Chapter I.-Toxemia, the Efficient (First) Cause of All Disease
Chapter II.-Causes of Constipation
Chapter IV.-Constipation as Found in Various Derangements
Chapter V.-A Few Personalities
CONSTIPATION AS FOUND IN VARIOUS DERANGEMENTS
1--Constipation of the Neurotic
AN EXTREME type of nervous temperament, presenting mentalor physical symptoms described in previous chapters--under a drouthy state of body--andespecially given to worry, insomnia, and many hysterical symptoms. There may be heartdisturbance--endocarditis--and arterial hardening; giddiness, black specks beforethe eyes, and often great mental discomfort; such symptoms as belong to pronouncedenervation and toxemia. There is often much poverty of flesh, and little or no appetite,except for coffee and a roll, and almost no desire for water; in a small percentageof these cases, however, there may be a voracious appetite, with inability to digestmore than a small share of the food eaten.
Treatment: Patient must take the rest cure--must beput to bed and company proscribed. Such patients must be kept away from business,domestic and social life. They may be allowed to read a little--not enough, however,to fatigue. A short warm bath before retiring time every evening, or of a morning,if the evening bath causes nervousness; follow with enough towel rubbing to dry theskin; then the patient should be left alone for the night. Frequent gentle rubbingof the spine has a quieting effect.
Every morning a glass or two of warm or cold water. Coldwater may cause discomfort because of stomach neurosis. The water should be sippedslowly. A warm sponge bath may be given at bedtime; follow with dry rubbing withsoft towel or open hand. Fruit often disagrees; when it does, then for breakfasta few sips of gruel or teakettle tea. At noon combination salad and spinach. Forsupper, one or two Triscuits* or slices of whole-wheat bread toasted, eaten dry witha little butter, followed with a pint or more of teakettle tea. When better, rawfruit for breakfast, meat and salad at noon, and buttermilk for supper. Food mustbe limited, and patient kept in bed until nerve energy is restored; then secretionsand excretions will return. The constipation is due to enervation. (*See Appendix.)
Give of any foods only in amounts that can be taken withrelish. If there is no relish for any food, a fast must be taken of sufficient durationto permit a keen relish to come for any food, Positively no eating without enjoyment.When no food is eaten, three pints of water should be taken each day until freshfruit can be taken with a relish and comfort; then stop water drinking.
A small warm-water enema--one pint of water every night followingevery day passed without a bowel movement. If a high enema appears to be needed,it may be given once or twice a week until the bowels can be depended upon to movedaily. If the tongue is coated, and there is much discomfort, no food; hot stupesto abdomen and perfect quiet to full relief.
When patient is much better, he may get out of bed from tento three o'clock daily, and the food may be increased. Breakfast may be the same.Dinner: Every other day meat, and the alternate days starch, and with both dinnersvegetable puree or cooked vegetables and combination salad. A short sleep of a halfhour's duration after the noon meal should be established as a daily habit. Restand sleep are necessary to prevent a return of the nervous symptoms.
2--Constipation in the Neurasthenic
Those coming under this head are naturally introspective--inclinedto be self-centered, and to enlarge upon and exaggerate the importance of all theirdiscomforts. These subjects are known by all who have met them as semi-invalids;they have the disagreeable habit of talking to everyone they meet about themselves--abouttheir ills and the treatment. Doctors, with strong personalities, may uproot oneset of beliefs (cure one set of symptoms) by substituting another set; but to ridsuch a patient of all belief in disease--remove the sick habit entirely--is almostimpossible, and indeed it is an accomplishment vouchsafed only to high-class medicalartists--psychologists. The "bull in the china shop" variety of doctorsonly vandalize such sick people. If such invalids can be swept off their mental legsby an overwhelming interest in a profession, business, art, or social life, whilethe mental absorption is in full force, the sick habit may be forgotten, and theerstwhile constipation will be forgotten--cured--also. It takes a wise doctor todetermine just how much truth, or real excuse, there is for all the complaining ofthese psycho-pathogenetics,* and a still wiser one to lead them out of their delusions.(*Psycho-pathegenetics--mental builders of disease.)
Treatment: The treatment for this class of patientsmay be summed up in a few words, namely, treat them daily according to their moods,which may be different each day. Eating suggested for the neurotic may be usedin these cases.
The class of doctors who treat patients in keeping with whatthey (the patients) say concerning themselves are a dangerous class for neurasthenicsto employ, for heroic treatment applied to fanciful ills, or ills that are crisesscintillating from an unrecognized perverted nutrition or acidosis, must in timewreck the best constitution. If the doctor employed has surgical mania, the patientmay be induced to have several of his minor organs removed, etc.
The neurasthenic is very sensitive and possesed of a mercurialnature, and should be taught early in life not to take himself too seriously--notto take his sensations to heart--not to build too largely on any symptom; for, beingvery sensitive, introspective and self-centered, unless trained to think in otherlines, a sick habit will be built that will baffle the most skilled physician inhis efforts to cure.
When this class of patients concentrate their attention ontheir bowels, the central thought is that the bowels are hopelessly constipated.The neurasthenic is a pessimist; his ills are always to be, but never are, cured.It proves the truth of the saying: "As a man thinketh in his heart, so is he."This class of patients can be cured, but never by doctors who believe in diseaseas an entity.
These patients are not so set that they can not have theirminds changed. To illustrate: Suppose the whole force of the mind is set on constipation;then a thorough examination is made--the examination of course must always be impressive,scientific--and the physician must find a disease of greater importance than thesluggish state of the bowels; say a slow-forming tumor on the pleura, which in timemust exert so much pressure on the lungs as to develop a very harassing cough. Ifthe physician is forceful enough, he will cure his patient of constipation, but developa distressing cough that in time will wear the patient out, unless another psychologicalpathology can be exchanged for the cough. In the field of medical diagnosis justsuch swapping of one disease for another is of daily occurrence. An imaginative doctorand a neurasthenic patient have a monkey-and-parrot time of it. The parrot alwaysgets the worst of it, however.
Self-delusion is more or less a complication to be met within all sick people. Most sick people are easy marks, and are more or less victimsof the fools or knaves of the profession--they are easily humbugged. The professionis divided into three classes. One class deliberately and premeditatedly misleadthe patient; the second class are deluded by the sick and harm the patients by helpingthem to delude themselves; the third class are honest and endeavor to lead the peopleinto the light of truth about themselves and their diseases. The "code of ethics"is a social gulf fixed between laymen and the profession. When a professional mancrosses to the people he leaves hope behind.
The neurasthenic must be treated as each case demands, andas the changing moods of each case demand. The symptoms are to be treated as similarsymptoms are treated in other diseases. The mind must be controlled; the patientmust be led, never agreed with. Great tact is required.
3--Constipation of the Plethoric*
(*Plethoric, polyemic, too much blood--full-blooded.)
Too much blood comes from an omnivorous digestion--a digestionthat utilizes one hundred per cent of the food intake in those who overeat habitually.
Plethoric patients, pronouncedly catarrhal; gastro- intestinalcatarrh; thickened mucous membranes of throat and nose; more or less deafness; adenoidsand enlarged tonsils; giving a history of regular bowels; much over weight; subjectto many crises, such as headache, sore throat, toothache, spongy gums, pyorrhea,neuralgia, rheumatism, lumbago, heavy sleeping, and tired and uncomfortable on awakening;drowsy after eating; broad, thick tongue, heavily coated; rotten breath and odorfrom body; full pulse and an overworked heart and other symptoms; may be a littlesugar and albumen in the urine; dizzy, light-headed; and in advanced cases hyperemiaof the brain, pain in the back of the head, and, if not relieved, apoplexy, paralysisand death.
Constipation in this class of patients is more on the orderof an impaction; the bowels move daily, yet there is a fecal retention causing thegiving out of bad odors of breath, skin and the gas that passes from stomach andbowels. All secreting organs are eventually enervated from being worked overtime,elimination under the circumstances is always imperfect, and more or less decompositionis taking place in the bowels all the time, causing septic infection, setting upanemia, kidney and other derangements. To this class belong Bright's disease, diabetes,colitis, piles, apoplexy, asthma, tuberculosis, skin diseases, pyorrhea and otherdiseases. Many are carried off with pneumonia and other acute diseases. These arethe patients who are infested with germs and parasites, for they eat so much thatthey overtax their digestive secretions and lose the protecting power of these secretions.Resistance being lost, these are the "carriers" so-called--a class of peoplewho have no recourse when abused by medical superstition. They are also the classwho are infested with hook-worm, tape-worm, etc.
There may be collateral symptoms, such as fullness in head,inclination to giddiness, headache, backache, a tired feeling all the time, moremarked on getting up of a morning; feet and hands inclined to swell; eyelids puffof morning; the face is inclined to puff, grow turgid and purplish on lying down;sleep is more or less disturbed from difficult breathing, the cause being a turgidor congested state of the mucous membrane and submucous tissues of mouth, throat,and pharynx. The full tissues drop down into the throat and obstruct breathing. Thetoxin poison absorbed from the intestines in these subjects develops hard arteries,high blood- pressure, and tends to cerebral hemorrhage or apoplexy, kidney and hearttrouble, diseases of liver, gall-duct and gall-bladder, rheumatism and other derangements.These become, many of them, the victims of epidemics.
The treatment should be a continuous fast, enemasof salt water and lavage daily until elimination has rid the patient of all his malodors,which means getting rid of toxemia.
Enemas are highly necessary in these cases, and they shouldbe used until the bowels are thoroughly cleaned out. Stomach lavage daily until thetongue is clean and bad odors all gone. At the end of the first week or ten days,if the tongue and breath are bad, give a small dose of the laxative which I name"Three-In-One."* (*See Appendix.) Use one heaping teaspoonful in a pintof quite warm water and pour into the stomach through the stomach tube after thelavage and before the tube is removed. The laxative is to be used daily unless morethan one bowel movement is secured each day, then cut the "Three-In-One"to one-half teaspoonful, but continue the same amount of water. As the patient improvesand the bowels are moving daily, the "Three-In-One" may be reduced to one-fourthheaping teaspoonful in the same amount of water. When the laxative is no longer necessary,the pint of water, either quite warm or cold, should be used as a daily habit. Thislaxative is all that is left of my original drug armamentum. Bran, agaragar, enemas,and oils have proved a vanity and a vexation of spirit. The use of them is alwaysfollowed with constipation. Even "Three-In-One" will fail if patient returnsto old habits of eating and stimulating. A hot bath daily, followed with cold spongeor spray, and then a coarse towel rubbing. Is it necessary to say that tobacco andalcoholics must not be used? Indeed, this treatment, to make life safe, makesthe giving up of all stimulants very easy for those who wish to get rid of theirhabits.
Food will not be given until the patient is comfortable,seldom before the end of the third week, and even a longer fast may be necessary.When symptoms indicate that food may be given, feeding will start with fresh uncookedfruit three times a day, and water-drinking is to be stopped; after three days onfruit continue fruit for breakfast; salad at noon; buttermilk at night. If all isgoing well at the beginning of the second week, salad and spinach for dinner; everyother day add meat; on alternate days baked potato, corn bread, or any coarse breadmay be eaten with succulent vegetables and a salad. Spinach or onions should be oneof the cooked vegetables at each dinner because of their laxative properties. Ifthe bowels fail to move daily, prunes may be added to the fresh fruit meals; andif the bowels persist in being sluggish, every evening the small salt enema is tobe used.
When all signs of plethory and toxemia are gone, and thereis a lack of vim, and a tendency for too much loss of weight, a starch may be addedto the buttermilk for supper-two ounces of toasted bread and butter; or any of thebreakfast foods; occasionally, once or twice a month, thoroughly cooked beans orpeas. Always observe rule No. 1,* if digestive trouble-constipation and toxemia-wouldbe avoided. (*See Appendix.)
4--Constipation in the Sedentary or Inactive
This is a condition brought about by sedentary habits. Thereis usually gas distention, causing discomfort--often pain under liver. Intra-abdominalpressure, due to gas distention and accumulated fat, brings on hernias, floatingkidneys, painful urination and irritable bladder and piles. Habitual gas distentionis accompanied by colitis and proctitis, causing tormina or great straining at stool,which forces prolapsus of the colon and rectum. Drugs--any of the laxative or aperientdrugs or mineral waters--figs, confectioner's wares, sugar or sweetened foods, andtoo much starch, aggravate and complicate. Prostatic enlargement is intensified andin time brings on retention of urine. Where there is a ptosic state of the pelvicorgans--falling or misplaced womb, ovaries, or tumors of womb and ovaries--all lendtheir influence in bringing on obstruction and constipation.
At the beginning of chronic constipation, ptosis is quitegeneral, and is more or less operative as one of the causes of constipation in allold or young adults who are inactive, and may be in children who are fed too muchsweets and are forced into enough inactivity to induce atony (lack of tone) of themuscular system.
The first cause of loss of tone or energy is inactivity,and anything practiced in daily life that uses up nerve energy adds to the loweredresistance. Lost resistance is another name for enervation. Enervation andinactivity lead to atony and lost functional power.
When the body is enervated there is a checking of all secretionsand excretions. This retention of excretory material poisons the system, producingtoxemia, which in turn further weakens organic functioning. The diathetic organs--theorgans hereditarily below the normal standard--give down first, and in our presentstate of civilization the bowels appear most vulnerable.
There is, undoubtedly, in those who are greatly troubledwith constipation a diathesis--a heredity--a tendency to take on constipation, becausewe see daily others subjected to the same influence and they do not develop it.
Eating too freely of fresh fruits, in conjunction with amixed rich diet, causes fermentation and diarrhea, followed by constipation. In theenervated this eating habit further weakens muscular action, and when the dieteticerrors are corrected for a time, the bowels are left obstinately constipated. Diarrheaand constipation are often found alternating.
Observant people have noticed that when their bowels havebeen overstimulated to move even to diarrhea, by imprudent eating or drugs, or bylaxative foods, a period of atony (inactivity) follows. If the subject is melancholic,hysterical, neurasthenic, anemic, or building arteriosclerosis, an imprudent physicianmay convert a moderate atonic constipation into an obstinate chronic type by urgingthe use of drugs or enemas.
After constipation is once established, then physical degenerationadvances very rapidly, and will continue unless drugs or enemas are used to forcedaily evacuation; but such relief is unsatisfactory, for the more forcing the moreobstinate the constipation will become.
This class of patients are usually quite catarrhal; theyfrequently develop asthma, hay fever and colitis. Simple catarrhal inflammation,marked by periodic diarrhea, is a forerunner of membranous inflammation; indeed,the catarrhal stage is the earlier or first stage of the membranous form. In thelatter stage, or chronic catarrh of the colon, the first symptom to draw the attentionof the patient to the disease of the bowels is the coating of hard fecal lumps (sybala)with a jelly-like substance. When this symptom appears there is usually gas distentionin lower bowels, flatulency of stomach and bowels, tired feeling or want of energy,fullness of head, dizziness, drowsiness, lack of attention, difficulty in concentration;when there is pain it is caused by gas distention or impaction. The hardened fecesare usually found at the flexures of the colon; they irritate and cause pain or colic;there are long strings of mucus, bands of mucus, sometimes mucus the shape of thelining membrane of the bowels, thrown off; the latter often causes the patient tothink the mucous membrane is sloughing off. When this stage is reached a spastic*state of the bowels is sometimes developed-there is a drawing or distorting of theshape of the bowels which obstructed the mechanism, which adds to constipation andcauses a state demanding surgical interference. (*Spastic, drawn out of place.) Certainlysuch cases are out of the physician's class; but no operation should be performedunless demanded by a malposition made permanent by organic change. Adhesions followingoperations do rarely occur, but when they do, surgery is the treatment necessary.
Treatment: It should be obvious to the discerningthat the most important measure to adopt in the treatment of constipation causedby inactivity--sedentary habits--is physical culture, and there is not a more loathedprescription, unless it is the restriction of food to the gluttonous, for atony ofthe muscular system leads to apathy--laziness--a loathing of activity.
The listless, apathetic patient dreads motion; when the muscularsystem is flabby, the mental corresponds, and the rule is that the will is paralyzed.These people will not exercise unless forced to do so; if left on honor to practicea given amount of exercise daily, their honor is weaker than their desire to rest.If they could be cured without an effort on their part, they would buy and pay wellfor health; they would not keep it, however, if to retain it required daily attentionin the line of dieting and exercise. There appears to be but one way to keep theapathetic patient from falling down into complete intestinal muscular paralysis,and that is to furnish enough amusement to stimulate activity. Women of this classare strong for the butterfly life. When there is amusement on hand--an opportunityto see the wheels go round--they can show great activities and can be as lively intaking exercise as those with the more active temperament; but as soon as the stimulant--theopportunity to have pleasure--is passed, they settle down into a state of lethargyand cannot be induced to take exercise even if the neglect causes them to have mostmiserable health. People of this temperament, when they have once brought on toxemiaand constipation, will be forever seeking health, and forever refusing to do whatis necessary to gain health. They want to find some one who can cure them in spiteof themselves. The constipation in colitis is made worse by carbohydrate foods; hence,besides exercise, these patients must be put on a very restricted diet. Bread, cerealsof all kinds, sweets of all kinds, must be interdicted, except a very limited amountof thoroughly toasted bread and sweet, fresh fruit. The sweet dried fruits eatenquite regularly cause indigestion and fill the bowels with gas.
Apples well ripened and sweet grapes are admirable in thewinter; most of the summer fruits, including melons, may be eaten in the summer.Fruit and teakettle tea for breakfast; two ounces of toasted white bread, eaten drywith a little butter, followed with a glass of buttermilk sipped slowly, followedwith two glasses of hot water, may be eaten at noon. For dinner in the evening, meat,non-starchy vegetables--those maturing above the ground--and a combination salad.If any change is made, the toast can be cut one-half and the milk and water doubledin quantity.
Enemas, two quarts of blood-warm water, may be used twicea week; and a small enema, one pint of warm water, every night when the large enemais not used. The small enema should be held fifteen to twenty minutes before tryingto have a movement. No drugs or food laxatives are to be used.
If exercise is taken every three hours faithfully, and theabove diet rigidly adhered to, a cure will follow.
It should be remembered that chronic colitis with constipationis not cured by conventional treatment; much malpractice is resorted to. This diseasecreates so many symptoms that patients are subjected to many operations which leavethem no better, if not worse. Social life must be given up and a business made ofgetting well.
A poised state of mind and body must be cultivated, or thebest treatment will fail.
5--Constipation in the Aged
The old and feeble cannot take exercise, for they fall intothe very bad habit of never bestirring themselves. There is an inexcusable, becausesilly and untrue, idea that old folks must be dignified and never move in any undignifiedmanner; which, literally interpreted, means they must move with dignity and gracebecoming people of their age. This sluggishness leads to such a state of lost muscularpower that helplessness follows, and everyone who happens to be near such a subject,recognizing the physical weakness, lends a hand to help. Everybody takes a hand insaving the old man or the old woman from making an effort; the result is that oldpeople get to looking for and expecting a lift from everybody, allowing their muscularsystem to die from inactivity--lack of use. The result is aging and premature death.No part of the body suffers more from physical neglect than the bowels, and constipationin the old is due to this cause, plus coffee and toast; hence there can not be anycure unless there is a retracing of steps--a going back and building power throughexercise. Massage and mechano-therapy may give a little relief, but the eternal fiatwas sent out at the beginning of time. Man must earn his digestion by work--to himthat hath courage to work for muscle, muscle shall be given, but to him who hathnot courage to work for power, even that which he hath will be taken from him. No,we never get so old but that we shall be punished by our sins of omission of work.
Those who are senseless (illogical) may say father and motherhave been so good that God will spare them for the good they have done. Yes, theirgod, the god of bad habits, will spare them; but the real God happens to have jurisdictionover the laws of daddy's and mamma's personal being, and He does not change His laws.When man became a living soul he became the builder of himself by a wise adjustmentof himself to the laws which are fixed and eternal. We answer to the laws of ourbeing, and God never interferes when one of His saints becomes constipated from inactivity.There is but one cure, and that is activity--get a hustle on ourselves.
Treatment: As old people will not exercise to restoretone, there is no help for them except to eat laxative foods and take the lighterforms of laxative drugs so long as they will act; then the stronger drugs and highenemas must be used until death. Of course, fruit cooked and raw, vegetables cookedand raw, are very necessary foods for old as well as young. Old people with kidney,bladder and urethral irritations should not eat root vegetables--only vegetablesthat grow above ground. At all ages those who are constipated and have excessiveor frequent urination, with discomfort in bladder or urethra, with dilated veinsat the mouth of the urethra caruncle, should not eat the root vegetables.
Old people who have fallen into a state of inactivity andhave enough ambition to make a reasonable effort to renew life will find obedienceto the law of their nature will be followed by a gradual amelioration of their discomfortsand a renewal of life and vigor.
Radical changes in the order of their living is not advisable.
If toast and coffee has been the breakfast, they should eathalf as much toast; changing white bread for whole-wheat, and, instead of softeningthe bread in the coffee, eat it dry. If chewing it is impossible, break a portionand gum and mouth it until liquefied, then swallow, then take another portion, treatingit the same way, and continue until the whole allowance is eaten; then sip the coffeeslowly; after the coffee, sip slowly a cup of equal parts of hot water and milk.Beginning the fourth day, eat the bread the same way, prepare the coffee the sameway, but before pouring the coffee place in the cup one tablespoonful of hot milkand water, then fill the cup with coffee, sip slowly, and follow with a cup of hotmilk and water. At the end of seven days use two tablespoonfuls of hot milk and waterbefore filling the cup with coffee.
In seven days more use three tablespoonfuls of hot milk andwater before filling the cup with coffee, sip slowly, then follow with the cup ofhot milk and water. Continue the reduction of coffee until the coffee is droppedand two cups of hot milk and water are being taken, after which take the half ofa good eating apple, reducing the bread one-half. If the apple can not be chewed,chop it fine, or grind it in a vegetable mill, and eat it slowly, sucking and tastingand mixing with saliva. Unless much saliva is taken with the apple, starch and milk,the patient will be troubled with gas.
One week after beginning the apple, stop the bread and eata whole apple before sipping the two cups of teakettle tea; continue for seven days,then begin a gradual increase in the water and milk until one quart is taken, precedingit each morning with an apple or some other fresh fruit.
The noon meal may be a dish of salad--a dinner plate full:lettuce, tomatoes and cucumbers in the summer; in winter, lettuce, tomatoes (cannedor fresh) and celery. Three-fourths of the salad should be lettuce. Dress with salt,oil and lemon juice. Every other day with the salad, meat--lamb, chicken, egg orcottage cheese--and one or two cooked nonstarchy vegetables, those maturing abovethe ground. The alternate days use starch in place of meat. See list of starches.
Evening meal, a glass of buttermilk, followed with a glassof hot water. When more buttermilk can be taken with a relish, it may be taken, alwaysfollowed with a like quantity of hot water.
No water is to be used between meals. if desired, a glassof hot or cold water may be taken on getting up of a morning.
These patients are usually quite stiff in the spine; theyshould exercise every three hours, using the first three movements exclusive of theothers, for one or two weeks, adding the others one by one, in the order named andas strength will permit.
The exercise must be started moderately and increased asstrength increases. Regularity and persistence will be rewarded with a gradual gain.
All laxative drugs and food must be quit. A small enema--ahalf or a whole pint of warm water--may be placed in the bowel with a fountain syringeevery night and held for fifteen or twenty minutes, then try to have a movement;if not successful, don't worry, but try it the next night and every night, excepton days when the bowels move.
Patience and persistence will surely be rewarded; rememberit took years to bring on this enervated state, and it takes time and perseveranceto overcome it. Fretting, worrying and impatience will certainly hold back recovery.To cure constipation means the restoring of lost energy, and it cannot be accomplishedquickly. Correct eating, and eating lightly, with the faithful carrying out of theexercise program, is the only way to cure. Enervating the bowels by the persistentuse of so-called remedies builds the very derangement which they are given to relieve.
6--Constipation of Infants
Babies from birth are often constipated; the common causeis overfeeding. Reducing the intake of food one-half, and the use of suppositoriesor other innocent nursery palliatives are often all that is necessary to bring aboutfull relief and cure, but where overfeeding is persisted in, all palliatives failin the course of time to relieve. Overfeeding, or whatever the cause, must be discoveredand removed.
Galactorrhea (excessive secretion of milk) is a common causeof overfeeding soon after the birth of a child. To relieve the discomfort of themother from the distention of the breasts, nurses and friends, and too often thedoctor, urge the mother to feed the child frequently; consequently a child that wouldsleep twenty-three and a half hours out of twenty-four is shaken up from ten to twelvetimes every twenty-four hours and made to nurse. The result is that the child iseducated into gluttony. "If God did not intend the child to be fed all it couldhold, why did He provide so much?" Consequently, when the babe is so full thatthe milk jostles out of its mouth every time it is moved, stupidity continues todeclare, as it always has: "All healthy children spit up their food; all healthychildren have colic for three months after birth; and all healthy children floodthemselves out of their beds at night from frequent urination (polyuria)."
Here we have the primary cause of about all infantile diseases.Children started in this way are in line for constipation and the sequential toxemia(infectious diseases).
The mother is advised to eat for two during pregnancy; andafter child-birth she is urged to gluttonize--inundate her body with fluid foods,table beverages, including light alcoholics, to cause her to give plenty of milk--todevelop galactorrhea (excessive secretion of milk); and if the fluid excess doesnot cause galactorrhea and constipation, it will develop polyuria (excessive urination)and constipation, which derangements are also, as stated above, developed in thechild.
The mother's excessive eating and drinking bring her to discomfort,and often to ill health, and, worst of all, may cause galactozemia (loss of milk).
When a child must be given artificial feeding after havinggluttonized on the mother's milk until constipated, and forced into polyuria, theprospects of evolving into health on artificial feeding are slim, and hopeless unlesscarefully taken care of and by wiser heads than have conducted the care of the childup to the forced change.
Treatment: To control galactorrhea of mother and herconstipation, she must stop drinking; positively no water at meal times nor betweenmeals; no table beverages of any kind. By controlling excessive lactation or urination,fluid distribution will be normalized and the diverted fluid secretion to the breastsor kidneys will be restored to the bowels and constipation overcome. While this changeis being brought about, which should not be expected to take place suddenly, simpleremedies for securing a daily evacuation must be used, namely, rectal dilators; halfpint water and teaspoonful of salt placed in rectum and held for half hour; quartof soapy water; if small enemas fail, use large ones of simply pure warm water. Coarsebread and butter, the bread well baked, may be eaten for breakfast with a few blackfigs or dry prunes, or baked apples without dressing. Tensing exercise of the entirebody for half hour before getting out of bed every morning, giving special attentionto the bowels; also brisk walks of a mile or more, twice daily. Cooked spinach andonions; raw spinach may be used in the combination salad.
Laxative mineral waters are not good, for they will be carriedout of the system through the lacteal glands, thereby making the baby sick; or ifthe kidneys are overactive the kidney route will be taken, leaving the bowels unaffected.
If the mother is quite stout--overweight--her eating shouldbe for breakfast: fresh uncooked fruit--whatever fruit is seasonable; if berry time,berries, a reasonable amount of sugar and milk half cream; baked apples with sugarand milk half cream. Dinner at noon may consist of meat, eggs or fish, a combinationsalad and two cooked, succulent, topground vegetables; fruit for dessert if desired.Evening meal, stale or toast bread and milkbutter very sparingly.
Those who are starch and sugar poisoned--those young motherswho are chocolate-candy poisoned--may complain that fruit distresses them; causesthem to bloat and feel uncomfortable. They should cut down the amount, but they shouldnot stop fruit eating. When mother and child are quite normal the mother may havefor supper: biscuit, butter and honey with fresh fruit every other day; the alternatedays, cereals dressed with salt and butter or milk half cream, no sugar. Occasionallya baked potato or corn bread, using not to exceed a cubic inch of butter for theentire day, half of which may be used at supper. Toasted bread inclines to constipate,hence well-baked bread is better than twicebaked bread; stale bread is best. Masticationis of more importance than the kind of bread!
If the milk secretion declines rapidly, the mother may begiven a glass of whole milk after her breakfast and supper are eaten (before leavingthe table, of course).
Correcting excessive milk secretion (galactorrhea) will usuallycorrect constipation in the mother.
CONSTIPATION A SIGN OF OVERFED BABIES
Children who are fed every two hours the first two monthsand every two or three hours, night and day, after that age must present symptomsof indigestion, such as more or less milk curds in stools, gas in stomach and bowels,constipation, restlessness, fretfulness, crying and sucking at hands or anythingthat touches the mouth; this latter symptom is mistaken for a sign of hunger, and,to add pain to misery, more nurse is given. Such signs, interpreted as hunger inchildren being fed every three hours, are reflex symptoms and should be interpretedas due to discomfort in stomach and bowels, and, instead of giving more food, nofood except fruit juice (orange in winter, and berries, or juice from a Tilden salad,in summer) every three hours or three times a day until comfortable; then returnthe child to the breast and feed not oftener than four times a day, and positivelyno feeding at night. Watch the stools and if white specks appear reduce the lengthof time the child nurses one-fourth or one-half, if necessary to secure perfect digestion.
How long should a child nurse? That must depend on the amountof labor required to get the milk. Some breasts require little drawing; the milkflows without eff ort on the baby's part. When the milk flows easily the child shouldbe held above the breast, causing it to take the milk against gravity. Ten minuteswill fill the babe to overflowing where the milk draws easily; six minutes at sucha breast will be long enough to give the baby sufficient; while there are other motherswho will have to allow their babies to nurse twelve to twenty minutes. The guidemust be curds in stools and constipation. Neither will be in evidence when the childis not overfed. But after constipation is brought on and the kidneys are forced todo vicarious work for the bowels, the feeding must stop for a day or two; then givethree or four to eight or twelve minute nursings three times a day. The mothers withthe easy flow should give three to four minutes for their babies to nurse; and theother mothers the time specified above. As the children improve, increase the timeuntil they are taking all they want three times a day.
If mothers or nurses would watch the babies and cut downthe intake of food instanter on the appearance of curds in stools or on theincrease in urination, constipation would not flourish as it now does among youngchildren.
7--Constipation in Children
Children should be educated into having a bowel movementevery morning before starting to school. It is the parents' duty to see to the educationof their children in a knowledge of laxative foods, and when to eat them, and theevils resulting from neglect of the bowels.
School boards should provide footstools where the vault seatsare too high. It is necessary for the thighs to press against the abdomen to givethe abdominal muscles support while bearing down to force expulsion of feces. Thisis required by grown-ups as well.
Treatment: When children become constipated theirdiet must be modified to meet requirements. The amount of starch must be reduced.They should not eat more than half their usual amount of bread, toast, cereals orbreakfast foods. They are to be fed more fruit: prunes, black figs, fresh pears,baked apples, fresh uncooked fruits. The child should eat all desired of the fruitsfor breakfast, followed with a cup or two of teakettle tea.
Cooked cereal, dressed with milk and salt, followed withteakettle tea for lunch. No cream or sugar.
For dinner, whole-wheat biscuit, or muffins, butter and alittle honey; follow with a glass of teakettle tea, sipping slowly. This dinner everyother day; the alternate dinners may be whole-wheat bread, corn bread or baked potatoesand butter with a combination salad; also succulent vegetables if desired.
When mucus is occasionally seen in the stools it indicatescolitis. Abdominal paincolic-is caused by gas distention, with soreness to touchon slight pressure. Stop food, use copious enemas until bowels are relieved of accumulation,and then feed as above directed, watching for symptoms of constipation. When thereis distention from gas with soreness or pain, give fruit juices only and relievethe gas distention by enemas. Don't allow a surgical maniac to remove the appendix.
Positively no eating between meals. Sweets, especially syrups,eaten with bread or other starch, tend to develop acidity and colic. Sugar on breakfastfoods leads to indigestion.
Children with constipation, frequent attacks of colic, ordiscomfort in stomach and bowels must be kept away from candy and sweets. Sweet potatoes,navy or butter beans, ginger bread, sugar on breakfast foods, and eating betweenmeals must be avoided. They should be allowed to stay from food long enough so thatthey can take with relish toasted whole-wheat bread and butter, and after eatingit dry, then sip with a spoon a glass or two of teakettle tea; this is for breakfast;for noon meal, bread, butter and fresh fruit; evening meal, a combination salad andtoasted bread, once a week baked potatoes and once or twice a week meat. Positivelynothing between meals, not even water. If bowels remain constipated after one weekof this style of feeding, then change breakfast to a bowl of well-cooked porridge,made from corn or oatmeal. Stir in the porridge one teaspoonful of flaxseed meal,dress with salt and butter, or milk half cream.
Where children are troubled with polyuria (passing greatquantities of urine) they must be fed dry foods and fresh fruit, and kept away frommilk and water.
Regular meal times, no eating between meals, eating the breaddry, no water drinking, will correct constipation in a short time. If meals are asdirected above there will be no thirst. Thirst comes from conventional eating--wrongfood combinations-and when the water-drinking habit is established, indigestion,catarrh and all children's diseases follow. Keep this in mind: all diseases of childhoodstart with gastro-intestinal catarrh, even diphtheria and smallpox.
8--Atonic and Spastic Constipation
The difference between atonic and spastic constipation maybe explained as follows:
Atonic Constipation is common; in fact, most constipationsare of this order. Sluggishness of the bowels may exist for some time without causingappearances of ill health; perhaps there may be a heavy head or headache, and a lackof energy, without the cause being known. Flatulency and gas distention may causesome discomfort; laxative foods and enemas are effective for relieving. In commonconstipation there is no excess of mucus; rectum is often full; the sigmoid flexureand the transverse colon are inclined to be full.
Treatment: Large enemas twice a day until bowels arecleared out, then small enemas every night. Stay in bed for two weeks or longer.Practice the tensing exercise every three hours, as long each time as possible; increasethe amount taken as fast as strength increases. When out of bed add walking and otherforms of exercise. Get busy, stay busy, and take the M. D. P. Recovery will be slow;but a cure will be speeded up by lots of exercise. Keep the mind and body poised.
Spastic Constipation: The spastic or distorted bowelis caused by drawing or spasm, and is not very common; when present, it may havea neurosis or lead-poisoning history; always gastro-intestinal catarrh, or pronouncedcolitis with ulceration. The leading symptoms are pain, and mucus in the stools.Pain may be slight or very severe. Some authorities declare that pain belongs tospastic constipation. My experience does not quite agree. Pain is always found incatarrh of any portion of the intestinal canal, and the reason for it is that starchis not well digested and requires so much time that fermentation takes place, causingdistention. Distention or inflation with gas is the cause of great discomfort. Wherethe gas is confined to a given locality by spasm or contraction, the pain is oftenvery great, driving the surgeon more anxious for fees than cures to remove the appendix,ovary, womb, gall-bladder, resect a part of the colon, or remove something, anything.No cure can follow, but that does not matter; the operation was skilfully and successfullyperformed. Such operations are on the order of daylight bank robberies, except thatthe intimidation is by a threat that the disease will kill, instead of a gun-play;the latter may be a little more honorable and without detrimental after-affects.
Drugs or anything to force a movement must be much more powerfulthan is common for atonic constipation and much more painful. Many place diagnosticsignificance in the shapes of fecal matter as expelled, which is said to be pencil-or ribbon-like. Certainly such shapes must be made by the outlet--the anus; for apeculiar shape formed above must be changed at the outlet. In palpating, the colonfeels hard, cord-like and about the size of the little finger, and sensitive. Themost pronounced symptom is long, stringy, membraneous stools.
Treatment: So far as curing this type of constipationis concerned, it depends on whether the patient will co-operate. It takes time andpatience. A stay in bed for months is necessary, with poise of mind and body. Reliefmay be given these patients by teaching them to eat within their digestive limitsof the stomach and upper bowels. Foods that require several hours to digest are passedon to the colon, where digestion has ceased because of disease, and decompositionis ever present. These are not diseases to be corrected by laxative foods and drugs.Enemas high or low when necessary are the only forcing measures that should everbe employed to secure an evacuation; all others increase the disease. Very rarelymineral-spring water enough to bring relief when the enemas fail; the water fromthe spring, not the concentrates.
Meat, eggs, fish and dairy products may be used, but neverin conjunction with starch. Starchy foods should not be eaten. Ripe fruit isalways admissible. Unripe fruit causes gas distention and pain. Gruel made of anyof the cereals and strained, removing bran, hull or rough particles, may be used,if pain does not follow; if pain follows, the starch is not digested and it shouldnot be given. Meat should not be swallowed in chunks. Lamb, chicken, fish or eggswith vegetable salad, dressed with sugar and salt, no oil, for dinner. Milk and water,fifty-fifty, for the other two meals.
Those with this form of constipation are made very miserableby eating foods rich in cellulose; indeed, this element in fruit and vegetables mustbe removed. In severe types of this disease cooked vegetables are not to be used.
Rough foods usually given to overcome ordinary constipationmake patients with colitis, especially the spastic type, most miserable.
For breakfast, a cup or two of gruel (when it can be takenwithout pain following), seasoned with salt and very little butter. It is to be takenhot and thin enough to sip slowly; or
one or two eggs beaten with strained orange or grapefruitjuice, enough to make a cup of the mixture; or two glasses of hot milk and water,equal parts. These foods are to be taken very slowly. In severe cases hot milk andwater up to one quart, twice a day; and for dinner, meat and salad. When much betterthe dinner may be lean meats broiled or cooked en casserole; a puree of tomato, spinach,celery, asparagus, or cabbage; -and a combination salad run through a vegetable millor cut very fine; and then the patient must masticate and insalivate well.
Suppers should be the same as breakfast. Milk and water isa safe meal.
Tensing exercise should be practiced daily as much as possible.
All very sick people should attend the Tilden Health Schoollong enough to be educated into knowing how to take proper care of themselves.
(Falling of the Stomach)
(Falling of the Intestines)
A gravitating of the stomach and bowels means the same asgravitation or falling down of the muscles of the arms, legs, abdomen, neck, jawor cheeks, and gives as much excuse for surgery as do the latter muscles of the surfaceof the body. Suppose a surgeon should propose surgery for relaxation--ptosis--ofthe biceps? Beauty doctors shorten the muscles at the sides of the face of lazy women.Expert surgeons operate on gluttonous men and women because their sagging stomachsand bowels refuse to carry the load placed upon them. Why? The bowels and musclesnamed have lost their tone from neglect of exercise, and to endeavor to restore themto their rightful position by surgical operation is idiotic faddism. Certainly toadvocate such a procedure shows ignorance of the fundamentals of physics.
The lost power may be shown in many ways. One of the commonestis gas distention with borborygmus (rumbling in bowels). When the lost tone is greatthe bowels may become greatly distended because they have lost power to force thegas down and out. This lost peristaltic (expulsive function) power favors accumulationof fecal matter and gas. In severe ballooning of the intestine I have seen patientsand doctors fooled into believing that pregnancy existed. Lost tone of stomach andbowels, due to neglect of exercise, is followed by slow digestion and a filling upof these organs with gas. The gas distention favors constipation; also, besides causingdiscomfort, pain, heart palpitation, nervousness, apprehension and discouragement,the gas distention, in those with much fat accumulation, causes intra-abdominal pressureand a dropping down of the pelvic organs--the reproductive organs--and bladder. Thisadds another cause of constipation by obstructing the rectum and furnishes operationsfor exploiting surgeons.
Ptosis of the sigmoid flexure of the colon, and prolapsusof the rectum, present the most obstinate forms of constipation. Indeed, the name"constipation" is a misnomer, for the inability to have a movement is dueto obstruction--a blocking of the passage by folding and dropping down of the mucousmembrane of the colon and rectum into the axes of the rectal strait, most effectuallyblocking the fecal passage.
The free circulation of the blood in the pelvic organs isinterfered with, causing passive engorgement; following which enlargement of thewomb and fibroid growth develop, which adds to the obstruction. Add to this formidablearray of symptoms colitis, proctitis, prolapsus of the rectum and piles, and we havea complicated state that taxes the most skilled physicians to overcome. Surgery curesby removing the offending organs--simple, isn't it? Add poverty to a symptomcomplexof this character and, without excellent good sense on the part of the patient, acure is hopeless. Of course charitable hospitals relieve these patients of theirappending organs, for God's sake, and incidentally give practice to ambitious surgeons,enabling them to become expert in alluring the elusive lucre from one checking accountto another, and in this way improve the circulation and keep the public's feet warm.
Treatment: Such cases require several months in bed,with faithful exercising every three hours every day, and a limited supply of food.
Exercise is positively necessary to help overcome thismost stubborn type of constipation, and in no other way can it be cured.
Exercise is a necessary auxiliary to the cure of all diseases,and certainly constipation is no exception to the rule. The best treatment must failunless perfect poise of mind and body can be secured. Impatience, irritability, fear,apprehension put such cases in the invalid class for life.
Self-control must be the first therapeutic measure instilled,without which the treatment starts with failure. Full self-control places nearlyevery incurable disease in the curable class. Self-control means the giving up ofevery bad habit, both mental and physical. This accomplished, nature has a clearfield; all the doctor can do is to help in removing obstruction, not organs, butbad habits of body and mind, giving hope and overcoming ignorance; and in this heis liable to be more of a vandal than a help if he fails to keep his eye on service.
Ptosis or falling down of the abdominal and pelvic organsis the cause of the diseases that furnish the surgeon with most of his operations.Constipation is first, last and all the time one symptom of ptosis; it is built byptosis and ptosis is built by it. When constipation is established, increase in toxemiafollows as surely as the night follows the day--as surely as effect follows cause--andwhen toxemic saturation is developed, the universal cause of all diseasesis established. Just what disease will develop depends on diathesis, habits and environmentalinfluences. Diathesis, like the tubercular or gouty, will cause those who have erredin living until their general health is broken down with toxemia to develop tuberculosisor rheumatism. Those with special organic diatheses will have their vulnerable organsbreak down and disease will be in keeping with the diathesis; for example, if thehereditary tendency is to cancer of the breast, womb, or stomach, this disease ofthese organs will develop. Habit and environment will hasten the development of diseasesto which inheritance predisposes, and where there is no predisposition, the organsthat receive the stress of bad habits will give down and in time develop organicdisease.
When so much disease and its accompanying discomfort andunhappiness are liable to follow neglect of exercise and right living, it certainlybehooves the healthy and those who are just entering the life of invalidism to getbusy and right all errors. It is no uncommon thing to see the food-poisoned draggingthemselves about, old and decrepit, yet not sixty years of age, many from thirtyto forty.
Exercise or physical culture cannot take the place of correctdiet, and vice versa; and the mental attitude is not to be neglected. It shouldnot be forgotten that optimism is as necessary as right living and exercise, forit is optimism that makes reform possible; the pessimist paralyzes his will for actingand getting benefit by autosuggestion. To him it is: "Oh, what's the use?"There is but one answer, namely, everything is purposeful and necessary, and is forour good if we learn from experience to adjust ourselves to nature's requirements.It is only when we disregard law and order that we pay with discomfort, and if wedisregard pain and refuse to be taught by it, then we pay with our lives.
When there is constipation, gas in bowels, and the accompanyingdiscomfort, and the X-ray doctor declares that there is ptosis, and the surgeon declaresthere is appendicitis or gall-bladder derangement, and consultants insist on takingout the appendix, and draining the gall-bladder or extirpating it, etc., etc., don'tdo it, but get busy as follows:
In all cases of ptosis the patient must be kept in bed withwarmth to feet, and taught the tensing exercises. The knee-shoulder position mustbe practiced often every day.
After the morning exercise, a warm sponge bath, followedwith dry towel rubbing; then back to bed, to be followed with exercise every threehours. Patients in full weight should fast for a week, and when the tongue is coated,a stomach lavage every morning for a week; a two-quart warm-water enema every nightfor a week and after the first week a pint salt-water enema may be used every nightuntil the bowels are regular. It should not be forgotten that as soon as enervationis overcome, secretions and excretions will be established, after which the bowelswill function. Every forcing measure used to move the bowels, even the larger enema,enervates and delays recovery. Sometimes, in nervous subjects who are more constipatedin their minds than in their bodies, a little forcing may be necessary for the psychologicaleffect. Those in full flesh should fast until well cleaned up.
Correct all constipating habits. All stimulants--tobacco,coffee, tea and overeating, as well as improper eating--must stop. Exercise mustbe practiced daily--often enough and long enough at a time to restore tone to theentire body.
Patients should be free from discomfort for two days, thengive orange juice three times a day. If the patient is heavy, overweight, he shouldfast for a week or two before beginning on the fruit. A daily enema should be useduntil food other than fruit is being eaten.
The first food besides fruit should be dry toast, followedwith a pint of teakettle tea, and given morning, noon and night; after the firstday a dish of prunes may be eaten with the breakfast; this eating is to be continuedfor two or three days, then for noon or night dinner give lamb or chicken stew, cookedspinach or onions, and one other succulent vegetable, and a Tilden salad. This meatdinner is to be used every other day, and after a week other meats, eggs, and fishmay be used.
The object in eating should be to keep as nearly normal aspossible; overeating leads to faulty elimination--constipation.
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