– BERNARD H,

Stools 
 Very hard; small and incomplete evacuation; Broken masses, mixed with, or followed by, a liquid discharge.
 Before stool 
 Strong desire, or the desire may be wanting; Flatulent colic; Pain at the anus; Straining efforts, often followed by tenesmus.
 During stool 
 Pain in the rectum, with ringing in the ears; Difficult stools, evacuated only after very great efforts.
 After stool 
 Pains similar to those during stool, with syncope; Sensation as though all the faecal mass had not passed, followed by excessive and painful accumulation of flatus, contractive pain in the perineum after a scanty, hard stool.
 Concomitants 
 Hypochondriacal. Painful tympanitis of the abdomen, with flatulency (also Carbo veg.). Indigestion resulting from a too free use of a farinaceous, heavy and fermentable diet. Acidity and heartburn, together with a irresistible drowsiness after dinner, followed by great exhaustion. Disagreeable weight in the hypogastrium; sensation of gurgling in the abdomen; borborygmus, especially in the left side under the ribs. Distention of the abdomen without the escape of gas or without any relief following its passage; the flatulency is odorless (Carbo veg.). Itching and tension in the anus in the evening in bed; itching eruption at the anus painful to the touch. Violent dorsal pains before the emission of urine; difficult urination; cutting or burning pains in the urethral canal; urine with a reddish sediment.
 In connection with chronic intestinal catarrh, we have : Weakened nutrition, dirty-gray or copper coloration of the face, moroseness, dejection.
 Haemorrhoids with pain and itching at the anus, and frequent, profuse discharge of blood.
 Generalities 
 In obstinate cases, with an almost complete state of atony of the intestines (see Natrum mur.). Also in the constipation of infants and the haemorrhoidal diathesis. It is employed by Dr. Hughes, following Teste, in the dangerous form of enteritis developed in children by a diet consisting only of milk and farinaceous substances, and which they are unable to digest; here also, when Lycopodium fails, Nux succeeds.
 Hartman says that Lycopodium30 is one of the most useful remedies in the constipation of infants for restoring the contractility of the intestines which have been lost.
 Jahr gives this drug when neither Sulphur nor Calcarea have been sufficient to overcome the predisposition to constipation, with ineffectual desire, or hard stools and difficult evacuation.
 Kafka says that Lycopodium should be carefully studied in relation to chronic intestinal catarrh with sluggishness of the peristaltic movements; it is also of service in the constipation of those who are tormented with night pollutions or addicted to masturbation; after repeated affectations of the peritoneum with urinary complications. This remedy has been of service to him in a case of fatty degeneration of the liver with concomitant venous hyperaemia.
 The flatulent colics, bloating, and constipation following the disappearance of eruptions upon the skin, are valuable indications for Lycopodium.
 [Dr. Lilienthal adds to the general outline of this drug : Abdominal plethora, with constipation in elderly people of the higher classes, with no desire for stool.]
 Carbo veg. alternated at intervals of every eight days, very often facilitates the action of Lycopodium.
 Dr. Hughes says : Lycopodium holds a high rank as a remedy for constipation, very much resembling Bryonia.
 the remedy should be given in the medium and higher attenuations, and continued for a long time.
 Case 24
 A man, 38 years of age, of ordinary constitution, was in unusual good health with the exception of a constipation which he could only remove with purgatives. For the last three years this constipation had increased to such a degree as to almost resist the action of purgatives. Each evacuation produced the most terrible pains in the rectum, and sometimes left the patient in a state of syncope for a quarter of an hour. Even when the paroxysms were lighter, the patient remained for several hours unable to make the least movement on account of the persistence of the pains. The mucous membrane of the rectum was very much injected, excoriated in some places, with slight varicosity of the veins. The most careful touch gave rise to acute pains, and cramp-like constriction of the sphincter. Loss of appetite and bad humor. General condition good. Bell., and for a month Nux vom., gave slight relief. Lycopodium6 (five drops morning and evening) brought amelioration within a few days, and a complete cure within three months. – Dr. Hilberger. 

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