Intestinal Ills

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, fistul?, 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!

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.

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 17? 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.