Numerous laboratory experiments have shown that the use of tobacco in any form has a paralyzing effect upon the splanchnic nerves. Without the aid of the sympathetic nerves, normal, rhythmical bowel movements are impossible. The fact that some persons observe an apparently favorable influence from smoking, is accepted as evidence that the effects of the weed are favorable to the bowels. These cases are exceptional. They happen to be cases in which there is an excessive action of the sympathetic nerves, so that the paralyzing influence of tobacco seems to be helpful. In general, and in the long run, however, the use of tobacco is highly injurious. Kreuznach, of Vienna, has recently shown that nicotine produces arteriosclerosis of the splanchnic vessels. That is, it produces hardening and degeneracy of the vessels which supply the colon and other abdominal organs. This change in the blood vessels gives rise to general degeneracy and atony, and hence to constipation, by which it is always accompanied.
Alcoholic beverages of all sorts tend to produce constipation, by causing chronic and intestinal catarrh, ulcer of stomach, and paralysis of the sympathetic nerves.
Opium in all forms produces a specific effect in paralyzing the bowels. In former times in was customary to administer opium in sufficient doses in certain cases to cause complete inactivity of the bowels for a week or more. In such cases the constipation induced was often the beginning of chronic constipation of a most obstinate character.
The very common use of opium for the relief of pain is a prolific cause of constipation, especially among women. The fact that a laxative drug is given to overcome the constipating tendency, does not prevent the evil that results, but only adds another.
Bromides and sleep-producing or hypnotic drugs of all sort tend to produce constipation, although some of them are less harmful than opium. Fortunately, the use of these drugs may easily be dispensed with when the resources of hydrotherapy and other physiologic means are made use of.
One of the best evidences of the universal prevalence of constipation is afforded by the enormous use of laxative or purgative drugs. The quantity of this class of drugs used annually far exceeds that of any other class. Besides drugs proper, there is sold a prodigious quantity of laxative mineral waters. It would be difficult in the average community to find a household in which there is not kept on hand a supply of some favorite laxative. The columns of the newspapers are filled with advertisements of drugs which act upon the bowels. Many housekeepers lay in supplies of bowel medicines as regularly as the stock of groceries and other necessaries, and medical advice is sought no more in relation to one than the other. Laxative drugs have come to be regarded as staple commodities which stand, next to food and drink, as necessities.
Unquestionably, an inestimable amount of injury is done by the use of these intestinal irritants, most of which are nostrums of the worst sort, providing temporary relief only at the expense of permanent injury.
It is not too much to say that all laxative drugs are harmful. There is no such thing as a harmless laxative medicine.
Laxative drugs act in different ways, and some are more harmful than others. "Salines" impose heavy burdens upon the kidneys, besides irritating the bowels. When long used, they produce an obstinate intestinal catarrh, which aggravates the constipation. Almost without exception, laxative drugs increase the condition which they are supposed to cure. The most difficult cases to cure are those which have long made use of laxative drugs.
Not the least of the damage done by laxatives is the injury to the stomach. The drug is administered by the mouth for the purpose of relieving a difficulty at the other end of the digestive tract, than which it would seem nothing could be more irrational. In a large number of cases of constipation, the whole trouble is a loss of the rectal reflex. The feces accumulate in the rectum or the pelvic colon because of failure of the discharging mechanism. What could be more really absurd and irrational than to irritate and worry the stomach and the whole twenty-five feet of small intestine, besides the cecum and the greater part of the colon, just for the purpose of exciting to action the last six inches of the intestinal tube, the rectum.
As we shall see in the further study of this subject, constipation is not a disease, but only a symptom The morbid condition upon which the symptom depends may be any one of a score or more of things, or several in combination. For the most part, these conditions, as we shall presently see, are such as are certain to be greatly aggravated by the use of laxatives or irritants of any sort.
The use of laxatives as a routine measure, a practice which is almost universally in vogue with the profession as well as with the laity, is most illogical, and is productive of a prodigious amount of injury.
The use of laxative drugs to cure constipation must be regarded as one of the most certain and prolific causes of this condition, and a person who has once formed the habit of using laxatives must as a rule continue the practice as long as he lives, unless he is so fortunate as to find some one wise enough to show him the way out of his troubles.
The systematic use of purgatives for "cleansing the system," irrespective of the state of the bowels, is a very old custom still in vogue in various places. Nothing could more effectively operate to produce the most obstinate sort of constipation. An excellent illustration of this baneful practice and its results came under the writer's observation a number of years ago. A man past middle life sought relief from a constipation which he declared responded to no drug in any dose. He had taken half a pound of "salts" without effect. The history which he gave revealed the cause of his unfortunate condition. The patient stated that when a child at home it was the practice of his mother to give to each child every Friday night a dose of "salts" as a sort of house-cleaning process to prepare the family for the proper observation of Sunday - whatever that may have meant. The result was that after a few years the weekly dose was quite insufficient, and daily doses of increased size became necessary. The dose increased from year to year, and new remedies were adopted as one after another ceased to be effective, until the whole list of laxatives had been exhausted.
In another case, a patient who had taken at first small doses of licorice root and other simples, had become so constipated that even croton oil no longer produced laxative effects. The only remedy that remained at all efficient was a tablespoonful of un-ground mustard seed taken before breakfast Many more lamentable examples of addiction to harmful and diseases-producing laxatives might be cited, but such cases are familiar to every trained nurse as well as all physicians.