Hypericum perforatum — St John's wort — holds one office in the materia medica above all others. Boericke states it in his first line: "The great remedy for injuries to nerves, especially of fingers, toes and nails."
The guiding thread through every indication is in his next sentences: "Crushed fingers, especially tips. Excessive painfulness is a guiding symptom to its use. Prevents lockjaw. Punctured wounds." Where an injury hurts far beyond what its appearance explains, and the pain runs along the course of a nerve, this remedy stands almost alone. Boger compresses the pain character into a phrase worth memorising: "Intolerably violent, shooting, lancinating along nerves; toward trunk."
The remedy is prepared, per Clarke's heading, from a tincture of the whole fresh plant. Clarke lingers on the signature — the leaves "sprinkled with pellucid dots and black glands," most conspicuous in H. perforatum, which "have evidently given the signature which has led to the chief use of the plant in medicine, namely, as a remedy for wounds or perforations of the integuments."
In practice Hypericum belongs to the small group of remedies every prescriber must be able to differentiate at speed in trauma: Kent writes that "the surgery of Homeopathy largely involves the use of Arnica, Rhus tox., Ledum, Staphysagria, Calcarea and Hypericum," and his lecture is essentially a map of where each begins and ends. This guide profiles Hypericum for clinical study from Boericke's Materia Medica, Kent's Lectures, Clarke's Dictionary and Boger's Synoptic Key. The originals can be read in full — Kent's Hypericum, Clarke's Hypericum and Boericke's Hypericum — through Similia's free digital materia medica.
The Hypericum State
Hypericum is not a constitutional type but a state following injury — and a specific kind of injury. Clarke defines the territory exactly: "The particular kinds of wounds for which Hyp. has been found of signal service are wounds of parts rich in nerves, brain, spine (spinal irritation from falls), coccyx, finger-ends; wounds from stepping on nails, or any punctured wounds."
Boger's regional summary is the same map in capitals: "SPINAL NERVES: COCCYX. Inter-scapular. Meninges," with the vertex added; his causations read "INJURY: Jar. Concussion. Penetrating. Shock. Bruises."
Kent describes the moment the state declares itself. After a finger-end is bruised or lacerated, a nail torn off, or a nerve "pinched between a hammer and the bone in a blow," the nerve "becomes inflamed and the pain can be traced up along the nerve, and it is gradually extending toward the body from the injured part with stitching, darting pains, coming and going, or shooting up from the region of the injury toward the body, a dangerous condition is coming on. In this condition Hypericum is above all the remedies to be thought of."
The danger he means is tetanus: "It hardly need be said that lock-jaw is threatening... When these pains come on Hypericum will stop them, and from this stage to advanced states of tetanus with opisthotonos and lock-jaw Hypericum is the remedy." Its deeper pathology, in his summary, is "an ascending neuritis" — "its action is upon the nerve sheaths and meninges, with stitching, tearing, rending pains along the nerves, wherever there are injuries."
Mental and Emotional Picture
Effects of shock and fright. Boericke lists "Effects of shock" among the mentals, and Clarke's causation line is simply "Fright. Bites. Wounds. Shock." Clarke expands: "Hyp. is called for in nervous depression following wounds; effects of shock, fright and mesmerism."
The levitation sensation. The remedy's strangest and most confirmable mental. Boericke: "Feels as if lifted high in air, or anxiety lest he fall from heights." Clarke traces it to the proving — a prover woke at 4 a.m. with "a feeling as though she were suspended and not lying in bed" — and notes it "has led to cures in effects of accidents attended with the sensation 'as if being lifted high into the air; and great anxiety lest she should fall from this height.'"
Mistakes in writing. Boericke gives it in two words; Clarke fills it out: "Makes mistakes in writing; omits letters; forgets what she wanted to say."
Melancholy and drowsiness. "Melancholy" (Boericke), with "Constant drowsiness" recorded by both Boericke and Clarke — a quietly useful concomitant in post-traumatic states.
Physical Affinities
Nerves and Extremities
The core province. Clarke's Generalities section is the fullest single statement: "Injuries to parts rich in sentient nerves, esp. fingers, toes, and matrices of nails. Mechanical injuries, wounds by nails or splinters in the feet, needles under the nails, squeezing, hammering; of the toes and fingers, esp. the tips of the fingers; when the nerves have been lacerated, wounded, torn, with excruciating pains." His criterion for severity: "Lacerations, when intolerable, excruciating pain shows nerves are severely involved."
Boericke's extremity symptoms carry the same signature into neuritis: "Pain in toes and fingers, especially in tips. Crawling in hand and feet. Lancinating pain in upper and lower limbs. Neuritis, with tingling, burning pain, numbness and flossy skin." Clarke adds the memorable textures: "Hands and feet feel fuzzy"; "The feet feel pithy, as if pricked with needles." Boger records "Neuralgia of stump" and the odd sensation that "limbs feel detached."
Spine and Coccyx
Boericke: "Pressure over sacrum. Spinal concussion. Coccyx injury from fall, with pain radiating up spine and down limbs." Clarke: "Cervical vertebræ very sensitive to the touch. Consequence of spinal concussion... After a fall, slightest motion of arms or neck extorts cries."
Kent's coccyx teaching is built on a case that ended badly — a man thrown onto his coccyx by a lurching tram car, dead in ten days while "nobody could find out what was the matter with him" — and on many that ended well: "Many times I have seen Hypericum cure similar conditions. Injuries of the coccyx are among the most serious and troublesome injuries that the physician comes in contact with." He includes the chronic form: "Many a woman sustains an injury of the coccyx during labor, and however, slight, soreness remains for years afterwards."
Head
Three sensations of high value. Boericke: the head "feels as if touched by an icy cold hand"; "Head feels longer — elongated to a point" (Boger: "Head feels drawn to a point"); and "Brain feels alive," with Clarke's variant of a "buzzing sensation in vertex at night as if something living were in brain." Boericke also lists the fracture context: "In fractured skull, bone splinters."
Scars and Old Injuries
Kent describes the painful cicatrix: an old scar re-injured, where "stinging, tearing pains come in that cicatrix... and the pain runs toward the body along the course of nerves. A painful cicatrix with pain shooting up toward the centre of the body following up the nerves. Hypericum is the medicine for that." Clarke's skin section confirms: "Painful scars in tissues rich in nerves." Kent also gives the wound that will not heal: "A wound will sometimes yawn, swell up, no tendency to heal, look dry and shiny on its edges, red; inflamed; burning, stinging, tearing pains... That wound needs Hypericum."
Rectum
An affinity easily forgotten: Boericke writes that Hypericum "has an important action on the rectum; hæmorrhoids... Hæmorrhoids, with pain, bleeding, and tenderness." Clarke reports Roehrig considering it "the nearest thing to a specific in bleeding piles," with Ussher's indications "pain, bleeding and tenderness."
Respiratory
Boericke: "Asthma worse foggy weather and relieved by profuse perspiration." Clarke confirms the cured cases — "asthma < in foggy weather; the attacks were > by copious expectoration" — and adds "Whooping-cough < 6 to 10 p.m."
Key Modalities
Worse from:
- Injury — jar, concussion, penetrating wounds, shock, bruises (Boger's heading)
- Cold; dampness; fog — Boericke: "Worse, in cold; dampness; in a fog; in close room; least exposure"
- Touch — the wounds are exquisitely sensitive
- Change of weather; before storms — the spasmodic asthmatic attacks
- Motion — after a fall, "slightest motion of arms or neck extorts cries"
Better from:
- Bending the head backward — Boericke's single amelioration
- Lying on the face — Boger
- Copious expectoration — for the asthma; profuse perspiration likewise
The weather sensitivity is worth underlining because it is unexpected in a "trauma remedy": fog and damp aggravate almost everything in the remedy, and Boger's General Analysis files Hypericum under both "change of temperature, weather, seasons, oncoming storms" and "dampness."
Keynote Symptoms
- Injuries to nerve-rich parts — fingertips, toes, matrices of nails, coccyx, spine
- Excessive painfulness — pain out of proportion to the visible injury
- Intolerable shooting, lancinating pains along the course of nerves, towards the trunk
- Punctured wounds — nails, splinters, needles, bites
- Prevents lockjaw — the remedy of threatening tetanus after nerve injury
- Coccyx injury from a fall, with pain radiating up the spine and down the limbs
- Spinal concussion; cervical vertebrae sensitive to touch
- Painful scars in tissues rich in nerves
- Sensation of being lifted high in the air, with anxiety of falling from the height
- Head feels elongated; forehead as if touched by an icy cold hand
- Neuritis with tingling, burning and numbness; hands and feet feel fuzzy
- Asthma worse in foggy weather, better from copious expectoration
- Haemorrhoids with pain, bleeding and tenderness
Clinical Applications
Lacerated and crushed nerve injuries. The headline use — Kent: "Hypericum belongs to lacerated wounds and when there is laceration of parts that are full of small nerves, sentient nerves, give it at once. Do not waste time with Arnica because there is soreness, for the soreness is of much less importance than the danger from nerves in lacerated wounds."
Threatening tetanus. The shoemaker's awl, the carpenter's tack, the bite — trivial wounds followed the next night by violent shooting pains up the limb. Boericke: "Prevents lockjaw"; Clarke's Guernsey case documents a boy with locked teeth and stiff neck after a rat bite, convalescent by the next morning on Hypericum, chosen because there was "more tenderness about the wound than the appearance would indicate."
Coccyx and spinal injuries. Falls on the coccyx, railway and staircase falls, spinal concussion — including the lingering post-partum coccydynia Kent describes.
Post-operative pain. Boericke: "Relieves pain after operations. Quite supersedes the use of Morphia after operations (Helmuth)." Clarke adds Gilchrist's regime of Hypericum 3x controlling pain after laparotomy.
Painful cicatrices and non-healing wounds. The re-injured scar with ascending nerve pain; the yawning, dry, shining wound with no tendency to heal.
Neuritis and neuralgia after injury. Boericke: "Traumatic neuralgia and neuritis" — with tingling, burning and numbness marking the nerve as the injured tissue.
Bleeding, tender haemorrhoids — with the triad of pain, bleeding and tenderness.
Differential Diagnosis
Hypericum vs. Ledum. The essential pair; Kent says they "run close together, and they have to be compared." Ledum is the preventive of punctured wounds — the stepped-on nail, the bite — while the pain remains "a dull aching in the part that was injured." The moment the pain shoots from the wound up along the nerve, the case has become Hypericum. Clarke's touch test confirms: Hypericum wounds are very sensitive to touch, Ledum punctures "not particularly sensitive."
Hypericum vs. Arnica. Arnica answers to the first hours of bruising — Kent: "for the first hours for bruised conditions and concussions and shocks Arnica is routine... But you will find Arnica only fits into that one place." Arnica's picture is soreness of soft parts; Hypericum's is nerve pain out of proportion, with shooting pains and the threat of tetanus. In coccyx and spine cases Kent is explicit that Hypericum, not Arnica or Rhus, "is to be given at once."
Hypericum vs. Ruta. Ruta owns the fibrous and periosteal layer: Kent — "for bruised of bone, cartilages, tendons, insertion of tendons, bruises about cartilages and about joints, Ruta is better than any other remedy," with its "lingering, sore, bruised places on bones." Hypericum's tissue is the nerve itself; the pain shoots and lancinates rather than aching in a sore spot.
Hypericum vs. Staphysagria. For clean incised wounds — the surgeon's cut rather than the crush — Kent assigns Staphysagria: after surgery, where "the walls of the abdomen take on an unhealthy look, and there are stinging, burning pains, Staphysagria is the remedy that will make granulation come immediately," and it is likewise "the natural antidote to stretching" of sphincters. Hypericum remains the remedy of the lacerated, torn, nerve-involving wound.
Repertorisation Tips
These rubrics carry Hypericum in high grade:
- Generalities; INJURIES; nerves, of
- Generalities; INJURIES; punctured wounds
- Generalities; PAIN; shooting; nerves, along the
- Back; INJURIES; coccyx, of; falls, from
- Back; CONCUSSION of spine
- Extremities; INJURIES; fingers; tips of, crushed
- Generalities; WOUNDS; painfulness, excessive
- Generalities; WOUNDS; bites of animals
- Generalities; TETANUS; wounds, after
- Mind; DELUSIONS; lifted high in the air, as if
- Head; ELONGATED, sensation as if
- Respiration; DIFFICULT; foggy weather agg.
- Rectum; HAEMORRHOIDS; painful; bleeding
Anchor on the aetiology plus the pain behaviour: an injury to a nerve-rich part, with pain excessive for the appearance and shooting along the nerve towards the trunk. Confirm with touch-sensitivity of the wound and, where present, the levitation sensation or the fog aggravation. If the pain stays dull and local in a puncture, re-examine Ledum before committing. Our beginner's guide to repertorisation sets out the method in more detail.
Deepening Your Study
- Boericke gives the sharpest short statement of the remedy — the guiding symptom of excessive painfulness, the lockjaw prophylaxis, the coccyx keynote and the fog-aggravated asthma
- Kent's Lectures are indispensable here: the full trauma-remedy map (Arnica, Rhus, Ledum, Staphysagria, Calcarea, Ruta, Hypericum), the ascending-neuritis doctrine and the coccyx cases
- Clarke's Dictionary holds the signature discussion, the proving details behind the levitation sensation, and the recorded cures — the rat-bite tetanus case, the laparotomy pain regime, the bleeding piles
- Boger's Synoptic Key and General Analysis compress the remedy for revision: spinal nerves, coccyx and vertex; jar, concussion and penetrating injury; fogs and damp
You can read all of these side by side for any remedy through Similia's free digital materia medica. To place Hypericum among its peers, see the guide to the essential polycrest remedies, or read how materia medica and repertory work together in case analysis.
