A woman aged fifty years has had constipated bowels for a long time, now for two weeks she has had haemorrhoids, as is usually the case during the menstrual period. They are now present about midway between periodical visitations.
Her symptoms are:
1. Constipation; difficult passing of motion.
2. External haemorrhoids from exertion after stools.
3. Biting, stinging sensation as if the rectal membrane were torn.
5. After stool all the nerves of the pelvis seem in a high degree of tension, and the flesh of the perineum feels as if it has been torn from the bones.
6. Aching from the lumbar region down the thighs.
7. Sleepless before midnight.
8. Peevish disposition.
9. Melancholy; over troubles about family affairs.
What would you prescribe for her and how did you arrive at the remedy?