New England School of Homeopathy (NESH)

The New England Journal of Homeopathy


The Cycle of Conium maculatum

Paul Herscu ND, DHANP with Chris Ryan MD

Conium maculatum, or Poison Hemlock, was in the potion that killed Socrates. Today, homeopathic Conium maculatum is most commonly thought of in connection with a leading cause of death in the modern world-- cancer. But Conium maculatum, like every remedy in the materia medica, has more than one face, more than one potential use, and in fact a full cycle of complementary and contrasting characteristics, embracing the physical, mental, and emotional domains. What follows is a brief sketch of that cycle, which hopefully will clue you into the ideas of cycles and segments and then illustrate these ideas through the example of one remedy.

I recall treating one woman in her fifties who suddenly developed mastitis. Her right breast was extremely painful and inflamed. The soreness was throughout the breast, especially aggravated by touch or pressure, even from the touch of her bra or clothing. Upon palpation, I found that the breast had multiple nodules and that the nipple had became retracted. The nodules filled the whole breast extending into her axillary glands. It turned out that her horse had kicked her in that breast some months earlier and that after some weeks it felt better, but now all of the sudden this inflammation began. Conium maculatum 200C stopped the pains that day and the nodules and swelling decreased over the next two days; no other treatment was needed.

This case illustrates the most famous symptom for Conium maculatum - the hard indurations found throughout the body. While they may occur anywhere, they tend to occur in glandular tissue. A common etiology is injury to a particular location and then the hard nodules begin. Now what is interesting about this case is the questions it raises. Why did she respond in the manner that she did? Why did she develop the nodules? Why had she responded to the injury in such a way and why does Conium maculatum have such a famed keynote? Why does it produce and cure so many nodules and tumors? The answers to these questions lead to an understanding of remedy through cycles and segments, as mentioned in previous articles in this Journal as well as in the second volume of the Pediatric Materia Medica, Stramonium.

Tumors/A Rigid Nature

As mentioned, Conium maculatum is indicated in many forms of tumors, being the most emphasized segment of Conium maculatum, and the first we will address. Conium maculatum is famous for hard, enlarged, indurated growths, often found in glandular tissue. The breast is commonly affected, it develops hard painful lumps on either side. The nodules may be benign, and occur mainly before the menses, or may be cancerous tumors. Likewise, nodules may be in the lymph nodes that are indurated along with the primary cancer site.

Conium maculatum men may develop symptoms of prostatic hypertrophy, where the prostate is not just enlarged but also hard. The testes may be hard or enlarged. Any gland may swell, indurate and form a tumor, but it is interesting to me that it tends to be some of the glands most involved in relating to other people sexually- the breast and the prostate.

There are however other sites, non glandular sites, that also become hard and/or swollen. The eyes form cataracts, the nose forms polyps, the abdomen becomes swollen and hard.

Though less commonly found in practice, people needing Conium maculatum may describe symptoms as if a mass were present. These are mentioned here to show the cycle's segment in fuller detail. For example, under head pain one finds such descriptions as: 'feeling as of a foreign body under the skull'. 'feeling of a hard lump in the brain', 'sensation of a lump in right half of brain'. The throat also provides excellent examples of this, with: 'as if a round body were ascending', or 'constant inclination to swallow as from a lump in the throat'.

Hardness is exhibited on the mental/emotional level in symptoms that show rigidity or inflexibility or symptoms of being extremely closed. Symptoms such as superstitious, or conscientious about trifles in Conium maculatum are both examples of a kind of fixity of thinking. I recall one patient who had to have things his own way. I was treating him for frequent bouts of prostatitis-whenever he would sit on something cold, he would develop a prostatitis, replete with chills, sweats, and vertigo. During our case taking and in about five hours of outside discussions, I never was able to impact his thinking about anything in life. We spoke about politics, religion, society, the education of children, health, and a number of other things, but to each of this topics he had his opinion. He did not begrudge me my opinion, but had his opinions entrenched. He would spout his thoughts, pretty intensely for a while and then end with, "At least that is how I see it." I ultimately took it as a form of rigidity, as there are only a few reasons why someone would have so many strong opinions and not give in on any of them, (for example haughtiness), but for him the root cause was inflexibility.

They may develop fixed notions about different aspects of life. For example eating a certain way, or having a singular religious belief. This inflexible nature is what leads to the famed examples of becoming a monk or joining a religious order. However, it is important to realize that the religion is one example, but only an example, of the rigidity in this remedy.

Another interesting symptom that shows how closed up they are is found in the emotions, of being sad and not being able to weep. This symptom is shared with Natrum muriaticum and is found in both of these remedies for the same reason. Both remedies for their respected reasons, become so closed, so protective that they are not able to access and express their emotions. It is a block of these fluids that fills them inside, much as the breast swells or the prostate swells and hardens. To the extreme of this point, we may see how it leads to an inability to feel and move. The rubric 'Want of sensitiveness,' captures this state very well and we find Conium maculatum in italics there.

Paralysis, or extreme lack of movement, is another example of the shutting down process. For each of the hardnesses above, the materia medica describes a functional slowing or obstruction. The headache, for example, not only can feel like a lump, but is 'stupefying', dulling the thinking. The sight is 'dim' and 'myopic,' even without cataracts, and visual adaptation is sluggish. The ocular muscles may be partially or completely paralyzed, and the lids in particular may droop, as is seen in Gelsemium. The hearing is defective, the speech clumsy ('articulation imperfect' due to the stiff swollen tongue), swallowing impeded, with food going down the wrong way and stopping. Most characteristic is the gradual ascending paralysis of the extremities, first lower, then upper. Muscular weakness, trembling, unsteadiness rising and walking, and a heavy weariness are all found.

This hardening is the ultimate end-result of a closing off and shutting down process, that began in the preceding phase of the cycle. The kind of hardnesses is increasingly devoid of the vital force, which is why this remedy tends towards cancer.

Full/ Congested

In Conium maculatum, the inevitable result of closing off and holding in, is accumulation; it is a fullness and a heaviness. Whether you count this as a part of the holding-in phase, part of the tumor and hardness phase, or an aspect worthy of standing on its own, as I do, the same symptoms are encompassed. All the places that may get a tumor become heavy. All the places where there can be congestion we will find it. There is heaviness of the eyelids, as there is heaviness of the head, abdomen, and of course the extremities. The fullness of breasts and distention of the abdomen alluded to in the tumor section, apply equally here, the difference being quantitative not qualitative.

Another example of the congested, full state, due to this closed, static state would be palpitations while lying down-the heart throbbing for its connection, especially upon getting up and moving.

Discontent/Desire for Contact

In the tumor segment he is brooding and feels the aloneness but mostly he feels too alone, too separate and even though he may have a fear of others, he strongly desires to be with them. This is the part that really drives him to be with others. This is the part that is discontent with his present surroundings, with his situation of how he is ending up, sick and alone-thus leading him to crave connection. And this is the transition segment that will drive them out of the shut down tumor segment into the active segment.


They are too closed and need people. The primal desire to connect with others, which prompts a flurry of activity, or discharge of energy, quickly exceeds what is useful or comfortable.

Physically, the discharge is evident in most systems of the remedy. Tears squirt out of the eyes, the ears ring and hum, the obstructed nose bleeds or produces a purulent discharge, irritation of the throat at night, when lying down, which leads to a spasmodic dry cough. There is vomiting and diarrhea with urging, but probably the most famous keynote that belongs here has to do with the sex drive. There is an ever increasing desire for sexual contact. In some, it is described as a need to be with a sexual partner, but in others it is described as a strong need to discharge, to orgasm. I recall treating a man who would drive three hours every 10 days like clockwork, to have sex with his girlfriend. He had to. If he did not, if he missed one of those days, he would develop a prostate infection. This intense need for contact becomes a primary drive for them as they strongly need the contact and then the discharge that the contact affords them. I think this is the reason why Conium maculatum is listed in the rubrics that have the following idea-aversion to people yet averse to being alone.

One discharge that occurs during or after the tumor/shut down segment is exemplified in the famed keynote of Conium maculatum of perspiration and hot flushes, during rest, especially on dropping off to sleep or even closing the eyes.

On the mental level, this change from too little to too much activity is nicely expressed in the person who is sad and morose at some time and very alive and excited and happy at others.

The hysteria or mania may occupy them especially for work. There are many reasons and complaints and thoughts that drive the patient out of bed or into motion, though high among them is the impulse to work. It is the archtypical image that we have of someone who sublimates his or her sexual desire into a flurry of activity.

But like my patient, sex is another prime mover of this patient. In some of these patients the motion is seen elsewhere, but in some, sexual impulses and strong desires and images begin to fill him, or her, and they will become restless until they can have sex and discharge themselves and connect to another person.

We also see the openness and excess activity making Conium maculatum to very susceptible to injuries. We find injuries which lead to vertigo, weakness, and indurations, all segments which will follow. And it is the injury to the emotions-like grief -which lead to the following segment of weakness, dizziness and a closing off, similar to Cocculus indica.


The symptom that most succinctly captures the excessive nature of the activity is Cowperthwaite's 'giddiness', but the most famous is unquestionably the true, rotational vertigo that accompanies especially motion, as in first lying down at night or first rising in the morning. There is a considerable range of vertigo-inducing circumstances in Conium maculatum's materia medica, but many of them have to do with motion, showing the effect of all the motion from the preceding segment. Some of these include moving the head or eyes, and noise, especially conversation of others, but all reflect the tendency of activity which cause, and then the ensuing desire to shut-down. The aggravations and ameliorations of Conium maculatum can be understood as part of a cycle with an aggravation from seeing moving objects, as when they move too much, as they had in the preceding segment and a desire to close their eyes which ameliorates the vertigo, the closing the eyes leads to the next segment.

They have become weak and are unsure of themselves. Probably, one of the most useful symptoms for us is the keynote of emissions escaping or orgasms occurring from the slightest provocation. This symptom is sometimes related to the highest priority of having to connect with others or to discharge their congested full selves, but sometimes it is from weakness, like Natrum phosphoricum, where the fluid escapes from the slightest reason without their will. They can no longer be sure of themselves. Weakness is found not only on the muscular level, but in many areas. Mentally, symptoms of depression, sadness, or melancholy, 'timidity', weak memory, and indifference are found in abundance and most especially after sex or after a discharge. Appetite is lost and sexual power is decreased, despite interest. General aggravation from exertion, raising the arms, standing, sexual excess, old age, night may all be counted as examples of this weakness.

It is interesting to note that Conium maculatum is listed in almost every subrubric of the rubric Generalities Motion, both as amelioration/desire for motion and as aggravation/aversion to motion. We can see earlier why the desire/amelioration to move comes from. It is here that we find why there are so many symptoms that are aggravated by motion. Likewise it is here where we find all the aggravations from study, and aggravation from mental exertion

Desire to close off

The way that Conium maculatum deals with the vertigo/giddiness is to begin to control themselves, to shut down in a way that will eventually lead to the inflexible rigid tumor first described. Being so closed is an over reaction-- an essential need to shut down to benefit their overall health. The being too shut down is an overreaction or an overproduction of the symptoms that were needed in the first place.

On the physical level, this desire for the body to close off may be seen in a variety of constrictions, such as: 'tightness as if both temples were compressed', 'tenesmus', 'globus', 'dysmenorrhea', 'griping', 'constriction of the hypochondria as from a band', and 'constriction of chest', to name a few.

On the emotional level, examples of closing down in this self-defensive fashion include the aversion to company, 'averse to being near people, or hearing them talk'. They also have a fear of robbers, I think, again, for exactly the same reason as Natrum muriaticum avoiding company and fearing robbers - aversion to their protective enclosures being violated.

On the mental level, they become averse to using their mind, they do not want to work or study. They may not want to do much, just moping around the house.

Again, Conium maculatum, like every other remedy, has symptoms that seem to contradict themselves. For example in Conium maculatum we find that not only do they want to be alone and are averse to people, but that they may fear being alone as well. In the past we would have to pay attention to one of the symptoms and not the other, or try to explain this seeming contradiction in one way or another, but never very satisfactorily. Now we can see that the aversion to company must belong to this phase of the cycle and that Conium maculatum must have another phase, described in Vertigo/Giddiness, that gives the desire for people. Here is a good example of how analysis of remedies by cycles and segments permits understanding of apparently conflicting or contradictory rubrics within one remedy.

This segment leads us back to the first segment, that of being rigidly tight and compressed-the segment of tumors. The single best-known expression of the adverse effects of holding in must be the famous keynote: 'aggravation from continence'.

Conium maculatum is classically thought of first when cancer follows either the loss of one's sexual partner through death, or the institution of strict celibacy for religious reasons, i.e. entering a nunnery. Viewing the relationship of the desire to hold in to tumor formation in the Conium maculatum cycle, one following directly from the other, it is wonderfully clear how these two events are related in life.

So, in Conium maculatum, there is a basic desire, a strategic need, to holding on tight, holding in, and closing off. While this may be on the one hand a reasonable and understandable human response it is unfortunately the beginning of exactly the "too-closed" state where we came in, at the beginning of this discussion's examination of the cycle. If the activity had been just enough, rather than too much, then Conium maculatum would not need to hold on so tightly.

Or, on the other hand, if the holding on were just enough, rather than too much, he or she would not feel so closed in, and in need of actively reconnecting. But when the system does just enough, and neither too little nor too much, we do not have a chronic disease state, and do not need a remedy!

To summarize, Conium maculatum has the primary desire to be open and connected to others, but is unable to effectively maintain this. Motion in the direction of openness tends to result in excess, characterized by vertigo and sweating, to which the person reacts by closing off, but closing off too much so that they become paralyzed or develop rigid pattern of being mentally, emotionally or physically. This rigid aloneness is intolerable and drives them to desire to be with others and the cycle renews.

Paul Herscu ND, DHANP is the author of The Homeopathic Treatment of Children and Stramonium with an Introduction to Cycles an Segments. He is the founder and publisher of this Journal and the principle instructor for the New England School of Homeopathy. He practices, teaches and writes from Amherst, Massachusetts.

Chris Ryan MD practices in Boston, Massachusetts, and has Taken the NESH Level I, II, and currently the NESH Post Graduate Course.

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