W. Arbuthnot Lane

“ His views on this subject certainly did not meet with encouragement in the United States, partly, I suppose, because of religious or legal objections, and probably to a great extent from the ignorance of the public and even of our profession on the subject of intestinal stasis. I am inclined to think that when women know more about the physiology of life they may exert some influence on legislation. This is more likely to develop, in the first instance, in the United States, where both men and women hold broader views and are less tied by creeds and tradition than they are in the old world. ”

“ The several viscera are influenced by this tendency in a varying degree in proportion as they themselves vary in weight. For instance, the stomach and the large bowel are probably the most variable in weight, since a quantity of material collects in them and passes along at a comparatively slow rate. The more or less fluid nature of the contents of the large bowel assists in its accumulation at certain points, as, for example, in the cæcum and in the middle of the transverse colon, while in the stomach the pressure is exerted on its convexity. ”

“ The loss of fat in the face and neck produces an appearance of age, distress, and disappointment which is most pathetic, particularly in the young subject. The loss of muscularity is shown in a complete want of tone, the muscles being flaccid and in­elastic. In the case of the abdominal muscles this is particularly serious, since one important factor in controlling the position of the viscera is lost more or less completely. The individual is also unable to lead an active physical life because of the poor muscular development. ”

“ The squatting posture, so common among savage races, is never employed. Therefore with us, from an early hour in the morning till a late hour in the evening, or for at least 16 out of the 24 hours, the tendency to drop of the viscera exists, while during the night this tendency is more or less in abeyance, but in a degree below the normal of the savage. ”

“ An alcoholic woman may be cheerful under the influence of her drug, but in no circumstance does the toxæmia of intestinal stasis produce other than a depressing influence on the mind and on the body generally. ”

“ In consequence, an obstruction exists at the junction of the descending colon and sigmoid, and again in a more severe form at the end of the sigmoid. In consequence of the latter obstruction the loop becomes abnormally large and nature's efforts being only partially effective produce a condition which is infinitely worse than the normal loop, and a so-called volvulus results. The fixation of the sigmoid as a straight tube is unfortunately associated with a diminution in its calibre and in its muscularity, and irritation, abrasion, ulceration, and cancer of the mucous membrane result. ”

“ The English corset is disastrous in that it exerts a constrict­ing encircling pressure on the abdomen about the lower costal margin and exaggerates the tendency to downward displace­ment of the viscera. The straight-busked French corset is much less harmful, and if skilfully made and applied serves to exert a moderate pressure on the lower abdomen. The corset that is most efficient is one that, while exerting a firm and constant pressure in a backward and upward direction on the abdomen below the umbilicus, leaves the upper portion of the abdomen quite free. ”

“ In the former the viscera tend to displace upwards by their own weight, while in the latter they are forced upwards by the forcible apposition of the thighs. In our state of civilisation the recumbent posture is only assumed at night, and even then only partially, since the heavy buttocks and thighs sink deeply into the bed. ”

“ Nature deals with this modification of the normal mechanical relationship of the individual to its surroundings in precisely the same way as it deals with any specialised mechanical function, whether active or passive. ”

“ The patients usually suffer from abdominal symptoms, varying from a colicky pain due to obstruction at a flexure or at the sigmoid, or to a flatulent distension of the stomach or intestine due to decomposition produced by the delay in evacuation of the contents, or to the presence of a pancreatitis or of gall-stones. ”

“ They frequently suffer severely from headache, either continuously or at intervals, and they awake in the morning with a headache, feeling they have obtained no rest or advantage from their sleep, and that they are just as tired and exhausted as when they went to bed. The world seems always chill and gloomy to them, quite apart from the intestinal pain and discomfort which they so often experi­ence. ”

“ The erect posture affects men and women differently, for the reason that the abdomen of the woman is relatively much longer than that of the man, while the female thorax and pelvis differ materially from the male. ”

“ This habit of keeping the trunk erect from morning to night, whether the erect or sedentary attitude is assumed, is almost universal in the condition of civilisation which exists with us in the present day. It is necessitated by our habit of using chairs and by the fact that circumstances and surroundings do not lend themselves to our lying or squatting on the floor. ”

“ My friends have often said to me that they were sure patients would never submit to such a serious opera­tion as removal of the large bowel. They forget that to these sufferers life bas no attraction, and the risk of the operation at least affords them a chance of escaping from it. ”

“ When an attitude of activity is assumed on a single occasion certain tendencies to change exist. If this attitude is assumed habitually these tendencies to change become actualities, and the skeleton varies from the normal in proportion to the duration and severity of the attitude. ”

“ In the young subject they become hard and nobbly, and may be sore and painful at the menstrual periods. Later in life they develop a cystic change, which may be painless or may be associated with attacks of pain owing to the distension of one or more cysts. ”

“ Again, the fixation of attitudes of rest, such as lateral curvature, flat-foot, knock-knee, &c., has a similar damaging effect, both on the altered joints and on the body generally, and materially affects the length of life and the capacity of enjoyment of the individual. ”

“ The pull exerted by the heavy loaded cæcum upon such of the proximal portion of the appendix as is fixed by acquired adhesions to the abdo­minal wall produces a kinking of the appendix at the junction of the fixed and mobile portions. In consequence of this secretion tends to accumulate in the distal portion of the appendix and concretions form in it, or it may become more or less acutely inflamed, producing varying conditions of what is called appendicitis. ”

“ The pigmentation of the skin in these toxic people is a very marked feature. Like many of the symptoms which result from intestinal stasis, but in a greater degree, it varies with the colour of the hair. ”

“ The muscles are not only small and feeble, but become very soft and friable, so that they tear readily, and when sutured yield and afford no security to the ligature. The condition of the breasts is also a very important one. ”

“ The mental condition which is brought about by auto-intoxication is most distressing. While it renders the sub­jects miserable, and unable to concentrate their attention on work or pleasure or to control their tempers, it makes them most unpleasant companions. ”

“ Though the degenerative change commences in the upper and outer zones it may spread to the entire breast. It is very much more common in the virgin, and only arises in the married woman when intercourse is abstained from or is very irregular. ”

“ The pulse is very feeble and soft. While the trunk is fairly warm, a hand passed over the shoulder of a toxic patient comes very abruptly at the level of the insertion of the deltoid on a cold zone, and this coldness becomes more marked as the hand descends to the fingers. ”

“ Their resisting power to the entry of organisms is subnormal and the organism which most commonly effects a foothold is tubercle. The younger the subject the more readily does tubercle appear to be able to invade some tissue damaged by traumatism. ”

“ These patients depend more or less completely on their diaphragm for obtaining enough oxygen to carry on their mechanical relationship to their surroundings which becomes more and more modified as the condition progresses. ”