Ordine: Saxifragales Bercht. & J.Presl

Famiglia: Paeoniaceae Raf.

Tribù: Paeonieae

The genus Paeonia, previously belonging to the Ranunculaceae family but now assigned to the Paeoniaceae family (of which it is the only genus), currently includes over thirty species (accepted names) (according to [WFO]). They are generally herbaceous plants provided with rhizomes and/or fleshy or swollen roots [WFO], even if also suffruticose species exist (all included in the sect. Moutan, the so-called tree peonies, often used as garden plants).

According to the tradition of Greco-Roman medicine, peonies are endowed with remarkable therapeutic virtues. Theophrastus reports that the name of the genus actually derives from that of Paeon (Παιών), an ancient Greek divinity and physician of the gods (later identified with Apollo or Asclepius), who used the roots of the plant to heal Pluto from a wound inflicted to him by Hercules. The same medicine was used by Mars to heal the wounds caused by a clash with Diomedes [Peroni].

Also according to Pliny the Elder (“Naturalis Historia”, book 25 par. 29), the peony, considered by the author the most ancient of cultivated plants, retains the name of its creator (Paeon).

The Mediterranean tradition recognized two types of peony: the male peony (Paeonia mascula (L.) Mill.), which according to Dioscorides has “walnut fronds”, and the female peony (Paeonia officinalis L.), which instead has leaves “incised as those of Alexanders”. An interesting features of these plants is the coexistence in the fruits (follicles) of both shiny blue-black and red seeds (the latter being probably sterile). This characteristic is reported in classical herbaria, in which a therapeutic distinction is also made between the two types of seeds, also basing on the different signature: for example, Dioscorides, writes “ten, or twelve grains of his red seed drunk in austere wine stagnate red menstruation” (this prescription is found even in the Herbario novo, written by the Renaissance physician and botanist Castore Durante and published for the first time in Rome in 1585).

Although the species most commonly used today is P. officinalis, P. mascula has been traditionally assigned the same properties [Durante, Mattioli]. According to Castore Durante, the roots of the male peony “are very powerful, & valuable against poisons” [Durante].

In Chinese medicine, the most used peony species are Paeonia lactiflora Pall. (syn.: Paeonia albiflora Pall.) and Paeonia anomala subsp. veitchii (Lynch) D.Y. Hong & K.Y. Pan (syn.: Paeonia veitchii Lynch.).

Paeonia officinalis and Paeonia mascula (L.) Mill.

Primary functionality:	Sun
Secondary functionality:
Nature:	dry and slightly hot
Taste:	bitter-aromatic, slightly astringent with a hint of sweetness (root)
Tropism:	head, central and vegetative nervous system, digestion organs (stomach, pancreas, intestine), uterus.
Humoral actions[i]:	resolves heat (yellow bile) excesses and tension stagnation, expels perverted melancholy and phlegm while at the same time supplements correct phlegm
Tissue states:	Heat excess, tension stagnation, perverted phlegm and melancholy, phlegm deficiency
Clinical actions:	analgesic, anxiolytic, anticonvulsant, antidiarrheal, antiepileptic, antiinflammatory, antipyretic, antispasmodic, emmenagogue, eupeptic, lithontritic, muscle relaxant, narcotic, pain reliever, sedative, vasodilator.
Used parts:	roots, flowers, seeds

Description

Nowadays the roots and the flowers of peonies are recognized as antispasmodic, sedative of the central and vegetative nervous system, narcotic, muscle relaxant, pain relieving and anti-inflammatory [Peroni], but in fact peony’s activity is rather complex. Traditionally it is considered an emmenagogue capable also of expelling afterbirth, a pain reliever/antispasmodic, a plant that “stagnates the body flows”, “cleanses the obstructed liver, & kidneys”, driving “out the stones of the kidney, & of the bladder, mitigating their pains“, as well as a drug capable of soothing the nerves in case of nightmares and calming anxiety [Durante]. In the words of Dioscorides:

“The dried root is given to those women, who do not purge themselves in childbirth: drunk in the quantity of one Almond, it causes menstruation. It is given with Wine for body aches: it helps the overflow of the gall, and the pains of the kidneys, and of the bladder. Its decoction made in wine, and drunk stagnates the body. Ten, or twelve grains of its red seed drank in austere wine, stagnate the red menses: they are also eaten for the vomiting of food, and for the gnawing of the stomach. Drunk by children, they break their stones, which begin to form. The grains, which are black, are drunk at the number of fifteen with honeyed water, or with Wine, to the gravacuore, which compresses during the night at sleep: and in addition to this, to the prefocations, and the pains of the matrix.” (see [Mattioli]).

Paeony root was used in Greek medicine to relax the expectant mother, reduce cramping, and encourage labor. After the birth it was used to stop fits and seizures in children. [Wood]

Galen mentions the ancient custom of tying a peony root around the neck of a child to prevent epileptic seizures. Although skeptical, Galen tested this method on an epileptic boy and found it curative. [Durante, Mattioli, Wood] This usage has been confirmed by Matthew Wood to work with children, adults, and even dogs. [Wood]

William Salmon (1710) notes that the decoction or extract works just as well as hanging the root around the neck. [Wood]

According to Castore Durante, “the root of the peony […] frees those who hang it to the neck from epilepsy, & not only benefits this evil, […] but also all the other defects of the head: & the same makes its seed, which is valuable also against ghosts, & fears”. [Durante]

According to the same author, also the distilled water of the roots and flowers “comforts the heart, & given three tablespoons of it helps the children, who suffer from epilepsy. It is good for the apoplectic, & the paralytic”. And also “the seed of the peony, given thirty grains cleaned from the rind & powdered to drink with wine, are worth to those who have lost their speech.” [Durante]

Paeony root can be beneficial in brain injuries, besides epilepsy. It’s interesting to note that William Coles, in his “Adam in Eden” (1657), reports that peony buds look like a head, complete with sutures, and so it has to be a brain or head remedy. [Wood]

In the nineteenth century, the powder, the extract, the syrup and the decoction of peony root and seed were used, as narcotics and antispasmodics, in the treatment of epilepsy and intermittent fevers. [Peroni]

According to Simone Iozzi, the fundamental biological activity of the peony is to mitigate the excessive excitatory reactivity of the central nervous system when it is in a state of hyperexcitability with repercussions on the physical body and especially on the abdominal organs (spastic colitis, dysmenorrhea), without “affecting in the least the psychic state of the subject”. [Iozzi]

Peony root is indicated when the period is characterized by cramping and heavy bleeding, conditions usually associated with an estrogen excess profile. In these cases, the appearance of acneform sores on the chin (usually a sign of inflammation in the ovaries and estrogen excess or intolerance to estrogen) is a specific indication. [Wood]

Peony is an excellent remedy in middle-aged, menopausal women who fit the estrogen excess profile: plump, red, flushed, warm. It is also indicated in young women who are oversensitive to estrogen. [Wood]

The extracts has vasodilator and muscle relaxant properties, acting as general sympatholytics with a negative bathmotropic effect on the heart. A regulating activity on gastric acidity and a protective activity on the mucous membranes of the stomach has been observed. [Rossi]

The roots of P. officinalis possess hepatoprotective activity. [Ahmad]

In Chinese medicine, white peony root (Bai Shao, Radix Paeoniae Alba) and red peony root (Chi Shao, Radix Paeoniae Rubra) are used. The first is obtained only from Paeonia lactiflora Pall., while the second can also be obtained from Paeonia anomala subsp. veitchii (Lynch) D.Y.Hong & K.Y.Pan.

The roots of Paeonia lactiflora collected in the wild and those of Paeonia anomala subsp. veitchii are only used to produce Chi Shao. Bai Shao is obtained from the roots of the cultivated Paeonia lactiflora alone, through a transformation process (Pao Zhi) which consists of boiling and subsequent elimination of the external peel. Chi Shao always has the outer rind intact.

Bai Shao is essentially used to tonify the Blood, while Chi Shao is used to purify the heat and cool the Blood.

Traditional Chinese herbalism classifies white peony root as bitter, sour, and mildly cooling. It is indicated in irregular periods, vaginal discharge and uterine bleeding, and menstrual cramping, accompanied by a pale face, a lusterless complexion and dull, lusterless nails, breast distention and premenstrual syndrome. [AmDragon, Wood]

It is also used in night sweats; when there is “deficient blood,” yang floats to the surface and causes heat and sweating. For this reason it is also used in fever with spontaneous sweating. It is suited to Liver Qi stagnation or stagnant Qi with hypochondriac pain, breast distention, and irregular menses. It is also used for muscle spasms and pain of hands and feet, abdominal pain and tenesmus or straining in dysentery. Headaches and dizziness caused by “overactivity of Liver Yang” come under its purview. It is contraindicated when there is cold or Yang deficiency. [Wood]

According to Matthew Wood, there are very few differences between P. officinalis and P. lactiflora [Wood]. The same author compares pulsatilla, black cohosh and peony (previously three Ranuncolaceae) calling them the “three sisters”. They all have a powerful action on the female hormonal system, but pulsatilla acts primarily on the regulation of the hypothalamus-pituitary axis, black cohosh acts on estrogen deficiency and peony on excess estrogen. [Wood]

Properties

Temperature and taste

The root is an aromatic bitter, slightly astringent with a hint of sweetness.
The nature of peony is dry and slightly warm. According to Galen, the “temperament of Peony, […] is desiccative, and composed of thin parts, but not strongly hot, but temperate, or warmer in temperament” (see [Mattioli]).

Signature

Peony is classically considered a solar plant, as can be seen, for example, in Castore Durante who describes it as an “herb consecrated to the Sun” [Durante] and in Culpeper, according to which “it is an herb of the sun, and under the lion” [ Culpeper-Sibley].

Tissue phases

N/A

Actions and indications

Humoral actions

Peony resolves heat (yellow bile) excesses and tension stagnation, expels perverted melancholy and phlegm while at the same time supplementing correct phlegm.

Tropism

Head, central and vegetative nervous system, digestive organs (stomach, pancreas, intestine), uterus.

Clinical actions

Peony is analgesic, anxiolytic, anticonvulsant, antidiarrheal, antiepileptic, antiinflammatory, antipyretic, antispasmodic, emmenagogue, eupeptic, lithontritic, muscle relaxant, narcotic, pain reliever, sedative, vasodilator.

Peony also exerts a regulatory action on the gastric activity and a protective action on the mucous membranes of the stomach; it sedates the central and vegetative nervous systems, operating as a general sympatholytic with a negative bathmotropic effect on the heart [Durante, Mattioli, Peroni, Rossi]. An accelerating activity on macrophage phagocytosis has been demonstrated for the tincture [Peroni].

Principal actions:

Antispasmodic[Durante, Mattioli, Peroni]
- Liter.: fresh root juice: 10-30 g per day [Peroni]
Sedative [Peroni]
- Liter.: fresh root juice: 10-30 g per day [Peroni]
Emetic [Iozzi, Peroni]
- Liter.: seed powder (0,5 g) [Peroni]; root in high doses [Iozzi]
Anxiolytic [Durante]
Antiepileptic [Durante, Pelikan, Wood]
Emmenagogue [Durante, Iozzi, Mattioli, Peroni, Wood]

Specific indications

Constitutional aspects

Women; middle-aged, estrogen excess, plump, red-faced, with menopausal flushing. [Wood]
Women; young, often red-haired, aggravated by estrogen; acne-form sores on the chin; worse at ovulation and before the period. [Wood]

Mind

Nightmares. [Boericke, Clarke, Hering, Scholten, Wood]

Head, nervous system

Headaches, migraines (root tincture) [Peroni, Rossi]
Epilepsy [Durante, Pelikan, Wood], infant spasms [Pelikan]
- An ancient specific for epilepsy and seizure that has been verified. The fresh root is tied to a string and hung around the neck; it is beneficial for about a month, or until the root dries up completely [Durante, Wood]
- Seizures; in children during teething [Wood]
Night scares, nightmares [Durante, Mattioli]
Antidepressant (water distilled from roots and flowers) [Durante]
- Liter.: “The WATER distilled from the root, & from the flowers, comforts the heart” [Durante]
Apoplexy [Durante]
- Liter.: “[The WATER distilled from the root] helps the apoplectic, & the paralytic” [Durante]
Paralysis [Durante]
- Liter.: [The WATER distilled from the root] helps the apoplectic, & the paralytic” [Durante]
Hyperexcitability of the nervous system with somatization especially in the abdominal area (colic, dysmenorrhea) [Iozzi]
Head injuries (cf. Acorus calamus) [Wood]
Headache, dizziness; aggravated before the period [Wood]
Blurred vision, eyelid twitching, eye irritated [Wood]

Face

Acneform sores on the chin, worse before the period; facial redness [Wood]

Gastrointestinal system

Colic, gastrointestinal spasms, colitis [Iozzi, Peroni, Rossi]
- Liter.: Colic (petal infusion, root decoction, root tincture), gastrointestinal spasms (tincture of the roots), intestinal colic (2% root decoction in enema) [Peroni]
Gastritis, ulcers (root tincture) [Peroni]
Gastrointestinal spasms accompanied with hyperacidity (gastritis, ulcers, colitis). [Rossi]
Abdominal pain and spasms, in dysentery [Wood]
Hemorrhoids (external) [Wood]

Female reproductive system

Dysmenorrhea [Iozzi, Peroni, Rossi, Wood], premenstrual syndrome [Peroni]:
- Liter.: Dysmenorrhea (petal infusion, root decoction, root tincture), premenstrual syndrome (root tincture) [Peroni]
- Painful premenstrual syndromes accompanied by tachycardia, pelvic heaviness and headache [Rossi]
- Fullness, heat, redness, discomfort before the period [Wood]
- Irregular periods with cramping and heavy bleeding [Wood]
Retention of afterbirth (failure to expel the placenta after delivery) [Durante, Mattioli]
Menopause: fullness, heat, redness, hot flashes [Wood]

Respiratory system

Wooping cough [Peroni, Wood]
- Whooping cough in children, with seizures [Wood]
- Liter.: root tincture [Peroni]

Liver and gallbladder

Gall overflow (cholestatic syndrome) [Durante, Mattioli]

Urinary system

Urinary lithiasis (kidney, bladder) [Durante]
- Liter.: “It drives out the stones of the kidneys, and of the bladder, alleviating their pains” [Durante]
Edema, ascites [Pelikan]

Limbs

Spasms in the hands and feet [Wood]

Fever

Fevers with heat and fluid loss, cramping, seizures, easy sweating (cf. Verbena hastata) [Wood]
Night sweats and heat [Wood]

Other

Diabetes mellitus [Wood]

Used parts and collection

Peony roots and flowers are normally used; according to some authors, seeds are also used, which exert an emetocathartic action (see for example [Peroni]).

The roots are harvested during the autumn and dried in the sun. The flowers are harvested from May to June, possibly collecting only the petals; after harvesting, they are quickly dried in the shade. The seed capsules are harvested at full maturity (from July to August) and the extracted seeds are dried in the shade in a thin layer. [Peroni]

According to Castore Durante, “The WATER distilled from the roots alone is worth more valiantly to the same things, first infusing the roots into wine, & then distilling the whole thing” [Durante].

Preparation and dosage

The mother tincture is made from the fresh roots picked during the autumn; the final solution has an alcohol content of about 60° [Rossi]. Tea or tincture are administered in small to moderate doses [Wood].

The fresh root hung around the neck is the best method for seizures, since the body is exposed to a constant, small dosage through the vapor rising from the drying root. When the root dries out, use another one [Wood].

In Chinese Medicine Chi Shao is usually administered in 4.5-15g doses (dried herb); Bai Shao is usually administered in 5-30g doses (dried herb). The tincture of both herbs is administered in 2-4ml doses. [AmDragon]

Contraindications and side effects

P. officinalis has traditionally been used in Persia as an abortifacient. A crude alcoholic extract of the root produced uterine stimulation in the rat [Madari]. For this reason it is contraindicated in pregnancy.

Its use is not recommended in severe forms of dysentery [Peroni].

The following contraindications are reported in Chinese medicine:

Chi Shao: contraindicated in case of diarrhea. Do not use postpartum if the lochia has already passed. Do not use if the abdominal pain has already ceased. Do not use if sores have already perforated. Use caution with Blood Deficiency and with Deficiency Cold. Use with caution in conjunction with anticoagulants and antiplatelet drugs as there may be a synergistic effect.
Bai Shao: contraindicated for those with diarrhea from Deficiency Cold (Yang Deficiency), for those with eczema or rashes from External Wind Attack with incomplete expression. Contraindicated postpartum for those with Blood Stagnation or those who are still bleeding. Do not use in large doses or over a prolonged period for those with Liver disorders. Bai Shao may be associated with drowsiness, so use caution when driving or operating heavy machinery. Use caution for those taking: anticoagulants or antiplatelet drugs; insulin, sulfonylureas and other anti-diabetics since there may be a synergistic effect leading to hypoglycemia; sedatives as this herb has a sedative and analgesic effect on the central nervous system, prolongs sleeping time induced by barbiturates and has a protective effect against seizures induced by cardiazol. [AmDragon]

Homeopathy (Paeon)

Only Paeonia officinalis has been proved homeopathically so far.

The homeopathic mother tincture is prepared with the fresh root dug in spring (in autumn the root is said to be inert). [Clarke]

Paeonia officinalis < replanted: it takes a few years before it will blossom again. [Scholten]

The main issue is the home and family. They need a stable home and have an aversion to changes. Sudden and unexpected changes in particular seem to affect them profoundly. They cannot stand being sent away from home. They get complaints from being left by their family. They can feel it as if they are being cut from their roots. That is probably why they have marked cutting and stabbing pains, as if from knives. [Scholten]

They are anxious they may lose their family. In nightmares this can come back as the death of family members. In general they can be anxious people, having a fear of strangers and new things. They prefer to keep things unchanged. It is a kind of nostalgia. When they lose their home or something similar they can become very depressed. [Scholten]

Physically, the rectal and anal symptoms (nearest to the root chakra) are most important. Chronic ulcers on lower parts of body, leg, foot, toe, also breast, rectum. [Boericke, Clarke]

PULSE: contracted. [Clarke]

MOUTH: tongue red [Clarke, Scholten]

Mind

Homesick; forsaken, alone. [Scholten]

Oversensitive, < bad news [Clarke, Hering, Scholten], about family or home. [Scholten]

Dullness of senses, thoughts vanishing, < entering warm room. [Scholten]

Depression with irritability [Clarke, Scholten]; after 5 p.m. [Clarke]

Delirium. [Clarke, Scholten]

Excitement. [Clarke, Scholten]

Anxious, apprehension, timid, afraid to talk with any one, < evening. [Clarke, Hering. Scholten]

Ill-humour. [Clarke, Scholten]

Ailments from loss of home, marriage, being cheated, robbed. [Scholten]

Desire to take large doses of medicines. [Scholten]

Sleep: restless; sleepiness all afternoon; starting on falling asleep, even during day. [Clarke]

Dreams: dreams unremembered [Clarke]; anxious, sad, vivid, wonderful; quarrelsome; disturbing; amorous [Clarke, Hering, Scholten], with emission [Clarke]; terrifying dreams, nightmares; [Boericke, Clarke, Hering, Scholten]; of a ghostly figure sitting on his chest, oppressing his breath, waking groaning or making respiration anxious [Clarke, Hering, Scholten]; anxious and vivid dreams of death [Clarke]; death of relatives; persecution by witches in long dark clothing. [Scholten]

Colour preference: 15-16E. [Scholten]

General

Sensation: congestion, rush of blood, head, face, chest, anus. [Scholten]
Weather: < coming into warm room, < cold, wet weather, < open air [Scholten]; rainy weather [Clarke]. Coming into warm room after a walk in cold air he gets nausea and feels faint [Hering].
Time: < 5 pm [Scholten]; < After sleep at night, at noon [Clarke]
Aversion: food: appetite lost. [Clarke, Scholten]
Desire: Thirst. [Clarke]
Sleep: somnambulism; starting on falling asleep. [Scholten]
Physical: < touch, < pressure, < injury; < motion, < stool; – >> walking. [Scholten]
Weakness: when walking, with heaving of chest and limbs, so that often she must stand still; > eating, with heaviness of limbs. [Clarke]
Fever: Shivering. Coldness of one ear at 5 p.m., with heat of the other. Coldness of limbs, with (burning) heat in face, back, and chest. [Clarke]
Heat: at night disturbing sleep; general, waking after midnight, with heat in region of stomach. Hot skin. Heat in head; in face; as from nettles, on chest, neck, back, and shoulders. Rush of blood to head and face with sweat. [Clarke]
Rest, position, motion: Pain compelling the sick to walk the floor all night, due to fissures of anus. Rolling on floor from pain, due to fissures of anus. Sitting posture: painful from abscess below coccyx. Motion: vertigo. Walking: < pain from collar bone to diaphragm. [Hering]
Attacks, periodicity: an hour or two after stool; pains recur and last twelve hours. For ten years: ulcer on leg. For eighteen years: ulceration of rectum. [Hering]

Body

General: cancer. [Scholten]
Nervous: epilepsy, cramps. [Scholten]
Vertigo: < motion, > drinking, < warm room, reeling and staggering [Scholten]. On every motion, with constant reeling and staggering. [Clarke, Hering, zurLippe]
Tissues: Varicose veins, ulcers and fissures. [Hering]

Head

Headache: congested (fullness, and rush of blood to head), pulsating; arteritis temporalis. [Clarke, Scholten]
Rush of blood to head and face. Nervous. Vertigo when moving. Burning in eyes and ringing in ears. [Boericke]
Dullness, heaviness, vertigo, and feeling of heat in head. [Clarke, Hering, zurLippe]
Syncope and cold sweat. [Clarke, Hering]

Eyes

Burning heat, red; watery; dry, burning, itching, smarting, as sand, < opening (not easy to open); conjunctivitis; contracted pupils. [Clarke, Scholten, Hering, zurLippe]
Violent tearing around right eye. [Clarke, Hering]

Ears

[Clarke, Scholten]
Jerking in cartilages of ears. [Clarke]
One ear cold, the other hot, 3 p.m. [Clarke]

Nose

Posterior nares full of mucus, catarrh. [Clarke, Scholten]
Stoppage of nose: in evening, in morning in bed, with dryness. Crawling in tip of nose. [Clarke]

Face

Congestion, puffy; burning heat, red; crawling upper lip and tip of nose. [Clarke, Hering, zurLippe, Scholten]

Mouth

Tongue red; violent pressure, articular fossa of lower jaw to inner ear, > jaws open, > drinking, < pressing jaws together; biting posteriorly in palate in evening. [Clarke, Scholten]

Throat

Swallowing difficult; constant scraping, coughing, hawking; as if an acrid, burning vapour ascended throat [Clarke, Scholten]. Hawking, tenacious mucus, with scanty expectoration [Clarke, Hering, Scholten, zurLippe]
Burning and heat in fauces extending to pharynx; in throat and oesophagus, < hawking. [Clarke, Hering, zurLippe]
Complete loss of voice, could not utter least sound for hours (after smelling). [Hering]

Lungs

Breath oppressed, < nightmare. [Scholten]

Heart

Pain, dull shooting from front to back through heart [Clarke, Scholten], anxiety. [Scholten]

Pulse

Contracted. [Clarke]

Chest

Heat; sticking pain in left chest. [Boericke, Clarke, Scholten]
Ulcers; breast ulcer. [Clarke, Hering, Scholten]
Sticking: in right side near sternum, on a level with nipples or near right nipple; to right of ensiform process, with pressure; downward sticking in left chest; backward sticking as if through heart; < walking. [Clarke]
Pain beneath the heart as from anxiety [Clarke]; sternum pain [Clarke, Scholten]; dull shooting from front to back through heart. [Boericke, Clarke, Hering]
Throbbing through right chest and extending posteriorly up to nape of neck, where it terminates in intermittent pinching. Violent shootings vertically from collar bone down through heart to diaphragm, < in walking. [Clarke, Hering]

Stomach

Nausea, > drinking; vomiting [Clarke, Scholten]
Pressure in the pit of the stomach, as from great anxiety. [Clarke, Hering, zurLippe]

Abdomen

Rumbling (borborygmi); pain, griping, aching, pinching, cutting, epigastrium, umbilical region, muscles, anxious; weak liver [Clarke, Scholten]; griping pain in forenoon, preceded, and especially followed, by anxiety, trembling of limbs and arms, as if frightened, and apprehension when any one spoke to him, unpleasant news affected him exceedingly [Clarke].
Sensitiveness, < along transverse colon and epigastric region, that were hard and retracted.[Clarke]

Rectum, anus, stool

Fissure, fistulae, ulcers, rhagades, abscess; haemorrhoids large, inflamed, ulcerated, perineum; pain, excruciating, biting, itching in anus, burning, shooting, splinter-like, stabbing, as knives, itching, > rising, > walking; purple, covered with crusts [Boericke, Clarke, Hering, Scholten]. Biting itching in anus that provokes scratching in afternoon; the orifice seems somewhat swollen [Clarke, Hering]. Running and fetid ulcer in the anus, towards the perineum, with much oozing. [Boericke, Clarke, Hering, Scholten, zurLippe]
Sudden, pasty diarrhoea, with faintness in abdomen [Clarke, Boericke, Hering, Scholten, zurLippe], with anal burning after stool [Boericke, Hering, zurLippe], then internal chilliness [Boericke, Clarke, Hering, zurLippe]. Stools thin, frequent [Clarke].
Painful diarrhoea. [Clarke]

Urinary

Burning micturition, with urine scanty. [Clarke, Scholten]
Constriction in region of neck of bladder, so that urine passed only in driblets. [Clarke]
Frequent and copious micturition, disturbing sleep at night. [Clarke]

Female

Genitals swollen and painful [Clarke, Scholten].
Uterus problems after childbirth. [Scholten]

Neck and Back

Decubitus (bed-sores) of coccyx; ulcers below coccyx, around sacrum. [Clarke, Hering, Scholten]
Sticking: in last cervical vertebra; in scapulae; in places in back, > scratching. [Clarke]

Limbs

Varicose veins, swollen, congested, red, painful; rolls on floor from pain. [Boericke, Scholten]
Pain in wrist and fingers, knees and toes, tearing; cutting pain, as a knife, toes. [Clarke, Scholten]
Jerking and tearing in extremities; paroxysmal tearing, then numbness. [Clarke]
Weakness of legs, inhibiting walking [Boericke], weakness of extremities in evening [Clarke].
[Clarke, Hering]
Acute lancinations under axillae. [Clarke]
Tickling as if an insect were creeping on forearm. [Clarke]
Tense feeling in muscles across elbow on flexing arms. [Clarke]
Cramp in articulations. [Clarke]
Dead feeling in one finger. Right ring finger, which received four weeks previously a blow from a blunt rapier, seems as far as the first and second phalanges dead, cold, devoid of blood, shrivelled, yellow, and without sensation, in afternoon. [Clarke]
Sudden thrusts (blows) outward or inward side of left knee. [Clarke]
Sensation in lower part of calf as if aponeurosis of muscles and tendons were tense or bruised, making walking difficult, towards evening. [Clarke]
Pain in corns. [Clarke]
Swelling of toes, with contraction, intermittent sticking (jerking pains) through them. [Clarke]

Skin

[Boericke, Hering, Scholten]
Blisters [Hering, Scholten]; ulcers, chronic, oozing offensive moisture [Boericke, Clarke, Hering, Scholten], on leg, foot, toes, breast; < walking long, pressure of boots [Clarke, Hering, Scholten].
Bed sores, decubitus, coccyx; [Clarke, Hering, Scholten]
Heat [Scholten]; itching and burning, as from nettles [Boericke, Clarke, Scholten], > scratching [Clarke].
Abscesses, boils, carbuncles. [Scholten]
Bunions. [Scholten]
Pressure: destroyed vitality of skin. [Hering]

References

[Ahmad]	Feroz Ahmad et al., “Effect of 70% ethanolic extract of roots of Paeonia officinalis Linn. on hepatotoxicity”, Journal of Acute Medicine, 3 (2), 45-49 (2013)
[AmDragon]	https://www.americandragon.com/ (Retrieved: 2022-05-05)
[Boericke]	William Boericke, “Pocket Manual of Homoeopathic Materia Medica & Repertory” (1927)
[Culpeper-Sibley]	Nicholas Culpeper and Ebenezer Sibley, “English Physician and complete Herbal”, London (1789)
[Durante]	Castore Durante, “Herbario nuovo” (1667)
[Madari]	Hamta Madari and Robert S. Jacobs, “An Analysis of Cytotoxic Botanical Formulations Used in the Traditional Medicine of Ancient Persia as Abortifacients”, J. Nat. Prod. 2004, 67, 1204-1210
[Mattioli]	Pietro Andrea Mattioli, “Discorsi di M. Pietro Andrea Mattioli sanese, medico cesareo, ne’ sei libri di Pedacio Doscoride Anazarbeo della materia Medicinale” (1746)
[Pelikan]	Wilhelm Pelikan, “Le piante medicinali”, Natura e Cultura Editrice (1999)
[Rossi]	Massimo Rossi, “Tinture Madri in fitoterapia”, Studio Edizioni
[Scholten]	Jan Scholten, “Wonderful Plants”, Stichting Alonissos (2013)
[WFO]	http://www.worldfloraonline.org/ (2022-05-04)
[zurLippe]	Adolf zur Lippe, “Key to the Materia Medica” (1854)