Stools
Hard, knotty, insufficient, scanty, like sheep-dung; Difficult, covered with mucus; Retarded, with discharge of blood.
Before stool
Frequent desire, but without ejecting anything, or there is only an emission of wind and mucus.
During stool
Pain in the rectum extending to the perineum and vagina; Shooting and tearing in the rectum and at the anus; Prolapse of the anus; Sense of weight at the anus; Terrible straining to pass stool covered with mucus; Bloody discharge.
After stool
Sensation of weight at the anus; Burning in the rectum and anus; Haemorrhoids.
Concomitants
Headache. Sensation of cold in the stomach. Pyrosis. Nausea, often coming in paroxysms. Tingling in the rectum, with itching at the anus; oozing of moisture from the anus. Haemorrhoids. External chilliness. Emaciation. Uterine affections and leucorrhoea. Herpetic eruptions.
Generalities
In pregnant women, and in children where manual assistance has to be rendered, in consequence of the excessive straining. When the constipation is associated with dyspepsia and chronic affections of the stomach.
Jahr says that Sepia is suitable for case of chronic or obstinate constipation, especially after the unsuccessful use of Sulphur and Nux vom., especially in females or persons subject to rheumatism.
[Hempel and Arndt write : Persons of light complexion, soft muscular tissue; of a depressed, sad, anxious state of mind, easily excited and worried; the symptoms are aggravated in the middle of the forenoon, and when sitting quiet, and are relieved upon moving about.]
Case 50
A middle-aged woman suffered from haemorrhoids, herpes, cramps and constipation. No stool took place except under the influence of a purgative. She had been without a faecal movement for several days, and the obstruction had caused the abdomen to swell, and had produced still more dangerous symptoms, such as congestion of the head, etc. The only thing to do was to free the bowels, and for this purpose homoeopathy alone furnished the means. But the difficulty was to avoid a commingling of the remedies and the purgatives which she was unable to pass. In similar cases I have always substituted enemata of cold water in the place of the purgatives, and at the most a drop of the tincture of Opium. When I have thus broken up the habit, I am able to administer the remedies with greater success. But here all my efforts, directed against the torpidity of the intestinal canal, were failures. The best indicated remedies such as Nux, Petroleum, Alumina, Sepia, and even Plumbum did not produce any result. The constipation remained unchecked, and the symptoms became so threatening that I was about to counsel the administration of purgatives during the intervals. The enemata of soap likewise gave no relief, and I determined to administer at the same time Sepia in repeated doses. For a month the patient took every eight days a dose (30th), then every fifteen days, in all six doses. A stool from time to time gave great relief. – Dr. Gross.