Hydrocotyle asiatica

Hydrocotyle asiatica is a creeping, marsh-loving umbellifer (Apiaceae/Umbelliferæ) native to South and East Asia. Traditional medical systems (Ayurveda, Unani) used the plant as a vulnerary for chronic skin ulcers and as a tonic; pharmacognosy identifies triterpenoid saponins (e.g., asiaticoside, madecassoside) with trophic effects on connective tissue—an observation that accords with the homœopathic sphere of action on skin and subcutaneous cellular tissue, especially thickening, induration, and dyskeratotic patches [Hughes], [Clarke]. The mother tincture is prepared from the fresh herb; triturations and centesimals follow standard methods [Allen], [Clarke]. Toxicologic notes are scant; the remedy-picture rests on provings and abundant clinical confirmations in dermatoses (psoriasis, lupus, leprosy-analogues), pruritus (notably vulvar), and hypertrophic states of mucosa and cervix [Hering], [Clarke], [Boericke].

In eclectic and herbal practice Centella was prized for chronic ulcers, indolent wounds, and as a general “alterative”; in Asia it was a common topical for skin granulomas and a cooling internal for “heat” ailments. Such traditional use around connective-tissue repair and skin trophicity harmonises with the remedy’s affinity for hypertrophy and induration of skin and cervix, pruritus, and slow, non-suppurative ulceration [Hughes], [Clarke].

Hydrocotyle’s pathogenesis derives from small American and European provings and extensive [Clinical] confirmations in skin disease (psoriasis—circinate and palmar, lupus, leprosy), pruritus vulvæ, and cervical hypertrophy/erosion with leucorrhœa [Allen], [Hering], [Clarke]. The remedy is therefore essentially a clinical-polished portrait anchored by strong, repeated observations rather than by a large Hahnemannian proving.

• Skin and subcutaneous cellular tissue—thickening, induration, circinate or mammillated patches; psoriasis (especially palmar and circinate forms), lupus/lupoid granulomas; intolerable itching with burning after scratching; fissures and rhagades (see Skin). [Clarke], [Boericke], [Hering].
• Female pelvic organs—cervix uteri hypertrophied and granular (“erosion”), pruritus vulvæ of tormenting intensity, thick leucorrhœa; pelvic bearing-down from connective-tissue laxity/overgrowth (see Female). [Clarke], [Boericke], [Phatak].
• Mucocutaneous junctions—lips, anus, vulva: cracks and raw, glazed surfaces with scant pus but much thickening (see Mouth, Rectum, Skin). [Clarke], [Boger].
• Lymph and trophic beds—slow, non-suppurative ulceration with indurated base; old cicatrices and keloidal tendencies (see Skin). [Clarke], [Hering].
• Palms and soles—intense pruritus and hyperkeratosis; psoriatic disks; cracks that smart and burn (see Extremities, Skin). [Boericke], [Clarke].
• Nervous terminations of the skin—formication, “crawling,” numb zones about patches (leprosy-analogue) (see Skin). [Clarke], [Hering].
• Cervico-vaginal mucosa—granulation and hyperplasia with itching far out of proportion to visible discharge (see Female). [Clarke], [Phatak].

• Cold applications and cool air to the part—mitigates burning after scratching (echoed under Skin/Female). [Clarke], [Boericke].
• Gentle bathing with tepid water; bland, emollient dressings—soothes cracks and glazed surfaces (Skin/Rectum). [Clarke].
• Uncovering and loose clothing around vulva or affected skin—reduces friction-provoked itch (Female/Skin). [Phatak], [Clarke].
• Rest and avoidance of heat or exertion—lessens pruritic surges (Generalities/Skin). [Clarke].
• After onset of menstrual flow when pruritus vulvæ is premenstrually worse (Female). [Clarke], [Phatak].
• Evening applications followed by brief exposure to cool night air—patients report a calmer night (Sleep/Skin). [Clinical], [Clarke].
• After stool when fissures are gently cleansed and an emollient applied (Rectum/Skin). [Clarke].
• Distraction/occupation—reduces scratching impulses in neurotic pruritus (Mind/Skin). [Farrington], [Clarke].

• Heat—of bed, warm rooms, hot bathing; itching becomes intolerable and scratching is irresistible (Skin/Female). [Boericke], [Clarke].
• Scratching—gives momentary relief but is followed by burning and smarting; excoriations extend (Skin). [Clarke], [Hering].
• Night—itching and crawling sensations drive from bed (Sleep/Skin). [Boericke], [Clarke].
• Woollens, tight garments, friction—set up prickling and burning (Skin/Female). [Phatak], [Clarke].
• Pregnancy and before menses—pelvic congestion heightens pruritus vulvæ (Female). [Clarke], [Phatak].
• Weather changes to warm damp; heated rooms in winter (Skin). [Clarke].
• Spices, alcohol—flush the skin and increase itch (Food & Drink/Skin). [Clarke].
• Mental dwelling on the irritation—itch amplifies when attention is fixed on it (Mind/Skin). [Farrington].

• Pruritus (especially vulvar)
– Sepia: bearing-down, indifference; pruritus with yellow-green discharge; Sep. better vigorous exercise; Hydrocotyle’s itch is out of proportion to discharge, worse heat, better cool, with cervical hyperplasia. [Kent], [Clarke].
– Kreosotum: excoriating, offensive leucorrhœa corroding parts; Hydrocotyle discharge scant/moderate, itching primary; less corrosion. [Hering], [Clarke].
– Rhus toxicodendron: itching better hot water; opposite modality to Hydrocotyle. [Boericke].
• Psoriasis / Palmar–Plantar
– Kali arsenicosum: inveterate psoriasis with violent burning and restlessness; Hydrocotyle more hypertrophic/glazed, less restlessness, better cool. [Clarke], [Boger].
– Graphites: fissures with sticky honey oozing; obese, chilly; Hydrocotyle has burning after scratch, glazed plaques, less oozing. [Farrington], [Clarke].
– Chrysarobinum: thick infiltrated eczema/psoriasis with honey crusts; Hydrocotyle more indurated/glazed with intolerable itch. [Clarke], [Boericke].
• Lupus / Lupoid
– Arsenicum album: ulcerative, burning pains better heat; Hydrocotyle prefers cool; less constitutional anxiety. [Kent], [Clarke].
– Kali bichromicum: punched-out ulcers with viscid plugs; Hydrocotyle shows indurated, glazed, slowly extending lesions. [Boger], [Clarke].
• Leprosy analogues / Anaesthetic rings
– Psorinum: filthy skin, offensive discharge, chilliness; Hydrocotyle less offensive, more hypertrophic, heat-worse itch. [Hering], [Clarke].
– Sulphur: universal itch, heat of vertex, offensive sweat; Sulph. craves warmth despite itch; Hydrocotyle craves cool. [Kent], [Boericke].
• Cervical hypertrophy / Erosion
– Murex: uterine congestion with increased desire; Hydrocotyle has pruritus and structural hyperplasia without erotic keynote. [Clarke].
– Alumina: dryness with itching and fissures at orifices; Hydrocotyle more hypertrophic/granular cervix with heat-worse pruritus. [Boger], [Clarke].

• Complementary: Sepia—pelvic support and bearing-down; Sep. covers constitutional stasis; Hydrocotyle addresses pruritus vulvæ with cervical hyperplasia and cool-amelioration. [Clarke], [Kent].
• Complementary: Graphites—fissures at orifices with thickened skin; Graph. for oozing/honey crusts; Hydrocotyle for glazed thickening and burning after scratch. [Farrington], [Clarke].
• Complementary: Kali arsenicosum—in obstinate psoriasis; use Hydrocotyle when cool amel., burning after scratch, hypertrophic plaques dominate. [Boger], [Clarke].
• Follows well: Sulphur—after Sulph. rouses the reactive plane, Hydrocotyle reduces hypertrophy/pruritus in heat-worse cases. [Kent], [Clarke].
• Follows well: Arnica/Calendula (locally)—once surface trauma is calmed, Hydrocotyle consolidates trophic repair (clinical). [Clarke].
• Precedes well: Thuja—if warty sycotic overgrowth remains after itch abates. [Clarke], [Boericke].
• Related: Chrysarobinum (psoriasis/eczema), Kreosotum (corroding leucorrhœa), Rhus tox. (hot-water amel.), Arsenicum (heat-amel. opposite), Petroleum (winter cracks, but oiliness). [Clarke], [Boericke], [Boger].
• Inimicals not recorded; individualise by modalities (heat-worse, cool-better) and hypertrophic skin/cervical signs. [Clarke], [Boericke].

Hydrocotyle’s essence is the conjunction of hypertrophy and itch: connective-tissue overgrowth of skin and cervix produces circinate or mammillated, glazed patches and granular erosions; these burn and itch intolerably, especially with heat and in bed, and scratching—though momentarily blissful—inevitably begets smarting and further excoriation. Its signature polarity is simple and reliable: heat aggravates and summons the itch; coolness—air, water, loose clothing, bland unguents—brings quiet. The kingdom signature (Plant—Apiaceae) appears as surface reactivity and trophic modulation rather than deep organ spasm (cf. Conium, Cicuta). Miasmatically, a sycotic hypertrophic drive makes disks, warts, keloids and a beefy cervix; the syphilitic current contributes fissure, ulcer and lupus when unchecked; psora supplies the furnace of itch. The pace is chronic, indolent, and non-suppurative: lesions expand peripherally without storm, patients sleep poorly from heat and itch, and morale sinks under nightly torture.
Clinically this produces a recognisable patient: they dread warmth; the very act of going to bed heralds a siege of itching, especially of palms, soles, or the vulva. They will say, “Cold water is the only thing that helps.” Patches are thick, slow, and glazed more than oozy; if scaly, they are psoriatic rather than eczematous. At orifices the skin cracks and smarts; at the cervix it is hypertrophic and granular with little corrosive discharge but much itch. Mental disturbance is reactive—peevish, despondent from lost sleep and disfigurement—and lifts conspicuously when the surface cools. Differentials resolve along the heat axis: Arsenicum burns but wants heat; Rhus itches but is pacified by hot bathing; Sulphur’s itch with heat often paradoxically seeks warmth; Graphites oozes honey and is sluggishly moist; Kreosotum corrodes; Kali-ars. is a sterner, restlessly burning psoriasis. Hydrocotyle fits when the mind says “I must be cool,” the hands and vulva agree, and the tissues are thick yet quiet, itching to madness in the least heat [Clarke], [Boericke], [Boger], [Phatak]. Practically, success depends on aligning regimen with the remedy: cool sleeping conditions, loose cotton, avoidance of spices/alcohol, bland emollients, and minimal scratching. Under such conditions the medicine’s action often shows early as longer “cool intervals” at night, less post-scratch burn, softening of plaques, and steady regression of cervical granulations.

Indications: Psoriasis (palmar/plantar, circinate); lupus/lupoid granulomas with indurated bases; leprosy-analogous anaesthetic rings; fissures and glazed rawness at orifices; intolerable pruritus vulvæ (especially heat- and night-worse) with granular/hypertrophic cervix; keloidal scarring tendencies [Clarke], [Hering], [Boericke], [Phatak]. Posology: Low to medium potencies (3X–6X, 6C) repeated once–twice daily in chronic hypertrophic skin states; 30C when the keynote modalities are striking across sites (pruritus vulvæ + palmar psoriasis) [Clarke], [Boericke]. Repetition: taper as burning-after-scratch subsides and sleep improves; resume during warm-weather relapses. Adjuncts: cool bathing; loose cotton; bland, unscented emollients; avoidance of hot rooms, alcohol, spices (explicitly matching modalities) [Clarke], [Phatak].
Case pearls:
• “Palmar psoriasis, heat-worse, burning after scratch; Hydrocotyle 3X + cold soaks—night torment ceased, plaques softened.” [Clinical], [Boericke], [Clarke].
• “Pruritus vulvæ with granular cervix; worse before menses and in bed; Hydrocotyle 6C cleared itch and reduced cervical hyperplasia.” [Clarke], [Phatak].
• “Lupoid facial patch—glazed, indurated, little pus; cool regimen + Hydrocotyle narrowed the ring steadily.” [Clinical], [Clarke].

Mind
• Mind—Irritability—itching from—heat in bed agg. Cutaneous-driven temper. [Clarke].
• Mind—Anxiety—appearance about—facial patches. Social withdrawal sign. [Clarke].
• Mind—Aversion to company—skin disease from. Practical case-guidance. [Clarke].
• Mind—Dwelling on complaints—itch increases. Attention fuels itch loop. [Farrington].
• Mind—Sleep lost—pruritus from—peevishness. Confirms nocturnal torture. [Boericke], [Clarke].
Head/Face
• Face—Lupus—indurated base—non-suppurative—heat agg., cold amel. Hydrocotyle type. [Clarke].
• Scalp—Itching—scratching → burning. Modality hallmark. [Clarke].
• Lips—Cracks—angles—heat agg.—cool water amel. Orifice fissure theme. [Clarke].
• Head—Heaviness—evening—warm room agg. Heat-sensitivity marker. [Clarke].
• Face—Eruptions—circinate—glazed. Psoriatic/lupoid edge. [Clarke].
Female
• Vulva—Pruritus—intolerable—night—heat of bed agg.—cold applications amel. Cardinal rubric. [Boericke], [Clarke], [Phatak].
• Cervix—Hypertrophy—granular (erosion). Structural keynote. [Clarke].
• Leucorrhœa—moderate—itching out of proportion. Distinguishes from corrosives. [Phatak].
• Menses—Before—pruritus worse; during—relief. Cyclic cue. [Clarke].
• Bearing down—pelvic—connective-tissue changes. Supportive sign. [Clarke].
Skin
• Skin—Itching—violent—heat agg.—scratching amel. then burning. Core modality. [Clarke], [Boericke].
• Skin—Psoriasis—palmar/plantar—circinate—heat agg., cold amel. Target indication. [Clarke].
• Skin—Lupus—indolent—indurated edges—little suppuration. “Glazed” Hydrocotyle ulcer. [Clarke], [Hering].
• Skin—Fissures—at orifices—smarting—cool water amel. Orifice theme. [Clarke], [Boger].
• Skin—Keloid—tendency—old scars. Hypertrophic trope. [Clarke].
• Skin—Formication—crawling—warmth agg. Sensory pointer. [Clarke].
Extremities
• Hands—Palms—itching—intolerable—warmth agg.—cold water amel. Workroom cue. [Boericke], [Clarke].
• Feet—Soles—cracks—smarting after scratching. Plantar fissures. [Clarke].
• Extremities—Eruptions—circinate—glazed—psoriatic. Distribution clue. [Clarke].
• Nails—Pitting—psoriatic patches near. Ancillary sign. [Clinical].
• Clothing—Friction—agg.—woollens agg. Practical modality. [Phatak].
Rectum
• Anus—Fissures—glazed—itching—burning after scratch—cool bathing amel. Management rubric. [Clarke], [Boger].
• Anus—Pruritus—night—heat of bed agg. Sleep-breaking sign. [Clarke].
• Skin around anus—thickened—indurated. Trophic echo. [Clarke].
• Stool—Passage—cracks smarting. Orifice sensitivity. [Clarke].
Generalities
• Heat—aggravates—bed; warm room. Master modality. [Boericke], [Clarke].
• Cold—applications—amel.; cool air—amel. Master amelioration. [Clarke].
• Hypertrophy—connective tissue—skin/cervix. Structural keynote. [Clarke].
• Night—agg.—itching. Circadian pattern. [Boericke].
• Friction—wool—agg. Everyday trigger. [Phatak].
• Scratching—amel. then burning—worse. Behavioural-cue rubric. [Clarke], [Hering].

Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): skin/cervical hypertrophy, pruritus vulvæ, modalities (heat-worse, cool-better), lupus/leprosy range; clinical notes.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—intolerable itching (palms, vulva), psoriasis/lupus sphere, burning after scratching, modalities.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879–1891): confirmations in trophic skin disease, leprosy analogues, fissures; sensory polarity itch→burn.
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–1879): proving fragments and clinical collations; preparation notes.
Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): botanical/pharmacognostic background; connective-tissue rationale for skin/cervical indications.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): repertorial cues—fissures at orifices, heat-worse itch, circinate plaques; relationships.
Farrington, E. A. — Clinical Materia Medica (1890): organ-affinity method; comparisons for pruritus vulvæ and psoriasis set; mental overlay secondary to skin.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): miasmatic colouring and differentials (Sep., Ars., Graph., Sulph.) used herein.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (20th c.): clinical keynotes—pruritus vulvæ, wool/friction aggravation, cyclic aggravations.
Tyler, M. L. — Homœopathic Drug Pictures (20th c.): practical picture sketches for skin remedies, heat/cold modalities, and patient management hints.
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): brief therapeutic groupings (psoriasis, pruritus vulvæ) informing clinical tips.