Stools
Small, hard, blackish or discolored balls; Large masses; Hard, and full of small masses; Hard, alternated with liquid, frothy stools.
Before stool
No desire, or with the desire to go to stool, there is a sensation as though the anus was closed.
Concomitants
Nervous and irritable; head feels heavy and the thoughts are stupid. Congestion of blood to the head. Headache, vertigo, red face, sleepiness. Dryness of the month, thirst and want of appetite. Beating and sensation of heaviness in the abdomen with pressure over the stomach. Anxious sensation in the epigastrium [colic, with great pressure downward upon the rectum and bladder, without any passing off of gas, faeces or urine]. Retention of urine. Constipation alternating with a diarrhoea so painful that an attack of cholera morbus might be expected.
Generalities
The majority of authors recommend Opium for constipation or intestinal obstruction, when it is of a paralytic nature or associated with incarcerated hernia. It is one of the principal remedies in lead colic; also when the constipation is the result of pressure upon the rectum in consequence of a gravid uterus or abdominal tumors; and for nursing infants, aged persons, and those of a torpid or plethoric habit. In all these conditions there is the absence of expulsive efforts, showing the complete inactivity of the rectum.
Espanet says that we will meet with many stubborn cases where its employment is necessary and where we will have to aid its action by intercurrent doses of Nux vom., Lead, and Cantharis.
Prost-Lacuzon recommends it for the constipation of pregnant women, in cases where Sepia has failed.
Hirschell writes : Opium is indicated after a debilitating disease, or where there is a paralysis of the intestines in consequence of a protracted attack of diarrhoea, in subjects leading a sedentary life, and also in robust and healthy men.
Jahr, after describing the indications for Nux vom., add : Opium is of service for this same sensation of occlusion of the anus, but without the frequent desire of the former.
Hartmann recommends Opium for the constipation of children, when all the symptoms of Nux vom. exist, except the fruitless efforts at stool, and also, when the latter remedy has failed.
It is sometimes necessary to give an intercurrent remedy and again return to Opium.
[Lilienthal gives : Constipation from inactivity of the the rectum, but there is a want of sensibility in the abdominal condition and hardly any inconvenience is felt from the accumulation of faeces; constipation of good-humored, corpulent women and children.]
Dr. Gross begins the the treatment of persons suffering from chronic constipation, and accustomed for a long time to the use of purgatives, by substituting clysters of cold water and at the most, a drop of the tincture of Opium. When I have succeeded, he adds, in thus breaking off the habits of these patients. I administer the remedies to them with perfect success.
Case 38
A bright little girl, 6 1/2 years of age, had been a sufferer from urticaria, which was aggravated whenever she ate a strawberry or even a strawberry pastil, but which I had cured with Cancer fluviatilis12. She was now seriously affected with a constipation characterized by the the evacuation of large faecal masses. On account of the distress and pain she delayed going to stool for as long a time as possible, but when it became absolutely necessary, it produced the most severe pains and caused her to cry aloud. Opium3 removed the entire trouble. – Dr. Rafinesque.
[In Hempel and Arndt’s Materia Medica we find three clinical cases in which Opium gave relief. These we have condensed as follows :
Case 39, 40, 41
A young girl, 12 years of age, subject to obstinate constipation, had every two or three days a hard, grayish stool, in small balls, like sheep-dung. There was also present, pressure over the eyes, anxiety about the heart, stitching pains in the chest and abdomen; she looked pale and sickly. Repeated small doses of Opium30 cured her. Sulphur, Nux vom. and Silicea had failed.
The other patients, respectively a man of 60 years, and a woman of 56 years of age, suffered from obstinate and long continued constipation, which purgatives and injections hardly succeeded in relieving. The intervals between the stools would extend from several days to one or two weeks. In the former case Opium, 1st decimal trituration, and in the later Opoium200 gave relief.
A very interesting case, to long for insertion here, of intestinal obstruction and faecal tension, accompanied by the most severe symptoms, is given in the Hahnemannian Monthly, vol. x., p. 393, in which Opium30 was successful.
For the constipation of infants with complete inactivity and large stools, Opium200 has so far proven an efficient remedy in our hands.
Case 42
While the present work was in course of preparation, a young man, a theological student, came to me to complaining of a constipation of five days standing. The constipation was the only condition complained of, and was without desire for stool. During the first two days of the suppression of the stool there had been a sweetish taste in the mouth and some feeling of malaise. Opium4, three pills every two hours, produced a stool on the following day, and every day regularly from that time.]