This symptom may result either from the excessive formation of gas in the intestine, or from the accumulation of gas. A certain amount of gas is natural. The presence of gas in the intestine is an aid to peristalsis. This is especially true of the large intestine.

Excessive formation of gas occurs through the action of bacteria upon the food stuffs. Gas is most readily formed from cooked starch or sugar, but may be formed from cellulose and from protein. Odorless gas is usually formed from starch or sugar, inflammable gas from cellulose, and gas having a foul odor from protein. These different elements of the food are acted upon by different species of bacteria, so that the character of the gas formed in the intestine becomes something of an index to the sort of bacteria present. Bacteria which act upon starch, sugar and cellulose are comparatively harmless while the presence of foul smelling gases indicates the presence of putrefaction and the pernicious bacteria and the virulent poisons which are always present in this condition.

The formation of gas in excess is due primarily not so much to the excessive use of starchy food, as many persons suppose, but to stasis or stagnation of the food. Bouchard showed long ago that if the foodstuffs remain in one part of the alimentary canal, even in the stomach, fermentation and other bacterial changes take place.

An important remedy for flatulence, then, is increased intestinal activity. When the gas is confined to the colon an enema, either warm or cool, will usually secure relief; for permanent relief the causes of the constipation must be removed by systematic treatment.

Flatulence which is not relieved by emptying the colon is due to incompetency of the ileocecal valve. The absence of the check valve at the junction of the small intestine with the colon permits the gas to pass back into the small intestine. This condition is generally greatly mitigated by increased activity of the bowels; a radical cure may be accomplished by repairs of the ileocecal valve.

Flatulence may become dangerous in cases of high blood pressure with degeneration of the blood vessels. The great accumulation of gas in the intestines forces the blood out of the abdominal vessels into the general circulation, and so raises the blood pressure. If the blood pressure is already high, and the blood vessels seriously weakened, the rise of pressure may be sufficient to cause a rupture and apoplexy with paralysis, if the rupture occurs in the brain.

The wet girdle or moist abdominal bandage is often found a most efficient means of combating flatulence. The bandage must be kept moist, and should not be too warmly covered. The mackintosh cover must be omitted, the purpose being to promote evaporation and thus maintain a mild stimulant action upon the intestine. The bandage will dry out in three or four hours, when it should be renewed. It may be worn with advantage both night and day. The bandage must be changed or boiled daily to avoid producing skin infection.

Flatulence in the colon always means stasis, that is, delayed feces which need removal. Persons who have been accustomed to a hearty meat diet sometimes suffer considerably from flatulence when a change is made from meat to vegetables, but this should not be considered as a need to return to a highly nitrogenous diet. After a short time the activity of the bowels will be increased to such a degree that the constipation will be overcome, and the flatulence will disappear. In cases in which the free use of cereals or starch food is accompanied by acidity of the stomach or heartburn soon after eating, the difficulty may be relieved by increasing the amount of fat taken with the meals. Usually one or two tablespoonsful of olive oil taken at the beginning of the meal will cause the disappearance of this unpleasant symptom.

Foul Tongue And Bad Breath

These common conditions are more often due to constipation than to neglect of the mouth. A high protein diet, that is the free use of eggs and meats, together with constipation even in very mild degree, will cause coating of the tongue and a fecal odor of the breath. The general low resistance caused by chronic toxemia destroys the ability of the saliva to prevent the growth of germs in the mouth and the result is coating of the tongue, ulceration of the. gums and decay of the teeth.

The cure is not to be found in dentifrices, lotions, tooth brushes or dental procedures, "mouth treatment," etc, but in removal of the cause by draining the bowels through diet and other measure, to move thoroughly three times daily. Of course the toilet of the mouth and "mouth treatment" by a skillful dental surgeon must not be neglected.

A diet consisting exclusively of wheat bran and fruit, preferably apples and oranges, continued for three or four days will rapidly clear the tongue and sweaten the breath in ordinary cases. Half a pound of sterilized bran should be eaten daily and apples may be eaten in any quantity which does not cause inconvenience. Twelve to sixteen apples taken at four meals will usually be found sufficient. The fruit must be eaten raw and should be well chewed. One or two apples or other fruit may be eaten whenever a craving for food is felt. Fruit imposes little or no labor upon the digesive organs. Berries, grapes, peaches, oranges, melons, tomatoes, lettuce cucumbers and celery may be added to the bill of fare if desired. The greater the bulk and the less the actual food value represented in the food the better.

The addition of bran is necessary for the reason that the tender cellulose of fruit is often almost completely digested and so furnishes little residue.

The "milk regimen" conducted according to the author's method (see pages 188-190), for one to two weeks rarely fails to clear the tongue and to remove the foul odor of the breath.