Self-Kneading Of The Bowels At Stool

In many cases of cumulative constipation the chief trouble is in the pelvic colon. This loop of intestine, usually about a foot in length, and possessing thick muscular walls, becomes sometimes so enormously stretched and attenuated by accumulations of fecal matters and gas that its walls are weak and contract very feebly, and it is no longer an efficient instrument for forcing the feces into the rectum, and thus inducing the defecating reflex by which the bowel is normally emptied. In such a case the patient may sometimes assist himself by placing the hand at the lower part of the abdomen on the left side and making deep pressure with the tips of the fingers, or placing the fist between the thigh and the abdomen so as to compress the pelvic colon. Kneading of the iliac colon, which lies in the hollow of the left iliac bone, is also useful.

The Cannon Ball

The cannon ball is a rather old-fashioned but useful means of self treatment, by which the patient may apply massage to the colon in a very efficient way. A small cannon ball weighing about twenty or twenty-five pounds is rolled along the course of the colon from the cecum toward the rectum. The patient should lie with the shoulders slightly elevated so as to relax the abdominal muscles as much as possible.

The cannon ball should be applied daily soon after breakfast, or a little before the time at which the bowels are most likely to move. The chief benefit to be derived from the cannon ball is to aid in propelling into the rectum from the pelvic colon a sufficient amount of fecal matter to awaken a lively stimulation of the defecating center, and so to secure a strong impulse and a full evacuation of the colon below the splenic flexure.

The Weighted Compress

This consists of a thick flannel compress between the folds of which is quilted in a considerable quantity, say fifteen to twenty-five pounds, of lead shot. The compress should be large enough to cover the entire abdomen. It should be applied for an hour before time for evacuation of the bowels, deep breathing movements being executed in the meantime at the rate of twelve to sixteen per minute.

The Shot Bag

This device has essentially the same purpose as the preceding, but may be applied in such a way as to secure a more pronounced local effect; as, for example, to force stagnating material out of the cecum or the iliac colon. It may, in some cases, also be of service in forcing feces from the pelvic colon into the rectum, when the pelvic loop has been weakened by excessive overloading and distention with gas. The usual weight of the shot bag is twenty to twenty-five pounds. It should be placed over the spot where the accumulation can be felt with the fingers or seen with the X-ray and should be left in place for an hour, while deep breathing movements are practiced at the rate of twelve to sixteen per minute.

This simple measure has the advantage that it may be used by the intelligent patient at his home, and its use may be continued for an indefinite time without injury, which cannot be said of any drug remedy. All drugs which act by irritating the intestine, sooner or later, usually sooner, produce colitis and other disorders. There are no harmless drugs. Of course this does not apply to such purely mechanical and harmless means, as bran and paraffin.

Relaxed protuberant abdomen, a result of bad sitting position and relaxed muscles.

Relaxed protuberant abdomen, a result of bad sitting position and relaxed muscles.

The same person standing poise corrected and abdomen held up by a spring supporter.

The same person standing poise corrected and abdomen held up by a spring supporter.

Pneumatic Compression Of The Abdomen

Compression of the abdomen by an inflated rubber bag is a measure of value, of which the writer has made use for some years. On one occasion, a patient who seemed dead from surgical shock was restored almost instantly by placing a rubber bag under an abdominal bandage and inflating it as fully as' possible. The face, which had become ashen gray, while the heart had ceased to beat, at once became flushed with the color of health, the heart began to beat, the patient began breathing, and death was averted. This observation showed the effect of abdominal compression applied in this way, and suggested the use of the same means to increase the intra-abdominal tension as an aid to bowel movement. In using the bag for this purpose, it must be tightly compressed by means of a stout bandage, and must be large enough to cover the whole abdomen, so that when inflated it will well fill the abdominal cavity, pressing before it the relaxed abdominal wall.

The compression bag is of special service in cases in which the abdominal muscles are very greatly relaxed, as in women who have borne a number of children, and whose muscles have not been well developed. It is most applicable to those who have not a superabundance of fat, especially those who have lost much in weight after having been over-fat.