Cellulose. Rough food containing much cellulose is the first thing thought of when the physician's mind turns from cathartics and all kinds of drug stimulation, enemas, suppositories, rectal dilators, etc.

Bran bread, graham bread, whole-wheat bread, bread with flax-seed in it, oils, agar-agar, water-drinking, and many other bowel persuaders, are in daily use by the people and prescribed by the profession.

The use of bran in constipation marks the early stages of dietetic evolution. When a physician begins to talk bran, eat bran, prescribe bran, insist on bran, and can expatiate for hours on the virtues of bran, it is safe to say that he is in the prehistoric age of dietetics. His next evolution will bring him to the calories and protein age, where he will spend his idle hours figuring out menus with an eye single to the correct number of calories (heat units) and protein contained therein. If heat units and protein were all that is necessary for a correct dietetic blend, then butter, oil, or sugar, and eggs or cheese, would be the only food required. One may know, or think he knows how many heat units, and how much protein, are required by a man of so many pounds' weight; and he may know how to figure out and properly blend menus which will contain just the required heat units, and the proper weight of protein; yet he is many years removed from a successful dietetic physician. Indeed, any layman may have all this knowledge, but it takes the dexterity of a physician to apply the knowledge successfully.

All dieticians must go through these stages of development; and they all go through them in the same way--namely, with the mental horizons fastened down tight, so as to prevent the knowledge they think they have from slipping away. But they do not know that when the horizon fits too tight, it keeps knowledge out as well as keeps ignorance in.

It is not necessary to take up bran and other rough foods for a separate study, for all can come under one head, The object of rough foods is to prick and prod the bowels into activity. The effect is the same as prodding a jaded horse, or giving strychnine to a flaggering heart; namely, it hastens to prostration.

It is only a question of time when bowels that are forced to act will cease to act, except by the use of more and more powerful stimulation.

No one has ever been cured of constipation by the use of rough food--by bran or whole-wheat or graham bread. These breads, like laxatives, will keep the bowels regular for a time; but the end of their laxative effect comes, and then a change in bowel stimulants must be had.

A very serious objection to eating rough bread to keep the bowels moving is that too much is used-more bread is eaten than should be, and starch poisoning is developed. Those who are most constipated are often the very people who have the least power to digest starch in this from; and, as a consequence, they are often injured more than benefited by the use of bran.

It should not be forgotten that the gastro-intestinal tract is a pleasure resort for bacteria. The food eaten serves to feed them. But the reason why they are there in great abundance is because they are needed. They are a conservative necessity. They are as necessary as enzymes (unorganized ferments); for when enzymic power is unavailing for liquefying ingested aliments, the microbes (organized ferments) lend a hand and bring the refractory ingesta to a liquid form for expulsion. It is not so much for refractory aliments that microbes are needed as for liquefying the superabundance of the supply taken in beyond the enzymic power.

Enzymes are limited, and the power of the organism to manufacture the unorganized ferments is limited; hence, when the food intake is beyond the enzymic power, organized ferments, the germs--bacteria or microbes--start up fermentation in carbohydrate foods, and decomposition--putrefaction--in the proteins. The bacterial fermentation cannot be exhausted; for the bacteria are organized as needed. The organized ferments are dispersed when they are no longer necessary.

So much more food is taken than is required by the average person that it is not strange that the alimentary canal becomes the mecca for germs.

The estimated number of microbes in the digestive tract is 411,000, 000,000; a few billions more or less cannot matter. It is obvious that the number must vary from millions to billions. Large numbers are not necessary, if we admit overeating is not necessary. A hibernating animal will have few, and perhaps none, unless the slight distintegration calls for a few. In hibernation enzymes are not needed and are not secreted. Where the least food is taken there will be fewer bacteria, and obviously less enzymic secretion.

Bowels that are abused by converting them into veritable gehennas require rapid developing of microbes to meet the demand for organized ferment. If an unusual meal be eaten of fish, meat, or sausage, and the enzymes are unequal to the task, in from twelve to fifteen hours, or less time, vomiting may occur, and a fetid diarrhea starts up and relieves the system of the poisoning.

Imported sausage is liable to start up botulism or allantiasis--sausage poisoning. Ptomain (cadaver poisoning) brings on great enervation. Besides vomiting and diarrhea, there may be skin and kidney enervation, great nervousness, dizziness, and double vision; the temperature drops, cold sweat appears, and the patient dies in a collapse. This is the severest type of food poisoning.

Chronic subacute food poisoning, ending in constipation, is what concerns us most. As time runs on, the intensity of food-poisoning symptoms grows less and less, until there are scarcely any symptoms of decomposition, except gas in the bowels, which is ill-smelling, a chronic tired feeling, constipation, with catarrhal mucus passing with most bowel movements, which are scybalous (hard and lumpy in character) and often coated with catarrhal matters, giving them a grayish, glazed appearance. This state of the bowels. is called colitis, and proctitis often accompanies it. This condition is brought on from years of abuse in over-eating, and the catarrh is a conservative measure.

The symptom complex may be stated as follows: decomposition, intestinal irritation, diarrhea, alternating with constipation, inflammation, ulceration, confirmed constipation. The systemic symptoms are chronic toxin poisoning, lymphatic involvement, pelvic diseases, appendicitis, ovaritis, sexual neurosis, liver and kidney diseases, tuberculosis, arteritis, arteriosclerosis, cancer, and others.

Those with chronic constipation and its accompanying toxin poisoning must necessarily grow old rapidly and develop old-age diseases, such as cirrhosis, sclerosis, or cancer.

Constipation is a conservative measure. Nature is always marshaling her forces in such a way as to strengthen all weak points, and, when necessary, the various organs of the body are made to do vicarious work--work for others.

In constipation of this character the kidneys eliminate for the bowels. At first the fluid intake is diverted to the kidneys to prevent dilution and ready absorption of toxins; and, secondly, the toxin irritation of the nucous membrane of the bowels causes an exudation of mucus which coats the membrane and renders absorption slow and difficult. In confirmed constipation almost the entire fluid intake is diverted kidneyward, leaving the bowels with a Saharian dryness. This vicarious habit becomes so firmly established that a cure for constipation means a cure for polyuria (excessive urination). A true etiology of all affections of the body must give, as the leading factor, confirmed, chronic constipation, with more or less colitis, and more or less malnutrition, with greater or less poverty of flesh, or more or less waterlogging of the tissues of the body, which is a form of obesity.

Excessive weight, with anemic complexion, often means polyuria diverted into the tissues of the body--in common language, urinating in one's body. The subject may be young, and the average person may mistake rotundity for robust health; but the true physician will not be mistaken.

Nature works and schemes in various ways to save us. The fecal waste is made to dry up by diverting the fluid to the kidneys. If the kidneys are failing, the water will be retained in the tissued of the body--the cellular tissues become waterlogged, or a diarrhea may relieve the waterlogged tissues. This is the true explanation of many intractable diarrheas.

The leading etiological factor, then, in constipation is toxin infection, which first stimulates, then irritates, then inflames, then ulcerates, then hardens and strictures, and finally degenerates into cancer. Add to this all the vicarious and auxiliary affections, including every constitutional derangement that is caused by toxemia, and we have, as a leading etiological factor in all the diseases of the body, constipation. Toxin causes constipation, bacterial fermentation causes toxins, and eating beyond enzymic power leaves no alternative but to get rid of the surplus intake of food by decomposition.

Intestinal fermentation and gas distention, with intestinal putrefaction and excruciating colics, diarrhea and nauseous evacuations, bad breath, malodorous skin, lassitude, dizziness, headache, are the first developments, which recur, or come and go with irregularity, until constipation is established; then come reabsorption, chronic, systemic toxin poisoning, and the development of conservative affections--namely, any intercurrent affection, fevers, etc. --which should be looked upon as crises in chronic toxemia from constipation. The lighter affections that come and go are periodic attacks of dizziness, headache, fatigue, coated tongue, fetid breath, insomnia, eczemas, acne, and other skin diseases, as well as night sweats. Add to this state intercurrent affections from unusual causes, and we have a picture of chronic constipation.

The latter half of the nineteenth century built many fortunes out of pills. Pills, squills, and opium have built a financial nobility unequaled by that of beer and whisky. The financial world may boast of the colossal fortunes which it has built on trafficking in human health and life, but esthetism and ethics certainly cannot be proud of the mutilation and wrecked lives which represent the graduates from our sanatoria, hospitals, and "surgical plants."

As a result of medical wisdom (?), constipation is universal; and the McLeans and Beachams have taken the lion's share of glory and filthy lucre for the benefaction. But it is the elite of the medical profession that popularizes quackery by making drugs popular.