That excellent and truly homoeopathic work on diarrhoea by Dr. J.B.Bell contains the indications for some one hundred and forty remedies in this complaint. The following are perhaps the more often indicated.
**Arsenicum, it may be said, is always thought of in diarrhoea. Given a case of diarrhoea, and two remedies always come to mind, namely, **Arsenicum and Veratrum, and immediately the distinguishing features of these are gone over much in this way:
**Arsenicum. @ **Veratrum
Stools in small quantities. @ Profuse stools. @ Restlessness, anguish and intolerance @ No restlessness, anguish or of pain. @ intolerance of pain. @ Great thirst, but for small @ quantities and often. @ Great thirst for large @ quantities of cold water. @ The prostration and weakness are out @ Great prostration follows @ the stool the stool, of all proportion to [email protected] not more, however, than the @ profuseness warrants.
The two remedies are easily distinguished, and it would it seem to be the height of imbecility to alternate them.
The grand characteristics of **Arsenicum in diarrhoea, therefore, are:
1. The small quantity.
2. The dark color.
3. The offensive odor.
4. The great prostration following.
Another grand feature is the burning in the rectum, which almost amounts to a tenesmus. The stools of **Arsenicum are dark yellow, undigested, slimy or bloody; they are often dark green and very offensive; they are worse at night and after eating or drinking. **China, Ferrum and Arsenicum all have undigested stool coming on after eating. Among the principal causes of the diarrhoea calling for **Arsenicum, and one which would be an additional indication, is chilling of the stomach by cold food, ice water or ice cream. It is also the remedy for diarrhoea from tainted food and so-called ptomaine poisoning. It hardly seems possible that **Arsenicum with these characteristics could be misprescribed.
Veratrum album. [Verat]
The characteristics of **Veratrum album are no less well marked than are those of **Arsenicum. They are as follows:
1. A profuse watery stool, forcible evacuated.
2. Pain in the abdomen preceding stool.
3. Great prostration following stool.
4. Cold sweat, coldness and blueness of the body generally. The stools of **Veratrum are watery, containing therein flakes, and are commonly called rice-water discharges. Preceding the stool is a severe pinching colic in the abdomen, and this pain is apt to continue during the stool. Nausea, too, is often an accompaniment. Cramps in the feet and legs may also be present. **Jatropha has a profuse watery discharge, evacuated with great force, and the patient is cold as under **Veratrum; but with Jatropha a great quantity of wind escapes. **Cuprum is also similar in many respects to **Veratrum. Here the cramps are very severe and extend to the chest; it has the vomiting and purging of **Veratrum, but not the cold sweat. Among the prominent general symptoms of **Veratrum is the great thirst for very cold water in large draughts. From personal experience I believe **Veratrum acts better in the higher potencies in diarrhoea; in the lower potencies it may produce unfavorable results from too sudden stoppage of the discharges, while in the higher potencies, 12th,30th etc., its acts **tuto, cito et jocunde.
Cinchona officinalis. [Chin]
**Arsenicum and Veratrum in a certain case having been excluded, perhaps the next remedy coming to mind is **Cinchona. Indeed, it may come to mind at once if the diarrhoea be a painless one. **Cinchona, Podophyllum and Phosphoric acid have painless stools. Or, if the stool be undigested, it will come promptly to mind along with **Podophyllum and Ferrum, which is a very efficient remedy in painless diarrhoea. The characteristic **Cinchona diarrhoea is a painless one, of a cadaverous odor. It is slimy, bilious, blackish and mixed with undigested food; it is worse at night and after eating, with a rapid exhaustion and emaciation, and this exhaustion, emaciation and debility at once distinguish the remedy from **Phosphoric acid, which is similar, lacking the debility, but having the following:
1. Rumbling in abdomen.
2. Perspiration of the whole body.
3. Thin watery painless stools.
4. Much thirst.
The **Cinchona diarrhoea is worse after eating, here resembling **Ferrum and Arsenicum. If it be caused or made worse by fruit, it is an additional characteristic indication for its use. It is a great favorite in summer diarrhoeas, also **Iris versicolor, when there is much sour vomiting. Cinchona has a similar thirst to **Arsenicum, the patient drinks little and often, but it lacks the burning to **Arsenicum. Diarrhoeas coming on after attacks of acute illness are often met by **Cinchona. It also corresponds to the chronic diarrhoeas of aged persons.
The diarrhoea of **sulphur is very characteristic. It has changeable stools, yellow, watery, slimy, and in scrofulous children may contain undigested food. It is worse in the morning about four or five O’clock, when it wakens the patient and drives him out of bed in great haste. For these early morning diarrhoeas we have a number of remedies. **Bryonia is one, but the stool of Bryonia comes on after the patient has been up a while and has moved about, here presenting the worse-from-motion symptom of that drug. **Natrum sulphuricum is another; it has morning stool associated with a great deal of flatus, and it comes on usually as soon as the patient stands on his feet in the morning, or sometimes during the forenoon. **Rumex crispus is another and it has exactly the same symptom as Sulphur, but it is usually associated with cough. **Podophyllum is another and perhaps the most similar to Sulphur in this respect. It hurries the patient out of bed and it has changeable stools, but it is more apt to continue throughout the day and is associated with soreness in the liver. There is with Sulphur a tendency to rectal soreness, there is itching and soreness at the anus, the stools being acrid and excoriating. **Phosphorus has a morning painless stool and so has **Dioscorea, but the colicky pains of this remedy starting from the umbilicus and radiating to all parts of the body should be easily distinguish. **Petroleum has early morning stools associated with emaciation. They differ from **Sulphur in occurring also throughout the day. **Kali bichromicum has also a watery gushing stool coming on in the morning and followed by tenesmus. The stools of **Sulphur are offensive and the odor of the stool follows the patient about as if he had soiled himself. The stools often alternate between constipation and diarrhoea, and if haemorrhoids be present it is an additional good indication for **Sulphur. A diarrhoea of mucus streaked with blood, preceded by colic, is also often found under the remedy.
Aloes is a remedy whose chief action is on the rectum. It produces a constant desire to stool, and the passages are accompanied with a great deal of flatus. The great characteristic of the drug feeling of uneasiness, weakness, and uncertainty about the rectum; there is a constant feeling as if stool would escape, the patient dares not pass flatus for fear of the escape of faeces. This condition is met with in children sometimes, they pass faeces when passing flatus. **Aloes resembles **Sulphur, Thuja and Bryonia in having an early morning stool; like **Sulphur wakens the patient and hurries him out of bed to the toilet. It is worse from eating but it seldom continues during the day. The weakness of the sphincter ani is also found under **Phosphoric acid, where we have also stools escaping with the flatus. The **Aloes patient will also pass stool when urinating. Haemorrhoids which are characteristically swollen and sore accompany the **Aloes stool. The stool themselves are yellow and pasty or lumpy and watery, and before the stool there are griping pains across the lower part of the abdomen and around the navel. These pains also continue during stool and passage usually relieves them. The essentials are:
1. The lumpy, watery stool.
2. The intense griping across the lower parts of the abdomen before and during stool, leaving after stool.
3. The extreme prostration and perspiration following.
Croton tiglium. [Croto-t]
**Croton tiglium is one of the great homoeopathic remedies for diarrhoea, which might readily be imagined from the prompt action of the drug in the minutest doses of the crude substance in the intestinal canal. Its characteristics are a yellowish, watery stool pouring out like water from a hydrant, and especially associated with nausea and vomiting and aggravated by eating and drinking. There are a number of drugs which are very similar to **Croton tiglium and they may be mentioned here. The first is **Elaterium. This is a remedy for frothy, copious, forcible diarrhoeas preceded by cutting in abdomen, chilliness, prostration and colic. They are always gushing and may be olive-green in color. The second is **Gratiola; this has a gushing watery diarrhoea coming out like water from a hydrant; the stools are yellowish green and frothy and there is associated with them a cold feeling in the abdomen. The third is
This has a profuse, gushing, watery diarrhoea; but here there is much wind and flatulence and great prostration. The fourth is **Gamboge. This has a stool expelled “all at once”, with much relief following. Stools thin and watery. The characteristics of the stool of **Croton tiglium are:
1. The yellow, watery stool.
2. The sudden expulsion.
3. The aggravation from drink and food; and to this we may add the quite common accompaniment of nausea, preceded by a little pain in the abdomen.
One symptom always leads to the thought of this drug, and that is sourness of stools and sourness of the whole body, though **Rheum is not only remedy for sour stools nor are sour stools the only indication for **Rheum; indeed, they may be wanting in sourness and **Rheum still be the remedy. For sour stools, besides **Rheum, we have notably **Calcarea carbonica, Magnesia carbonica and Hepar. Magnesia carbonica is said to follow Rheum well, and, besides sourness, it has the frothy, green, frog-pond scum stool, and it is especially suitable to infants when the stools are of the above character and accompanied with discharge flatus and much crying. Debility is also characteristic of the remedy. Characteristic among the symptoms of **Rheum, besides the sourness, is a griping colic often followed by tenesmus. In color, the stools are brown and frothy, and usually sour; they are worse from motion and after eating. Chilliness during stool is also characteristic. The continuance;of the colic after the stool also suggests the remedy.
**Podophyllum, as we have seen, has an early morning diarrhoea. The stools are watery, yellow, profuse, forcible and occur without pain any time from three o’clock to nine in the morning, and a natural stool is apt to follow later in the day. It occurs, too, immediately after eating resembling **cinchona and Colocynth, and it has still another resemblance to **Colocynth in its colic, which is relieved by warmth and bending forward. Following the diarrhoea of **Podophyllum is a sensation of great weakness in the abdomen and rectum, this weakness of the rectum being a great characteristic of the remedy. The rectum prolapses before the faeces are evacuated; here it differs from the prolapses which would call for **Ignatia, Carbo vegetabilis and Hamamelis.
**Podophyllum has proved useful in the diarrhoea of dentition when cerebral symptoms are present. Sometimes a headache will alternate with the diarrhoea. This also occurs with **Aloes. The stools of **Podophyllum are often undigested; and here the remedy touches **China and Ferrum, which are the great remedies for undigested stools. A deposit of mealy sediment further indicates the remedy in diarrhoeas of children.
**Podophyllum and Mercurius have some symptoms in common; both affect the liver both have a tongue taking the imprint of the teeth, but the stool of Mercurius is accompanied by straining. The great characteristics of Podophyllum may be thus summed up:
1. Early morning stools.
2. Watery, pasty yellow or undigested stools, forcibly expelled.
4. Weakness in the rectum following stool.
**Podophyllum also resembles **Calcarea carbonica and Phosphoric acid in many respects; the rapid debility and exhaustion distinguish it from the acid, and the absence of general **Calcarea symptoms from Calcarea. It is especially useful in the obstinate diarrhoeas of unhealthy infants in the 3x dilution.
Straining at stool is the great characteristic of Mercurius, and this is more marked under **Mercurius corrosivus than under the solubilis. The former is the great homoeopathic remedy for dysentery. It may be remarked, in passing, that the allopaths have recently discovered this application of **Mercurius corrosivus. The stools of Mercury are slimy and bloody, accompanied by a straining and tenesmus which does not seem to let up; so we have what is characteristically described as a never-get-done-feeling. There is accompanying, much hepatic soreness, flabby tongue taking imprint of the teeth, and before the stool there is violent urging and perhaps chilliness. Bayes praises **Mercurius in a diarrhoea of yellow or clay-colored stool. A sickly smell from the mouth is characteristic of the remedy, and if the remedy perspiration so characteristic of **Mercurius be present the choice is easy. Prolapsus of the rectum may follow the stool.
**Calcarea should never be overlooked in any intestinal trouble; as we have seen, it is one of the great remedies for sour stools, and for undigested stools. It is one of our best remedies for chronic diarrhoea, its symptoms produced by the provers are very few, yet prescribed for its general symptoms it has proved very useful, for it is just in a genuine **Calcarea patient that one usually finds diarrhoea. Diarrhoea occurring during dentition in infants with open fontanelles call for **Calcarea. **Calcarea phosphorica, too, is a very useful remedy in these diarrhoeas, but the diarrhoea of **Calcarea phosphorica is distinguished by being a ***spluttering diarrhoea, forcibly expelled, but watery, greenish, or undigested, and with a great deal of offensive flatus. **Calcarea carbonica is more suited to fat children. **Calcarea phosphorica to those who are old and wrinkled. Both of these remedies, as well as **Silicea and Sulphur, come in most frequently in the diarrhoeas of scrofulous and rachitic children. In the **Calcarea carbonica patient there is usually a ravenous appetite, and, as in **Phosphoric acid, the stools do not seem to weaken. This is especially true of another of the Calcareas, Calcarea acetica. **Calcarea Prescribe for the patient instead of the diarrhoea at all times, but more especially if Calcarea be given.
**Phosphorous is especially a remedy for chronic forms of diarrhoea. It has green mucous stools worse in the morning, often undigested and painless. The stools pass as soon as they enter the rectum, and contain white particles like rice or tallow. **Apis has a sensation as if the anus stood open, and the involuntary escape of faeces in **Phosphorous reminds also of **Aloes. **Chronic, painless diarrhoea of undigested food call sometimes for Phosphorus. It is profuse and forcible and aggravated by warm food, and the patient often vomits; in fact, one of the characteristics of **Phosphorous is the vomiting of what has been drunk as soon as it becomes warm in the stomach. With the diarrhoea there is a weak, gone feeling in the stomach, and perhaps burning between the shoulders. The frog spawn, or sago, or grain of tallow stool is most characteristic of the remedy.
Argentum nitricum. [Arg-n]
**Argentum nitricum is quite similar to **Arsenic in many ways. The stools are green, slimy and bloody, like chopped spinach in flakes. **Aconite has a green stool like spinach. With the stool there is a discharge of flatus and much spluttering, as in **Calcarea Phosphorica. The stools are worse from any candy, sugar, or from drinking. The sudden attacks of cholera infantum in children who have eaten too much candy will often be removed by **Argentum nitricum. The children are thin, dried up looking, and it seems as if the child had but one bowel and that extended from the mouth to the anus. Another characteristic of **Argentum nitricum is its use in diarrhoea brought on by great mental excitement, emotional disturbance, etc.
**Gelsemium is one of the most prominent remedies for diarrhoea produced by fright or fear; it appears suddenly and the stools are yellow and papescent.
**Opium has diarrhoea from fright and so has **Veratrum album.
**Pulsatilla, too, may be indicated in diarrhoea from fright; the stools are greenish yellow and changeable.
**Dulcamara has diarrhoea from changes in the weather or in temperature, as in those employed in packing house who change frequently from hot to cold, or diarrhoea in the mountains where the midday is hot and the nights excessively cool.
There are a number of minor remedies for diarrhoea, but these very minor remedies become of major importance when they are closely indicated.