CONSTIPATION.
Atony of the muscularis of the intestine is admittedly the direct cause, in most instances, of constipation. It is the condition known as “torpor of the bowels.” It is ordinarily due to abnormal innervation of the parts. The inefficient innervation may be—and in females frequently is—reflex, or its cause may be sought for in the central nervous system. The condition of the voluntary abdominal muscles is likewise a factor in the alvine process. Sluggishness of the abdominal (portal) circulation is a not infrequent etiological concomitant of constipation, and, finally, the conditions grouped as “dyspepsia” may form the causative feature of a case. I have mentioned these different causes simply in order to account to some extent for the almost wonderful effects in this condition of electric baths. When we consider that in every one of the morbid conditions here enumerated, electricity is a very efficient remedy, and that for the resulting muscular atony it may be called a specific, it will not appear surprising that a mode of application which brings the electric influence to bear on both cause and effect—often on a combination of several of the causes enumerated, should be attended with such brilliant results. I have thus far met with no failure in the electro-balneological treatment of constipation.
In the majority of cases the following method has proven the most efficient. The first ten minutes of the bath should be devoted to the administration of a galvanic current, as intense as can comfortably be borne by the patient. The one pole should be connected with the head-electrode, the other, by means of the surface board, applied alternately, to the epigastrium, chiefly, and to the hypogastric region. The current should a portion of the time be ascending, the rest descending. Occasionally the current should be rapidly reversed by means of the commutator, the intensity however having been previously reduced, in order to avoid too severe a shock; this will cause efficient contractions of the abdominal parietes, and probably also of the intestinal muscularis. The second ten minutes of the bath should be devoted to faradization, employed in the same manner as the previous galvanization, only that here the direction of the current is immaterial, and no reversals are requisite. The current should be of sufficient intensity to produce energetic but not painful contractions of the abdominal parietes.
Case XXVIII. Mrs. * *, aet. 55, in average health, without however being robust, had suffered from constipation for about thirty years. She had had every possible medicinal treatment, with no avail. Nothing had ever ameliorated her condition. Without the aid of a cathartic, her bowels moved but once every week or ten days. She was of course compelled frequently to resort to laxatives. In the fall of 1873 I ordered her electric baths. She was not very energetic in anything, and this lack of energy caused her to take the baths less frequently than I desired her to. Had she taken them regularly, she would probably have been restored in as many weeks as it took months to effect her restoration. As it was, she took some thirty baths in the course of about fifteen months. For nearly a year past she has had a passage every day with the utmost regularity. No adjuvant treatment was employed in this case.
Case XXIX.* Emil Miller, a bright child two years of age, was brought for treatment July 7th, 1874. He had suffered from obstinate constipation almost from his birth. Had been under the care of several physicians, but had never received any benefit from treatment. Even with the aid of powerful cathartics, given in doses suitable for an adult rather than a child, defecation took place only once every three or four days, and was so exceedingly painful as to elicit cries of pain from the child. The feces were always hard and lumpy, and of an abnormally light color. A digital examination per rectum revealed considerable flaccidity. My diagnosis was paresis of the muscularis of the intestine. I ordered faradic baths. On July 12th the first bath was administered, and I must confess that the result was a perfect surprise to me. True, I had expected a cure to take place; but I had looked for gradual improvement, and was not prepared for a result such as was here obtained. From the time the first bath was taken, defecation took place regularly once a day, without pain; the feces became perfectly normal both as to color and consistency, and the boy continues to the present day to defecate regularly and in every respect normally. To insure permanency, the baths were continued, at first twice, then once a week. They have now been discontinued for upwards of a year, there being no occasion for their further use. No other therapeutic measures, internal or external, were resorted to in this case, nor was any change made in the diet of the child.