The Treatment Of Mixed Cases Of Constipation

In many, perhaps the majority of cases of constipation, the type of the disease is mixed. The association of spastic constipation with latent or cumulative constipation is specially common. Cases which begin as simple constipation, later become cumulative constipation, and finally develop spastic or latent constipation through infection of the colon, or colitis, the natural result of stagnation of the bowel contents.

The measures recommended for the treatment of spastic constipation should be applied with such other measures as may be indicated. If the rectum and the pelvic colon are filled with feces, these must be removed by the means recommended in the treatment of cumulative constipation, and the general measures suggested for the relief of that form of the disease must be perseveringly employed.

In the use of electricity in cases of this sort, the applications must be combined with hot applications, in order to avoid increase of the spastic contraction.

When electricity is applied to the rectum, a fomentation should be applied to the abdomen during the application, or immediately afterward.

The thermophore affords the most effective means of applying heat to the abdomen during electrical applications. During a general cold application heat should be applied over the abdomen, to protect the intestine.

A flannel bandage should be worn over the abdomen constantly when the moist abdominal bandage is not employed, and an abdominal supporter should be worn.

Coarse vegetables and other bulky food stuffs should not be avoided because colitis is present Colitis is the result of constipation, and this will be aggravated by the bland concentrated diet, which is commonly recommended for colitis. Experience has very clearly demonstrated the value of a bulky vegetable diet in colitis as well as in constipation.

Agar-agar is specially valuable in these cases, for the reason that it affords bulk, and aids in clearing away the accumulated mucus, while at the same time producing no irritation. The irritation supposed to rise from the cellulose of fruits is far less than is generally thought. Bran and ground wood have been used with excellent results as poultices for raw surfaces and dressings for wounds. Wet bran, like wet paper, is not irritating.

Treatment Of Disorders Which Result From Constipation

While constipation, through the autointoxication to which it leads, is both an exciting and predisposing cause of many very serious chronic diseases from which human beings suffer, there are many other maladies which are so immediately aggravated by an inactive state of the bowels, that this condition becomes a dominant factor in dealing with them. In this chapter a brief mention will be made of the more important of these diseases.

Catarrhal Colitis

The chief seat of this disease is the lower colon, especially the pelvic colon and the iliac colon. Sometimes, however, the effect extends to the entire colon.

The disease is essentially a chronic infection of the mucous membrane, and is the result of the injury done to the tissues by the prolonged contact with putrefying fecal matters which in constipation accumulate and are often retained for days in the lower colon. To understand the effect of these poisonous matters upon the mucous membrane, when acting continuously for days with constantly increasing virulence, it is only necessary to consider for a moment what result would follow an application of the same sort of material to the skin for several days in succession. The remarkable vitality with which the mucous membrane is endowed, enables it to retain its integrity for a considerable length of time, but sooner or later, its resistance breaks down, and it becomes the seat of a chronic inflammation similar to that which affects the mucous membrane of the nose in nasal catarrh. An examination of the stools shows constantly present mucous and white blood cells, which are thrown off by the mucous membrane in its efforts to defend itself against the attack of the myriads of microbes which are constantly assailing it, and the various highly virulent poisons which they produce. The character of these poisons may be judged from the nauseous odors emanating from the putrefying feces which are discharged when a laxative is administered, and sometimes as the result of an enema. The real character of the feces produced by a constipated person cannot always be judged by an examination of the hard, dry masses which are discharged from the lower bowel, for the reason that the noxious substances which they contained have been absorbed higher up in the bowel.

Some persons, indeed, have made the mistake of supposing that the comparatively inodorous feces which they discharged, and which have been retained so long that they have become as hard, and dry as wood, afford evidence of an exceptionally aseptic and wholesome state of their intestine. In one such case the writer succeeded in disabusing the mind of a very optimistic individual, by administering a dose of charcoal, which, acting as a laxative, brought down from the cecum and transverse colon a semi-fluid stool which was loathsome almost beyond description, and which when submitted to chemical and bacteriological examination, was shown to contain prodigious numbers of bacteria, and putrefaction products in extraordinary amount. This person, a man of unusual intelligence, but unacquainted with the physiology and bacteriology of the intestine, lived under the erroneous impression that by the thorough mastication of his food he rendered digestion so complete, and his intestine so sterile, that the putrefactive processes commonly present were suppressed, whereas, the truth was that putrefaction was very active in his colon, and his feces were inodorous only because they had been retained so long that the putrefactive process had consumed everything putresicible, and the maladorous and other substances had been taken up into the blood by the absorption, and had been discharged through the lungs, skin and kidneys, instead of being eliminated through the bowels, the natural and only safe and decent outlet for such loathsome products. In this case, as might be expected, evidence of the presence of catarrhal colitis was present, the little knob of wooden-like feces discharged at intervals of several days, being always covered with a thick layer of opaque mucus.