Constipation in Old Age- Daily evacuation, which is the rule in youth and middle life, is often an excess in advanced life, when three or four time a week is sufficient. it is desirable that this physiological fact should be known, as old persons often trouble themselves, needlessly on this point. If constipation give rise to any in convenience in. the aged, it is best met by rise to any inconvenience in. the age, it is best met by oleaginous articles of diet-butter, fat, bacon, etc. -which should be taken as largely s can be digested. Pure olive oil, a dessertspoonful after each meal, when it can be taken is often a most valuable remedy. Of late years refined petroleum oil in similar doses has been much used and often with success.
SYMPTOMS-headaches; feverishness; pressure or distention in the stomach and bowels; urging and repeated but fruitless efforts to evacuate the contents of the bowel, or complete torpor without desired; pulsation or pain in the abdominal; Piles and varicose veins; uneasy breathing disturbed sleep; depression of mind, etc. If constipation be persistent, it may be attended with vomiting.
CAUSES- In most instances Constipation depends upon some family habit in the patient the regulation of which will probably in very case suffice to remove this condition. the following are a few of he faults in question. Sedentary habit; smoking tobacco to excess; drinking too much beer, port wine, or tea; dissipation the exclusive use of superfine flour; taking good too dry and to destitute of succulent vegetables;neglect in attending to the calls of nature to relieve the bowels; loss of tone in the mucous lining of the bowels from the use of purgatives Sometimes constipation is the result of disease of other parts-disease of the liver, brain, or spinal cord, or other membranes. head against the remedy must be direct to the cure of the disease, if that be possible, rather than to the simple removal of one of the symptoms to which it gives rise.
TREATMENT-The following remedy, s it should be distinctly borne in mind, and not intended merely to ‘act upon he bowels. but to correct the derangement upon which the Constipation depends.
epitome of treatment.-
Chronic Constipation.-Sulph.; Plumb (with Colic_; Opi (with drowsiness); Nux v. (with Headache, and ineffectual urging;Bryonia (with throbbing Headache and torpor of the bowels); Lycopodium (with flatulence); Hydras. (simple cases; Alumina (dry pale motions); AEscul., Aloes, or Collinsonia (with Pils) Nat-Mur., Podoph., Sepia,Carbo V., Ver-Alb. Ac-Nit is strongly recommended by Dr.,. Dyce Brown and others.
LEADING INDICATIONS.-
Nux Vomica-Constipation occurring in connection with other affections; habitual Constipation, with frequent ineffectual efforts to stool; also with nausea, congestive Headache, ill- humour, and uneasy sleep. It is especially useful when the affection is consequent on Indigestion, the use of alcohol, tobacco, or coffee; of persons who take too little open-air exercise and for students, and literary men.
Bryonia-Chilliness throbbing headache; pain in the region of the liver; also in persons having a tendency to Rheumatism; and when there is no inclination to stool.
Opium-complete torpor of the bowels, especially after unsuccessful remedies, s and when the motions are hard and lumpy, with Headache, drowsiness, dizziness, congested face, a nd retention of urine. Opium is well adapted tot he age, d and to persons of a torpid or plethoric temperament, who do not readily respond to other remedies. it is interesting to note that half minim does of Tincture of Opium have been recommended for Constipation by so orthodox an authority as Sir T. Lauder Brunton.
Lycopodium-Rumbling and flatulence;l full, distended abdomen; Heartburn; water-brash; difficult evacuations.
Hydrastis-Simple chronic Constipation. Hydras., Gives tone locally and generally.
Plumbum Obstinate cases, as from palsy of he intestines, weather painless, or with severe Colic; unsuccessful efforts to evacuate, with a painful constricted feeling about the anus; the motions are dark, and passed in small balls. for persons of a paralytic diathesis it is strongly indicated,.
Ignatia-Constipations with Prolapsus of the rectum on slight efforts of evacuate; creeping, itching sensation in the rectum as of thread-worms.
Veratrum Alb-a paralyzed state of the rectum with dryness of the bowels; useful very often in infants, as is also silica.
Nat-Mur-With dispiriting mood, dryness and soreness of mouth, slight Ulcerations of the tongue.
Sulphur- Habitual costiveness, with flatulent distention of the abdomen, Piles, etc. As an in the current remedy it acts like Opium, but having a wider sphere, and being useful innumerous forms of disease, it s of far greater value.
DIET AND ACCESSORY MEASURES-Meals should, be taken with regularity, animal food eaten sparingly, but vegetables and ripe fruits freely. Coarse oatmeal porridge, with treacle, may be taken for breakfast, and brown bread should always be preferred to white. It brown bread be not eaten exclusively, a little should be taken with nearly every meal; its effects will thus be more uniformly exerted through the alimentary canal than if only taken occasionally. Water is an extremely valuable adjunct, both as a beverage and for external use. For tea and coffee, cocoa from the nibs may be substituted with great advantage. Spirituous liquors. highly-seasoned food, and late suppers, would be strictly avoided.
Walking-exercise in. the country, with he mind uncumbered, is useful, particularly in the morning; but it should not be carried to the point of inducing fatigue or much perspiration. Frictions over the abdomen, by towels horsehair glove, s or the hands, are frequently of get utility; they tend or rouse the paralyzed action to the bowels, and to dispel accumulations of flatulence.
The abdominal Compress Secale28 ) is extremely valuable in correcting Constipation, and in obstinate cases may be own day and night. It should not be used by aged an weakly persons, in whom there dose when the wet linen continue to feel could long after it has been applied. In other cases the chill produced by the sudden application of the wet cloth rapidly disappears,. ad in from five to ten minutes a comfortable warmth results, proving its suitability to the patient.
Regular Hour-Regularity on attending to the calls of nature should be observed as there is probably no function of he animal economy more completely under the influence of habit than the one in question; nor is there any that may be more effectual deranged through the influence which the will can opposite to it. Through the influence which the will can oppose to it. By fixing the mind on this operation for a short time, the bowels will at length respond, and a habit become established which will tend to procure both comfort and health.
Injections-In obstinate, protracted Constipation attended with feverishness, and hardness or fullness of the bowels, and when it is ascertained that the lower bowel is obstructed with faecal matter, too large or too hard for discharge, e and the means before suggested have not proved at once effectual, a nd enema may be relief. The injection should consist of about a pint or more or tepid water (to which a little common salt should be added) which should be carefully and slowly injected up the rectum by means of the Enema directly on the seat of obstruction, a n injection is far preferable to the derangement of the whole alimentary tract with strong drugs which excite violent action only to reduce it to a state of great debility and torpor than existed before. The use of glycerine suppositories or the injection of a teaspoonful of glycerine into the rectum is often very convenient and quite sufficient to give the necessary relief. See Chronic Intestinal Toxaemia
166.-Fistula in Ano (Fistula in ano).
DEFINITION-A fistula in ano is a narrow pipe-like track, opening by an internal orifice on the mucous surface of he bowel and by an external on the cutaneous surface near the anus.
CAUSES-Fistula originate in Abscesses, in the tissues round the anus, or by the ulceration of the mucous membrane of the rectum, and degeneration of mucous membrane of the rectum, and generation of feculent fluids and gases, which gradually excite progressive ulceration toward the surface. The disease is frequent in consumptive patients, from tuberculous ulceration of the mucous membrane of the rectum.
SYMPTOMS-There first appears on one side of the rectum a small hard lump, which, a s it continues to en large, occasional considerable pain and not infrequently much constitutional disturbance. the surrounding parts soon become much swollen, a the skin red, and suppression quickly follows (ischiorectal abscess)l During the formation of the Abscess, the patient complaints of pain in passing his motions, high are sometimes slightly tinge with blood. Great else follows the discharge of the Abscess, which is generally most offensive, and the swelling subsides; but there still remains a small opening near the anus, discharging a little offensive and irritating pus, and upon pressure a hardened track may be felt, leading toward the bowel. This is the Fistula. The external orifice of the Fistula is often very small and difficult to find in. the folds of the thin skin near the anus, a nd is sometimes concealed by a papilla.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."