Constipation Relief

Folks have been seeking constipation relief for thousands of years. Too often a constipation sufferer depends on laxative pills, long after a doctor has recommended them. They are a short term solution to constipation but should not be depended upon for normal bowel movements.

To illustrate how long this dependence on purgatives has been occurring here is a 19th century doctor describing his patient suffering from constipation and how he cured her constipation.

I was fetched by Mr A., one evening in January
1870, to Hammersmith to see his wife. He believed her to be dying, from four days' continual purging and vomiting (attacks recurring at intervals of six to eight minutes). I will make, in the first instance, a few remarks on my knowledge of this patient, before attending her on this occasion. This lady had been for many years a martyr to constipation, and had been  in the almost daily habit of obtaining temporary relief by the use of purgative pills. Two to five drops of this tincture repeated every hour.

In the years 1865-6-7, she had been under my care, at various times, for violent attacks of colic, and had derived great benefit from the treatment pursued; whilst under my care her bowels always acted comfortably without purgatives. She always, however, went back to her pills after my back was turned.

It may appear incredible that any one in their senses could act so foolishly. This, however, is not at all the only instance that I have met with, of patients relapsing into the use of pills when no longer under regular medical treatment. Whether it is on account of their cheapness, or griping qualities, I know not, but the British public is dearly fond of purgative pills.

The usual result followed, that is to say, her bowels became more and more constipated, so that at last she " never had any want for stool until after three or four pills," and she "did not believe that they could act without purgatives."

Mrs A. had no fresh attack of colic until 6th January 1870, when she was attacked by her old enemy. As she had in the meantime removed to a western London suburb (at a considerable distance from my house), Mr A. called in Dr B., a well-known local practitioner. Dr B. carried out the treatment recommended in the above-mentioned work; first, he gave a purgative* to clear the stomach and bowels out, and * Khubarb was certainly present in the mixture that she first took. I may incidentally mention, that my patient received from Dr B". ten six-dose bottles of medicine in the five days that then an opiate to suppress the colic. The result of this treatment was the setting up of attacks of vomiting and purging every few minutes.

On my arrival at the patient's bedside, I found her in a state of extreme prostration, from the long-continued, and almost continual, sickness and purging. This prostration was not to he wondered at, for she had been purged or sick, or both at once, six or seven times an hour, day and night, for quite four days. So convinced, in fact, was the patient that her death was imminent, that she had expressed her last wishes to her husband respecting their children and other matters.

She was evidently under the influence of the opium, for she had little or no pain, although the vomiting and purging continued as badly as ever. She was also almost worn-out by want of sleep, for the so frequent retching and diarrhoea quite prevented her obtaining any. I forget the exact treatment pursued, but I know that I prescribed hot fomentations to the abdomen, and exhibited alternately, respectively, drop and half-drop doses of the strong tinctures of Nux vomica and Ipecacuanha, at short intervals; also that I substituted on the following day the Veratrum album for the Ipecacuanha, 

Two or three days later, I had the satisfaction of finding the vomiting arrested, and the purging much diminished; at the end of the week the latter also ceased. In fact, the patient was cured.  I think the patient was fortunate to escape with her life.

Mrs A. made a good recovery, with the aid of appropriate medicines and a liberal diet. I am glad to be able to add (1873), that this nearly fatal experience of the danger of purging, has quite weaned her from the use of pills. I prescribed subsequently what I considered to be a suitable regimen for her case, and, at the request of her husband, gave him a prescription, for her use whenever the bowels were more confined than usual. She has had no bad attack of colic since; she had, however, a threatening of one, about six months after her illness, for which Mr A. consulted me at once. I then learned, that though her bowels still were constipated, yet they were much less so than formerly, when she was " taking pills;" also, that she continued to follow closely all my instructions as to diet, etc.

What has been usually the course pursued in cases of chronic constipation ? The patient has taken in the first place, for a slight costiveness, some magnesia or rhubarb; he has then become accustomed to the drug's action—that is to say, its secondary action was exerted, so that his bowels were more constipated than before. The patient has then been obliged, to procure an action of the bowels, to employ a somewhat more active drug. And so the patient has gone on, until at length the strongest purgatives have failed to produce the required action of the bowels. Thus, what at first was merely a slight costiveness, of but little moment, became at last a disease of the rectum,* characterized by obstinate constipation. 

* For atony of the rectum is truly a disease.