Like **Nux vomica, 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 the haemorrhoids The rectum contracts & protrudes 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 has ineffectual urging to stool. In **Nux vomica, as, we have seen, this is due to irregular peristaltic action, while with **Lycopodium it is due to a constriction of the rectum. The mental symptoms here, too, are of the utmost importance; the depression, the melancholy and the apprehension are characteristic.
Graphites is one of our best remedies in constipation, if Homoeopathy 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 composed 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, burn, 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: **Silicea, Nitric acid, Paeonia and Ratanhia; these, with **Graphites, will remove in most cases the underlying disease leading to the fissure. Aching of the anus after stool is also characteristic of **Graphites, and sometimes we have with the drug 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.
With Platina, there is torpor of the whole intestinal 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 constipation 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.
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 we have a condition where the sphincter suddenly contracts and the partially expelled stool recedes. **Causticum has constipation due to powerlessness of the rectum, so that the patient almost stands in order to enable him to get sufficient power to expel the stool, but the spasmodic condition of Silicea is absent. As with **Graphites, Silicea has a great deal of soreness about the anus, also an oozing of moisture. There is urging to stool and a sensation as if faeces remained in the rectum.
Veratrum album. [Verat]
Though this remedy is;one of our greatest diarrhoea remedies, it has a marked effect in the treatment of constipation. The symptoms calling for its use are as follows: There is complete atony of the intestines, as under **Bryonia and Opium. The faeces accumulate in large masses in into a sweat; but finally has to give it up, and the faeces have to be removed by artificial means. There are extreme cases where the patient is able to force a passage for himself; the stools are large, hard and black. As with the diarrhoea there may be faintness after the stool.
Dunham speaks of the constipation of **Veratrum as one characterized by a disposition to stool in the upper part of the intestinal canal and an indisposition to stool in the lower part. Dr. Bryce claims that it will bring stool quickest of any medicine I ever tried.” He used 3x. It comes in very well after **Nux vomica, especially in constipation of children.