Cephaëlis ipecacuanha — ipecac-root — is the remedy of nausea that nothing relieves. Boericke states it plainly: "The principal feature of Ipecacuanha is its persistent nausea and vomiting, which form the chief guiding symptoms." Boger compresses the same fact into three capitalised words and a symbol: "HORRID NAUSEA; not > vomiting" — the patient vomits and is no better for it.
Clarke explains what makes the symptom so recognisable: "The special form of nausea is a constant but unavailing desire to vomit; or immediately after vomiting there is, instead of relief, a desire to vomit again." Lippe reduces the whole remedy to four words: "Nausea accompanies most complaints."
The medicine is prepared, Clarke records, from tincture and trituration of the dried root, of the natural order Rubiaceæ. It is "a botanic relative of China, and it is also an antidote to the latter" — a relationship Clarke connects with its "large sphere of usefulness in intermittent fever", above all in cases spoiled by quinine.
In daily practice Ipecacuanha belongs to the acute prescriber's working kit: gastric attacks after indigestible food, the bronchitis of infancy, whooping cough, spasmodic asthma, and — the field Kent valued above every other — bright-red haemorrhage with nausea. "I could not practice medicine without ipecac., because of its importance in hemorrhages."
This guide profiles it for clinical study from Boericke's Materia Medica, Clarke's Dictionary, Boger's Synoptic Key, Lippe's Keynotes and Kent's Lectures. The originals can be read in full — Clarke's Ipecacuanha, Boericke's Ipecacuanha and Kent's Ipecacuanha — through Similia's free digital materia medica.
The Ipecacuanha State
Ipecacuanha is an acute remedy of rapid pace. Kent's whole comparison with Antimonium tartaricum turns on this: "Ipecac. brings on its symptoms rapidly and effects a crisis speedily." Whatever the complaint — cough, colic, fever, flooding — it arrives fast and centres on the stomach.
Boericke sketches the susceptible subject: "Especially indicated in fat children and adults, who are feeble and catch cold in relaxing atmosphere; warm, moist weather." Clarke agrees: it is "specially suited to stout persons of lax fibre; to fair people; to women and children", and to those with "a history of epistaxis or other blood-loss."
The causations are concrete and worth asking after directly. Boericke: "Indicated after indigestible food, raisins, cakes, etc." Clarke's list runs: "Vexation and reserved displeasure. Injuries. Suppressed eruptions. Quinine. Morphia. Indigestible foods." Lippe adds the bad effects "from effects of pork eating" and "from the abuse of opium, arsenic and quinine."
Boger's master generalisation converts the long symptom list into a single clinical test: "CONTINUOUS NAUSEA, gastric disturbances, BRIGHT RED, GUSHING HÆMORRHAGE (rapidly clotting), or shortness of breath accompany most complaints."
Mental and Emotional Picture
The mind is not the centre of this remedy, but what the sources record is characteristic enough to confirm a choice.
Irritable contempt. Boericke: "Irritable; holds everything in contempt." Clarke has "Moroseness, with contempt for everything" and a "Disdainful humour."
Desires it cannot name. Boericke: "Full of desires, for what they know not." Clarke's version: "Desire for a number of things, without knowing exactly which" — the emotional counterpart of a capricious stomach.
Screaming children. Boger: "Cries, screams and is hard to please." Clarke observes that "the irritability of the elders becomes in children crying and screaming" — a useful confirmation in infantile diarrhoea and bronchitis.
Intolerance of noise. Clarke: "Cannot endure the least noise."
Depression riding on irritated tissues. Clarke's condensed keynote for the whole remedy is "mental depression with tissue irritability" — a sunken, miserable mood accompanying violently irritated mucous membranes.
Physical Affinities
Stomach and abdomen
The centre of gravity. Boericke: "Constant nausea and vomiting, with pale, twitching of face. Vomits food, bile, blood, mucus." The mouth is moist with "much saliva", and — the great negative — "Tongue usually clean." Boger adds "Clean or red, pointed tongue. NO THIRST" and a "miserable sinking or hanging loose feeling at stomach"; Boericke's wording is "Stomach feels relaxed, as if hanging down."
The colic is cutting and umbilical: "Cutting, clutching; worse, around the navel." Kent watches the pain cross the abdomen "from left to right", so severe that it "holds him transfixed in one position". Stools are "pitch-like green as grass, like frothy molasses, with griping at navel", or dysenteric and slimy; in Boericke's dysentery indication, "while straining pain so great that it nauseates."
Respiratory organs
The second great sphere. "Dyspnœa; constant constriction in chest. Asthma. Yearly attacks of difficult shortness of breathing." The cough is "incessant and violent, with every breath"; the "chest seems full of phlegm, but does not yield to coughing" — which Boger fixes as "LOOSE (coarse) RATTLE IN CHEST, WITHOUT EXPECTORATION."
In children this becomes the classic suffocative paroxysm: "Suffocative cough; child becomes stiff, and blue in the face. Whooping-cough, with nosebleed, and from mouth." Boger's compressed picture: "Paroxysms of retching, incessant or SUFFOCATIVE cough; with every breath; stiffens out, turns red or blue and finally is nauseated, gags or vomits" — worse on stepping into the open air, better from warmth and repose. Kent's whooping-cough summary: "The red face, thirstlessness, violent whooping, with convulsions, with gagging and vomiting of all that he eats are the symptoms that you will generally find."
Kent calls Ipecacuanha "especially the infant's friend", commonly indicated in the bronchitis of infancy: "The child coughs, gags and suffocates, and there is coarse rattling which can be heard throughout the room, and the trouble has come on pretty rapidly." Boericke completes the sphere with "Hoarseness, especially at end of a cold" and "hæmoptysis from slightest exertion."
Haemorrhages
"Hæmorrhages bright-red and profuse" (Boericke). Clarke supplies the confirming concomitant: "A grand keynote for Ipec. in hæmorrhages (whether of lungs, bowels, uterus, or other parts) is nausea with the hæmorrhage", and the character of the flow: "The blood is bright red and the flow steady."
Kent's uterine picture is the fullest in the literature: "When the uterus is continuously oozing, but every little while the flow increases to a gush, and with every little gush of bright red blood the woman thinks she is going to faint, or there is gasping, and the quantity of the flow is not sufficient to account for such prostration, nausea, syncope, pallor, Ipecac. is the remedy." Boger abbreviates it to a line: "Uterine hæmorrhage; gasps with each gush of blood."
The renal variant is just as specific. Kent: "The urine is extremely red with blood, which settles to the bottom of the vessel, and lines the whole commode with a layer of blood the thickness of a knife blade." And he marks the limit: when patients "have bled until they have become anaemic, and are subject to dropsy, Ipecac. ceases to be the remedy; its natural follower then is China". Lippe adds that the remedy "relieves the exhaustion following bleeding from the orifices of the body."
Head, face and fever
The headache is bruised and bony: "Bones of skull feel crushed or bruised. Pain extends to teeth and root of tongue" (Boericke); Clarke's fuller wording is "pain, as of a bruise, in all the bones of the head, as far as the root of the tongue (with nausea and vomiting)." The face shows "blue rings around eyes"; Boger notes "Face pale; blue about eyes or lips." A small confirmatory oddity from the eye section: "Nausea from looking on moving objects."
In fever: "Intermittent fever, irregular cases, after Quinine. Slightest chill with much heat, nausea, vomiting, and dyspnœa" (Boericke). Boger: "Suppressed or mixed intermittents; nausea in all stages", with the lateral curiosity "one hand cold, other hot." Clarke preserves Jahr's practical advice: "in all cases of intermittents in which no other remedy is particularly indicated Ipec. should be given to begin with. It will either cure the case or bring out more definitely indications for another remedy."
Key Modalities
Worse from:
- Periodically — "Worse, periodically" heads Boericke's modality line; Boger and Clarke both repeat it
- Veal, pork, rich and mixed foods, ices — Boger's aggravation list reads "Overeating: Ices. Pork. Veal. Mixed or rich foods"
- Moist warm wind (Boericke); Boger's "WARMTH; damp" and the warm room
- Lying down (Boericke)
- Motion — Lippe: "Motion aggravates"
- Quinine and suppressed eruptions (Boger; Clarke)
Better from:
- Open air — Boger and Lippe agree ("Amelioration in the open air"), though the cough paroxysm itself is worse "stepping into open air" and better from "warmth and repose" (Boger)
- Profuse secretions — Boger lists "Profuse secretions. Foamy discharges, stool, etc." among the ameliorations
- Rest, pressure — Clarke: "> By rest; by pressure; by closing eyes"
- Cold water for the spasmodic cough — Clarke: "Cold water > spasmodic cough"
The apparent contradictions — open air relieves generally yet aggravates the cough paroxysm — are recorded as such in the sources, and are worth observing rather than smoothing over.
Keynote Symptoms
- Persistent nausea unrelieved by vomiting — the master symptom
- Clean (or red, pointed) tongue with moist mouth and profuse saliva
- Thirstlessness through most complaints
- Bright-red, profuse, gushing haemorrhage with nausea; gasping and faintness with every gush
- Cutting, clutching colic around the navel
- Green, frothy-molasses stools; dysentery with nausea while straining
- Incessant, suffocative cough with every breath; child stiffens and turns blue
- Coarse rattling in the chest without expectoration
- Yearly attacks of asthma
- Intermittent fever after quinine, with nausea in all stages; one hand cold, the other hot
- Ailments from indigestible food, pork, veal, rich food, ices
- Pale face with blue rings around the eyes
Clinical Applications
Clarke's clinical schema runs from asthma, bronchitis and whooping-cough through cholera, dysentery, haemorrhage and intermittent fever to vomiting of pregnancy — a broad but coherent territory.
Gastric attacks. After "indigestible food, raisins, cakes, etc.", with the persistent nausea and clean tongue. Clarke's contrast with the nearest rival is exact: in dyspepsia from rich food, "Pul. has foul tongue, Ipec. clean; with Pul. symptoms last only whilst food is in stomach, Ipec. when stomach is empty."
Bronchitis of infancy. Kent's rapid-onset picture: audible coarse rattling, gagging cough, a pale child who "looks dreadfully sick".
Whooping cough and spasmodic asthma. The suffocative paroxysm with stiffening, blueness, epistaxis and vomiting; Boericke's "yearly attacks of difficult shortness of breathing."
Haemorrhages. Uterine, pulmonary, renal, nasal — bright red, steady or gushing, with nausea and disproportionate faintness. Boericke: "Uterine hæmorrhage, profuse, bright, gushing, with nausea"; menses "too early and too profuse."
Dysentery and infantile diarrhoea. Green slimy stools with awful tenesmus and nausea while straining; Lippe records its use in "the secondary stages of cholera, when marked nausea and persistent vomiting is present."
Intermittent fever. Irregular, suppressed or quinine-abused cases with nausea in all stages.
Vomiting of pregnancy. Boericke's female section lists it alongside the "pain from navel to uterus."
Differential Diagnosis
Ipecacuanha vs. Antimonium tartaricum. The classic chest comparison, to which Kent devotes a page: both have rattling and vomiting, but "the Ipecac. symptoms correspond to the stage of irritation, while the Tartar emetic symptoms appear in the stage of relaxation." Ipecacuanha's trouble arrives within hours and reaches its crisis fast; Antimonium tartaricum's comes "at the close of a bronchitis when there is threatened paralysis of the lungs", with great exhaustion, deathly pallor and sooty nostrils.
Ipecacuanha vs. Cuprum metallicum. Boericke lists Cuprum as complementary, and the two meet in whooping cough and asthma. In Cuprum the convulsive element dominates — Clarke: "spasms of flexors predominate", and in asthma the "spasmodic element predominates" — while in Ipecacuanha the nausea, gagging and rattling chest lead the case.
Ipecacuanha vs. Arsenicum album. Kent: "Ipecac. is sometimes as restless as Arsenic., but the Ipecac. prostration comes by spells, whereas the Arsenic prostration is continuous." Arsenicum burns, fears and sips; Ipecacuanha is thirstless behind its clean tongue. Clarke notes that Arsenicum follows well in cholera infantum, debility, colds, croup and chills.
Ipecacuanha vs. Phosphorus. In post-partum haemorrhage Kent separates them by the accompanying state: gushing bright blood with nausea and faintness calls for Ipecacuanha; but where the labour ran with "a hot head, an uncontrollable thirst for ice cold water" and the flooding arrives unexpectedly after an orderly delivery, "Phosphorus will nearly always be the remedy."
Repertorisation Tips
These rubrics carry Ipecacuanha in high grade:
- Stomach; NAUSEA; constant
- Stomach; NAUSEA; vomiting; not ameliorated by
- Mouth; DISCOLORATION; Tongue; clean
- Stomach; THIRSTLESS
- Generalities; HÆMORRHAGE; bright-red, profuse
- Female; METRORRHAGIA; gushing; nausea, with
- Cough; SUFFOCATIVE
- Cough; WHOOPING
- Chest; RATTLING; expectoration, without
- Respiration; ASTHMATIC
- Abdomen; PAIN; cutting; navel, about
- Chill; NAUSEA, with
Anchor on the triad that runs through every sphere — persistent nausea, clean tongue, thirstlessness — then confirm with whichever local group leads the case: the suffocative rattling cough, the gushing bright haemorrhage with faintness, or the umbilical cutting colic with green stools. If vomiting relieves, or the tongue is thickly coated, reconsider the prescription. Our beginner's guide to repertorisation sets out the anchoring method in more detail.
Deepening Your Study
- Boericke condenses the guiding triad — persistent nausea, clean tongue, bright profuse haemorrhage — and carries the practical dose note ("Third to 200th potency")
- Boger's Synoptic Key supplies the master generalisation that nausea, gushing haemorrhage or shortness of breath accompany most complaints; his General Analysis ranks NAUSEA, RATTLING and RESPIRATION among the remedy's grand characteristics
- Lippe's Keynotes opens with "Nausea accompanies most complaints" and records the exhaustion after blood-loss and the cholera indication
- Kent's Lectures teach the pace of the remedy, the full haemorrhage practice, and the Antimonium tartaricum distinction
- Clarke's Dictionary holds the richest compilation — the unavailing-desire-to-vomit analysis, Jahr's intermittent-fever advice and the constitutional portrait
You can read all of these side by side for any remedy through Similia's free digital materia medica. To place Ipecacuanha among its peers, see the guide to the essential polycrest remedies, or read how materia medica and repertory work together in case analysis.
