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 quantity 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 assimilation 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 canals 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 canal, 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 canal. 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 quantity of water not only increases the secretions of the kidneys—assisting them in the work of carrying off solid constituents, 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 quantity 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 deg.) 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 quantity 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 quantity 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 constitution 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 canal. When it is of the temperature of about 60 deg. it gives no very decided sensation either of heat or cold; between 60 deg. and 45 deg. it creates a cool sensation, and below 45 deg. a decidedly cold one. Water at a temperature of about 50 deg. is a generator of appetite. A sufficient quantity 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 deg. and 100 deg. 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 deg. to 120 deg., 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 pass 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 canal.

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 quantities as indicated.



CHAPTER XXVI.

PROPER TREATMENT FOR DISEASES OF THE ANUS AND RECTUM VERY ESSENTIAL.

No doubt the readers of the preceding chapters on proctitis 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 proctitis. 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 anus and rectum 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 anal and rectal canals 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 anal 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 anal and rectal canals 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 quantities as the case demands. It does not irritate the diseased canals—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 quantity at subsequent injections to one or two pints at a time. The temperature should be 100 deg. to 105 deg. or more. Some people have an idea that water at the temperature named has a remedial effect on an inflamed anus and rectum. 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 deg. to 105 deg. 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 rectum. In the majority of cases its use should be limited to aiding the feces to escape from their normal receptacle—the sigmoid flexure—whenever proctitis does not extend beyond the rectum. But many persons are deceived by the conduct of proctitis 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 deg. to 130 deg. properly applied is a good therapeutic agent in the treatment of proctitis. 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 anal canal; 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 anus and rectum, involving considerable prolapse, much swelling around the anus, 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 anal tissues, which assists 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 buttocks need be immersed in the hot water.

Spring Water the Ideal Beverage.

Those who suffer from disease of the rectum, 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 proctitis 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 proctitis 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, sexes, 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 " Organic matter " 680 " Saline bodies " 420 "

4. From the intestines: Water " 2,000 " Organic and mineral substances " 800 "

Total daily expenditure: Solid matters " 17,150 " Water " 49,500 "

Altogether about eight and a half pounds.

The credit side of the sheet is about as follows:

Solids (chemically dry foods) " 8,000 grains Water, combined or otherwise 35,000 to 40,000 " Oxygen, absorbed by the lungs " 13,000 "

Altogether about eight and a half pounds.

With the proper balance between the intake and the outgo, the functions of the body will be carried on normally, but the balance must be a proper one; that is, not only must the entire waste be repaired but the correct proportions of one kind of food and another must be observed. If all the elements needed are not furnished there can be no true counterpoise.

How do we expend the energy? By the common wear-and-tear incident upon all voluntary motion, all work and recreation, carrying on the internal movements of digestion and respiration, by thinking, by loss of temperature, by indulgence of any of our functions, and by any wrong indulgence especially. Excessive use, voluntary or otherwise, will of course diminish our total capital and cut short our lives. Could we always maintain the right balance we need never die.

The importance of what has been said must now be clearly apparent. We ought to be wisely interested in choosing the proper foods for our daily needs and in having them properly prepared; we ought to know how much carbohydrates we need, how much proteids, and regulate our diet accordingly. The foods which contain nitrogen are chiefly the following: flesh of all animals, milk, eggs, leguminous fruits (peas, beans, lentils); those which contain carbohydrates chiefly are bread, starch, vegetables and especially potatoes, rice, etc.; foods supplying fat are butter, lard, fat of meat, etc. Salts are furnished in almost all other substances, but especially in green vegetables and fruits. Liquid food is obtained by water, too often neglected, and tea, coffee, beer, cider, etc.

Alcohol has no power to form tissue or to repair waste and cannot be regarded as a true food. Tea and coffee are almost entirely stimulant, not nutritious, and should be taken sparingly or not at all.

The common mistakes in diet are over-feeding or taking too much of one kind of food, and of the latter class perhaps an excess of starchy food is the most mischievous. If taken in excess, especially by the young, the starchy foods are not digested and what does not digest must putrefy: the result is a bowel distended with harmful gases. Many people eat too much nitrogenous food, with resulting plethora or gout. A great deal of vigorous exercise in the open air is required to use up such a diet.



CHAPTER XXVIII.

SELECTION AND PREPARATION OF FOOD.

The requirements for normal digestion, assimilation and elimination are: (1) An intestinal canal clean and sound from mouth to anus; (2) nutritious food properly prepared; (3) regularity and moderation in eating; (4) free use of pure water, sufficient to forward the emulsification and assimilation of the food and the elimination of waste—whether that waste be of the residual portion of the food or of detritus of tissue; (5) a seasonably clad body, free from fatigue or loss of sleep; (6) a cheerful mind.

Every sensible person will grant that a good digestion of vegetable or animal food furnishes sufficient steam and stimulus for the physical man; that a good digestion of intellectual food (ideas) furnishes the corresponding requisites for the mental man; and that exalted sentiments are the pabulum of the spiritual.

Why over-stimulate the physical, and reflexively degrade the mental and spiritual, by indulgence in tea, coffee, beer, wine, liquors, opium, tobacco, etc.? Over-stimulation will bring on indigestion; and prostration will follow that. Remember that Nature does not carry long credit accounts.

A suggestion for the selection and preparation of physical foods is here given; this book being hardly the place for a corresponding list of mental and spiritual foods.

FOODS EASY OF DIGESTION.

ARTICLES OF FOOD HOW PREPARED TIME OF DIGESTION

Venison steak Broiled 1 hour 30 minutes Pig's feet soused Boiled 1 " 00 " Brains Boiled 1 " 45 " Salmon, tripe or trout (fresh) Boiled or fried 1 " 00 " Eggs, fresh Whipped 1 " 30 " Rice Boiled 1 " 00 " Sago or barley Boiled 1 " 45 " Apples, sweet and mellow Raw 1 " 30 " Tomatoes or lettuce Raw 1 " 30 " Melons or watercress Raw 1 " 20 " Peaches, plums or pears Raw or stewed 1 " 30 " Oranges or bananas Raw 1 " 30 " Asparagus or dandelion Boiled 1 " 30 " Onions or apricots Stewed 1 " 30 " Mushrooms Boiled 1 " 30 " Cereal coffee Boiled 1 " 30 " Blackberries 1 " 30 " Grape-nuts 1 " 00 " Lemons 1 " 00 " Watermelons 1 " 00 " Doxsee's clam juice and little neck clams 1 " 00 " Milkine, Horlick's and Mellin's food 1 " 30 " Cereal milk 1 " 00 " Armour & Co.'s Vigoral. 1 " 00 " Valentine's or Wyeth's beef juice or Wiel's beef jelly 1 " 00 "

FOODS NOT SO EASY OF DIGESTION.

ARTICLES OF FOOD HOW PREPARED TIME OF DIGESTION

Beef Boiled 2 hours 00 minutes Pig, sucking Roasted 2 " 30 " Liver, beef (fresh) Broiled 2 " 00 " Lamb, fresh Broiled 2 " 30 " Turkey, domestic Roasted or boiled 2 " 30 " " wild Roasted 2 " 18 " Goose " Roasted 2 " 30 " Chicken Fricasseed 2 " 45 " Codfish, cured and dry Boiled 2 " 00 " Oysters, fresh Raw 2 " 35 " Hash (chopped meat and vegetables) Warmed 2 " 30 " Eggs, fresh Roasted 2 " 15 " " " Raw 2 " 00 " Milk Boiled 2 " 00 " " Uncooked 2 " 15 " Gelatine Boiled 2 " 30 " Custard Baked 2 " 45 " Tapioca or barley Boiled 2 " 00 " Beans, green Boiled 2 " 30 " Sponge cake Baked 2 " 30 " Apples, sour and mellow Raw 2 " 00 " " " " hard Raw 2 " 50 " Parsnips or green corn Boiled 2 " 30 " Potatoes and yams Roasted or baked 2 " 30 " Cabbage, head Raw 2 " 30 " " " with vinegar Raw 2 " 00 " Cauliflower Boiled 2 " 00 " Peas (green) or squash Boiled 2 " 00 " Cranberries or cherries Stewed 2 " 00 " Rhubarb or figs Stewed 2 " 30 " Turnips Boiled 2 " 30 " Sprouts Boiled 2 " 00 " Raspberries Raw 2 " 00 " Dates Raw 2 " 00 " Buttermilk Raw 2 " 00 " Pumpkin Cooked 2 " 00 "

FOODS SOMEWHAT DIFFICULT OF DIGESTION.

ARTICLES OF FOOD HOW PREPARED TIME OF DIGESTION

Beef, fresh, lean Broiled 3 hours 00 minutes " " " Roasted 3 " 00 " Beef, dry Roasted 3 " 30 " " with salt only Boiled 3 " 45 " " " mustard, etc. Boiled 3 " 30 " Pork, steak Broiled 3 " 15 " " recently salted Broiled 3 " 15 " " " " Raw 3 " 00 " " " " Stewed 3 " 00 " Mutton, fresh Broiled 3 " 00 " " " Roasted 3 " 15 " " " Boiled 3 " 00 " Flounder, fresh Boiled 3 " 30 " Oysters, fresh Roasted 3 " 15 " " " Stewed 3 " 30 " Codfish (salted) or whitefish Boiled 3 " 00 " Sausages, fresh Broiled 3 " 20 " Rabbits Broiled 3 " 00 " Butter or cream 3 " 00 " Eggs, fresh Hard-boiled or fried 3 " 30 " " " Soft-boiled 3 " 00 " Potatoes, turnips or carrots Boiled 3 " 30 " Radishes or lentils Boiled 3 " 30 " Bread (white) fresh Baked 3 " 15 " " whole wheat Baked 3 " 30 " " rye Baked 3 " 30 " " graham Baked 3 " 30 " " corn Baked 3 " 15 " Corn cake Baked 3 " 00 " Apple dumpling Boiled 3 " 00 " Soup, mutton or oyster Boiled 3 " 30 " " bean Boiled 3 " 00 " " chicken Boiled 3 " 00 " Chocolate or cocoa Boiled 3 " 00 " Currants or filberts 3 " 00 " Raisins 3 " 00 " Hazelnuts 3 " 30 " Peanuts Roasted 3 " 00 " Potatoes (sweet) Roasted 3 " 00 " Walnuts 3 " 30 " Chestnuts Roasted 3 " 15 " Beans, lima Boiled 3 " 00 " Zwieback 3 " 00 " Turkey Boiled or roasted 3 to 4 hours Eels Fried 3 " 4 " Oleomargarine 3 " 4 " Cabbage Boiled 3 " 4 " Buckwheat cakes 3 " 4 " Mutton, lean Roasted 3 " 4 " Herring Broiled 3-1/2 " 4-1/2 " Cheese 3-1/2 " 6 "

FOODS VERY DIFFICULT OF DIGESTION.

ARTICLES OF FOOD HOW PREPARED TIME OF DIGESTION

Beef, fresh, lean Fried 4 hours 00 minutes " old, hard, salted Boiled 4 " 15 " " recently salted Boiled 4 " 30 " " " " Fried 4 " 15 " " fat or lean Roasted 5 " 15 " " suet (fresh) Boiled 5 " 30 " " soup with vegetables and bread Boiled 4 " 00 " Beef, soup from marrow bones Boiled 4 " 15 " Pork, fat and lean Roasted 5 " 15 " " recently salted Boiled 4 " 00 " Pork recently salted Fried 4 " 15 " " ham Cured 4 " 30 " Veal Broiled 4 " 00 " " Fried 4 " 30 " Mutton, suet Boiled 4 " 30 " Fowls Boiled or roasted 4 " 00 " Heart, animal Fried 4 " 00 " Salmon, salted, or mackerel Boiled 4 " 00 " Cabbage, with vinegar Boiled 4 " 30 " Cheese, old, strong Raw 3-1/2 to 6-1/2 hours Duck Roasted 4 hours 30 "



CHAPTER XXIX.

DIET FOR INDIGESTION.

Indigestion is a symptom of a functional disturbance or is due to a local disease in some portion of the digestive apparatus. Therefore diet must be adapted to the sensibility of the stomach and bowels, to gastric and intestinal secretions, mobility, absorption and elimination, to the abnormal increased feeling of hunger or to the absence of the sensation of hunger.

The food should be of easy solubility and offer slight resistance to the digestive juices. It should not mechanically or chemically irritate or impede intestinal peristalsis. It should not increase fermentation or putrefaction and the greater portion of it should be absorbed.

The object of diet is not to eat less food than usual but to secure more nourishment until the proper quantity is consumed each day. The restriction of foods does not mean limitation. Regular hours for meals should be religiously observed by sufferers from indigestion. The food should be thoroughly masticated. Good judgment should be used by each individual in selecting and preparing the foodstuffs; also in the amount taken at each meal, and the proper length of time to continue the diet.

You may take:

Soup—in moderate quantity: Doxsee's clam juice, and little neck clams; cream of peas, etc.; vermicelli; tapioca; tomato; clear soups of chicken, beef, mutton.

Fish: trout; bass; perch; shad; weakfish; whitefish; smelts; raw oysters.

Meat: roasted or boiled beef; mutton; venison; calf s head; tongue; sweetbread; lamb chops; squab; roasted partridge; pigeon; calf's-foot jelly; Armour & Co.'s Vigoral; Valentine's or Wyeth's beef juice, or Wiel's beef jelly.

Eggs: raw; soft-boiled; poached; omelette; eggs on toast.

Bread—all over a day old: brown; graham; gluten; rye; zwieback; crackers; cracked wheat; corn meal; hominy; wheaten and graham grits; rolled rye and oats; granose; cerealin; macaroni with toasted bread-crumbs; farina, boiled with milk; Milkine; Horlick's or Mellin's food.

Vegetables: spinach; green peas; greens; lettuce; watercress; sweet corn; asparagus; celery; artichokes; baked tomatoes; cauliflower.

Dessert: baked, roasted or stewed apples; stewed pears or peaches; baked bananas; grapes; oranges; and most ripe fruits, if fresh.

Beverages: hot, cool or cold water an hour before meals. Drink freely of the same during meal-time, but not to wash down food. Drink also: cereal coffee; buttermilk; koumiss; fresh cider; bouillon.

Avoid: coffee; tea; milk; ice-water; cocoa; chocolate; malt liquors; spirituous liquors; sweet and effervescent wines; sugar; candies; foods containing much starch; rich soups; sauces and chowders; all fried foods; hot or fresh bread; griddle-cakes; doughnuts; veal; pork; liver; kidney; hashes; stews; pickled, canned, preserved and potted meats; turkey; goose; duck; sausage; salmon; salt mackerel; cabbage; radishes; cucumbers; cole-slaw; turnips: potatoes; beets; pastry; jellies; jams; nuts.



CHAPTER XXX.

DIET FOR CONSTIPATION AND OBSTIPATION.

Diet is too often a makeshift for ignorance, or it may be an aid until the cause of indigestion is removed; or if not curable, a compromise effected on the best possible terms for continued existence. We have found out the almost universal cause for constipation, obstipation and costiveness; therefore until you can have the proper local treatment we suggest the following foodstuffs, trusting to the sufferer's judgment how much and how often to take the nourishment.

Coarse foods, stimulants and laxatives unduly excite the bowels. Avoid them if possible. Be regular in your habits as to meal-times; eat three times daily, and about an equal amount at each meal.

You may take:

Soup: all kinds of meat and vegetable soup; broth; bouillon. Reliable preparations of beef juice, jelly, etc.

Fish: all kinds, broiled or baked; raw oysters; Doxsee's clam preparations.

Meat: boiled or roasted; poultry; game, etc.

Bread: graham; brown; whole wheat; corn; rye; ginger; shredded-wheat biscuit.

Cereals: wheaten grits; wheatena; granose; oatmeal porridge; Milkine; Horlick's and Mellin's food.

Vegetables: cauliflower; spinach; beans; asparagus; carrots; onions; Brussels sprouts; tomatoes; peas; celery; cabbage.

Vegetables should be especially well cooked to render them soft and easy of digestion.

Salads: may be eaten if dressed with a generous supply of olive oil.

Dessert: oranges; melons; prunes; tamarinds; figs; apples (raw or baked); pears; plums; peaches; cherries; raisins; stewed fruit; honey; blackberries; strawberries; huckleberries; bananas.

Some may find it advantageous to eat fruit before or between meals.

Beverages: water—pure spring water preferably; if this cannot be had, get, if possible, distilled water that has been aerated; buttermilk; fresh cider; beer; ale.

Mineral waters like Hunyadi, etc., irritate the cause of constipation (proctitis) in a way similar to cathartic remedies.

Drink a tumbler or more of hot or cold water an hour before meals—preferably hot water. If the hot water be distasteful add a little salt. Drink freely of water about the temperature of 60 deg. during the meals, but not for the purpose of emptying the mouth of food.

On retiring at night and rising in the morning sip slowly from a quarter to half pint of water (hot or cold). In the morning be sure to rinse the mouth free of the accumulated mucus before drinking the water.

The use of tea, chocolate, coffee and alcoholic drinks is so abused by those even who consider themselves temperate in their habits, that I recommend these beverages as remedies only in certain conditions of the system.

About four pints of pure water (i.e., free from all salts or other foreign ingredients) should be imbibed in twenty-four hours.

Avoid: sweets; pastry of all kinds; puddings; rice; milk; cheese; new bread; nuts; fried foods; rich gravies; farina and sago puddings; salt meats; salt fish; veal; goose; liver; hard-boiled eggs; pork; tea; tobacco; spirituous liquors; uncooked strawberries and huckleberries. Avoid also tomatoes and peaches when not fresh, as the acid generated by keeping them a few days is very irritating to an already inflamed bowel.

Avoid substances that would inflame the tissues or cause congestion of any organ of the body. If the tongue be coated avoid sugar, starchy foods and fresh milk.



CHAPTER XXXI.

COSTIVENESS, DIET, ETC.

Take anything in the way of food which the unconsciously starved person can eat without the stomach and intestines protesting too much; any of the foods recommended for constipation, indigestion, diarrhea; and take yet more food if by so doing there is a gain in flesh, after exercising much patience as to time.

Irrigate the system by imbibing freely of hot and cold water at various periods of the day. Good red wine mixed with the water drunk at meal-time may serve a good purpose in helping to enrich the blood.

Keep the pores of the skin open by bathing; and all the functions of the body active by exercise, massage, pure air, sunlight, rest, sleep and seasonable clothing.

The large intestines should be kept clean by proper amounts of water injected into them. The local cause of all the trouble should be treated by a competent physician.

And with all the efforts, continue the treatment long enough to accomplish some good and then a much longer time to get well. Do not give up treatment under which you have improved if it requires one, two or three years to accomplish what you have so well started out to do.



CHAPTER XXXII.

DIET FOR DIARRHEA.

A period marked by constipation, biliousness or poisons generated within or taken into the intestinal canal is often followed by diarrhea. Mental excitement will induce it in some persons. More often man's early and most common malady, proctitis, is the direct or indirect cause. Some forms of ulceration of the lower bowel induce diarrhea. Chronic cases of diarrhea usually follow the decline of vitality marked by the symptom of Costiveness, which means the interruption of all the functions of nutrition. The intestinal canal is then like a rubber tube with the contents hurried through it. The whole system is irritable as the result of an accumulation of secondary symptoms expressed by the word auto-intoxication.

The food should be nutritious and non-irritating to the intestinal canal.

Reliance must be placed, in severe cases, on liquid foods and beverages.

The more solid foods may be taken in limited quantity as the recovery progresses. In more acute cases it is well to stop all food for twelve or twenty-four hours.

You may take:

Liquid Food and Beverages: Drink, if possible, pure spring water. If this cannot be obtained, sterilize the water, or distil and aerate it; it must be pure and soft. Better still: drink toast- or rice-water; kefyr, four days old; koumiss; lactic-acid water; zoolak; egg lemonade; sterilized milk with one third lime-water; whortleberry wine; acorn cocoa; unfermented grape-juice.

Soup: chicken; mutton; clam; oyster broth; Doxsee's clam-juice; bouillon; Milkine; Horlick's and Mellin's food.

Meat: minced chicken; scraped beef; roast fowl; beef steak; fillet of beef; raw beef; sweetbread; raw oysters.

Eggs: lightly boiled, poached.

Cereals and Fruit: grapes at all hours, eaten without seeds or skin; arrowroot; tapioca; sago; barley mush; macaroni; rice boiled with milk; milk toast; dry toast; crackers; junket; bread pudding; egg pudding, not sweetened; hasty pudding, with flour and milk; mashed potatoes.

Avoid: pork; veal; nuts; salt meats; fish; fried foods; sugary foods; fruits, cooked or raw; oatmeal; brown and graham bread; new bread; vegetables; and most soups.



A FINAL WORD TO THOSE TO WHOM I HAVE DEDICATED THIS BOOK.

It is very evident from the perusal of this work that the symptoms of proctitis, both general and local, proceed from no trifling disease; and also that the disease may have existed for a very long time, perhaps as much as twenty, forty or more years. During the greater part of its existence all sorts of medication have been tried to allay this or that annoying prominent symptom with a hope of a cure.

At the congress of physicians that met in Paris in 1900, one of the subjects discussed was chronic constipation and their "wise" conclusion was that man needed more grease, therefore they mourned the loss of the frying-pan.

Symptoms induced by proctitis in various parts of the body are often accompanied by painful local symptoms, called piles or a "touch of the piles." Then local medication is added to the general treatment, and as usual matters go from bad to worse. Physicians consulted have been honest and kind, but with all their advice the increasing troubles continue. Your demands grow more pressing on your doctor and as a last resort he mentions a surgical operation for the removal of one or more painful local symptoms. The fright is sufficient in most cases to make the sufferer endure the ills he has rather than flee to others he knows not, even risking life itself. Others more bold submit to an examination by the surgeon, which proves so painful at the time and causes so much subsequent suffering that they are now really content not to importune any more for help.

A few in desperation make up their minds to have the local anal symptom removed regardless of the final result.

Thus millions of human beings have suffered and died and countless numbers are enduring the ills they have, not knowing of a rational and humane system of treatment; a treatment that not only removes the numerous annoying symptoms, but the cause as well; a system that will stand the test of time, of common-sense, of constant investigation to know the why and wherefore of both disease and treatment.

For over twenty years I have concerned myself with this and allied ailments, and have treated—without the use of the knife—all cases of piles, polypus, fissure, stricture, ulcerations, etc. At the present time physicians are writing me in this wise: "I want to take a course of instruction from you. I have performed some successful surgical operations on the rectum, but it is not profitable; the people will not submit to it." Another writes: "Your treatment of hemorrhoids has been brought to my notice by my friend and patient, Mr. ——. The method you practise is certainly an ideal one and seems to have been most successful in your hands, and I would like to adopt it."

To physicians and laymen interested, I will send, for twenty-five cents, my treatise on Diseases of the Anus and Rectum (entitled How to Become Strong). It contains over 100 anatomical illustrations, and 125 testimonials, and forms, therefore, a valuable adjunct to this volume.

All whose testimonials appear in the 64-page book suffered from proctitis to a greater or less extent and with the exception of a few all suffered from chronic constipation, indigestion, etc.

Surgeons usually desire strong and vigorous patients. The author asks merely for an intelligent patient, or for some one to direct the home attention necessary between treatments.

This book, as well as the one entitled How to Become Strong, and the author's other printed instructions, are the result of his desire to make his patients intelligent on the subject of the disease and symptoms for which they seek his assistance. They truly cannot know too much for their own good in this regard; an ignorant patient can not do justice either to himself or to his physician. Those who have tried all the fads and so-called cures in order to relieve their troubles will certainly appreciate what I have here presented for their study. With enlightenment comes the desire to set things right. So I have no appeal to make to the lazy: I shall leave them to their ills and their pills. And for those who appreciate the beauty of cleanliness, both external and internal, I shall write another book on that subject, including a prophecy for coming generations. Eternal vigilance is the price we must pay if we would enjoy the highest physical, mental and spiritual expression of our personalities.

Thanking the indulgent reader who has read my description of Intestinal Ills, I advise him to rewrite it in his own organism, if not in printer's ink: the world will be better for it!



INTESTINAL ILLS.

NO. 1.

CHRONIC CONSTIPATION AND THE USE OF THE ENEMA.

"Civilized" man is the victim, by inheritance from distant ancestors, of undesirable characteristics, traits, and tendencies. While, during the long process of evolution, some of the cruder features of the physical and mental traits have been refined or eliminated, the modern man still clings to certain habits inherited from his wholly animalistic days. Even as the man of that day, so the man of to-day eats far too much and far too frequently.

To the scientific eye, your capacious digestive apparatus is a psycho-physical exhibit of the racial proclivity to overeat. Here, in this exhibit, the race's inordinate craving for food and drink, its gluttonous thought, have embodied themselves; and this exhibit, this apparatus, is accordingly not merely physical, but also psychical, for its sub-conscious outreach for "more and always more" is only too apparent. Man's stomach and bowels are too much like those of a mere animal, and are the source of nine-tenths of his ills.

All great consumers of foodstuffs, Nature declares, should walk on all fours; if you will persist in walking on your hind legs, you will have to pay the penalty. You will, moreover, contract other habits not conducive to real animal health. And, as Nature predicted, man's social customs to-day are out of all accord with gluttonous feeding; he, as well as his capacious bowels, suffers the consequences of his excessive feeding, and this suffering leads him to adopt artificial means for relief or escape. Up-to-date civilization has constrained man to adopt a cooped-up existence, one that shuts out, to a great extent, sunshine and air; an existence, moreover, that involves but a limited amount of exercise. How, then, can it be otherwise than—gormand that he is—that he should fare ill with this gluttonous, mammoth digestive canal?

Man is not as yet more than half human, and he will not become truly human until he makes more use of the upper lobes of his brain, nor until the spiritual part of his nature becomes dominant. When that day dawns he will have a corresponding evolution of the physical body, especially of the gastro-intestinal canal. Some one has sagely said that man's brain is a mere extension of his intestinal canal. Well, possibly by and by the intestinal canal may become an extension of a spiritually awakened mind, with all its dominating influence over the physical body. Surely the evolutional trend from animal to complete manhood may be aided by intelligent foresight as to bodily care and hygiene.

Cooped up like a canary bird, or penned up and fattening like a hog, with his enormous eating capacity and vast intestinal storage space, poor man has matters made worse by having his several orifices liable to inflammatory invasions. He does not seem able to escape from his enemies anywhere.

The mucous membrane lining the orifices of the body is nothing more than the skin turned in to line canals for air, gases, liquids, and solids to pass in and out in order to keep up the physio-logical functions of the body. Very rarely, indeed, do we find, from childhood to old age, the orifice of the intestinal sewer otherwise than chronically inflamed, the invasion extending, moreover, the whole length of the rectum for some distance into the sigmoid colon.

It is no trifling matter to have the function of some thirty feet of the gastro-intestinal tract disturbed, especially of the large intestine—some five feet in length, two and a half inches in diameter in not a few sections.

Almost without exception, we find the lower portion of the intestinal sewer the seat of chronic inflammation that extends into the sigmoid colon; and, as an inevitable result of the inflammation, contraction more or less permanent has taken place in the circular and longitudinal muscular bands that form its structure. The constriction is especially severe at the junction of the rectum with the sigmoid colon, where it flexes upon itself in the region where the bore of the rectum is less. The comparative shutting up of the caliber of the upper end of the rectum and lower portion of the sigmoid colon occasions undue retention of the feces and gases which accumulate, and in accumulating dislocate various portions of the large intestine, thus forming pouches, sacks, reservoirs, prolapse, etc., which hold the products of putrefaction as well as the irritating, poisonous mucus thrown out from the inflamed tissue.

I regard the occlusion of the upper portion of the rectum, and especially of the region involved in the flexure of the bowel, as the most usual seat and source of constipation. Not so very long ago it was the custom to stretch the sphincter muscles for the "cure" of constipation; at the present time the "cure" is found in the valves of the middle lower portion of the rectum. The folly of these "cures" becomes apparent when we understand that the parts treated were neither the seat nor the source of constipation. I have always regarded great retention of feces in the rectum as impaction in a delivery canal, due to contraction of the anal muscles, not as constipation, which can only take place in the temporary storage-place—the sigmoid flexure. The lower two-thirds of the rectum plays no part in constipation of the bowels.

Form a manikin, made out of very thin, soft rubber tubing, to represent the stomach and small and large intestine, holding the various parts in place with elastic bands, and cotton to represent fat. When all portions are properly and anatomically placed close the lower eight or ten inches of the manikin, representing the lower portion of the sigmoid colon, rectum, and anus, just as tightly as we should find it closed in sufferers from chronically acute proctitis and colitis. Now insert at the stomach portion of the manikin a generous amount of man's usual mixture of foodstuffs and liquids, and repeat the supply three or four times during the day (without any previous attempts at cleansing), and then note the fermentative and putrefactive changes that take place; the ensuing bacterial poisons and the great volume of poisonous gases—all of which occasion squirming, twisting movements of the manikin as dislocations here and there occur, as pouches and reservoirs develop, as the walls become distended with gas and putrid substance; and then, time elapsing, the usual foodstuffs are added to the foul mass within! Now, if there is any pity in your soul, you medical man, for the enfouled and deformed human manikin, you will want to wash it out with cleansing water before its structure comes to an untimely end. We medical men all know the numerous and grave symptoms exhibited by one or more organs of the body, or by all of them, from the persistent work of the deleterious gases and bacterial poisons on the system—a work going on for years, finally placing the victim beyond medical aid. All of us are agreed that the capacious gastro-intestinal canal should be clean. What, I submit, is the best means of keeping clean this long, large, tortuous, spacious, valved and flexed canal—a canal that disease has here and there pouched, dislocated, bagged, reservoired; a canal at whose lower end a great cesspool exists; that, like other portions of the gut, is never empty and clean—what is the best means but a flushing with copious amount of water?

Proctitis or colitis is a very serious disease; like a railroad injury, it is found, on examination, to be much worse than appearances at first indicated.

A physician who prescribes for a case of chronic constipation or diarrhea without first examining the sufferer for proctitis and colitis, is either ignorant or does wilful harm to his patient and injury to his practice. The abominable, aboriginal and almost universal custom at the present time of giving some physic to "cleanse" the gastro-intestinal canal is in every respect a deplorable mistake for a conscientious doctor to make.

Many persons suffering from chronic constipation drink very little or no water. As a consequence, they are a sort of dirty, dried-up plant, with but little juice of life in them.

Others, again, equally unclean, or more so, take a moderate amount of fluid every day, and present a more or less roly-poly appearance, with considerable abdominal distention, due to malnutrition and gases. Of course, their eyes, skin, tongue, breath, and lack of vim and vigor tell the story of a long process of self-poisoning, with every now and then the eventuation of a storm of foulness, called a bilious attack—meaning an overflow of filth. Death often brings about a radical change in such poisoned bodies.

Now, what can a prescriber of a gastro-intestinal ejector expect to accomplish by disturbing the maleconomy of this apparatus? Usually he expects that considerable trouble will ensue; consequently, he will add belladonna or some other soothing drug to mitigate the act of expulsion. The ejector (called laxative, purgative, cathartic) occasions irritation, which sets up twisting, writhing, rumbling of the bowels, accompanied with a shower of liquid into the canal (as tears fill the eyes from the effects of sand or a blow), which liquid mingles again with the putrid refuse materials, from which it had been recently absorbed, and, mingling, proceeds to fill up the normal and abnormal spaces just described, to be again reabsorbed into the system. Oh, the foulness of it all! The spirits of the departed, as well as the still incarnate patients, demand of the healing art safe and sane hygienic methods of cure. The enema, regularly and properly used, is the remedy par excellence.

Those that suffer from chronic constipation are usually deficient in the quantity and quality of intestinal secretions. Physic increases the depletion of the intestinal juices. Of the watery secretion forced into the bowels, four-fifths are reabsorbed into the system, plus poisons and filth. The system soon becomes accustomed to the irritation of drugs, and requires an ever-increasing amount. These irritate and increase the chronic inflammation of the lower bowel, often to the extent of a discharge of blood.

Straining effort to induce defecation is injurious. The use of massage, of vibratory exercises, of electricity; the spraying of cold water on the abdomen, etc.,—none of them are calculated to remove or even to relieve the proctitis and colitis.

The temperature of the water used for an enema should be about one hundred degrees. It should be taken at least twice daily, preferably on retiring at night and soon after breakfast, at regular times, if possible. Such practice obviates the need of large injections.

In beginning the use of the enema it is well to inject from a half to a pint of water, and expel it. This constitutes a preliminary injection. Frequently it is desirable to take another preliminary injection before taking the large one, which latter is variously called "flushing the colon," "taking an enema," "taking an internal bath" or "a washout," etc. It is essential first to get rid of the feces and gases in the rectum, so that they be not sent back when you proceed to flush the colon.



NO. 2.

OBJECTIONS TO THE USE OF ENEMA ANSWERED.

The privilege of raising objections belongs to the ignorant as well as to the intelligent. But the objector is under as great obligations to state his reasons as the advocate.

The first plausible objection to the use of the enema is that it is not natural.

Admitting this charge, I should say that, inasmuch as proctitis, colitis, and constipation are unnatural, the use of a preternatural or, in other words, a rational means to overcome the consequences of these diseases is imperative. The enema is such a means.

Can any one that suffers from proctitis, etc., have a natural stool? Unnatural conditions require preternatural aids, as we all know. The injected water dilates the constricted portion of the gut and arouses a revulsive impulse to expel the invading water. In obeying this impulse the imprisoned feces, gases, etc., are ejected with the water.

It may be unnatural to put water into the rectum, etc., but once there its expulsion from healthy bowels would be quite natural. No natural action can be expected from unhealthy bowels; they do the best they can under the circumstances. Eye-glasses, false teeth, crutches, etc., are unnatural but invaluable aids, but no more so than is the enema as a means of relief from overloaded bowels. The enema, moreover, be it noted, not only aids the system by relieving it of its loads; it cleanses and soothes an organ that must be kept at work and perform its functions even when invaded by disease.

Surely it is unhygienic and irrational to ignore the valuable service of the enema in cases in which the bowels are in an unnatural condition.

The second objection is that the water will wash away the mucus from the mucous membrane of the bowels and leave them dry and parched, and thus apt to crack and break in two. I would remind the objector that, since about 75 per cent. of the normal feces is water, it seems strange that so great a quantity of water in contact with the mucous surface of the bowels should not also cause dryness.

The integument of the body and that of the mucous membrane are similar in structure, yet whoever had a fear of producing dryness of the skin by much application of water? The mucous membrane is simply the skin turned inward; and since it is much more vascular it is less apt to become dry—if, indeed, its dryness were at all possible. The objector should also remember that the body is composed of over 80 per cent. of water—an organism not to be made dry or parched by the application of water to the skin or to the mucous membrane two or three times a day.

The mucous membrane of the lower bowel is not unlike that of the mouth, throat, or stomach. Do you realize how often the upper end of the intestinal canal is washed or bathed daily with liquids, soft and hard drinks, hot and cold, especially by those who have formed the drink habit instead of the enema habit?

They have no fear of drying the mucous membrane thereby; but if you can instil this fear they will increase the quantity with pleasure.

This second objection, being the result of too vivid an imagination and too little reflection, is a very nonsensical objection indeed.

A third objection is that if you begin the use of the enema you will have to continue its use; you can't stop, and, lo and behold! the enema habit is formed—a new habit in addition to the many habits civilized man is already carrying; the constipated habit, the physic habit, the sand, bran, sawdust-food habit, the muscular peristaltic habit, etc.—and with all these habits the poor victim of proctitis and intestinal foulness wonders that he is alive.

Usually the first symptom of proctitis is constipation, and for relief the enema habit should be formed and continued while the constipation remains. When the proper means are found to remove the intestinal inflammation—proctitis and colitis—then the constipation will disappear, and with its disappearance the enema habit can be discontinued. But let it be well noted that the enema is itself an aid in curing the cause, an aid superior to any other at our command. A cleanly habit ought not to be an objectionable one, especially in cases in which it is most needed to prevent toxic substances from entering the system.

A fourth objection is that after taking the first enema the constipation is worse.

With many persons a certain amount of undue accumulation of feces will excite a sufficient muscular effort of the gut to force the dried mass through the proctitis- and colitis-strictured bowels. This unnatural effort may occur once a day or once in two or three days, and has doubtless been a habit of many years' duration.

To introduce a new order of conduct on the part of the bowels requires time. If the bowels have been in the habit of expelling feces in the morning, and an enema were taken the night before, there might be no desire to stool the next morning because of the fact that the bulk or accumulated mass of excrement was no longer there to create a vigorous call or impulse for defecation.

But we have found the extent of local damage and reflex to the organs, and more especially the constant absorption of poisons into the system, due to the presence of feces. It is for this reason that the elimination of feces twice or thrice in twenty-four hours is advised. The condition for which an enema is used is one of disturbance and poison to the system. It is, therefore, a most unnatural condition. What is more rational, consequently, than to employ an "unnatural" yet not harmful means to bring about a more normal condition, one free from poisoning and irritating consequences?

A fifth objection is made by those who have as a symptom of proctitis a large development of pile tumors or hemorrhoids (distended mucous membrane). The objection is that at times these tumors or sacs prolapse very freely during the act of expelling the injected water. But this prolapse occurs in many cases whether water is used or not.

A certain amount of anal irritation caused by the passage of feces occurs, causing contraction of the circular muscular tissue that forms the anal and rectal canal, also of the longitudinal muscular bands and the levator muscles of the organs. The enema lessens or entirely diminishes the irritation of passing feces, and the natural result is that the serum-filled sacs, called piles, and the tissue loosened by the inflammatory product will more readily prolapse during the act of defecating. It is simply a choice between irritation of the stool keeping the tissue up and no irritation permitting a prolapse.

Of course, if there be no expulsion of feces and water the stretched or dilated sacs may keep their places in the rectum. And then again, the enema may be used for quite a period, when all at once a large prolapse of sacculated mucous membrane occurs, and the enema is thought to be the cause of it. That this is not the cause, let it be remembered that in all cases of proctitis the chronic inflammation is apt to become subacute or acute, and that this intense engorgement and enlargement of the tissue with blood and the increased fever in the parts often result in prolapse at any time, especially at times of convulsive effort at evacuation.

Whatever follows the proper use of an enema, even though what follows be annoying, should not be blamed on the enema, for its action is most kindly, lessening as it does the irritation that otherwise would be more severe when the feces pass through a disease-constricted canal.

The sixth objection is that the use of the enema will weaken the bowels, which are already too "weak" to expel their contents. "Atony, paralysis, fatty degeneration of the gut, are bad enough," say these objectors, "without having an enema increase their uselessness." Diagnosis wrong and objection groundless.

Distend and contract an organ for a short time two or three times a day, and it will gain in strength from the exercise. Every one knows that this is the case. What more gentle means of exercising the large intestines than by the enema?

But the truth of the matter is that in all cases of proctitis and constipation the diseased portion of the gut is too active in its muscular movements, contracting spasmodically, as it does, at even the suggestion or suspicion of feces near it. Every impulse of the bowels above the constricted section to force the feces down through the closed bore only intensifies the spasmodic action and increases the muscular obstruction, compelling the victim to resort to some one of the many drastic means of relief.

The enema does no more than kindly to dilate the constricted region, which, when dilated, evokes a harmonious concerted action of all the nerves and muscles to pass along and down the burden of feces, which, without the aid of a flood of water, they had been incapable of moving, and would have had to leave to poison the system.

The seventh objection is quite naive: "Inasmuch as the Indians of this country had no use for the enema, why should we resort to it?"

The all-sufficient answer to this objection is that the Indians lived a natural life, while ours is artificial. Much can be said on this point, but the reader is surely rational enough to follow out the distinction suggested. Our lives are much more important than were the lives of the aborigines of this country, and our "demands of Nature" are more exigent. If your life is of no greater value than theirs, for leisure's sake don't use the enema! You will be taking too much trouble. It really should seem that the cleanliness of the skin and mucous membrane, the care we take of our bodies, is an indication and measure of our sense of refinement. An ancient Scripture hath it: "Let those that are filthy, be filthy still." It all depends upon how you wish to be classed—with the filthy or the cleanly.

The eighth objection to be noted is the fear of "poking things" (points of instruments) "into the rectum."

This looks like a real objection. No healthy nor even unhealthy organ, for that matter, should be "abused." And what seems more likely to cause it trouble than to poke a hard or soft rubber point or tube through its vent in opposition to its bent or inclination? Still, the muscles of the vent are strong, and they soon accommodate themselves to the practice. Their slight disinclination is not to be considered alongside of the relief and cure you effect by the use of the enema.

Have no fear that the point will occasion disease when intelligently used. Always see to it that the point is scrupulously clean. Those made of hard rubber or metal can be kept so without effort.

Soft rubber points are always foul and dangerous, especially after they are used a few times. A good rule is never to put a point higher in the bowel than is absolutely necessary.

The ninth objection seems serious. It is that in taking an enema the water escaping from the syringe point will injure the mucous membrane where the jet strikes. But on examination this objection falls to the ground, for it stands to reason the jet cannot directly hit the surface for more than a moment. Immediately thereafter the accumulation of water will force the jet to spend its energy on the increasing volume, to lift it out of the way so that the continuous inflow may find room.

But even were it possible for the jet to strike a definite section of the mucous membrane during the taking of the enema, it could do no harm provided the water be at the proper temperature. And this is true even if a hydrant pressure be used. Not a few persons use the hydrant pressure of their houses in taking an enema. For a really successful flushing of the colon a considerable pressure is requisite to force the volume up and along a distance of five feet, especially when sitting upright. But it is folly to use a long syringe point, since it is like introducing one canal into another for the purpose of cleansing it. Therefore, have no fear from the use of proper syringe points; the jet of water will not hurt the mucous membrane. My professional brethren at least ought to know that the idea of such harm is sheer nonsense.

The tenth objection to using an enema is in being obliged to use it from the fact of having such a disease as chronic inflammation of the rectum and colon. Every victim hates to be compelled to do a thing, and the victim of proctitis and colitis is no exception to the rule. In fact, he is beginning to realize that unless he uses it his system will be poisoned by the absorption of the sewage waste. Let the victim object to the disease that necessitates the use of the enema and he will shortly be well. Then this objection to the use of the enema will indeed be the most important of all.

The eleventh objection, and the most ridiculous of all, is that it requires too much time to take the enema twice or thrice daily.

I lose all patience with persons urging this objection. Those that have little or no system with their daily duties seldom have time to do anything of importance. They suffer from "haphazarditis," a very difficult disease to cure, and they are in many cases hopeless. Usually they are an uncleanly lot of people, full of good intentions, but their intentions though taken often, seldom operate as an antidote to foulness. Their one sigh the livelong day is: "Oh, could we be like birds that can stool while on the wing or on foot!" This feat of time-saving being hardly possible in the present incarnation and order of society, they content themselves with making a storehouse out of the intestinal canal for an indefinite length of time as they concern themselves with external affairs of work or sport. A sorry lot they are indeed when they are laid up for repairs. Many doctors, I am sorry to say, encourage with a chuckle this foolish practice. "Any time to stool you can manage to get, so that you stool at least once a day, or once in every two or three days; stool when it is normal for you to do so." This criminal advice just suits the sleepy, the lazy, or the "awfully busy."

The American habit of doing things en masse, of handling things in large quantities or in bulk, has something to do with their don't care constipated habit. Small evacuations two or three times a day seem too much like small business, which, of course, is a waste of precious time. Wholesaling, laziness, lack of system, hurry, are the cause of good-for-nothingness of body and mind. It should never be too much trouble to restore the lost impulse for stooling twice or thrice daily.

Is it a small matter to have the main sewer of a city partly or entirely closed, or the main sewer pipe of a dwelling stopped up? Think of the dire results, notwithstanding that the windows and doors remain wide open! The Board of Health would soon deal with the negligent official or landlord. With very few exceptions, "civilized" men, women, and children are negligent and niggardly caretakers of the human dwelling place—the marvellous body of man. "Lack of time," "haven't the time," or "no time," is the excuse they give themselves and others.

Notwithstanding the numberless victims around them, none of these negligent and niggardly ones seem to get alarmed until the secondary symptoms, such as indigestion, gout, rheumatism, or disease of some vital organ, are sufficiently annoying to demand attention. But I have full faith in humanity. Man does the best he knows how, as a general rule. But often he doesn't know how; he needs enlightening.

The hints I have given will, I am confident, be considered and acted upon by all to whose attention they are brought, for by acting upon them, normal bodies and minds will result, and blessings attained heretofore considered impossible. Normal health depends on right doing and being. Eternal vigilance is the price to be paid for the attainment and maintenance of the goal of normal life and progress. Eliminate all waste material from the body and all shifty vermin from the mind, and the millennium for all things in the universe will soon dawn.



FOURTEEN REASONS

WHY WE SHOULD BATHE INTERNALLY AS WELL AS EXTERNALLY

1. Because very few persons are free from chronic inflammation of the anus, rectum, and sigmoid flexure, which causes contraction of the caliber of the organs.

2. None escape self-poisoning from the gastro-intestinal canal. Many are constantly being poisoned from the entrance of bacterial and other toxic substances into the system.

3. Nine-tenths of the ills that afflict mankind have their origin in a foul digestive apparatus and a consequently poisoned body.

4. Disease of the anus, rectum, and sigmoid flexure results in from two-thirds to three-fourths of the feces being daily absorbed into the system.

5. Feces unduly retained become very foul or malodorous. If the feces of birds and domestic fowls and animals were as obnoxious as that usually ejected by man their discharges would require immediate removal from human neighborhoods.

6. Man is the only creature that has formed the habit of making a fecal cesspool of his large intestine; hence his diseases of many varieties. There is nothing wholesome about him and he is quite destitute of vim, vigor, and push. The fecal poisoning of his parents is stamped upon him, and the unhygienic condition of his bowels makes matters worse.

7. Man needs to form the habit of stooling as frequently as birds, fowls, and quadrupeds—at least as many times in twenty-four hours as he partakes of food.

8. Making a reservoir of the lower bowels is not a time-saving habit, but, on the contrary, a breeder of many poisons, causing all sorts of acute and chronic diseases, which demand much time and attention, as countless numbers know to their sorrow.

9. You are a factor in the social and business world; then why not look, feel, and be your best by simply adopting internal hygienic measures?

10. By the use of the Internal J.B.L. Cascade Bath you can secure two or three stools a day, as desired; and while you are preventing self-poisoning you are regaining a normal habit and natural health, which for so many years and generations have been denied you. Do not longer perpetuate the dire results of a foul alimentary canal and consequently diseased body.

11. All desire to be strong and healthy, and many would add beauty of form and complexion, which is also commendable. This can be attained by preventing disease through hygienic attention and the proper use of water.

12. The gastro-intestinal canal is a physiological, moving food supply for the body, and, like any other vessel that has contained fermenting substances, it should be emptied and cleaned before a fresh supply is put into it. This is only a sensible, reasonable, and cleanly duty to one's self.

13. Who can fear being made sick by adopting cleanly habits? You have perhaps tried all other means to keep well, and have failed; now try intestinal cleanliness—a method you should have thought of long ago.

14. Every one desires to avoid surgery, the taking of numerous medicines, and the spending of money in that way—and they can be avoided if you keep clean, both internally and externally.

* * * * *

You're Not Healthy Unless You're Clean INSIDE

And the one way to real internal cleanliness—by which you are protected against ninety per cent of all human ailments—is through proper internal bathing, with plain antiseptic warm water.

There is nothing unusual about this treatment—no drugs, no dieting—nothing but the correct application of Nature's own cleanser. But only since the invention of the J.B.L. Cascade has a means for proper internal bathing existed.

Only one treatment is known for actually cleansing the colon without the aid of elaborate surgical apparatus. This is

THE INTERNAL BATH By Means of the J.B.L. Cascade

Prof. Metchnikoff, Europe's leading authority on intestinal conditions, is quoted as saying that, if the colon and its poisonous contents were removable, people would live in good health to twice the present average of human life.

Dr. A. Wilfred Hall, Ph.D., L.L.D., and W. E. Forest, B.D., M.D., two world-famous authorities on internal bathing, are among the thousands of physicians who have given their hearty and active endorsement and support to the J.B.L. Cascade treatment.

Fully half a million men and women and children now use this real boon to humanity—most of them in accordance with their doctor's orders.

LET DR. TYRRELL ADVISE YOU

Dr. Tyrrell is always very glad of an opportunity to consult freely with anyone who writes him—and at no expense or obligation whatever. Describe your case to him and he gives you his promise that you will learn facts about yourself which you will realize are of vital importance. You will also receive his book, "The What, the Why, the Way," which is a most interesting treatise on internal bathing. Consultation with Dr. Tyrrell involves no obligation.

CHARLES A. TYRRELL, M.D. 134 W. 65th Street, New York



IF YOU SUFFER FROM ROUGH, SCALY, CRACKED SKIN

If You Value a Good Complexion

Dr. Tyrrell's Health Soap

Effectually Disposes of Troubles. It Is Refreshing, Purifying, Invigorating

Among the necessities of life there is one to which few people pay the attention they ought, and that is Soap. Yet it is undoubtedly a most important matter, for the skin is a very delicate and sensitive organ, and the constant application of impure or inferior Soaps injures its texture, and gives rise to numerous cutaneous troubles. Most people are content, so long as it appeals to the eye and the sense of smell, without stopping to consider that perfumes may be employed to hide defects.

Dr. Tyrrell has given this matter long and profound consideration and now offers to the public a SOAP that leaves nothing to be desired. It is not only absolutely free from any deleterious substance, but is a perfect antiseptic and healing soap. Its use thoroughly cleanses and invigorates the skin, keeps it soft, flexible and healthy, and effectually prevents rough, cracked and scaly conditions. It is invaluable for TAN, FRECKLES, SUNBURN, Etc., and is a perfect hygienic safeguard against cutaneous disorders. It is a positive pleasure to use it for the toilet or bath, as it leaves such a grateful, refreshing after-effect.

As a SHAVING SOAP it is unequalled, absolutely preventing those disagreeable results that frequently follow the use of impure soap.

25 Cents Per Cake

Manufactured solely by CHARLES A. TYRRELL, M.D. Formerly President of Tyrrell Hygienic Institute 134 W. 65th Street, New York City



Sufferers from Catarrh

THERE IS GLORIOUS NEWS FOR YOU.

No matter how much you may suffer from that most distressing and inconvenient complaint, a speedy and effective release from your sufferings is now offered to you.

THE J. B. L. CATARRH REMEDY

Is one of those sterling specifics whose curative effects are quickly realized on the first trial. It is intended to be used in connection with the flushing treatment, and the two used in conjunction

RARELY FAIL TO EFFECT A CURE.

Catarrh is first caused by inflammation of the membrane of the nasal cavities and air passages, which is followed by ulceration, when nature, in order to shelter this delicate tissue, and protect the olfactory nerves, throws a tough membrane over the ulcerated condition.

Flushing the Colon lays the foundation for recovery, but the membrane must be removed, and for that purpose the J.B.L. Catarrh Remedy IS WITHOUT AN EQUAL.

It is composed of several kinds of oils, and gently, but effectually, removes the membrane that nature has built over the inflamed parts, while its emollient character soothes and allays the inflammation. These drugs are not absorbed into the system, but act only locally.

THE MOST OBSTINATE CASE WILL READILY YIELD TO THIS TREATMENT.

The price is One Dollar per bottle, which, in view of its marvellous curative power, is a veritable gift, and with each bottle we furnish an inhaler specially manufactured for the purpose. Two bottles will usually effect a cure—though one has been frequently known to do so in mild cases—but in the event of any one taking six bottles without being cured, we will forfeit

ONE HUNDRED DOLLARS,

now deposited in the Lincoln Trust Co. of New York, if they can honestly make oath that they have faithfully used the remedy according to the directions, and have received no benefit from it.

YOU CANNOT AFFORD

to neglect this opportunity of ridding yourself of this most distressing complaint, which, if neglected too often

LEADS TO CONSUMPTION.

DELAYS ARE DANGEROUS.

CHARLES A. TYRRELL, M.D. FORMERLY PRESIDENT OF TYRRELL'S HYGIENIC INSTITUTE, 134 WEST 65TH STREET NEW YORK



The J.B.L. Antiseptic Tonic

should always be used when introducing water into the intestines. The use of this preparation renders the water completely sterile unless it be notoriously impure. Such water should never be used. But the Antiseptic Tonic possesses another important property which is most valuable in cases of Constipation, for it acts as an admirable tonic on the muscular coat of the colon, strengthening it and restoring it to normal. For these reasons it is invaluable. Owing to the importance of using the tonic, I have arranged to make it as inexpensive as possible and am prepared to furnish it (to users of the Cascade only) in one pound air-proof cans at the price of $1.00; by mail twenty cents extra. You can buy this at your druggist and save mail charges.

Charles A. Tyrrell, M.D. 134 West 65th Street, New York City

THE END