Ipecacuanha — Homeopathic Remedy Profile

Ipecacuanha is the remedy of the unrelieved stomach. Prepared from the dried root of Cephaelis ipecacuanha — a small Rubiaceae shrub from the rainforests of Brazil — it stands in the materia medica as the polychrest of constant nausea, bright red hemorrhage, and the rattling chest. The picture has a peculiar wholeness: a sickly disgusted countenance with blue rings around the eyes, a tongue that stays clean while the stomach turns, and a child whose cough ends with a stiff blue spell at the window.

At a Glance

• Kingdom: Plant (Rubiaceae)
• Abbreviation: ip.
• Common potencies: 6C, 30C, 200C, occasionally 1M
• Evidence grade: C (Traditional and clinical materia medica)
• Key theme: Persistent nausea unrelieved by vomiting; bright red gushing hemorrhage; rattling respiration

Source and Preparation

The drug substance comes from the underground rhizome of Cephaelis ipecacuanha (also catalogued as Carapichea ipecacuanha, Psychotria, or Uragoga), a creeping perennial of the Brazilian and Bolivian forest understory. In crude doses the root is famously emetic — Portuguese physicians learned from Tupi healers to use it for dysentery and bilious fevers, and it remained an officinal emetic in European pharmacopoeias for three centuries. Hahnemann proved it early; its provings appear in the Pure Materia Medica.

The dried root is triturated, then taken into liquid potencies by serial dilution and succussion. The remedy is acquired as a dynamic preparation whose action does not depend on chemical persistence of the source. Whatever the gross root provokes — gagging, retching, salivation, intestinal looseness, respiratory irritation — the potentized form addresses when those same self-expressions of the organism arise from disease.

The Essence of Ipecacuanha

The Ipecacuanha state is a state of thwarted discharge. The stomach wants to empty and cannot. Vomiting comes, sometimes violently, but it does not relieve. The nausea returns immediately. The chest is full of mucus but the cough is loose and coarse and rattling, and nothing is expectorated. Blood flows, bright and red, in gushes, and the patient sinks under it. Exertion without resolution. The countenance speaks the state: corners of the mouth drawn down, blue rings around the eyes, a face that says nausea even when the patient cannot.

Around this physiology a mood gathers. Ipecacuanha patients are morose, peevish, scornful. They are full of desires but do not know what they want. They hold everything in contempt. A child screams incessantly; an adult is disdainful, hard to please, irritable in suddenly appearing spells. The mental state is not the fiery competitive ambition of Nux Vomica nor the weeping clinging of Pulsatilla. It is the contempt of someone whose body has been retching for two hours and cannot stop.

Two other features anchor the essence. The oversensitivity is to temperature: worse in warm moist weather, faints in a hot room, cannot tolerate dry cold either. And the remedy is markedly periodic. Fevers return, migraines return, hemorrhages return, with nausea threading through every stage — a relapsing roughness, the same disturbance reappearing because the organism has not been able to discharge it.

What distinguishes Ipecacuanha from neighbouring remedies is that the simultaneity of nausea and hemorrhage, and of nausea and respiratory rattle, is the picture. When a respiratory case has nausea, when a bleeding case has nausea, when an asthmatic gasps and feels sick at the same instant — Ipecacuanha rises to the head of the prescription list.

Clinical Portrait

Mind and Temperament

The Ipecacuanha mind is darkened and impatient. Mental depression and dejection overlaid with a scornful, fault-finding mood. The patient holds everything in contempt. There is a curious symptom in the materia medica: "full of desires, but do not know what they want." This restless wanting without object distinguishes Ipecacuanha from true torpor. Hard to please. Censorious. Disposed to slander.

In fevers the mental state becomes anxious and moaning. Children scream and shriek before convulsions. The remedy is indicated for ailments from anger, mortification, vexation, and reserved displeasure — a held-in resentment that never finds expression. The held-back emotion has the same shape as the held-back vomit and the held-back hemorrhage.

I have seen the picture clearest in a child of about two — pale, fat, lax-tissued, screaming, throwing fists into the mouth, with green slimy stools and a sticky moist tongue that stayed pink in the middle. The mother had given fennel tea, then a pediatric anti-emetic, then ice cream to soothe him, all of which made the case rougher. A single dose of 30C settled the screaming inside an hour and the diarrhea by the next morning.

Head and Sensorium

The Ipecacuanha headache is gastric: nausea precedes it and persists through it. Migraine with bilious vomiting, with nosebleed, with the sensation as if the bones of the skull were crushed or bruised. The pain is often over the left eye or in the occiput, with throbbing in the forehead. Cold sweat on the forehead is a small confirmatory sign that distinguishes this gastric migraine from the dry heat-and-throb of Belladonna.

Vertigo arrives with tottering and staggering, worse on walking and turning, and a peculiar vertigo of early pregnancy. Nausea on looking at moving objects is highly characteristic — a confirmation in seasickness, car sickness, and any vertigo with nausea inseparable. Gushing lachrymation accompanies the nausea. Photophobia may be present without redness.

Digestion

The stomach is the seat of the remedy. Ipecacuanha's keynote — the keynote that organizes the whole picture — is persistent nausea not better by vomiting. The patient retches, gags, vomits bile or food or mucus or grass-green matter or even blood, and the nausea returns at once. The stomach feels hanging down relaxed, empty and sinking. The tongue, despite all this disturbance, stays clean, or only slightly coated — the differentiating point against Antimonium Crudum, which has a thick milky-white coat with the same dyspeptic complaints. Clean tongue with severe nausea is one of those small unspectacular keynotes that pays back for life once it is learned.

Stomach trouble follows rich food, pork, veal, pastry, candy, ice cream, unripe fruit, salads, fats, cold drinks, and black coffee. The thought or smell of food may cause the patient to gag. Great disgust and loathing of food, alternating curiously with violent hunger when nausea momentarily abates. Thirstlessness predominates, except during fever. Cramps and clutching pains around the navel, sometimes radiating from navel to uterus.

In obstinate food poisoning where nothing — not even a sip of water — will stay down, Ipecacuanha frequently acts where other remedies have failed. The hallmark is continuous gagging rather than the discrete violent vomit of Veratrum, and the absence of the burning thirst of Arsenicum Album.

Abdomen and Stool

Colic is cramping, cutting, clawing — pains as from a hand clawing inside the intestines — worse around the navel. Cold drinks, ice cream, unripe fruit, and beer provoke it. In children the colic is dramatic: screaming, restlessness, tossing about, knees drawn up.

Stools are mucous, fetid, worse at night, brown or grass-green or lemon-coloured or pitch-black. There is the unmistakable description of stools "like frothy molasses" with griping at the navel, often spurting out with much flatus. In amoebic dysentery the urging is tenesmic, and the dysentery is often accompanied by a hot head with cold legs. Cholera infantum in its first stage — nausea, vomiting, colic, and watery diarrhea together — is one of the classical Ipecacuanha presentations. The remedy was used widely in the nineteenth-century epidemics and remains a standard reference for any acute summer diarrhea where vomiting and nausea dominate.

Respiration

The chest picture is as distinctive as the stomach picture. Loose, coarse rattling rales in the chest without expectoration is the keynote. The chest feels full of phlegm, but the cough does not yield it. Cough is suffocative, paroxysmal, incessant, with every breath. Cough with nausea. Cough with vomiting.

Whooping cough is a classical indication: the child stiffens, becomes blue or red in the face at the end of the paroxysm, may bleed from the nose or mouth, and gags up mucus or vomits at the close of the fit. In the elderly the remedy is useful for dry spasmodic coughs in fits, and for the rattling bronchitis where the wheeze is louder than the productive cough.

The asthma picture is one of constriction. Constant constriction in chest and larynx, worse at least motion. Violent dyspnea with wheezing. Threatened suffocation from accumulation of mucus. The patient gasps for air at the open window. Pale, stiff, blue. Nausea may accompany the attack. Humid asthma — asthma triggered by damp weather or sudden weather changes — is the Ipecacuanha environment. Asthma following suppressed eruptions is well documented; so is asthma in young fat lax-tissued children who catch cold in warm moist wind.

In rattling bronchitis Ipecacuanha compares closely with Antimonium Tartaricum. The difference: Antimonium Tartaricum is sleepier, more drowsy, with obvious collapse and the "drowning in mucus" picture; Ipecacuanha is more anxious, more nauseated, the rattle coarser without the same impending-suffocation note.

Hemorrhage

If the stomach is the seat, the blood is the signature. Ipecacuanha covers hemorrhages of a very particular character: bright red, fluid, often gushing, accompanied by nausea and a sinking sensation. The blood may soak through the bed to the floor. Gasping with each gush. Faintness rather than excitement.

• Epistaxis — bright red nosebleed during cough, headache, every cold; during whooping cough fits; always with nausea and sinking.
• Hemoptysis — bright frothy blood from the lungs with nausea, constriction, rattling cough, on the slightest exertion.
• Uterine hemorrhage — profuse, bright red, steady flow or gushing, with nausea and gasping at each gush. Menses too early and too profuse, returning every two weeks. Menstrual cramps with nausea and vomiting forcing the woman to lie perfectly still. Postpartum and post-miscarriage hemorrhage. Threatened miscarriage with sharp umbilical pain running downward to the uterus.
• Hematemesis — vomiting of blood with food, bile, mucus, grass-green or pitch-black matter.
• Hematuria — with nausea, cutting in abdomen and urethra, short oppressed breath.
• Hemorrhoidal bleeding — bleeding hemorrhoids, often with rectal pain so great that it nauseates.

Across all sites the picture is consistent. Fresh-red. Gushing rather than oozing. Slow to clot. Always with the gastric note: nausea, faintness, empty sinking stomach.

Female

The Ipecacuanha woman bleeds. Menses early, profuse, bright red, with cramps radiating from navel to uterus and running downward. Constant nausea and vomiting accompany the menses; the patient must lie still — motion intensifies cramping and nausea both. Cutting pains cross from left to right in the uterus. Between the periods, debility and leucorrhea.

In pregnancy this is one of the most frequently indicated remedies for hyperemesis gravidarum that does not respond to dietary measures, with the characteristic features: nausea unrelieved by vomiting, no thirst, clean tongue, faint sinking in the stomach. The same picture extends to threatened miscarriage with sharp umbilical pain, and to postpartum hemorrhage of bright red blood with nausea and disgust.

Face and General Appearance

The countenance is a small clinic in itself. Pale, puffed, or sunken. Blue rings encircle the eyes. Lips blue during chill. Sometimes redness around the mouth; a white linea nasalis along the nose. Mouth corners drawn down. A peculiar almost pathognomonic feature: one side of the face hot, the other cold, or one cheek red while the other is pale. Small but reliable.

In convulsions the body becomes rigid and stretched out, followed by spasmodic jerking of the arms toward each other. Tetanic spasms of the back bending the spine backwards or forwards (opisthotonos and emprosthotonos) appear in the older literature for infantile convulsions, often with the cough fits.

Skin and Fever

Pale lax skin. Miliary rash. Erysipelas. A peculiar symptom: itching with nausea, the patient scratches until vomiting follows. Suppressed rashes — especially in scarlatina, measles, and other exanthematic fevers — provoke Ipecacuanha states: cough, asthma, convulsions, diarrhea that begin when the rash recedes prematurely.

Temperature is irregular. Chill alternating with heat, or short chill followed by long heat. Chill with nausea, vomiting, dyspnea, great lassitude, oppression of the chest. The intermittent fevers of Ipecacuanha — particularly those suppressed by quinine or with stages jumbled and mixed — are a classical indication. Nausea threads through every stage. Profuse night sweats, with the curious one-cheek-red feature.

Modalities

Worse:

• Warm moist weather, damp wind, sudden changes in weather
• Warm rooms, summer heat (causes faintness)
• Overeating; rich, mixed, or fatty foods; pork, veal, ice cream, pastry, candy, unripe fruit, salads, lemon peel
• Vomiting itself (no relief), motion, lying down, exertion
• Periodic returns (fever, migraine, hemorrhage)
• Looking at moving objects, light, candlelight
• Anger, vexation, reserved displeasure
• Cold drinks, cold water, dry cold
• Suppressed eruptions; suppressed menses; drugs, especially morphine and quinine

Better:

• Open air, gasping at an open window
• Rest, lying perfectly still
• Pressure, touch
• Closing the eyes
• Cold drinks (for some throat and stomach states)

Relationships

Complementary: Cuprum Metallicum and Arnica. Cuprum follows in spasmodic and cramping states (whooping cough, convulsions, severe asthma) — the two share the stiff blue child at the end of a cough paroxysm. Arnica complements in hemorrhagic and traumatic states with bright red bleeding, shock, and sinking.

Antidotes: Arnica, Arsenicum Album, China, Copper fumes, Dulcamara, Ferrum, Laurocerasus, Opium, Sulphuric acid, Tabacum, and Antimonium Tartaricum.

Compare:

• Antimonium Tartaricum — also rattling chest, but more drowsy, with collapse and a thickly coated tongue. Ipecacuanha rattle is louder, the patient more nauseated, the tongue clean.
• Antimonium Crudum — also gastric upset, but with a thick milky-white coat (clean tongue is the differentiator in favour of Ipecacuanha).
• Tabacum — also deathly nausea, but colder, with icy sweat and a desire to uncover the abdomen. Ipecacuanha is hotter, more anxious, more bleeding.
• Arsenicum Album — also restlessness and nausea, but with burning pains, midnight aggravation, intense thirst for sips, fastidiousness. Ipecacuanha is thirstless and morose.
• Phosphorus — also bright red bleeding, but with craving for cold drinks vomited as soon as they warm, and a tall sympathetic constitution rather than the lax fat child of Ipecacuanha.
• Pulsatilla — also thirstless and desirous of fresh air; the moods are opposite (tearful vs. scornful), and the menses are opposite (scanty changeable dark vs. profuse bright red).
• Chamomilla — also a screaming child hard to please, with the one-red-one-pale cheek; differentiator is green stools and cutting teeth in Chamomilla vs. gushing diarrhea and nausea in Ipecacuanha.

Clinical Uses

Persistent Nausea and Vomiting

This is the central indication. The picture is the same whatever the cause — pregnancy, chemotherapy aftermath, post-anaesthetic nausea, gastroenteritis, motion sickness, migraine: continuous nausea, vomiting that brings no relief, clean tongue, thirstlessness, faint sinking in the epigastrium, pale face with blue rings under the eyes. 30C every two to four hours typically settles an acute case within twenty-four hours; in obstinate hyperemesis gravidarum, 200C once or twice daily under practitioner guidance often acts where lower potencies have only partially held.

Whooping Cough and Spasmodic Cough

The keynote presentation: rattling chest, suffocative paroxysms, stiff blue face at the end of the fit, nosebleed during cough, vomiting of mucus closing the paroxysm. Compare with Drosera (worse at night, deep barking cough) and Cuprum Metallicum (more spasm, more bluing, often follows Ipecacuanha well).

Asthma With Rattling Chest

Humid asthma — triggered by damp weather, in fat lax children, with constriction and an anxious face, with concomitant nausea. The chest sounds full but the cough produces little. Compare with Antimonium Tartaricum (more sinking, less nausea) and Sambucus (more pure laryngeal spasm, more night terror).

Acute Hemorrhages

Bright red, fluid hemorrhages with sinking and nausea, from any orifice. Epistaxis after coughing or trauma. Hemoptysis on the slightest exertion. Postpartum and post-miscarriage hemorrhage. Menorrhagia with cramps and nausea. A reliable first-line homeopathic prescription while definitive medical care is being arranged for serious hemorrhage. Compare with Phosphorus (bright red bleeding with thirst and craving for cold drinks), China (passive bleeding with collapse from loss of fluids), and Sabina (clotted mixed bleeding with pain from sacrum to pubis).

Diarrhea, Dysentery, and Hay Fever

Summer diarrhea with nausea, watery stools, mucus and blood, tenesmus, hot head and cold legs. Cholera infantum in its early stages. Stools described as frothy and molasses-like. Compare with Podophyllum (profuse painless gushing yellow stools, worse morning, with prolapse) and Veratrum Album (cold sweat, simultaneous violent vomiting and diarrhea, collapse).

Hay fever with continued sneezing, coryza, wheezing cough, and itching of nose and eyes — particularly when the case includes nausea or asthmatic constriction. Gushing lachrymation with the sneezing, photophobia without redness, and the same warm-moist-weather aggravation that marks the asthma picture.

Migraine With Nausea

Gastric migraine in which nausea precedes the headache and persists throughout. Bruised feeling through the bones of the head, cold sweat on the forehead, desire to lie perfectly still. Compare with Iris versicolor (bilious migraine with stringy vomit) and Sanguinaria (right-sided headache rising from the occiput).

Featured in our guides

Ipecacuanha is featured in Best Homeopathic Remedies for Pregnancy.

Frequently Asked Questions

What is the keynote difference between Ipecacuanha and Antimonium Crudum for gastric upset?

The tongue. Both remedies cover indigestion from rich food, candy, and ice cream, with nausea and vomiting. Antimonium Crudum produces a thick, milky-white coat on the tongue; Ipecacuanha leaves the tongue clean, or nearly so, despite the severity of the gastric upset. When the tongue is clean and the nausea is persistent and not relieved by vomiting, Ipecacuanha is almost always the better prescription.

How is Ipecacuanha typically prescribed for pregnancy nausea?

For ordinary morning sickness with the Ipecacuanha picture — persistent nausea, thirstlessness, clean tongue, pallor with blue rings under the eyes, vomiting that brings no relief — practitioners typically begin with 30C, one dose two to four times daily as the nausea presses, reducing as the picture eases. In obstinate hyperemesis gravidarum, where the woman cannot keep down even water, 200C once or twice daily under qualified guidance has often resolved cases where lower potencies stalled. Selection is always against the totality, not against pregnancy as a diagnosis.

Can Ipecacuanha really stop a hemorrhage?

The remedy has a long clinical reputation in bright-red gushing hemorrhages with the characteristic nausea-and-sinking picture, and in acute settings it acts swiftly when the picture fits. Serious bleeding still warrants immediate medical assessment. Within that frame, a single dose of 200C administered while definitive care is being arranged has frequently slowed or stopped bleeding that matched the remedy's bright-red, fluid, fainting picture.

Why is Ipecacuanha useful in both digestive and respiratory cases?

The remedy acts on the pneumogastric (vagus) nerve, and its symptoms span the territory that nerve innervates — stomach, lungs, larynx, heart. This is why the same patient may show simultaneous nausea and constriction in the chest, why the cough fit can end in vomiting, why menstrual cramps are accompanied by nausea, and why a migraine has a gastric origin. In any case where two of these systems are speaking together, Ipecacuanha rises in the rubric.

References

1. Boericke, W. Pocket Manual of Homoeopathic Materia Medica. 9th ed. B. Jain Publishers, 2002. Ipecacuanha.
2. Clarke, J.H. A Dictionary of Practical Materia Medica. B. Jain Publishers, 2005. Ipecacuanha.
3. Kent, J.T. Lectures on Homoeopathic Materia Medica. B. Jain Publishers, 2006. Ipecacuanha.
4. Hahnemann, S. Materia Medica Pura. Vol. II. B. Jain Publishers (reprint). Ipecacuanha.
5. Allen, T.F. The Encyclopedia of Pure Materia Medica. Vol. V. B. Jain Publishers (reprint). Ipecacuanha.
6. Hering, C. The Guiding Symptoms of Our Materia Medica. Vol. VI. B. Jain Publishers. Ipecacuanha.
7. Murphy, R. Nature's Materia Medica. 3rd ed. Lotus Health Institute, 2006. Ipecacuanha.