Aesculus hippocastanum in Constipation Cases

- BERNARD H,

Stools 
 Large, dry, hard, difficult, dark; In the form of balls; First part hard, black, the last about natural consistency, but white as milk; Hard, knotty, dry, and white. (See Nux v.)
 Before stool 
 Constant desire; Sensation as if a foreign body was in the rectum, or as if the rectum was full of small sticks, with fruitless efforts at evacuation, and violent pains though the hips and sacrum; Heat and contraction of the rectum, with a sensation as if it was prolapsed, dryness and itching of the anus, with tension of the mucous membranes and the neighboring integuments; Pain, constriction, weight, prickings and itching, with tenesmus of the rectum and anus, the pains irradiate to the posterior surface of the body.
 During stool 
 Continuation of many of the symptoms enumerated above. Sensation as if the intestine was obstructed by folds of mucous membrane, which were threatening to rupture under efforts at defecation; Haemorrhoids with a slight bloody discharge but with intense pain; Inability to expel the stool from weakness of the rectum; Shivering while at stool.

Aesculus hippocastanum

 After stool 
 Colic at the umbilicus, with severe pains and tearing at the anus; Reddish, painful, and burning haemorrhoidal tumors; Bleeding piles; Prolapsus recti et ani; Burning and contraction in the rectum, itching at the anus and a sensation of excoriation; Backache.
 Concomitants 
 Depression of spirits. Vertigo. Nausea, vomiting or violent retching. Throbbing in the abdominal and pelvic cavities; passing fetid flatus. Urine dark, muddy, passed with much pain. Pain and a sensation of paralysis in the kidneys extending to the hips, with aggravation from rising. This pain is not intense, but rather a sensation of painful weakness which is aggravated by exercise and relieved by repose; when the patient attempts to walk or to attend to his usual occupations, the pain at the lower portion of the back appears and he is compelled to rest.
 Generalities 

Chronic constipation associated with haemorrhoids. Dr. Hughes says : When the haemorrhoids are only secondary, that is to say, dependent upon a congestion of the portal system or of some other intra-abdominal part, Aesculus is probably inferior to Nux vom. and Sulphur. When they are associated with varicosis elsewhere and bleed freely, Hamamelis is a better remedy. But when the only concomitant symptom, and the only appreciable cause of their development is constipation, and when there are severe pains but little loss of blood, Aesculus will in all probability effect a cure. I have also cured with this medicine a case of intense pain at the anus after stool, resembling that caused by fissures.
 [Hempel and Arndt * write : Chronic constipation begets haemorrhoids, and usually a redical cure of piles is out of the question unless you correct this predisposing cause. The curative effect of Aesculus upon cases of chronic constipation furnishes us the rationale of brilliant cures of piles performed with it, often in a comparatively short time, after other efforts of skilled prescribers had utterly failed.]
 Meyhoffer has employed this drug with great advantage in a case in which pharyngo-laryngitis coexisted with haemorrhoids and constipation.
 We have confirmed the recommendation of Aesculus in chronic constipation connected with a haemorrhoidal diathesis, in the case of a man thirty-five years of age, who had suffered from chronic and hereditary haemorrhoids, and who, independent of an inveterate constipation, carried upon his face a mask of acne rosacea; the relief was marked and permanent.
 Case 1 
 C. E., a young man of active habits, complained of a haemorrhage from the anus after stool. The bowels were constipated, and were only moved every two or three days, and accompanied by great effort and pain. The blood was dark colored. Seminal emissions with erections, towards morning, followed by a desire to urinate. Aesculus3, four pills every two hours, removed the trouble within a week. - T. M. S.