Graphites in Constipation Cases

- BERNARD H,

Stools 
 Hard, knotty, with discharge of mucus and blood; In lumps united by threads of mucus; Large and ball-shaped; Long and slender in shape.
 Before stool 
 Great desire.
 During stool 
 Hard stool, with much urging and sticking in the anus; Great straining even when the stool is not hard; Shooting pains in the anus; Discharge of white mucus.
 After stool 
 Prolapsus recti and haemorrhoids, as if the rectum was paralyzed; stitching, tearing, and soreness in the rectum.
 Concomitants 
 Burning heat in the stomach after eating and from the least aggravation of the general conditions, or distress after a meal (a result due to the abdominal venous plethora).
 The abdomen is very much distended from the accumulation of gases. Hardness in the region of the liver. Pains in the haemorrhoidal protrusions. Fissures of the anus with sharp cutting pains during stool, followed by constriction and aching for several hours, worse at night. Skin dry and rough; or with herpetic eruptions, secreting an aqueous or viscous liquid.
 Generalities 
 Constipation in subjects of the herpetic diathesis or with a scrofulous cachexia. In hypochondriacal subjects with marked abdominal symptoms.
 Hahnemann says, that when there is chronic constipation and when a delay of several days in the appearance of the menses gives rise to complications, we can seldom succeed in the treatment without having recourse to this remedy.
 Willmar Schwabe says, that diarrhoea never alternates with the constipation which corresponds to Graphites.
 [Constipation in women who are inclined to erysipelatous inflammation and ulcerative processes of the lower extremities on a rheumatic basis, and who are of a timid, morose and dejected disposition. - H. Goullon, Jr.]
 Case 13 - gastro-intestinal affection accompanied with erythema of the face
 Mlle M -, twenty-eight years of age, brunette, has been subject to constipation wince early childhood; congenital without doubt, this tendency, which, in her case is not hereditary, has been aggravated by a vicious alimentation composed especially of pastry, sweetmeat of all kinds, etc. Later, obedient to a false idea of modesty, Mlle M -, delayed as much as possible the act of defecation; ten days would often pass without stool, to her great satisfaction. The menstrual epoch was marked by the appearance of violent pains in the forehead, followed each day, almost at the same hour ( 3 p.m. ) with redness of the nose, cheeks and eyes. The disposition became at the same time more irritable; extreme sullenness, desire for solitude, dread, fear of coming spectres, interrupted by rare intervals of sleep, appetite whimsical. M. Cruveilhier was consulted without success for eighteen months. M. Lheritier advised the use of the waters of Plombieres. The amelioration of the digestive tract which was manifest during the use of the waters did not last, notwithstanding the Nux vomica pills, various purgatives, the tea of St. Germain and many other remedies prescribed by the sub-inspector at these Springs. M. Cazenave saw only the erythema of the face and was no more successful with his cosmetics. After failure in the treatment by several other physician, I was called and found the following symptoms :
 Sadness, weeping, sullenness, desire for solitude, fear of spectres, horrid fancies; aversion to occupations formerly loved, the piano and needlework; no sleep or else one disturbed by dreams, constant headache with sensation of fullness or dilatation of the cranium. Congestion of the face, redness of the face, especially across the nose, which was increased in size. This redness comes on about 3 p.m. , and is produced by the most insignificant incident, a draught of air, a sojourn in a room occupied by several persons during digestion, by study, and is accompanied by a stupefying headache. The eyes are heavy, and the patient complains of a feeling as if a leaden weight was pressing on the forehead. The skin of the congested portions of the face is rough and shining; the pores are sensibly opened. This disfiguring appearance is very annoying to the patient, who being rich and able to enjoy every luxury, cannot appear without this disfiguring mask. Obstinate constipation, which is prolonged from eight to twenty-one days. Stools like sheep-dung, covered with grayish matter, and sometimes streaked with blood. Menses profuse and debilitating. Leucorrhoea succeeding the menses (during four days), with ringing in the ears. Capricious appetite, sometimes ravenous hunger and then again prompt satiety. Swelling in the region of the stomach, aggravated by pressure of the clothing. Cold feet and knees. I began the treatment with Sulphur which seemed to be called for by the moral symptoms, and especially the constipation, with stools enveloped in mucous matter, and the development of the haemorrhoidal vessels giving rise to the blood in the stools. This remedy in the 6th produced a stool sufficiently abundant on the first and second days, but without any relief to the other symptoms. Twelve days later, I gave Graph. 30, a teaspoonful night and morning. This remedy, repeated every twelve days, produced a real amelioration. The stools took place every four days and then every other day. The bloody streaks disappeared; the appetite became regular; the swelling and the tenderness from the pressure of the clothing gradually passed away. The congested conditions of the face did not appear every day. Continued for three months, in alternation every twelve days with Plumb. 30, Graphites re-established the intestinal functions. But the redness did not disappear entirely except under the influence of Alumina30, two doses given at intervals of two months. The patient is now in perfect health. Graphites and Alumina in alternation, always prevents the tendency to constipation which appears in consequence of the balls, soirees, and too prolonged vigils.