Intestinal irrigation

It does seem sometimes that man in his ignorance gets nothing right except to walk forward instead of backward. Even so, most likely he walked on all fours for ages, judging from his progress to date, before he learned to walk on his hind legs. To-day we find him self-poisoned, auto-intoxicated, a gastro-intestinal neurasthenic. His bowels are filled and stretched with ancient feces and gases, and his stomach is burdened with undigested food and tenacious mucus.

The average man’s scanty excreta from the bowels are dry, hard, lumpy, and foul, exhaling a noxious odor; and these excretions may be passed once a day, or once in two or three days, or with some persons too often, should diarrhea supervene. Two-thirds to three-fourths of the fecal mass is absorbed by the system every day; and this absorption is accompanied more or less constantly by symptoms of indigestion, biliousness, uric acid, and many other distressful conditions.

His breath and the exhalations of a garbage-can are much alike; in fact they are twins, the only difference between the human and metallic receptacles being that one is capable of walking and the other is not. Both manifest the same conditions.

His mucous membrane is covered more or less with catarrhal discharges, which result in granulated deposits, especially near the orifices. The skin is often sallow, dry, yellow, scaly, flabby. The hair is dry, non-oily, with a scaly scalp, and often there is a loss or total lack of hair. The teeth are decayed, the gums are found to recede, and the eyes, muscles, joints, etc., are more or less affected by calcareous deposits.

Man is seldom or never in a normal physiological condition. He is either obese or emaciated and lean. Most bodies are anemic and ill-conditioned, a prey to several ailments. Of course, civilized man uses drugs; he would not be civilized were he not to use on occasion a stimulant, tonic, sedative, narcotic, etc., and he has to keep in continual touch with a doctor, to take care of him by prescribing special diet, fasts, exercise, and what not for his numerous bodily infirmities. Generally these prescriptions are ineffective and leave him physically weaker and financially poorer, with the barren consolation that he has really tried everything under heaven that the wisest knew or that money could buy. Yes, indeed, he tries everything: everything but water—pure, soft, spring or distilled water. He never—like the flirt—“thought of such a thing”! Very few “humanals” think it worth while to irrigate themselves inside and out.

Victims of semi-ignorance, too, get things most abominably mixed. They are often half wrong and half right; hence they never enjoy good, sound, robust health and its blessings. Physiologically, these people are what old-time pastors used to describe as lukewarm—neither hot nor cold, neither good nor bad, neither dirty nor clean, neither fish nor fowl, neither one thing nor another. So we find them also complaining and looking for the fountain of health and strength, but not looking very anxiously—they are not interested enough in the matter. Whenever they possess an equal mixture of ignorance and laziness, there is not much hope for them.

Note the position of the stomach in health, and how, by slight muscular action, it can free itself of its contents. When dilatation or displacement, or both, occur, the power of rapidly expelling its contents is diminished to the extent in which the change from the normal position and size takes place. I have found that, if there is a normal passing down of the ingesta and also of the feces, the stomach will perform its functions perfectly. Fear of “stomach trouble” is groundless if you keep the digestive and eliminative apparatus in good working order. But this requires that you must keep them clean, and to do so you must drink plenty of water before each meal.

The organs are held in position by a ligamentous attachment and abundant fatty tissue, which serve as a connective cushion that furnishes aid in supporting the organs in their proper place. In chronic cases of self-poisoning, the victim, as a rule, becomes anemic and emaciated, and loses thereby the fatty support required by the organs. They are consequently apt to become displaced and the muscular tissue weakened, with the consequent pendulous condition of the abdomen often observed in both children and adults.

The clay-colored, flabby, obese, anemic victims may retain their worthless adipose tissue; but they suffer quite as keenly as if they had lost it—from the fact that this tissue is impregnated with poison and filled with gas, and from the further fact that this abnormal tissue presses on the vital organs here and there as the victim wheezes or puffs along on his road through existence.

There is not the slightest doubt that nine-tenths of gastro-intestinal ills and their effects can be prevented or cured by thorough irrigation of the canal, from mouth to anus, if it does not itself perform the cleansing process three times in twenty-four hours.

CHAPTER VIII.
Methods of Stomach Cleansing.

Lavage is a term restricted to irrigation of the stomach—a term that has become more or less popular of late with physicians, but is not so popular with those who have to swallow a rubber stomach tube, or with the anxious mother or friends who are usually not permitted to be present on such occasions because of the disturbed and cyanotic appearance of the patient—an appearance produced by the introduction of the catheter. Much can be said, however, of the good results following irrigation of the stomach by the employment of the stomach rubber tube, and in a special class of cases its use is imperative.

But my purpose in this chapter is to advocate the drinking of water as the means par excellence for effective irrigation of the assimilative and eliminative organs, and to make it plain that this form of irrigation is essential for the preservation of health and the relief and cure of chronic inactivity of the principal organs of the system. Usually the drinking of water at regular intervals is sufficient; but in exceptional cases a generous drinking will result in a complete unloading, which can be accomplished with ease and with little loss of time.

Should your stomach be actually performing its office, the suggestions I am about to give will, if followed, keep it sweet, clean, and in good condition, and will also flush all the tissues of the body as well.

The first duty on rising in the morning should be that of flushing the colon, as previously recommended, and flushing the stomach, as now recommended. Take one or two goblets of water (about eight ounces each) at a temperature most agreeable, which, however, should not be ice cold. An hour or half an hour later, during the breakfast, take one goblet of milk and water or two of water alone, when the mouth is free from food. About eleven o’clock in the forenoon, one or two goblets of spring or distilled water, at its natural temperature, should be drunk to cleanse the stomach, duodenum, kidneys, etc., and to flush the tissues of the body. At the noon meal one or two goblets, and at four or five in the afternoon a similar amount, should be drunk—the latter as a cleanser before the evening meal, at which about a pint or more is drunk to aid in emulsifying the food, as at the breakfast and noon repasts. As a rule, besides the amounts drunk at meal-time, there should be consumed as much as two quarts daily, and the best time for this is when the stomach is empty, or when it ought to be empty. At bedtime, one or more glasses may be drunk if one does not suffer from inconvenience from a full bladder during the sleeping hours.

One should make water-drinking a habit, like eating, sleeping, defecating, etc. Water-drinking should be performed at regular periods during the day. System is as essential for the harmonious working of the organs as it is for the relations of the departments in a business, or of the details of any particular department. The guide to the order and temperature to be adopted is agreeable­ness. Find out by experiment what is most agreeable and beneficial to you, and continue the practice with slight variations adapted to the changes of the seasons and the conditions of the system. There must, however, be some training done in most cases, and what is not agreeable at first may become so.

All persons suffering from proctitis and colitis and their symptoms, as described in the previous chapters of this work and in Intestinal Ills, will require, now and then, if not under treatment, special irrigation of the stomach to remove fermentative matter, particles of undigested food, and tenacious, ropy mucus before the next meal is taken. Otherwise the condition will be made doubly bad, for the fresh material is piled on top of the unduly retained contents of the stomach. As evidence of our civilization, we clean pots and kettles before the next meal. We even clean our fingers before, during, and after the meal. Teeth, mouth, and face get their proper cleansing. Why should we suppose that stomach, duodenum, and kidneys, which receive all sorts of stuff, should remain clean without an occasional flushing? They need rinsing out after brewing the wine of life. The water drunk between meals not only cleanses the organs through which it passes but irrigates the whole system, keeping a normal amount of water in all the tissues, which is as necessary for the maintenance of health as is the due supply of water to the plant in your conservatory.

Observe the large percentage of human beings that are anemic, sallow, clay-colored, or white—a few obese, but the many spare, lean, gaunt—all of them expressing the disgust of the soul in having such an abiding-place. If all the organs and tissues of the body were kept flushed, what a fresh and inviting spot the soul would have for the cultivation here on earth of the arts of life!

Water is the wholesomest of all drinks. It quickens the appetite and strengthens the digestion. It is the most effective agent in the work of elimination—in ridding the system of waste material. Properly taken, it prevents the undue clogging of the organs and tissues, and tends to cure or relieve those that had become clogged, and it does this by washing away the substances for which the system has no further use, and which if they remained would poison it.

It is said that if water be drunk freely during a meal the gastric juice will become diluted or washed away. A similar objection is offered concerning the use of the enema. The horse, it is alleged, should have more sense than to drink from three to six gallons of water and almost immediately thereafter eat a peck or more of oats and a quantity of hay, for it ought to know that there is no room for food with such an amount of water in the stomach. If such objectors could but see the horse smile at such arguments—for it secretly knows that the water does not remain in its stomach, and that its gastric juice is naturally strong and needs dilution—they would stand aghast. Would we not be better off if we were not influenced by fool talk like the above advice to the horse, especially as regards our internal economy?

The stomach, like the freight station, can accommodate only a limited amount. Its contents must be rapidly dispersed, and every muscular contraction and every respiration gives it an impulse. Disease and lack of irrigation will occasion an accumulation or congestion of the contents in the gastro-intestinal canal, and then the victim of slow transit complains of indigestion, biliousness, flatulency, uric acid, and of many other ills. Your foul, furred tongue is a very good indication of the trouble below, so it is wise to examine it in the morning to learn your interior condition. Many persons scrape their tongue with a knife because of heavy coating and offensive odor and taste. Dyspeptics of this order need a thorough internal bath from above (per os) and from below (per anus).

Some that suffer from undue gastric retention and indigestion will find relief by flushing the colon and the stomach, as herein specifically directed. Others may find it desirable to start with a mild laxative and an intestinal wash-out with hot water in which some antiseptic or stimulant has been dissolved. The special stomach cleansing is accomplished by the rapid drinking of one tumbler of hot water after another, until a pint or more is taken into the stomach, or until a sensation of vomiting is felt, which may be encouraged by putting the end of the finger down the throat as far as possible or the end of a long lead-pencil wrapped in a little muslin. After as much of the contents of the stomach as is desired is thus cast forth, drink freely of water again, as much as you may think proper, which will be discharged into the duodenum. If this gastro-cleansing has occurred near meal-time omit the meal altogether, and in an hour or two drink as much water as is agreeable, to make sure of a thorough washing out of the erstwhile neglected receptacle—the stomach. This special washing out of the stomach may be repeated as often as occasion demands it. It frequently happens with some persons that an hour after a meal there is a hint that all is not well. This may be concealed or corrected by drinking a goblet or two of water, which practice will permit the brew to go on without further attention to the vat.

Water may be taken at all times of the day or night if occasion arises for its therapeutic effect in addition to its regular period of use. Usually physic, pepsin, soda, charcoal, whiskey, etc., are kept within reach, and are resorted to on such occasions with the thought that one or more of them will do the work. They will not, however, any more than red paint will act as an antidote to poor health by painting the cheeks with it. Water, hot water, especially when used plentifully, is the only solvent of dirt.

Very few realize how essential water is to digestion and to the digestive canal after the process of digestion is completed; and that it has physiological effects on the system generally is less widely known. There exists a great natural demand for water to carry on the normal functions of the system; for both atmosphere and heat draw moisture from the body, and a considerable amount is utilized in the processes of our daily work and in unexpected efforts. An organism composed of almost eighty per cent. of water requires a generous supply for subsistence—a supply equal to the expenditure of vitality involved in carrying on the numerous functions of body and brain.

Some day it will be discovered that water is mainly the element employed in psycho-physiological processes. Water is easily changed to air, and atmospheric air to water, in the system. The generous consumer of air and water will have a good stock of vital or of psychical force on which to draw for the process of thinking. A thinker is a creator, and he must be successful if his thoughts be rightly directed and he have an ample supply of liquid food—water.

CHAPTER IX.
When Enemas Should Be Taken.

Method is imperative in this strenuous life of ours. Nature in her universal operations seems to sanction a uniform system in our daily conduct. Had we a regular time for doing things, periodicity would be established in our sleeping, eating, bathing, defecating, work, recreation, etc. Unfortunately, we are prone to ignorance, self-indulgence, procrastination, which render us careless and reckless in regard to the common-sense conditions of normal living; and before we are fairly out of our ’teens we begin to bear a crop of proctitis, colitis, con­sti­pa­tion, etc.

It is in this way that periodicity as to stooling is lost, and whim, convenience, or necessity takes its place. As a result, we dribble or strain under the fecal and gaseous burden. This happy-go-lucky method accounts for much of the gastro-intestinal disorder complained of by so many, who “want to die” when the painful neurasthenic blues hover around and pervade their bodies like a dense fog.

The insidious manner in which proctitis, colitis, con­sti­pa­tion, and self-poisoning progress from mild through medium to severe stages does not, generally, alarm the victim of intestinal neurasthenia until many years have elapsed, and one or more of the vital organs have become diseased, and the whole system is thoroughly under its toxic effects. Thus, slowly, are the various segments of the gastro-intestinal canal changed to an abnormal condition.

Suppose the tissues of one of your arms and hands were inflamed, constricted, or swollen, and that the nerves of motion were uncertain, shaky, and “kinky,”—all of which conditions we often find in the digestive apparatus,—and that finally recovery takes place under persevering and patient treatment; how soon, think you, could a sensible person expect the limb thus affected to become as useful as its companion that had never been disturbed by disease?

Unfortunately, we have not two sets of bowels. Ocean steamers are equipped with two sets of motion-producing engines, so that the disability of one will result in no loss of speed. When man places as much commercial value on himself as he does on his machines or on a boat, he will either induce Nature to furnish him with an extra set of energy-producing organs, or he will take the best possible care of the only one she vouchsafes to him—a care that extends from os to anus.

Civilized man does, indeed, take a little notice of a sore mouth (although indifferent about an unclean one), and will even try hard to have it heal, because a sore mouth may be seen, and is likely to disfigure him. But a sore anus and rectum may, for all he seriously cares, play their painful and poisonous pranks until he is put to bed disabled or is sent to an asylum—or to the final inn where all diseases of the body cease from troubling and the weary organs are at rest.

To re-establish that normal régime of physiological relations called health, after many years of perverse relations and disorderly practices, obviously requires time and intelligent, faithful attention to prescribed conditions.

The factors or causes that militate against the removal of curable diseases are:

(1) The neglect of a local disorder until it has had time to exhaust the general vitality of the system.

(2) Inattention on the part of the patient after he has obtained temporary or partial relief.

(3) The victim arbitrarily setting his own time limit for the cure of the disease.

(4) His wilful disobedience of prescribed rules.

(5) Inability to realize the importance of having the cause removed, as well as the local symptoms.

Confining attention for the present to proctitis and colitis, I wish to impress the patient, as well as the physician, with the fact that no better measure for relieving or removing these undermining disorders can be adopted than the regular practice, twice or thrice daily, of intestinal irrigation by means of enemas. The persistent use of the enema is directly influential in relieving and removing the symptoms of such disorders. These symptoms may be piles, prolapse, skinny tabs, fissure, dull pains, soreness, itching channels, stricture of the anus and rectum, ulceration, abscess, fistula, cancer, etc.

In the early history of ulcerative proctitis and colitis, the local symptoms at the anal vent may not be noticeable; yet the disease may be quite well developed for six or nine inches along the bowels. The early or more obscure symptoms are mild and unnoticeable; then they progress into notice, sometimes most sharply; finally we have severe and chronic con­sti­pa­tion, indigestion, flatulency, diarrhea, etc., and, keeping pace with these, we have the stages of self-poisoning, which is known as auto-infection or auto-intoxication.

With other measures, the most effective for relieving and removing these symptoms of proctitis and colitis is the enema night and morning. During the long period of relaxation at night, the functions of elimination and repair are, with the great majority of us, going on under abnormal conditions—such, for instance, as excessive fermentation and bacterial putre­fac­tion, which generate poisonous gases that are absorbed by the nerves and bring about the condition of malaise we complain of when we rise in the morning. We then find our bowels distended and ready for relief—and also, strangely, “not ready”!

Before dressing, therefore, is the time to relieve the excessive pressure from gases and feces, and a slight enema is accordingly advisable, say from half a pint to a pint of water, which should be expelled at once. This removal of the contents of the rectum and perhaps of the sigmoid flexure will permit the contents of the ascending and transverse colon to pass more readily toward and into the sigmoid flexure, as though they had been invited to come; and, indeed, such passage is rendered inevitable by the removal of the local gas and feces in their path. When half an hour or more has passed and breakfast is over, it is time for the regular and complete evacuation of the bowels, by the aid of the internal bath, or, as some describe it, by a full flushing of the colon.

In our early efforts to establish harmony and periodicity with the enema, it is advisable to resort to a mild vegetal laxative, in some cases, rather than to let the tongue indicate so much foulness and allow the feelings to become so intensely blue that they cannot be hidden by even the utmost effort at pleasantry. Extreme cases may call for different aids toward relief, until, one by one, these aids may be dropped—the last one to be discontinued being the enema.

For a short time at the start it is, perhaps, best to confine one’s self to two enemas, especially if fairly successful with the attempt at a thorough cleansing after breakfast and before retiring at night. The sleep will be sounder and the patient will be more apt to rise refreshed with a clean tongue and cheerful spirits. So much will this before-bed enema do for him that he may soon find it unnecessary to take the preliminary injection on rising, inasmuch as fermentation and gas will no longer trouble him. But individual experience and intelligence must dictate the course in this respect. Let the patient study himself and note the demands of his system. It may even be, indeed it is frequently the case, that a patient requires several enemas during the day. When abnormality has set in, it gives rise to all sorts of freak requirements, and the victim must, for a time, accede to its whims.

Quite frequently, owing to various causes, the feces will descend into the rectum, which is properly a conduit, not a receptacle. While there it occasions much nervous irritation of the whole system and makes its victim desperate. It is wise, under such a condition, to take slight injections for relief. Never allow any foulness to accumulate. Establish the habit of internal cleanliness. The new sense of bodily purity will be so great that it can never be outgrown.

Nature easily accommodates herself to habits, whatever they be—normal or abnormal, wholesome or unwholesome, cleanly or uncleanly; and the train of consequences will be accordingly good or evil. My point may be easily illustrated by the habits of “civilized” man in regard to bathing. Many persons never take an external bath, and are not conscious of any bodily discomfort arising from the omission of this presumably necessary practice. As the summer approaches, another batch of “civilizees,” so fortunate as to be within convenient distance of a pond, lake, river, or ocean, begin to feel the real need of a “dip,” and are uncomfortable until they get it. This is surely a sign that the spirit of cleanliness is beginning to stir in the breast of humanity. Then there is another contingent that bathe once a week, and should their regular routine in this respect be interfered with they would at once feel unclean—nay, even dirty, and, sometimes, “nasty.” Others, again, bathe twice or thrice weekly, and this quota of the human race feels very uncomfortable and foul when hindered for a week from following this routine; indeed, such bathers often imagine that a dire illness is impending. Finally, the “salt of the earth” take an external bath once or twice a day, and, should their routine be suspended for twenty-four hours, visions of madness or suicide begin to haunt them until relieved by soap and hot water, or the cold plunge, as their habits require.

Of course, the same rule applies to the routine concerning the teeth, facial ablutions, etc. Nature is stored habit, and she feels outraged when her proprieties are disregarded. Let us pray, therefore, that the habit of cleanliness may become contagious!

Now, the parallel between external and internal cleanliness is quite obvious. Those whose bowels move but once in two or three days do not realize how foul they are. Others have a scant evacuation once in twenty-four hours, and they imagine that they are as clean as those that take an external bath once a week think themselves to be. Still others have two stools daily, and they feel as clean internally as those that take three external baths weekly. And, finally, there are a few who, defecating thrice daily, feel quite as clean as does the most persistent external bather. Thus we see that cleanliness, external and internal, is a habit, a new nature, attended with exquisite comfort and pleasure—a quality that may lead to the goal of divine purity in realizing the joys of hydropathy.

The wild woodland flower grew and blossomed without attention, attracting but little interest. After, however, the florist has cultivated it to the high stage of development in which we find it to-day, with its stalk, stem, leaf, and fragrant petals displaying their marvelous symmetry and beauty, we begin to appreciate the value of labor, pains, cultivation. In like manner, it is our imperative duty to give proper care to every requisite detail in the transformation of our body into a human flower of health, grace, joy, and harmony.

The great majority of those that do me the honor to read what I have to say on internal and external cleanliness will, doubtless, not agree with me as to the frequency of the ablutions in twenty-four hours. Yet I have a suspicion that if my objectors were to try an external and an internal bath, on both rising and retiring, they would soon consider the practice too delightful to be foregone; they would soon develop more sweetness of character and be more particular as to the purity of their nether garments, and, finally, would seem ensphered by an atmosphere peopled with angels.

My proposition is this: First make a man clean, internally and externally, and thus you may make him good; after you have made him good you can make him healthy in both body and mind; after you have made him healthy you can make him full of joy.

To recapitulate: A good time to take your internal bath is about half an hour after each meal. Cultivate regularity in this, and Nature will second your efforts and establish a periodicity for you by her suggestive impulse and call. Our internal economy should not be slighted as it has been. The intestines are good, faithful, patient servitors, ready to perform their lowly office even when we are inattentive and heedless. Sometimes, however, they become rebellious, after they have stood more abuse than one would think them capable of standing. Let us reform our bad habits; our servitors are willing to enter with us into better habits, and co-operate with us in a truly human life. Can you not spare a few minutes, three times a day, at regular periods, for inner purification? You will find it very easy when once you make it a matter of routine.

Now note this point: The work of your brain depends on the power sent to it by the gastro-intestinal canal. A motor car goes no faster than the power furnished enables it to go. So your brain activity is ever on a par with the energy supplied from this usually despised intestinal source; that is, it can never rise higher than the supply of this energy warrants, and it always falls to the level of this supply, for it depends on it absolutely for sustaining power. It would seem, therefore, that common sense would be sufficient to shame us into keeping clean, scrupulously clean, the canal that supplies us with working force—the canal that extends without a break from mouth to anus. Yet my experience shows that almost everybody cares more for his outsides than for his insides—more for squandering his stored energy than for looking out for its constant renewal—and that most patients are foul all the way down.

Well-fed animals that have the range of Nature are plump, and have healthy hair, skin, teeth, etc., because their intestinal organs perform their functions frequently and fully. When animals become domesticated and “civilized,” they become con­sti­pated and catch various human illnesses or grow a crop of their own. Well-fed “humanals” grow thin and puny, or bloated with gas, looking like corpulent clay men, without natural teeth, without natural hair, their skin dry and of a sickly hue, bloodless, fading away because of an early blight before they have completed their early growth. Heredity is blamed for the bloodless, nerveless, brainless body, when, as a matter of fact, its degeneration is due to foulness within.

Birds, beasts, and savages (more fortunate than civilized man) have the wide earth on which to stool when Nature calls. Their handy water-closet enables them to enjoy good health. As civilization advances, and business and social customs become more complex, water-closets get fewer and less accessible. As a consequence, man has to use his large intestine for a storehouse. He has done this so long that it seems impossible to break him of the foul habit. But he is paying the penalty. Many have abused the bladder in the same way, and had this been a large organ like its brother, the colon, we would long ago have heard the stereotyped excuse in regard to this function, “Oh, any time to urinate that I can find will do.” Those who object to the new order of bowel relief should, on the same principle, object to frequent bladder relief.

I submit this proposition to the judgment of unprejudiced minds: Is it not reasonable that so harmless and efficient a remedy as the internal bath should be adopted by all intelligent persons? Inasmuch as neglect—due to social, business, and other customs, and to lack of conveniences for ready relief—has brought upon us so much fecal poisoning and local disorders and so many abnormal and pernicious systemic results, it should not be considered too great a task to take an internal bath three times a day to amend our outrage on Nature—an outrage that involves our health and general well-being, here and hereafter. We owe it, not only to our possibilities, but also to posterity, that fecal poisoning be banished. We have no right to communicate such a taint to our children. They have a right to be free from such poison. Do we ever think of their claims in this regard? Let us leave them a better legacy, by adopting the thrice-a-day use of the enema for the purification of the alimentary canal!

CHAPTER X.
How Enemas Should Be Taken.

METHODS OF INTESTINAL IRRIGATION.

A satisfactory appliance for taking an enema should possess the following features: capacity, adaptability, convenience, cleanliness, durability, and sufficient external anal and water pressure to effect a thorough flushing or an agreeable vaginal injection while one is in a sitting position over a water-closet bowl.

There are several postures in which an enema may be taken. For those physically able, the most convenient, cleanly, and comfortable manner in which the thrice-daily inner bath may be had is the usual upright position on a water-closet seat. For those not physically able to sit upright, or for those that are not up-to-date and still adhere to the use of the fountain or the bulb syringe, the best method is not the usual sitting position, but the recumbent one. They are advised to lie on the right side, or on the back with hips raised. As a rule, a water-closet room is too small for reclining purposes, and, besides, the necessary rubber sheet and toweling convenience may be absent. Another drawback to lying full length for the purpose of flushing the colon is that with short arms and the lack of external anal pressure there is apt to be an escape of water and feces around the anal point, necessitating much cleansing, considerable annoyance from nasty odors, and an irritating waste of time.

Various devices, advertised as great inventions, have been resorted to for the purpose of overcoming such malodorous and uncleanly incidents. Among them is one that may be described as a colon tube, ranging from nine to eighteen inches in length, which can be attached to a fountain or a bulb syringe. The tube is usually of flexible rubber, colored red to hide as much as possible the cumulative evidence of saturated filth and bacterial poison, the presence of which a white tube would betray too readily.

I fail to see the necessity of introducing a rubber canal of such length into an intestinal channel five feet long for the purpose of “cleansing” the latter. The project lacks common sense. What a ridiculous practice—to worm or bore a hole through the impacted feces as you work your tube upward, then to squirt a little water into the middle of things, or as near to the middle as you have managed to get with a tube that will persist in bending on itself, and then to withdraw it covered with liquid filth! What folly to put a canal into a canal—the one inserted being one-fifth the length of the one to be cleansed! Is not the original physiological channel good enough to convey the antiseptic water or oil, or both? Why not have the rubber canal five or six feet long if one foot is so essential?

We should remember that ulcerative proctitis and colitis have made the use of the enema a necessity; that, accordingly, the diseased, constricted gut or canal must be treated very gently and not irritated in any avoidable way. The least irritation will result in still greater muscular contraction. It stands to reason that the effort to reach the healthy portion of the bowel with a slightly flexible colon tube frustrates its own purpose, and that it is besides a source of serious and unnecessary irritation. While this rubber tube is being forced up one’s bowels it often becomes lodged here and there in the valves and folds of the mucous membrane. It has been found that the effort used to dislodge it sometimes results in a doubling of the tube on itself in the form of a knot, and that the end first introduced comes back to the anus waiting to escape with the next push! We need not argue that this forced looping and knotting of the tube is very injurious to the diseased intestinal region, and that no one would care to introduce it two or three times a day.

Does not common sense suggest that the rational way is to open the bore of the alimentary canal by beginning at its end; that liquid should be applied directly to the first feces encountered, and that as this impacted mass is removed the progress should be successfully upward? The liquid as it enters dilates the channel, and as it passes on and up it eventually gets beyond the diseased section of the bowels. Here, by a gentle and soothing dilatation, we create at once an impulse in the imprisoned feces and gases to descend and escape. What other method is so kindly, and yet so effectual? We avoid, by this means, irritating the diseased and constricted muscular canal; whereas by the tube method we occasion still greater contraction, the inflamed surface having a tendency to contract and close tightly over the tube. The flood of liquid dilates the canal; whereas the forced rubber tube, by irritation, contracts it. Besides, as has been pointed out, the conduct of the tube working in the dark is most uncertain.

Suppose the rubber tube does finally reach the section of the colon free from inflammation; that its passage thither has greatly increased the spasmodic contraction of the diseased portion of the gut, and that, of course, it had great difficulty in circum­venting the resistance offered by the valves, curves, and short bends—suppose all this, and an idea of how the contents of the bowel above the diseased zone are imprisoned will dawn upon you. For, after the tube has reached this point of impaction, the distention there is most unduly increased by the sudden gush of water, and, what is of still graver import, the presence of the tube prevents its return flow. Then as the object is being removed the watery feces following closely after are impeded by the increased irritative contraction set up by the tube.

In short, this greatly extolled colon tube subjects the region of proctitis and colitis, as well as the healthy section, to just such objectionable procedure until the amount of water injected becomes so extremely large that a means of escape is irresistibly produced by the great pressure above. Is it wise treatment to irritate the diseased portion of the bowels, and to distend still further the healthy portion above, in order to get rid of distention due to feces and gases? Without increasing the danger by injecting water into the already unduly distended colon by the use of the tube, the imprisoned feces and gases of themselves alone have been known to exert sufficient pressure to occasion prolapse of the sigmoid flexure into the rectum or undue displacement of the organ. Surely it were better to get rid of the imprisoned contents by removing them from near the vent and working one’s way gradually upward than to add more to the store and burden, which only causes unendurable excitement and fierce demands for relief.

The rectal enema, taken in the rational way, simply dilates the portion of the gut that is morbidly contracted—a procedure that is very beneficial and should be continued just so long as any remnant of the inflammation remains in the tissues. Kindly treatment is essential, because ulcerative inflammation is an irritable condition and tends to contract the muscular tissue at the slightest touch of a foreign substance. What, I repeat, is more kind and soothing than antiseptic water mixed with oil?

Advocates of the colon tube assert that water entering the lower portion of the rectum will occasion ballooning of this portion of the gut. After an experience covering twenty or more years, I am in a position to say that there is absolutely nothing in this objection—that water used in this way cannot produce such a pathological condition. Ballooning of the lower portion of the rectum is occasioned by impaction of feces, which remain lodged often for weeks or months at a time in this locality. Whatever dilatation the use of the enema may transiently produce would be only healthy exercise for the diseased organ. An instrument is frequently used properly to dilate the more or less contracted canal above and below the distended pouch for a distance of from six to ten or more inches. Nothing but good results can follow the proper use of the enema two or three times a day in all forms of local disease of the anus, rectum, and colon.

CHAPTER XI.
The Internal Fountain Bath.

THE AUTHOR’S UNIQUE INVENTION.

The author has searched the markets of the world for suitable apparatus for intestinal irrigation, so that he, as a specialist in this line and in anal and rectal diseases, could recommend it to his patients. None of the appliances to be had, however, quite answered the purpose he had in view. All of them had some drawbacks. Owing to this fact, after much experimentation he has invented an instrument that is herein fully described to show its serviceable­ness. Were this volume to be issued without this description, the author would be inundated with interrogatories concerning the best instrument to be employed by its readers, or whether the appliances they have on hand would answer the purpose. As the object of this book is practical, not literary, it is not out of place, the author thinks, to describe the invention and its unique serviceable­ness, as well as its special adaptability for the tri-daily employment of enemas.

The instrument is known as “The Internal Fountain Bath for Home Treatment.” The following illustration gives a very good idea of its construction and merits:

The Internal and External Fountain Bath is an appliance that I have devised and supplied to my patients for many years with most satisfactory results in every particular. Several other enemata and recurrent douche instruments which I have used did not wholly meet the requirements in capacity or aseptic features; but long use of this apparatus in all the various bowel troubles has demonstrated, to me as well as to my students and patients, that the instrument is the best that can be made, perfectly meeting all the requirements essential for scientific results.

Features and Uses.

The Fountain Bath is the product of necessity, effort, and long experience in accomplishing a definite purpose fully and properly. Figure 18 illustrates a large enamelled metal reservoir for water. Figure 21 shows a hard rubber combined enema and recurrent douche appliance for the application of water to the mucous membrane of the large intestine, the temperature of which should range from ninety to one hundred and thirty-five degrees or more. To one end of the handle is attached a hard rubber anal cone (Figure 27), inside of which is a valve (Figure 29), which is opened and closed by turning the handle, permitting the water to pass through the rectal point (Figure 25), or (Figure 26) into the bowels and return into the toilet basin without removing the point. At the other end of the handle is attached a glass reservoir for the use of oils. Figure 22 is a metal handle with a glass reservoir and a hard rubber anal cone. Figure 23 is a metal handle without glass reservoir, and both are intended for the use of water at a temperature of from ninety to one hundred and five or one hundred and ten degrees. A thermometer is absolutely necessary to determine the temperature of the water during its use as a depurent and antiphlogistic remedy. The heating appliance will keep the water at a desired temperature during its application, which is a very essential feature indeed.

Water Capacity.

The Fountain Bath reservoir holds three gallons of water, which is quite sufficient to meet all requirements of the various complicated cases of bowel and uterine troubles which require a generous supply of tepid or very hot water. This obviates any interruption in the use of the enema or the recurrent douche treatment until one or both are satisfactorily completed, and without changing one’s position on the toilet seat. It requires a quantity of water to irrigate the large intestine, which is some five feet long and two and a half inches in diameter. It is foolish to attempt to irrigate one end of a long, tortuous, foul sewer with one or two quarts of water and hope for good results. Water is cheap, then why not clean out and keep clean?

Adaptability.

For the first time in the history of enemata appliances can an enema, recurrent douche, or vaginal injection be taken with water at any desired temperature and at the same time be medicated with any remedy desired. External pressure against the anal orifice is regulated at will; also the flushing of the integument about the anus and buttocks is easily accomplished before leaving the toilet seat.

Convenience.

This scientific device can be used without assistance. It has one feature moreover, that renders it unique among rectal appliances, namely that you may take a number of rapid injections without changing your seat. You may inject a small quantity of water (from eight to twelve ounces), and expel it immediately; then you may follow with a larger amount (from one to three pints), and expel that also, then in the same manner flush the colon. A complete internal bath may be effected in the same way by using three, four or more quarts of water. In this way, thorough depurating results may be obtained. The several preliminary injections of gradually increasing quantities of water free the lower bowel of feces, germs, and gases which otherwise might be forced by the flushing process backward into and along the colon. With the Internal Fountain Bath, unlike other syringes, it is not inconvenient to take preliminary injections before flushing the bowels. After the flushing the rectal and anal canals the bowels can be easily cleaned their entire length, as can also the integument about the anus and buttocks by letting the jet of water play on these parts to wash away any germs and other poisonous discharges. All the necessary movements of the anal point are easily made with the handle which projects between the limbs in front of the toilet seat.

Cleanliness.

The water reservoir is enameled white, both inside and out and free from poisonous substances. The enamel is not injured by the use of any germicidal remedies that may be placed in the water, or by the water being brought to a very high temperature to destroy bacterial poisons. Furthermore this enameled surface is easily cleaned, thus avoiding foulness of the reservoir from continued use. The glass medicine case and anal cone attached to the handle, as well as the anal point, are all detachable and easily cleaned, and the handle is of sufficient length to obviate soiling the hands and impregnating them with odors.

To bring away a quantity of feces does not exhaust the purpose of the enema. The intestinal sewer requires further cleaning from end to end, and the external parts around the anus as well. By playing a jet of water on the external anal region you finish the enema and avoid the very uncleanly practice of using “toilet paper” as a means of external cleansing. It is strange that otherwise cleanly people are content with such uncleanly treatment of these parts. They imagine that “toilet paper” will effectually remove the excrement and its attending odors. They would not think it sufficient thus to clean their hands if soiled by excrementitious matter. It is the old story, “out of sight, out of mind,” and of letting any make-shift in such cases answer; but the spirit of cleanliness is abroad in the land, and the Silent Club of the Cleanly is being formed through just such agencies as the Internal Fountain Bath. Many have doubtless longed for a better practice but did not know what to do. The “toilet paper” habit will pass with the once-a-day habit of stooling, the con­sti­pa­tion habit, and the physic habit, for all four are uncleanly in the extreme.

Durability.

The enameled metal reservoir and the metal and hard-rubber parts of the handle ought, with care, to last a lifetime; the soft-rubber tube, if properly cared for, will be of service for a long time.

External Anal Pressure.

This is of very important assistance in flushing the colon, as it aids in preventing the return of the injected water, and thereby promotes its conveyance along the colon until it arrives at the surgically famous vermiform appendix. It is not strange that both ends of the large intestine—the anus and rectum and the appendix region—have kept the surgeons busy, and I may add the undertaker likewise. These two ends are of extraordinary concern, because they manifest intense symptoms and pathological consequences. Modern medical practice is the heroic treatment of symptoms and consequences and not patient search for causes of disease and sensible treatment of it, as explained in my treatise dealing with “Intestinal Ills,” as well as in the present volume.

Water Pressure.

Two or three gallons of water, suspended at the usual height of enemata appliance, affords quite enough pressure, especially when the outlet and tubing are amply large. The shut-off on the rubber tube enables the user to gauge the flow of water to a nicety.

Time Required.

The time required for taking an internal bath—that is, for a complete flushing of the bowels—will vary in individual cases. After removing the local deposits in and near the rectum by one or two rapid injections of very small quantities of water, two to four quarts are taken into the intestinal canal at one time, and this constitutes the enema proper. Now, many persons will find it advantageous to let the flushing water enter very slowly, taking from two to five minutes, or even more. With some, if the water is allowed to flow in very rapidly, the various segments of the rectum and colon may not readily accommodate themselves to the inflow, and will too soon make an expulsive effort, returning the water before it has dissolved the feces or united with them, thus defeating the object sought through the enema. With other persons, however, the flow may be as rapid as desired. The speed must be left to individual judgment and experience.

Temperature of Water for an Enema.

The chief purpose of an enema is to produce depuratory results; that is, to remove morbid matter from the bowels and then to cleanse them. To accomplish this effectively and at the same time to avoid exciting an increased flow of blood to the diseased gut, the water should be about the normal temperature of the body, which is about 98 1/2 degrees. Water too hot or too cold will aggravate the sensitive, inflamed surface; and, as it is this very inflammation that causes the abnormal action of the bowels for the relief of which the enema is taken, the temperature of the water is most important. If it range between 90 and 105 degrees it will do, for within those extremes it will not be likely to increase the existing chronic engorgement of the tissues. Under no circum­stances should very hot or very cold water be used for the removal of fecal accumulation. Physicians so incompetent as to make a wrong diagnosis of the cause of chronic con­sti­pa­tion and its numerous symptoms often prescribe a wrong treatment in the use of water. From two to ten minutes’ use of very hot or very cold water in cases of proctitis and colitis will only increase the chronic engorgement of the blood-vessels and tissues and increase the morbid symptoms. When water is applied to the mucous membrane anywhere throughout the body, I use it hot exclusively, as that temperature has then certain advantages over cold. In the chapters treating upon the different uses of hot water, I give the hydro-therapeutic action of such liquid on the tissues of the body.

Quantity of Water to be Used.

The quantity of water to be injected into the colon at one time must vary in each case and also on each occasion. In the beginning of its use and for some time following, a greater amount may be required than will be necessary when, with its continued use, a better action of the bowels becomes established.

In cases of chronic con­sti­pa­tion and semi-con­sti­pa­tion, the kidneys, lungs, mucous membrane, and skin eliminate a daily accumulation of feces from the system equal to two-thirds or three-fourths of the amount of normal feces. This accounts for the frequency of chronic disease of these organs. To establish a new régime in the mode of fecal and gaseous elimination requires much time and patience in the use of the enema. Nearly all persons can take the enema with comfort and satisfaction. Now and then, however, there is a person who finds it a little troublesome to inject over a quart of water at one time, while most persons can inject over four quarts without inconvenience. I would advise patience and perseverance on the part of those who find it irksome to inject a sufficient amount thoroughly to cleanse the colon, or the portion thereof involved in undue accumulation.

Enough water should be injected to bring away what would constitute the normal amount of feces to be passed at a regular stool. Gradually, as the practice is established by the use of the enema twice or thrice daily, it will be easy to determine the proper amount of feces to pass. And note this fact: it is just as easy to establish the habit of three evacuations in twenty-four hours as of two or one.

Whenever the amount of water injected proves sufficient at any time to bring away all the feces that should pass, it is not necessary at that sitting to repeat the dose, except it be for subsequent cleansing, as a sort of gargle. No possible harm can come from the generous use of the enema during a lifetime; indeed, its constant use will prolong life and make it more comfortable.

CHAPTER XII.
Benefits of the Inner Bath.

I speak from clinical observation with the use of various rectal and colon specula, of which I have over fifty. I have watched the progress of cases that were using the enema twice or thrice daily, and of cases that were also using the intestinal recurrent douche, which latter required an hour’s continuous application of hot water, and I know, therefore, whereof I speak when I affirm its salutary effect both on the local organs and on the general system.

Many that write about the use or abuse of the enema have never seen the mucous membrane of the rectum and colon. Most of what is written on the subject is worthless. The author of this book writes from the accumulated experience of daily examinations with specula for a period of over twenty-three years. Had he merely used his fingers or hand for making rectal examinations, or had he contented himself with prescribing for symptoms reported by the sufferer, his views and opinions as to the use and benefits of the internal bath would have been on a par with those that, by the old methods, make futile efforts in diagnosis and treatment.

Some good souls now and then become oversolicitous as to the matter they should pass when their bowels are already empty, and they feel alarmed if the enema fails to produce an evacuation. Such timid ones should remember that what they cannot accomplish at one time and with one attempt they may at the next, and that thus slowly the new order of fecal elimination will become established. It takes time and patience; but is this cause for apprehension when diagnosis, treatment, and means of relief are right? I claim that flushing of the colon is the best means for removal of the consequences of proctitis and colitis, and that it should be employed by all that have these chronic ailments. Let them get relief for the symptoms at once and in this rational way, after which let them seek scientific treatment for the ailments themselves; for, sooner or later, they will be compelled to seek it by the severe complications that will inevitably set in.

TRY SCIENTIFIC AND PRACTICAL MEASURES.

Some persons find difficulty in estimating—or think they do, which in most cases is nearer the truth—the amount of water they can inject at one time, when it would work a great relief to their bowels were they able to inject from two to four quarts. It is half the battle to know your efforts are rightly directed; for, when you are defeated, you will try a thousand and one changes—an experiment first with one element of the difficulty and then with another. You will experiment with the temperature, with the speed of flow into the rectum and colon, with intermittent flow, etc. Be a little scientific and original in this matter, I pray you, and know no defeat!

As to the intermittent flow, the following way may be found judicious in some cases: Take in just sufficient water—a few ounces perhaps—to provoke an evacuation, and proceed till you have taken half a dozen or more. After this you can take a greater quantity for a washout. But this is not exactly what is meant by the term “intermittent flow.” It means that you may make the experiment—if you find it difficult to fill up after ridding yourself of the local accumulation—of turning off the stop-cock for a moment, thus giving your bowels a slight rest, and then turning it on again, alternating in this way for some minutes. Many little devices of similar utility will suggest themselves to those who know no defeat. Remember that, now that you are in serious trouble, it is not the easiest thing in the world to get out of it.

Should your stomach raise objections to the enema, change the time. If abdominal pains are severe, change the temperature of the water and the time and manner of injecting it. In other words, do something different, but be determined to conquer and take the internal bath at proper periods every day.

LIBERATING THE WATER.

Some persons who find no trouble at all in taking a large quantity of water have much difficulty in expelling it, or rather in expelling all of it at once. Various methods may be resorted to to liberate the retained water. One is to inject a little more, as a provoker, when all will escape without further difficulty. Another method is to resort to various motions of the arms and body. Some find relief by raising and projecting both arms together slowly, and then stretching and holding them aloft for a few moments. Other methods are: to twist the trunk a few times, to walk up and down a little, to bend forward and backward, etc. Still another method is to massage the abdominal walls, beginning at the ascending colon (see Fig. 12), passing upward to the left along the transverse colon, and then downward until the lower portion of the sigmoid flexure is reached. When beginning the massage, one should use stroking movements from right to left over the entire surface, and then go over it again with rotary strokes. Some may find it advantageous to knead the abdominal muscles, gradually reaching the deeper parts as the air is expelled from the lungs, which expulsion may change the position of the various segments of the intestine and thus afford an opportunity for the feces, gases, and water to escape. Before rising in the morning and retiring at night, it will be found advantageous by some persons to spend about ten minutes in making the three kinds of manipulations described. It is an excellent practice for every one to lie flat on the chest and abdomen and draw in several deep breaths just before rising. This exercise will strengthen the muscles of those parts and benefit the internal organs as well.

THE ENEMA AS A PERMANENT PRACTICE.

In the effort to restore the long-abused bowel to its normal functioning by the use of the enema and massage, there may be, in the beginning of such treatment, an exceptional case in which a mild laxative is indicated as the desirable thing, rather than that a furred tongue and base bodily feelings shall evidence too much foulness all the way up to the mouth.

The enema, of course, constitutes the chief means and mainstay of relief from ob­sti­pa­tion of the bowels, and one by one the other aids are to be omitted. Moreover, when the time comes that the bowel is freed from the disease that occasioned the occlusion and ob­sti­pa­tion,—that is to say, when the bowels evacuate themselves naturally three times a day,—then the enema itself may be omitted, or it may be continued without harm by those whose sense of cleanliness would induce them to keep up the practice in preference to the uncleanly habit of using toilet paper as a partial means toward cleanliness. Surely there is no harm in substituting a better habit for a worse one—one, moreover, that we should be ashamed to continue! As no one would think of cleaning his soiled fingers with toilet paper, as already said, so no one with any real sense of decency will continue the attempt to clean his anal orifice with such material when he has learned a better and more effective way. Likewise, after having learned the rational mode of relieving the surcharged bowels, no wise person will continue the use of physic, coarse food, gymnastic exercises, and other futile and foolish practices as remedial measures for intestinal ailments.

No one suffering from proctitis and colitis can have a clean and healthy sigmoid flexure and rectum unless these be kept clean by the regular use, three times a day, of the enema. From the day when the disease invades these parts there is and will continue to be a clogged, plastered, or incrusted passage for more or less of the entire length of the colon. This must be so in the nature of things, since these organs are unable to perform their functions while the disease is present. Just think of possessing a filthy, congested intestinal canal, without one day of real cleanliness for twenty, forty, sixty, or more years! It is not the easiest thing in the world to cleanse this channel even by the use of the enema; for the ancient contents refuse dislodgment even after repeated flushings, and it is only after many days of persistent and patient irrigation that the intestines are freed.

Some persons are apprehensive as to the quantity of water the large intestine will hold with safety. Let me reassure them. It is capable of holding about three gallons without too great distention. One-third of this amount, however, is quite sufficient to bring away the accumulated fecal mass, and in many cases a much smaller amount will answer the purpose—especially when, as advised, it is used two or three times within twenty-four hours. After a thorough evacuation, water should be injected one or more times until it returns clear and free from fragments of feces.

If I were asked to name the greatest curse parents could inflict upon their helpless offspring, I would say fecal auto-intoxication. A large volume could be written on the subject, and I trust the hints here given will lead to discussion of this grave matter.