– BERNARD H,

 Stools 
 Ball-shaped, hard as stone; Small, hard balls covered with a greasy pellicle, or they resemble sheep-dung; Large and hard, and covered with a glairy mucus; Dark colored.
 Before stool 
 Ineffectual urging, either with or without tenesmus; Complete atony of the rectum; Severe colic-like pains with constriction or spasm of the anus.
 During stool 
 Great effort; Violent colic pains.
 After stool 
 Colic, and at times diarrhoeic discharges.
 Concomitants 
 Great depression of spirits. Pale, emaciated. Anxiety and tenderness. Abdominal colics; Violent, cutting pains; abdomen hard and retracted, with drawing sensation from the abdomen to the to the back; anus feels as if contracted; prolapse of the anus. Nausea and vomiting. Loss of appetite, sweet taste in the mouth, violent thirst.
 Generalities 
 Obstinate constipation. In pregnant women, persons of a paralytic diathesis, or when the constipation is due to paralysis of the intestines. Especially valuable when there is present dryness of the excretion and a muscular atony. In many of the cases calling for the use of this drug there is an absence of the intestinal mucus and bile.
 Often suitable in cases where Platina seems to be indicated but fails.
 It is recommended, in alternation with Opium, for obstinate constipation in those who are otherwise in good health; the stools are very painful and hard. Also where there is general or partial paralysis with wasting away of the tissues.
 The acetate, carbonate, and metallic lead seem equally effective in practice.
 Case 44 
 Plumbum aceticum is the best aperient that I have found; although a slow acting remedy, it cures promptly enough when administered in a very small dose. A woman who had suffered for a long time with cramps in the hypogastrium, and who had not had any stool for nineteen days (when she did have a stool it was as hard as stone and required the greatest efforts) took Plumbum12 one-fourth of a grain. Eight hours later she had a copious evacuation, which was hard, it is true, but without effort. She had three more in twenty-four hours, the last two being natural; from this time the stools remained normal. I had given her before, a grain of the 6th; four days later, she had had an extremely copious stool, which partially soft in consistency. – Dr. Hartlaub.
 [In Hempel and Arndt’s Materia Medica we find :
 Case 45 
 Constipation of several years standing. The stools consist of hard balls; there is little or no pain present. Plumbum, five powders, one night and morning, was given; several months later the cure was still permanent.
 Case 46
 Even with a purgative, motions are hard and dark; numb extremities; knife frequently drops from his hands. Urine difficult, dribbling; high-colored and fetid. Sexual functions weak. Pulse quick, weak. Plumbum carb1. – Raue’s Record, 1872, p. 151.
 Case 47 
 Mrs. R., age 50. Pale, emaciated; constipation in spite of cathartics. Faeces in small lumps; abdomen large; convolutions of intestines could be seen and felt through the abdominal parities. After eating, violent retching and vomiting of food or mucus. Violent, spasmodic, cutting, contractive pains, with great restlessness, anxiety, and cold sweat, would bring lumps as large as a fist on the left of the abdomen. Plumb. 5.
 Case 48 
 Mrs. E., 40 years of age, has suffered for a year from severe cardialgia. Constipation, once a weak a hard, knotty stool. Severe colicky paroxysms with nausea and vomiting. Patient atrophic and anaemic. Taste sweet; abdomen compressed like a board. Paralytic weakness of extremities; hands and feet cold; lack of perspiration. Plumbum aceticum 30, 6, 3, produced a cure in a few days. – Raue’s Record, 1870, p. 215.)] 

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