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The Influence Of Unduly Frequent Use Of Purgatives On The Female Organism

( Originally Published 1923 )

IN Paris, in the Eighteenth Century, it was the custom of the "dames du monde," compelled to give careful consideration to the maintenance of their good complexions, to have a midwife come to their apartments daily and administer to them a "wholesome" enema. At the present time it would certainly be held rather too much trouble to have the clyster woman come everyday, and besides it would be unnecessary, since with the help of an ingeniously devised apparatus, the enterocleaner, any woman, sitting in a warm bath, can automatically wash out the entire bowel and free it of all stagnant fecal masses. When carried out by a practised hand, this is an entirely acceptable procedure, which, furthermore, is unattended with the disadvantages possessed by most purgatives, viz., that the bowel becomes sluggish thereafter. I have employed this procedure in several of my lady patients in Carlsbad, and observed very good results from it in every instance. It is thus possible for me to recommend a periodic cleaning out of the bowel by this method as a special "intestinal cure."

In young women and girls the procedure is, of course, indicated only where constipation is actually present, but in older women, from about forty years on, it would seem of advantage, especially if there is a tendency to constipation, to carry out the enterocure regularly every week or two. In my book on "Old Age Deferred" I have already emphasized the value of a thorough clearing out of the bowel at least once weekly in the prevention of premature ageing.

In general, however, one can get along without any artificial means of assistance by merely taking care to secure a daily bowel movement with the aid of an appropriate diet yielding plenty of residue material.

The diet in general plays a preŽminent part in regulation of the bowel function. A large allowance must be made in it for foods yielding much residue, such as coarse brown bread, graham bread, green vegetables with high cellulose content, fruit and preserves, and marmalade, the sugar content of which also exerts a favorable influence. As al-ready stated, fluids must likewise be taken in sufficient amount. The kinds of food just mentioned have the property, acting either in a direct, mechanical manner through their coarse consistency, or through the fermentative processes set up by them in the intestine, of producing stimulation of the bowel wall, which is followed, in turn, by contractions and expulsion of the intestinal contents.

There are some women, however, to whom such a diet is distasteful, or whose stomachs, as in many cases of nervousness, will not tolerate such a coarse diet; or again, who want quick results. These re-sort to purgatives. At first even the milder agents, such as rhubarb, magnesia, tamarind, etc., prove effective, but upon continued use their action in many instances becomes less marked, so that gradually drugs of increasing power have to be resorted to.

Even the enemas which many women administer to themselves lose their effect after a time, as the intestinal nerves and muscles relax in their activity, so that, just as in the case of a refractory horse, one is led to use the whip with increasing vigor, so in these cases drastic purgatives have fin-ally to be resorted to. Such agents, however, contain substances capable, especially if taken rather frequently, of exerting harmful effects on a number of different organs, including the stomach, bowel, liver, kidneys, and even the female reproductive organs.

Even chronic catarrh of the stomach and intestine may result. Thereupon the general state of nutrition of the body suffers, and with it the appearance of the skin surface, in which connection it should be pointed out that frequently only a portion of the intestinal contents is expelled, the remainder giving rise to processes of decomposition and fermentation. It is no wonder, then, if such ladies exhibit a muddy, dark yellowish complexion and find it necessary to remedy it by means of various toilet preparations.

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