Fasting

In a state of absolute fasting the intestine is in a state of complete inactivity. The normal stimulus of food is lacking, and there is nothing to call forth the rhythmical activities which accompany normal digestion. In another chapter we shall discuss at some length the question of fasting as a curative means, a method which has almost assumed the character of a fad in certain sections.

Pain

Pain in almost any part of the body may arrest intestinal action by causing a reflex interference. Pain or inflammation in any part of the abdomen, especially such painful affections as rectal ulcer or fistula, inflamed hemorrhoids, chronic appendicitis, inflammation of the bladder, prostate, uterus, ovaries, and other pelvic organs, all give rise to inaction of the intestine, not only by inhibiting or preventing peristalsis, but also by causing obstruction through contraction of the ileocecal sphincter. The pain and irritation of an ulcer or fistula, or inflammed hemorrhoids, may induce constipation by causing spasms of the anal muscle, and so preventing the normal relaxation in the act of defecation.

Miscellaneous Causes

Depressing emotions, such as anger, fear, or despondency, all suppress the normal movements of the intestine, and thus form a vicious circle which continually aggravates both the malady and its cause.

Heat lowers muscular tone, and hence checks the intestinal movements. This is well seen in the relief obtained by the application of a fomentation to the abdomen, or the administration of a hot bath or a hot enema in a case of intestinal colic or diarrhoea.

Hot drinks, as well as hot baths, tend to slow intestinal movements, and the habitual use of warm enemas certainly aggravates the condition for which the treatment is given.

Sweating, if very profuse, encourages intestinal inactivity by removing large quantities of water through the skin, and thus producing excessive dryness of the intestinal contents.

Elevated body temperature, whether caused by fever or by a hot bath of some sort, slows the intestinal movements.

Sleep and inactivity slow the intestinal movements by lessening the activity of the diaphragm and the abdominal muscles. The first voluntary movements made on awakening in the morning often start up peristalsis, and often provoke a desire for evacuation of the bowels. Persons who lead inactive lives almost always suffer from constipation, though often unaware that this is the case, for reasons which we 6hall present later.

Prolonged cold sitz baths cause intestinal inactivity by inducing a spasm of certain of the food gates, probably the ileocecal sphincter. This result occurs if the bath is continued for more than seven or eight minutes. When for any reason the use of the prolonged sitz bath becomes necessary, special precautions in diet and otherwise must be taken to prevent producing this undesirable effect.

A diet largely made up of meat necessarily favors intestinal inactivity, first because the complete digestion of the meat leaves too little residue to stimulate peristalsis, and second because an excess of protein encourages putrefactive processes in the intestine, which establish an alkaline condition of the intestinal contents, and thus prevent normal intestinal activity. The stools of flesh eaters usually have a very strong ammoniacal odor, and when tested by the chemist are found to be strongly alkaline. Alkalies paralyze the colon, while acids stimulate it.

The Causes Of Constipation

The causes of a disease so universal in civilized communities must be very numerous to produce this condition in so great a number of people living under many different conditions, and with different habits of life. In general it may be said that the causes of constipation are abnormal habits or conditions of life, the result of what we call civilization. Savages rarely suffer from constipation, which is also true of the more primitive of so-called civilized nations. Chronic intestinal inactivity is much, less frequent among country people than among those living in the city. It is manifestly a morbid condition peculiar to a state of high civilization; and modern medical researches tend to show that this condition and its results may justly be looked upon as among the fundamental causes of the race degeneracy which is becoming every year more apparent in all highly civilized communities.

We may therefore expect to find adults suffering from constipation much more than children, although this malady often begins early in life. Women are more subject than men to intestinal inactivity and all the terrible consequences which result from this condition. Westphalen asserts that four-fifths of all women suffer from constipation from their youth onward, a statement that is corroborated by Foges, the eminent specialist of Vienna, and that few experienced practitioners will deny. Adults have been longer exposed to the degenerative influences of civilized life than have children, and the life of civilized women is to a considerable degree more highly artificial and upnatural than that of men.

Professor Virchow more than half a century ago called attention to the fact that post-mortem examinations show evidences of disease of the intestines in almost every case of many hundreds examined, irrespective of the cause of death. Indeed, he declared it to be almost impossible to find an adult person whose intestines did not show adhesions and other evidences of chronic disease. At that time the origin and significance of these inflammatory conditions was not understood. We now know that infections of the interior of the intestine, by causing inflammation of the intestinal walls, readily extend to the outside, giving rise to inflammatory changes and adhesions. In these adhesions, located in various parts of the intestine, but particularly at special points noted by Professor Virchow, and more recently by Dr. Arbuthnot Lane, we have both a consequence and a cause of constipation.