Convallaria majalis

A small perennial of Asparagaceae (older Liliaceæ). The plant contains cardiac glycosides—notably convallatoxin—that, in crude form, slow and strengthen systole but readily provoke nausea, vomiting, headache, brady-arrhythmias, and collapse in overdose ([Toxicology]). These pharmacodynamics parallel the homœopathic picture of heart insufficiency, dilated, laboring heart, dyspnœa on the least exertion, dropsy, and cardiac asthma, with reflex gastric irritability and head heaviness. Mother tincture is prepared from the fresh herb in flower; triturations and potencies are made therefrom. [Hughes], [Clarke], [Allen], [Boericke]

Historically used by herbalists and eclectic physicians as a digitalis-like cardiotonic in valvular disease, cardiac dropsy, and arrhythmia, prized for less cumulative gastric toxicity than foxglove, yet recognised as a narrow-index drug. These traditions corroborate the remedy’s myocardial and conduction affinities. [Hughes], [Hale], [Clarke]

Our knowledge derives from Hale’s New-Remedy provings/clinical series and collations by Allen, Hering, Clarke, with abundant [Clinical] confirmations: breathlessness on the slightest exertion, cannot lie down for fear of suffocation, irregular weak pulse, dilated heart, ankle œdema, palpitation with uterine disorders/pregnancy, and scanty urine in cardiac failure. [Hale], [Allen], [Hering], [Clarke], [Boericke]

• Myocardium (systolic failure). Strengthens but reveals exhausted muscle—weak, irregular, sometimes intermittent pulse; dilated heart with precordial oppression and air-hunger on the least exertion. See Heart/Respiration/Generalities. [Boericke], [Clarke], [Hale]
• Conduction system. Auriculo-ventricular delay or extra-systoles with sinking at epigastrium; symptoms oscillate with posture and effort. See Heart/Sleep. [Hughes], [Allen]
• Coronary & anginal sphere. Anginal oppression with pain radiating to left arm/jaw, often in anæmic or valvular subjects; better absolute rest, worse climbing, close rooms. See Chest/Respiration. [Clarke], [Farrington]
• Lungs (cardiac asthma/pulmonary congestion). Orthopnœa, cough from serous engorgement; cannot lie down; cyanosis about lips. See Respiration/Chest. [Hering], [Boericke]
• Serous tissues—dropsy. Ankles, feet, and eyelids œdematous; ascites/anasarca of cardiac origin; urine scanty. See Extremities/Urinary/Skin. [Clarke], [Boger]
• Vagus–solar plexus (cardio-gastric reflex). Nausea and vomiting accompany palpitations; epigastric sinking signals rhythm lapses. See Stomach/Heart. [Hughes], [Allen]
• Uterus–heart axis. Palpitation and dyspnœa during pregnancy, menses, or uterine displacement; the heart labours with pelvic engorgement. See Female/Heart. [Clarke], [Hale]
• Cerebral circulation. Vertigo on rising or stooping, head heaviness in warm rooms during heart struggle; relief with air and rest. See Head/Generalities. [Allen], [Clarke]
• Kidney (secondary). Scanty, dark, sometimes albuminous urine in cardiac failure; diuresis follows cardiac improvement. See Urinary. [Clarke], [Boericke]
• Peripheral veins. Cold, bluish extremities, empty veins, weak return; cramps of calves at night in heart patients. See Extremities/Sleep. [Boger], [Boericke]

• Absolute rest; sitting propped up (orthopnœa posture); head high in bed. [Hering], [Clarke]
• Cool, fresh air; window open; gentle fanning; night air if not damp. [Boericke], [Clarke]
• Quiet, slow breathing, refraining from speech during palpitation. [Allen], [Farrington]
• After passing urine when diuresis begins in cardiac dropsy—breathing eases. [Clarke], [Boericke]
• Small sips of cold water for nausea/air hunger (avoid large draughts). [Hale], [Clarke]
• Pressure of hand over precordia during flutter (reassurance–vagal). [Allen]
• Daytime repose; midday nap often steadies pulse (if half-sitting). [Clarke]
• Gentle supported walking on the level in cool air between attacks. [Farrington]
• Loosened clothing about chest/waist. [Clarke]
• After a soft stool if flatulent distension had embarrassed the heart. [Clarke], [Dewey]
• Silence and darkness when anginal anxiety is high. [Farrington]
• Warmth to feet (hot bottle) while chest is kept cool and airy. [Boger]

• Least exertion—climbing stairs, hurrying, raising arms, or speaking much. [Boericke], [Clarke]
• Lying down, especially left side; after first sleep the suffocation drives up. [Hering], [Allen]
• Warm, close rooms; stale air; crowds. [Clarke], [Boger]
• After meals, especially late/evening meals; flatulence or indigestion. [Clarke], [Dewey]
• Alcohol, coffee, tobacco in sensitive hearts. [Hale], [Clarke]
• Emotion (sudden joy, fright, grief) or mental exertion. [Kent], [Clarke]
• Menstrual/pregnancy congestion; uterine displacement. [Clarke], [Hale]
• Stooping or sudden rising; vertigo, rush to head. [Allen]
• Cold, damp night air (cardiac asthma) though cool fresh air generally relieves. [Boericke], [Clarke]
• Tight clothing/collars; belts round epigastrium. [Clarke]
• Loss of sleep; night watching. [Kent]
• Suppression of accustomed discharges or checked perspiration. [Boger]

Myocardial weakness / dilatation

• Digitalis — Very slow, feeble, irregular pulse; great death-fear; bluish face; often must lie on left quietly. Conv.: effort dyspnœa, orthopnœa, more oppressive weight, cool air >, less sheer bradycardia. [Clarke], [Farrington], [Boericke]
• Crataegus — Tonic to myocardium with insomnia, nervous dyspepsia; lacks orthopnœa keynote. Use Crataegus to consolidate after Conv. clears acute effort-dyspnœa. [Clarke], [Farrington]
• Strophanthus — Weak heart with emaciation, diarrhœa, and tobacco intolerance; less anginal weight; stool and urine more active. Conv.: more oppression/orthopnœa. [Hale], [Clarke]
• Adonis vernalis — Low-tension pulse, dropsy, renal element; gastric less; Conv. has stronger cardio-gastric link. [Farrington]

Angina / precordial constriction

• Cactus grandiflorus — Iron band constriction; squeezing pains; haemorrhoidal temperament. Conv.: weight/oppression with orthopnœa, cool air >. [Clarke], [Farrington]
• Spigelia — Stitching points, left-sided, worse motion, often neuralgic; eye involvement. Conv.: less stitching, more sinking and labour. [Farrington], [Boger]
• Aurum — Hypertensive, sclerotic angina with melancholy; Conv. is cardiac failure with effort dyspnœa. [Kent], [Clarke]

Cardiac asthma / orthopnœa

• Arsenicum album — Great anxiety, restless despite weakness; burning; wants heat and sips. Conv. wants cool air, silence, rest, less anxiety. [Farrington], [Clarke]
• Laurocerasus — Cyanosis, coldness, gasps, desire for air, but with nervous collapse. Conv. maintains labouring heart and gastric link. [Clarke]
• Ammonium carb. — Obesity, 3 a.m. dyspnœa, worse lying; less cardiac lesion. Conv.: overt heart insufficiency. [Boger]

Dropsy (cardiac)

• Apocynum cannabinum — Dropsies with profuse urine once it starts; chilly; gastro-intestinal irritability primary. Conv.: heart-first, orthopnœa, diuresis follows cardiac relief. [Farrington], [Boericke]
• Helleborus — Pale, cold, hydrocephalic/serous states with mental dulness; heart less central. [Clarke]

Cardio-gastric reflex

• Nux vomica — Gastric–cardiac from overindulgence; irritable, chilly, spasmodic; less orthopnœa. Conv.: sinking at epigastrium synchronised with pulse. [Farrington], [Clarke]
• Tabacum — Sinking with cold sweat, deathly nausea; collapse; pulse thread-like. Conv.: not collapse but laboured heart with nausea. [Hughes], [Clarke]

Female heart

• Lilium tigrinum — Pelvic congestion, heart flutter with irritability and bearing-down; less true cardiac failure. Conv.: effort-dyspnœa in pregnancy/menses. [Clarke], [Farrington]
• Kalmia — Shooting pains from heart to left arm, slow pulse; rheumatic history. Conv.: oppression with weak pulse and dropsy. [Boger], [Farrington]

• Complementary: Crataegus — strengthens myocardium and sleep after Conv. has relieved orthopnœa. [Clarke], [Farrington]
• Complementary: Apocynum cann. — assists dropsy once cardiac action steadies. [Boericke], [Farrington]
• Complementary: Cactus grand. — addresses persistent constriction after oppression lessens. [Clarke]
• Follows well: Digitalis — when digitalis has steadied rate but gastric intolerance ensues; Conv. maintains heart with less gastric distress (clinical tradition). [Clarke], [Hughes]
• Follows well: Naja — if valvular murmurs persist with effort dyspnœa and oppressed chest. [Farrington]
• Precedes well: Strophanthus — for rehabilitation of tone and exercise tolerance. [Hale], [Clarke]
• Precedes well: Arsenicum — if cardiac asthma retains anxious restlessness despite relief of oppression. [Farrington]
• Related/Compare: Adonis, Laurocerasus, Aurum, Spigelia, Kalmia, Iberis amara (cardiac stimulant). [Clarke], [Boger]
• Antidotes (practical): Nux for gastric aggravation from dosing; Camphora in impending collapse (traditional). [Hughes], [Dewey]
• Inimical: None fixed; avoid routine alternation with Digitalis/Strophanthus without clear indication shift. [Kent]

The essence of Convallaria is the labouring, dilated heart that fails under effort, compelling the patient to economise breath and seek air. The picture is remarkably physiologic: the myocardium is unequal to demand; systole is weak, rhythm irregular; venous beds engorge and serous spaces fill. The body responds with orthopnœa—cannot lie down—and a visceral programme of silence, stillness, and cool air to reduce oxygen cost (Essence ↔ 10a rest/cool air; Respiration/Heart). Warm, close rooms, stair-climbing, after meals, and emotion push the system into air-hunger, epigastric sinking, and palpitations felt as missed beats or shocks in the precordia; open windows, propped posture, and small cold sips rapidly curtail the storm (Essence ↔ Modalities) [Clarke], [Boericke], [Hale].

A second axis is cardio-gastric: the stomach speaks for the heart—nausea, retching, distension, and a stone-like weight after eating mirror the systolic struggle; the “sinking at epigastrium” times a rhythm lapse (Essence ↔ Stomach/Heart) [Hughes], [Allen]. Third, the dropsical tendency—ankle oedema, puffy lids, scant urine—marks sycotic retention layered upon syphilitic failure; diuresis returns as myocardial efficiency rises, and the patient breathes again (Essence ↔ Urinary/Extremities). Psychologically, this is not a grand anxiogenic remedy (contrast Arsenicum); the fear is practical and situational: suffocation in bed, stairs, crowds, warm rooms. He becomes briefly taciturn, conserving air; cheer returns with ventilation and a steadier beat (Essence ↔ Mind/Sleep). Among congeners, Digitalis sinks to bradycardia and death-fear; Cactus clamps with iron band; Strophanthus and Adonis tone a flabby heart; Crataegus rebuilds after crisis; Convallaria excels in the crisis of effort dyspnœa, orthopnœa, weight at heart, and gastric accompaniment, especially in women whose heart labours under pregnancy or menses (Essence ↔ Female/Heart) [Farrington], [Clarke], [Boericke].

Practical care matches the essence: air the room; prop the patient; schedule small, frequent, non-greasy meals; avoid late suppers, alcohol, coffee, tobacco; and let speech be brief during recovery. Prognosis reads in later onset of nightly dyspnœa, longer conversation without panting, flatter sleep tolerated, steady pulse without epigastric sinking, and the ankle pit that at last does not form. [Clarke], [Hale], [Boger], [Boericke], [Farrington]

• Orthopnœa with weak, irregular pulse; effort dyspnœa; ankle oedema. Conv. 3x–6x or 6C–30C q4–6h in the acute window; prop, ventilate, silence, small cold sips; space/stop promptly as breath eases and urine increases. [Boericke], [Clarke], [Hale]
• Anginal oppression (weight on heart) in anæmic/valvular subjects; warm rooms and stairs <; air and rest >. Prefer 30C p.r.n. with strict after-meal moderation and open windows. [Clarke], [Farrington]
• Pregnancy heart (palpitation, orthopnœa, ankle swelling). 6C–12C once or twice daily while regulating rest, salt, fluids, and stair exposure. [Clarke], [Hale]

Case pearls (one-liners):
• Widow, 62, cannot lie down; ankles pit; pulse irregular—Conv. 3x q6h + open window: slept propped; on day 3 ankles softer, urine freer, could lie flatter. [Clarke], [Boericke]
• Shopgirl, stairs bring choking; warm room worse; left-arm ache after meals → Conv. 30C p.r.n.; ate early, walked level in cool air; anginal weight ceased in a week. [Farrington], [Clarke]
• Primigravida with nightly orthopnœa, ankles thick: Conv. 12C q.d. + regimen; could sleep on two pillows, swelling receded by fortnight. [Hale]

Mind

• Anxiety of suffocation in warm, close room. Practical, situational fear. [Clarke]
• Aversion to talking during palpitation. Conserves breath. [Allen]
• Fear on lying down at night—heart will fail. Orthopnœa cue. [Hering]
• Desire for open window; better air. Management key. [Clarke]
• Aggravation from emotion (joy, fright, grief). Trigger rubric. [Kent]
• Irritable when forced to hurry or climb. Effort sign. [Clarke]

Head

• Vertigo on rising or stooping, with rush to head. Postural cardiac sign. [Allen]
• Headache after meals with palpitation. Cardio-gastric link. [Clarke], [Dewey]
• Heaviness and fullness in close room; air >. Environment matches. [Clarke]
• Blackness before eyes on exertion. Low output marker. [Allen]
• Face pale or dusky during dyspnœa. External barometer. [Clarke]
• Sweat on face with palpitation. Autonomic clue. [Boericke]

Chest / Heart / Respiration

• Orthopnœa; cannot lie down for fear of suffocation. Central keynote. [Hering], [Clarke]
• Palpitation on least exertion or talking. Effort intolerance. [Boericke], [Allen]
• Pulse irregular, intermittent, weak. Conduction/myocardial sign. [Allen], [Clarke]
• Oppression, weight at heart, radiating to left arm. Anginal type. [Clarke]
• Warm, close room aggravates; cool air ameliorates. Master modalities. [Clarke], [Boger]
• Epigastric sinking with missed beat. Cardio-gastric valve. [Hughes], [Allen]

Stomach / Abdomen

• Nausea and vomiting with palpitations. Reflex hallmark. [Hughes]
• After meals aggravation, especially late supper. Practical rule. [Clarke], [Dewey]
• Flatulence embarrasses heart; eructation relieves. Mechanical link. [Clarke]
• Abdominal fullness with cardiac dropsy. Terrain. [Boericke]
• Desire for small cold sips. Coping measure. [Hale]
• Alcohol/coffee/tobacco aggravate heart. Lifestyle rubric. [Hale], [Clarke]

Urinary

• Urine scanty in cardiac failure; albuminous. Secondary kidney. [Clarke]
• Diuresis returns as breathing eases. Prognostic sign. [Boericke]
• Night urination fatigues; day drowsiness. Sleep impact. [Clarke]
• Oedema ankles with scant urine. Dropsy link. [Clarke]
• Pressure marks (pitting). Objective rubric. [Boericke]
• Better after passing urine (breathing freer). Clinical note. [Clarke]

Extremities

• Oedema of ankles, pits on pressure; evening worse. Cardiac dropsy. [Clarke]
• Cold, bluish hands and feet. Low output. [Boericke]
• Cramps in calves at night. Poor return. [Boger]
• Numbness left arm with heart oppression. Anginal companion. [Farrington]
• Fatigue on climbing stairs disproportionate to effort. Effort test. [Clarke]
• Needs support to shoulders and head to rest. Position rubric. [Clarke]

Sleep / Generalities

• First sleep broken by suffocation; must sit up. Night pattern. [Hering]
• Better sitting propped; head high. Posture law. [Clarke]
• Warm room aggravates all; open window >. Environmental master. [Clarke], [Boger]
• Least exertion aggravates; silence and rest ameliorate. Energy economy. [Allen]
• After meals worse; small, frequent feeding better. Regimen. [Dewey]
• Tight clothing aggravates; loosen clothing better. Mechanical aid. [Clarke]

M. Hale — New Remedies: Clinical and Pharmacological (1864–1891): proving/clinical—effort dyspnœa, orthopnœa, cardio-gastric link, pregnancy heart; dosing traditions.
T. F. Allen — Encyclopædia of Pure Materia Medica (1874–79): collated symptoms—irregular/intermittent pulse, vertigo on stooping/rising, epigastric sinking, nausea with palpitations.
Constantine Hering — The Guiding Symptoms of Our Materia Medica (1879): confirmations—orthopnœa, cannot lie down, night cardiac asthma, sweat with palpitations.
John Henry Clarke — A Dictionary of Practical Materia Medica (1900): substance background, cardiac–coronary sphere, dropsy, modalities (warm room <, cool air >), female heart.
Richard Hughes — A Cyclopædia of Drug Pathogenesy (1891–95) & Manual of Pharmacodynamics (1894): pharmacology of convallatoxin; cardio-gastric reflex; toxicology parallels.
William Boericke — Pocket Manual of Homœopathic Materia Medica (1906): keynotes—dilated heart, weak irregular pulse, orthopnœa, dropsy; practical hints.
C. M. Boger — Synoptic Key of the Materia Medica (1915): modalities—exertion <, close room <, air >; dropsical and venous themes; relationships.
E. A. Farrington — Clinical Materia Medica (1887): comparisons—Digitalis, Cactus, Spigelia, Arsenicum, Apocynum, Crataegus; guidance in angina and cardiac asthma.
James Tyler Kent — Lectures on Materia Medica (1905): miasmatic colouring; emotional triggers (fright, grief, joy) in heart disease; general analysis.
W. A. Dewey — Practical Homœopathic Therapeutics (1901): regimen—after-meal rules, window-air; dietary cautions (alcohol/coffee/tobacco).
Adolph von Lippe — Text-Book of Materia Medica (1866): early clinical notes—dyspnœa on exertion, evening aggravations, rest posture (confirmatory).
E. B. Nash — Leaders in Homœopathic Therapeutics (1899): concise leadership—effort dyspnœa, orthopnœa picture; bedside distinctions from Digitalis/Cactus.
H. C. Allen — Keynotes and Characteristics (1898): brief heart keynotes—intermissions, epigastric sinking, exertion <.
Margaret Lucy Tyler — Homoeopathic Drug Pictures (1942): bedside pictures—open-window amelioration; pregnancy heart pointers; practical management notes.