The Project Gutenberg eBook, Intestinal Ills, by Alcinous Burton Jamison This eBook is for the use of anyone anywhere at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this eBook or online at www.gutenberg.org Title: Intestinal Ills Chronic Constipation, Indigestion, Autogenetic Poisons, Diarrhea, Piles, Etc. Also Auto-Infection, Auto- Intoxication, Anemia, Emaciation, Etc. Due to Proctitis and Colitis Author: Alcinous Burton Jamison Release Date: August 19, 2008 [eBook #26365] Language: English Character set encoding: ISO-8859-1 ***START OF THE PROJECT GUTENBERG EBOOK INTESTINAL ILLS*** E-text prepared by Juliet Sutherland and the Project Gutenberg Online Distributed Proofreading Team (http://www.pgdp.net) Fancy title page INTESTINAL ILLS CHRONIC CONSTIPATION INDIGESTION AUTOGENETIC POISONS DIARRHEA, PILES, ETC. ALSO AUTO-INFECTION, AUTO-INTOXICATION, ANEMIA, EMACIATION, ETC. DUE TO PROCTITIS AND COLITIS PUBLISHED BY CHAS. A. TYRRELL, M.D. 134 WEST 65TH STREET, NEW YORK CITY 1915 COPYRIGHT, 1901 by ALCINOUS B. JAMISON, M.D. 43 W. 45TH STREET, NEW YORK U. S. A. TO THE UNFORTUNATE SUFFERER FROM ILLS DESCRIBED IN THIS VOLUME AND TO THOSE WHOM I HAVE HAD THE PLEASURE OF CURING THIS BOOK IS RESPECTFULLY DEDICATED BEAUTY'S FALL. It was an image good to see, With spirits high and full of glee, And robust health endowed; Its face was loveliness untold, Its lines were cast in beauty's mold; At its own shrine it bowed. With perfect form in each respect, It proudly stood with head erect And skin surpassing fair; Surveyed itself from foot to head, And then complacently it said: "Naught can with me compare." When lo the face began to pale, The body looked too thin and frail, The cheek had lost its glow; The tongue a tale of woe did tell, With nerves impaired its spirits fell; The fire of life burned low. In the intestinal canal Waste matter lay, and sad to tell, Was left from day to day; And while it was neglected there It undermined that structure fair, And caused it to decay. The doctor's words I would recall Who said: "Neglect precedes a fall," And verily 'tis true; For ye who disregard your health, And value not that precious wealth, Will surely live to rue. PREFACE. The following chapters were contributions to Health—a monthly magazine published in New York City. Certain peculiarities of form and considerable repetition of statement—both of which the reader cannot fail to notice—are owing to the fact that about two-thirds of the chapters were written under the caption "Auto- genetic Poisons in the Intestinal Canal and their Auto-infection." In revising these contributions for book form I have given to each chapter a caption of its leading thought; but I am convinced that repetition of some of the matters treated, especially if the repetition be in a somewhat different connection, is not such a very bad thing. I have used my blue pencil sparingly, and as a consequence the consecutive reader will find that constipation, diarrhea, biliousness, indigestion, auto-infection and proctitis are treated in nearly all the chapters—but with varying applications. Therefore anyone suffering from one of these complaints would better read the whole book instead of only the chapter with the corresponding title. These pages were written for intelligent laymen by a specialist, during a busy, assiduous practice. I take such radical ground, however, going to the very root of the matter, that the general practitioner will do well to give my thesis his careful consideration; he should at least glance at the following Introduction for the gist of my claim. CONTENTS. PAGE CHAPTER I. Man, Composed almost wholly of Water, is Constipated. Why? 1 CHAPTER II. The Physics of Digestion and Egestion 12 CHAPTER III. The Interdependence of Anus, Rectum, Sigmoid Flexure and Colon 24 CHAPTER IV. Indigestion, Intestinal Gas and Other Matters 29 CHAPTER V. Key to Auto-Infection 36 CHAPTER VI. How Auto-Infection Affects the Gastric Digestion, and Vice Versa 46 CHAPTER VII. How Auto-Infection Affects Intestinal Digestion, and Vice Versa 56 CHAPTER VIII. The Cause of Constipation and how we ignorantly Treat it 64 CHAPTER IX. Cures for Constipation: "Fearfully and Wonderfully Made" 71 CHAPTER X. Biliousness and Bilious Attacks 78 CHAPTER XI. King Liver and Bile-Bouncers 83 CHAPTER XII. Semi-Constipation and Its Dangers 89 CHAPTER XIII. The Etiology of the Most Common Form Of Diarrhea, i.e., Excessive Intestinal Peristalsis 98 CHAPTER XIV. Ballooning of the Rectum 107 CHAPTER XV. Ballooning of the Rectum—continued 117 CHAPTER XVI. The Usual Diagnosis and Treatment of Bowel Troubles Wrong 126 CHAPTER XVII. Costiveness 132 CHAPTER XVIII. Inflammation 137 CHAPTER XIX. Proctitis and Piles 148 CHAPTER XX. Pruritus or Itching of the Anus 156 CHAPTER XXI. Abscess and Fistula 164 CHAPTER XXII. The Origin and Use of the Enema 173 CHAPTER XXIII. How often should an Enema be Taken? 180 CHAPTER XXIV. Man's Best Friend 190 CHAPTER XXV. Physiological Irrigation 191 CHAPTER XXVI. Proper Treatment for Diseases of Anus and Rectum Essential 202 CHAPTER XXVII. The Body's Book-keeping 215 CHAPTER XXVIII. Selection and Preparation of Food 220 CHAPTER XXIX. Diet for Indigestion 227 CHAPTER XXX. Diet for Constipation and Obstipation 231 CHAPTER XXXI. Costiveness, Diet, etc. 235 CHAPTER XXXII. Diet for Diarrhea 237 A Final Word 240 NO. 1. Chronic Constipation and the Use of the Enema 245 NO. 2. Objections to the Use of Enema Answered 257 INTRODUCTION. The keynote of this book is Proctitis, inflammation of the anal and rectal canals. Hardly a civilized man escapes proctitis from the day of the diaper to that of death. The diaper is in truth chiefly responsible for proctitis, and proctitis is in turn chiefly responsible for chronic constipation, chronic diarrhea, auto-infection; and hence for mal-assimilation, mal-nutrition, anemia; and for a thousand and one reflex functional derangements of the system as well. The inflamed surface of the intestinal canal (proctitis) inhibits the passage of feces. Absorbent glands begin to act on the retained sewage, and the whole system becomes more or less infected with poisonous bacteria. Various organs (especially the feeblest) endeavor to perform vicarious defecation, and the patient, the friends, and even the physician are deceived by such vicarious performance into thinking and treating it as a local ailment. I cannot, accordingly, insist too emphatically that proctitis, the exciting cause, must be treated primarily if we would cure chronic constipation. Millions of human beings are sent to untimely graves by these ailments. Indeed, the body of nearly every human being is a pest-house of absorbed poison instead of being the worthy temple of a wondrous soul. All due to Proctitis! INTESTINAL ILLS CHAPTER I. MAN, COMPOSED ALMOST WHOLLY OF WATER, IS CONSTIPATED. WHY? Naturally the mind of man was first educated to observe external objects and forces in their effects upon himself, and the external still continues to engross his attention as if he were a child in a kindergarten. Fascinated by the Without, he ignores the Within. But, marvel of marvels, Disease (which when looked at with discerning eyes is seen to be an angel in disguise) comes to enlighten him concerning the world within. Disease gradually acquaints him with the fact that there are within him organs and functions corresponding to the objects and forces in the world without,—servitors in fact which must not be ignored under penalty of transforming them into foes to his well-being. Disease makes him aware that by ignoring the claims of his inner relations he has been converting his very food, juices and gases into insidious and formidable poisons, which perforce he absorbs into his blood and tissues and circulates throughout his entire system. Thus does the disguised angel admonish the ignorant that the rights of the inner world must not be ignored—that one's duties thereto cannot be neglected without disastrous consequences. Thus does Pathology, which is really Physiology reversed, become the self-revealer par excellence. Through digestion and assimilation the physiological process takes up the food, juices and gases, to support and augment the life of man. The pathological process, on the contrary, because the conditions for nutrition are ignored, reverses the upbuilding processes; and the organs of life wither, waste and weaken, until life goes out like fire unfed. Man has been slowly learning to take sanitary measures in reference to everything that contributes to comfort in his surroundings, and hygienic measures in reference to everything conducive to stability in his health. Through ages he has learned, by experience and experiment, of the changes that inevitably occur in such perishable nutritive substances as water, milk, meats, vegetables, fruits, etc., if they be left uncared for; and he has been led thus to the inference of the law of decomposition—or putrefactive and fermentative changes. Idle substances, like idle minds, have decomposition and the devil for companions. Substances confined in containers open to the air—ponds, cesspools, etc.—are every-day object lessons to man of the fact that the chemical changes they undergo furnish the conditions for breeding bacterial poisons, and that these poisons are a dread menace to animal life. If the reader will observe the analogy between the decomposition of substances in vessels or pools, and the decomposition of food in the reservoir called the stomach; and its further decomposition in a long canal (the small intestine), connecting the stomach with other receptacles called the colon and sigmoid flexure; and then the decomposition of their contents; he will readily comprehend the chemical putrefactive or fermentative changes or bacterial action that take place in the organism, if for any reason the contents be confined. Of the four chief elements that enter into the composition of living bodies three are gaseous, or convertible into gas. In the physical man water constitutes three-fourths of the weight of the body. This being so we realize why, notwithstanding our sense of solidity and weight, chemical changes occur quite as readily in our organism as in the substances we see about us. There are no waterproof walls in the body of man to impede the percolation of liquids freighted with promiscuous Passengers from the alimentary canal; Passengers designed to nourish the organs for which they have an affinity. But there are those that have no organic affinity, and these are tramps, vagabonds, and even murderers, disturbing and destroying the normal functions of the system. Through extravasation, that is, through fluid infiltration of tissues, these Passengers come to be one with us, and we make them part of our tissue; but some of the Passengers are the demolishers of the living temple. Water is universally present in all the tissues of the body, and it is indispensable for introducing new substances into the system and for eliminating the worn-out tissues and foreign substances. It is indeed important to emphasize the fact that properly to eliminate the foreign and waste products from the system requires, in a healthy person, at least five pints of water during twenty-four hours. The amount of gastric juice secreted in twenty-four hours is from six to fourteen pints; of pancreatic juice, one pint; of bile there are two to three pints, and of saliva one to three pints. It is estimated that the juices secreted during digestion in a man weighing 140 pounds amount to twenty-three pounds in twenty-four hours. These fluids are poured back and forth in the process of transforming food into flesh and eliminating waste material. In the alimentary canal there are vessels for holding fluid, semi-fluid and moist masses of substance, in all of which decomposition occurs if the substances be retained beyond the normal length of time. These vessels or reservoirs are the stomach, duodenum, small intestines, colon, sigmoid flexure, and too often the rectum. Through the harmonious action of this intestinal retinue of servitors man is well equipped and qualified for health, and he in whom this harmonious subservience prevails is among the blessed and elect of mankind. But alas! the great majority of human beings are sufferers from the inharmonious and insubordinate action of these servitors. How many a human being suffers from chronic constipation and indigestion, the exciting causes of which are insidious, and the consequences a protean enemy to his happiness! Medical writers on the subject of chronic constipation have assigned numerous causes, and likewise prescribed multitudinous remedies to the patient; but as a general rule this patient, after suffering various woes, if still surviving the many years of medication, rebels against taking further remedies and resigns himself to the chronic enemy on the best terms he can make with diet. For this large class of chronic sufferers we have good news; and for the class that have suffered five or ten years we have better news; and for the class of infants and children that have started on the road of ill-health we have real glad tidings. To know that there is only one chief cause for chronic constipation and its train of disorders, and that that cause overshadows all other causes combined, and is easily diagnosed and treated, is news long hoped and prayed for by a multitude of sufferers the world over. Twenty years as a specialist in diseases of the lower bowels have demonstrated to the writer that chronic inflammation, and often ulceration, of the rectum and sigmoid flexure, in ninety-nine cases out of a hundred, is the cause of chronic constipation and the long army of ills resulting from it. And yet, as the reader is well aware, constipation has had many "causes," since the days of Hippocrates, especially the abnormal condition of the liver. The etiology, that is, the exciting cause, of the inflammation of the anus, rectum, colon, etc., may date from the time a diaper was placed on the new-born infant. Excoriations of the integument about the anus by the excretions of bowels and bladder indicate that the mucous membrane of anus and rectum demands local remedies, as well as the integument of the buttocks, and that it is not the liver which is at fault. The many applications of the diaper during the period of its use, and the frequently delayed removal at night or during long rides in baby wagons, railway trains or carriages, and during long social visits of the nurse; constipating foods, lack of drinking water, constipating medicines, followed by all sorts of purgatives, etc., are among a few of the direct causes of diseases of the rectum. A child at the age of eighteen months with a healthy rectum is most rare. The ten thousand and one chances for contracting disease of the anus and rectum do not cease with the period of infancy. The child is left pretty much to shift for itself as to regularity of eating and the evacuation of the contents of its bowels, wherein disease has already obtained a foothold. All kinds of foodstuffs, at all hours, with seeds, stones, etc., are poked into its stomach, followed by constipating remedies to quiet inevitable troubles, or brisk purgatives given with the hope of expelling the arrested contents of the bowels. Is it any wonder that ninety-eight persons of adult age out of every hundred suffer more or less from chronic inflammation and ulceration of anus, rectum, sigmoid flexure, colon, or appendix? Traumatic (externally produced) injuries to the mucous membrane of the rectum frequently cause inflammation, and hard pieces of bone, wood, seeds, imbedded in the feces, scratch, cut and bruise the tissues before and during the act of defecation. Cold boards, stones, earth and other substances used as seats may produce inflammation of the rectum. There are many and various causes which may be the means of exciting inflammation of the anus and rectum later in life; but it is the writer's opinion that the cause can be traced back to infancy or early childhood, and that accidents or imprudence in after years merely excite an already-existing chronic inflammation. Piles, fissure, itching pockets, tabs, prolapse, abscesses, fistulæ, etc., are only the outcome and symptoms of a chronic disease which has incubated for fifteen, twenty or more years. None of this list of troubles produces constipation. It is the inflammation located at the middle portion of the rectum and extending into the sigmoid flexure that causes constipation; that protean monster which deranges more lives with nervousness than any other pathological condition to which the flesh of man is heir! CHAPTER II. THE PHYSICS OF DIGESTION AND EGESTION. A tree is simply an extension from its roots; and, in an analogous manner, man's body may be said to be an extension from the alimentary canal. Does it not follow, consequently, that the digestive apparatus, from a physiological point of view, is the most important organ of the human body? It must be prime and paramount because all other organs depend upon it: it provides them with nourishment for preservation and improvement, and it punishes them—if they do not mind the laws of normality—by withholding its gifts, or by presenting these gifts in the form of poisons that impoverish, hinder and degenerate the system of organs. Uncleanliness is surely one of the chief ways in which physiological thoughtlessness is exhibited, and due punishment will inevitably follow disobedience. Foodstuffs are prepared for assimilation in the alimentary laboratory through the process of normal fermentation. Is it not essential, therefore, that the connecting canals and receptacles be cleansed of the fermented debris that may remain unused and unexpelled, before more food be taken by the digestive apparatus? The all-important question is:—How soon and how well have the residuary part of the food (for some part will always be undigested or unassimilated), and the waste resulting from worn-out tissues of the various organs, been eliminated from the system? Wisdom declares that it is not so much what we eat, but what and how well we eliminate, that decides the issues of health and disease. Do the egesta pass out in the form of normal feces? Three times in twenty-four hours foodstuffs are taken, and as many times the bowels should be freed of accumulated excrement and gases. Does Nature have her way, or do neglect and bad habits rule the assimilative and eliminative functions of the bowels? The habit of storing feces for twenty-four hours ought to concur and keep pace with a habit of eating one meal in the same period. Household and laboratory receptacles in which fermentation has occurred are emptied and cleaned before fresh material is put into them. Is not the same precaution more essential with the receptacles for digestion and egestion? They constitute our chief physiological economy; they are precious household and laboratory utensils; exceedingly precious, as we can purchase no other set when these are worn and wasted beyond repair. What marvelous possessions, and how reckless most of us are with them! Neither love nor money will bring another "body"-house to us when this decays; when poisons or parasites infest it as the result of a pernicious diathesis, of debasing, destructive tendencies; in short, of unmindfulness! Too often criminal negligence or the lack of proper convenience has brought on the habit of using the intestinal canal as a storehouse for dried feces, and the glands and blood-vessels as reservoirs for the absorbed fluid poisons from the feces that have been stored and thus dried. This baneful habit is general throughout civilized communities. It is this habit that has made the words "constipation," "indigestion," "diarrhea," etc., familiar and household subjects of complaint. Medical writers agree that "constipation" is the most common malady that afflicts mankind; but they are also unanimous in preposterously attributing the cause to the abnormal action of the liver and the secondary symptoms of constipation. Chronic constipation is the result of proctitis and colitis. Proctitis, the inflammation of the rectal and anal canals, is the most common disease that afflicts the human creature from infancy to old age; and colitis is only the extension of proctitis to the colon. The scientific diagnosis of constipation predicates proctitis and sometimes colitis. It is declared that constipation is its primary symptom; and that diarrhea is one of its secondary symptoms, resulting from constipation. There is a legion of secondary symptoms of proctitis, all of which medical empiricism considers and denominates causes. As constipation is such an every-day complaint of almost everybody one meets, it will not tax our imagination unduly to conceive how it may be a frequent cause of diarrhea, which is only Nature's effort to get rid of its useless and excessive burden of retained feces and gases. Constipation, semi- constipation, and irregular action of the bowels, excessive fermentation, putrefaction, self-generated or auto- infection, are the factors to be considered. It is to be noted that in many cases diarrhea is simply an increased peristalsis of the bowels, often due to local and diffused irritation and often to inflammation of the mucous membrane (not infrequently with ulceration); all of these may be the outcome of fecal impaction. To make intelligible the physics of the digestive and egestive processes, we must understand the apparatus. One would naturally think that were the bends or curves of the large intestine undone, it would be found to be a long, straight, smooth canal or bore like a rubber tube. But such is not the case. The outer muscular longitudinal bands are much shorter than the musculo-areolo-mucous tube, an arrangement which brings about a transverse puckering of the gut and mucous membrane, thus forming valves, folds, sacs or pouches at short intervals along the canal. These transverse folds or valves inhibit the too hasty passage of the feces along the bowels by checking and retaining the egested product in the large recesses or pools between the folds; they thus serve as so many dams in the passage of feces toward elimination. This wise provision of Nature to moderate the steady motion of the feces as they proceed toward the sigmoid flexure or receptacle, to wait there till there is a proper stimulus for expulsion, is wofully abused by man. He is quite willing to take foodstuffs three or four times a day, to fill the long row of intestinal pools between the dams with feces and gases in all stages of decomposition, not dreaming of the danger from developing bacteria and their absorption into the system. Really he is inclined to eat at all times, yet begrudges a few minutes spent in a hurried effort to perform the act of defecation once in twenty-four hours. Some of us even have our minds absorbed in reading while awaiting an "automatic action" of the bowels. What a contrast between the gusto and time spent in taking foodstuffs and the indifference and indolence regarding the action of the bowels, unless indeed severe biliousness or diarrhea reminds us strongly of our sewer of waste products. An attack of acute or chronic diarrhea is the penalty some pay for long inattention to the demands nature makes for intestinal cleanliness three times in twenty-four hours. Constipated people, semi-constipated people, irregular people and twenty-four-hour people, are not healthy. They are constantly being poisoned by the abnormal products of indigestion and putrefaction resulting from fecal stagnation, which products enter the blood and circulate through every tissue of the body. All cases of proctitis are more or less accompanied by constipation and diarrhea. In all cases of chronic constipation I have found proctitis, and often colitis, and am forced to believe it is the most common and proximate cause of chronic constipation of the bowels. Constipation being a primary symptom, there must of necessity follow numerous secondary symptoms, of which diarrhea well marks the progress of septic infection. Some of the symptoms of infection are headache, megrim, vertigo, dyspepsia, foul tongue and mouth, back- aches, stiff neck, gnawing pain or numb feeling at the lower end of the spine, biliousness, bad odor from breath and skin, muddy complexion, cold hands and feet, jaundice, neurasthenia, loss of memory, drowsy feeling, pernicious anemia, emaciation, flabby obesity with pallor, capricious appetite, fits of great mental depression, palpitation of the heart, bloating of the stomach and bowels, disturbance of the kidneys, liver, lungs and mucous membrane in general, and especially chronic rhinitis and pharyngitis, which latter are among the first symptoms of imperfect alimentary excretion. As auto-intoxication (that condition of the system when it is continually poisoned, usually by one's own excretions) gains the mastery of the vital forces at any period of life, the mucous membranes are likely to be first affected by inflammation of catarrhal character; then the serous membranes of the body. Mal-assimilation, mal-nutrition, cell-atrophy, are symptoms of the giving way of the vital energies to the invasion of the filth and bacterial poisons absorbed from the intestinal canal. On the inner surface of the alimentary canal, from the stomach to the colon, there are, it is estimated, over 20,000,000 rootlets (called glands, lacteals, follicles, villi), which take up intestinal juices as roots of a plant take sap from the soil. These millions of rootlets give a velvety appearance to the alimentary canal, like a nap or downy surface. Intestinal rootlets of the small intestines, like vegetal rootlets, demand a certain amount of normal fluid and solid substance, free from noxious gas. It is the down or nap of fabrics, and not their body, that shows damage first. So it is with the frail structure of vegetal and animal life if not properly supplied with nourishment from day to day. There is probably in the vegetal bodies a continuous circulation of sap corresponding to the digestive circulating fluids of the alimentary canal. This circulation from the alimentary canal to the blood-vessels, and from the blood-vessels to the alimentary canal, involves a wonderful mechanism, facilitating the flow of several gallons daily from each to the other during the process of metamorphosis of food into flesh. You can thus see how inevitable it is that the functions of these millions of secreting and excreting rootlets will be disturbed by the clogging of the system with filth and bacterial poisons as a consequence of chronic constipation, biliousness and general foulness of the alimentary canal. Through such disturbance nutrition is diminished, cell-atrophy progresses, and emaciation becomes more marked. The progressive destruction of these rootlets, involving the pathological change indicated, will be manifest in one of its results, either costiveness or diarrhea. Often the power of properly digesting and absorbing the foodstuffs is so greatly diminished that the alimentary canal is about as useless as a soft rubber tube. Millions on millions of these glands, lacteals and follicles in the stomach and small intestines, are destroyed like the rootlets of a plant or tree in unwholesome soil. The active circulation of the digestive fluids ceases, and the sufferer is said to be costive or to have chronic diarrhea. Both symptoms are the outgrowth of many years of intestinal foulness, and indicate the degree and character of intestinal irritability and semi-starvation of the body, as a consequence of either the absorption of poisons or the excessive elimination of the vital substance of the body through diarrhea. CHAPTER III. THE INTER-DEPENDENCE OF ANUS, RECTUM, SIGMOID FLEXURE, AND COLON. Physiologically, or in a normal state, the rectum is not a receptacle for liquids and feces but a conduit during the act of defecation. Should, therefore, the feces have passed into the rectum and the desire to stool be not responded to—though the desire continue urgent—the feces will be returned to the sigmoid cavity by physiological action. When, however, the functions of the anus and rectum are disturbed by chronic inflammation, etc., the lower portion of the rectum becomes a more or less roomy pouch, a receptacle for feces and liquids; and instead of being physiologically empty it becomes pathologically distended, the result of spasmodic action or of more or less permanent stricture of the sphincter ani. See illustration in my book entitled How to Become Strong (page 14). The putrid fecal mass of solid and liquid contents accumulated in the artificial reservoir at the end of the intestinal sewer, is one of the most common and serious pathogenic (disease-producing) and pyogenic (pus- producing) sources, which, by auto-infection, afflict man from infancy to old age. Here—in the dilated and obstructed sewer—the ptomain and leucomain class of poisons, and many of the poisonous germs, led by the king of morbid disturbers, the bacillus coli communis, find another and last chance to be taken up by the absorbing cells of the mucous membrane and returned to the blood; with which they are carried to all parts of the body, clogging the glands, choking up the pores and obstructing the circulation, thereby causing congestion and inflammation of the various organs. The action of cathartics, laxatives, etc., fills the ano-rectal cavity with a watery solution of foul substances; this solution is readily absorbed into the circulation, aggravating the auto- intoxication (the established self-poisoned condition) already existing. Danger does not end with the absorption of bacterial poisons, as we have to reckon with the deleterious effects of the various intestinal gases, resulting, with rapid augmentation of volume, from the putrefactive changes in the imprisoned feculent matter. A sphincter ani permanently constricted or irritable owing to disease results in an abnormal receptacle just above the anal orifice (as shown in the illustration referred to); and a constricted and irritable rectum results in the impaction and dilatation of the sigmoid cavity, which is normally a receptacle, closed at its lower end by circular fibres separating it (the cavity) from the rectum and performing the function of a sphincter muscle. The rectal muscular fibres perform the office of a sphincter for the sigmoid cavity. The pathological changes that result in rectal impaction of feces usually extend to the sigmoid cavity. This cavity is 17½ inches in length, shaped in a double curve like an italic S. Civilized man should consider the disturbance to the functional action of body and brain, and the danger to health and longevity involved in the storage of effete and fetid matter. The disturbance and danger are enhanced when the tissues of the sigmoid flexure and the rectum are invaded by inflammation. A healthy action of the sigmoid receptacle depends on the rectum (a conduit six to eight inches in length); and as it is the universal verdict that disease of the rectum is one of the most common maladies that afflict the human race, it must inevitably follow that the feces will be abnormally stored in the sigmoid cavity, occasioning thereby habitual constipation which in turn brings on a host of functional disturbances throughout the system. The colon is a receptacle and a conduit some three feet in length (see ib. p. 13) and its action depends upon the ability of the sigmoid flexure to perform its function as a final normal receptacle; and this in turn upon the rectum, which depends on the sphincter ani. The colon does not appear to possess any digestive powers, though it is capable of absorbing substances. Its function is not only to receive and forward the trifling residue of food which escapes digestion and absorption, but chiefly to excrete, through its own minute glands, the waste of the system coming from the blood. The excretion from these glands of the colon into the colon, plus the effete portion of the food received by the colon from the small intestine, approximate in weight from four to six ounces in an adult person in twenty-four hours; and of this amount passed 75 per cent is water; so that were the excreta dried the solid matter thus evacuated would not be found to weigh more than one ounce, or one and a half ounces. CHAPTER IV. INDIGESTION, INTESTINAL GAS, AND OTHER MATTERS. We noted the fact that the "digestive secretions" in a man weighing 140 pounds amount to twenty-three pounds in twenty-four hours; now add to these the food and liquids taken in that period, and you will form some estimate of the work done in the human chemical laboratory in its normal and abnormal states. We noted further that substances confined too long in receptacles decompose and generate pathogenic poisons, that is, poisons productive of disease; and that the intestinal reservoirs are no exception to this law of putrefactive changes. How could we avoid drawing the inference, therefore, that disease-breeding germs, (generated in the organism and hence called "autogenetic"), and their auto-infection, i.e., absorption by the system, are an inevitable consequence of the undue retention and fermentation of the contents of these reservoirs: a consequence, in other words, of that intestinal uncleanliness commonly called biliousness, constipation, indigestion. By far the most common and immediate source of autogenetic (self-produced) poisons and their auto- infection, is some degree of chronic constipation and the deadening, smothering effects of constipation on digestion; an effect analogous to what takes place when we allow waste material or ashes to bank up against a fire, shutting off its draft. Does the fire then continue to digest the coal? Clog up the receptacle for ashes and the coal grows cold. Dam up the colon or sigmoid and digestion is disturbed, diminished and debased, as evidenced by the local and general discomfort, and later by the train of inevitable disorders. Indigestion is a household word. It has the widest range of all the diseases, because it forms a part of almost every other; and some diseases, such as chronic catarrh and pulmonary consumption, are in many cases produced by indigestion; which in turn had its source in chronic constipation caused by injury or inflammation of the lower bowel, as explained in our first chapter. Diminished nutrition, impoverished blood, and loss of weight of from ten to twenty-five pounds, are the signs that indicate the coming disaster to the sufferer from auto-intoxication: the thoroughly poisoned state of the system resulting from auto-infection. Vessels used by the dairyman and by those who furnish us with food products and liquids are kept scrupulously clean. Why? Because it is a question of loss of trade—of money. Should these vessels be used when foul from fermentation or putrefaction of their contents, Wealth would flee from the coffers of our purveyors, and the Boards of Health would, or rather should, take a hand in the matter. And these same purveyors, by the way, why do they care more for Wealth than for Health, their own and ours? But why are we all of us so neglectful of Inner cleanliness and so careful of Outer? The receptacles of the inner man reek with augean filth, and we cleanse them not. The immortal fountains of Health and Happiness are dammed, blasted and degraded by just this neglect of our imperative duty; the duty of furnishing full opportunity for the functions of replenishment and life, by keeping the sewer passages clear. Are a sour stomach and foul intestinal canal fit receptacles for food and liquids? When our receptacles are in this condition, why do we add more material for the generation of poisons of the ptomain and leucomain classes, and morbid gaseous elements? It has been demonstrated that during fermentation an apple will evolve a volume of gas six hundred times its own size. What folly then to add to the fermenting mass! Food taken under such conditions will produce results not hard to imagine. The gases that are commonly found in the stomach and small intestines are carbonic acid, nitrogen, oxygen and hydrogen; while, besides all these, sulphureted and carbureted hydrogen are found in the large intestine, causing in a normal state the necessary and useful distention of the alimentary canal. The writer has long regarded the abnormal production of gaseous substances in the intestinal canal from putrefactive changes as of itself not only a grave menace to health, but as a condition productive of morbific results of which we have still much to learn. The more or less constant and excessive distention of the whole or even of a part of the intestinal canal by gases is a serious condition, affecting as it does the various organs of the body, not only through the absorption of these gases into the general circulation but also through the reflex nervous reaction of these organs. It is astonishing what amount of mechanical force is exerted by the gases in the intestinal canal. They distend not only the muscular walls of the intestines and stomach but the strong abdominal walls as well, until the clothing worn has to be loosened for ease and comfort. This more or less extreme mechanical pressure may account for many cases of hernia, prolapse of the uterus, dislocation of various organs, disturbance of the circulation of the blood, and interference with the function of the nervous system, as indicated by its many protests in the way of aches and pains. Naval-constructor Hobson has lately demonstrated the dynamic power of gas confined in bags or receptacles in raising battleships; and it still remains for some physiologist or pathologist to demonstrate the morbid dynamic results of gases confined in the alimentary apparatus. The deleterious effect of the abnormal quantity of gases on all the organs of the body is imperfectly understood at present, but will be better apprehended when we are able to study more minutely the pathogenic poisons of the human system. It is known, however, that a stream of carbonic acid gas, or even of hydrogen, will paralyze a muscle against which it is directed. CHAPTER V. KEY TO AUTO-INFECTION. In a previous chapter we stated that the average quantity of fecal discharge daily, by an adult, is from four to six ounces, and that of this weight 75 per cent is water. We referred of course to the daily passage from the bowels alone, not including that from the bladder. Our studies have thus furnished us with the key wherewith to unlock the secret chambers of auto-infection. What is that key? It is the discovery that the system may possibly absorb as high as three-fourths of this feculent substance in the colon; that this absorption is made possible by an obstructed or sluggish intestinal canal where disease germs are propagated and lodged; that these germs, along with a certain amount of excrement, invade the tissues by absorption; and that we thus have the system constantly saturated with poisonous germs and filth, re-excreted, re-absorbed and re-secreted—no one knows how many times—by the various organs of the body. That the importance of intestinal cleanliness may be better appreciated, I will quote from the following authors on the subjects of excretion, absorption and circulation of the intestinal fluids. Dr. Murchison states that: "From what is now known of the diffusibility of fluids through animal membranes, it is impossible to conceive bile long in contact with the lining membrane of the gall-bladder, bile-ducts, and intestine, without a portion of it (including the dissolved pigment) passing into the blood. A circulation is constantly taking place between the fluid contents of the bowel and the blood, the existence of which, till within the last few years, was quite unknown, and which even now is too little heeded. It is now known, says Dr. Parker, that in varying degrees there is a constant transit of fluid from the blood into the alimentary canal, and as rapid absorption. The amount thus poured out and absorbed in twenty-four hours is almost incredible, and of itself constitutes a secondary or intermediate circulation never dreamt of by Harvey. The amount of gastric juice alone passing into the stomach in a day, and then re-absorbed, amounted in the case lately examined by Grunewald to nearly 23 imperial pints. If we put it at 12 pints we shall certainly be within the mark. The pancreas, according to Kröger, furnishes 12½ pints in twenty-four hours, while the salivary glands pour out at least 3 pints in the same time. The amount of the bile is probably over 2 pints. The amount given out by the intestinal mucous membrane cannot be guessed at, but must be enormous. Altogether the amount of fluid effused into the alimentary canal in twenty-four hours amounts to much more than the whole amount of blood in the body (which is 18 pounds in a man weighing 143 pounds); in other words, every portion of the blood may, and possibly does, pass several times into the alimentary canal in twenty-four hours. The effect of this continual out-pouring is supposed to be to aid metamorphosis; the same substance more or less changed seems to be thrown out and re-absorbed until it be adapted for the repair of tissues, or become effete." The reader will readily perceive how the system may become so charged that other organs of the body will vicariously attempt to play the part of a receptacle and conduit for the bowel, in order to excrete and eliminate ancient and offensive filth and bacterial poisons. The phenomenon of vicarious excretion may occur through the kidneys, lungs, skin, throat, nose, vagina, or uterus, thus keeping up chronic diseases and discharges that would not exist but for the chronic constipation or even for incomplete action of the bowels each day. Over- distention of the rectum, sigmoid and colon, due to the pressure of gases and the impaction of feces, results in inflammation, ulceration, stricture, appendicitis, abscess, strangulation, intussusception, and abnormal ballooning or roominess in certain portions of these intestines or conduits. This roominess, though it becomes filled with feces, and often with liquids, permits of sufficient space for even the daily passage of feces without dislodging the stored contents. The fact that there is a passage daily deceives both sufferer and medical adviser as to the source of the poisonous condition of the system, and masks the origin of such disorders as chronic inflammation and ulceration of the nose, throat, lungs, stomach, duodenum, colon, appendix vermiformis, uterus, bladder, kidneys and edema of the legs. But these evidences of auto-infection are generally preceded and accompanied by a general loss of vitality and weight, by anemia, by a lowering of the resisting power of the organism—all of which produce a fit soil for the various diseases to which flesh is heir. As soon as the system becomes saturated with bacteria and effete matter, auto-intoxication results, in which condition there is but little or no store of vitality for resistance, reaction and recuperation. Dr. Bright has recorded several instances of fecal accumulation in the colon mistaken for enlargement of the liver and for malignant tumors. In one of the cases there was jaundice which disappeared after free evacuation of the bowels. Frerichs also relates a case where enlargement from fecal accumulation was at first ascribed to a pregnant uterus, and subsequently, on the supervention of deep jaundice, to an enlarged liver, but in which purgatives dispelled the patient's anxiety about a diseased liver and at the same time her hopes for a child. Dr. N. Chapman, in his Clinical Lectures (p. 304), says: "The feces sometimes accumulate in distinct indurated scybala or in enormous masses, solid and compact. Taunton, a surgeon of London, has a preparation of the colon and rectum of more than twenty inches in circumference containing three gallons of feces, taken from a woman, whose abdomen was as much distended as in the maturity of pregnancy. By Lemazurier, another case is reported of a pregnant woman, who was constipated for two months, from whom, after death, thirteen and one-half pounds of solid feces were taken away, though a short time before between two and three pounds had been scraped out of the rectum. Cases are reported by Dr. Graves of Dublin, which he saw in women, where from the great distentions in certain directions of the abdomen, the one was considered to be owing to a prodigious hypertrophy of the liver, and the other of the ovary; in the latter of which he removed a bucket-full of feces in two days. Mr. Wilmot of London has recently given a case where a gallon of matter was lodged in the cæcum, and the intestines perforated by ulceration." Dr. Pavy, in his treatise on The Functions of Digestion (p. 232), writes: "The morbid conditions that constipation may occasion are of various kinds. Under an undue retention of fecal matters within the colon noxious products may be formed there, and act as irritants upon the mucous coat, setting up inflammation, followed by ulceration. It is to be here remarked that fecal matters are sometimes retained in the sacculi or pouches of the colon, and may give rise to the circumstances referred to, whilst a passage exists along the centre of the canal that shall permit a daily evacuation to occur. The dejections, even, may be loose in character, and still the same sequence of events ensue. From the irritating influence of preternaturally retained feces, colicky pains are, as a rule, induced, and the ultimate effects may be such as to lead to the production of fatal inflammation. "The effect of constipation upon the muscular coat of the bowel is, through distention to which it is subjected, to weaken or deteriorate its evacuating power. As the result of a great amount of distention, like as happens in the case of the urinary bladder, more or less complete paralysis is induced. From the prolonged retention of fecal matter accompanying constipation, excrementitious products that ought to be eliminated become absorbed and thereby contaminate the contents of the circulatory system. As the result of this contamination, the secretions become vitiated, and a general disturbance of the conditions of life is produced. The action of the liver becoming deranged, its eliminative office is imperfectly discharged, and thus sallowness of the face and a bilious-tinged conjunctiva are produced. A coated tongue, foul mouth, loss of appetite, and other dyspeptic manifestations, accompany the general disorder of the digestive organs that prevails. The accumulation existing in the colon leads to a sense of distention and uneasiness in the abdomen. The kidneys vicariously discharge products that ought to have been eliminated by the alimentary canal. In this manner the urine becomes preternaturally loaded. From the contaminated state of the blood the functions of animal life also become disturbed; and hence the lassitude, debility, headache, giddiness and dejected spirits, that form such frequent accompaniments of constipation.... A distended cæcum, colon, and rectum may also, by the pressure exerted upon the nerves and vessels of the lower extremities, be the cause of numbness, cramps, pains and edema of the legs. The edema occasioned by constipation, if not exclusively confined to one side, will in all probability be decidedly greater in one leg than in the other." Case (from Gaz. Méd. de Paris, July 20, 1839): A woman of fifty was troubled with habitual diarrhea and frequent calls to urinate, in which urine could be discharged only by drops. After six years of suffering and unsuccessful use of remedies, she was examined for the first time per anum, and an accumulation of fecal matter discovered, forming a mass the size of an infant's head. This was removed and found to weigh four pounds. She then got well. CHAPTER VI. HOW AUTO-INFECTION AFFECTS THE GASTRIC DIGESTION, AND VICE VERSA. Frederick the Great said that all culture comes through the stomach. This saying emphasizes pithily the dependence of psychology upon physiology. The stomach with the intestines is certainly the source from which every portion of the body receives its nourishment and most of its diseases. The physiological plus and minus processes leave their reflex on the mind. Prof. Ch. Bouchard, in his lectures on Auto-Intoxication (Oliver's trans., p. 14), says: "The organism in its normal, as in its pathological state, is a receptacle and a laboratory of poisons. Amongst these some are formed by the organism itself, others by microbes, which either are the guests, the normal inhabitants of the intestinal tube, or are parasites at second-hand, and disease producing." In the preceding chapters we have mentioned some of the most common cases of retention of excreta in the rectum, sigmoid cavity, colon, cecum, duodenum and stomach, and how the consequent foul conditions often resulted in diarrhea. Auto-infection impairs the functions of every organ in the body, by clogging the pores with poisons and filth. By the transfer of disease germs from one infected, that is, tainted, contaminated part of the body to parts that were free from infection, the kidneys, mucous membrane and skin receive these unnatural products, and their functions are disturbed thereby. The disturbanc...