Manganum is preeminently a medicine that causes a kind of chlorosis, and is suitable for chlorotic girls, in "decomposed, waxy, anemic, pale, sickly, phthysis-threatening constitutions, with necrosis and caries of the bones, and organic affections. There is a history of a long period of scanty menses, or the menses have been delayed until the patient was eighteen or twenty years of age.A strong feature is great pain of the periosteum , and especially of the shin bone.Tendency to ulceration and eruptions , and around them thickening and infiltration. Chronic eruptions; inveterate like psoriasis. Small ulcers ooze and infiltrate with purple hardness. It has deep action, breaks down the corpuscles of the blood and lays the foundation for tuberculosis, especially in the larynx Repeated attacks of laryngitis, each leaving the patient in a worse condition than before Tuberculosis beginning in the larynx. Aversion to food, no appetite, nothing will tempt him. This, with great pain in the body, lays the foundation for a deep complaint. It is not an acute periostitis, but a passive pain all over.
Inflammation of the joints and swellings are suppressed and necrosis. Ulcers and suppurative processes assume a semimalignant quality and do not heal, presenting an erysipelatous appearance. Everywhere there is pain to touch and vibration. The bones ache from walking. Arnica only relieves for a day or two; but in this remedy it is deep and prolonged, and we would not think of Arnica or Baptism, which would only give relief for a day or so. Vesicular eruptions, infiltrated, deeply rooted, with a tendency to crack and bleed. Rough Skin and Psoriasis Complaints are worse in cold, wet weather and before a storm.
And now we will deal with some of the mental symptoms. There are only a few of them, but they are striking, and these delve into the very nature of the human. Anxiety and fear. Great apprehension. Something horrible is going to happen. Restless and anxious. He walks, and the more he walks, the more anxious he becomes. Try to occupy yourself mentally; he tries to occupy his mind, and the more he does this, the more anxious he becomes. He is tired and worn. You can't think; can't meditate He has difficulties in his business because he can't think straight. anxious restlessness
The weirdest part of all is how you get relief. He lies down and everything passes. You can't find that in all medicines; that's weird, strange and peculiar. And yet look how general it is; defines the whole nature of the sick man. His own life is exciting, tired and anxious. Great sadness and anguish. He lies down and says, "Why didn't I think of that before?" Perfectly comfortable now. He gets up, and anxiety and restlessness take hold of him again, and he is quite driven to distraction. See how, unlike Rhus, he gets relief from movement. See how, unlike Ars. that is, the patient goes from one bed to another from one bed to another and back; he can't sit still, or stay still, because his anxiety is worse holding still. See how striking these symptoms are and see the contrast we have. The most intimate life of the patient is talking with us and asking for remedies. Now we must read the internal signs and expressions of the disordered economy. So, you have these tormenting fears. Anxiety during the day while moving, improves while living below, sad, crying and in silence. I can't think of anything to comfort him, but when he goes to bed he finds peace. Is it any wonder, then, that some of these patients are driven into a lying state? And Manganum is a wonderful remedy for bedridden women who love to lie still, and it is said of them that they love to lie in bed.
In what we have seen, we see that everything brings out that same idea and the nature of the things that Hahnemann talks about in his first paragraph, that the only duty of the doctor is to pay attention to the patient, to the patient himself; and who is this patient? This is what we've been talking about, this is what we've been trying to get out here; and all the details that I am about to treat corroborate these very things. These details are so linked with these generals that are spoken of that they make a great unity of thought, and we cannot separate them. Irritability and low spirits, like Sulph. and Graph. It is similar to Arg. met., Phos., Graph. and Sulph., in their underlying tendency to tuberculosis. Preoccupation with small things. Headaches as in anemia. Terrible headaches; head feels heavy; adhesion pains; urgent and dull pains. Points like needles. Aggravation of the jerks when stepping, pain in the brain and skull. Skull sensitive to touch and pressure. Red numb spots here and there on scalp (like Phos.), as if developing erysipelas. Drawing, throbbing headache in the open air, better in the house. Other headaches improve in the air. Aggravation of a jar, movement and change in temperature and in cold and wet weather. Agglutination of the eyelids. It is a suppurative and catarrhal remedy. The eyelids are swollen. Eye pain when looking at close objects, especially a close light. I have used this medicine often with that symptom and have been cured when there was eye pain when sewing, reading fine print and doing anything that would focus vision. Route in nervous and gouty constitutions, when there is pain in the eyes and complaints from sewing and reading the fine print for a long time. Ruta is especially a remedy for artists who work with a magnifying glass.
Offensive ear discharges. Hearing choice is improved by blowing the nose. Stopped feeling enhanced by blowing nose. Eustachian tube catarrh. The external ear is painful to touch. Ear symptoms are numerous. It seems to many patients that all their problems lie in the ears. All aches and pains in the upper body settle in the ears. The pains in the throat shoot to the ears. There are pains in the throat and pain in the teeth that go to the ears. Pain in the eyes that focus on the ears. That's weird. The ear is a center of much tribulation. "Cataract Conditions, with Increasing Deafness". Cold and humid climate. It is deaf every time it rains coldly in the fall. Then there is pain, rawness and burning in the ear canal, very itchy.
Silica and Kali carbohydrate are the two main remedies for paroxysmal cough that occurs from scratching the ear canal. I have seen them choke, gag and vomit when they needed Kali carbs. After scratching the ear canal. Spadic cough from scratching the ear canal mainly belongs to silica and Kali carbohydrate, but Manganum has cured it. Itchy ears from talking, swallowing, laughing, or doing anything that makes the throat work. To speak, which is to use the larynx. When the bolus passes behind the larynx is when it takes place. It is sometimes present in the laryngeal physis, in chronic ulceration of the larynx, with burning, stabbing pains in the larynx shooting into the ears. In the Manganum test it is amazing how many ear symptoms are recorded. And all of these ear symptoms, like the others, occur, or are increased, in cold, wet weather. "Eustachian tube catarrh". Obstruction. It feels like the ears are clogged. "It feels like there's a leaf in front of your ear." In cold and rainy weather.
A strong feature that runs through the remedy is similar to Dulc., in that it is worse from cold, cold air, and cold, wet weather. His cold wakes up when it's cold. Each spell of cold and damp causes hoarseness and the formation of mucus in the throat. All his complaints respond to the weather. Wherever there is irritation, there is great pain. The eyes are red and adored. The throat is red and raw. Sections in the ears are followed by great sensitivity. Pain and tenderness run through all. Chronic cold. The nose stopped. Yellow, lumpy, green discharge in the morning. Bloody discharge. The nose and cartilages are adorable. Avoid manipulating the nose. No medicine will give you a sicker face. When people have bled and become pale and pale, the routine thinks of China, but when there has been no bleeding and this same state is present due to the decomposition of the blood corpuscles, one must think of Manganum. Chlorosis and pernicious anemia would suggest Manganum, and also picric acid and Ferrum. Small wounds fester; each bruise remains, adored for a long time. There is not much bleeding, since there is not much blood. Infiltration agrees with this remedy. I have seen it cure inveterate ulcers, calluses and bruises, in anemic patients. Old "fever sores" can be cured with this remedy. scaly rashes.
All kinds of stomach disorders. Indigestion. Lack of appetite. Drawing in the stomach region. Colic. Ally of these are made worse by cold wet weather. Pains are relieved by doubling double. It is a very useful remedy to avoid tabes mesantericas, anemic constitution, lack of appetite, diarrhea, pain in the intestines and, as the patient becomes emaciated, the glands feel. Useful in women who have been anemic for some time from loss of blood, but it is not so great a remedy for anemia after hemorrhages as it is for that condition resulting from the destruction of the blood corpuscles. Terrible hot flashes as Psor., Lach., Sulph. and Graph., which occur in women who have been anemic for some time.
It is also a great remedy for the liver. There is congestion and swelling of the liver. It has cured a tendency to degeneration of fatty. He has cured the jaundice; has cured many cases of gallstones; which means that the liver goes into such a slow state that the bile is unhealthy, the flow is impeded and then small nodules form in it, forming gallstones. It establishes a better working order of the stomach, a better working base of the liver, the bile becomes healthy and the gallstones dissolve in healthy bile. Gallstones are likely to occur along with gallstones.
It can be said that the abdomen is full of rumblings, and there are frequent gripping pains and these are done in cold and wet weather. They come from eating cold food, such as frozen foods. Cold things create a lot of distress in the liver region. Distress in the stomach and distress through the intestines. "Crying and contraction in the navel;" something like Plumbum, although it's not said to draw like a string at the navel, like Plumbum and Platinum. "Passes a lot of flatus with the stool. Irregular action of the intestines." There may be periods of constipation, interrupted with each indigestion, causing diarrhea so that the intestines are always irregular. It is never very safe, you have constipation or diarrhea. As we might suppose, the stomach is the faulty organ. "Anus cramps while sitting. Better lying down." It is a useful remedy for those flashes of heat that occur in the climacteric period. The mentioned chlorotic state is closely related to the menstrual state. Disorders of the uterus and stomach.
Very little menstrual flow. It lasts only a day or two, and it comes too soon. This is unusual in anemic conditions, unusual in chlorosis. In women beyond the change of life, every so often a small hemorrhage will come, a little watery discharge. Anemic old women, with a little watery discharge from the uterus. In the past we have had to rely mainly on Calcarea for elderly women with bleeding from the uterus. We are not surprised by all these weaknesses if we have muscular relaxation, and it is true in Manganum with these tired, weak and anemic women; and there is also prolapse of the uterus and prolapse of the rectum. A drag down of the intestines, and the entire abdomen feels heavy from a state of relaxation.
The region most threatened is the larynx, trachea, and lungs. If this anemic girl doesn't get better and has a better reaction, something serious will happen. Menstruation is simply a pale fluid or a bit of leucorrhea. Crude of the larynx. Hoarseness and loss of voice in a chronic state. It is suitable in recurring cases that come with every period of wet weather until tuberculosis finally sets in. Each cold causes additional problems in the larynx, causing laryngitis. It is a wonderful remedy for orators and singers, as useful as wet Argentum. Constant buildup of mucus, more forms as soon as you wipe it off. Hemming all the time and annoying everyone. Arg. met., Sil., Sulph., Phos. and Manganum do that. Each pain brings a sorr of mucus. Tuberculous laryngitis. Raw in the larynx. Expectoration of green mucus, great anemia. Every wave of cold awakens a bronchitis, like Dulc. Cold, dry weather sometimes relieves, but the patient is sensitive to cold; he is cold and anemic.
The cough improves when lying down. Most coughs are worse from lying down, and few remedies are better from lying. In Eyebright there is a cough from coryza, especially acute roe in vigorous persons, and the cough is better while lying. Again, there is a spinal nervous cough in the spinal subjects, the nervous girls, who have a cough as soon as they lie down, which is cured by Hyos. This remedy has a cough by day without a cough at night because it is lying. Arg. met. has a day-old cough; like Manganum, it refers to the larynx and is relieved by lying down. Cough worse from talking, laughing, walking, deep inspiration, and cold, wet weather.
This remedy is most useful in recurring complaints, and is almost never seen in the first attacks. It is very useful in patients who are gradually declining. Ulceration and bleeding in the lungs. The bleeding is watery, like bloody saliva or bloody mucus. The patient becomes nervous, shaky, and has palpitations.
The extremities are full of anguish, even gouty. Pain in the bones, burning in the soles, arthritic enlargements, painful periosteum, pain in the joints. It does not have rapid inflammatory rheumatism, like Puls. and Bell., but tenderness of the joints, without much swelling and aggravation from wet weather, like Rhod., Rhus, and Dulc.
This remedy generally does not occur in fever, but in cases of low typhoid fever, after the fever has subsided a little, the bones are tender, they are all over the place, the patient does not gather, there is prolonged convalescence, especially in ill-treated cases, which have been drugged until the blood corpuscles are ruined. You would think that if he could only start a large abscess, he would be better, but he has not enough vigor for that. Some of these patients have "fever sores," and this acts as a seton and relieves them; but this patient cannot develop one, only the periosteum is damaged and has infiltrated. 
 Insignares Carrione, E. (2012). Practical Manual of Homeopathic Therapy . (Tenth edition). Bogota, Colombia: Magnofarma
 Kent, JT (1992). Repertory of the homoeopathic materia medica . B. Jain Publishers.