SECT. XIII.—ON THE ALVINE DISCHARGES.
Of the alvine discharges, the best is that which is soft and compact, and is evacuated at the hour which is customary in health. Such excrement is yellowish, of the proper consistence, and not very fetid; for whatever is different from these is not good. That which resembles in colour the food which has been taken, or is thin, wants the natural juices, and is passed quickly, is indigested. But that which is intensely yellow, if evacuated in the beginning of a disease, indicates that the complaint is of a very bilious nature; but if after the acme, that the body is properly purged. The green is the sign of verdigris-green bile, but the black of black bile, or of adust blood mixed with it. The livid marks a coldness and considerable mortification of the internal parts. The oily is the mark of a melting of the fat in the body; as the glutinous, which is worse than the oily, is a mark of a melting of the parts of the animal. That which is very fetid is a mark of no small degree of putridity. With regard to them all, if the quality of the excrements does not correspond with the food which had been taken, you may thus judge of the affection. Of all kinds, the worst and most fatal is black, livid, oily, and what is hastily passed.
Commentary. See, in particular, Hippocrates (Prognost.); and Galen (de Crisibus, xi.) Galen remarks that the stomach may do its office properly, but that, owing to the heat of the neighbouring parts, the moisture may be dissipated, and the contents of the bowels rendered too dry; or that, owing to an imperfect distribution of the chyle, they may be too liquid. When the alvine discharges are soft and consistent, we are certain that both the digestive and distributive functions are properly performed, and likewise, that no part within the belly is in a state of inflammation. He afterwards makes many other ingenious observations on this subject, the importance of which, towards the restoration of health, is now generally admitted. He remarks, that, agreeably to the description of Hippocrates (Prognost.) the proper alvine evacuation ought to be yellowish; for, if very yellow, it indicates the presence of too much bile, or, if it do not partake of that colour at all, it indicates that the passage of the bile to the intestines is stopped. Rhases and Avicenna concur in this remark. Galen describes the frothy evacuation, which appears to be the same as the one resembling yeast, described by modern authorities. Hippocrates (Progn.) and Galen makes mention of a discharge, which consists of small, hard, and convoluted portions. Galen is of opinion that it is occasioned by constipation and heat of the bowels. According to Hippocrates, a discharge of black bile indicates that death is at hand. (Aphor.) Theophilus treats of this subject at such length that we cannot afford room for a proper outline of what is contained in his treatise. Bloody evacuations, he says, proceed either from disorder of the liver, ulceration of the intestines, or rupture of a vessel. Discharges of pus may come either from the liver, or from the stomach, or from the intestines. A viscid and fatty evacuation indicates melting of the body, and if attended with a fetid smell, putrefaction. Flatus in the bowels may either arise from flatulent humours forming in the bowels, or food dissolved into gases by the heat of the parts. (De Excrementis.)
The account of this subject given by Haly Abbas (Theor. vii, 16, and x, 10) is excellent, but principally collected from the Greek writers. An unctuous discharge, he remarks, is occasioned by a melting of the fat. If it be viscid at the same time, it indicates also a wasting of the principal members. A frothy discharge proceeds from heat and flatulence. A green evacuation indicates immoderate heat, and the presence of bile. Black discharges consist either of black bile, or of common bile blackened by immoderate heat. This, he says, is the worst appearance of all. If blood is discharged after the fæces, it may be supposed to come from the small intestines; but if before, from the large; and if mixed with the fæces, it probably comes from the intermediate parts. See also Alsaharavius (Theor. ix), and Rhases (Cont. xxxi.) Rhases states that white fæces arise from jaundice. When the discharges are watery, the nourishment of the body is stopt.
The opinions of Hippocrates and Galen on this subject are correctly stated and explained by Prosper Alpinus (De Præsag. Vita et Morte ægrot. vii, 11.)