Constipation.
Selected writings of John King:
At the time this paper was written, cathartics in drastic doses were in general use for the relief of constipation. With the introduction of resin of podophyllum and oleo-resin of iris and other agents peculiar to reform and early Eclectic practice, a new treatment of constipation was made possible. Professor King did not approve of the indiscriminate use of cathartics, and his views foreshadowed those now universally accepted by the profession at large. Note his conclusions in the paragraph preceding the last in this article. As stated in the paper, catharsis is not by any means desirable in this affection, but a gradual restoration of peristaltic activity is to be established, and this, he advised, to be accomplished with tinctures of agents, most of which were then new to medicine in general, but which are now quite generally employed for the very purposes and in the same manner as advised by Professor King.—Ed. Gleaner.
CONSTIPATION.—In commencing the treatment of constipation, we never administer a cathartic until we have faithfully but uselessly tried injections of cold water; though the cold water will almost invariably cause a motion of the bowels. After an evacuation has been obtained, we administer, in combination with saturated tincture of Nux Vomica, either one, or a mixture of two or more of the following articles, viz.: Saturated tinctures of Iris Versicolor, Podophyllum Peltatum, Convolvulus Panduratus, and Euphorbia Ipecacuanha. If one combination fails, or loses its action, another is generally most certain to succeed.
A favorite preparation is one ounce each of the saturated tinctures of Iris Vers. and Pod. Pelt., to which is added from three to six drams of a saturated tincture of Nux Vomica. The dose is ten drops on sugar three times a day. Some patients, however, will require fifteen or twenty drops, while in others three drops will suffice. This does not produce a purgative effect, nor is a catharsis by any means desirable in this affection, but by gradually restoring the peristaltic action to a healthy standard it causes one, but should never exceed two natural evacuations daily.
If, as is most generally the case, disease of the, liver, kidneys, or other organ attends, the proper treatment for such disease must be adopted, giving alteratives, tonics, etc., as required, which will not interfere with the means for the constipation. From this course I am most constantly successful in all diseases of a chronic character.
Previous to exhibiting this tincture, if the tongue is coated white, manifesting acidity of the stomach, the proper alkaline remedies must be given, particularly when the constipation, as is generally the case, is connected with some chronic affection. If, in addition to this white coat, there is a preternatural redness, of the tip and edges of the tongue, indicating internal irritation or inflammation, prussic acid in some form must be given; I prefer an infusion of peach leaves, wild cherry leaf or bark, etc., aided in extreme or obstinate cases by small doses, say two or three grains, of diaphoretic powders, every three hours. As, soon as this condition of things has abated, or become removed, I commence with the above tincture in doses of ten drops three times a day; its action will be manifested in from one to eight days, by which time we will be enabled to regulate properly the quantity of the dose, which must never in any case exceed twenty drops. When its influence is not apparent until after several days, an evacuation must be produced daily by cold water injections. If the tincture produces no effect after a trial of ten days, some other combination of the above tincture must be employed in the same doses, one of which is certain to succeed.
When the disease is cured and the costiveness removed, we must then ascertain its permanency by gradually increasing the daily intervals between its administration, giving them at first every other day, then every third, fourth, etc., until their use be entirely suspended.
The only restriction in diet is to avoid acid, indigestible, and fat or greasy food or drink, allowing, however, lean meat—the food to be thoroughly masticated, and the whole body and limbs to be regularly bathed once in every week with weak lye water, cold or warm, as suits the feelings of the patient.
I am perfectly satisfied that the regularly or irregularly continued administration of cathartics, in chronic disease, particularly when constipation is present, is highly pernicious and often prevents a cure; while on the other hand the omission of cathartics in acute diseases is an evil as much to be dreaded and avoided as their employment in chronic diseases.
It must not, however, be supposed from the above that cathartics are never useful in chronic cases, for I have at times found them invaluable, more particularly in the commencement of the treatment, when cold water injectments are of no avail, or, when for certain purposes or indications it is found necessary to evacuate the intestinal contents as speedily as possible. A gentle but constant effect or influence of medicine will cure more chronic cases than all the severe or harsh measures that have ever been recommended.—JOHN KING, M. D., Western Medical Reformer, 1846.
The Biographies of King, Howe, and Scudder, 1912, was written by Harvey Wickes Felter, M. D.
