Accumulations in the colon at times become so great that their weight tends to displace portions of the bowel, and several instances have been observed in whom the transverse colon from this cause had descended to the pelvis. In other cases the portion of the organ referred to, thus weighted for long periods, no longer lay normally just beneath the stomach, but occupied a position varying from slight downward displacement to a situation approximately in rear of the umbilicus. Fecal accumulations also vary in density, and they at times are so hard as to be mistaken for gall-stones. And again their mass may be so great as to press upon one or other of the abdominal organs, thus interfering with its functions. In this manner the liver is often compressed and its flow of bile obstructed, while the urinary organs may suffer likewise. In one observed instance, after thorough cleansing of the colon by means of an enema, a loss in weight of ten pounds was noted; and in another fecal matter sufficient to fill a bedroom vessel of common size was taken from the bowel.

When feces are impacted in the colon it is difficult for the small intestine to perform its functions, for, not being able to discharge its waste freely, this organ in turn becomes clogged. Fermentation results, and the stomach is involved, while always the kidneys, the liver, the lungs, and the skin are forced to tasks beyond their capabilities, the two organs last named, in addition to their normal labor, being called upon to assist in the elimination of poisonous products not discharged, as they should be, through the bowels.

Fermentation and putrefaction of gathered waste in the colon at first occasion flatulent or gaseous distention, and the gas formed often encroaches upon the cavity of the chest, causing short and rapid breathing, and, when it invades the bend between the transverse and descending portions of the bowel, irregular heart action. As the result of pressure thus put upon the heart, death has often occurred, its cause being diagnosed as heart failure or organic heart disease. In other cases symptoms that have developed because of the formation of gas in the cecum and ascending colon have been diagnosed as appendicitis, and the patient has been operated upon surgically.

Long continued distention of the colon weakens its walls and causes the cavities or pockets already mentioned to form. Food not properly digested, not reduced to a condition adapted to the natural irritability of the intestines, may stimulate the colon to abnormal hasty contractions, as in diarrhoea, or it may prevent normal contraction of the organ. But, whether the fault lie in the quality of the food or in the digestive processes, the result is much the same. This observation applies as well to the ingestion of food in excess of the quantity needed for upbuilding and growth. In either case fecal matter accumulates because the colon is not normally excited to contraction, and cavities are formed because its fibres lose their natural resiliency from inaction and from the distention to which they are subjected.

It is of course to be understood that an impacted colon may result from a nerve supply insufficient to maintain the walls of the bowel in a state that will respond to the irritative presence of food waste. This constitutes a partial paralysis of the organ, and usually when inactivity of the kind is noted, it may in part be traced to spinal mal-adjustment or subluxation. In these circumstances the nerve fibres that transmit energy to the colon are impinged or pinched, and normal nerve vibration is prevented. In other words, motivating power is shut off at its source, and the sole means by which this deficiency may be corrected is by mechanical adjustment of the vertebrae involved.

A goodly portion of the information here recorded has been gained from examination of human bodies after death. In a number of these cases death was shown to have occurred because of ultimate organic inability of the intestines to function in that they had suffered in earlier years from lack of development, due either to insufficient nerve supply, the consequence of spinal mal-placement, to bowel inflammation in infancy, or to the paralyzing influence of drugs administered for the suppression of symptoms.

In other instances of post mortem examination colons were discovered with walls lined to a depth of an inch or more with a viscous mucus-like deposit, portions of which must have been in process of collection for months. In fact, in several cases the entire length of the intestinal canal was thus affected. And, even when deficiency in development existed, impacted refuse was found in amount sufficient to occasion wonder that life in the circumstances could so long have been maintained, since in this condition only a minimum amount of food could have been digested, and the body had been supported mainly by liquids. Here the absorbents of the intestines were completely buried in the deposit and thus were rendered inactive.

In connection with the subject in hand the germ as a factor in decomposition occurring in the colon must be referred to. The large intestine in a general sense is to be regarded as a receptacle for body waste. It forms a suitable culture medium well supplied with warmth, and in conditions as we find them today, there are microorganisms constantly present that are capable of consuming toxic substances, and in their turn of producing them. When normal discharge of refuse occurs, the time of its retention is so short that the organ is comparatively free from soil in which microbic growth and propagation may proceed. Delay in evacuation gives time sufficient for germ development more or less extreme in character.