Diarrhoea is generally a symptom of, or is developed in connection "with, some other disease. It may at times be looked upon as a dangerous and even alarming symptom, and again as the precursor of returning health, the welcome indication that the crisis is favorable, and that the disease is leaving the system. The favorable crisis of a disease not unfrequently shows itself in a diarrhoea. This diarrhoea is an indication that nature is reacting, bursting the fetters of disease, which have hitherto bound it, preventing its free action, and is returning to a healthy equilibrium. In these cases no particular treatment is necessary.

Another form of diarrhoea mentioned above, and by far the most common, is that which is developed in connection with some other disease. In these cases it is generally an unpleasant, and not unfrequently an alarming symptom, as in consumption, typhoid fever, etc, where the powers of nature are rapidly prostrated. There is no difficulty in distinguishing between the favorable diarrhoea of the crisis, and the unfavorable one of disease. In the former case, there is a perceptible amelioration of severe symptoms, the fever is sensibly diminished, and the pulse becomes more slow, soft and full, while in the latter case the pulse becomes weaker, the system more prostrated, or at any rate there are no ameliorating symptoms.

It will be unnecessary to refer to the treatment of this variety here, as it forms only one of a group of symptoms in other diseases, and will be treated in connection with those diseases, under their appropriate heads.

It remains then in this place only for us to speak of diarrhoea, when it occurs as a primary affection. In its duration, it may vary from a day to several days or even weeks, often running into a chronic form lasting for months or years. The peculiar symptoms are familiar to all. The attack is sometimes preceded by precursory symptoms of a gastric affection, and is ushered in by an increased and more frequent discharge from the bowels, the color varying more or less from the natural.

There are often nausea, flatulence, griping pain in the bowels, succeeded by stools of a fluid, watery, bilious, mucous, or bloody consistency. The tongue. may also be furred and the breath foul, but in simple diarrhoea, there is generally but little, if any fever.

Diarrhoea sometimes, as in bilious difficulties, and where it arises from indigestion or dissipation, may be highly beneficial, being the effort of nature to throw off those indigestible and irritating substances, which unless expelled in this manner, might create violent fever and serious disturbances. It may again be the result of cold, occasioned by dampness or changes of temperature, impurities of the air and impure food, or the effect of the mind on the body, the prostration of fear, or the violent excitement of anger. The bowels, as well as the stomach, sympathize with almost every organ in the body, and give indications of uneasiness, when those organs are deranged.

Diarrhoea is of itself indicative of some disturbed action about the bowels, and when this disturbance is of such a character, as to need medicine to relieve it, the remedy should be directed so as to remove irritation, restore the proper tone to the bowels and cause them to act in obedience with nature. Much harm is often done by suddenly suppressing a diarrhoea, by means of brandy, opium, and the general class of astringents. The disease is not removed any more, than is a putrid sore, which is covered with a plaster; it may be con-6* cealed from sight, but the irritating cause is still untouched.

Treatment

Diarrhoea is sometimes occasioned by the presence of undigested food in the intestinal canal In these cases a light cathartic, such as a dose of castor-oil will be of essential service in removing the irritating cause and prepare the way for other remedies. In the bilious diarrhoeas of summer and autumn when the stools are dark or frothy, a little sweet bottled cider of claret and water, sipped a few spoonfuls at a time, at intervals of two or three hours, will be of great service.

Dulcamara - is the prominent remedy in diarrhoea occasioned by cold, particularly in the summer and fall, and where the evacuations are of a green, yellow slimy or sour character, occurring particularly at night, preceded by colic and followed by debility; there may also be nausea, retching, restlessness, thirst and griping or lancinating pain in the bowels.

Dose

Two drops, or twelve globules, in a tumbler of water, a tablespoonful at a dose; or six globules dry on the tongue. Give every three, four or six hours.

China - if the diarrhoea is of a debilitating kind, occurring particularly after eating or in the night, and containing undigested food.

Dose

Same as Dulcamara. Give morning, noon and night.

Bryonia

When occasioned by the heat of summer, or when caused by cold, as drinking cold water, or when occasioned by vexation or passion, particularly if rheumatic symptoms are present. The evacuations may be almost involuntary, have a fetid smell, and be accompanied with flatulence or fermentation.

Dose

Same as Dulcamara. Give every four or six hours.

Chamomilla

Slimy, bilious, or watery diarrhoea of a yellowish or greenish color, resembling chopped eggs; there is thirst, tearing colic, griping and fullness in the pit of the stomach; the abdomen is hard and distended, the evacuations frequent and sometimes attended with nausea or bilious vomiting. It is a prominent remedy-in diarrhoea during dentition, and is often accompanied with cries, restlessness, and anguish. (See diseases of children.)

Dose

Same as Dulcamara. Give every three or four hours.

Ipecac

Watery diarrhoea, of a slimy, yellowish, or greenish character, with nausea, or vomiting of watery or green mucus; or putrid, bloody or slimy, with white flakes and tenesmus (see dysentery); tearing colic, with restlessness, cries and tossing. Particularly useful in children. (See Cholera Infantum.)

Dose

A powder, or three globules, every two, three, or four hours, according to the severity of the symptoms.

Pulsatilla

Particularly in diarrhoea from disordered stomach, or indigestion, and when there ate watery, bilious or slimy evacuations; tongue coated white, nausea, or slimy, bitter vomiting, colic and cuttings, especially at night; sometimes the evacuations are mixed with blood or change their color to yellow, white or green.

Dose

Two drops in a tumbler of water, a tablespoonful at a dose; or three globules on the tongue. Give every three or four houis.

Rheum

A prominent remedy when the evacuations have a sour smell, are of a liquid, slimy, fermented or greenish character, accompanied with colic, frequent ineffectual efforts to evacuate, and tenesmus, or profuse evacuation with vomiting; restlessness, anguish, and cries. A prominent remedy in children (see diseases of children). Chamomilla is often suitable after it.

Dose

Some as Pulsatilla.

Mercury

Particularly when there is danger of its assuming a dysenteric form, and where the stools are watery, slimy, or bilious, or of a bloody or greenish character, preceded by colic and griping, and followed by tenesmus and straining; there may also be nausea, shivering and shuddering.

Dose

A powder, or six globules, every three hours.

Colocynth

Watery or bilious diarrhoea with violent griping colic, particularly when caused by vexation or passion; where Chamomilla has not produced relief.

Arsenic

Burning evacuations of a watery, slimy, putrid or brownish character, with burning, griping or tearing pains in the abdomen, especially after midnight; thirst, nausea, or vomiting; emaciation and weakness; hollow eyes, pale cheeks. Coldness of the extremities, colic pains, distension of the abdomen, in alternation with Veratrum.

Dose

A powder or three globules every hour until a change.

Ferrum

Painless evacuations, especially at night, or after eating or drinking; thirst, emaciation, pain in the stomach, back and anus.

Dose

A powder, or six globules, morning, noon and night.

Sulphur

In those obstinate cases, where other remedies seem to have failed, and particularly where the evacuations occur at night, - with colic, tenesmus, shortness of breath, - of a slimy, watery, frothy, putrid, bloody or sour character; easily renewed on taking cold.

Dose

A powder, or six globules, every four or six hours.

Secale

Where the evacuations are painless and are expelled with great violence, often involuntarily and without premonitory symptoms, and followed by weakness.

Dose

Three globules, once in four or six hours.

Carbo-Veg

Diarrhoea of a putrid, fetid smell, or in wet weather, after taking cold. (See also Cholera.)

Dose

A powder, or six globules, every four hours.

Ignatia

Diarrhoea with rumbling in the bowels. occasioned by grief.

Dose

One drop in a tumbler of water, a tablespoonful once in two hours; or three globules dry on the tongue at the same intervals.

Nux-Vom

Scanty evacuations with griping pain, colic and tenesmus.

Phosphorus

I have found this a highly valuable remedy in chronic diarrhoea with painless evacuations, debility and emaciation.

Dose

A powder, or six globules, once in six hours.

Belladonna

Small stools with hearing down pain, flushed face, and congested feeling in the head.

Veratrum

Diarrhoea with symptoms resembling cholera (which see), or where there are cutting, griping pains, and debility. These symptoms we frequently see during the diarrhoea, developed in fevers.

In classifying some of the various remedies, we find where Diarrhoea occurs without pain, Fer., Chin., Phos., Secale are particularly indicated.

Diarrhoea with Colic: Coloc, Merc*, Nux-v., Cham*, Bry., Ars., Sulph., Puls., Rheum.

With Tenesmus'. Ars., Ipecac., Merc., Nux-v., Bell., Sulph.

With vomiting: Ars., Ipecac., Verat., Puls.

With prostration of strength: Ars., Chin., Verat., Phos., Sec.

Chronic diarrhoea: Code., Fer., Phos., Chin., Nit.-ac., Sulph.

In consequence of an eruption: Ars., Chin., Sulph., Merc, Pulsatilla.

In aged persons: Secale, Phos., Bryonia.

In tuberculous persons: Iodine, Colc., Sep., Sil., Sulph.) Phosphorus.

From taking cold: Pule, Chamomilla.

From cold drinks: Ars., Carb.-v., Puis. .

From sudden emotion - joy; Coff., Aeon., Pulsatilla' - Fright: Cham., Veratrum. - Grief: Phos.-ac., Ignatia - Disappointment or anger: Cham., Coloc, Nux-vom.

The result of indigestion: Ant., Coff., Ipecac., Nux, or Pulsatilla.

The result of a debauch: Carb.-v., Nux-v. Of milk: Bryonia, Sulphur. Of fruit: Ars., Chin., Pulsatilla.

Abuse of medicinal substances: Mercury, Hep.-s., Carb.-v., Chin., Nit.-ac. Of magnesia: Puls., Rheum. Of tobacco: Cham., Pulsatilla.

For more minute classification and special indications, see Materia Medica and symptomatic index. In chronic cases a dose of the remedy morning and evening will be sufficient.

Diet

Rest is advisable, particularly in severe cases. Fruits and acidulated drinks should be avoided, and the diet consist of light unirritating food, such as salep, farina, gruel, arrow-root, etc. In chronic cases the food may be nourishing, yet easy of digestion.