Fig. 1.
Radiograph showing tube (1) in the rectum; 2, probe inserted 83⁄4 inches; probes 2 and 4 pass on left side of rectum; 3 and 5 pass on the right; all pass into perirectal spaces; three probes are seen under the integument.
Fig. 2.
Radiograph showing tube (1) in the rectum; probes 2, 4, 6, passed on the left and front of the rectum; 3 passed forward; 5 under the integument along the spine; 7, 8, and 9 probes passed to scrotum and thigh.
Fig. 3.
Radiograph showing a large region more or less filled with bismuth from the anal canal forward and upward, as indicated by lines 1 and 2; a severe case of proctitis, sigmoiditis, periproctitis, and perisigmoiditis.
Fig. 4.
Radiograph showing a tube in the rectum and probe passed to the left of the rectum into the space where bismuth was injected; a case of acute proctitis, sigmoiditis, periproctitis, and perisigmoiditis at time of treatment.
Fig. 5.
Radiograph showing bismuth in a perirectal channel on the left side of the anus and rectum, which caused continuous annoying pain for many months.
Fig. 6.
Radiograph showing a long muco-cutaneous sac and perirectal channel into which bismuth was injected; a case of proctitis and periproctitis, etc.
Fig. 7.
Radiograph showing a tube in the rectum, a long probe and bismuth in perirectal space, also a probe in a submucous channel; a case of sigmoiditis, proctitis, periproctitis, and perisigmoiditis.
Fig. 8.
Radiograph showing bismuth injected in the perirectal space; a case of proctitis, sigmoiditis, periproctitis, and perisigmoiditis with severe constipation and indigestion.
Fig. 9.
Radiograph showing tube in the rectum, a probe and bismuth in perirectal space, and also a probe in a submucous channel; a case of proctitis, sigmoiditis, periproctitis, and perisigmoiditis.
CHAPTER XXV.
Chronic Mucous Proctitis and Sigmoiditis—Usually
Diagnosed as Chronic Mucous
Colitis.
Chronic mucous colitis ought to mean inflammation of the ascending, transverse, or descending colon. The length of the rectum varies from five to eight inches, and the average length of the sigmoid flexure is about nineteen inches; the length of the two organs is thirty or more inches. Chronic follicular, ulcerative proctitis and sigmoiditis, extending half, or even the whole length of the sigmoid flexure, causes great suffering, and the symptoms are similar to those attributed to chronic mucous colitis. For about thirty years I have positively known that many of my patients suffered not only from chronic mucous proctitis, but from sigmoiditis as well, since I was able to make positive diagnosis of the diseased condition for at least ten to fifteen inches up the lower bowels.
If the anal canal is inflamed from any cause and not cured, the chronic inflammation will gradually extend up the whole length of the rectum and into the tissues of the sigmoid flexure, invading the organ to a greater part of its length, if not all of it. The sigmoid flexure is the normal receptacle for feces, and gases, and physiologically and hygienically ought to be emptied three times in twenty-four hours to keep it clean for those who are in the habit of eating food three times a day. The hygienic condition of the sigmoid receptacle is entirely dependent upon a healthy condition of the rectum and a sensible tenant of the body; but when chronic proctitis has taken possession of the rectum and neighboring tissues, it serves no longer as a normal passageway for emptying the sigmoid flexure of accumulated feces, gases, and liquids.
At first inflammation causes spasmodic muscular contraction of the anus and rectum, which in time becomes more and more permanent stricture as the progress of disease advances, lessening the bore of the organs until it becomes very difficult for anything to pass into and through the rectal and anal canals. Inflammation extending from the rectum into the sigmoid flexure for perhaps its whole length, interrupts its functions likewise, thus creating another cause for undue accumulation of feces and gases in the organ; this accumulation of the waste material of the body becomes very foul, generating toxic gases, putrid substances, and poisonous germs which in turn irritate and excite the diseased organ from their constant contact with the follicular ulcerated mucous membrane of the sigmoid receptacle. Why should we not find in these cases all the symptoms attributed by authors to chronic mucous colitis? Especially so when we have, in addition to the enumerated symptoms of colitis, those caused by periproctitis and perisigmoiditis, which are always present and quite severe.
As a rule, the symptoms which have been diagnosed as those of chronic mucous colitis, membranous colitis, or ulcerative colitis are nothing more than symptoms of chronic mucous proctitis and sigmoiditis, accompanied by periproctitis and perisigmoiditis. Proctologists who have written on the subject of mucous colitis have noted the many symptoms very accurately, but have missed the usual location of a most aggravating disease from which mankind suffers early and late in life. Authors of books on stomach and intestinal troubles are also groping very much in the dark and are unable to diagnose the cause of a very common functional disturbance of the whole digestive apparatus, caused by proctitis and sigmoiditis, bringing numerous and severe primary and secondary symptoms to which other diseases may be traced.
Chronic proctitis and sigmoiditis and their local symptoms convert the sigmoid receptacle into an Augean stable, from which foul poisonous gases and germs are forced up and along the bowels, distending the descending and transverse colon and finally reaching the ascending colon and the cæcum, causing undue retention of their contents; hence so much attention to the cæcum and the vermiform appendix. The ends of a long rubber tube distended with gas will exhibit more strain and disturbance than the intermediate parts, and the same is true of the colon, owing to the intermediate sections of the organ possessing greater mobility. The great volume of gases confined in the colon prevents its normal peristaltic action, causing undue retention of contents, with resulting inflammation of the cæcum, as well as dislocation of the stomach, colon, etc., and suggesting radiographic and fluoroscopic examination and surgical operations to discover the cause of all the trouble, which should have been learned through use of the speculum before so many complications occurred.
In all cases of chronic mucous proctitis and sigmoiditis where there is a great amount of secretion of mucus, membranous cords, shreds, and casts (called mucous colitis), I have found the marked acute symptoms more or less periodic and accompanied by increased inflammation in all the tissues involved in the disease, which convinced me that the colitis we read about had become dislocated and was where I could see its results without the use of a speculum.
Through often witnessing the phenomena, I have learned what a “mucous colitis” storm means from a pathological exhibit, a personal demonstration, and a verbal description of what the sufferer is enduring. It requires the stuff heroes are made of to endure chronic mucous proctitis and sigmoiditis for ten, thirty, or forty years without the disease being accurately diagnosed, and to be told that all treatment is useless and that the trouble is in the head of the sufferer, that he is a hypochondriac, and a neurasthenic, terms often used by doctors who are unable to make a proper diagnosis of a case.
The common symptoms of mucous colitis have been accepted by writers on the subject, but as to the real cause of them there has been thus far only mere conjecture, just as the writers have been doing as to the cause of pruritus ani, scroti, and vulvæ. Dr. George M. Niles, of Atlanta, Ga., says: “In looking up the literature, one is amazed at the divergent views as to the etiology and management held by diligent students and competent observers. It is fairly well agreed that most cases occur in nervous, neurasthenic, hypochondriac, or hysteric individuals.” Others blame the liver, hysteria, constipation, fermentative processes in the intestines. How foolish to name symptoms of the disease as a probable cause of it! It is not necessary for me to again enumerate the many primary and secondary symptoms of proctitis and sigmoiditis, but I will mention briefly a few nervous symptoms which I think are due to the absorption of mucus into the system. There is that intense, exasperating, sore, and restless feeling, with inability to concentrate the mind, with the nerves and muscles of the body pinched and contracted. Such feelings are at their height during an acute mucus storm, which is an indication of increased inflammation in all the inflamed tissues, causing secretion of a great quantity of mucus or membranous casts. No doubt much of the inflammatory exudate from the mucous membrane, from the muscular structure of the organs, and the connective tissue surrounding and supporting the organs, passes into the sigmoidal and rectal canals, while a portion is absorbed into the system. In a similar manner, the inflammatory exudate from a subtegumentary mucus channel and cavity passes through the skin, causing moisture of the skin, pruritus ani, scroti, and vulvæ. I know of no non-malignant disease, where the symptoms may truly be said to be a thousand times worse than the disease that caused them, except in chronic proctitis and sigmoiditis.
Treatment of such cases has been very successful in my practice, requiring four principal aids: (1) Local treatment; (2) medicated enemata; (3) local medication; (4) the recurrent application of medicated hot water at a temperature of 125 to 135 or more degrees. A further valuable aid is the determination of the sufferer to get well by faithfully carrying out the home treatment. The more a patient studies my diagnosis and treatment of his case, the more he is encouraged that eventually a cure will be effected. Dr. James Moran of this city has been a student and assistant at my office for more than three years, and will bear testimony to the success of my treatment in all cases observed by him.
CHAPTER XXVI.
Antiseptic Employment of Powders and Oils.
DEPURANT POWDER.
Water at a temperature of from 120 to 135 or more degrees is an excellent antiseptic if properly applied to diseased tissue. Its anti-toxic, soothing, and healing properties, however, can be vastly increased by the addition of Depurant remedies. Water of this temperature, if used in the treatment of proctitis or colitis, should be applied with the aid of an Intestinal Recurrent Douche.
Water at a temperature of from 90 to 105 degrees—which is recommended for taking an enema—is antiseptic or depuratory only to the extent to which it washes away morbid matter from the intestinal canal. To increase its antiseptic and therapeutic value, as well as to meet other requirements, Depurant remedies are administered with the water during the flushing of the large intestine.
The Depurant Powder, prepared by the author, readily dissolves in the warm water and is brought into contact with every part of the mucous membrane as far as the antiseptic flushing extends along the intestine, thus leaving the washed and sterilized canal sweet and clean—a fit and proper channel and receptacle for the on-coming fecal mass. Here it may remain about four hours without danger of putrefaction, whereas, were the passage-way and receptacle foul, the feces would putrefy and form gases and toxic material in briefer time.
This Depurant remedy is not restricted to intestinal uses; it is equally efficacious when applied to the mucous membrane of any part of the body or to the skin. It may be used effectively for washing out the bladder or the vagina; for syringing the ear; for a mouth wash, tooth wash, gargle, nasal douching or spray; for a throat spray; for bathing infants; and for internal use where foulness of the stomach and small intestines exists. It is also a valuable adjuvant in the use of water for cleansing, or for hygienic purposes, on all the tissues of the body.
DEPURANT OIL.
Next to the use of water on the mucous membrane and skin as a hygienic and therapeutic agent, I am partial to some of our delightful oils, which are bland, non-irritating, and of a pleasing, nourishing, refreshing effect and exquisite odor.
To the oil selected as the base ingredient may be added other oils, and finally attenuated powdered substances of therapeutic value in soothing, purifying, healing, or any other purpose the case may call for. Pure olive oil is an excellent substance in which to incorporate Depurant remedies, especially when designed to be taken internally, by way of the mouth, or applied to the integument of the body. Certain other oils are equally pleasing though rather expensive. However, an inexpensive oil usually serves as a base in which to embody the proper medicinal remedies for Depurant purposes in the treatment of proctitis and colitis.
By a proper instrument the oil is carried into the intestines with the water used in flushing the colon, or that used with the intestinal recurrent douche treatment. The oil, being lighter than the water, is carried ahead or on top as the water passes up the bowels; and, as the two liquids open the crevices and folds of the mucous membrane or canal, every part of the latter is completely covered with the medicated oil, as with a covering of thin salve, ointment, or a poultice—in every nook and corner, just where it is most needed and where it should remain for its hygienic and healing effect.
Every kindly aid should be given a diseased organ, mucous membrane, or the skin, even if one knows it is for relief only; for the very aids that give relief are often essential when joined with medicinal or other treatment in effecting a cure.
It is advantageous in treating bowel troubles to use a rather heavy, tenacious oil for a base—one that may not be so pleasant to swallow or to use externally as some of the lighter oils. It is therefore advisable to have two kinds of Depurant Oil: one for internal use (by the mouth) and for the skin, the other for chronic disease of the lower bowel.
INTESTINAL ILLS.
By Alcinous B. Jamison, M.D.,
SPECIALIST IN RECTAL, ANAL, AND BOWEL DISEASES, AND
AUTHOR OF “HOW TO BECOME STRONG.”
Cloth, 277 pages
The above is the title of a work for non-professional readers on the cause and cure of many forms of bowel and stomach trouble, and their consequences, and the scientific treatment of piles, fistula, pruritus ani (itching), etc.
Science is here reduced to common sense; and the intelligent layman, following the directions of this book, especially as to “physiological irrigation,” will be able to prevent the usual daily foul state of the stomach and bowels. Here is set forth in plain language the accumulated experience of a thoughtful physician, who for over thirty years has studied the welfare of his patients in the treatment of those diseases which are peculiar to civilization. During this long practise, patients from all parts of the United States and other countries have come to New York City to be under the humane and skilful care of Dr. Jamison, who has the unique reputation of never employing the barbarous surgical and hospital methods in vogue throughout the world. No knife, ligature, clamp, or cautery has ever been employed by him in the treatment of even the most aggravated case of piles, or hemorrhoids; and no detention from business is necessary under his treatment for this symptom of proctitis.
Dr. Jamison’s discoveries in the line of his specialty have added much to medical knowledge concerning the etiology and pathology of proctitis, sigmoiditis, and of their symptoms—hemorrhoids, pruritus ani, constipation, etc. His diagnosis of these afflictions is original, as well as his treatment of such ailments—hitherto neglected or improperly cared for.
Physicians and surgeons of conventional schools of medicine are not aware that the common cause, and indeed the key, of all forms of anal, rectal, and bowel trouble is proctitis (inflammation of the lower bowel and sometimes of the colon); that proctitis is the cause of nearly all cases of constipation, diarrhea, indigestion, and biliousness; and that, finally, proctitis is the cause of auto-infection (self-poisoning) and its outcome—anemia, emaciation, etc.
No book to which physicians have access treats this subject so fully as “Intestinal Ills,” and yet in this volume it is presented in a popular manner suited to the common understanding.
The following enumeration of the chapter headings will give an idea of the scope of the treatise:
1. Man, Composed Almost Wholly of Water, is Constipated. Why?
2. The Physics of Digestion and Egestion.
3. The Interdependence of the Anus, Rectum, Sigmoid Flexure, and Colon.
4. Indigestion, Intestinal Gas, and Other Matters.
5. Key to Auto-infection.
6. How Auto-infection Affects the Gastric Digestion, and Vice Versa.
7. How Auto-infection Affects Intestinal Digestion, and Vice Versa.
8. The Cause of Constipation and How We Ignorantly Treat It.
9. Cures for Constipation “Fearfully and Wonderfully Made.”
10. Biliousness and Bilious Attacks.
11. King Liver and Bile-bouncers.
12. Semi-constipation and Its Dangers.
13. The Etiology of the Most Common Form of Diarrhea, i. e., Excessive Intestinal Peristalsis.
14. Ballooning of the Rectum.
15. Ballooning of the Rectum (Continued).
16. Erroneous Diagnoses and Treatment of Bowel Troubles.
17. Costiveness.
18. Inflammation.
19. Proctitis and Piles.
20. Pruritus, or Itching of the Anus.
21. Abscess and Fistula.
22. The Origin and Use of the Enema.
23. How Often Should an Enema be Taken?
24. Physiological Irrigation.
25. Proper Treatment for Diseases of the Anus and Rectum Very Essential.
26. The Body’s Book-keeping.
27. Selection and Preparation of Food.
28. Diet for Indigestion.
29. Diet for Constipation.
30. Costiveness, Diet, etc.
31. Diet for Diarrhea.
32. A Final Word.
You need this book for yourself and your friends. By making a present of it to some one requiring its light you will perform an act of unselfish kindness.
Price, cloth bound, lettered in gold, $2.00, post-paid to any address. In sending for the book please write name and address plainly. All orders should be sent to the author:
A. B. JAMISON, M.D.,
43 WEST 45TH STREET, NEW YORK CITY.
FOOTNOTES:
1 For numerous illustrations of the various morbid conditions of the anus and rectum, see the author’s 64-page booklet, entitled How to Become Strong.
2 Chapters XXII, XXIII, and XXIV have been revised from Papers contributed to Albright’s Office Practitioner, in 1908.
3 I found it more convenient to use the words mucus channel, mucus fistula, etc., in preference to sinus, as they better convey my ideas to the average reader.