Carbo Vegetabilis
Vegetable Charcoal C (impure). Trituration.
The essential features
If there is a one word that characterizes the pathology of this remedy, the word is emptiness. It is a feeling as if life has gone and left an empty space, a shell without life, an empty sack. Such are the feelings of the typical Carbo vegetabilis patient: totally devoid of energy and he will feel this way in both acute and chronic conditions.
If we want to generalise grossly about such pathology we can say that it is the result of imperfect oxygenation of the blood and sluggish circulation. The oxygen that keeps life going cannot reach the brain cells in sufficient quantity any more, so even death may seem to be imminent. It is a remedy we must think of in cases where the patient confirms that the present state has originated after a specific stress, be it a common cold, or a more severe acute disease, after a fall, an accident, any sort of loss of blood, a night of overeating and consequent indigestion, or due to drinking too much; in general it appears wherever the organism, under a particular stress, has fallen into a chronic state that has disturbed him for years without ever recovering.
Strong allopathic drugging, childbirth, surgical operations, etc. may also trigger such Carbo vegetabilis states of emptiness, apathy, exhaustion, weakness, acute as well as chronic. Carbo vegetabilis is a remedy that should be used very frequently – with tremendously beneficial results – after operations in order to bring back the patient more quickly from his long anaesthesia state.
It is interesting that this remedy has a reputation as a ‘corpse reviver.’ People who are almost dead, almost lifeless, come back to life with surprising ease under this remedy. Carbo vegetabilis will revive those patients, and if the pathology is such that it allows for a cure, the remedy will keep them alive for a long time. It will immediately help the circulation and allow the organism to transfer oxygen to the blood, thus preventing fainting or cutting it short; it will prevent severe complications or even death in certain cases; at least, this is the feeling that you have in watching such cases. There are many reports of such cures, as for example the following impressive case of Margaret Tyler: ‘A small girl with heart disease, and an acute exacerbation supervening that was abruptly ending her young life. She had a pneumonia with pleural effusion, an endocarditis with pericardial effusion, and one morning, when the Physician was going his round accompanied by several other doctors, she was found lying forward on the supports that had to be provided, because she could not rest otherwise, cold, white, unconscious; just alive, because she was still giving the infrequent sharp gasps of the dying. Carbo vegetabilis (I think 200) was quickly administered, while one of the doctors of wide experience exclaimed, “I’ll eat my hat if that child lives!” But before the ward round was finished she had regained warmth and consciousness; death had passed on!’
This is the way the emptiness and lack of vital power is experienced on the body level, but the Carbo vegetabilis emptiness is felt on all three levels. Emotionally the patient feels so empty of feelings that it causes him to be indifferent to anything and everything that happens around him, to all external impressions. It is one of the best remedies for this kind of depression that reaches that state of total indifference. Actually, it is not so much a true depression but a kind of apathy caused by deep pathology, which primarily affects the circulation. The patient does not care whether he lives or dies, whether his house is on fire, whether his loved ones are in danger. He simply does not have the energy to care. This state is reflected in Hahnemann’s proving symptom: ‘Indifference; he heard everything without pleasure or displeasure, and without thinking anything about it.’ If the patients previously loved music, it will not move or touch them any more when they are in a Carbo vegetabilis state.
The affections are ‘practically blotted out’, as Kent says, nothing seems capable to arouse or disturb the patient any more. Both horrible and pleasant things do not reach such a person, he seems little or not at all affected by them. ‘He cannot bring himself to realise whether a thing be so or not, or
whether he loves his family or not, or whether he hates his enemies or not’ (Kent). Patients may describe this state as a sensation as if ‘totally gone’, of resignation and giving up, as in a case of Beat Spring (cf. ‘The Mental Aspect in Remedy Choice’, Case 3), a woman with weakness and fainting states after parturition. She felt no anxiety, no restlessness, no irritability, which was an important differentiation point with Arsenicum.
On the mental level the emptiness takes the form of dullness and sluggishness. If the patient listens to a discussion, his mind does not grasp the ideas that are discussed; he seems stupid and too lazy to be moved into activity. Everything we do needs first the desire to do it, needs the feelings that will initiate it, but in Carbo vegetabilis we do not see such initiatives, such activity. The patient does not have the energy for the desire to arise, the initiative does not come, he only wants to lie down and sleep.
The patient cannot concentrate, cannot do his usual work. Because the mind is not functioning properly, indecision and irresolution result. And again, this mental condition seems to result from inadequate oxygenation of the brain, a consequence of sluggish cerebral circulation. As Kent puts it, ‘Inability to think or meditate, all of which is due to the turgescence.’ It is interesting that there are spells of loss of memory in Carbo vegetabilis. The patient suddenly loses his memory for a while, will not remember what he talked about a moment ago; later it returns just as suddenly. This seems to point to a circulation which is temporarily compromised.
Carbo vegetabilis may also be subject to fixed ideas; ‘arteriosclerotic’ ideas, as if there was not enough vitality in the brain to entertain a different point of view. ‘Ideas flow slowly; they constantly turn about one object, with a sensation as if the head were tightly bound’ (Hahnemann). In delirious states, this may be expressed by a repetition of the same words for hours.
Of course, you will not find these extreme states in all cases. Before such deep pathology you will see irritable moods with outbursts of anger, which will mostly occur in the morning. These moods come on because of a fatigue of the organism, making it difficult for the patient to take up stresses; much like the Nux vomica patient. There may be an irritability after eating, as if the food did not give the required energy, but instead produces a lot of gas, with flatulent distension, and brings on exhaustion in the mental sphere. Sometimes the exhaustion results in a certain aversion to company; the patient may feel better alone when depressed. In the state of irritable moods, we may also see a certain amount of general restlessness and nervousness, especially about health.
Another feature that is found in some patients is an indescribable, awful anxiety which mostly comes on in the dark and while they are in bed, especially in feverish states. ‘In the evening, anxiety, increasing for several hours, with heat in face’ (Hahnemann). The nocturnal anxiety can be coupled with restlessness and, in some cases, reach horrid dimensions. Even delirious states occur while the patients lie in the darkness, with visions of horrible figures. They cannot remain lying in bed after going to sleep from sheer anxiety. They wake at night with delusions and anxiety.
Kent writes: ‘There is anxiety, suffering, jerking, twitching, and he has the horrors. Everything is horrible… A peculiar sluggish, death-like sleep, with visions. The Carbo vegetabilis patient wakens in anxiety and covered with cold sweat.’ Interestingly, a typical feature is not a fear of the dark, but an aggravation from darkness.
Fear, which needs an object that is feared, is not so typical of this kind of Carbo vegetabilis state, but is rather an indefinite and general anxiousness coupled with weakness of mind and body. These patients are easily frightened or startled, with a discouraged and dejected mood. Tremulous anxiousness and restlessness, sometimes with weeping, even in the presence of strangers in the street. Eating may also trigger such anxiety states. Or we see a sort of anticipation anxiety: ‘If she is bound to speak in the presence of people, she feels her pulse throbbing everywhere, and her face, usually pale, becomes puffed and bluish red’ (Hahnemann). A fear of accidents has, however, been observed with this apprehensive mood. This fear has to be understood under the idea that the organism cannot support sudden changes, his circulation is too lazy to move suddenly and rescue the patient from a sudden shock. This lack of adequate ability to react can also be seen in some other symptoms: he feels unhappy with every little pain; weepy, everything appeared horrible to him, he was as if desperate. Nevertheless, Carbo vegetabilis is a remedy that you will need most frequently with physical complaints. In my experience, it is rather rare to encounter a Carbo vegetabilis patient who is seriously mentally ill.
The carbo vegetabilis child
An excellent description by Dr. Gounard of a Carbo vegetabilis case in a child (mentioned in ‘A Study on Materia Medica’ by N. M. Choudhuri, p. 177) will serve best to give a picture.
‘The patient presented a Hippocratic countenance, the eyes half open, nose pinched and cold, lips blue, pupils insensible; no complaint or crying from the child. The pulse I found small and quick, difficult to count, but beyond 130; the body thin, lean and marbled; feet and hands blue and cold, although constant application of hot cloths is made; abdomen distended with gas; respiration frequent, but not full. Auscultation revealed only tracheal sounds, and no vesicular murmur. The breath is cold. The previous history of the case, although not very clear, was not more encouraging. The child had, during the last two months, three nurses; since three or four days she had fever and a cough, and since noon has ceased to cough and to nurse; no stool or urine. Although preparing the parents for the speedy death of the child, I ordered a more frequent application of warm cloths, and in the meantime dissolved four globules of Carbo vegetabilis 30, in seven or eight tea-spoonfuls of water. A few doses of this were given every ten minutes. The child improved from this time.’
In severe diseases such as typhoid you may find the child lying almost semiconscious, losing urine and stool which is diarrhoeic; the abdomen is distended; the tongue dry, cracked and dark red; and complete exhaustion.
Sometimes Carbo vegetabilis children will also have a desire to ‘vent themselves’ in rage, with striking, kicking, and biting.
Important general conditions
As mentioned before, the action of Carbo vegetabilis centres on the circulation and more especially on the venous side of it. The blood seems to stagnate in the veins, especially in the capillaries of lips and limbs, and thus blueness and coldness of the body comes on. Ecchymoses are frequent; also varicose veins on different parts of the body: legs, genitals, nose, pharynx, etc. Or there may be a state where everything about the organism is turgid, distended and swollen. In these cases, there is a dull feeling in the limbs that makes the patient want to elevate the feet to let the blood run out, and this ameliorates his condition.
As Boericke says, ‘bacteria find a rich soil in the nearly lifeless blood stream’, and septic conditions arise. There is a general tendency to decomposition, necrosis, gangrene, with a marked putridity of discharges, ulceration, breath, sweat, etc. Boger resumes in his ‘Synoptic Key’: ‘Blueness and decomposition’ as a typical combination of features of Carbo vegetabilis. The discharges are also frequently acrid, corrosive, excoriating.
A lowered vital power, with lack of reaction of the organism, is very characteristic of the remedy (Carbo vegetabilis should be thought of in AIDS cases.) This weakness of the organism often dates from specific stresses, some of which were mentioned above. Very typical is a state of ‘never well since‘: never well since an acute disease, such as measles, never fully recovered from the effects of some previous illness. Margaret Tyler relates, however, that she had no good results in such cases when the symptoms didn’t agree; but if they did, the action could be miraculous.
The state after surgical operations where Carbo vegetabilis is indicated is like that: paleness, hardly signs of life; exhausted, cold, with a fine cold sweat, but a desire to be fanned all the same, especially in the head. In these conditions the remedy will help the patient recover much faster and without complication. Another indication is excessive flatulence after abdominal operations (where Carbo animalis may also be indicated). The acute collapse states of Carbo vegetabilis are virtually unmistakable. Deadly coldness, cold body, cold tongue, cold nose, cold breath, cold sweat, but in some cases the head remains hot in spite of the bodily coldness; air hunger, desire for fresh air, desire to have the windows open and to be vigorously fanned, notwithstanding the coldness; feeble, imperceptible pulse; oppressed and quickened respiration.
The weak, sick and exhausted feeling may become chronic and persistent, but it may also come on suddenly, in a moment. ‘Very frequent fainting fits, only momentary, even to sinking down…’ (Hahnemann) or ‘Sudden attacks of faint-like weakness‘ (ibid.) are symptoms caused and cured by this remedy.
Carbo vegetabilis will also be indicated in haemorrhages that are passive, oozing all the time. This kind of bleeding runs all through the remedy picture. Kent describes the Carbo vegetabilis haemorrhages: ‘On account of the feeble circulation a capillary oozing will start up and continue. The remedy hardly ever has what may be called an active gushing flow, such as belongs to Belladonna, Ipecacuanha, Aconitum, Secale, and such remedies where the flow comes with violence, but it is a passive capillary oozing… Black venous oozing.’
There are often blackish, putrid, slowly oozing exudation. The remedy has been used in severe diseases such as typhoid and yellow fever by the old homeopaths. An indication for the ‘haemorrhagic’ stage of yellow fever (with the characteristic black vomiting), which illustrates the concomitant symptoms of the Carbo vegetabilis bleeding very well, also in other diseased conditions: ‘Haemorrhages with great paleness of the face, violent headache, great heaviness in the limbs and trembling of the body.’
In digestive disorders, Carbo vegetabilis will often be the remedy of choice, especially when there is excessive flatulent distension. The food seems to be decomposed and to turn to gas before it can be digested. This will be accompanied by frequent eructations that relieve, at least for some time. Both symptoms, the flatulence as well as the amelioration from eructation, may be seen as general symptoms. For instance, asthma cases which are aggravated or accompanied by flatulent bloating are usually relieved by this remedy. The bloating causes the diaphragm to press upward and causes periodic dyspnoea or collapse states. And the eructation will not only relieve the distension of stomach or abdomen, but also symptoms such as headaches are better by belching.
Peptic ulcers, gastritis and colitis may also require Carbo vegetabilis. The digestive symptoms are generally worse from overeating, but specifically aggravated by eating fatty food; butter especially aggravates. In addition to this intolerance of fat, we see an intolerance of alcohol. There may not necessarily be a strong reaction, but enough for the patient to notice. Even after just a sip of alcohol, the face will flush to the roots of the hair; or else weakness and paleness ensues.
The diseases of the respiratory tract tend to settle in the lower parts, in the chest, even when they began with a coryza or ‘common cold’. Fairly advanced stages of lung conditions will require this remedy, e.g. a sudden decline of the vital powers from pneumonia. There is also a specific kind of asthma which is aggravated by lying down and relieved, again, by vigorous fanning. The modality ‘worse lying down’ is easily to understand; it is as if there were too little tonus of the venous system, making it impossible to balance the circulation.
Periodic asthma attacks, coming on over the week-ends. Hay-fever.
Carbo vegetabilis is one of the big remedies in whooping-cough, especially in the onset of the disease.
In ulcers, especially ulcus cruris varicosum, Carbo vegetabilis has a good reputation. Burning pain, more so at night; offensive, putrid discharge; mottled or livid discoloration of the surroundings. The ulcers tend to bleed easily. There is a marked tendency to gangrene and necrosis in these cases.
Burning is generally a sensation that runs through the remedy. Burning in the limbs, in bones and ulcers; burning in the blood vessels; burning in various parts of the skin. Often an internal burning is attended by external coldness. Some other general sensations: Feelings of heaviness or weight everywhere; rheumatic drawing pains through the whole body, with coldness of the hands and feet.
Some more modalities:
Warmth and overheating will very often bring on complaints. But on the other hand, there is a tendency to catch colds from any draught of air, and this sensitivity is most marked after having been heated. ‘In a warm room he tends to sweat at the upper part of the body, and he then catches cold as easily’ (Hahnemann). This is a general combination of modalities. As Kent puts it: ‘He suffers from the heat and is chilled by the cold; every draught chills him; and a warm room makes him sweat, and thus he suffers from both.’ But one should keep in mind that air hunger is also a marked symptom of the remedy and that fanning and fresh cold air will ameliorate in cases of collapse, fainting, weakness, asthma, and so on; in spite of the coldness and chill.
Damp weather or surroundings also cause the pathology, particularly warm sultry weather, but also wet and cold air (as in hoarseness, cough).
Vertigo
Vertigo with frequent momentary attacks of fainting. Vertigo with fainting, after sleep, when sitting or standing up, also before getting up in the morning, when still in bed. Vertigo from turning in bed, with perspiration over the entire body.
‘Whirling in head, all day’ (Hahnemann). Walking and sitting may bring on vertigo; also vertigo on stooping, with the sensation as if the head is reeling to and fro. Vertigo such that he has to hold on to something to prevent himself from falling.
Vertigo from flatulence; vertigo from venous stasis, especially after excesses of eating or drinking.
The vertigo attacks may be preceded by some drops of blood from a nosebleed. Sometimes with the fit there is a pressive pain in the forehead.
Head
Carbo vegetabilis headaches centre in the occiput. They often extend upwards from the nape of the neck or from the spine. Dull headache in the occiput. Sometimes these headaches commence after eating. ‘After each meal, pains extend up the spine, until a dull occipital headache ensues about one hour after eating’ (Klassische Homöopathie 2/89). ‘Pressure in the occiput, especially after supper‘ (Hahnemann). Or there are violent pressive pains at and in the occiput, near the nape of the neck. These dull or pressive occipital headaches may reach a formidable intensity; the patient can no longer move, cannot turn over, cannot lie on his side, cannot be jarred, for if he tries to do so, his head seems to burst. Sometimes such pain expands over the whole head and to the eyes. With such pain, a strange confusion in the head may come over the patient. He cannot think properly, has to make an effort to collect his senses.
Pressive frontal headache, particularly immediately above the eyes; the eyes ache when they are moved. Pressive pain in both temples.
Burning in the head; hot head, cold body and breath; a ‘hot spot’ the size of a hand during continuous headache; burning and violent pressive headache in the evenings in bed.
Rushes of blood to the head, sometimes followed by nosebleed; the head feels turgid and distended. A feeling of weight or heaviness like lead is very characteristic. Pulsating headaches, especially in the evening in bed, with difficult breathing; throbbing in the temples and a sensation of fullness in the brain after sleep, on waking from a midday nap; or painful throbbing in the head on taking a breath.
Headaches are brought on by overheating, especially if exposed to a draught while in a heated state; as Hahnemann puts it, ‘from fast alternation between warm and cold’. Also, any over-indulgence (in wine, in food, especially from eating fatty food) might bring on a headache, and an interesting modality is headaches relieved by eructation.
The scalp is very sensitive to pressure. A characteristic symptom is: ‘The hat presses upon the head like a heavy weight, and even after removing it the sensation continues as if the head was bound up with a cloth.’ Headache as if the scalp and membranes were too tight and contracted.
This constriction is better from uncovering the head; also from fresh cold air and being fanned.
With the pressive pain, even touching the hair causes a sore pain.
The hair falling out is a strong indication, especially if it occurs after severe stress, such as an acute disease, after parturition, etc., which is consistent with the general causation of a Carbo vegetabilis state. Sweat on the forehead, very often cold sweat, is also typical.
Eyes
Something like a heavy weight on the eyes, must exert them very much when reading or writing to distinguish between the letters. Pressure in the eyes, with heat. Burning in the eyes.
With the pressive headaches, there may be lachrymation and an urge to close or contract the eyes; also a pain in the eye as if it were being pulled out.
Pain in the orbits and eyeballs passing to the back of the head, which is better on walking in the open air, worse on lying down.
Exertion, such as overwork, fine work, and staring, makes them weak and aching, and may cause myopia (whereas farsightedness is more typical of Carbo animalis). The eye muscles ache when looking upwards.
Agglutination of eyelids at night. Unable to open the eyes at night, when she cannot fall asleep.
Itching about the eyes and the margins of the lids, especially in the morning.
Black floating spots before the eyes, or sees circles with a brighter field inside, or there is flickering vision in the morning on rising. In states of weakness or exhaustive diseases, the eyes are dull, without lustre, deep-set; the pupils do not react to light. Haemorrhages in the eyes, with burning and congestion to the head.
Ears
‘Something heavy seems to lie in and before the ears; they seem stopped, but the hearing is not diminished’ (Hahnemann). There can also be deafness, particularly after acute exanthemata.
Ears dry, lack of cerumen; or it has an offensive odour. Otorrhoea: discharge of a thickish, flesh-coloured, offensive moisture; especially after exanthematous diseases, such as measles or scarlet fever.
Pain from the right ear down the neck, on turning the head; after itch-like eruptions.
Heat and redness of the left ear, every evening. Tearing-burning pain in the earlobe.
Itching in the ears, along with an inclination to swallow in order to relieve it. Or: feels compelled to bore his finger into his ear to relieve the irritation, but it always returns.
Ringing in the ear, especially in connection with vertigo; or roaring noises, e.g. after coitus.
Hearing is very acute: sensitive to loud talking; or when waking at night with a rush of blood to the head, the slightest sound seems to reverberate in the ear.
Tearing pain in the depression behind the right ear.
Parotitis, mumps; swelling of parotids, with metastasis to the testes.
Nose
Nosebleeds. A very typical kind of nosebleed is described in this proving symptom: severe nosebleed, several times daily for two weeks, with very pale face before and after each attack. Or the nosebleed comes at night, with an paroxysm of blood. Epitaxis every time he stoops or strains at stool, or as a prodrome of a fainting attack, also from emotional excitement or jarring of the body.
The Carbo vegetabilis coryza is apt to travel downwards, finally settling in the chest and severe chest colds, in turn, frequently begin in the nose, with coryza. In the course of its movement downwards, the mucous discharge, at first thin, becomes thick, yellowish-green and bad tasting. Always suffering from coryza, especially when he is overheated (which happens very easily), sweating, and then being exposed to the slightest draught.
Some characteristic coryza symptoms:
Irritation but ineffectual sneezing from the left nostril, which becomes moist; after blowing the nose the right nostril becomes obstructed, with a crawling sensation and biting pain as in coryza
Frequent sneezing with constant and violent crawling, tickling, and catarrhal rawness in the nose and chest, at night in bed. Violent sneezing, followed by a biting pain in and above the nose, with lachrymation; has the same pain on blowing the nose. These symptoms may indicate Carbo vegetabilis in hay fever.
Constant sneezing at night. Sneezing may cause stitches in the abdomen, or burning over a large portion of it.
Continuous copious mucus from the posterior nares.
Drawing in the root of the nose. Or: pressure in the nasal root and bones.
Violent coryza with hoarseness and rawness in the chest; with cough; especially inclined to catch a cold in moist warm weather. Fresh open air may actually ameliorate the coryza. The discharge may be fluid or dry, with obstruction of the nares. Very often the coryza is attended by digestive disorders with flatulence.
Tip of nose red, sore, scabby.
Face
There is an expression of intense exhaustion in the face. It is very pale, greyish-yellow, pinched, corpse-like, and often cold, covered with a cold sweat. Or it is dusky, dark red, bluish red, with a fine network of capillaries as if marbled. Sometimes, when the head is congested, the cheeks are flushed and at the same time cold clammy sweat appears on them.
Exciting influences can make the usually pale and pinched face bloated and red, hot: face becomes hot when anxious; flushing to the roots of the hair even with a sip of wine; purplish, bloated face when she has to speak in front of others, with pulsation over the entire body.
In the facial bones, there are many acute pains, especially drawing and tearing ones. Drawing pain in the jaws on both sides, with drawing in the head and a confused feeling. Jerking tearing in the upper maxilla, right side. One-sided tearings in the zygomata. Or: drawing and aching pain in the nervus facialis.
A key-note is twitching in the upper lip.
The lips tend to swell and crack; sometimes they are discoloured brown or even blackish.
Pimples, pustules, and herpes are found in the face, often around the lips and in the corners of the mouth. Acne and especially acne rosacea is a condition where Carbo vegetabilis may be indicated, especially in young people.
Mouth
Carbo vegetabilis has been prescribed in stomatitis or scurvy-like states, because there are many symptoms pointing to these conditions: Gums receding from the teeth, particularly the incisors, with ulceration, looseness of the teeth and easy bleeding. Bleeding of gums when brushing the teeth, or when sucking at the gums. Sore pain in the gums, by day. They are painfully sensitive when chewing. Pustules on the gums.
Aphthae, small ulcers scattered throughout the mouth; greyish colour, burning like live coals. Putrid odour and taste.
The bleeding can be of a blackish, oozing, decomposed, putrid quality, described in the ‘Generalities’ section, making gums and tongue appear black. The teeth are very sensitive to cold or warm things taken into the mouth; also to air that is inspired. Inspiration may cause a painful throbbing. Salty foods cause pain in the teeth, especially in the gums.
Generally, the teeth tend to decay easily, but also sound teeth will often ache. ‘Drawing and tearing pain in all molars.’ ‘Tearing in incisor teeth.’ Coldness of breath, and of the mouth, teeth, tongue, throat is an important feature in the collapse-like states noted above; but there may also be heat in the mouth, with rawness and dryness of the tip of the tongue. Tongue sensitive, with a raw feeling.
The mouth is either dry (but without thirst) or there is an increased collection of saliva, which often becomes stringy and tough and may taste foul. Taste: bitter, particularly before and after eating; salty, especially after eating.
The tongue can have a white coat, or yellow-brown mucus covers it.
Heavy feeling of the tongue, can hardly be moved, speaking is very difficult.
Pains often locate in the root of the tongue; they are cramp-like, or are felt as a pressive tearing. Pressing pain on the palate, the posterior part.
Throat
The characteristic symptom here is a sensation as if tight or contracted in the pharynx. It may be sore and inflamed, with a feeling as if something were lodged in it. Food can hardly be swallowed because of a spasmodic constriction, which, however, may not be attended by any pain. There is inflammation and swelling of the uvula.
Scraping, smarting, biting and burning pain in the throat, palate, fauces, with a feeling of rawness. Sensation of extreme dryness, as if all moisture is absorbed by blotting paper. A feeling of something hot and acrid rising in the oesophagus, as in heartburn. Sore pain in the fauces and choanae on swallowing, coughing or blowing the nose.
Much tough mucus in the throat, which compels the patient to hawk it up and it is easily ejected; it is sometimes foul, bloody, blackish. Varicose veins in the pharynx.
Air passages
Hoarseness, even aphonia, is an indication for Carbo vegetabilis. It may come on in the morning, but the remedy will particularly be required in evening when there is evening hoarseness, caused by the cold, damp evening air. ‘Severe roughness of larynx, with a deep roughness of the voice; the voice is lost when he exerts it.’
Much scraping, tingling, tickling in the larynx, also much rawness and roughness in the throat and chest. Has to clear his throat so often in the evening that the larynx becomes raw and sore. Pain as if sore and ulcerated in the larynx and trachea. Severe ulcerative pain in the larynx and region of the thyroid cartilage, on coughing.
Unusual feeling of dryness in the trachea, hawking does not relieve it.
Frequent recurrent irritation to cough, in the posterior part of the throat, which stimulates a short cough Such tickling and itching irritations are especially worse in the evening after lying down.
Bronchial catarrh, hoarse, mucous rales; chest and ribs feel as if bruised; nails are blue and extremities cold; especially in old people or after diseases such as measles.
Mucus in large quantities lodges in the air passages, felt particularly at night, choking the patient when he coughs, sometimes accompanied by vomiting of mucus; better when sitting up or moving.
Respiration and cough
Laborious, quick and short respiration, with cold hands and feet. Even Cheyne-Stokes breathing, especially in organic heart diseases.
In dyspnoea, oppression of the chest, and asthmatic respiration Carbo vegetabilis may be indicated, especially when these conditions are caused or attended by flatulent distension pressing upwards and relieved by eructation.
Difficult respiration with fullness of the chest and palpitation, even on slight motion, most severe in the evening.
Rattling or whistling respiration, with air hunger, especially at night in bed; cannot remain in bed because of air hunger. The strong craving for fresh air is a general symptom of the remedy: asthma is worse in warm rooms, wants the windows open in spite of feeling cold and chilly, wants to be fanned. ‘The remedy cures asthma. We will see the patient propped up in a chair by an open window, or some member of the family may be fanning him as fast as possible. The face is cold, the nose pinched, the extremities cold and he is as pale as death. Put the hand in front of the mouth, and the breath feels cold. The breath is offensive; putrid’ (Kent).
Asthma of the elderly and of those in poor, exhausted conditions; weakness, trembling; looks as if he is dying; full of wind, but cannot release it. Cyanotic, bluish skin in asthmatic conditions. Asthma as a sequel to measles or other acute diseases; winter attacks of asthma; attacks during the weekends; chronic asthma once or twice monthly. In some cases the attacks always come on during sleep.
Loses breath on turning in bed, or on falling asleep; or attacks of chest constriction which prevent breathing. An urge to take a deep breath, with moaning, frequently recurring Painful throbbing in the head and teeth during inspiration.
Carbo vegetabilis is an important remedy in whooping-cough, especially in the beginning stages of the disease. Bonninghausen describes the cough like this: ‘Spasmodic, hollow whooping-cough in short attacks, which are relatively rare (4-5 per day); as of sulphur vapours, or excited by a tingling
irritation in larynx and throat; without expectoration in the evening, in the morning with yellow, greenish or pus-like expectoration, sometimes brownish-bloody, less frequently tough, white and mucous or watery; expectoration has a putrid, sour or salty taste and a bad odour.’
The cough is especially worse in the evening, until midnight; after lying down; also in damp cold weather or on going from a warm to a cold place.
It is especially accompanied by severe burning in the chest, or else or by a ‘raw pain‘ there (as if the flesh were raw); also with flatulent disorders. Coughs every time after eating to satiety. Eating or drinking generally aggravates, but especially cold drinks.
Violent tickling cough, with whitish sputum, in the morning after waking.
Itching in the larynx causes cough with tough, salty sputa, in the evening on going to sleep and in the morning, one hour after rising. Cough with sneezing or ending in sneezing (Agaricus).
With each coughing spell, painful shootings through the head.
Dry cough after each expiration, with a flush of heat and sweat.
Paroxysmal hard spells of coughing, very laborious, not ceasing until masses of offensive sputa are coughed up. The cough is frequently accompanied by choking, retching, and gagging, and ends in vomiting of mucus.
Chest and heart
‘Severe burning in the chest, as from glowing coals, almost uninterruptedly‘ (Hahnemann) is a key-note of the remedy. It is seen in many chest infections, regardless of their pathological name.
The chest feels weak and fatigued, especially on waking. This weakness is often attended by a continuous sensation of weight upon the chest. Pain in the chest and in the region of the heart, due to obstructed flatulence; also a warm ebullition or orgasm of blood in the chest from the same cause, with anxiety.
It may be seen in extremely progressed and severe cases of pneumonia, with threatened paralysis of the lungs, foetid sputa, cold breath, cold sweat, threatened gangrene. Emphysema.
Pressive tearing on or in the left side of the chest.
Pressive pain superiorly in the right side of the chest, through to the right shoulder-blade.
‘Brown spots on the chest’ is an indication given by Hahnemann.
Burning pain is also found in the heart region, with congestion in the chest and violent palpitation. Palpitation occurs mostly while sitting and after a meal. It may continue for days, sometimes so violent as to shake the whole body. Deep respiration and eructation ameliorate.
Carbo vegetabilis is useful as a heart remedy, especially in old people with heart problems. The chief indications are exhaustion, shortness of breath, coldness of breath, blueness from venous and capillary congestion together with easy flushing and all these symptoms become worse from taking alcohol. The pathological diagnoses may include such severe states as endocarditis with effusion, hydrothorax, etc.; also aneurysma
cordis.
The pulse may be intermittent and irregular, and is often very feeble, can hardly be felt.
Stomach
The digestive system is a very important sphere of action in Carbo vegetabilis. Digestion is generally slow and sluggish, and all food that is taken seems to cause complaints, even the simplest and most easily digestible. Specially strong aggravations are found after all kinds of rich and fatty food, especially after butter; after milk, which causes flatulence; after pork and poultry; after overeating of any kind; after cold drinks, especially iced ones; after all kinds of flatulent foods.
Kent says that a Carbo vegetabilis state can be reached by ‘stuffing’ the patient: ‘I would feed him with fats, with sweets, puddings, pies and sauce, and all such indigestible trash, and give him plenty of wine – then I would have the Carbo vegetabilis patient.’ The stomach complaints include, in
particular, an excessive painful flatulence, mostly in the stomach region and the upper abdomen, with much sensitivity in this region to touch and a sensation as if the stomach were about to burst, which often comes on one hour after a meal and may last for hours. Lying down aggravates the pain and the distension. Frequent empty eructations occur, which can last for hours and be very annoying, but they definitely tend to ameliorate the distension. The same modality applies to ‘eructation downward’ (flatus).
There are desires for sweet and salty foods, also for sour things and coffee, but all these foods tend to cause complaints if eaten. On the other hand, aversion to meat, especially to fatty meat, and to milk and butter are often seen as being very strong. ‘Aversion to the most digestible and the best of food’ (Kent). In a Carbo vegetabilis state there may be a loathing even of the thought of food.
Violent, almost continuous eructation. Frequent empty eructation, preceded by a short pinching in the abdomen. Often the eructations are hot and offensive, tasting rancid or sour, and are attended by gagging almost to the point of vomiting. Sour eructation after drinking milk, or in the evening on walking in the open air. Eructation following eating or drinking anything.
Heartburn, especially at night; hot and acrid rising. Water brash. ‘Feels acridity in stomach when lying on the back and on walking in the open air’ (Hahnemann).
Nausea is felt especially in the morning. ‘Nausea in the morning one hour after waking, with squalmishness in the stomach’ (Hahnemann). It may also appear at night and before or after a meal, attended by gagging and retching; the heat of the sun causes a nauseous feeling. Vomiting of blood; of bile; of mucus.
After every meal there is a sense of general heaviness and fullness, and much sleepiness. The stomach aches and feels as if it is heavy and hanging down on standing and walking.
Burning in the stomach, almost continuous; sometimes spreading to the small of the back (compare Bismuthum) and even to the shoulders. The burning and bursting pains predominate, but there also other characteristic pains. For instance: Contractive spasm of the stomach, even at night, rising to the chest, with distension of the belly; has to bend double, cannot lie down because it aggravates; pain comes on in spells and takes away the breath. Or: burning and lancinating in the epigastrium and deep in the abdomen, with anguish, flatulence and diarrhoea.
The stomach cramps can come on in nursing women, after nursing their baby (as an example of aggravation from loss of fluids); also from emotions such as fright, vexation, disappointment etc. Thus, Carbo vegetabilis may be indicated in peptic ulcers.
Abdomen
The most marked symptom of the abdomen is the excessive flatulence and distension already described under ‘Stomach’. Two symptoms from ‘Chronic
Diseases’ to illustrate the nature of this bloating: ‘Obstructed flatulence in the left upper abdomen, more towards the back, with squeezing pain.’
And: ‘Flatulence collects here and there in the abdomen, under the short ribs, or in the region of the bladder; it produces squeezing and pressing pain and gradually passes through the rectum, with a feeling of heat there.’ Burning, squeezing, pressing and pinching pains are characteristic. Any tight clothing around the waist is unbearable. Sometimes the flatulence produces a violent ‘paralytic’ drawing pain that goes down into the left thigh. There is also some active movement in the abdomen, often with audible rumbling.
Discharge of flatus generally ameliorates, and the flatus are profuse, hot, moist, and very offensive, with a putrid odour.
Carbo vegetabilis is indicated in excessive flatulence from atony of the bowel; after surgical operations; has even been used successfully in paralytic ileus with a tendency to distension of the belly.
Dragging or squeezing pain in the abdomen after stool. Dragging and bearing down pain, even labour-like. Colic from riding in a car.
Stitching pain in the region of the liver and epigastrium, also in the spleen, and thence to both sides, increased by deep inspiration.
Pinching in the abdomen, under the navel, starting in the left side and moving to the right.
Heaviness in the abdomen. Sensation as if it was hanging down heavily; forces the prover to walk bent over.
Pain in the abdomen as from over-lifting or a sprain; comes on as soon as she lies on the side; felt mostly in the left side.
Hypochondria feel bruised and sore to the touch. The liver region, in particular, is very sensitive, with a bruised pain or a constant dull heavy feeling. Stitches in the spleen.
Rectum and stool
With the discharge of flatus (see under ‘Abdomen’), faeces may involuntarily escape; or there is an ineffectual urging for stool, with only wind passing, attended by a painful pressure in the rectum.
Carbo vegetabilis may have constipation or diarrhoea. In constipation, the stool may be tough, hard, scanty, not properly cohering; but also soft stool is voided only with great exertion. A well-confirmed indication in diarrhoea is painful diarrhoea in the elderly. Involuntary diarrhoea with simultaneous voiding of urine has also been cured by the remedy.
Carbo vegetabilis may be indicated in cases that resemble cholera or typhoid, when the general symptoms of weakness, exhaustion, putridity, etc. agree. The stools often cause burning in the rectum. They are very foetid and putrid. ‘Putrid stools with cold breath‘ is a good indication. Thin, pale stool; light-coloured mucous stools. Discharge of slime along with the urging for stool.
Yellow, stringy mucus is wound around the stool, the last part of which is all bloody.
Much bleeding from the anus; during and after each stool.
Before stool: much pressure, with pressure on the bladder and in the back (frequently in women). After stool: feeling of total emptiness in the abdomen; weakness; anxiety, trembling debility.
Discharge of an acrid, corrosive, excoriating moisture, or of a musty-smelling fluid from the anus; excoriating moisture also on the perineum.
Burning at the anus, with an annoying sensation of dryness in it.
Itching at the anus, also great soreness and burning. ‘Itching at anus in the morning in bed, increased by scratching, afterwards burning.’ Soreness of the perineum, with a painful itching when it is touched. Rawness and chafing of children in hot weather.
Crawling sensation in the rectum, with complaints of ascarides; has also caused the passage of a tapeworm.
Griping or gnawing pain in the rectum when not at stool.
Haemorrhoids: protruding; painful, or tingling itching, but especially with burning pain; thick, swollen, blue; suppurating and offensive.
Urinary organs
The urine may be diminished in amount, with a dark colour, or thick and with a very stale odour; or it is copious and clear yellow. There can be some thick and milky urine at the end of urination.
Varices of the bladder. Dark red urine, as if mixed with blood; red sediment.
Frequent anxious urging to urinate, day and night; may be awakened early in the morning by urging. Pressure on the bladder, must rise several times at night to urinate. Nocturnal enuresis in children.
Spasmodic narrowing of the urethra, every morning.
Tearing in the urethra during urination; the last drops consist of mucus and cause pain when discharged. Smarting pain during urination. After urinating, tearing and drawing in the urethra.
Sexual organs
Carbo vegetabilis may be indicated in complaints after sexual excesses (e.g. weakness, exhaustion). There may be an annoying abundance of lascivious thoughts, but also a total lack of sexual desire in the morning.
Genitalia – male
Ejaculatio praecox, followed by roaring of blood in the head.
Continued erections at night, without voluptuous sensation or fantasy.
Violent ejaculation, painfully exciting the nerves, with violent burning in the forepart of the urethra and severe cutting and burning during urination. Smooth, red, moist spots on the glans penis.
Itching, soreness, excoriation at the preputium. Itching at the thigh near the scrotum, with moisture at this place. Crawling in the testes and scrotum.
Swelling of the testes from metastasis of mumps.
Genitalia – female
Soreness, itching, burning and swelling of the pudenda is a frequent condition. Sometimes these symptoms are excited by a corroding leucorrhoea, or they are worse during the menses. ‘Heat and redness of vulva.’ ‘The menstrual blood, coming six days later than usually, was as if corrosive and excoriated the parts.’
Itching of the vulva and anus at the same time; especially during the menses.
Varices of the female genitals, with dysuria, have been cured by this remedy. Aphthae or red sore places that look like ulcers on the external genitalia, with itching and fluor. Tumours in the genitals; bluish, hard, with shooting and pricking pain.
Vaginal fistula, with burning pain; often attended by much eructation of wind that relieves for only a short time.
Menses too early; too profuse, but sometimes also scanty. Protracted menstruation has also been cured by this remedy: a dark, putrid passive oozing, continuing almost until the next menstrual period. Thick and strong smelling blood, acrid, excoriating; or else pale.
Menorrhagia with burning across the sacrum; passive flow. Metrorrhagia from uterine atony, patient is cold and deathly pale, constantly wants to be fanned.
The menses can be preceded by spasmodic abdominal pain and leucorrhoea, by itching eruptions, e.g. on nape of neck, also by burning in the genitalia; during the menses colic in the hypogastrium, headache contracting the eyes, vomiting, burning in the palms and soles, and toothache may occur.
‘During diminished menstrual flow, much cutting in abdomen, aching in back and bruised pain in all bones.’
Greenish fluor, or thick and yellow. Profuse, very thin leucorrhoea only in the morning on rising, but no discharge all day. Intermittent fluor, comes and goes suddenly. Corroding, excoriating fluor, with swelling of the vulva, itching and burning; preceding or following the menses. Tendency to abortion from inertia of uterus.
Labour pains weak or ceasing, with great general debility; especially after severe disease or great loss of fluids. Brown, foul smelling lochia.
States of exhaustion from nursing, with stomach pain.
Has been used in lumps in the mammae, with induration of the axillary glands and burning pains; also in uterine cancer where the pain was burning and came on in paroxysmal spells.
Neck and back
Swelling and aching of the cervical glands, especially the dorsal ones (near the nape).
Stiffness of the nape of the neck. Tearing pain in the muscles of the neck and nape of the neck.
Drawing pain in the nape, rising into the head, with nausea and a flow of water from the mouth.
Scattered red spots on the neck, with itching and stinging.
Heaviness and painful stiffness of the back, especially on rising in the morning. Rheumatic drawing pain throughout the back, worse while sitting or stooping, especially on the left side; also burning pain in different parts, especially in the scapular region and about hips, with aching along the spine; or the whole back is sore, as if bruised.
Severe sacral pain, cannot sit, feels like a plug in the back; has to lie on a pillow. Great tension and stiffness in the small of the back, sometimes with a cold feeling and numbness in that location.
Near the lowest part of the spine, a cramp-like pressive pain. Pressive, sore pain below the coccyx.
Extremities
Lassitude (more in the lower limbs), heaviness (sometimes only left-sided) and even numbness in the extremities. Heaviness and stiffness in the limbs when standing up after sitting for some time, ceasing after walking. The limbs on which he is lying are apt to go numb.
Pain in the limbs as from over-lifting or sprain; bruised and drawing pain of all the limbs; burning in the limbs and bones. Boring pain, as if in the marrow, in all the bones of the extremities before a fever attack. Tearing pain in the limbs that seems to extend up to the head and end there. Cold extremities; very cold hands and feet, particularly in the evening; cold knees, or icy cold legs down from the knees; unilateral coldness, mostly left-sided.
Involuntary twitching and trembling of the limbs, sometimes preventing the patient from falling asleep. Gangraena senilis beginning in the toes. Ulcers at the tips of the fingers and toes. Drawing pain at night in the arm he lies on.
Paralytic lassitude in the arms and hands, especially on writing which is difficult and slow for him. Paralytic feeling and weakness of the fingers of the right hand or in the right wrist when grasping anything, with tearing pain.
Burning on the right shoulder.
Pain as if beaten, in the elbow joints of both arms.
Drawing tearing in the forearm, from the elbow to the hands and even into the fingers, aggravated on moving the part.
Tearing in the right or left wrist; also in the fingers.
Fine, itching eruption on the hands.
Sensation of stiffness in the lower limbs after a nap in the evening, making his gait uncertain, ceasing after some motion. Tension in the joints of the hips, knees, and feet, especially in the morning on rising.
Severe paralytic drawing pain from the abdomen into the left thigh; with flatulence. Tearing in the lower limbs, which seems to increase from accumulation of flatus in the abdomen.
Drawing pain in the hip joint, down the thigh, which increases on walking. Tearing drawing pain below and at the side of the hip, extending to the back, frequently recurring. Drawing pain in the thighs.
Paralytic feeling in the left leg.
Ulcers on the legs; ulcus cruris varicosum, indolent; pain better by elevating the leg (compare the section ‘Important general conditions’ where more symptoms of ulcers are listed).
Varices, especially in pregnant women.
Cramp in the soles of the feet, in the evening after lying down; the toes are drawn crooked. Feet feel as though dipped in cold water.
Foot sweat, excoriating toes; often with a putrid odour; cold.
Sleep
Much sleepiness, sometimes irresistible, during the daytime, especially after lunch; has to take a nap before and after noon. Sleepiness in the morning when sitting and reading, disappearing on movement.
Falls asleep late, not before 1 a.m. Uneasiness in the body, headache, oppression of the chest, starting and pain in the limbs, coldness in the hands and feet, pain in the eyes etc. prevent the patient from falling asleep with ease.
Frequent waking from cold limbs, especially cold knees. The sleep is disturbed by delusions; by feelings of heat and pulsation in the head, with fear of apoplexy; by anxious dreams that make him start. In the morning he feels weary and unrefreshed; all the limbs feel bruised.
Many vivid dreams, which are often forgotten; sleep full of fantastic dreams. Much yawning and stretching, which tends to ease the symptoms.
Fever, chill, perspiration
Coldness and chill predominant (compare the description in the ‘Generalities’ section).
Characteristic is chill with great thirst, particularly for cold drinks, whereas during heat the thirst may be wanting altogether. ‘Chill, with a marked degree of thirst; no thirst, or but slight during fever, but patient wishes to be fanned all the time, as if to compensate for the lack of thirst.’ Feeling of heat internally while the body feels cold to the touch.
Shaking chill with blue finger nails. Clarke describes ‘a typical case of Carbo vegetabilis intermittent: Headache for one or two hours before the chill.
Chill always from 9 to 10 a.m., beginning in feet and hands, spreading over body; nails very blue.’
Shivering in the evening, with fatigue, and before going to sleep a flush of heat ensues. Frequent flushes of heat; also after drinking wine, or combined with anxiety and pain.
Strong tendency to sweat, especially about the head and face, also generally at the upper part of the body; inclined to catch a cold from it. Profuse perspiration at night, worse before midnight, and in the morning. Sweat during and after eating. The perspiration may exhaust the patient, and it tends to have a putrid or sour odour and is often cold.
Skin
Blue and cold surface, often with ecchymoses. ‘Blue colour of body, with terrible cardiac anxiety and icy coldness of whole surface’ (Noack / Trinks).
Carbo vegetabilis has a good reputation in ulcers, especially indolent ulcers, even those with a tendency to necrosis and gangrene (see ‘Generalities’). The provings elicited this symptom: ‘An ulcer which had already healed breaks up again and discharges serum mixed with blood instead of pus; the place is hard and pains on touch.’ Wounds become gangrenous. Decubitus; senile gangrene beginning in the toes.
Mezger reports a case of a suppurating phlegmone of the whole left leg in a diabetic woman. After incision the wounds only healed partially, and sequestra were discharged. Three long fistulae remained from the incision wounds, with bloody and purulent secretion, and the whole leg was cyanotic. Carbo vegetabilis produced a homeopathic aggravation of the pain and secretion, then an amelioration, and in three weeks the wounds had healed.
General tendency to varicose veins, often with ulceration.
Telangiectasis in children; elevated, round, flat, soft, elastic, red tumours, formed by a net of dilated capillary vessels, with violent haemorrhaging after slight injuries.
Folds of the skin become raw and ulcerated.
Fine, moist rash, with burning at spots where there is no eruption. Burning at various places on the skin, especially at night in bed.
Itching all over the body, especially in the warmth of bed; cannot fall asleep. Itching sticking on the side on which he lies. Moist herpetic eruptions, especially in the face. Acne rosacea.
Summary
The principal symptoms of Carbo vegetabilis are the following:
Ailments after the shock of an accident or acute illness (often pneumonia): lowered vitality, indifference, coldness. Sluggishness affecting physical and emotional levels.
Apathy, mental dullness, lapses in memory, fixed ideas.
Lung conditions; e.g., pneumonia, asthma. Respiration aggravated by lying down, ameliorated by vigorous fanning.
Generally worse lying down (headache, intestinal discomfort, asthma etc.).
Desires air. The desire to be fanned is of central importance.
Great coldness of the breath, extremities, tongue, nose, etc. but sometimes with a hot head.
Desires salt (also sweets and coffee).
Collapse or fainting with coldness, blueness, desire for air.
Extreme gastrointestinal bloating, with frequent eructation, which relieves.
Aggravation from fat and butter. Intolerance of alcohol.
Elderly patients with indolent skin ulcers, with heart diseases, weak, fainting.
Clinical
Acidity. Acne. Angina pectoris. Aortitis. Aphonia. Asthenopia. Asthma. Breasts, erysipelas of. Bronchitis. Burns. Carbuncle. Catarrh. Chilblains. Cholera.
Constipation. Cough. Deafness. Debility. Diarrhoea. Distension. Dysentery. Dyspepsia. Emphysema. Erysipelas. Eructations. Feet, cold. Flatulence. Gangrene. Haemorrhages. Haemorrhoids. Hair, falling out. Headache. Heart, diseases of. Influenza.. Intertrigo. Irritation. Laryngitis. Lungs, congested. Measles. Mumps. Nose, bleeding of. Oesophagitis, Orchitis. Otorrhoea. Pregnancy, disorders of. Purpura. Scabies. Scurvy. Shivering. Sleep, disorders of. Starting. Stomach, disordered. Stomatitis. Trachea, dryness of. Tympanitis. Typhus. Ulcers. Yellow fever.
Relations
Antidoted by: Ars., Camph., Coff., Lach., Nit-s-d., Ferr. (Teste).
It antidotes: Effects of putrid meats or fish, rancid fats, salt or salt meats; Chin., Lach., Merc.
Complementary: Chin.; Dros.; Kali-c. (stitches in heart – Carb-v. contains potash). Carb-an. has more pronounced induration of glands and is suited to cases which have been opened too soon; is more appropriate to cancer and syphilis than Carb-v. Carb-v. has weak digestion in nursing women; every particle of food disagres; Carb-an. has coldness at the stomach, better by hard rubbing or hard pressure; piles, with oozing of inodorous fluid. Carb-v. is near-sighted; Carb-an. far-sighted. In ear affections Carb-an. has swelling behind the ear. Carb-v. is more suited to sequelae of exanthemata. Many of the effects of Carb-v. are like those in Lyc., and an occasional dose of Carb-v. assists the action of Lyc. Compare also Raph. in flatulence.
Compatible: Ars., Chi., Dros., Kali-c., Ph-ac., Bell., Bry., Nux-v., Sep., Sulph.
Compare: Graph. and all the carbons. Caust., Lach., Eup-per., Phos. and Rumex. in hoarseness (Rumex. is worse at 4 a.m. and 11 p.m. Caust. worse in the morning; from dry cold. Carb-v. worse in the evening; from damp evening air). Camph.; Chin. in haemorrhages, intermittents, hectic, affections of drunkards; Ip. in haemorrhages and intermittents; Meny. in intermittents with coldness of legs; Op., Sulph. and Pso. in deficient reaction; Sul-ac. in dyspepsia of drunkards (Carb-v. has more putridity; Sul-ac. more sourness); Phos. in easily bleeding ulcers; Puls., bad effect from fatty food and pastry; Sulph. in acrid-smelling menses; erysipelas of breasts; Ars. and Bell-p. in effects of ice-cream and ice-water in hot weather. Nux-v. in dyspepsia, easily angered; effects of debauchery (Nux-v is thin, spare, yellow, wiry; Carb-v. sluggish, stout, lazy); Sec. in haemorrhages, cold breath; coldness worse by warmth. Calc., Carb-an., and Stram. in aversion to darkness; Lach. in weak digestion (Lach. craves milk; Carb-v. has aversion to it), intolerance of clothing round waist; intermittent fever, flashes of burning heat without thirst. Sep. in bearing-down in the rectum and vagina (Carb-v. has the strong odour of menses which Sep. has not). Rhus-t. in strains; in typhus; Colch. in cholera; Cupr. in cold breath, prostration.
