Colocynthis is the remedy of pain that folds the body in two. Boericke states the characteristic without ornament: "Agonizing pain in abdomen, causing patient to bend double, is most characteristic." Clarke, quoting Guernsey, makes the posture itself the prescription: "The doubling over of the patient is the chief characteristic."
The medicine is made from Citrullus colocynthis — the bitter apple or bitter cucumber, in Clarke's description "N. O. Cucurbitaceæ. Native of Turkey. Tincture of pulp of fruit." In crude doses a drastic purgative; in potency, the great remedy of cramping visceral and nerve pain.
What raises Colocynthis above a mere colic remedy is its causation. Kent: "These pains are often due to a very singular cause, namely, anger with indignation. Hence persons who are haughty and easily offended or chagrined have Colocynth complaints. Anger will be followed by violent neuralgia in the head, eyes, down the spine and in the intestines." Boger fixes the anatomical range — the trifacial, abdominal, spinal and sciatic nerves — and the character: "SUDDEN, ATROCIOUS CRAMPINGS, gripings, tearings, etc., making him TWIST, turn or cry out in pain."
This guide profiles Colocynthis for clinical study from Boericke's Materia Medica, Kent's Lectures, Clarke's Dictionary, Boger's Synoptic Key and Lippe's Keynotes. The originals can be read in full — Clarke's Colocynthis, Boericke's Colocynthis and Kent's Colocynthis — through Similia's free digital materia medica.
The Colocynthis State
Colocynthis acts on a prepared ground. Kent: "You will seldom find this medicine indicated in strong, vigorous, healthy people who have suddenly become sick." The remedy "produces a state in the nervous system like that found in individuals who have for years been laboring under annoyances and vexations" — his examples are the businessman whose affairs keep going wrong, and the woman who "must watch her unfaithful husband night and day" until she "gradually assumes a sensitive irritable state of mind and is upset by the least provocation."
Boericke's patient sketch matches: "irritable persons easily angered, and ill effects therefrom. Women with copious menstruation, and of sedentary habits. Persons with a tendency to corpulency." Clarke adds that it "is suited to blondes; persons of choleric temperament; and those liable to cramps and colic, from fruit, lead-poisoning, or excessive venery."
Even the season is characteristic: Boericke opens with "often indicated in the transition season when the air is cold, but the sun is still powerful enough to heat the blood."
Mental and Emotional Picture
Anger with indignation. The grand causation, named by every author. Boericke: "Mortification caused by offense. Anger, with indignation." Lippe: "Bad effects, either from mortification caused by an offense, or else from anger with indignation." Clarke's causation list runs: "Anger. Indignation. Chagrin. Grief. Catching cold."
Kent's consulting-room dialogue. The causation surfaces the moment one asks. "The physician asks: 'What has happened to give you these pains?' Her answer is likely to be: 'My servant spilled some dirty water on a handsome rug, we had some words over it, and this is the result.'"
Becomes angry when questioned. Boericke's phrase — "extremely irritable. Becomes angry when questioned" — pairs with Clarke's "aversion to talk; disinclined to answer questions." Kent: "Disinclined to talk or to answer, or to see friends. His friends irritate him and he wants to be alone."
Anguish and restlessness with the pain. "So severe that the patient is unable to keep still" (Kent); he "screams with the pains" and "walks about the room and becomes increasingly anxious as the pain goes on." Lippe's colic keynote includes "great anguish"; Boger notes the "distorted face."
Weakness beneath the storm. Kent observes that "in spite of extreme restlessness there is great weakness with the pains" — in chronic diarrhoea with severe colic the patient may become so weak "that he can hardly speak," and "a feeling of faintness, or even fainting, is by no means an unusual concomitant."
Physical Affinities
Abdomen — the Centre of the Remedy
Boger writes it in capitals: "WAVES OF VIOLENT CUTTING, GRIPING, GRASPING, CLUTCHING OR RADIATING ABDOMINAL COLIC DOUBLE HIM UP; > HARD PRESSURE; < least food." The sensation vocabulary is a study in itself — Boericke: "cutting, twisting, grinding, contracting and bruised; as if clamped with iron bands"; "sensation as if stones were being ground together in the abdomen"; Boger's "intestines feel squeezed between stones"; Lippe's "pain as if cutting with knives."
The behaviour at the bedside is diagnostic. Clarke: "The patient bends double or presses something hard against the abdomen. He leans over chairs, the table, or bedposts to get relief." Kent adds the paroxysmal build: "Colic comes on in paroxysms that grow in intensity" until nausea appears, the patient vomits, "and he continues to retch after the stomach is empty" — Boger's shorthand, "vomits from pain."
Two aggravations complete the picture: "cutting in abdomen, especially after anger" (Boericke), and Guernsey's "the pain is < by eating or drinking the least amount." In infants: "Colic of infants when they are relieved by lying on the stomach" (Kent) — screaming returning the moment the position changes.
Head, Face and Eyes
"Develops most of its symptoms in the abdomen and head, causing intense neuralgias" (Boericke). The headache is "lateral cutting... with nausea, vomiting," better pressure and heat, and Kent adds the odd modality "becoming unbearable when moving the eyelids."
The facial neuralgia is a leading indication. Kent: "In Colocynth the pains come in waves, are better from heat, from pressure, worse if anything during rest, and are brought on by excitement or vexation. They are generally on the left side; while those of Belladonna are on the right, and are caused by cold." The infraorbital pain "sometimes... feels like a hot wire, sometimes like a cold nail." Boericke notes "neuralgia, with chilliness; teeth seem too long"; Clarke's toothache is "as if the nerve were pulled or stretched."
In the eyes, "pains sharp, boring, better pressure," and one prognostic observation of real weight: "violent pain in eyeballs which precede the development of glaucoma" (Boericke); Clarke's provers record "eyes feel hard."
Female Sphere
"Boring pain in ovary. Must draw up double, with great restlessness" (Boericke) — and the posture again: "In the violent ovarian neuralgias of Colocynth, the woman will flex the limb of the painful side hard against the abdomen and hold it there" (Kent). Clarke: "Cramp-like pain in l. ovary; in uterus; as if parts were squeezed in a vice," with dysmenorrhoea and "suppressed catamenia, with cramping pains > by bending double; or caused by indignation or chagrin." The emotional causation reaches even the puerperium: "Lochia suppressed; puerperal fever after vexation." Boger notes "pains alternating between ovaries."
Sciatica and Limbs
"Sciatic pain, left side, drawing, tearing; better, pressure and heat; worse, gentle touch" (Boericke) — the paradox of gentle touch aggravating what hard pressure relieves. Boger describes "screwing, band-like or shooting sciatic pains; < least motion, rotation or night, > lying on painful part."
The muscular signature is contraction: "Contraction of muscles. All the limbs are drawn together... muscles and tendons feel too short; numbness with pains" (Boericke); Boger's image — "limbs drawn up like a hedgehog." The hip has two classical sensations: Clarke's "pain in the coxo-femoral joint, as if it were fastened with an iron clasp," and Lippe's "when walking a sensation as if the psoas muscle was too short."
Stool and Urine
"Dysenteric stool renewed each time by the least food or drink. Jelly-like stools" (Boericke); Boger's "yellow, frothy, watery, shreddy, sourish or gelatinous stools; with colic and gas"; Kent's dysentery "from anger with indignation; the most awful tenesmus during stool." Clarke adds the relieving discharge: "if a stool occurs it gives immediate relief (Nux the opposite)."
The urinary picture is small but distinctive: "red, hard crystals, adhering firmly to vessel" (Boericke), urine that "soon becomes thick, gelatinous, and glutinous" (Clarke), tenesmus of the bladder — and through the whole remedy the "urinous odor of perspiration."
Key Modalities
Worse from:
- Anger and indignation — the causation and the aggravation in one
- The least food or drink — every paroxysm renewed by it
- Night, in bed (Boger); evening and night generally
- Lying on the painless side — Boger's counterintuitive marker
- Drafts; taking cold
- Gentle touch — while hard pressure relieves
- 4 p.m. — Clarke: "At 4 p.m. the colic came on, six days in succession," verified clinically
Better from:
- Doubling up; drawing up the limbs; lying with head bent forward
- Hard pressure — the signature amelioration
- Warmth and heat
- Coffee (Boger); Clarke adds tobacco-smoke for the colic
- After stool or flatus
- Gentle motion — Clarke: abdominal pains "> by violent exertion"; Guernsey describes the twisting, turning relief-seeking motion
Kent's caveat deserves its own line: "All pains are better from pressure, but this is in the beginning. After the pain has been going for several days with increasing severity, the part becomes very sensitive and pressure cannot be endured." A late Colocynthis case may therefore hide its own keynote.
Keynote Symptoms
- Agonising abdominal colic causing the patient to bend double
- Better hard pressure — leans over chairs, table, bedposts; presses fists into the abdomen
- Ailments from anger with indignation
- Colic renewed by the least food or drink
- Intestines as if squeezed between stones; "as if clamped with iron bands"
- Paroxysms of increasing intensity ending in vomiting
- Left-sided facial neuralgia in waves, better heat and pressure
- Boring ovarian pain; limb of the painful side flexed hard against the abdomen
- Left sciatica better hard pressure and lying on the painful side
- All the limbs drawn together; muscles and tendons feel too short
- Jelly-like stools with colic and gas
- Infant colic relieved by lying on the abdomen
- Red, hard urinary crystals adhering to the vessel
- Urinous odour of perspiration
Clinical Applications
Flatulent and dysenteric colic. The core territory: gas colic, dysentery with tenesmus, cholera-form states — wherever the doubling-up, pressure-relieved paroxysms appear. Kent notes the Guiding Symptoms devote "several pages of repetitions" to this region.
Infant colic. The child relieved lying on the stomach, screaming when moved — with the emotional causation often visible in the nursing dyad's circumstances.
Menstrual and ovarian neuralgia. Dysmenorrhoea with cramps better bending double; ovarian neuralgia with the flexed-limb posture; suppressed menses or lochia after indignation.
Facial neuralgia. The left-sided wave-like prosopalgia better heat and pressure — one of the three great faceache remedies Kent names, beside Belladonna and Magnesia phosphorica.
Sciatica. On the strict indications: better hard pressure, heat and lying on the painful side, worse rest and least motion — not as a routine prescription.
Colic of lead poisoning. Boericke records: "Colocynth is the best antidote to lead poisoning (Royal)"; Clarke lists cramps and colic "from fruit, lead-poisoning, or excessive venery."
Gouty and rheumatic eye affections. Boring eye pains better pressure; Clarke's clinical list includes ciliary neuralgia and glaucoma — with Boericke's warning sign of violent eyeball pain preceding it.
Differential Diagnosis
Colocynthis vs. Chamomilla. Clarke: "Cham. is also very close, both having colic from disturbing emotions, but the Cham. child does not double up, it tosses about." Chamomilla's anger is expressed — loud, capricious, demanding to be carried, one cheek red; Colocynthis is the indignant adult or the infant who quiets only on its stomach, folded over the pain.
Colocynthis vs. Staphysagria. The two remedies of anger with indignation, and Clarke notes "they follow one another well." Staphysagria suppresses the wrath — the insult swallowed, with trembling, bladder irritability, and, as Clarke puts it, "black or decayed teeth and sore eyelids... and there is chronic tendency to colic"; Colocynthis discharges it into immediate, violent, doubling colic and neuralgia.
Colocynthis vs. Nux vomica. Both are irritable, choleric, overindulging types with cramping abdominal complaints — Boericke groups them under "anger, with indignation." The stool separates them: in Colocynthis "if a stool occurs it gives immediate relief (Nux the opposite)" — Nux's ineffectual urging relieves nothing, and its colic lacks the dramatic doubling-up amelioration.
Colocynthis vs. Magnesia phosphorica. Nash's judgement, preserved by Clarke: "Mag. Phos. comes nearest to it in colic and neuralgic affections." Both are better from heat and pressure; Magnesia phosphorica's pains "shoot like lightning along the nerves" (Kent) and lack the anger causation. Dioscorea completes the trio by opposition: wind colic "> by stretching out" — the exact reverse of the Colocynthis posture.
Repertorisation Tips
These rubrics carry Colocynthis in high grade:
- Mind; AILMENTS FROM; anger, vexation; indignation, with
- Mind; ANGER; questioned, when
- Abdomen; PAIN; cramping; bending; double; amel.
- Abdomen; PAIN; pressure; amel.; hard
- Abdomen; PAIN; eating; after; agg.
- Abdomen; PAIN; anger, after
- Face; PAIN; neuralgic; left
- Face; PAIN; warmth; amel.
- Female; PAIN; ovaries; bending double, amel.
- Extremities; PAIN; sciatica; pressure; amel.
- Extremities; PAIN; sciatica; lying; side, on; painful, amel.
- Rectum; DIARRHOEA; anger, after; indignation, with
Anchor on the triad — causation (anger with indignation), posture (bending double, hard pressure) and paroxysm (waves renewed by the least food or drink) — and the remedy nearly repertorises itself. Where the case is neuralgic rather than abdominal, keep the same two modal anchors (heat, pressure) and add laterality. Remember Kent's caveat: in a case of some days' standing the pressure amelioration may have inverted, so take the history of the early paroxysms, not only the present state. Our beginner's guide to repertorisation sets out the method in more detail.
Deepening Your Study
- Boericke gives the sharpest sensation vocabulary — clamped with iron bands, stones ground together — with the seasonal note and the lead-poisoning clinical
- Kent's Lectures supply the causation doctrine, the consulting-room dialogues, and the indispensable caveats on routine sciatica prescribing and late pressure-sensitivity
- Clarke's Dictionary holds Guernsey's classic characterisation, the fullest differential paragraph (Chamomilla, Staphysagria, Dioscorea, Veratrum) and the 4 p.m. periodicity
- Boger's Synoptic Key compresses the colic into its capitals-line and adds the nerve-trunk map, the hedgehog posture and "lying on painless side" aggravation; his General Analysis flags cramp, cutting and pressure-amelioration as leading generals
- Lippe's Keynotes distils the colic sentence — bending double, knives, bowel pressed between two stones — and the double causation of mortification and indignation
You can read all of these side by side for any remedy through Similia's free digital materia medica. To place Colocynthis among its peers, see the guide to the essential polycrest remedies, or read how materia medica and repertory work together in case analysis.
