A patient experiences persistent nausea and vomiting with a clean tongue and an urge to induce vomiting. Which remedy is most appropriate?

• A. Ignatia
• B. Ipecac
• C. Kali bich
• D. Ledum

Answer: (B)

When a patient has nausea that dominates and leads to recurrent vomiting, with the tongue staying clean, the remedy that best fits is Ipecacuanha. This remedy is classically associated with a vomiting-dominant gastroenteric disturbance: constant nausea, frequent vomiting, and often a lot of saliva, where vomiting does not bring lasting relief. The clean tongue helps distinguish this picture from others that might show coated or discolored tongues with different symptom patterns. The other options don’t align with this vomiting-first presentation: Ignatia is more about emotional distress and related physical symptoms; Kali bichromicum is linked to thick, stringy discharges and specific mucus phenomena; Ledum connects to injury- or cold-related complaints. So the persistent nausea with urge to vomit and a clean tongue points to Ipecac.