bloated and tense during illness.

Urination frequent in nervous children. Involuntary urination during coughing fits is occasionally reported. Urine may be dark and offensive. Slight burning during urination due to nervous excitement.

Constipation common during neuralgic conditions. Hard, difficult stools in nervous children. Sometimes tenesmus with mucus observed during coughs that strain the abdomen.

Rarely indicated; may assist with neuralgic testicular pain or nervous sexual debility in sensitive individuals.

Occasionally helpful in neuralgic dysmenorrhoea, particularly with concurrent respiratory or nervous symptoms. Menses may be irregular or suppressed during periods of stress. Nervous twitching and anxiety before menses.

Shortness of breath during and after cough. Sighing respiration, as if unable to get a full breath. Breathing aggravated by lying flat. Oppression of chest with a sensation of impending suffocation. Breathing shallow and rapid in children during febrile states.

Palpitations from nervousness or emotional excitement. Pulse may be irregular during fever or cough. Heart feels fluttering with each paroxysm of coughing. Pressure or tension in the precordial region during emotional distress.

Dry, hacking cough, worse at night or when lying down. Characteristically worse when lying on the back. Cough may be reflex from nervous tension or due to laryngeal irritation [Hering]. Pain in chest muscles after coughing fits. Spasmodic nature of cough is a keynote, with paroxysms that leave the child breathless or anxious. Cough sometimes ends in a sobbing inspiration. Palpitations with cough or anxiety.

Neuralgic pain in cervical spine and right shoulder blade, radiating down the arm. Violent drawing or twitching sensation, especially when trying to lift the arm or turn the head [Clarke]. Stiffness in nape of neck and shoulders, especially on waking. Pain worsens from cold and improves with warmth and pressure.

Most notable in the right upper limb, especially the shoulder joint. Pain is drawing, neuralgic, and cramp-like, often rendering the arm nearly immobile. Twitching and restlessness in limbs, particularly at night. Cramping of fingers or hands during exertion. Coldness in feet with hot flushes in upper body. Restless legs in bed.

Skin pale and cool during nervous exhaustion. Dry or clammy during fever. Pruritus in small patches may accompany nerve-related states. Hypersensitivity to touch in the affected neuralgic areas.

Restless, unrefreshing sleep. Children toss and turn or moan in sleep. Frequent waking with cough or from fright. Twitching of limbs during sleep. Dreams vivid, often of falling or flying. Sleep better after 2–3am.

Frightful or disturbing dreams. Dreams of danger, being chased, or choking. Children cry out or wake suddenly. Dreams that repeat nightly.

Mild to moderate fever in the evening, especially with cough. Heat alternates with chills. Flushed face and hands, but feet cold. Sweat breaks out during fever, but offers little relief.

Chilliness predominates in early stages of illness. Heat and sweat occur later. Coldness in extremities with facial flushing. Sweating mostly on upper body. Sweating does not relieve other symptoms.

Aversion to rich, sweet, or fatty food. Desire for warm drinks. In children, a craving for milk which aggravates. Loss of appetite during cough or neuralgic symptoms. Sensation of fullness after a few bites.

Symptoms are generally right-sided, especially in shoulder and upper extremity. Neuralgic, drawing pains predominate. Nervous, sensitive, twitchy constitution. Symptoms often appear or worsen at night, especially after lying down. Marked oversensitivity to touch, noise, and excitement. Cold air and damp weather aggravate almost all symptoms. Great restlessness, especially in children with respiratory complaints.

• Spongia tosta – Dry, barking cough with anxiety; but more hoarseness and thyroid affinity
• Causticum – Right shoulder paralysis with dry cough, but more weakness than spasmodic pain
• Bryonia alba – Painful shoulder with immobility, worse from slightest motion
• Phosphorus – Right-sided chest symptoms with dry cough, but more burning and thirst
• Cimicifuga – Neuralgic pains, especially in neck and shoulders, but often with uterine symptoms
• Drosera – Spasmodic coughs, but more violent and worse after midnight

• Complementary: Bryonia, Causticum
• Follows well: Belladonna, Aconite
• Antidotes: Nux vomica, Camphora
• Inimical: None well established

• Excellent in dry, tickling coughs of children, worse at night
• Especially useful in neuralgic right shoulder pain, better from pressure
• Consider for nervous twitching and restlessness in sensitive patients
• Can assist in nervous headaches and minor insomnia from overexcitation
• Low to medium potencies (6C–30C) frequently used; 200C occasionally indicated in chronic neuralgia

Mind

• Nervousness, children
• Restlessness, night
• Anxiety, evening

Respiration

• Cough, dry, night
• Oppression, lying down
• Suffocation, sensation of

Extremities

• Pain, shoulder, right
• Twitching, sleep, during
• Neuralgia, arm, shoulder

Sleep

• Disturbed, from cough
• Dreams, frightful
• Sleep, unrefreshing

Generalities

• Better pressure
• Worse cold air
• Worse night

• John Henry Clarke – Dictionary of Practical Materia Medica: Provided details on shoulder affections and cough
• William Boericke – Pocket Manual of Homoeopathic Materia Medica: Gave indications for respiratory and nervous symptoms
• C. Hering – Guiding Symptoms of Our Materia Medica: Confirmed key modalities and neuralgic patterns
• E.M. Hale – New Remedies: Offered clinical confirmations in shoulder neuralgia and children’s cough
• T.F. Allen – Encyclopedia of Pure Materia Medica: Supplemented proving data and cough-related symptoms