Purgation, says Trall, "is vital action in relation to things abnormal," and is in proportion to the vigor of the bowels. He points out that "when the bowels expel colocynth or croton oil with a force that seems to tear and rend the whole intestinal tube" that the "force is exerted in ratio to the necessity for it."

When purgatives or laxatives are taken, the excess of healthy bowel action these occasion is intended to expel the irritating and poisonous substance. Tickle the nostrils with a feather and mucous will be poured out to wash away the feather. Drop a grain of sand into the eyes and tears will be poured out to wash it away. In like manner, when irritating and poisonous drugs are taken, large quantities of watery mucous are poured out upon them by the lining membrane of the stomach, intestine and colon to flush it out. The mucous not only washes it away, but envelopes and dilutes it, thus rendering it less harmful.

This is the so-called purgative action of the drug. It is not drug action at all. It is vital action in self-defense. Purgation is not what the drug does to the body, but what the body does to it. In the relations between living and lifeless matter, living matter is active, lifeless matter is passive.

If the bowels have been weakened or depraved by purgatives, or if the patient is too weak to act upon the drug, the purgative is no purgative at all. The vigor with which the body expels the laxative or purgative is, thus, an index to the integrity and vital vigor of the organism.

Whether a diarrhea is a means of expelling a poisonous drug or rotting food, it is a curative act. It is an extraordinary bowel action an excess of healthy action, and it is extraordinary because of extraordinary conditions. It is an effort to meet the needs of the occasion. It is vital or physiological action.

Look at the putrescent mass of materials rushed out of the digestive tract by a diarrhea in an intestinal "disease" and try to imagine health and such material in the same body. This mass of fermenting, putrefying food is not compatible with health. In some conditions of the digestive tract the most wholesome food acts as an irritant, even without undergoing decomposition, and increased peristalsis with an out-pouring of mucous, hurries it along and out of the system.

In Asiatic cholera the fluid from the bowels comes largely from the blood and tissues. In dysentery (inflammation of the bowels) the stools are often made up almost wholly of blood, pus, and mucous. In both these diseases as well as in fevers the protective and purifying character of the diarrhea is apparent. Its true nature cannot be mistaken. Dr. Tilden has admirably expressed this fact as follows: "Influences that might create pneumonia in the winter time will pass off as diarrhea in the summer time.

"Intestinal diseases are either acute or chronic and are usually named acute catarrh or chronic catarrh. For instance, an acute attack of gastritis is named acute catarrh of the stomach, and the chronic is known as chronic gastritis or chronic catarrh of the stomach. If the inflammation is in the colon it will be acute or chronic, and will be spoken of as catarrh of the large intestines or colitis.

"Diarrhea will sometimes pass off in a few hours or a day. This is really not a disease, as it is caused by irritating foods, for instance; if one eats freely of spinach, it may act on the bowels in two or three hours, causing one or several liquid discharges then the effect is gone. There is no catarrh about this, it is simply a little local irritation, the same as would occur to the nose after inhaling pepper or snuff; so long as the irritation of the pepper continued there would be an extra amount of secretion thrown out. This is nature's way of protecting the mucous surfaces from irritation. If the irritation comes from decomposed food, and this decomposition is continuous day after clay, at first it creates irritation of the mucous membrane, and finally, it becomes a chronic inflammation or catarrh. If an irritation is very great there may be a chill caused by the blood being drawn from the surface of the body to the mucous membrane in the bowels, for it must not be forgotten that there are antibodies in the circulating medium; they are the natural defenders of the body, and when there is a threatened absorption in the intestines of a toxic material, nature in self-defense calls an extra amount of blood to the mucous membrane; this causes a pouring out of a great amount of secretion into the bowels. This secretion antidotes the poison and causes such an accumulation of fluid to take place in the bowels that it passes out as a diarrhea.

"In cholera nature's efforts are so great at flooding and washing out of the alimentary canal the poison that threatens absorption that there is copious discharge into the bowels of the serum of the blood. This serum is thrown into the intestines through the mucous membrane which is being irritated by the toxic material, and if it were not for this copious outpouring of fluid, the poison would be absorbed.

"Sometimes the effort on the part of the system to rid itself of a poison is so great that the subject will die of collapse, brought on from the tremendous loss of the fluids of the body. This is a case of an overworked conservative measure, or in other words, nature kills herself in her efforts at saving herself. The chill that is experienced is very much on the order of the chill that is experienced when tonsillitis or diphtheria begins. The surface of the body is deprived of the circulating fluid and as a result of that there is deficient oxidation and a consequent chilling.

"As I explained in my first volume under the head of tonsillitis, the congestion of a mucous membrane or catarrh, is a conservative effort on the part of the system to prevent absorption of materials that threaten the integrity of the organism, and so long as the defense is. required--so long as it is necessary for nature to keep her defenders at certain points in the alimentary canal to prevent absorption--the catarrhal state will be continued in spite of all treatment, except that of removing the necessity for this standing army of defense."

Should the diarrhea be checked; should it be subdued and suppressed? Or, should it be permitted to consummate its work? Suppose the diarrhea that is intended to expel mercury is checked and the drug is permitted to enter the body, there to work havoc throughout the whole system. Would this not be the same as if the diarrhea which is intended to expel the rotting food is suppressed and absorption of the poison formed by the rotting food is forced? In combating what the physician, his patient and the friends and relatives of the patient consider to be "disease", or a symptom of "disease", is not the whole combat waged against the body itself?

To suppress a diarrhea by inhibiting bowel function is to lock-up in the intestinal tract the putrescence and poisons that the diarrhea is intended to eliminate. So far from being curative is such a procedure that it actually lays the foundation for some serious pathology. Dr. Tilden says that many speedy deaths occur from suppression of acute fluxes, forcing the retention of the fluids, which quickly decompose and overwhelm the system with their toxicity.