According to that homoeopathic patriarch. Constantine Hearing, constipation is paradoxically the healthiest disease that a person can have. “Everybody,” he says, “many congratulate himself if he have no worse disease than this. Experience shows that individuals of costive habit become very old and remain very strong…The widely extended idea that it is healthy to purge, not only in disease, but also occasionally, when a man does not feel quite well…is altogether false and groundless.”
There may be considerable variations in the frequency of defecation which are quite consistent with good health. Certain individuals habitually evacuate the bowel twice or thrice daily, having otherwise a feeling of discomfort, while a movement every two, three or four days may be the rule in persons who present no evidence of ill health.
As a symptom, constipation is common to many diseases and conditions.
The etiology of the same is one of the most important guides to the treatment.
Dietetic causes are not uncommonly responsible for the existence of constipation. If the food is of such a nature as to be almost completely absorbed (milk, meat, extracts, eggs), there is an insufficient amount of waste material to give a normal stimulus to peristaltic action.
Constipation may also arise from a too scanty taking of fluids, whereby the stool become dry and hard, thus lacking the smoothness which normally enables them to slide without friction along the mucous lining of the intestine. Overloading the intestines with food of a coarse and bulky nature may give rise to constipation by over-distending and weakening the intestinal tube. Beverages which contain tannin, like tea or red wines, may lessen intestinal secretion and so cause constipation.
Eating improper foods, such as rich pastries. In this condition two remedies especially come to mind.
Puls. Especially in pregnancy. Stool large with much urging and backache, or stools insufficient and finally consist only of yellow mucus.
Nux v. Irritable, frequent, ineffectual urging, passing little or nothing each time.
Negligence in the regularity, of defecation and of eating, imperfect mastication. sudden changes in the quantity and quality of food, sedentary habits and consequent insufficient exercise, are more or less potent factors in causing intestinal torpidity. It is imperative that some hour most suitable to the individual should be selected and that time rigidly adhered to. It is also as necessary that regularity of meals should be adhered to.
Alterations of quantity and quality of intestinal juices. Here a number of remedies are of service.
Op. Arrested secretions, stools hard black balls, irritable and nervous.
Nat. s. This remedy acts principally on the liver, have lack of bile, sick headache, etc.
Nat.p. Acts on both liver and intestines. Stools hard, dry and light in color.
Bry. The greatest in dryness of mucosa. Stools hard, dry, dark in color as if burnt. This dryness begins with the mucosa of the mouth and extends the entire length of the digestive tract. Drinks large quantities of water at long intervals.
Other important remedies are Nat.m., Graph., Verat. a., and Op.
Constipation may be due to a weakened condition of the abdominal muscles. Pregnancy is most often productive of this condition.
Kali. c. will often to wonders in this condition, especially if other symptoms of the remedy are present, such as sensation of coldness in the bowels as if cold fluid passed through. Fullness, heat and great distension immediately after eating.
There are certain local conditions which may inhibit the emptying of the rectum by causing pain, with consequent reflex spasm of the anal sphincter. There are fissure of the anus, inflamed haemorrhoids, ulcer of the rectum in the neighborhood of the anus, irritable or inflamed prostate gland, and a tender and prolapsed uterus or ovary.
In fissure many remedies are of use, such as
Nit. ac. Tenesmus, bloody stools. Very painful stool mass, tightly packed together. Sensation of splinters in rectum.
Phytolacca. Pains shooting from the anus into rectum and along perineum. Stools bloody and hard.
Paeonia. Constant oozing from the rectum.
Ratanhia. Sudden stitches in the anus, aching and burning in the anus for hours after stool, violent itching.
Custom of taking purgatives. This to my mind is one of the hardest conditions to overcome. I used to advise the gradual reduction of the dose and administered the indicated at the same time. I found that this so prolonged the course of treatment that is necessary for a cure that I now stop the cathartic at once and although the patient suffers some discomfort for a time, yet by the use of high enemas and careful diet I have had very little difficulty and find that the patients prefer the temporary discomfort to a prolonged course of treatment.
Loss of motor power of the intestine. In this Op. stands first. Constipation after fright or fear, nervous and irritable, passes nothing but hard black balls. No inconvenience felt from accumulation of faeces.
Lyc. Constipation of infants especially. Restores contractility. In those addicted to night pollutions or masturbation. No desire or strong desire with constriction.
Collin. Inertia of lower bowels with haemorrhoids, especially during pregnancy.
Plat. No desire, stools large, impossible to pass without manual assistance. This resembles Selen.
Inflamed haemorrhoids. Can be cured and permanently so by the indicated remedy, but need not be considered here. Also enlarged prostate, though this condition is more stubborn and only a few cases respond to treatment. Prolapsed uterus and ovaries when causing constipation must be considered surgically, except where pessaries are well borne and properly support the uterus, in which case constipation promptly disappears and with the careful selection of the remedy much can be done to restore the uterus to its normal condition.
Where reflex spasms of the sphincter muscle is to blame Lyc. is thought of first and I cured a case of years standing by this remedy. A desire for stool followed by painful and prolonged contraction of sphincter. Nux v. has also cured many cases.
Lach. Constriction especially during climacteric, hot flushes, contracted feeling about the neck, cannot stand anything about the neck.
Plumb. Painful constriction of anus with hard lumpy stool like sheep dung.
Nat.m. Obstinate retention, stool irregular, on alternate days anus contracted, torn or bleeding.
Sil, Constrictive pain, very difficult passage stool passes part way then recedes.
Plat. Obstinate cases where Nux v. has failed. Stool hard and in black balls.
Acute constipation. This is due to obstruction such as hernia, volvulus, intussusception, etc. and in most cases must be treated surgically. Soon we find symptoms of collapse where such remedies as Verat. a., Carb. v., Mur. ac., Camphor., etc., are indicated. The most obstinate constipation is that due to a constitutional trait, and this is most often found to be hereditary. Here, as in all other cases, we are dependent upon the totality of symptoms in the selection of the remedy, and in conclusion I will relate a few cases.
I.S.W.,. female, age 40, has suffered many years from stomach and bowel trouble. Stools not very hard, light in color and must take cathartic every night. Appetite poor, color sallow, depressed and melancholy, cannot have a passage with anybody about the house. Ambra g. 30 gave prompt relief and no return in six months.
II. J.C.W., male, age 50, has taken cathartic all his life and cannot have passage without it. Appetite poor, insomnia, has a violent temper which shows itself at the slightest provocation. An empty gnawing feeling in the stomach which is relieved by eating. Likes to be alone. This patient was taken off his cathartic at once and for some days following was quite sick, but by diet, high enemas and Anac, beginning with the 30th and ending with the CM. given about a month apart, in one years time he had sufficiently recovered so that he needed no more cathartic though he occasionally misses a day without passage.