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Good Health and Bad Medicine:
 Carsickness And Seasickness

 Constipation - Part 1

 Constipation - Part 2

 Spastic Constipation

 Colitis

 Piles

 'gas' And Bloating

 Alkalizers And Acidosis

 Indigestion

 Diet - Part 1

 Read More Articles About: Good Health and Bad Medicine

Constipation - Part 1

( Originally Published 1940 )

MORE people are troubled by constipation than by any other common ailment. More money is spent on laxatives than on any other medicine. More nonsense has been written about constipation than about any other human disorder. For these reasons more space will be given to this subject than is usually accorded to it in a book of this size.

First it should be made clear that the chief function of the colon or large bowel is to store waste material derived from the digestion of the food and to prepare this waste for expulsion. Obviously an organ that has such a function cannot have the clean polished appearance of a tooth. It is normal, it is physiological, for the colon to be "dirty" and to contain waste matter. In the treatment of constipation, the aim must be to restore normal conditions of evacuation and not to clean out the entire length of the colon. The latter condition is abnormal. Unfortunately, the desire to clean out the colon is an obsession with many people and constitutes the basis for the cathartic habit and other ills.

Another lesson in physiology that should be mastered is that a bowel movement every day is not necessarily essential to good health. Many people in perfect health have an evacuation no oftener than once every two or three days or even longer without the slightest ill effects. Every person's bowel has its own law of frequency of movement. For some, that will mean two movements a day; for others it will mean one movement every three days. Try to discover what is for you the natural rhythm of the bowel, and be guided by that and not by the rhythms dictated by advertising copywriters.

More people think they are constipated than actually are constipated. The test as to whether constipation exists is not how often the bowels move but how completely and comfortably they move. If evacuation is difficult, painful or incomplete (if it leaves a sense of fullness in the rectum), it is probable that constipation actually exists and therefore treatment should be sought.

If true constipation actually exists, rational treatment can be prescribed only after careful questioning and examination by a physician have determined whether the condition is due to organic or to functional causes. Constipation due to ulcers, inflammation, tumors or other organic disorders can be relieved only by curing the underlying disorder. A complete medical investigation is particularly important for those adults who, accustomed to regular and satisfactory evacuations, begin to experience a persistent change in the character and frequency of bowel movement., Too often such changes are caused by tumors of the colon or rectum.

We should like to emphasize persistence. of the condition. Temporary interruptions in the rhythm of the bowel occur to everyone and do not signify anything serious. Travel, a change in diet, or emotional excitement can cause such a temporary lapse. After a day or so, and usually without the need for any artificial stimulation, the normal rhythm will return.

Temporary "clogging of the bowels" has never caused any of the myriad symptoms and ailments attributed to it by quacks and high-powered advertising. Even if the constipation is habitual and requires persistent medical treatment, it never has and never will cause insanity, high blood pressure, arthritis, epilepsy, excessive perspiration or any other disorder. Nor does constipation, either temporary or permanent, produce any such condition as auto-intoxication. Although headache, indigestion and biliousness may accompany constipation, that does not mean that these symptoms are caused by "auto-intoxication."

The belief in auto-intoxication seems to have arisen when it was discovered that the colon contains billions of germs. It seemed obvious to assume that stagnation of waste matter in the colon would promote the growth of these germs and the absorption of poisonous products. The terms "putrefaction" and "fermentation" were invoked and a pat little theory was constructed to suggest the evil consequences of constipation and the necessity for combating stagnation or "clogging" of the intestines by every variety of laxative and cathartic and by colonic irrigation.

However, there is no scientific evidence for such assumptions. In the first place, it is well known that the colon of every normal, healthy person contains billions of germs and that these germs are ordinarily harmless. In fact, many of them have a useful function. In constipation the stool be-comes hard and dry because of prolonged retention in the colon. The stool also lacks all nutritive material. In order that germs may live and grow, moisture and food are necessary. In the constipated colon, the germs do not find suitable conditions for growth, since there is little moisture and no food.

Furthermore, it has never been proven that poisons are produced in the constipated colon. Suppose, on the other hand, that a cathartic is taken. A liquid stool is then produced in which bacteria can thrive and manufacture poisons, since there is an abundance of water and since the cathartic has caused the rapid propulsion of food through the small intestine into the colon before digestion has been completed. With catharsis, therefore, the two requisites for the growth of bacteria and the manufacture of poisons—moisture and food—are present. Most people who believe they are suffering from auto-intoxication are actually suffering from an intoxication caused by catharsis. As Dr. Walter C. Alvarez, one of the most distinguished investigators of diseases of the digestive tract, has said ". most students of the subject of auto-intoxication have actually come to the conclusion that man is safest from poisoning when he is constipated."

Then what does cause the headache, biliousness and other symptoms that accompany constipation? Dr. Alvarez was able to show that in a certain percentage of people the symptoms are caused by mechanical distension of the rectum by the retained feces, and that as soon as the distention of the rectum is relieved—as by an enema, for example—the symptoms disappeared. In fact, he was able to reproduce the same symptoms in some of his subjects simply by stuffing the rectum with cotton.

In other people the symptoms are due to psychological factors. The evils of constipation have been so long dinned into them by fraudulent advertising and bad training during infancy and childhood that when constipation does occur they feel anxious and experience all variety of symptoms.'

The main thing to remember is that constipation by itself never has and never can cause any serious ailment. If the constipation is temporary, there are a few simple measures that can be followed for relief, but it is not necessary to fret over it. As a rule, the bowel will take care of itself if it is given half a chance to do so with the natural resources at its command.

The great majority of instances of habitual constipation are caused not by organic disease, but by what are known as functional factors. These include faulty or inadequate diet, bad habits and difficult social and economic conditions.

Habitual, severe constipation in children and many adults is also caused by psychological factors and it is by no means far-fetched to suggest that psychiatric treatment may be necessary in such cases.

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