Iberis amara

Iberis amara is a small, bitter annual of the Cruciferæ with white cruciform flowers, native to dry, chalky places in Europe and long cultivated as an ornamental. The fresh plant abounds in glucosidic “mustard-oil” principles and bitter constituents; as with other crucifers, topical rubefaction and a reflex influence upon circulation are noted in crude use [Hughes], [Clarke]. The homœopathic mother tincture is prepared from the fresh herb in flower; triturations and centesimals are then made according to the pharmacopœia [Allen], [Clarke]. Proving and clinical experience converge upon the heart and circulation—palpitation, irregular action, valvular murmurs, dyspnœa on the least exertion, with attendant vertigo, head-congestion, and left-sided radiations to shoulder and arm—whence its reputation as a minor but pointed cardiac remedy [Hering], [Clarke], [Boericke].

Historically employed as a simple bitter and carminative in domestic medicine, and as a horticultural plant; not a significant drug in orthodox practice. Its acrid-bitter nature and family relations (mustard oils) explain the reflex circulatory excitations seen in crude experiments and echoed in the homœopathic picture [Hughes], [Clarke].

Our knowledge rests on small provings (American school) and numerous [Clinical] confirmations in cardiac cases: palpitation with vertigo and frontal fulness; dyspnœa on ascending; precordial oppression with pains to left scapula/arm; irregular, intermittent pulse; cardiac murmurs (mitral, aortic) and failing compensation; cold extremities with faintness [Allen], [Hering], [Clarke], [Boericke]. The remedy’s picture has been repeatedly verified in out-patient dispensary work for “nervous heart” and early valvular disease [Clarke], [Boericke].

• Heart muscle and valves—palpitation, irregularity, intermittency; dilatation and early hypertrophy; systolic murmurs (esp. mitral); oppression and pain radiating to left shoulder/arm (see Heart/Chest). [Clarke], [Boericke], [Hering].
• Arterial and venous circulation—flushes to head; vertigo, congestive headaches; cold extremities with weak peripheral pulse (see Head, Extremities). [Allen], [Clarke].
• Respiratory co-operation—dyspnœa on least exertion; orthopnœa; must sit up (see Respiration). [Boericke], [Hering].
• Cardio-neurotic sphere—anxiety about the heart, tremulousness, startings at night; palpitation from emotion or tobacco (see Mind, Sleep, Food & Drink). [Clarke], [Hughes].
• Left-sided chest wall and scapular region—aching/stitching under left scapula; pains shoot down left arm (see Chest, Extremities). [Clarke], [Allen].
• Hepatic/epigastric sympathy—weight at epigastrium with cardiac oppression; nausea during palpitations (see Stomach). [Allen], [Clarke].
• Visual/aural circulation—blurred sight, blackness before eyes, noises in ears synchronous with pulse during attacks (see Eyes, Ears). [Allen], [Hering].

• Absolute rest; sitting quietly, propped up; head and shoulders raised (orthopnœa relief) (Respiration/Heart). [Clarke], [Boericke].
• Cool, moving air; open window; gentle fanning during palpitation (Respiration/Generalities). [Clarke].
• After a slow, cautious walk in open air once acute fluttering subsides (Respiration). [Clinical], [Clarke].
• Pressure of the hand over præcordia; steady support across the chest (Chest). [Clinical].
• Small sips of cold water during nausea of cardiac origin (Stomach). [Allen].
• Quiet, darkened room; avoidance of mental excitement (Mind/Sleep). [Hering].
• Sleep with the trunk raised; half-sitting (Sleep/Generalities). [Clarke].
• Abstaining from tobacco and strong coffee (Food & Drink). [Hughes], [Clarke].

• The least exertion—ascending stairs, hurrying, stooping; even turning in bed brings palpitation/dyspnœa (Generalities/Heart/Respiration). [Clarke], [Boericke].
• Emotional disturbance—sudden joy, fright, anxiety; cardiac tumult follows (Mind/Heart). [Hering], [Clarke].
• Warm, close room; overheating in bed (Respiration). [Clarke].
• Tobacco, alcohol, strong coffee—palpitation, irregularity and dyspnœa (Food & Drink/Heart). [Hughes], [Clarke].
• Lying on the left side; pressure of bedclothes across præcordia (Sleep/Chest). [Boericke], [Clarke].
• After meals, especially if heavy or late; epigastric weight with heart oppression (Stomach/Heart). [Allen], [Clarke].
• Sudden movement; rising quickly from chair or bed (Generalities/Head). [Allen].
• Weather changes—damp chill or oppressive heat—strain the circulation (Generalities/Respiration). [Clarke].

• Aetiology / Triggers
– Aconitum: palpitation from fright with acute fear of death; Acon. is stormy, feverish; Iberis is cooler, effort- and heat-worse with orthopnœa. [Kent], [Clarke].
– Gelsemium: cardiac weakness with tremulousness and slow action; Iberis shows tumultuous, irregular action and head-congestion. [Farrington], [Clarke].
• Cardiac—Pace and Pulse
– Digitalis: failing compensation with slow, weak pulse; fear to move; Iberis has bounding/irregular pulse, effort-worse tachy-palpitations. [Clarke], [Boericke].
– Strophanthus: dilated heart with breathlessness on exertion; Stroph. more tonic, less head-congestion; Iberis adds vertigo, visual obscurations. [Boericke], [Clarke].
– Crataegus: myocardic tonic without a proving picture; Iberis has specific modalities (left scapula pain, warm-room agg.). [Clarke], [Boericke].
• Sensation / Constriction
– Cactus grandiflorus: “iron band” around heart; Iberis lacks the vise-like clamp, has more flutter and radiation to left arm. [Clarke], [Boger].
– Spigelia: sharp, stabbing left chest pains, sensitive to least motion; Spig. more neuralgic; Iberis more circulatory tumult with orthopnœa. [Farrington], [Clarke].
• Radiation / Arm
– Kalmia: pains shoot to left arm with slow pulse; Iberis with irregular, often quick pulse and head symptoms. [Boger], [Clarke].
– Naja: valvular disease with throat constriction and nocturnal aggravation; Iberis has warm-room and exertion aggravation with vertigo and visual blur. [Clarke], [Boericke].
• Vascular Head
– Glonoinum: violent throbbing, head feels enormous, heat-sun agg.; Iberis head-congestion is secondary to cardiac tumult and relieved by cool air. [Clarke], [Kent].
– Aurum: hypertrophy with profound melancholy; Iberis has anxiety about heart but not Aurum’s suicidal gloom. [Kent], [Clarke].

• Complementary: Crataegus—tonic support in dilatation while Iberis quiets tumult and orthopnœa. [Clarke], [Boericke].
• Complementary: Strophanthus—failing compensation and exertional dyspnœa; Iberis for irregular, effort-provoked palpitations; Stroph. for myocardial tone. [Boericke].
• Complementary: Kalmia—left arm radiation; Kalm. when slow pulse and neural shooting dominate. [Boger], [Clarke].
• Follows well: Aconite—after acute fright/panic settles, Iberis controls persisting palpitation. [Kent], [Clarke].
• Follows well: Naja—in valvular disease with throat constriction once distressing tightness abates, Iberis for effort-dyspnœa. [Clarke].
• Precedes well: Digitalis—when action sinks slow after Iberis has controlled tumult; change as pace changes. [Clarke], [Boericke].
• Related: Cactus, Spigelia, Glonoinum, Convallaria, Adonis vernalis—distinguish by quality of pain, pulse, and modalities. [Clarke], [Boericke], [Boger].
• Antidotes/Aggravants: Tobacco and strong coffee aggravate Iberis states; abstinence assists action. [Hughes], [Clarke].
• Inimicals not recorded; individualise by cardiac modalities and left radiation. [Clarke].

Iberis amara is the picture of the heart that “flies into tumult” at a touch—by the least ascent, a warm room, a fright, or a draught of coffee. The pulse bounds or stumbles; the chest grows tight; breath shortens until the patient must sit up and call for the window to be opened. In the same moment the head flushes—then goes black; the eyes blur, the ears roar; and an aching draws beneath the left breast to the scapula and down the arm. Relief is homely and precise: quiet, cool air, propping up, a steady hand on the præcordia, and abstinence from stimulant and tobacco. This mechanical, modal clarity is the clinical strength of Iberis. It lies between the purely functional “nervous heart” and the organ with early dilatation and valvular murmur: it does not replace Digitalis when the pulse has sunk slow and weak, nor Cactus when an iron band clamps the chest, nor Spigelia when stabbing neuralgic pains dominate; rather, it calms the tumultuous, irregular, effort-provoked palpitation with orthopnœa and left-sided radiation that is its seal [Clarke], [Boericke], [Hering].
Its miasmatic hue reflects this middle ground: sycotic overactivity—hypertrophic effort and congestion—slides toward a syphilitic failing compensation when murmurs and dilatation appear, while psoric reactivity colours the anxiety, startings, and cardio-neurotic urination. The generalities—worse exertion, warm rooms, emotion, tobacco/coffee; better cool air, rest, high pillows—recur in every subsection, and the organ affinities interlock cleanly: heart action ↔ head-congestion/vertigo ↔ visual/aural obscurations ↔ left shoulder/arm radiation ↔ dyspnœa of exertion. The remedy’s pace is rapid in onset but not overwhelming; it is the middle of the day stair and the warm theatre, more than the midnight angina. In the dispensary patient who says, “If I so much as hurry or sit in a warm room, my heart flutters—I must sit up by the open window till it goes off; the pain runs to my left shoulder,” Iberis deserves first thought. Practical prescribing couples the remedy with environment: ventilation, graduated exertion, and the avoidance of stimulants; under this regimen, one expects fewer startings from sleep, longer intervals without orthopnœa, and the return of steady pulse on moderate ascent [Clarke], [Boericke], [Allen].

Indications: Palpitation and dyspnœa on the least exertion; orthopnœa—must sit up; pulse irregular/intermittent; præcordial oppression with pains to left scapula/arm; effort- or heat-provoked attacks with head-congestion and visual obscurations; early mitral murmur or cardiac dilatation; tobacco/coffee heart [Clarke], [Hering], [Boericke], [Allen]. Potency/posology: Low to medium potencies (Ø, 3X–6X) traditionally in failing compensation or valvular states (drops in water t.d.s.–q.i.d.); 6C–30C where the modal and sensory corroborations are strong and the case is more functional; repeat according to attack frequency, then lengthen intervals as exertional tolerance returns [Clarke], [Dewey], [Boericke]. Repetition: In acute paroxysms dose more frequently for several hours, then reduce; in chronic exertional dyspnœa, steady doses with lifestyle measures. Adjuncts: Cool, well-ventilated rooms; head and shoulders raised for sleep; graded exercise; strict avoidance of tobacco and strong coffee; moderation in meals (explicit modality alignment) [Hughes], [Clarke].
Case pearls:
• “Mitral systolic murmur with dyspnœa on ascending one flight; left scapular ache—Iberis 3X t.i.d. with window ventilation: stair tolerance advanced steadily” [Clinical], [Clarke], [Boericke].
• “Palpitation in warm room, head swam, could not lie on left—30C at bedtime; slept propped, no night startings for a week” [Clinical], [Clarke].
• “Tobacco-heart in clerk—irregular pulse, dyspnœa on hurry—abstinence + Iberis 6X regularised action” [Hughes], [Clarke].

Mind
• Mind—Anxiety—heart, about—palpitation with. Useful in cardio-neurosis. [Clarke].
• Mind—Fear—on lying down—suffocation from. Orthopnœa anxiety. [Boericke], [Clarke].
• Mind—Irritability—palpitation during. Neuro-cardiac excitability. [Clarke].
• Mind—Starting—sleep on—palpitation with. Night attacks. [Clarke].
• Mind—Company—desire for—during attacks (needs support and air). Practical bedside cue. [Clinical].
Head
• Vertigo—on rising—blackness before eyes—palpitation with. Key circulatory sign. [Allen], [Clarke].
• Head—Congestion—warm room—agg.—cool air—amel. Tracks modalities. [Clarke].
• Head—Pain—frontal—exertion agg.—rest amel. Effort link. [Clarke].
• Pulsation—carotids—palpitation during. Objective sign. [Clarke].
• Head—Pressure—band-like—tachycardia with. Common accompaniment. [Boericke].
Eyes
• Vision—blurred—palpitation during. Cardio-ocular link. [Allen].
• Photopsia—sparks—effort agg. Early warning of a turn. [Allen].
• Diplopia—transient—cardiac tumult during. Severe attacks. [Allen], [Hering].
• Blackness before eyes—ascending stairs—agg. Exertion test. [Clarke].
• Eyes—Pupils—dilated—palpitation with. Reflex sign. [Hering].
Ears
• Noise—humming—roaring—pulse synchronous. Circulatory hum. [Allen], [Clarke].
• Hearing—diminished—congestion with. Head-vascular pointer. [Clarke].
• Ears—Fullness—palpitation with—warm room agg. Simple confirmation. [Clarke].
• Sensitive to noise—startles, palpitation provoked. Reflex excitability. [Hering].
Heart/Chest/Respiration
• Heart—Palpitation—least exertion—agg. Cardinal rubric. [Clarke], [Boericke].
• Heart—Irregular—intermittent—attacks during. Rhythm pointer. [Clarke].
• Heart—Murmurs—systolic—mitral—with dyspnœa. Structural cue. [Clarke], [Boericke].
• Chest—Pain—left—scapula under—arm to—extends. Radiation key. [Allen], [Clarke].
• Respiration—Orthopnœa—must sit up—warm room agg., cool air amel. Master modality. [Clarke].
• Respiration—Ascending—stairs—agg. Exertional index. [Clarke].
• Clothes—intolerance—about chest—oppression. Practical marker. [Clarke].
• Pulse—bounding—then weak—alternating. Turbulent pattern. [Boericke].
Extremities
• Upper limb—Left—numbness/tingling—heart symptoms with. Radiation sign. [Allen].
• Weakness—legs—after slight exertion—palpitation with. Tolerance gauge. [Clarke].
• Coldness—hands—palpitation with—sweat. Autonomic tone. [Hering].
• Cyanosis—fingers—dyspnœa during. Severity marker. [Clarke].
• Cramps—calves—exertion agg. Peripheral circulation. [Clinical].
Generalities
• Exertion—least—agg.—palpitation/dyspnœa. Central generality. [Clarke].
• Warm room—agg.; Open air—amel. Environmental key. [Clarke].
• Position—lying on left—agg.—must sit up. Positional rubric. [Boericke].
• Tobacco—agg.; Coffee—agg.—palpitation. Etiologic rubrics. [Hughes], [Clarke].
• Rising—quickly—agg.—vertigo, faintness. Handling cue. [Allen].
• After meals—agg.—epigastric weight with oppression. Diet link. [Allen], [Clarke].

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–1879): proving fragments for Iberis; head/ocular/epigastric symptoms; cardiac notes.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879–1891): clinical confirmations—palpitation, orthopnœa, left-arm radiation, irregular pulse.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): cardiac sphere, modalities (exertion-, heat-worse; cool air better), valvular notes; relationships.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—palpitation on least exertion, orthopnœa, cannot lie on left, left scapular pains.
Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): substance background (Cruciferæ, bitter/mustard principles); tobacco/coffee aggravation; clinical remarks.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): repertorial entries—left arm radiation, exertion aggravations, environmental modalities.
Farrington, E. A. — Clinical Materia Medica (1890): comparative cardiac therapeutics—Spigelia, Cactus, Digitalis vs Iberis.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): miasmatic framing and comparisons (Acon., Aurum, Digitalis, Glon., Naja).
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): therapeutic grouping for cardiac dyspnœa/valvular disease; posology hints.
Tyler, M. L. — Homœopathic Drug Pictures (20th c.): clinical sketches of “nervous heart” states corroborating Iberis modalities.