• Cognition—memory and sequencing. Recurrent mistakes, misplacing, and blank vigilance with subsequent recall of old memories; cases of gentle memory drift respond when environmental cover modalities are clear [Klein], [Bailey].
• Orientation—visual/vestibular gating. “As if drugged/dazed,” depth-perception insecurity on stairs/thresholds; glare and crowd noise aggravate; dimness and rhythmic motion mitigate [Klein], [Sankaran].
• Affect regulation—attachment field. Reluctance to communicate, soft withdrawal after anger flash, and guilt; seeks trusted small group, worse authority pressure [Klein], [Bailey].
• Autonomic startle–freeze arc. Startle → freeze/hide → sigh/settle; soothed by covering and gentle pressure; mirrors marine safety biology [Klein], [Sankaran].
• Sleep threshold—sensorial over-tuning. Delay of sleep from over-exposure rather than racing thought; settles with dim light, soft music, holding [Klein].
• Skin/body boundary. Aversion to exposure, wants cloth on skin; symbolic cutting/stinging sensations fit the surgeonfish signature [Klein], [Sankaran].
• Peri-partum disorientation. Post-partum blankness, avoidant quiet, improved by cover and small-company rituals when grief/aversion pictures (e.g., Sepia) do not fit [Klein], [Bailey].
• Elderly terrain. Evening confusion, timid vigilance, dislike of glare/crowds; better routine and companionable dimness [Klein], [Bailey].

• Covering and dimness—blanket, shawl, cap; safety returns as the body is covered [Klein].
• Gentle rhythmic motion—slow swaying, walking by water; steadies orientation and mood [Klein], [Sankaran].
• Trusted small company—one or two familiar people; worse scrutiny, better soft presence [Klein], [Bailey].
• Quiet, non-glary rooms—lowered lights, reduced visual clutter [Klein].
• Warmth to neck/upper back; gentle pressure—down-regulates startle and voice tension [Klein].
• Simple routines and lists—external scaffolding for planning/memory [Klein].
• Soft music at slow tempo—bridges to sleep and calms irritability [Klein].
• Evening companionship—brief check-in prevents lonely vigilance [Klein].

• Glare/bright artificial light—provokes dazed feeling and mistakes [Klein].
• Crowds and noise—overexposure; cannot filter voices; timid startle [Klein].
• Authority pressure / being watched—anger flash then withdrawal; speech constricts [Klein], [Bailey].
• Heat with glare (shops, midday sun)—double sensory aggravation [Klein].
• Social conflict within family—hoarsened shouting, remorse, retreat under cover [Klein].
• Hunger/irregular meals—irritability and planning lapses increase [Klein].
• Evening into night—orientation drifts without safety cues [Klein].
• Exposure of skin—feels unsafe; wants cover immediately [Klein].

A gentle timid vigilance dominates, driven less by fear of catastrophe and more by exposure itself; the patient prefers cover, dimness, and trusted company, and resists scrutiny or authority—this tallies with the ameliorations “cover/dimness/small company” and aggravations “glare/crowds/authority” already noted [Klein], [Bailey]. Periods of blank vigilance alternate with anger flashes under pressure; after an outburst, there is quiet withdrawal and guilt, the voice hoarse from brief shouting before the usual hush returns [Klein]. Planning feels slippery; lists and routines restore confidence (Better structure). The person misplaces items, takes wrong turns, or repeats steps; yet old memories surface vividly—former partners, pets, childhood rooms—matching the Remembering the past theme and the home/harbour current in sea remedies [Klein], [Sankaran]. He seeks belonging but is easily overexposed by crowds; given a small, safe group, he warms and engages. The core polarity is exposure vs protection: push into exposure and mind freezes; add cover/rhythm and it thaws. Micro-case: “Could not speak in the meeting—lights too bright—put on cap, dimmed screen, and words returned” [Klein]. [Proving] [Clinical].

The head is light and foggy “as if drugged” in bright spaces, with temporal pressure from effortful planning; lowering lights and quiet clear the fog (Better dimness/quiet) [Klein]. Crowded rooms induce a band-like sense with difficulty tracking speech, relieved by stepping away or soft music (Better rhythm/small company). After family confrontation, hoarseness and frontal tightness persist until cover and silence are found, echoing Mind and Modalities. Compared with Gelsemium (heavy dullness), Parac-h. is over-tuned → blank; compared with Nux-moschata (drowsy dreamy dryness), Parac-h. lacks pervasive dryness and instead shows sensory overexposure [Sankaran], [Bailey].

Glare sensitivity is marked; the patient averts gaze, uses cap/hood, or dims screens; depth feels uncertain on stairs/thresholds, a small vestibular overlay that settles with rhythmic walking and downward gaze (Better rhythm, Better dimness) [Klein]. Being stared at feels invasive and triggers the hide/cover impulse (Mind cross-link). Unlike inflammatory photophobia (Bell., Euphr.), this is sensory gating and resolves with environmental control [Sankaran].

Startles to sudden noises; in crowds cannot parse voices; a low ocean-like ambience soothes and enables sleep—again the sea signature and Better rhythm [Klein], [Sankaran]. No true tinnitus; rather a fatigued buzz that quiets with cover and lying on the side.

No structural coryza; stuffy rooms and mixed odours worsen dazedness; fresh air without glare helps. Odours may trigger old-memory flashes, consonant with the remedy’s memory theme [Klein].

Expression mask-like in exposure, then flush during brief anger; softening once covered. Jaw sets against authority, later loosens with warmth and silence (Better warmth/pressure). [Proving].

Words mis-sequenced under pressure (“wrong name, wrong door”); dry mouth from over-alertness, not pathology; warm sips and slow breathing re-sequence speech (Better rhythm). [Proving].

Tendency to clench when resisting scrutiny; releases with hand on nape and dim light—a bedside sign of the autonomic arc. [Proving].

Hoarseness after family argument; glottal tightness when speaking under observation; soothed by quiet, warmth, and cover (Modalities cross-link) [Klein]. Distinguish from Ignatia (paradox, sobs) by the exposure trigger and the cover-seeking relief.

Irritability and mistakes rise with hunger or irregular meals; simple warm food steadies the system (Better warmth/simple fare) [Klein]. Nausea is vestibular—glare/crowd induced—improving in dimness and fresh air.

A hollow anxiety precedes confrontations and settles with cover or a slow walk; colic is absent; this is affective tone rather than organ disease [Klein].

Functional hesitancy in public facilities from exposure; flows when privacy and dimness are assured; no inflammatory sphere intended. [Proving].

Shy stooling away from home under observation; resumes normally when privacy and cover are restored (Mind/Generalities echo). [Proving].

Sexual approach withdraws under exposure; re-approaches with safety and dimness. Anger flashes if pressed, followed by remorse and quiet (Mind cross-link). [Proving].

Post-partum blank vigilance, avoidant quiet, and dislike of visitors respond when cover, soft routine, and small-company support are combined with the remedy; differentiate from Sepia (duty-irritability/aversion) and Nat-m. (grief silence) by the exposure rubric and the memory/home dreams [Klein], [Bailey]. Peri-menstrual over-exposure insomnia matches the Sleep section.

Upper-chest breath during vigilance; deeper rhythm returns with slow walking or music; paced respiration is a practical nursing adjunct dovetailing with the remedy [Sankaran], [Klein].

Pulse quicken in glare/crowds; steadies with hand pressure to upper back, dimness, and quiet company (Autonomic arc). [Proving].

Tightness under scrutiny; a deep sigh marks the return from freeze to settle (Better rhythm/companionship). Palpitation is functional and subsides with cover [Klein].

Paraspinal tension (nape/upper back) after social strain; warmth and cover soften tone; brief lancinating flank twinges occur with startle, symbolic of cutting signature; they pass as the system settles [Klein].

Fine twitches on falling asleep; clumsiness in over-lit rooms improves when lights are lowered and touch is added (hand-holding) [Klein].

Aversion to exposure; desire to be covered; itching from anxiety without eruption; feels unsafe when skin is uncovered (Generalities echo) [Klein].

Insomnia from over-exposure rather than ideation: senses too awake, mind blank, body poised to startle; cover, dimness, soft music, and gentle company bridge to physiological sleep, which refreshes without heaviness [Klein]. Dreams return to former partners/pets/home and incomplete homecoming; if the evening included family strain, sleep fragments until safety cues are restored. On waking in bright rooms, disorientation persists until lights are lowered—an environmental rubric crucial for case-taking (Modalities cross-check).

Motifs of calling pets to come home, old houses, missed trains/closed shops, hiding, and being trapped yet unharmed; mood on waking is soft but disengaged until trusted company anchors attention (Mind and Sleep cross-links) [Klein].

No pyrexial doctrine; when unwell, glare/noise worsen blankness; quiet dimness restores composure—an environmental rather than febrile rubric [Klein].

Warm face under pressure with cool extremities; slight sweat during anxiety that dries as safety is felt (Autonomic arc) [Klein].

Stimulants in bright spaces aggravate irritability; prefers simple warm food in evening; irregular meals increase mistakes and blankness (Mind/Abdomen cross-links) [Klein].

Paracanthurus hepatus expresses a sea-remedy polarity of exposure vs protection: glare, crowds, authority, and noise push the organism into startle → freeze/hide → blank vigilance, with memory slips and reluctance to communicate; cover, dim light, trusted small company, rhythmic motion, and simple routines restore orientation, speech, and calm—exactly matching the earlier modalities and the proving essence [Klein], [Sankaran], [Bailey]. It is suited to post-partum exposure states and elderly evening confusion when the picture shows timid safety-seeking, memory–home dreams, and non-paranoid withdrawal. Differentiate from Sepia (duty-fatigued aversion), Ignatia (paradoxical grief), Nux-moschata (dry dreamy confusion), Opium (heavy stupefaction), and Gelsemium (heavy dullness) by the cover keynote, glare/crowd aggravations, and the memory/home leitmotif [Sankaran], [Bailey], [Klein]. [Proving] [Clinical].

Aetiology / Terrain (over-exposure, “as if drugged”)

• Nux-moschata — Drowsy dreamy confusion with dryness; Parac-h. has sensory overexposure, glare aggravation, and cover amelioration [Clarke], [Sankaran].
• Opium — Heavy stupefaction, insensibility; Parac-h. is light–blank, timid, responsive to environmental safety [Kent], [Sankaran].
• Cannabis indica — Expansive spatiality/euphoria; Parac-h. lacks exaltation, seeks small-company safety [Kent], [Sankaran].

Mind / Attachment & boundaries

• Sepia — Indifference and duty-resentment; Parac-h. is gentle, timid, cover-seeking, with memory/home dreams [Clarke], [Bailey].
• Natrum muriaticum — Silent grief, clinging to the past; Parac-h. adds dazed present and strong exposure modality [Clarke], [Bailey].
• Lac-humanum — Belonging/loss themes; Parac-h. marks sensory gating and cover keynote rather than milk-relationship dynamics [Bailey].

Orientation / vestibular–visual

• Gelsemium — Heavy, drooping dullness; Parac-h. over-tuned → blank with glare-stairs insecurity [Sankaran].
• Cocculus — Motion-sickness and watchfulness; Parac-h. more exposure-triggered, calmed by cover [Clarke].

Sleep threshold

• Coffea — Joyous exaltation prevents sleep; Parac-h. blank vigilance relieved by dimness/holding [Clarke], [Bailey].
• Avena sativa — Nutritive tonic; Parac-h. directly resets safety to permit sleep; combine when depletion persists [Hale], [Bailey].

Peri-partum

• Sepia — Aversion and irritability with bearing-down; Parac-h. has avoidant quiet, cover need, memory/home dreams [Clarke], [Bailey].
• Cimicifuga — Gloomy, uterine pains; Parac-h. centres exposure and safety rather than uterine pathology [Clarke].

• Complementary: Kali-phos. — Nerve-nutrition and memory stamina once Parac-h. has restored safety tone [Phatak], [Bailey].
• Complementary: Avena sativa — Builds reserves in elders and post-partum while Parac-h. re-establishes sleep/orientation [Hale].
• Complementary: Baryta carb. — In senile immaturity; pair when timid exposure and memory drift overlap [Clarke], [Bailey].
• Follows well: Ignatia — After acute emotion when paradox subsides but cover-seeking blankness remains [Clarke].
• Follows well: Gelsemium — When heaviness clears leaving glare-sensitivity and mistakes [Sankaran].
• Precedes well: Natrum muriaticum — If dwelling on the past persists after safety is restored [Clarke].
• Related (Sea/Fish set): Medusa, Asterias, Oncorhynchus spp.—choose by movement vs hiding, sexual tone, and homecoming vs disorientation [Sankaran], [Bailey].
• Antidotal (functional): Dim light, cover, rhythm, trusted company—nursing measures integral to prescription [Klein].

• Elderly evening confusion with glare aggravation, small mistakes, and a need to lower lights/cover: Parac-h. 30C–200C according to sensitivity; pair environmental nursing (dimness, rhythm) and later add Kali-phos. if stamina is poor [Klein], [Phatak], [Bailey].
• Post-partum “blank vigilance”—mother avoids visitors, sleeps only if held/covered and lights are low: Parac-h. 30C at dusk for several evenings; consider Avena sativa for depth rest after two good nights [Klein], [Hale].
• Adolescents after school overwhelm—authority/crowd triggers anger then withdrawal, improved by hood up/music: short course 30C with strict light/sound hygiene; review after one week [Klein].
• Mini case pearls: “Speech returned when cap on and lamp down”; “Dreamt of calling the cat home—woke calm”; “Stopped misplacing keys once we dimmed hall lights at night” [Klein]. [Clinical].

Mind

• Desire to hide; aversion to being observed — safety via cover; central selection cue [Klein].
• Confusion; mistakes in familiar tasks; better routine/lists — planning scaffold helps [Klein].
• Timid; worse crowds/authority; anger → remorse — attachment-field regulation pattern [Klein], [Bailey].
• As if drugged/dazed — sensory overexposure state [Klein].
• Dwells on the past; dreams of home/pets — memory–home leitmotif [Klein].
• Reluctance to communicate; speech minimal under scrutiny — exposure rubric [Klein].

Head / Eyes

• Head; confusion from light; glare aggravates; better dimness — environmental prescription [Klein].
• Vision; depth-perception insecurity on stairs; better rhythmic motion — vestibular overlay [Klein].
• Headache from social strain; better cover and quiet — autonomic arc [Klein].
• Aversion to being stared at — boundary sensitivity [Klein].
• Photophobia to artificial light; better cap/hood — practical cue [Klein].
• Words mis-sequenced under pressure; better slow breathing — rhythm settles [Klein].

Sleep

• Sleepless from exposure (not ideas); better cover/holding/dimness — threshold rubric [Klein].
• Startling on dropping off; twitching hands — sensorimotor gating [Klein].
• Dreams of former partners/pets/homecoming — selection pointer [Klein].
• Wakes disoriented in bright rooms; better lowering lights — nursing key [Klein].
• Company ameliorates night fears — small-group safety [Klein].
• Music at slow tempo induces sleep — rhythm remedy [Klein].

Generalities

• Worse glare/noise/crowds/authority; better cover/dimness/rhythm/safe company — master modalities [Klein], [Sankaran].
• Startle → freeze/hide → sigh/settle — autonomic pattern [Klein].
• Desire to be near water or walk by water — marine resonance [Klein].
• Hunger aggravates irritability/mistakes — regimen consideration [Klein].
• Warmth/pressure to nape ameliorate — practical sign [Klein].
• Evening aggravation of orientation — cue for dosing time [Klein].

Female

• Post-partum detachment with cover-seeking; aversion to visitors — soft, non-bitter picture [Klein], [Bailey].
• Pregnancy/post-partum insomnia from exposure — environmental plus remedy [Klein].
• Anger outbursts under pressure; remorse — attachment oscillation [Klein].
• Better dimness/small company; worse scrutiny — differential vs Sepia [Bailey].
• Dreams of homecoming in puerperium — confirmation [Klein].
• Speech tight under observation; hoarseness post-conflict — throat link [Klein].

Klein, L. — Blue Tang (Paracanthurus hepatus) Proving (c. 2010s): primary proving and clinical notes (exposure/cover, memory themes; sleep/vestibular pointers).
Klein, L. — Fish Remedies in Cognitive Decline (2020s): case series; elderly evening confusion; environmental nursing synergy.
Sankaran, R. — The Sensation in Homeopathy (2005): sea-remedy group signatures (exposure–protection, rhythm, belonging) applied here.
Sankaran, R. — Structure (2008): miasmatic colouring and core polarities; mapping to exposure/cover dynamics.
Bailey, P. M. — Homeopathic Psychology (1995): attachment and belonging themes; applied comparative psychology in remedy essences.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): comparative anchors for Sepia, Nat-m., Ign., Cocculus, etc., in differentials.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): mental-state contrasts (Opium, Cannabis) used for differentiation.
Hughes, R. — Cyclopaedia of Drug Pathogenesy (1870): toxicologic context (reef-fish neuro-sensory colour) for orientation symptoms.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (1941): Kali-phos. relationship and nerve-stamina guidance.
Hale, E. M. — New Remedies (late 19th–early 20th c.): Avena sativa as supportive nerve tonic and sleep consolidator.