As the necessary result of this gradual accumulation, the pelvic loop of colon becomes distended more and more. This fact accounts for the variation in the size of this part of the colon which is far greater than in any other part. The late Dr. Byron Robinson of Chicago found in two hundred carefully measured pelvic colons a variation in length from five inches to thirty-three inches. The writer has several times encountered at the operating table cases in which the pelvic colon was between two and three feet in length.

This stretching may extend to other parts, affecting chiefly, of course, the movable parts of the colon. The transverse colon often becomes loaded with delayed and dried feces, which in thin persons may be felt as hard irregular masses lying in the region of the umbilicus.

The cecum is also often found greatly distended as the result of this hoarding of feces by resisting the "call". It is very probable that the fecal matters are sometimes forced back into the transverse colon and the cecum by the strong contractions of the colon in attempts at defecation. When a "call" is experienced, there are at once set up colon contractions which would expel the feces if permitted to do so; but as the anus is held closed by voluntary contractions, the feces cannot be forced downward after the pelvic colon is filled, and the natural result is a slipping back of fecal matters into the first half of the colon, some portion even reaching the cecum.

By resisting and ignoring the kindly hint of Nature, that the body requires an opportunity to dispose of its poisonous wastes and refuse, thousands, perhaps we should say millions, of men and women have brought upon themselves untold miseries, and have shortened their lives and have greatly impaired their efficiency and usefulness. Not a few persons are almost at once conscious of injury. A dull headache appears. There is less appetite than usual for the next meal. Sleep is less sound and refreshing. The urine has a stronger odor, and the breath is offensive. These are simply the evidences of poisoning by absorption of toxins. The absorbent process which dries out and hardens the feces, carries with the water that is taken up and poured into the blood, quantities of poisons which it holds in solution. These poisons overwhelm the liver with unnecessary labor, tax the kidneys, irritate or stupefy the brain and nerves, and disturb every bodily function.

The prompt evacuation of the bowels in response to Nature's "call" is a sacred obligation which no person can neglect without serious injury. Ignorance of this fact is one of the chief causes of the prevalence of constipation, a condition in which the body becomes a storehouse of the most disgusting and offensive material, which saturates the tissues with its horrible effluvium and its virulent poisons and taints the very springs of life.

This fault is perhaps more common in America than in any other part of the world, especially in the cities. In English, German, French and Austrian cities places are abundantly provided, where well kept toilet conveniences are offered at a very small cost. One sees often in Vienna such notices as the following: "Urinal free. Seats, one 'heller' (a farthing or half cent)." The toilet arrangements at railway stations are sanitary and well cared for. There is room for great improvement in this particular in this country. Mothers should give more attention to the habits of their children in this respect. School teachers, at least in the primary grades, should instruct their pupils concerning the importance of giving prompt heed to the "call" of the bowels for attention. Among savages this function receives much attention. A missionary physician tells of an Arab who declined to live in Aden because the city regulations required that the bowels should be evacuated only in certain places, as in all civilized communities, rather than anywhere at any time the "call" demanded.

The worst results of these habits of postponing attention to the bowels to a convenient time, is the fact that the "call" after a time ceases. It is no longer made; or, if made, is so faint that it is not recognized. The continued pressure of the mass of hardened feces upon the nerves of the rectum destroys their sensibility, so that the "reflex" is no longer in operation. The defecatory center is not notified that evacuation is necessary, and the accumulation of feces continues with no remonstrance. Quite a large proportion of chronic sufferers from constipation reach this condition before they really begin to give serious attention and study to the matter.

There are thousands of persons who never experience a desire for evacuation of the bowels except after taking a laxative. The cure of cases of this sort is one of the most difficult problems connected with this class of disorders, but with the thorough co-operation of the patient the normal "call" may be restored by patient application of the proper measures. No victim of this condition 6hould rest contented until this has been accomplished. For the body to be deaf to the needs of its sewage system, by which its most poisonous waste matters are removed, is a far more dangerous and serious condition than for it to be deprived of the sense of hearing. Fortunately this condition, serious as it is, may usually be relieved by the use of simple means.