Stools
Hard, difficult, crumbling; Large masses; Indolent, irregular, or alternating with diarrhoea.
Before stool
Frequent desire but without result; Inactivity of the rectum and no desire; Burning in the rectum.
During stool
Pulsation, contraction, and a lancinating pain at the anus as from ulceration; Tenesmus; Haemorrhage from the rectum.
After stool
Burning and smarting in the anus and rectum; Ripping up sensation in the anus; Tenesmus; Fissures with bleeding and smarting, burning, pains; Haemorrhoids with stinging pains and soreness at the anus; Prolapsus ani.
Concomitants
Depression of spirits. Disturbed mental condition. Dryness of the mouth; superficial ulcerations of the tongue. Irritability and persistent dryness of the mucous membranes, with tendency to catarrhal affections. A greater or less number of gastric pains, with loss of appetite, heartburn, eructations, rarely sour, more often burning, as when after eating some article of food fried in rancid butter. Pressive pain running from the navel to the pelvis. A sensation as of a weight hanging across the pelvis and bladder, aggravated during motion, and compelling the patient to bend forward when seated. Moisture and herpetic eruptions about the anus. Pressive pain in the left side of the hypogastrium. Swelling of the abdomen. Cutting pains through the bowels during the day. Gurgling of wind through the bowels. Excessive sensitiveness to cold. Perspiration on slight motion. Irritability of the skin; dirty-colored skin; eczema, acne and pustules.
Generalities
Haemorrhoidal constipation. A constipation accompanied with a state of weakness or inaction of the intestines, seems to be more characteristic of this remedy, than the frequent urging. In cases of great atony of the intestines, so that they do not assist in the evacuations of the faeces. Chronic constipation ameliorated or aggravated according to the activity or inertia of the intestines. In obstinate constipation when the intestine presents a state of torpor almost equivalent to paralysis, but without pain, and when for days and weeks there is no desire to go to stool; when, finally, the hardness, dryness, and size of the faecal mass produces, mechanically, fissures and consequent tearing and burning pains in the anus. In cases accompanied by tumefaction of the liver or spleen, fatty degeneration of the heart or valvular lesions. The indications for Natrum mur. are analogous to those of Lycopodium, and the two remedies may often be alternated with success. Espanet ranges Natrum mur. by the side of Cuprum and Plumbum for constipation followed by colic and diarrhoea. In cases where a chronic constipation has resisted Sulphur and Nux vom. If the patient uses salt in excess, it will be necessary to correct this habit, and give at first Spir. dulc., nitr. or Arsenic as antidotes. [Phosphorus (abuse of salt in food); Arsenic (bad effects of sea-bathing).]
Case 29
Xavier Spiss, aged 11 years, born of scrofulous parents; his oldest brother is a mute and almost an idiot; he himself is a mute and idiotic, with puny appearance of body and limbs; the abdomen is large and hangs upon the thighs, it is tympanitic, hard, and on deep pressure nodulated tumors can be felt; he cannot walk or even stand upright; he remains seated in his cradle and swings back and forth day and night; he sleeps very little and with the exception of water, milk, potatoes and brown bread he refuses all nourishment. This poor creature has suffered since his birth, with constipation. Injections of all kinds, aperients, resolvents, laxatives, and purgatives have been administered, from the prune juice and castor oil, to gamboge and croton oil. At 8 years of age, he would go three or four weeks without stool; during the first two weeks of this period, the child did not appear to suffer, but toward the third week the appetite diminished, the child cried, held the bowels with the hands, rolled over, pulled at the hair and sometimes vomited sour mucus or food. All injections and purgatives seemed to lose their power. Between the twentieth, and thirtieth day there would occur a massive, black, hard stool, which was accompanied by a bloody discharge and prolapse of the rectum, which was fissured; during the stool the child uttered piercing cries, and afterward was pale, prostrate, and tranquil. On Nov., 19th, when the constipation had been present for three weeks, I gave the patient a dose of Natrum m. 12. On the morrow he had a stool without pain. I then ordered the mother to give him a dose twice a week; but the effect did not respond to my expectation, although I had varied the 12th with the 3rd and 30th dilutions. In February I prescribed one globule of the 30th, dry, upon the tongue, in the morning while fasting, twelve or fourteen days after the stool. The action was prompt and persistent; each time that the medicine was given, the child had, on the following night and succeeding morning a copious and free evacuation, and for the last three months the stools are regular, at the same intervals, even without medicine, for they often forget to give it. It was not necessary, perhaps, to give the medicine every fifteen days, for it we can believe our experimenters, the action of Natrum m. 30 continues for forty or fifty days. – Dr. Gross.