Chapter 5 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 Kr?ger, furnishes 12? 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 c?cum, 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 c?cum, 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.