Stools
Hard, dry, pale or clayey, and voided with difficulty; Hard, crumble when evacuated, of a clay color, often streaked with green; Hard stool, coated with yellow, tenacious mucus; Thick, transparent mucus or mixed with blood.
Before stool
Tenesmus.
During stool
Tenesmus; Prolapse of the rectum in consequence of efforts at defecation, together with a mucous discharge.
After stool
Prolapsus ani; Haemorrhoids.
Concomitants
Fullness in the head; headache. Loss of appetite; impaired digestion. Various gastric and intestinal manifestations. Fetid flatus. Frequent urination. Pain and weakness in the back. Exhaustion from the natural, but too frequent stool.
General aggravation in the morning.
Generalities
Infantile constipation.
In old intermittent cases, or those due to a residence in or return from India (in these latter cases Cedron is, also, at times, useful).
Ruddock given : Diarrhoea with generalized icterus or alternating with constipation. Constipation which often succeeds to an attack of diarrhoea in infants who are artificially nourished, when the stools are hard, crumbly, clayey.
Podophyllum is also serviceable in the constipation with irritation, and when occurring in persons of sedentary habit.
Rego writes : The primary effects of Podophyllum upon the intestine show a functional exaltation characterized by a diarrhoea variable in form, almost always accompanied with pain in the abdomen; and the secondary effects show a certain state of atony represented by constipation alternating nearly always with liquid dejections or again by hard, dry stools, expelled with difficulty.
“By its action on the liver”, says Dr. Hughes, “Podophyllum merits the name of the vegetable Mercury”. I do not believe this generalization is well founded. The bilious condition in which I have found it useful differs very much from that calling for Mercury. The attempt to force by the vis a tergo, in the case of jaundice due to obstruction, is sometimes justifiable. In these cases, of which an example is given by Dr. Hale, Podophyllum, in the dose of 3 to 10 grains of the 1st decimal trituration, is best adapted to produce this effect. On the same principle we can give it as advised by Dr. Ringer, in dose of 1/6 to 1/30 of a grain in the constipation of infants.
[Hempel and Arndt write : The attenuations should be used. The practice of giving the crude resinoid in light doses, for the sake of getting an immediate action of the bowels, is reprehensible.]
Podophyllum30 has recently given me a most successful result in a case of infantile constipation with prolapsus of the rectum.
Case 43
[An adult patient suffering with inactivity of the liver, complained of great mental depression, chilliness, cold perspiration restless sleep, furred tongue (showing the imprints of the teeth), nausea, clayey, delayed stools; fullness, tenderness, and stitch-like pain in region of the liver, irregular action of heart and general prostration. A cure was wrought with a few doses of Podophyllum. – Dr. A. K. Hills in N. Y Med. Times, vol. ix., p. 308. ]