This most troublesome and obstinate difficulty more frequently exists as a symptom of some other derangement. When however it seems to be the principal symptom, it requires patience and care in the use of remedies to effect its removal. It may arise from inaction of the liver, a general derangement of the digestive organs, causing weakness of the bowels, from mental difficulty, and an almost infinite variety of causes. Thus we frequently see it in persons of sedentary habits, as a result of dissipation, or mental anxiety, in pregnant females, and in various forms of disease.

It can frequently be removed by means of a change of diet, fresh air, judicious exercise, perfect regularity in eating and the time of stool. Looking at this trouble in its true light, we very readily perceive the injurious effects produced by cathartics. The bowels, inactive and debilitated, are roused to violent action only to settle back into a state of greater weakness and inactivity than before. The experience of all accustomed to cathartics shows, that their secondary effect is almost always constipation. Hence they should be avoided entirely or only resorted to in extreme cases. Where mechanical means are necessary, injections of cold or tepid water may be used, or if the case is urgent, or these should fail, a tablespoonful of sweet-oil and a teaspoonful of salt may be added.

Water is also an exceedingly valuable remedy both as a drink and as an external application. The sitz-bath, or a shower-bath, the water falling obliquely over the abdomen, and perhaps stomach and liver, are not un-frequently highly advantageous. (See Wet Sheet) The diet also should be simple, easy of digestion and of an opening kind. Hence, bread made of unbolted flour, fruits and vegetables perfectly fresh and ripe, may be eaten freely, together with a moderate amount of meat simply cooked. Late suppers, highly seasoned food, etc. should of course be strictly prohibited. The general directions given in treating of dyspepsy may also be observed here.

How much more consistent with common sense is the doctrine, which teaches us that when the bowels or digestive organs are weakened, or in a measure paralyzed so as to be unable to perform their functions aright, that we should by gently stimulating nature, rouse it from its torpor to its natural and healthy action, rather than by strong mechanical means weaken it for a moment, only to render it by the violence of its action more helpless than before ?

If we only reflect, that constipation is generally the result of a torpor, or want of action in the intestinal canal and digestive organs, we should hardly think of removing the difficulty by those means, the unavoidable tendency of which would by to weaken those organs.

The prominent remedies in the treatment of this disease are: Nux.-v., Sulphur, Bryonia and Opium. Besides these Sep., Loch., Lyc., Plat., Calc., Phos., Ant., Sil., Coc, Alumina, Veratrum, Puls., Carb.-v., etc., are also frequently indicated.

For persons of sedentary habits: Bry., Nux.-v., Sulph., Lyc., Op., Plat. are generally indicated.

That of drunkards, Nux-v., Opium, Sulphur.

Following diarrhoea or purging: Nux-v., Opium, Ant., Lachesis.

In old persons, often alternating with diarrhoea: Ant., Op, Phos., Bry, Lachesis.

In pregnant women: Nux-v.,Op., Sep., Alum., Bry., Lyc..

In Lying-in-women: Ant., Bry., Nux-v., Plat.

In Infants : see diseases of children.

When traveling in a carriage : Plat., Alum., Opium.

During a sea-voyage: Cocc., Silic., Tab.

For other varieties, see Symptomatic Index.

Particular Indications.*

Alumina

I have found great benefit from this remedy in cases of obstinate constipation, when the faeces were dry and hard, great inactivity of the large intestines, and the movements were accompanied with considerable straining, and also when attended with haemorrhoidal tumors. It may frequently be given in alternation with Bryonia.

* For general directions as to the administration of remedies. see page 12.

Dose

A powder, or three globules, every night.

Bryonia

Particularly indicated in those of an irritable, passionate character, and also in rheumatic persons; in warm weather, or when occasioned by a disordered stomach with chilliness and headache. It alternates well with Nux-vomica or Alumina.

Dose

One drop, or six globules, in a tumbler of water, a table-spoonful every night.

Nux-vom. is an important remedy in constipation, especially in chronic cases, occasioned by coffee, dissipation, or from sedentary habits, also in persons subject to haemorrhoids, or in consequence of indigestible food, or a too hearty meal; and especially when there is nausea, distension, pressure and heaviness about the abdomen, headache, ill-humor, and fullness about the head, disturbed sleep, and general sensation of dullness, frequent and ineffectual effort to evacuate, with a sensation as if the anus were contracted. It is frequently advisable to alternate it with Sulphur; Sulphur in the morning, and the Nux at night.

A powder, or one globule, may be given at a dose.

Sulphur

In cases of habitual constipation, particularly if there is a tendency to haemorrhoids, or uneasiness about the abdomen, with ineffectual efforts to evacuate.

Dose

Same as Nux, with which it may often be alternated.

Opium

More particular in recent cases, or in old persons, and frequently in chronic cases occasioned by sedentary habits. There is headache, determination of blood to the head, redness of the face, want of appetite, weight in the abdomen, sensation as if the anus were closed, and the intestinal canal paralyzed.

Dose

One drop, or six globules, in a tumbler of water, a table-spoonful morning and night.

Pulsatilla

Similar indications to those of Nux; especially useful in persons of a mild, cold, phlegmatic ternperament, or when occasioned by derangement of the stomach from fatty food. Dose. - Same as Opium.

Sepia

Particularly suitable to females, where there is irregularity of the menses, and also where there is a derangement of the circulation of the liver, accompanied with languor, heaviness, and pain in the head; hard, bullet-shaped fasces; also indicated in rheumatic persons. It is frequently suitable in chronic cases after Nux and Sulphur.

Dose

A powder, or three globules, morning and night.

Platina

Obstinate constipation and ineffectual desire to evacuate, accompanied with pain in the abdomen and stomach; excessively difficult evacuations, with tenesmus and tingling in the anus.

Dose

A powder, or three globules, morning and night.

Plumbum

Very obstinate constipation, either painless, as if the bowels were paralyzed, or accompanied with severe colic, particularly about the navel, or when there is ineffectual effort to evacuate with painful sensation of constriction about the anus. Particularly useful in persons affected with palsy, epilepsy, dropsy or emaciation.

Dose

A powder, or three globules, morning and night.

Silicea

Especially in scrofulous constitutions, in verminous difficulties, and where dyspeptic symptoms are present. There may be ineffectual effort to evacuate, and colic.

Dose

Same as Platina.

Veratrum

Severe constipation, headache, flushed face; nausea, tenderness of the abdomen to the touch and especially in bilious, gastric and hypocondriacal individuals.

Dose

Two drops, or six globules, in a tumbler of water, a table-spoonful morning and night.

Lycopodium

Particularly where there is a scrofulous constitution, and also from long-continued dyspepsy, or abuse of medicines.

Dose

A powder, or six globules at night.

Conium

In old people or females, and where there is ineffectual effort to evacuate.

Dose

Same as Opium.

In obstinate constipation the application of the Galvanic Battery to the region of the liver and abdomen will often produce relief.

In recent cases of constipation, the remedy should be given more frequently than in the chronic form. In the former, where the accompanying symptoms are violent, it may be necessary to give it every three or six hours.