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.