It may be asked, why has not this discovery been made before? In the first place, the colon has had but scant attention paid to it in the dissecting room, until of late years the appendicitis craze has awakened some interest in it. Its importance was not realized-the circulatory and nervous systems receiving the lion’s share of attention. In the second place, in holding post-mortems the organ was avoided, cut off, if in the way, and thrown into the slop bucket. It was known to be always full, but no one ever asked whether or not it was natural in its fullness of fæcal matter, and as a result, probably the profession knows the least about this important organ, of any in the human body. Strange, is it not, that among the seven thousand physicians ground out and polished in the mills of wisdom each year, that there was not one who had originality enough to ask the question, Is it natural that this scent bag of filth should always be so full of putrid matter that we cannot abide one moment with it? And, inasmuch as it is so, is it not a great detriment at least to our health to carry this mass of filth around with us, from day to day, from week to week, and from year to year-absorbing its poison back into the circulation? Strange that these questions did not present themselves to some one of the enterprising youths of our original young America.
The muscular fibres of the intestines are circular and longitudinal. In the large intestine the longitudinal fibres are shorter than the tube itself, which length permits the formation of loculi (cavities). These become the seat of fæcal accumulations, only too often unnoticed by the physician. It is undoubtedly a fact that the loculi of the colon contain small fæcal accumulations extending over weeks, months, or even years. Their presence produces symptoms varying all the way from a little catarrhal irritation up to the most diverse, and in some instances serious, reflex disturbances. When the loculi only are filled, the main channel of the colon is undisturbed. The most common parts of the colon to become enlarged are the sigmoid flexure and the cæcum (see diagram in beginning of book), but accumulations may occur in any part of the colon. The ascending colon is much more often filled in life than the books would lead us to believe; indeed, it may be said that chronic accumulations are oftener to be found in the ascending than in the descending colon, which is also contrary to the assertions of the authors. This is due partly to the fact that the contents of the colon have to rise in opposition to gravity, and partly to the semi-paralyzed condition of the muscular coat of the colon through inactivity. When the accumulations are large, the increased weight of the colon tends to displace it; and if in the transverse colon, that portion may be depressed, even into the pelvis.
The mass may be so enormous as to press upon any organ located in the abdomen, interfering with its functions; thus we may have pressure on the liver that arrests the flow of bile; or, upon the urinary organs, crippling their functions.
Of course, such excessive accumulations occur only exceptionally, and it is not to these that attention is particularly drawn, because when they are so excessive, any physician can detect them by palpation (touch).
It is to the minor accumulations particularly, that I wish to draw attention—the accumulations that we see in the majority of patients who visit our offices. Such patients assure us that the bowels move daily, but the color of their complexions, and the condition of their tongues, are enough to assure us that they are the victims of costiveness.
Daily movements of the bowels are no sign that the colon is not impacted; in fact, the worst cases of costiveness that we ever see are those in which daily movements of the bowels occur. The diagnosis of fæcal accumulations is facilitated by inquiring as to the color of the daily discharges. A black or a very dark green color almost always indicates that the fæces are ancient. Prompt discharge of food refuse is indicated by more or less yellow color. It would be interesting to inquire why fresh fæces are yellow and ancient fæces are dark.
Such patients have digestive fermentations to torment them, resulting in flatulent distension which encroaches on the cavity of the chest, which in excessive cases may cause short and rapid breathing, irregular heart action, disturbed circulation in the brain, with vertigo and headache. An over-distended cæcum, or sigmoid flexure, from pressure, may produce dropsy, numbness or cramps in the right or left lower extremity.