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
