Inefficient, black, hard, often streaked with blood; Large, hard stools, Black, dark, or brown in color, and hard and knotty in appearance (see Aesculus h.).
 Before stool
 Ineffectual urging, painful, almost constant, desire for stool; Pressure in the rectum, with lumbar pains; Sensation as though the anus was firmly closed and narrowed. (See Opium).
 After stool 
 Oppression of spirits; dislike for work and thought. Insomnia, anxiety and chilliness. Passive frontal headache, with or without congestion to the head, worse in the mornings. A marked degree of nervous erethism with a tendency to hypochondriacism of anger. Qualmishness in the epigastrium and abdomen. Dyspnoea from pressure upward of the diaphragm in consequence of the accumulation of gas. Distention of the abdomen, weight and pressure in the region of the stomach or spleen; at times cutting pains in the lower bowels with occasional eructation or flatulency (emissions which give slight relief). Heat, and stitching pains in the side; weight in the hypogastrium. Loss of appetite, bitter taste in the mouth, mucous coating of the tongue. Catarrh of the stomach with excessive acidity and flatulency (aggravated still further by the use of starchy foods). Alternation of diarrhoea and constipation. Haemorrhoids, painful and protruding, or attended with haemorrhage.
 Suitable for constipation arising from haemorrhoidal and dyspeptic troubles.
 Where there is an irritability of the intestinal tube (there is often in such cases some haemorrhagic irritation, in which the alternation of Bryonia with the Nux vom. renders good service). Nux here as in other troubles, is especially serviceable for those persons who lead a sedentary life, or are suffering from the effects due to prolonged night-watching, nursing, or mental overwork, or those who use in excess spirituous liquors, or overload the digestive tract with highly-seasoned food, or from abuse of purgatives or sexual excitement due to onanism, or when the constipation has been preceded by a diarrhoea or is the consequence of its sudden checking. It is also recommended for the constipation of pregnant women. Also for active, irritable infants, and for those who have been prematurely fed on meat, or when the trouble arises from the excessive use of coffee by the mother or nurse. It is suitable in the beginning of infantile constipation, as well as later, when the condition has given rise to various concomitant abdominal symptoms. According to Hartmann, benefit is often derived, in such cases, from the intercurrent use of Bryonia18, while Knorre considers Sulphur as one of the best alternating remedies.
 Rueckert considers Nux vom. to be generally indicated : 1. In pregnant women who do not complain of any others symptom, and also in children under the same circumstances. 2. When the constipation is idiopathic, especially when the abuse of coffee seems to be the cause.
 The absence of all desire for defecation or a want of agreement of the muscles which act in this function are positive contra-indications for the use of Nux vom.
 Dr. Hughes recalls the words of Schroeder von der Kolk : A long experience and numerous autopsies have proven to me that chronic constipation is almost always dependent upon contraction of the descending colon. To this Dr. Hughes adds, that in regard to the constipation of Nux vom. Dr. Carroll Dunham is right when he says : “This medicine does not diminish the action of the intestines, it rather augments it, but at the same time renders it irregular and spasmodic, preventing in consequence, instead of aiding in, the evacuations. It is for this reason that the constipation characteristic of Nux is accompanied with frequent desire but ineffectual efforts for stool, the action of the intestine being irregular and spasmodic; the constipation being the result of the irregularity in the action, and not of the inaction.”
 On the other hand, we would call the attention of our readers to the fact, that the physiological interpretation given by the authors mentioned above, upon the action of Nux vom. in constipation, is not accepted by all writers, especially in Germany. Thus Kafka writes in connection with the treatment of chronic intestinal catarrh; “Nux vom. administered in small doses, and not repeated too often, exercises a marked action upon the muscular tissue of the intestine. I insists upon the inactivity of the intestine in consequence of a diminution of the peristaltic movement as characteristic of Nux vomica.” Willmar Schwabe also considers Nux vom. as suitable for chronic intestinal catarrh with constipation from diminution of the peristaltic movement.
 In that which concerns the dose, we find the divergences of opinions which separates the homoeopathic school into numerous camps, on the question of therapeutics. This is a clinical problem not yet elucidated, and which we shall only discuss incidentally. We would only say that if M. Jousset prefers the 12th dilution of Nux vom. in the treatment of constipation, others administer the 30th, others, again, the dilution of Jenichen, or even those of Fincke. On the other hand we read in Rueckert : “In constipation I give Nux vom. 1, while at the same time the question might be asked if we would not obtain better results with the tincture than with the dilutions.”
 Case 30 
 No stool for six days, vertigo and giddiness, weight in the head similar to that caused by drunkenness, especially in the morning, burning heat and redness of the face, dryness of the mouth, bitter acid taste, heartburn, malaise in the morning, pressure in the stomach, tension in the abdomen after eating but a small quantity, tearing pains in the hypochondrium, tenesmus, pains in the anus and kidneys, pressure and constriction in the breast, restless sleep at night, depression of spirits, sleepiness in the morning before rising, lassitude, relaxation of the whole body. One drop of Nux vom., tinct., caused a cessation of all the pains. – Dr. Knorre.
 Case 31 
 A young woman who led a sedentary life, suffered for many months from a constipated habit and for the relief of which she was compelled to resort frequently to injections; she suffered from constant pain in the direction of the colon. Nux vom. 30 removed the abnormal condition and since that time the stools have been regular. – Dr. Malaise.
 Case 32 
 A young woman of strong constitution, a chambermaid, had been sick for three days. She suffers from the following symptoms : Great heat of the face, thirst, white-coated tongue, absence of stools for three days, languor, easily fatigued, the limbs are as stiff as boards and resist all movements, it is only with the greatest difficulty that she can ascend to the second story. I prescribed one drop of Nux vom. 30. On the morrow all the morbid symptoms had disappeared, and the stools were regular. – Idem.
 Case 33 
 A woman, 29 years of age, confined six weeks before, experiences the following symptoms : Acute pains at the pit of the stomach; palpitation of the heart with bluish lips; obstinate constipation, two stools in ten days; pulsative and hammering pains in the forehead, aggravated whenever the pains in the stomach are more intense; dry cough for several days; cramp-like pains in the lower limbs; swelling of the feet in the evening. The infant which was nursed by the breast vomited frequently. The patient was given three globules of Nux vom. 30. Ten days later the symptoms enumerated had disappeared and the mother and child enjoyed good health. – Idem.
 Three points deserve our attention in these three observations by Dr. Malaise : 1. Nux vomica alone was sufficient for the cure; 2. It acted very rapidly; 3. It was employed in the 30th dilution. In the observation of Knorre given above, we find the same efficacy from the use of Nux vomica alone, and the same prompt action; but the remedy has been given in the mother tincture.
 We will return, for the present, to the clinical collections of Rueckert and translate from them a noteworthy case of hypochondriacal constipation which was cured in a short time by Nux vom. alone, but this time in the 3rd dilution.
 Case 34 
 A teacher, age 40 years, having a tendency to constipation, suffered for six years from this infirmity until it became necessary to resort constantly to purgatives. The appetite was weak, tongue lightly coated, hunger soon appeased, eructations soon after eating, sensation of fullness and painful weight in the epigastrium. Regularly one hour after eating he suffered with flying chills followed by flashes of heat of equally short duration. Despondency which always increased after mid-day, accompanied with light vertigo and heat f the head, inability for intellectual work, constant preoccupation occasioned by a sensation of swelling of the abdomen. A stool every five or six days; after a purgative or injection there occurred a large, dry, stool, ordinarily in black balls, accompanied by severe pains and strong expulsive efforts of the rectum; the feet are habitually cold; the sleep does not refresh. The lungs, heart, liver and spleen are healthy. He bends forward, speech is embarrassed, the movements slow, gloomy expression of countenance with a dirty yellow complexion. Hypochondriacism bordering on melancholy. Old-school treatment and Carlsbad waters gave no relief. Nux vom. 3, two drops every evening was given. At the end of eight days there was amelioration and under the continuance of the remedy, a cure fifteen days after. – Dr. Linder.
 We have in the Homoeo. Rundschau for June, 1878, the following observation by Dr. Goullon on chronic infantile constipation; the interest attached in the case itself, the dose employed, and the familiar language of the recital, have led us to make a résumé translation of the article which is entitled, A Homeopathic Remedy Against Chronic Constipation :
 Case 35 
 Here is the demand which was addressed to me; “Have the kindness to send me a purgative for Eugenie, who is always constipated; she only has an evacuation every other day, notwithstanding the prunes, apples, brown bread, etc., which I give her. I have even resorted many times to injections, so severe has been her sufferings.” What reply ought a homoeopathic physician to make to such a question? The child here spoken of, was otherwise in good health and of an almost athletic constitution, but the mother was a sufferer from haemorrhoids. I took a small glass containing 100 drops of rectified alcohol. In this I placed two drops of the tincture of Nux vom., shook the glass one hundred times, and prescribed two drops of the dilution, to be given night and morning, in a teaspoonful of water. Under this treatment the evacuations became regular in a short space of time; at first, they were still slightly painful, although daily, but a present the act is easily accomplished. – Dr. Goullon.
 Nux vom. adds Dr. Goullon, is, in a certain sense, a remedy for the rectum, as well as a remedy for spasmodic action; from this arises its value, together with Belladonna, in cases of strangulated hernia.
 We will give here a personal observation, in which Nux vom. 12 acted very successfully.
 Case 36 
 M. X., aged 35 years, consulted me on Dec. 12, 1877, for a constipation of seven years standing. This trouble, attributed by the local physician as due to a state of general debility, had been treated with repeated purgatives, together with a tonic regimen. Nothing and been accomplished. My patient is a man of nervous temperament, lean, blonde, somewhat passionate. Besides the constipation, which I suspect, notwithstanding the absence of personal or hereditary antecedents, to be in correlation with the existence of internal haemorrhoids, there is dyspepsia, flatulence, tenesmus, and cardiac palpitations. I advised a lighter regimen and prescribed Nux vom. 12, in water, a spoonful to be taken night and morning for three days. After an interval of eight days, Sulphur30 was employed in the same manner. On Dec. 26th he returned, pleased with the marked amelioration which was manifested as soon as he began to take the Nux; the dame prescription was repeated, except that the intervals between the two remedies was to be ten days instead of eight. On Feb. 8, 1878, M. X., came back to say that he thought himself cured. I however gave him Lycopodium200, on account of the slight persistence of intestinal flatulency. To-day the cure is complete; – Dr. Bernard.
 Case 37 
 [A gentleman had a diarrhoea, which he checked with brandy; constipation followed, with heaviness in the abdomen and occasional cramping pains. Nux vom. 200, two doses, cure. – Dr. Guernsey in Raue’s Record, 1870, p. 215. ] 

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Dr.Devendra Kumar MD(Homeo)
International Homeopathic Consultant at Ushahomeopathy
I am a Homeopathic Physician. I am practicing Homeopathy since 20 years. I treat all kinds of Chronic and Acute complaints with Homeopathic Medicines. Even Emergency conditions can be treated with Homeopathy if case is properly managed. know more about me and my research on my blog https://www.homeoresearch.com/about-me/
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