This method acts upon the intestine by increasing the intra-abdominal pressure. It is most effective when applied in cases in which the abdominal muscles are weak and relaxed.
The compression may be made continuous by the application of a tight abdominal bandage; or intermittent pressure may be applied, if desired, by means of an inflated rubber bag. These measures will be explained more fully elsewhere.
Bodily activity is another way of mechanically stimulating the intestine. Vigorous exercise sets the diaphragm and abdominal muscles at work in such a way that the intestines are, between the two, vigorously kneaded and squeezed and thus stimulated to action.
Every farmer knows the constipating effect of idleness upon his horses and cattle. Most observing persons have noted in their own experience the advantage of taking a brisk walk before or after breakfast.
The sedentary man or woman not only loses the immediate benefit which results from the increased activity of the diaphragm and abdominal muscles, but his abdominal muscles become permanently weakened, relaxed, lacking in tone, and incapable of supporting the intestines in their proper place, thus adding a number of other factors which con-tribute very materially to the lessening of intestinal activity.
A stooped or relaxed posture in sitting or standing tends strongly to induce constipation by weakening the abdomial muscles and causing congestion of the liver and all other abdominal organs. The viscera, over-filled with blood, and lacking the support of the abdominal muscles, become prolapsed. The colon falls with the rest; kinks are formed; the intestinal contents stagnate; the bowel becomes distended; the ileocecal valve becomes incompetent, infection travels up the small intestine, and a long list of ills result. The check valve action of the ileocecal valve is essential to the onward movement of the food residues, and therefore the crippling of this valve paturally leads to constipation.
An erect posture secures proper exercise of the muscles of the trunk, correct breathing, normal circulation of blood in the viscera, and promotes in a high degree normal bowel movement.
Cold applications, and even extremely hot applications, act as powerful stimulants to the intestinal muscles. To be effective, the applications must be short and intense. The cold spinal and abdominal douche, and the cold douche to the feet and legs, are the most effective external procedures.
The application of cold water to the bowel by means of the enema at a temperature of 75° to 40°
F. produces almost instant contraction of the bowel. The action is so intense that great pain may be produced, especially if a very low temperature is employed.
There are certain foods and other agents and influences that exercise a decided deterring influence upon intestinal movements, either directly, or indirectly through the suppression of the normal stimuli.
Such foods as soups, gruels, porridges, and purees contain so little solid matter that the bulk, considerable though it may be when the food is eaten, is soon reduced to a very small volume. On this account liquid foods are almost always constipating. The only exceptions are those liquid foods which contain much sugar, acids, or fats.
Pasty cereals such as oatmeal mush, are decidedly constipating,in their influence, because of their pasty consistency and the little mastication which they receive. New bread, hot biscuits, "noodles," and doughy foods of all sorts are likewise objectionable.
Foods which contain little or no waste or indigestible material are so completely digested and absorbed that the bulk left in the intestine is insufficient to stimulate segmentation or peristalsis. In feeding the sick, the mistake is not infrequently made of feeding exclusively fluid or concentrated foods, with the idea that such foods tax the digestive organs least. In a sense this is true, but the importance of maintaining proper bowel action, is so great that this must be considered in the dietary, and with rare exceptions the patient will perfectly well tolerate simple salads, stewed fruit of some sort, whole wheat preparations, especially wheat flakes, in which the whole grain is represented.
The conventional "tea and toast" is about the worst diet that could be offered a sick person. The panadas, puddings, and "slops" of various sort are little better.
Fruit juices of all sorts are, on the other hand, most suitable for almost all forms of sickness. They contain choice nutriment in a form needing no digestion, ready for immediate absorption and assimilation.
Orange juice or freshly expressed juice of apples, grapes, or other sweet or sub-acid fruit, is ideal nourishment for the sick. In the absence of these fruits, dried fruit, soaked long in water may furnish a very fair substitute. Canned fruit juices come next in value. To these rice, or some other cereal food, may be added in proper amount, with malt sugar in some form.