It is astonishing what a number of people there are who drink little or nothing, and especially amazing is it to find this lack of sense in people suffering from constipation. One would suppose that they above all others would see the wisdom of irrigating their bowels. But it is seldom that there is one who thinks of such a thing. A cup of coffee or tea at meal-time, in addition to the liquid contained in the food, is the extent of water consumption by ever so many teetotalers and other "totalers," especially women, until they reach, say, thirty years of age. Such persons as a rule are not long-lived, inasmuch as their power of resistance is small, owing to their lack of blood, a lack in quality as well as in quant.i.ty. The blood pressure in their arteries and veins is light, as evidenced by their pale, sallow complexion, and the dry, scaly, feverish skin, which seldom or never perspires. The body garden has not been properly irrigated and is slowly drying up as age advances. Did you ever notice how like death such persons appear when they are asleep? Their dull, pasty complexions alarm us then. When I see them a desire to soak these dried specimens of humanity possesses me. Is it not unfortunate that we were not born with an automatic irrigator? We even lack a tube on our boiler to indicate the danger point! Deficient by nature in these little conveniences, and unaided by science, man is compelled to give some attention to the irrigation of his physiological soil, however indifferent or careless he may be.

Planters and gardeners have treatises on irrigation. Have mothers or nurses any similar guides? Such books are unknown to modern civilization. Infants, boys and girls, and adults are brought up haphazard, and their garden of life becomes choked with weeds. The drought soon makes itself felt, and a little graveyard mound is their usual fate. Before some of us wither and fade, to what a pest-weed is our adipose changed for want of life-giving water.

Man's most serious physiological fault is the toleration of constipation; or even of semi-constipation induced by the twenty-four-hour habit of stooling. In other words, his fault is the toleration of intestinal uncleanliness. And next to this foolhardiness is his negligence in the matter of drinking daily a quant.i.ty of pure soft water sufficient to aid in the proper stimulation and circulation of the blood, in the proper elimination of the waste material from the body, and in the proper a.s.similation of nutriment by the system.

If parents would encourage their children to become bibbers of pure spring water daily it would not be easy to make them bibbers of intoxicants in after years. I would give a child all the liquid it desires, I would even encourage it to take more rather than less, and the best liquid of all for this purpose is pure soft water. Man's body is 70 per cent water. It is therefore a good-sized water cask with a ramification of countless ca.n.a.ls or pipes imbedded in soft connective tissues, nerves and muscles, all of which are supported by a bony framework; through the centre of this runs the alimentary ca.n.a.l, down which waters may flow and disappear like unto a stream lost in the sand, to reappear and ooze from skin, lungs, kidneys and intestinal ca.n.a.l. Every organ and tissue luxuriates in water; they lave and live in and by it. With all kinds of food it is introduced into the body.

Water acts as a solvent for the nutritious elements and as a sponsor for the elimination of foreign substances and worn-out tissues of the system. It also serves to maintain a proper degree of tension in the tissues, which tension is essential to the proper circulation of the lymphatic fluids.

The tonic reaction of externally applied water is well known. But the advantages of the internal use of water are hardly known at all because the reactions of the circulation, temperature, respiration, digestion and secretions are less noticed.

Two or three pints of cold water at a temperature of forty to forty-five degrees drunk at intervals of half an hour will reduce the pulse from eight to thirty beats. The copious drinking of cold water will act as a diuretic, removing stagnated secretions, and will at the same time improve the quality of the pulse and the arterial tone. The drinking of warm water will increase the pulse from five to fifteen beats, and at the same time will relax the vessel walls and also increase the cutaneous secretions to a marked degree.

The drinking of a large quant.i.ty of water not only increases the secretions of the kidneys--a.s.sisting them in the work of carrying off solid const.i.tuents, especially urea--it also increases the secretions of the skin, saliva, bile, etc. Under proper conditions the internal use of water acts as a stimulant to the nerves that control the blood-vessels, a stimulant similar to that produced by its external application.

I advise the drinking of a copious quant.i.ty of water daily. There need be no fear that this practice will thin the blood too much, as the ready elimination of the water will not permit such a result to ensue.

I would further advise the generous use of water (temperature 60) at meal-times. I pray you do not drink to wash down food: a bad habit of most of us. Drink all you desire; and if you are like many who have no desire for water, cultivate it, even if it takes years. The imbibed water will be in the tissues in about an hour; and the entire quant.i.ty will escape in about three and one-half hours. The demand on the part of the system for water is subject to great variation and is somewhat regulated by the quant.i.ty discharged from the organism. Physiologists declare that water is formed in the body by a direct union of oxygen and hydrogen, but those who have cultivated the drink-little habit need not hope to find an excuse for themselves in this fact: chronic ill-health betrays them. Water in organic relations with the body never exists uncombined with inorganic salts (especially sodium chloride) in any of the fluids, semi-solids, or solids of the body. It enters into the const.i.tution of the tissues, not as pure water, but always in connection with inorganic salts. In case of great loss of blood by hemorrhage, a saline solution of six parts of sodium chloride with one thousand parts of sterilized water injected into the system will wash free the stranded corpuscles and give the heart something to contract upon.

When water is taken into the stomach, its temperature, its bulk, and its slight absorption react upon the system; but the major part of it is thrown into the intestinal ca.n.a.l. When it is of the temperature of about 60 it gives no very decided sensation either of heat or cold; between 60 and 45 it creates a cool sensation, and below 45 a decidedly cold one. Water at a temperature of about 50 is a generator of appet.i.te. A sufficient quant.i.ty should be taken for that end; say, one or two tumblers an hour or so before each meal, followed by some exercise. Those who have acquired the waterless habit, and the many ills resulting from it, will hardly relish cool water as an appetizer; but if they would become robust they must adopt the water habit--a habit that will refresh and rejuvenate nature.

Water of a temperature between 60 and 100 relaxes the muscles of the stomach and is apt to produce nausea, especially if the effect of bulk be added to that of temperature. Lukewarm water seems to excite an upward peristalsis of the intestines and thus produces sickness.

Hot water acts as a stimulant and antiseptic, as a sedative and as a food. Water at a temperature of 110 to 120, or more, will nearly always relieve a foul stomach and intestines. It should be slowly sipped, so that the stomach may not be uncomfortably distended. After imbibing a pint or a pint and a half, wait for fifteen or thirty minutes to give it time to pa.s.s into the bowels, then drink more if thought advisable. Drink it an hour before meal-time. It will excite downward peristalsis, will dilute the foul contents of the stomach, and will thus aid the escape of these contents into the intestines, which latter require the washing process as well. Sometimes it is a good thing to omit one, two or three meals while the washing process is being continued. Commence treatment with pure hot water. To make it appetizing, add a pinch of salt or of bicarbonate of soda; with children add sugar. It will pay you to follow this treatment for the cleansing of the alimentary ca.n.a.l.

The vitality of the body may be sustained for days and weeks on water alone; there is therefore no hurry about food. If human beings would only keep their bowels and stomachs clean they would avoid all the ills that flesh is heir to, except, of course, those due to accident.

My remarks have been confined to irrigation _per orem_ (that is, by way of the mouth), and nothing has been said of irrigation _per anum_ (by injection), since I have treated the latter subject fully in several previous chapters, to which the reader is referred. Be sure to follow the counsel there given, and use the enema two or three times a day in moderate quant.i.ties as indicated.

CHAPTER XXVI.

PROPER TREATMENT FOR DISEASES OF THE a.n.u.s AND r.e.c.t.u.m VERY ESSENTIAL.

No doubt the readers of the preceding chapters on proct.i.tis and its numerous symptoms--noted under separate headings--would like to know something about the home treatment for such an insidious and grave disease. Every sufferer wants to be a self-doctor. This commendable desire it is usually impossible to put into practice. If physicians so often fail to cure the ailments I have described, what can be expected of those who have no knowledge at all of diagnosis and treatment?

A skilful physician is the choicest gem of civilization, and an intelligent patient its worthy setting. Surely it is a moral crime, an inexcusable folly to tolerate a disease with its inevitable train of dire consequences, up to the point when the discomfort compels one to seek treatment. There are patients, of course, who have good and sufficient excuses for their painful predicament; they have, for example, tried persistently for relief and cure, but have failed to find a physician competent to treat their particular case. How many unskilled prescribers there are, and how glaring their shortcomings!

Some hold out taking inducements to sufferers; their one object being to transfer their patients' cash to their own pocket. 'Twere charitable to consider these ignorant; but alas! many of them are poisoned by the "fakir" germ. Stuff is sold by the conscienceless, claiming to cure "piles," to "give instant relief," and promising "a complete cure in a few days"; and as to itching piles, why! "only a few applications are necessary for a cure; six boxes for five dollars"! etc.

No remedy that sufferers apply themselves can be more than a temporary relief: it cannot really cure piles, polypus, fistula, tabs, pruritus (itching)--all of them consequences of proct.i.tis. Of course one should be thankful for the little relief to be got temporarily from advertised and drug-store drugs; nothing more than relief can be expected of them.

There are indeed times when a palliative treatment will serve to tide the sufferer over a few days until he is able to consult a competent physician. But how strange it is that so many sufferers regard their anatomy and physiology so lightly as to think of using remedies, even for relief, without first undergoing a thorough examination by a competent physician. In troubles of a rectal character it is exceedingly foolhardy to allow any one to prescribe without insisting upon a thorough examination to ascertain whether there be any disease of a cancerous nature present, or what the trouble actually is, and its progress. To expect one remedy or prescription to meet all the requirements for the cure of a chronic disease of the a.n.u.s and r.e.c.t.u.m and of the many complications accompanying it is hardly sensible, but that is just what a great many do expect. No one remedy in the market, or any number of them combined can effect a cure, for the simple reason that proper local treatment by a physician is of paramount importance.

Unless of a traumatic (externally produced wound) origin, diseases of the a.n.a.l and rectal ca.n.a.ls are usually of fifteen, twenty or more years' incubation before the annoying symptoms become apparent. This accounts for the slight attention to the maturing trouble and for the fact that such attention can afford nothing more than a palliation or postponement. A real cure requires a combination of means, all working harmoniously for the proper length of time. Proper treatment and the proper time are the two prime requisites; and the third and final requisite is, of course, a sensible patient.

Before home treatment is to be thought of it is accordingly advisable to have an examination and a prescription for the specific local treatment necessary for a trouble like piles, fissure, polypus, tabs, itching, fistula, varicose veins, abscess, ulcer, granulation, hypertrophy, or atrophy as the case may be. The local treatment can best be aided by a combination of remedies with suitable instruments for their use between the periods of local attention by the physician.

The writer of this has no cure-all to send the sufferers, although it might be to his financial advantage to have one; he is, however, always ready to advise and relieve those who cannot visit him immediately. The relief afforded often facilitates the cure by permitting a more extensive local treatment at the first visit.

_The Use of Instruments for Injecting Water._

To do something at home for one's self for relief from soreness and pain due to a.n.a.l and rectal diseases, a few suitable instruments are required with which specific remedies may be used, especially that excellent remedy--water.

It is unfortunate that the a.n.a.l and rectal ca.n.a.ls cannot be given rest when invaded by disease. Daily elimination of feces is a very important factor to health and to treatment. To accomplish this the very best means is water in various quant.i.ties as the case demands. It does not irritate the diseased ca.n.a.ls--as cathartics do--but aids in the escape of imprisoned feces and gases which lodge above the region of the morbid process. Evacuation should be accomplished twice a day, by the injection at first of three or four quarts of water--thus obtaining a good daily flushing of one's sewer--and then, if advisable, gradually lessening the quant.i.ty at subsequent injections to one or two pints at a time. The temperature should be 100 to 105 or more. Some people have an idea that water at the temperature named has a remedial effect on an inflamed a.n.u.s and r.e.c.t.u.m. It has none whatever; all it does is to wash away the deposits which might irritate the inflamed surface. Water at a temperature of 100 to 105 is not an especially good antiseptic; and its intestinal use should not be continued longer than to bring away the effete and fetid material which may be lodged in the colon, sigmoid flexure and r.e.c.t.u.m. In the majority of cases its use should be limited to aiding the feces to escape from their normal receptacle--the sigmoid flexure--whenever proct.i.tis does not extend beyond the r.e.c.t.u.m.

But many persons are deceived by the conduct of proct.i.tis and are thus likely to omit the regular irrigation twice a day. They believe themselves to be in pretty good condition and do not realize that their old, implacable enemy may be excited into riot any day; in which case the insurrection may last for months and then slowly settle down to semi-quiet again, reaching finally the point of its best behavior for a short period or until again provoked.

_The Use of the Recurrent Douche._

Water at a temperature of 120 to 130 properly applied is a good therapeutic agent in the treatment of proct.i.tis. At that temperature it is an excellent antiseptic and astringent. Its continuous use for half to one hour applied with a recurrent douche brings about a contraction of the engorged and dilated blood-vessels; and accompanied by local treatment and by other remedies is the best means known for restoring the nerves to their normal function of controlling the proper circulation of blood in the diseased organ. Treatment with the recurrent douche is of course to follow, not to precede, the evacuation of the bowels; but at any time when there is a tendency toward additional evacuation on the admission of the hot water, the new douche is easily adjustable to the contingency without removal from the a.n.a.l ca.n.a.l; it will facilitate the escape of the feces with the return flow of the water. The new recurrent douche has therefore the great advantage of promoting simultaneously both the thorough evacuation of the bowels, and the therapeutic effect of hot water.

_Sitz-Bath._

There are patients who, because of years of neglect of their local ailments, are taken with severe attacks of inflammation of the a.n.u.s and r.e.c.t.u.m, involving considerable prolapse, much swelling around the a.n.u.s, and general local soreness and pain; all of which is often accompanied by a general disrelish of life. For this condition nothing is so good as a very hot sitz-bath, if properly adjusted to the parts and continued for about an hour at a sitting. The alleviation afforded is so decided and the local and prolonged application of hot water so restorative that it may be left to the sufferer to determine how often this bath is to be repeated. It may be taken as often as there is an inclination to do so. The sitz-bath apparatus should be scientifically adapted to the parts so that the bather will not sit lower than ten or twelve inches, thereby avoiding a straining position. During the bath there should be more or less pressure against the a.n.a.l tissues, which a.s.sists the hot water in expelling the blood from the inflamed parts.

From the beginning to the end of the bath the water must be as hot as the tissues will tolerate. Only a small portion of the b.u.t.tocks need be immersed in the hot water.

_Spring Water the Ideal Beverage._

Those who suffer from disease of the r.e.c.t.u.m, with rare exceptions, are constipated or semi-constipated, which condition in turn aggravates or disturbs the inflamed parts. To overcome this constipated condition all sorts of laxatives are taken, which will in the end do grave harm not only to the whole system, but especially to the inflamed parts, irritating them still more. There is a valuable therapeutic agent seldom taken by the constipated; in fact, it is never thought of; unfortunately the remedy is not easily to be had in its pure state by most of us, boxed as we are in cities. Sold under various names as mineral water, it is too often adulterated. 'Tis a simple remedy, and yet it has a wider range of healing power than any other; a universal solvent, applicable to all diseases and all states of health. I would write it at the head of all remedial agents: pure spring water! We do not drink enough water. If we were to imbibe at least two quarts of pure water daily we would be healthier and have better movements of our bowels. Water may be taken freely during mealtime; not, however, for the purpose of washing down half-masticated food. Alcoholic drinks, coffee and tea would better be dispensed with, also tobacco. The nervous system has enough to bear without the use of avoidable irritants.

_Other Hygienic Agencies._

Too much cannot be urged as to the advisability of a proper amount of exercise, sleep, rest, food, breathing, cleanliness (internal and external), as well as and above all, pure, high-minded thoughts and serene temper--the outcome of the habit of viewing life philosophically. Care should be taken to protect the feet and body from sudden climatic changes, thus avoiding catarrhal troubles, especially of the lower bowels.

As to the wise and proper use of nature's pharmacopoeia, nothing need be said here. However, I may be within my limits when I advise patients to use a little sense and not neglect disease of the lower bowel any more than they would neglect that of the eye, ear and throat. In the latter case they submit at once to an examination. Why not in the former? Let them bear in mind that the cure of chronic proct.i.tis is no holiday job; that it is, on the contrary, a task which requires constant attention. To merely relieve the annoying symptoms that accompany it cannot be called a cure. But on the other hand relief may be the commencement of a cure. Of course the true way of looking at the subject of this disease is to regard the cure of proct.i.tis as necessarily leading to the disappearance in time of all the other troubles that were the outcome of that ailment. Through the harmonious efforts of patient and physician, marvellous results are often obtainable.

CHAPTER XXVII.

THE BODY'S BOOK-KEEPING.

Man's food is as varied as his work, more varied than the climate, with one food for the luxurious and one for the poor. The majority of us take what we can get, making no complaints; even when we have a cook and a good one the same is true. The ideal diet prepared by the ideal cook no one has as yet made fashionable, but one thing is within the reach of all--cleanliness of the sewers of the body. Keep the contents of the bowels moving down and out steadily and regularly and you may eat almost any food and in almost any preparation and still be healthy.

Just as a steam-engine, running at a given rate of speed, must be supplied with fuel sufficient to maintain that speed, so the human body must have the requisite food to maintain the speed of civilized society and business, and replace the waste of the tissues; otherwise decline sets in and the reserve store of strength is exhausted. How shall we determine the proper amount and kind of food for the various ages, s.e.xes, and conditions of life?

A leading authority says that the character and amount of the daily excreta furnish suggestions as to the required food supply. (Kirk's _Physiology_, p. 208.) These excreta are found to be carbon, nitrogen, hydrogen, oxygen in great part, with some sulphur, phosphorus, chlorine, sodium, etc. A summary is given (_ibid._, p. 432) of the expenditure for twenty-four hours:

1. From the lungs: Carbonic acid about 15,000 grains Water " 5,000 "

2. From the skin: Water " 11,500 "

Solid and gaseous matters " 250 "

3. From the kidneys: Water " 23,000 "