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 stool.@ 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