This section is from the book "Hartmann's Theory Acute Diseases And Their Homoeopathic Treatment", by Charles J. Hempel. Also available from Amazon: Theory of acute diseases, and their homoeopathic treatment.
§ 69. Diarrhoea.
Diarrhoea is generally a symptom of some more general disease, or a salutary crisis. However, diarrhoea may likewise occur as a primary disease of the reproductive system, accompanied with fever.
The essential character of diarrhoea is an increased and looser discharge from the bowels, the colour being more or less different from the natural. It is frequently preceded by the precursory symptoms of a gastric affection. Colic is not always present; sometimes, however, it is very violent (diarrhoea torminosa); tenesmus is scarcely ever present.
The disease lasts from a few days to several months, and even years. The discharges vary likewise, feculent, fluid, mucous, bilious, purulent, bloody. Diarrhoea may be without any danger, getting well of itself, or it may become dangerous by its continuance, or danger may actually be present when diarrhoea sets in.
A diarrhoea which is not manifestly dangerous ought not to be arrested suddenly; danger may be supposed to exist when the discharges are quite watery (although this is not always a symptom of danger),* and great debility after every evacuation, sometimes amounting to syncope.
The selection of the remedy depends upon the form and nature of the discharges. We distinguish the following kinds of diarrhoea: -
Diarrhoea stercoralis, being generally a consequence of overloading the stomach with heavy, undigestible fat, rancid, sour food and drink. It is preceded by offensive eructations, aversion to food, colic, distention and tightness of the stomach and abdomen, nausea, and sometimes vomiting; after these symptoms have set in, a quantity of flatulence is generally emitted, accompanied with loose, fetid, papescent stools, sometimes corroding the anus and causing a burning and pain in that part.
As regards the treatment, the same rules apply which have been laid down for the treatment of the precursory symptoms of gastric and bilious fevers. This kind of diarrhoea gets well of itself, as nature is competent to remove the noxious substances. In some cases a cup of black coffee will have to be used for that purpose, or, if this should not be sufficient, one of the above-mentioned remedies may be employed.
Diarrhoea aquosa serosa is a second form of diarrhoea. This diarrhoea is occasioned by a cold either of the feet or abdomen, and is sometimes a prevailing or even epidemic disease in the latter part of summer, or in the fall season. It is sometimes accompanied with a lancinating pain in the bowels and spasms in the abdomen, retching, and nausea. The discharges take place in rapid succession, they are watery, serous, have very little smell, sometimes, however, they are bilious; every discharge is accompanied with a new and violent attack of colic. The diarrhoea of children, occasioned by dentition, is of a similar kind, it is sometimes accompanied with heat, fever, and loss of appetite. If such diarrhoeas should be violent, and last a long while, serum and even fibrin are passed, occasioning sudden prostration.
* I am now treating a gentleman who has been suffering with watery diarrhoea for the last six years, from three to eight discharges a-day. He is as strong and healthy as any man - Hempel.
Dulcamara, frequently repeated, is the best remedy for most cases of this form of diarrhoea, when it takes place in the summer season, consists of green or yellow mucus, has a sour smell, the evacuations being preceded by colic, followed by debility and remission of the pain, and generally taking place in the evening. If the diarrhoea be not so much accompanied with pain in the bowels, but debilitating; if it be a kind of lienteria, where the evacuations take place shortly after a meal, and especially at night, with or without cutting in the bowels; if they contain undigested food, China will prove serviceable; in many cases Bryonia will have to be given, especially if the diarrhoea have been occasioned by a cold, if the evacuations occur almost involuntarily, have a fetid smell and brown colour, if they be liquid as in infants, accompanied with flatulence or fermentation in the bowels. This kind of diarrhoea is sometimes controlled by Rheum, especially when it affects children of any size, during dentition or afterwards, they look pale, grumble and quarrel a good deal, with heat all over; the evacuations are feculent, papescent, smell sour, and are accompanied with a constrictive pain in the bowels. Mercurius solubilis will afford help if the discharges of green mucus should be accompanied with a pinching and cutting pain, and should be so acrid that they cause a burning and itching of the anus; the rectum sometimes protrudes, and the stools are streaked with blood.
Chamomilla is the surest remedy against diarrhoea which occurs during dentition and is occasioned by a cold; it is generally watery, green or like chopped eggs, smells like putrid eggs and is accompanied with pinching colic. If the diarrhoea should set in with sudden prostration and a violent cutting pain in the bowels, the surest remedy is a small dose of Arsenic. Many homoeopathic physicians recommend Arsenic as the best remedy for diarrhoea from dentition; it seems however that latterly the tincture of Sulphur has been employed with more success than Arsenic. Characteristic indications for Pulsatilla are the greater frequency of the diarrhoea at night, especially before midnight, or immediately after getting up in the morning, the discharges being watery, green, bilious; Rhus is indicated when the jelly-like, yellow, and still more or less feculent discharges take place only after midnight and are preceded by violent colic which disappears after the evacuation. Calcarea acetica, several doses, has been successfully employed by some homoeopathic physicians against that kind of diarrhoea, if it was of long standing, or a watery, acrid diarrhoea, corroding the anus, and accompanied with vomiting of the ingesta soon after a meal, Ferrum metallicum is an excellent remedy. Acidum phosp. and Phosphorus are still more important, when the disease is one of long standing. These two remedies are particularly adapted to chronic, painless, half-liquid diarrhoeas, undermining the general health but slowly; or to diarrhoeas occurring from suppressed scarlatina, or to such as occasion a general nervous weakness with excessive emaciation.