Defecation

“ Neglect to establish or continue a habit of daily regularity in defecation leads to the accumulation in the rectum of masses of feces. Resisting the desire to empty the bowel interrupts the necessary reflex acts, and finally the muscular excitability and response to the presence of feces are entirely wanting. The continued contact of fecal matter with the mucous membrane wears out its susceptibility; the over-distension of the rectum enfeebles the power of its muscular wall, as is the case when all hollow muscular organs—stomach, heart, bladder—are overstretched. ”

“ Various instances are given of the efficacy of human ordure in undoing the work of witches; it was to be applied alone or mixed with garlic or assafœtida.
Take a liver, cut in pieces, and secretly place in the urinal of the patient; if the patient unconsciously use the chamber for defecation he will recover— (“Sagen-Märchen, Volksaberglauben,” etc., Drs. Birlinger and Buck, p. 481.)
The method of curing fevers by imbedding clippings of the finger and toe nails of the patient in wax and affixing to another person’s door-post, is mentioned by Pliny (lib. xxxviii. c. 24) . ”

“ 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. ”

“ It is most common in persons of a nervous, irritable temperament, from the age of thirty to forty-five or fifty, and who are subject to similar attacks in other parts of the body, particularly the face, stomach, testicle, or mamma. It is characterised by paroxysms of pain, which is usually described as of a tearing, burning, or lancinating nature, situated at the extremity of the rectum, from which it frequently extends to the sacrum, the loins, pubes, and genito-urinary organs. Defecation is painful, and the urine is discharged in jets or drops, attended with a burning or scalding sensation. ”

“ As this mass passes into and through the colon, being propelled by regular peristaltic waves, it acquires odor from the development of a substance which is a final product of the putrefaction of albumen.1 Gradually the more fluid elements are absorbed, and in the descending colon a less fluid or semi-solid consistence of the feces is reached. A healthy digestion and assimilation, with active and regular contractile movements of the muscular walls of the small and large intestines, are essential to normal defecation. ”

“ 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. ”

“ 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. ”

“ The acute type has an abrupt onset; pain is felt in the lower part of the abdomen, and the motions, rarely exceeding thirty daily, are accompanied by much griping and straining. Blood and mucus are present in the motions, and occasionally greyish material, consisting of leucocytes, mucus, Charcot-Leyden crystals, amœbæ, and bacteria, sometimes with particles of tissue. Nausea and vomiting may occur. Digestion is usually deranged. The abdomen is sunken, the liver and spleen are normal, but tenderness is felt along the course of the large intestine. The urine may be diminished in quantity. ”

“ Indeed, what would authorize us to regard any subject as affected with yellow fever, who would not present the pain in the stomach, the redness of the tip of the tongue, the thirst, irritability of the stomach, and vomiting either of simple mucus, or black [Pg 56] matter? And, on the other hand, how many have died with these symptoms, who were not affected with all the others we have noticed, and, on dissection, have shown no mark of disease, except in the digestive apparatus? Finally, can pain in the head, affections of the kidneys, vomiting of bile, &c. ”

“ When the powers of the constitution are strong, a person affected with a putrid fever ought to be bled in the commencement, provided there be no crudities in the stomach. But when the powers are weak, or the age of the patient is an objection, you must not bleed. After the evacuation by bleeding, it will be proper to clear away the putrid matters by urine, the belly, and sweating. And, if they have spontaneously been determined towards the mouth of the stomach, they may be evacuated by emetics, but otherwise you must not produce an unnatural irritation. ”

“ 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 general symptoms are, frequent stools with severe colick, gripes, and tenesmus, or urgency to exonerate the intestines: these evacuations are slimy, generally with intermixture of blood, and fragments of feces concreted into hard globules, and unusually fetid. It is also accompanied with sickness at the stomach and pain, inappetency, vomiting, flatulence, restlessness, foul tongue, and more or less fever. When fatal, many are destroyed between the seventh and twentieth days; but when moderate, it may be protracted much longer. Relapses{275} are frequent on any irregularity or intemperance. ”

“ Modes of Conveying.—The nearer a person is to a patient the more likely one is to take or convey the disease. Clothing, bedding, etc., may retain the poison for months. Scales from the skin of a patient, dried secretions, the urine if inflammation of the kidneys (nephritis) exists, the discharges (feces) from the bowels, are all means of infection. The longer a person remains near the patient the more likely he is to convey the disease. Foods handled by those sick of the disease, or by those who may have been near patients may convey the disease. This is especially true of milk. ”

“ Emaciation, from internal suppuration in any organ, and resembling phthisis, forbids the waters of Wisbaden. The same may be said of cachectic habits, where the blood is broken down, and the solids wasted. Dropsy of the chest, abdomen, or skin will be prejudiced by these sources—and in short, all diseases connected with, or dependent on defect of vital energy; or, in other words, debility of constitution generally. Catarrhal affections of kidneys and bladder—fluor albus—severe [57] derangement of the digestive organs, (grand derangement des organs de la digestion) —chronic diarrhœa, &c. ”

“ But of all such cases, the most formidable were those which took place about the pubes and genital organs. Such was the nature of these cases when attended with sores, and proceeding from an external cause; but the same things occurred in fevers, before fevers, and after fevers. fevers. But those cases in which an abscess was formed, and turned to a suppuration, or a seasonable diarrhea or discharge of good urine took place, were relieved thereby: but those cases in which none of these symptoms occurred, but they disappeared without a crisis, proved fatal. ”

“ Symptoms. These are well defined. It is characterized in its earlier stages by pain in the stomach and bowels, especially in the umbilical region, nausea, vomiting, diarrhea; later, the purging is excessive, and the matter dejected resembles rice-water, and contains white, solid, curd-like matter. The patient loses strength, and sinks rapidly. The secretory organs fail to perform their functions normally, the skin is sometimes moist, but oftener cold and dry; but little if any bile is found in the excretions, and the urine voided is very scanty. ”

“ From the Accounts we have in Authors, of the Dissection of the Bodies of Persons who died of the Dysentery, it would appear; that there is no Part of the alimentary Canal which has not some time or other been found inflamed, or in a state of Suppuration or Gangrene; and the Liver, Spleen, and other Viscera, have likewise been found diseased, but the Rectum and Colon have almost in all been more or less affected. ”

“ In conclusion, the surgeon is directed to pay great attention to the state of the urine in diseases of the eyes.
Dysenteries, when they set in with fever, alvine discharges of a mixed character, or with inflammation of the liver, or of the hypochondrium, or of the stomach, such as are painful, with retention of the food and thirst, all these are bad; and the more of these symptoms there are, the greater the danger; and the fewer, the more hope is there of recovery. Children from five to ten years of age are the most apt to die of this complaint; the other ages less so. ”

“ Several years ago I had an experience with the appendix, from which I learned something about one of the commonest of human ailments, constipation, or sluggishness of the bowels. This is a cause of innumerable chronic ailments grouped under the head of auto-intoxication, or the poisoning of the body by the absorption into the system of the products of fermentation and decay in the bowels. The bowels should move freely two or three times every day, and the movements should be soft. ”

“ Upon vomiting of blood consumption, and a purging of pus upward; upon consumption a defluxion from the head; upon a defluxion diarrhoea; upon diarrhoea a stoppage of the purging upward; upon the stoppage of it death.
81. In the discharges by the bladder, the belly, and the flesh (the skin?) if the body has departed slightly from its natural condition, the disease is slight; if much, it is great; if very much, it is mortal.
82. Persons above forty years of age who are affected with frenzy, do not readily recover; the danger is less when the disease is cognate to the constitution and age. ”

“ These symptoms are usually preceded by the continued use of food of a cold and incrassating nature, repletion, indigestion, inactivity, and the like. When the attack proceeds from flatulence, there is rather a sense of distension. When it is from inflammation, there is a sense of heat in the part, and no inconsiderable fever, retention of the urine as well as of the fæces, pulsation in the belly, thirst, and troublesome heat, nausea, and vomitings, more especially of bile, which afford no relief. ”

“ The Treatment of Discharges from the Patient is the most important point in the management of infection. The stools should be received into a bed-pan containing a 5 per cent. solution of332 carbolic acid, a 3 per cent. solution of cresol or lysol, or a 5 per cent. solution of chloride of lime. Milk of lime (20 per cent. strength) is very reliable, when added like the preceding solutions in bulk equal to that of the stool to be disinfected. The urine and vomit, if any, should be treated in exactly the same way. The infection of enteric fever is often spread by undisinfected urine. ”

“ CASE IV. In Thasus, the wife of Philinus, having been delivered of a daughter, the discharge being natural, and other matters going on mildly, on the fourteenth day after delivery was seized with fever, attended with rigor; was pained at first in the cardiac region of the stomach and right hypochondrium; pain in the genital organs; lochial discharge ceased. Upon the application of a pessary all these symptoms were alleviated; pains of the head, neck, and loins remained; no sleep; extremities cold; thirst; bowels in a hot state; stools scanty; urine thin, and colorless at first. ”

“ Another species of ardent fever: belly loose, much thirst, tongue rough, dry, and saltish, retention of urine, insomnolency, extremities cold. In such a case, unless there be a flow of blood from the nose, or an abscess form about the neck, or pain in the limbs, or the patient expectorate thick sputa (these occur when the belly is constipated) , or pain of the hips, or lividity of the genital organs, there is no crisis; tension of the testicle is also a critical symptom. ”

“ The abnormal cavity, so difficult to empty properly owing to its depth and diseased outlet, is seldom free from gases, feces and liquids. Daily evacuations will not empty this cavity, nor will cathartics or diarrhea. A permanent cesspool of poisons is this, where all forms of poisonous germs are propagated, and infect the system by absorption. No use to take medicines for your poor blood, bad complexion and horrid feelings, as they will not cleanse the augean stable so long neglected. No use to journey to other localities for health so long as you carry so formidable a foe to health with you. ”