Constipation is an affection--it is not a disease; hence, whatever the cause is, it must be sought out and removed. To use anything--any one remedy or any hundred remedies--is equivalent to limiting cause, and that shows a fallacious understanding of what constipation is. No cure can come from a treatment based on a false conception of cause.

Constipation is one prominent symptom in a syndrome represented as follows: indigestion; catarrhal inflammation of the throat, nasal passages, stomach and intestine; diarrhea, alternating with constipation; intestinal indigestion; gas distention; headaches; heart palpitation; chilliness; cold hands and feet; dizziness; fermentation of starches; decomposition of proteins; constitutional toxemia; colitis; and ending in obstinate constipation and many collateral affections.

As to cause, it is as impossible to find a single cause as it is to find a single effect or a single remedy. The causes and effects become a tangled web, as we see causes becoming effects and effects becoming causes; but order comes out of chaos when we think of fermentation standing at the head of organization and disorganization--when we think of ferment, enzyme, and bacteria as cause and effect in every process of being. Causes that pervert the normal action of the ferments may be enumerated as follows: excessive eating; imprudent eating; eating wrong combinations, causing indigestion, fermentation, and decomposition, acidosis and toxin poisoning, which totals catarrhal inflammations of vulnerable parts; water-drinking, causing polyuria, diabetes, or Bright's disease; eating foods that are artificially prepared, or which are changed in their chemical constituents in preparing them for the table; overwork; worry; anything that uses up nerve energy; overworked emotions; lack of discipline; the use of stimulants of all kinds; neglect in the care of the skin; carelessness in looking after the functions of the body; in fact, any influences that will produce overstimulation, intoxication, enervation, imperfect elimination, etc., may be looked upon as so many causes making up the syndrome above mentioned. But without fermentation the named causes become meaningless.

It should be obvious to the discerning that if constipation is a prominent link in the chain of affections above described. it would be foolish to undertake to isolate that particular symptom and give it special treatment. The idea of finding a specific remedy for constipation is as absurd as it would be to discover a single remedy for catarrh, or a single remedy for toxin poisoning. Constipation should be looked upon as a leading symptom of a constitutional derangement for which the blanket term, chronic toxic poisoning, is quite fitting. And when the disease is cured, it will have to be cured by righting the errors of life, so as to bring the general health back to the normal. This we shall endeavor to describe in the following.

Before making any suggestions regarding cures, it shall be my endeavor to give a frank and honest criticism of the remedies usually resorted to.

Looking back over medical history for the past hundred years, what do we see regarding the bowels? Drugs and all manner of devices for compelling the bowels to move. What are the results from the various schemes of cure? Failure--always failure--and constipation everywhere , and increasing.

The fountain syringe, and the thousand-and-one oth er devices for getting water into the alimentary canal, constitute the second of a trinity of illogical plans for overcoming constipation. The first of these is pills, or drugs; the second is the fountain syringe, and other devices for waterlogging the bowels; and the third and last is water-drinking.

Physic for overcoming constipation should be thrown to the dogs; and, so far as intelligence is concerned, it has been. But there will always be mental slackers and stragglers on the road to reform; and this is true of drugs and physic in the treatment of constipation. As well undertake to cure inebriety without sobriety, as to cure constipation without curing toxin poisoning.

The plan of washing out the bowels is perhaps one of the most pronounced palliations ever introduced for constipation. How could it be more than palliative, when no causes are removed? Confirmed constipation will be the ultimate reward for a close attention to flushing out the bowels. Of course, there are a few who appear to be benefited; yes, there are a few who boast of breaking every health law and continue to live to tell the story. That fact, however, does not annul the law, nor remove the penalty for breaking it. None but the foolhardy or foolish will be governed by an apparent exception to a rule.

Enemas wash away natural mucus, and in time paralyze the bowels--leave them dead, so to speak.

On account of physic and enemas being unsatisfactory, excessive water-drinking has been pretty generally adopted. As in the case of all cure-alls, there has been an unthinking acceptance of the suggestion that water, drunk in sufficient quantities, will overcome constipation. This is one of the great medical mistakes of this century.

As stated before, nature works out many conservative schemes; and the scheme of routing all water intake out of the body by way of the kidneys is a conservative measure. If the water is allowed to be absorbed by the bowels, it carries toxins with it, and extra intoxication takes place; hence it is railroaded out by way of the kidneys. When these vicarious or auxiliary activities are established, any interference by way of forcing measures will end in failure, and the ending is worse than the beginning. When the bowels are constipated for any length of time, the constipation causes colitis; then the more water drunk, the more the kidneys act, and the drier and more constipated the bowels become, because nature is endeavoring to sidestep being overcome by toxin absorption. It is safe to say that the constipation accompanying colitis cannot be cured--not even relieved--by water-drinking. This constipation is often confirmed by bran-bread eating. Petroleum oil gives a questionable relief, and certainly will do harm when its use is continued over a long period. All :such remedies are miserable failures.

The capping climax of all medical and surgical inanities is the removing of a part of the colon to cure constipation, epilepsy, or ptosis.

Those who desire to overcome constipation must first stop overeating, and, when eating begins, eat properly.

The tensing exercise should be practiced twice daily --about fifteen to twenty minutes before getting up in the morning, and the same length of time after getting ready for bed at night. This is necessary to re-establish the normal tone to the muscular system and help to re-establish peristaltic action of the bowels. At the end of each exercise period the abdomen should be given firm and fairly deep massage. This massage should be clockwise around the navel--in other words, from left to right below the navel and from right to left above the navel. This brings the movement down on the left side and up on the right side of the abdomen.

In cases of prolapsus of the uterus in women, and in enlarged prostate in men, much time should be spent in the knee shoulder position.

There should be absolutely no straining at stool--straining brings on piles. If there is a desire for a movement, but the muscular effort amounts to a real strain, always use a little water in the form of a small enema, not more than a pint of water. That will start the movement and prevent development of prolapsus of the rectum or piles.

If one is eating little in an effort to overcome constipation, there will be much less fecal matter to be thrown out than normal, and under those circumstances a movement every other day should be sufficient to keep the bowels cleared. A person who is taking ordinary meals should find one good movement a day sufficient. If the bowels fail to move, however, don't worry--forget it--in all probability the movement will come the next morning. Don't be in too great a hurry to use artificial means to secure a movement. If it is necessary to use an enema to assist the bowels, it should be a small enema, about a pint of water or less. If a movement is not secured with the first pint of water, repeat, using another pint of water. This is better than using large quantities of water in one enema. One should always avoid large enemas. It washes the mucus out of the colon and is conducive to constipation.

In any case of sickness where there is reason to believe that the bowels have not been cleared out by enemas, then one should not hesitate to use a laxative. Castor oil is the safest laxative. The tasteless variety may be used with lemon juice to make it more pleasant. In cases of fever, the temperature will not come to normal until the bowels are cleared. This should be the sign that the bowels have not been cleared, and one should not hesitate to continue with the efforts to empty the bowels, because it means the end of whatever disease is threatening.

In extreme cases there is suffering from sensitiveness to touch over the bowels, caused by gas distention. Toxin infection is marked by tired feeling, headaches, heart palpitation, chilliness, cold hands and feet, dizziness, etc. When these symptoms are pronounced there may be obstinate constipation, and there may be vomiting with diarrhea. Where there is much gas distention the pain is great. These cases are usually operated upon for appendicitis. The proper treatment is: Send the patient to bed to stay; feed an apple, or its equivalent in any fresh fruit , three times a day. He should drink no water, but use an enema, every other night, of a pint of water, hold it in the bowels for ten or fifteen minutes, and then try to have a movement. This is a routine which I follow to stimulate the rectum for a short time at the beginning of treatment, and stop it as soon as possible. If thirst is driving and must be relieved, use a half-pint of water in the rectum with a syringe. Thirst should be endured until secretions are established in the intestines. This is necessary for a cure, and the end cannot be accomplished until polyuria or excessive urination is overcome. Excessive waterdrinking under these circumstances forces excessive flow of water by way of the kidneys, but depuration is not increased; indeed, retention of excretions is favored, and, instead of water-drinking being a benefit, it furthers toxemia.

Those who have not the will-power to eat carefully, and to go without drinking until cured of constipation, need never expect to be cured of this or any other disease.

I have seen obstinate constipation overcome by this plan, so that the patient was getting a movement almost daily within a month or six weeks. Overeating must be given up forever; for as soon as a cured case returns to the old style of eating, the bowel trouble will return.

These patients complain of gas distention. Fruit does often cause trouble of this kind. There is but one way to correct it--namely, eat less and less, or fast until the gas is gone; then eat; and if the gas or other ill feelings return, fast again.

It should be understood that there is a price that must be paid, by victims of bad habits, before they can be restored to the normal; namely, stop the bad habits. No one can give up inebriating habits--drunkenness--withouit paying the price of much discomfort, and those of very sensitive natures have great pain and suffering.

It must be understood that poisoning by alcohol or any other drug, and poisoning by retained excretions, or by the toxin of decomposition of protein (animal or vegetable), or fermentation of carbohydrates (sugar and starch), are all the, same. The nervous system is gradually broken down, and general weakness, or enervation, is brought on to such a degree that when the habit is broken off the victim suffers greatly. The whole organism feels the effect of the suspended stimulation. The whole body cries out its displeasure at being robbed of its stimulation. To stop any habit shocks the nervous system; but it is nonsense to think of curing in any other way.

People of no self-discipline--those who have been in the habit of indulging every desire, who dance immediate attendance on every impulse and whim--not only have to give up their stimulating habits, but are compelled to cultivate discipline. For the first time in their lives they are compelled to say no to their desire. They suffer fully as much from being forced to say no to a desire--a whim--as their nervous systems suffer from lack of the effect of the poison--stimulation--which they have given up.

'Those who are self-disciplined--those who have the control that a business training gives, or the self-control that must be developed in filling any responsible position--do not find it so hard to come under rules that are rigid enough to bring about a cure of chronic disease.

There are many disciplined people who have unwittingly brought upon themselves diseases from overeating and the use of stimulants, because they have been advised by reputable professional men to "eat good, nourishing food," "eat to keep up the strength," and "smoke or drink in moderation"; and they have looked upon medical men, of good standing in medical societies, as oracles of wisdom. When their attention has been called to the probable falsity of their teachings in this matter, they are slow--indeed, reluctant--to believe that the self-professed ethical profession is not more reliable in matters medical than someone who appears to be thinking thoughts that the school-men ignore or reject--someone with "peculiar views."

It is obvious, then, that the people are divided into two classes. The first class is composed of those of no discipline--those who are self-indulgent, and who are hard to discipline because they have a "right" to self-indulgence. "What are people on earth for? to make ascetics of themselves? I would rather have five years and freedom than ten years with restrictions." Which means five years of license, and enough suffering to kill the body in half the time that might be had with a discipline which gives peace, comfort, and the feeling of well-being that always accompanied self-control and full efficiency.

The other class are indulgent from advice--from authority. This class pride themselves on discipline to authority. Indeed, they are disciplinarians, and, to serve authority, they do not mind becoming ascetics when required to do so.

The first class are sensual and self-indulgent. And their reasoning is on a par with their lives. They believe that a system of cure which restricts them is an infringement on their personal rights. It is hard to impart enough knowledge to save them. Such people have knowledge, but no wisdom. Man must live his knowledge; then it becomes his own--it becomes wisdom!

The second class have the discipline that enables them to follow instructions, if they can be persuaded to give up their: conventional teachings--if they can be convinced that they have been taught wrong.

To cure colitis (which is another name for chronic constipation) means reforming the life of the patient. No, there can be no cure as long as one continues to smoke, to drink, to eat too much, to live sensually.

Those with great nervous prostration must go to bed for a few weeks. The eating at first must be as suggested above: nothing but a little fruit until comfort has been secured. If not too weakening, a two- or three-minutes' hot bath may be taken every morning, followed with a quick cold sponge-bath in summer time. The sponging should be followed with dry towel-rubbing. Friction mittins may be used to advantage in these cases.

When comfort has come, the eating may change a little.

For Breakfast.--Fruit in summer time, fresh fruits and prunes, in the winter time. Apples for winter may be had by almost anyone. With an apple, or its equivalent in other fresh fruit, 6 or 8 prunes.

For lunch: Two ounces of thoroughly toasted bread, whole-wheat, and not more than one-fourth ounce of unsalted butter, Each morsel is to be masticated until it turns sweet in the mouth; then take another bite, and treat it the same; and so on until the two ounces have been eaten. Then apples, or any other fresh fruit desired, may be eaten in reasonable amounts. Overeating must end if constipation is to be permanently cured.

If desired, the food suggested for the morning meal may be taken at noon and the suggestions given for the noon meal may be used for breakfast.

Those who are opposed to losing weight need not look for a cure. To cure means the complete renovation of the system--the renewal of digestion and assimilation, and the reestablishing and bringing-back to the normal of all secretions and excretions. All idea of eating up to the profession's standard amount must be given up; for a cure means eating properly, but not enough to keep the standard weight.

The morning and noon meals have been given. For dinner: Meat--lamb, chicken, and fish are the best meats--the lamb and chicken are to be cooked very tender; the fish should be baked and served with salt, lemon, and very little, if any, butter. In cold weather, a roast or a stew of pork may be eaten twice a week. With the meat or fish, one or two of the succulent cooked vegetables, and a combination salad made by combining lettuce, tomatoes, cucumber (or celery), and a very small bit of onion. A large dinner-plate of these vegetables, after they have been cut up, is the quantity required by grown-ups. The salad should be seasoned with salt and olive oil, or a mayonnaise made with lemon--not vinegar.

During the winter, grapefruit or cabbage slaw may be used in place of the salad.

On account of its laxative influence, spinach should be used as one of the cooked nonstarchy vegetables as often as possible. Do not overcook the spinach. It should be cooked just enough to thoroughly wilt the leaves.

Never eat unless comfortable from the preceding mealtime. Then eat deliberately, masticating thoroughly, and eat all desired short of discomfort. If enough is eaten to cause discomfort, the next meal should be omitted, and another, and others, until comfort is secured. Always try to eat in quantities short of enough to bring discomfort. What kind of discomfort? Any discomfort, either of mind or body. When gas is troublesome, stop eating until comfortable, then eat less; when gas reappears, then miss a meal; etc.

Many will worry about losing flesh and looking haggard. Losing flesh cannot be avoided. It is the price that must be paid to recover health. Looking haggard can be overcome, or rather prevented, by taking exercise. The faint-hearted, the self-indulgent--the babes and boobies of humanity--will make a fuss, stew and fret, and either fail to follow instructions closely enough to get well, or cause themselves a lot more trouble than necessary.

Hopefulness, and a determination to have health at the sacrifice of any comfort, will soon put any case on the highroad to health.

Getting well quickly, or in a reasonable time, depends much upon the mental attitude. Those who have no object in life, who live with nothing higher to hope for, or look for, than the indulging of sensual appetites, are hard, if not impossible to cure; for when their indulgences are cut off to bring health, they have nothing worth while to live for, and they become mentally depressed. They want to be cured, but they do not want to stop self-indulgence--they do not want the cause of their disease removed. Hence those who can reason should see how utterly impossible it is to cure them. They must drift from one palliative to another palliative to secure a little relief; but a cure that means the giving up of any habit will not he looked upon with favor, and will not be adopted,

Those who are looking for a remedy for constipation--those who wish to have a formula which they can have filled at the corner drug store, and take it, and have their constipation cured--will not appreciate my treatment. But, as stated above, there is no such thing as a specific remedy for this affection, any more than there is for any other affection. There is but on cure, and that is to right the life. Those who are unwilling to go through a routine of treatment that will evolve into full health need never expect to overcome constipation, and its many causes and consequences. If there is one organic change, more constant than another, accompanying confirmed constipation, it is sclerosis. A well-known type is arteriosclerosis.

Those who are looking for quick cures are doomed to disappointment; for the usual quick remedies are nothing more than palliation.