Gossypium herbaceum

The cotton plant (Gossypium herbaceum, Malvaceae) yields a root-bark long used in American domestic and eclectic medicine as a powerful uterine agent—emmenagogue and partus-accelerant—its decoctions promoting uterine contractions, relieving congestive dysmenorrhœa, and aiding subinvolution; in crude dosage it may provoke miscarriage, nausea, faintness, and pelvic cramp, foreshadowing the homœopathic picture. The homœopathic tincture is prepared from fresh root-bark, the pathogenesis being mainly clinical, with fragments recorded by Allen and collated by Clarke; the remedy has a marked action on uterus, cervix and ovarian ligaments, and a reflex upon stomach (vomiting of pregnancy), bladder (pressure), and spine (sacro-iliac ache) [Hughes], [Allen], [Clarke], [Boericke].

Cotton root-bark decoctions were employed by eclectics for amenorrhœa and as an oxytocic in tardy labour; folk use extended to habitual miscarriage and after-pains, and as a menagogue following chills. Such observations inform but do not govern homœopathic dose. (Cottonseed contains gossypol, a male antifertility toxin in crude pharmacology, but this belongs rather to toxicology than to the root-bark used in our pharmaceutic.) [Hughes], [Clarke].

No full Hahnemannian proving. The picture rests upon fragmentary provings (Allen) and abundant clinical confirmations—amenorrhœa with pelvic weight as if the menses would appear; dysmenorrhœa with cramp; nausea and vomiting of early pregnancy better lying still; threatened abortion with uterine colic and sacral dragging; subinvolution and prolapse symptoms better by rest and support. Tags: [Proving]/[Clinical]. [Allen], [Clarke], [Hering], [Boericke], [Farrington].

• Uterus (muscular body and cervix) — atony with congestion: amenorrhœa, suppressed menses with weight and bearing-down, threatened abortion; subinvolution; pains shoot to sacrum and thighs. See Female/Back. [Clarke], [Boericke], [Allen].
• Ovaries & Broad ligaments — dragging, left or right, worse jar and exertion; ovulation cramps; reflex vesical and rectal pressure. See Abdomen/Female/Urinary. [Clarke], [Hering].
• Stomach (gravid nausea) — vomiting of pregnancy, worse on moving or rising, better lying still; sympathetic faintness. See Stomach/Sleep. [Allen], [Boericke], [Farrington].
• Pelvic floor & Sacro-iliac supports — “broken back” feeling; worse standing/walking or lifting; better recumbency and a binder. See Back/Generalities. [Clarke], [Boger].
• Blood-vessels of pelvis — menorrhagia/metrorrhagia from atony; flow dark, clotty; relief as flow becomes free and even. See Female/Fever. [Clarke], [Phatak].
• Bladder (pressure) — frequent urging from heavy uterus; tenesmus vesicæ after exertion. See Urinary. [Boericke], [Allen].
• Mammæ (reflex) — sense of fulness and nipple sensitiveness about menses or early pregnancy. See Female. [Clarke].

• Lying perfectly still, especially on the back; avoids turning (relieves nausea of pregnancy and uterine colic). [Allen], [Boericke].
• Recumbency with hips slightly elevated; mechanical support (binder/hand) to uterus (relieves bearing-down). [Clarke].
• Flow becoming free when menses had been suppressed or scanty; head and sacrum ease (echoed in Symptomatology). [Clarke], [Phatak].
• Quiet cool air; loosening tight garments around waist; avoiding heated rooms (relieves faintness and pelvic heat). [Hughes], [Clarke].
• After stool and after passing urine (pressure lessened). [Boger].
• Gentle sips of cool water; small, frequent nourishment taken lying (vomiting of pregnancy). [Allen], [Farrington].
• Absolute sexual rest in threatened miscarriage; mental quiet. [Clarke], [Farrington].
• Sleep or even a short doze when kept still (nausea and cramp subside). [Boericke].

• Motion of any kind—rising, turning in bed, riding in a carriage, walking—provokes uterine pains and nausea/vomiting (grand aggravation). [Allen], [Clarke].
• Jar and lifting—stair-climbing, stepping down, carrying a child—renew bearing-down and threaten abortion. [Clarke], [Boericke].
• Early weeks of pregnancy (first trimester): morning nausea, uterine irritability. [Allen], [Farrington].
• Suppressed or delayed menses; getting chilled at menses; emotions (fear, grief) checking the flow—pelvic weight and cramp ensue. [Clarke], [Boger].
• Warm, close rooms; cooking odours during nausea; mental exertion while nauseated. [Hughes], [Allen].
• Coitus and sexual excitement in uterine atony states; next-day tenderness. [Clarke].
• Tight bands/corsets around waist or hips; pressure from clothing. [Clarke].
• Standing long at household work; fatigue of the day. [Boericke].

Vomiting of pregnancy (motion-provoked; stillness amel.)

• Symphoricarpus racemosus — severe NVP, constipation, often not better by stillness; indomitable emesis; Gossyp.: motion-provoked, better absolute rest. [Farrington], [Clarke].
• Ipecacuanha — constant nausea not relieved by vomiting; motion may aggravate but stillness not key; tongue clean; much salivation. Gossyp.: lying still decisive; uterine drag. [Allen], [Boericke].
• Colchicum — smell of food unbearable; extreme nausea; less uterine sphere; Gossyp. adds pelvic bearing-down and threatened abortion. [Clarke].
• Nux vomica — morning nausea in the irritable, with gastric spasm; movement less central; Gossyp.: uterine atony and motion-agg. dominate. [Kent], [Farrington].

Threatened abortion / early uterine colic

• Viburnum opulus — crampy uterine pains with external pressure amel.; less nausea-motion link; Gossyp.: stillness law + gastric reflex. [Clarke], [Boericke].
• Sabina — bright, active haemorrhage with pains from sacrum to pubes; often 2–3rd month; Gossyp.: atony, dark clots, nausea on movement. [Boger], [Farrington].
• Trillium — gushing bright bleeding with faintness on least motion; Gossyp.: darker, atonic, “weight” and binder-amel. [Clarke].
• Secale — passive dark oozing with coldness and better cold, desire to be uncovered; Gossyp.: seeks stillness and support, not cold exposure. [Kent].

Amenorrhœa / delayed flow with weight

• Pulsatilla — mild, weepy, thirstless, changeable; late menses; motion not the chief issue; Gossyp.: mechanical weight and stillness law; less emotional colour. [Farrington], [Clarke].
• Sepia — bearing-down with pelvic relaxation, better exercise, mental indifference; Gossyp.: worse motion, no Sepia mind. [Kent].
• Ferrum iodatum — anaemic plethora, thyroid heat, bright bleed; Gossyp.: darker atony, gastric reflex, stillness-amel. [Clarke].

Subinvolution / prolapse (post-partum)

• Bellis perennis — pelvic bruising after labour, loves cold bathing; Gossyp.: atony and weight with motion-agg., stillness-amel. [Clarke].

Fraxinus americana — heavy, enlarged uterus better binder, jar/stairs <; Gossyp.: adds gravid nausea and motion-agg. [Boericke], [Clarke].

• Complementary: Viburnum opulus — cramp-calmer in threatened abortion; Gossyp. for the motion-provoked nausea/atony background. [Clarke], [Boericke].
• Complementary: Fraxinus americana — mechanical subinvolution and prolapse after Gossyp. steadies nausea and atony. [Clarke].
• Complementary: Pulsatilla — delayed menses in timid girls; Gossyp. when motion-agg. and pelvic weight predominate; Puls. for emotional climate. [Farrington].
• Follows well: Bellis perennis — after strains of labour/trauma ease, Gossyp. completes uterine tone. [Clarke].
• Follows well: Nux vomica — after drugging/over-stimulation in nausea; Gossyp. when stillness-amel. and uterine drag persist. [Kent].
• Precedes well: Sepia — if chronic pelvic relaxation remains without motion-agg.; Sepia then constitutional. [Kent].
• Related/Compare: Sabina, Trillium, Viburnum, Sepia, Pulsatilla, Symphoricarpus, Nux-v., Ferr-iod., Fraxinus (see Differentials). [Farrington], [Clarke].
• Antidotes: Nux/Coffea for medicinal over-action; physiological antidote—absolute rest, cool air. [Allen], [Kent].
• Inimicals: none recorded; avoid promiscuous alternation among uterine congeners without a keynote shift. [Boger].

The essence of Gossypium is a uterus and stomach ruled by the law of stillness. The uterus is atonic and congested: it drags, it bears down, it threatens to evacuate its contents on the least motion—rising, turning, stepping, jar. The stomach echoes the same law—vomiting of pregnancy and nausea worse on moving, better lying perfectly still. A third chord is relief by outlet: when suppressed menses return and run evenly, the head lightens and sacrum eases. Thread these three and the picture clarifies. She lies on her back, hips a little raised, binder in place; she sips cool water lying, will not be hurried, will not be urged to move. The least jar—a carriage, a stair, a kerb—reignites pelvic cramp and retching. In threatened abortion the stillness becomes sacred, the voice lowered, the room cooled; a night without turning is victory. Compare Sepia, whose bearing-down likes exertion and whose mind is alienated; Gossypium is gentle, compliant, somatically obedient to rest. Compare Trillium and Sabina, leaders in bright, arterial bleeding; Gossypium is the darker, atonic flow with drag and nausea. Compare Pulsatilla for amenorrhœa in yielding temperaments; Gossypium is less tearful and more mechanical: “I am worse when I move; better when I lie quite still.”

Pathophysiologically, the picture reads as uterine smooth-muscle atony with irritability: movement increases intra-abdominal and pelvic tipping forces which, in a lax cervico-uterine complex, trigger reflex nausea via vagal mediation. Hence the simultaneity of womb and stomach; hence the law of stillness. The sacro-iliac “broken back” is the skeletal protest of a drooping uterus; the bladder frequency is merely its neighbour’s complaint. Practical management must therefore copy the remedy: absolute rest on the back, hips slightly raised; mechanical support; quiet cool room; no jar, no lifting; tiny sips and morsels taken without moving. Clinically, Gossypium has served in (1) amenorrhœa with pelvic weight and motion-agg. nausea; (2) threatened abortion in the early months with sacral drag and faintness on sitting up; (3) dysmenorrhœa of the atonic congestive type; (4) subinvolution with reflex gastric irritability; and (5) vomiting of pregnancy where stillness is a commanding amelioration.

Potency and repetition. In threatened abortion and early pregnancy nausea, 3x–6x or 6C at short intervals while absolute rest is maintained; in amenorrhœa/dysmenorrhœa with weight and stillness-amel., 6C–30C once to t.i.d. as needed; where the keynote is vivid and vitality fair, 30C–200C may be employed cautiously, spacing as the patient can move without nausea or bearing-down returning. Intercurrent Viburnum opulus is serviceable when cramping predominates without much nausea; Fraxinus when subinvolution and mechanical support are the lasting needs; Pulsatilla when the case melts into emotional, changeable amenorrhœa. The bedside tests are simple: the Stillness Test (better absolutely quiet); the Binder Test (support amel.); the Outlet Test (relief as flow frees). When a woman says, “If I lie quite still, I am safe; if I move, I am sick and feel it all drag down,” Gossypium stands central.

• NVP with motion-agg.; stillness-amel.—cannot even turn in bed without retching; sips cold water lying ⇒ 6C–30C, strict recumbency, cool room. [Allen], [Boericke], [Clarke].
• Threatened abortion (early months)—pelvic colic + sacral drag after jar/lifting; faint on rising; dark clots; better binder + lying still ⇒ 6x–6C q1–2h initially, then space. [Clarke], [Farrington].
• Amenorrhœa with sense menses will appear but checked; nausea on rising; relief when flow comes ⇒ 6C b.i.d. for several days around expected period. [Clarke], [Phatak].
• Post-partum subinvolution with gastric irritability and motion-agg. pelvic weight—combine rest/support with 6x; follow by Fraxinus/Helonias if mere atony persists. [Boericke], [Clarke].

Mind

• Anxiety about miscarriage; dreads motion or jar lest symptoms return — motion-fear driven by pelvic atony. [Clarke].
• Timid, whispers; seeks quiet, cool room; calmer when recumbent — environment–mind link. [Clarke].
• Despondent during amenorrhœa; hopeful the instant flow becomes free — outlet law. [Clarke], [Phatak].
• Aversion to being hurried or moved while nauseated — stillness imperative. [Allen].
• No Sepia-like indifference; mood governed by pelvic mechanics — differential pointer. [Kent], [Farrington].
• Faintness in warm rooms with fear of rising — thermal + motion nexus. [Hughes].

Head

• Headache, frontal/vertex, with suppressed menses; better when flow free — uterine–head hinge. [Clarke].
• Vertigo and faintness on rising; must lie down — motion-agg. [Allen].
• Heat of head in close rooms; cool air relieves if attained without movement — thermal nuance. [Hughes].
• Pallor alternating with flush during uterine colic — vascular sign. [Clarke].
• Heaviness of head with constant nausea; lying still — stomach reflex. [Allen].
• No throbbing fury (≠ Bell.), no sun-periodicity (≠ Sang.) — differential. [Farrington].

Stomach

• Vomiting of pregnancy, worse motion/rising, better lying perfectly still — master gastric rubric. [Allen], [Boericke].
• Nausea from cooking odours, especially in warm rooms — odour/heat nexus. [Hughes], [Clarke].
• Sips of cold water lying relieve; moving to drink aggravates — position-specific. [Allen].
• Nausea with pelvic bearing-down; efforts to vomit increase uterine pains — reflex loop. [Clarke].
• Morning worse in early months; quieting the room amel. — timing. [Boericke].
• Not relieved by vomiting unless she is still; differs from Ipec. — comparator. [Allen], [Farrington].

Female

• Amenorrhœa/suppressed menses with weight “as if would come,” nausea on rising — key indication. [Clarke].
• Threatened abortion (first trimester)—pelvic colic; sacral drag; motion/jar <; recumbency/support > — master uterine rubric. [Boericke], [Farrington].
• Dysmenorrhœa with cramp to sacrum/thighs; jar <; recumbency/binder > — mechanic. [Clarke].
• Menorrhagia/ metrorrhagia from atony, dark with clots; better when flow runs even — outlet law. [Clarke], [Phatak].
• Subinvolution with sacral weakness and vesical pressure — postpartum note. [Clarke], [Boericke].
• Breast fulness, nipple sensitive in early pregnancy with gastric reflex — concomitant. [Clarke].

Back / Generalities

• Sacro-iliac “broken back,” worse standing/walking, better recumbency/support — spinal hinge. [Boger], [Clarke].
• Jar, lifting, stairs aggravate pelvic/back pains — mechanical. [Clarke].
• Better hips elevated; binder relieves — support law. [Clarke].
• Faintness and pallor on attempting to rise — kinetic sign. [Allen].
• Weakness after uterine colic and nausea; sleep restores — restorative. [Boericke].
• Warm, close rooms aggravate; cool air relieves if movement is avoided — thermal. [Hughes].

Urinary / Rectum

• Frequency from pelvic pressure; worse standing/walking, better lying — pressure law. [Boericke].
• Tenesmus vesicæ after household exertion; quiet relieves — fatigue echo. [Clarke].
• Constipation from uterine pressure; stool difficult though not hard — mechanical. [Boger].
• Relief of pelvic weight after stool — drainage hinge. [Boger].
• Urging to urinate during uterine colic of abortion — concomitant. [Allen].
• No Cantharis-like burning; pain is pressure-reflex — differential. [Clarke].

Sleep

• Wakes on turning with nausea or uterine pains; must lie perfectly still — position rubric. [Allen].
• Sleep refreshes if posture is kept; short doze relieves nausea — restorative. [Boericke].
• Dreams of falling or expulsion of womb; fear to stir in sleep — symbolic. [Clarke].
• Morning rising renews nausea; must lie again — clock hinge. [Allen].
• Quiet room and pillow under knees prolong rest — management. [Clarke].
• Nocturnal cramps lessen with binder — bedside. [Clarke].

Generalities

• Worse motion, worse jar, worse rising — grand general. [Allen], [Clarke].
• Better absolute rest, lying still, mechanical support — grand amelioration. [Clarke], [Boericke].
• Relief when discharges are free (menses) — outlet law. [Clarke], [Phatak].
• Warm rooms/odours <; cool air > if no movement — thermal–odor. [Hughes].
• Sexual excitement and coitus < in atony — pelvic irritability. [Clarke].
• Standing household tasks <; afternoon fatigue — occupational rubric. [Boericke].

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): fragments and clinical notes—amenorrhœa with pelvic weight; nausea/vomiting of pregnancy worse motion; threatened abortion; modalities.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—uterine atony; threatened abortion; nausea of pregnancy better lying still; subinvolution; relationships.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): substance background; uterine and gastric spheres; binder/recumbency; odour/heat aggravations; comparisons.
Hughes, R. — A Manual of Pharmacodynamics (1870): pharmacologic and eclectic notes on cotton root-bark; thermal/odour aggravations; emmenagogue/oxytocic background.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879): confirmations—amenorrhœa, threatened abortion, sacral drag, motion-aggravation, rest amelioration.
Farrington, E. A. — Clinical Materia Medica (1887): differentials—Sepia, Pulsatilla, Sabina, Trillium, Symphoricarpus; early pregnancy indications.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): generalities—motion/jar <; support/rest >; pelvic pressure to bladder/rectum; miasmatic colouring.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): constitutional distinctions—Sepia vs mechanical uterine remedies; mental shading.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (1977): concise keynotes—amenorrhœa with sensation of impending flow; relief when discharge free; pelvic weight.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): practical remarks on uterine hæmorrhage and motion modalities; dosing hints.
Dewey, W. A. — Practical Homœopathic Therapeutics (1901): regimen and repetition in threatened abortion and NVP; rest and support doctrine.
Tyler, M. L. — Homœopathic Drug Pictures (1942): portraits of stillness-ameliorated pregnancy nausea and early miscarriage fear; bedside differentiations.