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Nux vomica. Perhaps no remedy in the Materia Medica
is oftener prescribed for anything than is Nux vomica for
constipation. Nux vomica has peculiar and characteristic
indications for constipation, and when prescribed upon these
indications it will cure every time. Nothing is surer than
this. But Nux vomica is often prescribed when these indi-
cations are not present, and often does much good ; in this
class of cases there will almost invariably be present one of
the great clinical indications of the remedy, and that is, its
value in antidoting purgative medicines. In many cases of
inveterate constipation calling for this, that, and the other
remedy, it will be noticed that expected results are not ob-
tained and will not be obtained until Nux vomica has been
given to antidote the effects of drastic medicines. Then the
case can be prescribed for, the indications followed, and suc-
cess result Hydrastis is another remedy that is useful some-
times after the abuse of purgatives, laxatives, cathartics and
their like. In all these cases, however, the sjrmptoms calling
for the respective drug should be present Hughes claims
it to be superior to Nux as usually prescribed. Hydrastis
has a symptom, however, which is quite characteristic, that
is a sinkings gone feeling at the epigastrium, which Nux
vomica does not have to any extent The constipation of
Nux vomica is usually of the kind induced by lazy habits,
inattention to Nature’s calls in the first place, want of exer-
cise, sedentary habits, and a sluggish condition of the whole

system. It is due not only to inactivity of the intestines, but


to an irregularity of the peristaltic actions, giving rise to the
great characteristic, constant inefiectual urging to stool, and
when the stool does occur it is incomplete and unsatisfactory,
as if a part remained behind. Absence of desire for defeca-
tion contra-indicates Nux. Carbo vegetabilis has urging but
it is due to wind, while Opium and Bryonia have no urging-
at all.

Anacardiufn resembles Nux vomica in many ways. It has
a sensation of a plug in the rectum which cannot be expelled.
There is a fitful intestinal activity but withal a power-
lessness of the rectum. Even soft stools are expelled with
difficulty. Small quantities may be expelled with each at-
tempt The mental symptoms of Nux are important in
treating constipation, for the effect that constipation has upon
the minds of some people is well known. In cases indicat-
ing Nux vomica there will be a great crossness, irascibility
and objection to all opposition. The Nux stool is also apt to
be large, and hemorrhoids are a frequent accompaniment
We may sum up Nux vomica by calling again the attention
to the mental characteristics, the sedentary temperament, the
fitful intestinal action and its antidotal relation to purgative

Sulphur. Many of the older homoeopaths used to give
Sulphur and Nux vomica in alternation for constipation.
They complement each other, follow each other well, but
better results will be obtained if each be given singly when
indicated ; for, surely, both cannot be indicated at once. With
Sulphur there is an ineffectual urging to stool, with a sensa-
tion of heat and di^omfort in the recttmi, and there is a
general uneasy feeling all through the intestinal tract, due to
abdominal plethora or passive portal congestion. It is a very
useful remedy with which to commence the treatment of con-
stipation, though, unless the symptoms call for it, it should
not be given. The stools are hard, dark, dry, and expelled
with great straining, the first effort to stool being extremely
painful. There is apt to be much twitching and burning of


the anus, the evacuations are often unsatisfactory, and, as in
Nux^ there is often a sensation as if a part remained behind.
Another characteristic symptom of Sulphur is constipation
alternating with diarrhoea. The general temperament of the
drug has much to do with its choice; in fact, almost all of the
indications for its use will be the general ones. The general
venous system is usually at fault in true Sulphur cases, and
anything that stimulates this system into action, such as
exercise and cold, always benefits the Sulphur patient

Opium. While the constipation of Nux is due to irregu-
larity of intestinal action, that of Opium is due to absolute
inaction of the intestines, a regular paralysis of the peristaltic
movement There is an absence of desire, absolutely no
urging to stool whatever, and so the faeces become impacted
in the bowels ; and when passed at all come in littie, hard,
dry, black balls, here resembling the stool of Plumbum^ but
with Plumbum there is some activity. Another drug which
has no urging to stool is Bryonia^ but here the lack of urging
is rather due to dryness of the mucous membrane than to
intestinal inactivity ; with Opium there is a want of sensibility
throughout the intestinal tract, and consequently the consti-
pation is not apt to inconvenience the patient, hence it is
apt to go on getting worse until the attention is called to
it by the flatus accumulating in the upper part of the
intestines. Where the faeces require artificial means for their
removal, this remedy should be thought of, though Selenium^
Alumina^ Plumbum, or Bryonia may be used in this con-
dition. Diminished secretions are also characteristic of
Opium^ so that dryness, as well as intestinal inactivity, is one
of the causes of constipation calling for this drug. It is indi-
cated especially in constipation of old people ; the patient is
drowsy and dizzy.

Plumbum. As we have already seen, with Plumbum there
is some intestinal action ; in fact, at times there is consider-
able. I^ead colic is one of the effects of the drug. So we
have urging to stool, and accompanying this urging is a colic


with a marked retraction of the abdominal walls. The stool
is passed with the greatest difficulty and consists of little
round balls which are black, dry and hard, and there is ac-
companying, a marked spasm of the sphincter ani which is
apt to be painful. The anus feels as if drawn upward. With
this drug there is loss of muscular activity and diminished
secretion of intestinal glands. Thus we see that the indica-
tions for Plumbum in constipation are concise and precise.

Alumina. Chief among remedies for constipation due to
dryness of the intestinal tract stands Alumina, There is
diminished peristaltic movements and complete inertia of the
rectum, so that we have the symptom, soft stool expelled
with difficulty, explained. There is littie or no urging to
stool. The stools may be hard and knotty like sheep dung,
or may be soft It is one of our most useful remedies in con-
stipation of children where the rectum is dry, inflamed and
bleeding about the orifice. Alumina differs from Bryonia
chiefly in the state of rectal inactivity. A dry mouth and an
irritated looking tongue may lead to the selection of Alumina.
There is much straining with the remedy and the stool is
passed in very small quantities, piece-meal, so to speak.

Bryonia. The large-hard-dry-stool-as-if-bumt of Bryonia
is as *^ familiar as a household oath.” The constipation of
the drug is due to dryness and there is no urging. Alumina
is similar ; its constipation is also due to drjmess, but it has
such complete inactivity of the rectum that even a soft stool
is expelled with difficulty. With Bryonia^ the stools are
passed with a great deal of difficulty, owing to an atony
of the intestines similar to Veratrum album and Opium.
Nux^ as we have seen, produces and cures constipation due to
fitful, irregular, peristaltic action. Bryonia cures constipa-
tion where not only the intestinal secretions are diminished,
but the muscular action as well. It is said to act better in
rheumatic subjects and in summer. The mental condition of
irritability and ill-humor will often be present as a concomi-


tant of the Bryonia constipation. Older writers alternated
Bryonia and Nux vomica with success in very obstinate cases.

Natrum muriaticum. All the muriates have crumbly
stools, and so we find that the characteristic constipated stool
of Natrum muriaticum is a hard and crumbly one ; the rectum
is dry, the stool is hard to expel and causes bleeding, smart-
ing and soreness in the rectum. There is ineffectual urging
to stool, with stitches in the rectum. It sometimes comes in
the most obstinate cases, which are accompanied by hypo-
chondriasis. Magnesia muriatica^ another of the muriates,
has characteristically a constipation in which the stools are
passed with great diflSculty, being composed of hard lumps
like sheep dung, which are so dry that they crumble as they
pass the anus. Ammonium muriaticum has this same
symptom of dry and crumbly stools, they may also be
coated externally with mucus. In constipation of young
people who are subjected to acne and comedos, Natrum
muriaticum should be thought of.

Lycopodium. Like Nux^ Lycopodium has a sensation after
stool as if something remained behind. Constipation, due to
constriction of the rectum, calls for this remedy, and here it
reminds one of Silicea. The constipation, too, is apt to be
associated with hemorrhoids; the rectum contracts and pro-
trudes with the stool. The stools are dry and hard, or the
first part hard, the last soft In the constipation of children
and pregnant women it often finds . a place, and it is here
praised by Hartmann. A great deal of rumbling in the
abdomen following the stool is an additional indication. Nux
and Lycopodium may be easily distinguished, though each
have ineffectual urging to stool. In Nux^ as we have seen,
this is due to irregular peristaltic action, while with Lycopo-
dium it is due to a constriction of the rectum. The mental
symptoms here, too, are of the utmost importance; the de-
pression, the melancholy and the apprehension are charac-

Graphites. Graphites is one of our best remedies in con-


stipation, if HomcEopathy can be said to have ” best remedies.”
With this drug there is no urging. The patient sometimes
goes days without a stool, and when it does come it is com-
posed of little round balls, knotted together with shreds of
mucus and accompanied with great pain when passing owing
to the fissure. These fissures, as well as the haemorrhoids
which accompany them, bum, smart and itch intolerably.
Excessive soreness of the anus in making the post defecation
toilet is an indication for its use. Three or four remedies are
usually to be thought of in this condition of fissure of the
anus; they are : Silica^ Nitric acid^ Pceonia and Ratankia;
these, with Graphites^ will remove in most cases the under-
lying disease leading to the fissure. Aching of the anus after
stool is also characteristic of Graphites^ and sometimes we
have with the drug an ineffectual urging. The mucus-
coated stool, the extreme soreness of the anus, the general
Graphites temperament of sadness and obesity, will easily
decide for the remedy. Graphites suits especially women
who suffer from a neglect to’ attend promptly to nature’s call.

Platina. With Platina^ there is torpor of the whole intes-
tinal tract, unsuccessful urging to stool and great dryness of
the rectum. The stools seem to adhere to the rectum like
glue or putty. There is great weakness in the abdomen and
a sensation as if there were a load in the rectum which could
not be expelled. It is considered a remedy for the constipa-
tion of emigrants and travellers, so it would seem to find an
additional indication where the trouble was brought on
by change in manner of living. It is also a remedy for the
constipation due to lead poisoning. There is frequent urging,
scanty dry stool and great abdominal weakness. As under
Ignatia^ there are sharp stitches in the rectum.

Silicea. When constipation is due to inefficient expulsive
force of the rectum and a spasmodic condition of the
sphincter then Silicea is our remedy. With this condition
and we have the symptom that the stool slips back when

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