Insecurity of rectum; rectum feels full of heavy fluid, which will fall out, and does, if he does not go to stool immediately. Diarrhea. Solid stool, passing (in large balls) away involuntarily and unnoticed. Great fullness and weight in whole abdomen, with feeling of weight in rectum and hæmorrhoids protruding like a bunch of grapes; > by cold water applied.
This remedy should be considered alongside of Podophyllum because it is one of the so-called cathartics. Although one is as decided a cathartic as the other the characteristics which guide to their choice are very different.
Both are apt to be worse during hot weather.
Both are apt to be worse in the morning.
Both are often well supplemented with Sulphur.
But now let us look at some of the more marked and peculiar symptoms of Aloe. Stools yellow, fæcal, bloody or transparent jelly-like mucus. Sometimes this jelly-like mucus (Kali bich.) comes in great masses, or “gobs,” and drops out of the rectum almost unnoticed. Again the stools are often passed involuntarily when expelling flatus or passing urine. There seems to be not only an actual weakness in the sphincter ani, but a distressing sense of weakness. The rectum feels as if full of heavy fluid which will fall out of escape from the patient, and in fact does so if he doesn’t “git there, Eli” This escape of stool with flatus in Aloe finds its counterpart in Oleander. No two remedies are more alike in this respect, though Muriatic acid is also similar. Again a very characteristic symptom in the Aloe diarrhœa is “Great rumbling in the abdomen just before stool,” and the feeling of weight in the rectum already mentioned is not always confined to the rectum, but is also felt through the whole pelvis and abdomen. Again, the rectum protrudes in Aloe like a bunch of grapes, and is relieved by the application of cold water. Muriatic acid is relieved by hot applications. Both of these remedies have blue hæmorrhoids; the Aloe itching intensely, while those of Muriatic acid are very sore and sensitive to touch, even of the bed clothes. In addition to the aggravations already mentioned, the diarrhea of Aloe is aggravated by walking or standing, after eating or drinking.
In dysentery there is violent tenesmus, heat in the rectum, prostration even to fainting and profuse clammy sweats. The weakness of the sphincter ani is also found in constipation. It is a curious symptom, and I would not believe it until I had seen it with my own eyes. “Solid stool passing involuntarily, passing away unnoticed.” I was called to treat a child five years of age suffering from birth with a most obstinate form of constipation. He had to be forced and held to the stool crying and screaming all the while being totally unable to pass any fæces even after an enema. After trying several remedies in vain, I asked the mother to turn the child over (he was in bed) to let me examine the anus and rectum. As she turned down the bed clothes to do so, a large chunk of solid fæces appeared in the bed. “There,” she said, “that is the way it is. Notwithstanding his inability to pass stool when he tries, we often find these things in the bed, and he does not know when they pass, nor do we.” I then gave a few doses of Aloe 200th and cured the whole trouble quickly and permanently.
Aloe like Podophyllum has also prolapsus uteri, and the feeling of heat, heaviness and fullness in the abdomen, pelvis and rectum guides to its selection. Like Podophyllum, also, its range of action is not wide, but positive, reliable and satisfactory.