In the early history of ulcerative proctitis and colitis, the local

symptoms at the anal vent may not be noticeable; yet the disease may be

quite well developed for six or nine inches along the bowels. The early

or more obscure symptoms are mild and unnoticeable; then they progress

into notice, sometimes most sharply; finally we have severe and chronic

constipation, indigestion, flatulency, diarrhea, etc., and, keeping

pace with these, we have the stages of self-poisoning, which is known

as auto-infection or auto-intoxication.

With other measures, the most effective for relieving and removing

these symptoms of proctitis and colitis is the enema night and

morning. During the long period of relaxation at night, the functions

of elimination and repair are, with the great majority of us, going

on under abnormal conditions--such, for instance, as excessive

fermentation and bacterial putrefaction, which generate poisonous

gases that are absorbed by the nerves and bring about the condition of

_malaise_ we complain of when we rise in the morning. We then find our

bowels distended and ready for relief--and also, strangely, “not ready”!

Before dressing, therefore, is the time to relieve the excessive

pressure from gases and feces, and a slight enema is accordingly

advisable, say from half a pint to a pint of water, which should

be expelled at once. This removal of the contents of the rectum

and perhaps of the sigmoid flexure will permit the contents of the

ascending and transverse colon to pass more readily toward and into the

sigmoid flexure, as though they had been invited to come; and, indeed,

such passage is rendered inevitable by the removal of the local gas and

feces in their path. When half an hour or more has passed and breakfast

is over, it is time for the regular and complete evacuation of the

bowels, by the aid of the internal bath, or, as some describe it, by a

full flushing of the colon.

In our early efforts to establish harmony and periodicity with the

enema, it is advisable to resort to a mild vegetal laxative, in some

cases, rather than to let the tongue indicate so much foulness and

allow the feelings to become so intensely blue that they cannot be

hidden by even the utmost effort at pleasantry. Extreme cases may call

for different aids toward relief, until, one by one, these aids may be

dropped--the last one to be discontinued being the enema.

For a short time at the start it is, perhaps, best to confine one’s

self to two enemas, especially if fairly successful with the attempt

at a thorough cleansing after breakfast and before retiring at night.

The sleep will be sounder and the patient will be more apt to rise

refreshed with a clean tongue and cheerful spirits. So much will this

before-bed enema do for him that he may soon find it unnecessary to

take the preliminary injection on rising, inasmuch as fermentation

and gas will no longer trouble him. But individual experience and

intelligence must dictate the course in this respect. Let the patient

study himself and note the demands of his system. It may even be,

indeed it is frequently the case, that a patient requires several

enemas during the day. When abnormality has set in, it gives rise to

all sorts of freak requirements, and the victim must, for a time,

accede to its whims.

Quite frequently, owing to various causes, the feces will descend into

the rectum, which is properly a conduit, not a receptacle. While there

it occasions much nervous irritation of the whole system and makes

its victim desperate. It is wise, under such a condition, to take

slight injections for relief. Never allow any foulness to accumulate.

Establish the _habit_ of internal cleanliness. The new sense of bodily

purity will be so great that it can never be outgrown.

Nature easily accommodates herself to habits, whatever they be--normal

or abnormal, wholesome or unwholesome, cleanly or uncleanly; and the

train of consequences will be accordingly good or evil. My point may

be easily illustrated by the habits of “civilized” man in regard

to bathing. Many persons never take an external bath, and are not

conscious of any bodily discomfort arising from the omission of this

presumably necessary practice. As the summer approaches, another batch

of “civilizees,” so fortunate as to be within convenient distance of a

pond, lake, river, or ocean, begin to feel the real need of a “dip,”

and are uncomfortable until they get it. This is surely a sign that the

spirit of cleanliness is beginning to stir in the breast of humanity.

Then there is another contingent that bathe once a week, and should

their regular routine in this respect be interfered with they would at

once feel unclean--nay, even dirty, and, sometimes, “nasty.” Others,

again, bathe twice or thrice weekly, and this quota of the human

race feels very uncomfortable and foul when hindered for a week from

following this routine; indeed, such bathers often imagine that a dire

illness is impending. Finally, the “salt of the earth” take an external

bath once or twice a day, and, should _their_ routine be suspended for

twenty-four hours, visions of madness or suicide begin to haunt them

until relieved by soap and hot water, or the cold plunge, as their

habits require.

Of course, the same rule applies to the routine concerning the teeth,

facial ablutions, etc. Nature is stored habit, and she feels outraged

when her proprieties are disregarded. Let us pray, therefore, that the

habit of cleanliness may become contagious!

Now, the parallel between external and internal cleanliness is quite

obvious. Those whose bowels move but once in two or three days do not

realize how foul they are. Others have a scant evacuation once in

twenty-four hours, and they imagine that they are as clean as those

that take an external bath once a week think themselves to be. Still

others have two stools daily, and they feel as clean internally as

those that take three external baths weekly. And, finally, there are a

few who, defecating thrice daily, feel quite as clean as does the most

persistent external bather. Thus we see that cleanliness, external and

internal, is a habit, a new nature, attended with exquisite comfort

and pleasure--a quality that may lead to the goal of divine purity in

realizing the joys of hydropathy.

The wild woodland flower grew and blossomed without attention,

attracting but little interest. After, however, the florist has

cultivated it to the high stage of development in which we find it

to-day, with its stalk, stem, leaf, and fragrant petals displaying

their marvelous symmetry and beauty, we begin to appreciate the value

of labor, pains, cultivation. In like manner, it is our imperative duty

to give proper care to every requisite detail in the transformation of

our body into a human flower of health, grace, joy, and harmony.

The great majority of those that do me the honor to read what I have

to say on internal and external cleanliness will, doubtless, not agree

with me as to the frequency of the ablutions in twenty-four hours. Yet

I have a suspicion that if my objectors were to try an external and an

internal bath, on both rising and retiring, they would soon consider

the practice too delightful to be foregone; they would soon develop

more sweetness of character and be more particular as to the purity

of their nether garments, and, finally, would seem ensphered by an

atmosphere peopled with angels.

My proposition is this: First make a man clean, internally and

externally, and thus you may make him good; after you have made him

good you can make him healthy in both body and mind; after you have

made him healthy you can make him full of joy.

To recapitulate: A good time to take your internal bath is about half

an hour after each meal. Cultivate regularity in this, and Nature

will second your efforts and establish a periodicity for you by her

suggestive impulse and call. Our internal economy should not be

slighted as it has been. The intestines are good, faithful, patient

servitors, ready to perform their lowly office even when we are

inattentive and heedless. Sometimes, however, they become rebellious,

after they have stood more abuse than one would think them capable of

standing. Let us reform our bad habits; our servitors are willing to

enter with us into better habits, and co-operate with us in a truly

human life. Can you not spare a few minutes, three times a day, at

_regular periods_, for inner purification? You will find it very easy

when once you make it a matter of routine.

Now note this point: The work of your brain depends on the power sent

to it by the gastro-intestinal canal. A motor car goes no faster than

the power furnished enables it to go. So your brain activity is ever

on a par with the energy supplied from this usually despised intestinal

source; that is, it can never rise higher than the supply of this

energy warrants, and it always falls to the level of this supply,

for it depends on it absolutely for sustaining power. It would seem,

therefore, that common sense would be sufficient to shame us into

keeping clean, scrupulously clean, the canal that supplies us with

working force--the canal that extends without a break from mouth to

anus. Yet my experience shows that almost everybody cares more for his

outsides than for his insides--more for squandering his stored energy

than for looking out for its constant renewal--and that most patients

are foul all the way down.

Well-fed animals that have the range of Nature are plump, and have

healthy hair, skin, teeth, etc., because their intestinal organs

perform their functions frequently and fully. When animals become

domesticated and “civilized,” they become constipated and catch various

human illnesses or grow a crop of their own. Well-fed “humanals” grow

thin and puny, or bloated with gas, looking like corpulent clay men,

without natural teeth, without natural hair, their skin dry and of a

sickly hue, bloodless, fading away because of an early blight before

they have completed their early growth. Heredity is blamed for the

bloodless, nerveless, brainless body, when, as a matter of fact, its

degeneration is due to foulness within.

Birds, beasts, and savages (more fortunate than civilized man) have

the wide earth on which to stool when Nature calls. Their handy

water-closet enables them to enjoy good health. As civilization

advances, and business and social customs become more complex,

water-closets get fewer and less accessible. As a consequence, man

has to use his large intestine for a storehouse. He has done this so

long that it seems impossible to break him of the foul habit. But he

is paying the penalty. Many have abused the bladder in the same way,

and had this been a large organ like its brother, the colon, we would

long ago have heard the stereotyped excuse in regard to this function,

“Oh, any time to urinate that I can find will do.” Those who object to

the new order of bowel relief should, on the same principle, object to

frequent bladder relief.

I submit this proposition to the judgment of unprejudiced minds: Is

it not reasonable that so harmless and efficient a remedy as the

internal bath should be adopted by all intelligent persons? Inasmuch

as neglect--due to social, business, and other customs, and to lack

of conveniences for ready relief--has brought upon us so much fecal

poisoning and local disorders and so many abnormal and pernicious

systemic results, it should not be considered too great a task to take

an internal bath three times a day to amend our outrage on Nature--an

outrage that involves our health and general well-being, here and

hereafter. We owe it, not only to our possibilities, but also to

posterity, that fecal poisoning be banished. We have no right to

communicate such a taint to our children. They have a right to be free

from such poison. Do we ever think of their claims in this regard? Let

us leave them a better legacy, by adopting the thrice-a-day use of the

enema for the purification of the alimentary canal!

CHAPTER X.

HOW ENEMAS SHOULD BE TAKEN.

METHODS OF INTESTINAL IRRIGATION.

A satisfactory appliance for taking an enema should possess the

following features: capacity, adaptability, convenience, cleanliness,

durability, and sufficient external anal and water pressure to effect a

thorough flushing or an agreeable vaginal injection while one is in a

sitting position over a water-closet bowl.

There are several postures in which an enema may be taken. For those

physically able, the most convenient, cleanly, and comfortable manner

in which the thrice-daily inner bath may be had is the usual upright

position on a water-closet seat. For those not physically able to sit

upright, or for those that are not up-to-date and still adhere to the

use of the fountain or the bulb syringe, the best method is not the

usual sitting position, but the recumbent one. They are advised to

lie on the right side, or on the back with hips raised. As a rule, a

water-closet room is too small for reclining purposes, and, besides,

the necessary rubber sheet and toweling convenience may be absent.

Another drawback to lying full length for the purpose of flushing the

colon is that with short arms and the lack of _external anal pressure_

there is apt to be an escape of water and feces around the anal point,

necessitating much cleansing, considerable annoyance from nasty odors,

and an irritating waste of time.

Various devices, advertised as great inventions, have been resorted to

for the purpose of overcoming such malodorous and uncleanly incidents.

Among them is one that may be described as a colon tube, ranging from

nine to eighteen inches in length, which can be attached to a fountain

or a bulb syringe. The tube is usually of flexible rubber, _colored

red_ to hide as much as possible the cumulative evidence of saturated

filth and bacterial poison, the presence of which a white tube would

betray too readily.

I fail to see the necessity of introducing a rubber canal of such

length into an intestinal channel five feet long for the purpose

of “cleansing” the latter. The project lacks common sense. What a

ridiculous practice--to worm or bore a hole through the impacted feces

as you work your tube upward, then to squirt a little water into the

middle of things, or as near to the middle as you have managed to

get with a tube that will persist in bending on itself, and then to

withdraw it covered with liquid filth! What folly to put a canal _into_

a canal--the one inserted being one-fifth the length of the one to be

cleansed! Is not the original physiological channel good enough to

convey the antiseptic water or oil, or both? Why not have the rubber

canal five or six feet long if _one_ foot is so essential?

We should remember that ulcerative proctitis and colitis have made

the use of the enema a necessity; that, accordingly, the diseased,

constricted gut or canal must be treated very gently and not irritated

in any avoidable way. The least irritation will result in still greater

muscular contraction. It stands to reason that the effort to reach

the healthy portion of the bowel with a slightly flexible colon tube

frustrates its own purpose, and that it is besides a source of serious

and unnecessary irritation. While this rubber tube is being forced up

one’s bowels it often becomes lodged here and there in the valves and

folds of the mucous membrane. It has been found that the effort used

to dislodge it sometimes results in a doubling of the tube on itself

in the form of a knot, and that the end first introduced comes back to

the anus waiting to escape with the next push! We need not argue that

this forced looping and knotting of the tube is very injurious to the

diseased intestinal region, and that no one would care to introduce it

two or three times a day.

Does not common sense suggest that the rational way is to open the bore

of the alimentary canal by beginning at its _end_; that _liquid_ should

be applied directly to the first feces encountered, and that as this

impacted mass is removed the progress should be successfully upward?

The liquid as it enters dilates the channel, and as it passes on and up

it eventually gets beyond the diseased section of the bowels. Here,

by a gentle and soothing dilatation, we create at once an impulse

in the imprisoned feces and gases to descend and escape. What other

method is so kindly, and yet so effectual? We avoid, by this means,

irritating the diseased and constricted muscular canal; whereas by the

tube method we occasion still greater contraction, the inflamed surface

having a tendency to contract and close tightly over the tube. The

flood of liquid dilates the canal; whereas the forced rubber tube, by

irritation, contracts it. Besides, as has been pointed out, the conduct

of the tube working in the dark is most uncertain.

Suppose the rubber tube does finally reach the section of the colon

free from inflammation; that its passage thither has greatly increased

the spasmodic contraction of the diseased portion of the gut, and that,

of course, it had great difficulty in circumventing the resistance

offered by the valves, curves, and short bends--suppose all this, and

an idea of how the contents of the bowel above the diseased zone are

imprisoned will dawn upon you. For, after the tube has reached this

point of impaction, the distention there is most unduly increased by

the sudden gush of water, and, what is of still graver import, the

presence of the tube prevents its return flow. Then as the object is

being removed the watery feces following closely after are impeded by

the increased irritative contraction set up by the tube.

In short, this greatly extolled colon tube subjects the region of

proctitis and colitis, as well as the healthy section, to just such

objectionable procedure until the amount of water injected becomes so

extremely large that a means of escape is irresistibly produced by the

great pressure above. Is it wise treatment to irritate the diseased

portion of the bowels, and to distend still further the healthy portion

above, in order to get rid of distention due to feces and gases?

Without increasing the danger by injecting water into the already

unduly distended colon by the use of the tube, the imprisoned feces and

gases of themselves alone have been known to exert sufficient pressure

to occasion prolapse of the sigmoid flexure into the rectum or undue

displacement of the organ. Surely it were better to get rid of the

imprisoned contents by removing them from near the vent and working

one’s way gradually upward than to add more to the store and burden,

which only causes unendurable excitement and fierce demands for relief.

The rectal enema, taken in the rational way, simply dilates the portion

of the gut that is morbidly contracted--a procedure that is very

beneficial and should be continued just so long as any remnant of the

inflammation remains in the tissues. Kindly treatment is essential,

because ulcerative inflammation is an irritable condition and tends

to contract the muscular tissue at the slightest touch of a foreign

substance. What, I repeat, is more kind and soothing than antiseptic

water mixed with oil?

Advocates of the colon tube assert that water entering the lower

portion of the rectum will occasion ballooning of this portion

of the gut. After an experience covering twenty or more years,

I am in a position to say that there is absolutely nothing in

this objection--that water used in this way cannot produce such a

pathological condition. Ballooning of the lower portion of the rectum

is occasioned by _impaction of feces_, which remain lodged often for

weeks or months at a time in this locality. Whatever dilatation the use

of the enema may transiently produce would be only healthy exercise for

the diseased organ. An instrument is frequently used properly to dilate

the more or less contracted canal above and below the distended pouch

for a distance of from six to ten or more inches. Nothing but good

results can follow the proper use of the enema two or three times a day

in all forms of local disease of the anus, rectum, and colon.

CHAPTER XI.

THE INTERNAL FOUNTAIN BATH.

THE AUTHOR’S UNIQUE INVENTION.

The author has searched the markets of the world for suitable apparatus

for intestinal irrigation, so that he, as a specialist in this line

and in anal and rectal diseases, could recommend it to his patients.

None of the appliances to be had, however, quite answered the purpose

he had in view. All of them had some drawbacks. Owing to this fact,

after much experimentation he has invented an instrument that is herein

fully described to show its serviceableness. Were this volume to be

issued without this description, the author would be inundated with

interrogatories concerning the best instrument to be employed by its

readers, or whether the appliances they have on hand would answer the

purpose. As the object of this book is practical, not literary, it is

not out of place, the author thinks, to describe the invention and its

unique serviceableness, as well as its special adaptability for the

tri-daily employment of enemas.

The instrument is known as “The Internal Fountain Bath for Home

Treatment.” The following illustration gives a very good idea of its

construction and merits:

[Illustration:

[Patented Dec. 31, 1901; Nov. 14, 1905.]

Figures 18, 21, 22, and 23.

18, Reservoir; 21, hard rubber handle; 22, metal handle; 23, metal

handle, hard rubber cone, and enema point; 19, lamp support; 20, lamp;

33, rubber tube and shut-off; 24, glass bottle; 27, hard rubber anal

cone; 29, valve; 28, enema point; 25 and 26, recurrent douche points;

30, glass bottle; 31, hard rubber cone; 32, enema point.

Figure 24, Page 120, illustrates the author’s rubber enema appliance,

The Niagara Fountain Syringe, holding about two gallons of water.]

The Internal and External Fountain Bath is an appliance that I

have devised and supplied to my patients for many years with most

satisfactory results in every particular. Several other enemata and

recurrent douche instruments which I have used did not wholly meet the

requirements in capacity or aseptic features; but long use of this

apparatus in all the various bowel troubles has demonstrated, to me as

well as to my students and patients, that the instrument is the best

that can be made, perfectly meeting all the requirements essential for

scientific results.

_Features and Uses._

The Fountain Bath is the product of necessity, effort, and long

experience in accomplishing a definite purpose fully and properly.

Figure 18 illustrates a large enamelled metal reservoir for water.

Figure 21 shows a hard rubber combined enema and recurrent douche

appliance for the application of water to the mucous membrane of the

large intestine, the temperature of which should range from ninety to

one hundred and thirty-five degrees or more. To one end of the handle

is attached a hard rubber anal cone (Figure 27), inside of which is a

valve (Figure 29), which is opened and closed by turning the handle,

permitting the water to pass through the rectal point (Figure 25), or

(Figure 26) into the bowels and return into the toilet basin without

removing the point. At the other end of the handle is attached a glass

reservoir for the use of oils. Figure 22 is a metal handle with a

glass reservoir and a hard rubber anal cone. Figure 23 is a metal

handle without glass reservoir, and both are intended for the use of

water at a temperature of from ninety to one hundred and five or one

hundred and ten degrees. A thermometer is absolutely necessary to

determine the temperature of the water during its use as a depurent and

antiphlogistic remedy. The heating appliance will keep the water at a

desired temperature during its application, which is a very essential

feature indeed.

_Water Capacity._

The Fountain Bath reservoir holds three gallons of water, which is

quite sufficient to meet all requirements of the various complicated

cases of bowel and uterine troubles which require a generous supply

of tepid or very hot water. This obviates any interruption in the use

of the enema or the recurrent douche treatment until one or both are

satisfactorily completed, and without changing one’s position on the

toilet seat. It requires a quantity of water to irrigate the large

intestine, which is some five feet long and two and a half inches in

diameter. It is foolish to attempt to irrigate one end of a long,

tortuous, foul sewer with one or two quarts of water and hope for good

results. Water is cheap, then why not clean out and keep clean?

_Adaptability._

For the first time in the history of enemata appliances can an enema,

recurrent douche, or vaginal injection be taken with water at any

desired temperature and at the same time be medicated with any remedy

desired. External pressure against the anal orifice is regulated at

will; also the flushing of the integument about the anus and buttocks

is easily accomplished before leaving the toilet seat.

_Convenience._

This scientific device can be used without assistance. It has one

feature moreover, that renders it unique among rectal appliances,

namely that you may take a number of rapid injections without changing

your seat. You may inject a small quantity of water (from eight to

twelve ounces), and expel it immediately; then you may follow with a

larger amount (from one to three pints), and expel that also, then

in the same manner flush the colon. A complete internal bath may be

effected in the same way by using three, four or more quarts of water.

In this way, thorough depurating results may be obtained. The several

preliminary injections of gradually increasing quantities of water

free the lower bowel of feces, germs, and gases which otherwise might

be forced by the flushing process backward into and along the colon.

With the Internal Fountain Bath, unlike other syringes, it is not

inconvenient to take preliminary injections before flushing the bowels.

After the flushing the rectal and anal canals the bowels can be easily

cleaned their entire length, as can also the integument about the

anus and buttocks by letting the jet of water play on these parts to

wash away any germs and other poisonous discharges. All the necessary

movements of the anal point are easily made with the handle which

projects between the limbs in front of the toilet seat.

_Cleanliness._

The water reservoir is enameled white, both inside and out and free

from poisonous substances. The enamel is not injured by the use of any

germicidal remedies that may be placed in the water, or by the water

being brought to a very high temperature to destroy bacterial poisons.

Furthermore this enameled surface is easily cleaned, thus avoiding

foulness of the reservoir from continued use. The glass medicine case

and anal cone attached to the handle, as well as the anal point, are

all detachable and easily cleaned, and the handle is of sufficient

length to obviate soiling the hands and impregnating them with odors.

To bring away a quantity of feces does not exhaust the purpose of the

enema. The intestinal sewer requires further cleaning from end to end,

and the external parts around the anus as well. By playing a jet of

water on the external anal region you finish the enema and avoid the

very uncleanly practice of using “toilet paper” as a means of external

cleansing. It is strange that otherwise cleanly people are content with

such uncleanly treatment of these parts. They imagine that “toilet

paper” will effectually remove the excrement and its attending odors.

They would not think it sufficient thus to clean their hands if soiled

by excrementitious matter. It is the old story, “out of sight, out of

mind,” and of letting any make-shift in such cases answer; but the

spirit of cleanliness is abroad in the land, and the Silent Club of

the Cleanly is being formed through just such agencies as the Internal

Fountain Bath. Many have doubtless longed for a better practice but

did not know what to do. The “toilet paper” habit will pass with the

once-a-day habit of stooling, the constipation habit, and the physic

habit, for all four are uncleanly in the extreme.

_Durability._

The enameled metal reservoir and the metal and hard-rubber parts of the

handle ought, with care, to last a lifetime; the soft-rubber tube, if

properly cared for, will be of service for a long time.

_External Anal Pressure._

This is of very important assistance in flushing the colon, as it aids

in preventing the return of the injected water, and thereby promotes

its conveyance along the colon until it arrives at the surgically

famous vermiform appendix. It is not strange that both ends of the

large intestine--the anus and rectum and the appendix region--have

kept the surgeons busy, and I may add the undertaker likewise. These

two ends are of extraordinary concern, because they manifest intense

symptoms and pathological consequences. Modern medical practice is the

heroic treatment of symptoms and consequences and not patient search

for causes of disease and sensible treatment of it, as explained in

my treatise dealing with “Intestinal Ills,” as well as in the present

volume.

_Water Pressure._

Two or three gallons of water, suspended at the usual height of enemata

appliance, affords quite enough pressure, especially when the outlet

and tubing are amply large. The shut-off on the rubber tube enables the

user to gauge the flow of water to a nicety.

_Time Required._

The time required for taking an internal bath--that is, for a complete

flushing of the bowels--will vary in individual cases. After removing

the local deposits in and near the rectum by one or two rapid

injections of very small quantities of water, two to four quarts are

taken into the intestinal canal at one time, and this constitutes

the enema proper. Now, many persons will find it advantageous to

let the flushing water enter very slowly, taking from two to five

minutes, or even more. With some, if the water is allowed to flow in

very rapidly, the various segments of the rectum and colon may not

readily accommodate themselves to the inflow, and will too soon make

an expulsive effort, returning the water before it has dissolved the

feces or united with them, thus defeating the object sought through

the enema. With other persons, however, the flow may be as rapid as

desired. The speed must be left to individual judgment and experience.

_Temperature of Water for an Enema._

The chief purpose of an enema is to produce depuratory results; that

is, to remove morbid matter from the bowels and then to cleanse them.

To accomplish this effectively and at the same time to avoid exciting

an increased flow of blood to the diseased gut, the water should

be about the normal temperature of the body, which is about 98-1/2

degrees. Water too hot or too cold will aggravate the sensitive,

inflamed surface; and, as it is this very inflammation that causes

the abnormal action of the bowels for the relief of which the enema

is taken, the temperature of the water is most important. If it range

between 90 and 105 degrees it will do, for within those extremes it

will not be likely to increase the existing chronic engorgement of the

tissues. Under no circumstances should very hot or very cold water be

used for the removal of fecal accumulation. Physicians so incompetent

as to make a wrong diagnosis of the cause of chronic constipation

and its numerous symptoms often prescribe a wrong treatment in the

use of water. From two to ten minutes’ use of very hot or very cold

water in cases of proctitis and colitis will only increase the chronic

engorgement of the blood-vessels and tissues and increase the morbid

symptoms. When water is applied to the mucous membrane anywhere

throughout the body, I use it hot exclusively, as that temperature has

then certain advantages over cold. In the chapters treating upon the

different uses of hot water, I give the hydro-therapeutic action of

such liquid on the tissues of the body.

_Quantity of Water to be Used._

The quantity of water to be injected into the colon at one time must

vary in each case and also on each occasion. In the beginning of its

use and for some time following, a greater amount may be required than

will be necessary when, with its continued use, a better action of the

bowels becomes established.

In cases of chronic constipation and semi-constipation, the kidneys,

lungs, mucous membrane, and skin eliminate a daily accumulation of

feces from the system equal to two-thirds or three-fourths of the

amount of normal feces. This accounts for the frequency of chronic

disease of these organs. To establish a new régime in the mode of

fecal and gaseous elimination requires much time and patience in the

use of the enema. Nearly all persons can take the enema with comfort

and satisfaction. Now and then, however, there is a person who finds

it a little troublesome to inject over a quart of water at one time,

while most persons can inject over four quarts without inconvenience. I

would advise patience and perseverance on the part of those who find it

irksome to inject a sufficient amount thoroughly to cleanse the colon,

or the portion thereof involved in undue accumulation.

Enough water should be injected to bring away what would constitute

the normal amount of feces to be passed at a regular stool. Gradually,

as the practice is established by the use of the enema twice or thrice

daily, it will be easy to determine the proper amount of feces to pass.

And note this fact: it is just as easy to establish the habit of three

evacuations in twenty-four hours as of two or one.

Whenever the amount of water injected proves sufficient at any time to

bring away all the feces that should pass, it is not necessary at that

sitting to repeat the dose, except it be for subsequent cleansing, as a

sort of gargle. No possible harm can come from the generous use of the

enema during a lifetime; indeed, its constant use will prolong life and

make it more comfortable.

CHAPTER XII.

BENEFITS OF THE INNER BATH.

I speak from clinical observation with the use of various rectal and

colon specula, of which I have over fifty. I have watched the progress

of cases that were using the enema twice or thrice daily, and of cases

that were also using the intestinal recurrent douche, which latter

required an hour’s continuous application of hot water, and I know,

therefore, whereof I speak when I affirm its salutary effect both on

the local organs and on the general system.

Many that write about the use or abuse of the enema have never seen

the mucous membrane of the rectum and colon. Most of what is written

on the subject is worthless. The author of this book writes from

the accumulated experience of daily examinations with specula for a

period of over twenty-three years. Had he merely used his fingers

or hand for making rectal examinations, or had he contented himself

with prescribing for symptoms reported by the sufferer, his views and

opinions as to the use and benefits of the internal bath would have

been on a par with those that, by the old methods, make futile efforts

in diagnosis and treatment.

Some good souls now and then become oversolicitous as to the matter

they should pass when their bowels are already empty, and they feel

alarmed if the enema fails to produce an evacuation. Such timid ones

should remember that what they cannot accomplish at one time and with

one attempt they may at the next, and that thus slowly the new order of

fecal elimination will become established. It takes time and patience;

but is this cause for apprehension when diagnosis, treatment, and means

of relief are right? I claim that flushing of the colon is the best

means for removal of the consequences of proctitis and colitis, and

that it should be employed by all that have these chronic ailments.

Let them get relief for the _symptoms_ at once and in this rational

way, after which let them seek scientific treatment for the ailments

themselves; for, sooner or later, they will be compelled to seek it by

the severe complications that will inevitably set in.

TRY SCIENTIFIC AND PRACTICAL MEASURES.

Some persons find difficulty in estimating--or think they do, which in

most cases is nearer the truth--the amount of water they can inject at

one time, when it would work a great relief to their bowels were they

able to inject from two to four quarts. It is half the battle to know

your efforts are rightly directed; for, when you are defeated, you will

try a thousand and one changes--an experiment first with one element

of the difficulty and then with another. You will experiment with the

temperature, with the speed of flow into the rectum and colon, with

intermittent flow, etc. Be a little scientific and original in this

matter, I pray you, _and know no defeat_!

As to the intermittent flow, the following way may be found judicious

in some cases: Take in just sufficient water--a few ounces perhaps--to

provoke an evacuation, and proceed till you have taken half a dozen or

more. After this you can take a greater quantity for a washout. But

this is not exactly what is meant by the term “intermittent flow.” It

means that you may make the experiment--if you find it difficult to

fill up after ridding yourself of the local accumulation--of turning

off the stop-cock for a moment, thus giving your bowels a slight rest,

and then turning it on again, alternating in this way for some minutes.

Many little devices of similar utility will suggest themselves to those

who know no defeat. Remember that, now that you are in serious trouble,

it is not the easiest thing in the world to get out of it.

Should your stomach raise objections to the enema, change the time.

If abdominal pains are severe, change the temperature of the water

and the time and manner of injecting it. In other words, do something

different, but be determined to conquer and take the internal bath at

proper periods every day.

LIBERATING THE WATER.

Some persons who find no trouble at all in taking a large quantity of

water have much difficulty in expelling it, or rather in expelling

all of it at once. Various methods may be resorted to to liberate the

retained water. One is to inject a little more, as a provoker, when all

will escape without further difficulty. Another method is to resort to

various motions of the arms and body. Some find relief by raising and

projecting both arms together slowly, and then stretching and holding

them aloft for a few moments. Other methods are: to twist the trunk a

few times, to walk up and down a little, to bend forward and backward,

etc. Still another method is to massage the abdominal walls, beginning

at the ascending colon (see Fig. 12), passing upward to the left along

the transverse colon, and then downward until the lower portion of the

sigmoid flexure is reached. When beginning the massage, one should use

stroking movements from right to left over the entire surface, and then

go over it again with rotary strokes. Some may find it advantageous to

knead the abdominal muscles, gradually reaching the deeper parts as the

air is expelled from the lungs, which expulsion may change the position

of the various segments of the intestine and thus afford an opportunity

for the feces, gases, and water to escape. Before rising in the morning

and retiring at night, it will be found advantageous by some persons

to spend about ten minutes in making the three kinds of manipulations

described. It is an excellent practice for every one to lie flat on the

chest and abdomen and draw in several deep breaths just before rising.

This exercise will strengthen the muscles of those parts and benefit

the internal organs as well.

THE ENEMA AS A PERMANENT PRACTICE.

In the effort to restore the long-abused bowel to its normal

functioning by the use of the enema and massage, there may be, in

the beginning of such treatment, an exceptional case in which a mild

laxative is indicated as the desirable thing, rather than that a furred

tongue and base bodily feelings shall evidence too much foulness all

the way up to the mouth.

The enema, of course, constitutes the chief means and mainstay of

relief from obstipation of the bowels, and one by one the other

aids are to be omitted. Moreover, when the time comes that the

bowel is freed from the disease that occasioned the occlusion and

obstipation,--that is to say, when the bowels evacuate themselves

naturally three times a day,--then the enema itself may be omitted, or

it may be continued without harm by those whose sense of cleanliness

would induce them to keep up the practice in preference to the

uncleanly habit of using toilet paper as a partial means toward

cleanliness. Surely there is no harm in substituting a better habit for

a worse one--one, moreover, that we should be ashamed to continue! As

no one would think of cleaning his soiled fingers with toilet paper, as

already said, so no one with any real sense of decency will continue

the attempt to clean his anal orifice with such material when he has

learned a better and more effective way. Likewise, after having learned

the rational mode of relieving the surcharged bowels, no wise person

will continue the use of physic, coarse food, gymnastic exercises, and

other futile and foolish practices as remedial measures for intestinal

ailments.

No one suffering from proctitis and colitis can have a clean and

healthy sigmoid flexure and rectum unless these be kept clean by

the regular use, three times a day, of the enema. From the day when

the disease invades these parts there is and will continue to be a

clogged, plastered, or incrusted passage for more or less of the entire

length of the colon. This must be so in the nature of things, since

these organs are unable to perform their functions while the disease

is present. Just think of possessing a filthy, congested intestinal

canal, without one day of real cleanliness for twenty, forty, sixty, or

more years! It is not the easiest thing in the world to cleanse this

channel even by the use of the enema; for the ancient contents refuse

dislodgment even after repeated flushings, and it is only after many

days of persistent and patient irrigation that the intestines are freed.

Some persons are apprehensive as to the quantity of water the large

intestine will hold with safety. Let me reassure them. It is capable

of holding about three gallons without too great distention. One-third

of this amount, however, is quite sufficient to bring away the

accumulated fecal mass, and in many cases a much smaller amount will

answer the purpose--especially when, as advised, it is used two or

three times within twenty-four hours. After a thorough evacuation,

water should be injected one or more times until it returns clear and

free from fragments of feces.

If I were asked to name the greatest curse parents could inflict upon

their helpless offspring, I would say _fecal auto-intoxication_. A

large volume could be written on the subject, and I trust the hints

here given will lead to discussion of this grave matter.

CHAPTER XIII.

OBJECTIONS TO THE USE OF THE 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 would 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. Eyeglasses, 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 load: it

cleanses and soothes an organ that must keep at work and perform its

function 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 seventy-five 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 who ever 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 eighty 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 instill 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 injury to the

organs, and more especially we have found 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 disturbing and poisoning to the system. It is, therefore, a

most unnatural condition. What is more rational, then, 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 would 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

intestine 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 _naïve_: “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 effectuate 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 all

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 marvelous 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.

[Illustration: Fig. 24.

NIAGARA FOUNTAIN SYRINGE.

(Patented Nov. 14, 1905.)

The above illustration represents the Niagara Fountain Syringe, to

which can be attached the enema handle, Fig. 22, Fig. 23, or the

combined enema and recurrent douche handle, Fig. 21, page 91. The

Niagara Fountain Syringe is made of soft rubber and holds about two

gallons of water, and is very handy when traveling or in need of a

hot-water bottle.]

CHAPTER XIV.

LAME BACK.

The manufacturers of various compounds advertised in our daily

newspapers and on the billboards usually select very common ailments or

symptoms on which to exploit the merits of their product. They make no

distinction between a disease and its symptoms; and why should they,

when their sole object is to sell their goods?

Lame back is a common weakness of that portion of the spine usually

spoken of as the “small of the back.” As a general rule, it is an

indication of some pelvic disease involving the anus, rectum, colon,

bladder, or uterus. Those who suffer from disease of one or more of the

pelvic organs will have at times reminders that they have a lame, weak,

or “dead” spot at the “small of the back” or a little lower down on the

spine.

As an illustration, a current advertisement reads as follows: “Weak

Backs! If you happen to be one of those unfortunate people with a weak,

lame, tired, aching back, it is time you were finding out about ----.”

Then the advertisement proceeds to tell how to put on a plaster or a

liniment, or rub the back for a week or two with the hands. Another

enterprising wonder-worker asks: “Do you get up with a lame back?

Thousands of women have kidney trouble and never suspect it.” “Lifted

from the depths of despair by----” etc. Now, this may be seriously

alarming to actual sufferers from lame back.

[Illustration: Fig. 19.

Showing the distribution of the sympathetic nerve about the rectum. 22,

the rectum; 23, the bladder; 26, the kidney; 20, the rectal plexus; 19,

the vesicle plexus; 18, the sacral ganglia; 21, the lumbar plexus; the

lumbar ganglia; 16, the mesenteric plexus; 15, the solar plexus; 27,

the aorta.]

The kidneys are located several inches above the region called the

“small of the back”; therefore, a difficulty in this region does not

necessarily indicate disease of the kidneys. Those who suffer from the

symptoms described--lame, weak, hot, dead spots, lumbago, rheumatism,

etc.--at this portion of the spine may suspect that some of the organs

in what is called the pelvic cavity are causing them. The spinal nerves

(lumbar nerves) on leaving the “small of the back” and proceeding lower

down are distributed to the anus, rectum, bladder, uterus, etc., and

when one or more of these organs are diseased the victim will have some

of the symptoms in the portion of the back mentioned above. The earlier

indications of a disease are usually localized, but, as the malady

itself persists indefinitely, both the sufferer and his physician

are often deceived as to the producing cause of the varying symptoms

manifesting throughout the body.

In this brief chapter I will confine myself to the diseases of the

anus, rectum, and colon, as causing so much annoyance from the symptoms

enumerated at or below the “small of the back.” The most common ailment

that afflicts mankind is chronic catarrhal inflammation of the anus,

rectum, and colon. The disease invades not only the mucous membrane but

the whole bowel structure, and the nerves report from the seat of the

trouble up to where they enter the spinal column--a region that should

be called the porous-plaster region rather than the “small of the back.”

The chronic inflammation involving eight to ten inches of the lower

portion of the intestinal canal, like all other diseases, has its

alternating periods of quietude and excitement; and the negligent

sufferer must count on having “stitches in the back,”--cold in the

back, lumbago, rheumatism, sciatica, etc., as they are usually called

for want of a definite idea as to the _cause_ of the annoying symptoms.

The physician consulted usually agrees with the sufferer’s diagnosis,

and coincides with the application of bands, porous plasters,

liniments, etc.--which may allay the neuralgic symptoms to some extent.

The reader is so familiar with illustrations in the newspapers and on

bill-boards of a man with a weak or lame back that it is unnecessary

here to take up space with a pen picture descriptive of the symptoms

and attitudes of a sufferer.

Those who have had occasion to acquire the warm-band, the rubbing with

liniment, and the plaster habits, had better direct their attention and

remedies to the _cause_ of the symptoms. One frequent source of all

these back symptoms is chronic inflammation of the anus, rectum, and

colon, with more or less ulceration accompanying it. In the female,

disease of the uterus complicates the painful symptoms. Usually among

the first indications of this disease is some degree of constipation,

which in time is followed by local symptoms known as piles, fissure,

itching tabs, clot of blood in a vein, abscess, etc. Constipation is

a prolific cause of indigestion, biliousness, flatulency, loss of

appetite, self-poisoning, anemia, emaciation, uric acid, neuralgia

in various parts of the system, catarrhal inflammation of the mucous

membrane of one or more organs, and many other symptoms.

A diseased organ is a constant source of unconscious and conscious

irritation to the sufferer. If the victim can tolerate the trouble he

seldom seeks treatment. “I will not bother with it as long as it is no

worse,” he says. At times, however, the symptoms become very annoying,

and measures are taken to allay them. During the long interval of

“better and worse” effects the malady is becoming more deeply seated,

and the symptoms eventually appear in all parts of the body.

As a rule, the majority of victims put off treatment until a protracted

period of extreme suffering or the fear of a fatal ending compels them

to consult a physician--who labors at a great disadvantage in seeking

to effect a cure on account of the long neglect.

Severe symptoms located at the porous-plaster region of the spine, when

brought on by disease of the lower bowel, usually indicate an acute

stage of chronic inflammation and retention of feces and gases in the

sigmoid flexure and colon. Acute or subacute inflammation and fever and

pressure of the feces are more than the long-abused nerves can endure,

and severe pain is the result.

Then the sufferer has something to say about his back, and what is best

to do for it.

The logical course is to unload the bowels of feces and gases by a

generous use of the enema and to treat the diseased tissues kindly. The

symptoms will soon disappear when the cause is removed.

CHAPTER XV.

URIC ACID.

A society leader, in speaking of her ills to a woman friend, said: “I

am ‘lousy’ with uric acid.” From infancy to old age, mankind is more

or less filled with uric acid and other poisons--the result of a foul

intestinal canal. Poisoned blood is a common symptom, and it arises

from an almost universal cause--chronic constipation. So universal is

constipation of the bowels in illness that it is the first duty of a

physician to prescribe some remedy to unload them.

It is said that a Boston doctor, whose practice was largely among the

wealthy classes, used to say: “There is no use in physicians pretending

to be anything else--they always smell of rhubarb.” And in an address

to a class of medical students an old doctor once said that he and his

associate practitioners had found that calomel and opium filled every

want in the ills they were called upon to treat.

For ages all mankind has striven to find a remedy effectively to clean

the intestinal tract. Pills, powders, tablets, wafers, suppositories,

salts, teas, candies, and syrups have been administered--all with

that sole purpose. Efforts have been made to accomplish this object

by utilizing every possible device and contrivance known to human

ingenuity. Calisthenics, massage, physical-culture exercise, mental

therapy, horseback riding, “dieting,” fasting--these are some of the

many means resorted to in order to “sterilize” the foul, constipated

intestinal canal.

Albeit that the cleaning of the digestive apparatus in the case of

a sick person is regarded as a necessary first help the world over,

few persons realize that it is of equal importance in the case of

a seemingly healthy person. Is it not a fair inference, therefore,

that where a purgative--such as calomel, or one of the innumerable

similarly-acting medicines--temporarily relieves a patient’s symptoms,

the timely precaution of keeping the intestinal canal and system clean

would prevent a person from getting ill?

The reader may think that, in these observations, I have wandered away

from my text, but, as uric acid is the _symptom_ of a combination and

complication of disorders of which constipation is the secondary cause,

the connection and sequence of my remarks are evident. It is safe for

a layman to assume that, where so many diverse schemes are employed to

relieve symptoms, the diagnosis is wrong--also the treatment.

A few of the many primary symptoms of proctitis and colitis are

constipation, diarrhea, indigestion, biliousness, flatulency,

putrefaction, and gaseous and bacterial poisons--a foul

gastro-intestinal canal, through which there are daily absorbed from

the bowels two-thirds to three-fourths of the excrementitious matter

into the system. With these facts before us we need not be astonished

at the statement that nine-tenths of human ills have their origin in

the digestive apparatus.

Among the secondary symptoms of proctitis and colitis is poisoned

blood--anemia, which is usually followed by impaired nutrition and

emaciation or obesity. Along with the changes in the blood and

nutrition there occurs lodgment or deposit of salts, acids, etc.,

in the various organs and tissues of the body. Almost every one is

familiar with gouty deposits in the finger joints and other joints of

the body. If the deposits occur in the muscular tissue it is called

rheumatism. If in the urinary organs we have gravel, Bright’s disease,

diabetes, cystitis, irritation of the neck of the bladder, frequent

calls to urinate; and the urine, scanty and high-colored, on cooling

reveals a crystalline deposit. The principal mineral substances of

the urine are as follows--of which one or more may become poisonous:

chloride of potassium, chloride of calcium, chloride of magnesium,

chloride of sodium, sulphate of potassium, sulphate of soda, sulphate

of magnesia, phosphate of soda, and phosphate of potassium.

The liver gets its share of the foul substances generated in the

intestinal canal, which cause congestion of the organ. Toxic biliary

salts and acids are present. The deposit may form gall-stones, and

jaundice and many other annoying symptoms may occur. The system is

simply a filter, or blotter, that lets the poisonous contents of the

intestinal canal pass through and out; but all the organs and tissues,

during the process, retain many of the foreign toxic substances, which

overtax (and frequently destroy) their functions with work that Nature

never intended they should do. Think of it--all the organs and tissues

around the intestinal canal serving as _fecal vents_! Deposits cause

irritation of nerve centers and nerve cells precisely as in fibrous

and cartilaginous tissues; and we speak of the symptoms as spinal

irritation, hysteria, chorea, lumbago, sciatica, nervous tension,

headache, irritability, despondency, melancholia, insomnia, dementia,

etc. From the disturbance of the voluntary and involuntary nerves we

have irregular circulation of the blood from disturbed heart action,

cold hands and feet, and flushing of the face alternating with pallor,

vertigo, and dizziness. The capillary circulation becomes obstructed

with crystallized bodies, as chunks of ice obstruct a stream of water.

Catarrhal inflammation of the mucous membrane is set up in various

parts of the body by the deposits in the membrane and the abnormal

means of their elimination through it. The skin of the body, which is

the mucous membrane turned outward, suffers likewise from diseases

having numerous names.

Doctors have always expressed a poor opinion of the liver because it

did not keep the bowels sweet and clean, and they mistakenly though

honestly called it “the lazy liver,” “the torpid liver,” “hepatic

insufficiency,” “atony of the liver,” “sluggish liver,” “hepatic

torpor,” “fatty liver,” etc.; and the poor victim of proctitis and

colitis was glad he had consulted the doctor and learned “just the

cause” of his internal troubles--and could suffer on more reconciled

to his malady since he knew its exact name and could continue to take

with regularity one or more of the many powerful liver exciters, to

stimulate activity in the liver and bowels once every day or two, if

possible. By some strange psychological or other influence of late

years, however, physicians have turned their attention to the “lazy

kidneys,” and now it is difficult to decide which they are purging

the most--the liver or the kidneys. At any rate, they both must be

violently excited at the same time, and we hear “lithia” mentioned,

or “laxative salts of lithia,” every time uric acid is thought of.

Stimulate the lazy liver and kidneys, and with abundant salts dissolve

out of the tissues and blood the precipitated deposits; this is the

fashion of the times.

Diagnosis wrong and treatment harmful! Water is by far the best agent

to dissolve salt compounds, to dilute acids, or to remove filth. It

is also the best means of soothing and relieving the long irritated

and inflamed tissues and organs, that have had from two-thirds to

three-fourths of the daily fecal mass thrust upon them and collected

in them, when they are called torpid, lazy, and whipped up unmercifully

by bile and urine bouncers. We ourselves would be very torpid,

sluggish, or “lazy” if called upon to do the work of two persons under

such embarrassing physiological circumstances as being filled with

toxic substances, or thoroughly auto-intoxicated.

When will common sense take the place of theories founded on guesswork,

and some thorough washing out by plain or distilled water be done,

internally as well as externally? After such an operation some specific

remedy may be taken, if demanded, with the certainty of permanent good

resulting. But remember, your aqueous body, held in its form by the

skin and mucous membrane, needs a well-nigh constant stream of pure

water flowing through it to keep it fresh and clean.

The diagnostic error of mistaking effect for cause, however, is

frequently made. Patients are treated for one of the secondary

symptoms--say uric acid--with a view to abate that disorder

and restore health, when treatment for the specific cause of

constipation--proctitis (inflammation of the anus and rectum)--would

restore the patient to his normal vigor. Pale, anemic sufferers from

constipation are often told that the restoration of their blood

to its normal state will effect a complete cure. No idea could be

further amiss, for if the poisoned victims take coal oil, fish oil,

malt compounds, iron, etc., as tonics, into a disordered stomach

and unclean bowels, how can anything more than imaginary relief be

obtained? Is it not evident that the chief disorder, _proctitis_, the

main cause of the trouble, has in no way been reached?

In other complications arising from constipation, a favorite diagnosis

is one of the secondary symptoms--“atony” of the bowels, liver, or

kidneys. In these cases nux vomica and various poisonous compounds

are given, but here also it stands to reason that the administering

of remedies for symptoms cannot effect a cure of a chronic local

disease of the anus, rectum, or colon. Then, again, by way of variety,

a diagnosis of “uric acid” is made for which irritant drugs are

administered to increase the eliminating or excretory action of the

bowels and kidneys. It is utter folly and absurdity to attempt the

cleansing of the intestinal tract by laxatives, cathartics, purgatives,

exercise, etc., and to make the kidneys and liver, overtaxed from foul

bowel products, do still more work by giving medicines to increase the

urinal and biliary secretions.

It does not require a knowledge of the principles of physiology and

pathology to know that no sufferer from chronic constipation can be

permanently benefited if any or all of the secondary symptoms already

noted be treated with the usual list of drugs and the cause ignored.

Much stress is laid upon the quantity and quality of food consumed by

most people, and many generalizers attribute chronic constipation, uric

acid, etc., to this very thing. Surely the average person knows that

too much or too little food taken at regular intervals is not conducive

to good health--a view that I have found borne out by a large majority

of my patients, who rarely overstepped the limits and knew when a

diminution in the supply of nourishment was advisable.

In the last analysis, the principal cause of ill health is lack of

elimination of the excretory organs. When the bowels fail to do their

proper work, the functions of the other organs of the body become

correspondingly affected and impaired, and general debility ensues.

In previous chapters, also in my book, _Intestinal Ills_, I have made

plain the causes contributing to chronic constipation and the use

of enemas and their origin. _Prehension_ and _elimination_ are two

subjects that are vital to the welfare of man. If the eliminating

power of the intestinal canal is normally active, the fortunate

individual may eat abundantly, or really in excess of the requirements

of the system, and still escape any ill effects, such as indigestion,

biliousness, acid in the urine, etc. The hearty consumer of food whose

bowels eliminate properly may suffer a loss of appetite, but it will

not be accompanied with foulness of the digestive apparatus.

When all the organs of the body perform their functions in a normal

manner, no part of the structure is in immediate need of repair. Every

organ whose function consists in building tissues, muscles, or some

other part of the body, having a sufficient supply of reserve nutriment

on hand, makes known this state throughout the organism; hence there

is no craving for food, no appetite, although the tongue, stomach,

and intestines are in a normal condition. In this state of surplus

of nourishment the person may omit a few meals or partake sparingly

until the expenditure is equal to the income. But such physiological

happiness is not for the person whose intestinal canal and system are

clogged and foul from undue retention of excrementitious material,

causing no desire for food, while all the atomic builders of the body

are wanting nourishment and protesting through the nervous system

against their impoverished condition.

Sufferers from self-poisoning, as described in this chapter, should

irrigate the system thoroughly by frequent drinking and by copious

injections of water into the bowels. The action of the enema if

properly given and the drinking of water that is pure or distilled

increase the quantity of urine and diminish the renal congestion, while

increasing the eliminative action of the skin.

Irrigation of the bowels for fifty minutes or more with hot water (120

to 125 degrees) increases the action of the kidneys. Hot irrigation

(125 to 135 degrees) is especially recommended to increase the

discharge of urine and the action of the skin, and should be continued

for sixty minutes or more. The Intestinal Recurrent Douche, described

in a subsequent chapter, is an excellent instrument for the employment

of hot water to produce diuresis and diaphoresis.

The Chemung Spring Water and Clynta Double-Distilled Water, sold in New

York, are excellent drinking waters and can be obtained at a moderate

price.

CHAPTER XVI.

RATIONAL SANITATION AND HYGIENE.

We, all of us, like to use things; indulgence is enjoyable, but it

generally ends with the day. Few of us “take thought of the morrow.”

Neglecting, as we do, the _instruments_ of use, their availability

for permanent subservience to our wants steadily diminishes, becoming

finally lost. Is it that we do not know any better, or is it that we

are really so intoxicated with the Present that we simply ignore the

well-known claims of the Permanent? Whatever the explanation may be,

it is nevertheless passing strange that little or no care is bestowed

on either our external or internal servitors, instruments, or organs,

which otherwise are ever ready to keep us well filled with the pure

wine of joy. Perhaps it is that many of us find Nature so lavish in

supplying us with the means of joy that we are naturally equally lavish

in wasting them. True economy--that is, the conserving of means for

their effective use--is yet to be learned by man. Especially is this

the case with our interior means, our flesh, blood, nerves, vital

force, etc. Nature seems so ready to recoup and renew the organic loss

incurred by our use or indulgence--recuperation seems so easy--that

we simply grow careless, reckless, prodigal, and before we are fairly

aware of it the disintegrative process gains an ascendency over the

restorative, and thenceforward our time will be spent in endeavoring to

cure what might have been kept whole or well.

Nor is it an organ of the body here and there that we neglect or abuse;

it is more especially the entire system of organs called “the body.”

The body is the organ of man’s spirit. We give no heed to its tones;

perhaps we have never caught its rhythm; certain it is that when but a

short time in our perverted hands its chords are more or less jangled,

and a minor part is played in the grand symphony of life.

The organ of man’s spirit! How rational, nay, how necessary, it would

seem to be to keep that instrument keyed to its perfect work!

But the ordinary denizen of civilization has a most ridiculous ideal

of physical capability, namely, that the savage--a being altogether

“physical”--was able to retain a healthy body till ripe old age

without attention either to sanitary surroundings or to the hygienic

functioning of his system of organs. The “civilizee’s” fancy picture

of the noble savage is not based upon verifiable fact. It is true that

we have a few attractive myths concerning savages that had survived

appalling hardship; but we are just learning of the innumerable host

that have perished periodically of various contagious diseases, and

of the countless number (infants, youths, and adults) that have

suffered from all sorts of ailments. Alas! how little we know--or, for

that matter, how little we seem to care--of the great multitude of

“civilized” fellow-creatures whose lives are all jangled and out of

tune through subjection to the many ills that flesh seems heir to; ills

that have arisen through either ignorance or the voluntary _ignoring of

the light of accessible knowledge_!

In another aspect the human race is like an army that concerns itself

with its immediate and imperative duties and has no time or thought

to bestow on those that fall out of the ranks. But slaves to stern

duty offend against Nature’s normality as do slaves to desire; and the

former little suspect that their retirement also is near at hand. In

health we seldom or never think of the conditions for the maintenance

of health. That these conditions should receive our prime attention

is obvious when we contemplate for a moment (1) our race of invalids,

and (2) the growing unsanitary condition of modern industrialism,

involving, as industrialism perforce must, the unsanitary life of the

factory, workshop, office, and hothouse home.

Again, with the advance of high-pressure civilization and culture

human beings are developing a more highly sensitive physical organism,

pitched to finer issues. How urgent the necessity for a greater

safeguarding of that organism!

If it be claimed that many of us do live up to our knowledge of health

conditions, and that we are notwithstanding unwell, I would answer

that our knowledge now is very disconnected, and that when the time

shall come that our itemistic information shall have coalesced and

formed a system of principles, we will then have trustworthy rules for

the acquisition of health habits and become completely normal physical

beings. At present most of us are intemperate in one or more ways. We

eat too much or too little--too rich or too poor food. So it is with

our drinking, our sleeping, our sporting, our enjoyment of this or that

excitement--the quantity or the quality of each of these is not well

adapted or proportioned to the conditions of normality.

Let me offer the health-seeker a few indications of the sanitary and

hygienic requirements demanded by Nature’s normality. In our family and

household life, to carry into execution daily hygienic measures, it is

essential that we have ample, accessible conveniences for the necessary

ablution of the body, externally and internally. How extremely rare it

is, however, that bath-tubs and water-closets are found in sufficient

quantity and suitable quality in our apartments. As household fixtures

they are usually about as scarce as hens’ teeth.

In New York City a house with from eight to sixteen persons is

restricted to the use of one water-closet and one bath-tub. On these

(and a laundry and servants’ privy in the basement) there is the tax of

ten dollars a year. Now, should that rare human product, an enlightened

and humane owner, put in eight more bath-tubs and water-closets for

the proper accommodation of his sixteen guests, so that each suite of

sleeping apartments should have its appropriate conveniences, he would

have to pay an additional tax of forty dollars a year. Is this tax

levied with the connivance of the Board of Health? It would seem so,

since no protest from that august body has ever been heard within the

memory of the oldest inhabitant. Indeed, the suspicion is not at all

unwarranted that if the masses were less constipated and better washed

they would have less use for the doctors, and that, therefore, it is

not well to encourage undue sanitation and hygiene.

It must be, too, that the Department of Water Supply has figured it out

quite beautifully that a saving will be insured in the amount of water

consumed by sixteen persons if they be restricted to one bath-tub and

one water-closet; otherwise forty dollars a year would not be charged

for eight additional tubs and closets for the use of the same number of

persons. Listen to a sample of their logic: “Sixteen persons with eight

additional bath-tubs and water-closets would use more water than if

they were restricted to one of each--hence the additional tax. We don’t

care a continental whether these human beings are clean externally or

internally; that’s not our lookout. But we do care that they shouldn’t

use more water than just so much, see!”

And does the august Board of Health raise the least objection to this

sort of logic? None whatever.

Professor C. S. Smith states that, out of 255,000 families in

tenement-houses in the city of New York, only 306 had access to

bath-tubs in their own homes in 1894. In 1897 one city block containing

904 families did not have a single bath-tub.

Paradoxical as it may seem, there is, notwithstanding the appropriation

every year for the New York City Board of Health of over one million

dollars, a prohibitive tax on bath-tubs and water-closets--that is, on

cleanliness--prohibitive on all homes except those of the wealthy. Is

it to be wondered at that contagious diseases are prevalent, especially

during the winter months, and that we have so many acute and chronic

maladies?

Let me make a suggestion here for the serious consideration of our

city fathers: Reduce the appropriation for the Board of Health to two

hundred thousand and give the other eight hundred thousand to the

Department of Water Supply, so as to abolish the tax on water-closets

and bath-tubs. If every citizen of New York could have all the water

he needed for cleanliness and comfort, there would be little excuse

for the existence of such a body as the Board of Health; its existence

would then be more honorable than onerous. Furthermore, the city, as

a corporate body, should manufacture bath-tubs and water-closets,

and furnish them at cost. Thus would it insure a great stride toward

the health of its own citizens. When the disease-producing microbe

becomes scarce, the occupation of the Health Board pathologist will be

gone. Hold! Could he not devote his time profitably to studying the

habits of health-producing microbes--for there _are_ such? Microbes

are absolutely necessary for higher forms of existence, it being now

well known that some microbes are destructive or pathological and that

others are constructive or physiological. Is it not much wiser to

spend our millions of dollars for the prevention of disease than for

quarantining it? Inducing, and even compelling, people to be clean is a

far better policy than to compel them to be vaccinated.

Now, we pay the Board of Health many thousands of dollars a year simply

for making cultures of disease-producing bacteria so that antidotes

may be found. The pictures and history of these bacteria are published

in many large volumes, costing the city several hundred thousand

dollars a year. Scientific as this practice undoubtedly is, it is very

expensive--and needless.

Every year thousands of children and invalids of New York receive

improper nourishment, or are made positively sick, on milk that is

either foul, stale, or ready to sour; and every summer thousands of

children die from complaints traceable to this source. Swill milk is

one of the great generators of disease-producing germs to which all

sorts of “complaints” are due. Does the Board of Health care a fig for

the generator? No; the Board is absorbed in watching the antics of the

germs! Mighty intellects are searching for malignant, multitudinous

mites. Yet there are just a few mites of common sense in existence,

which if encouraged will breed quite as fast as the sinister ones.

Indeed, there must be one or two at work in myself, for I seem to be

urged to say that if our City and State Boards of Health should see to

it that our cows are kept clean and healthy, our milk clean and pure,

our cans clean and well scoured, and our shops and ice-boxes clean

and free from odor, there would be no occasion for germ cultures of

diseases brought on by swill milk.

Our milk example will illustrate what germs of common sense would do

to ward off all kinds of disease-producing micro-organisms. Rigorous

regulations, well enforced, as indicated above, would work in other

lines as well. And when the source is gone sinister microbes will not

come into existence, and diseases that have resulted from such microbes

will have gone into innocuous desuetude.

There should be a bath-tub and a water-closet in every suite of

sleeping apartments. When this is the case, there will be a larger

number of persons clean internally and externally, and the doctors will

be on a hunt for health-producing germs instead of disease-producing

ones. Let us start an organized movement in this direction.

Last summer Medical Science went about killing mosquitoes on Staten

Island with a little spraying apparatus, and managed to disturb the

pest for a day or two from its customary bivouac. Christian Science

stood aloof and smiled superciliously, claiming that “there aren’t any

such things as mosquitoes; but if they should prove to exist, there

isn’t any malaria anyhow.” Good sense might have suggested to Medicus

the draining of the ponds for gardening purposes; and, if that were

not possible, the filling in of the edges and the making of deep-water

lakes for the sport-loving youth, who might be depended on to keep the

water stirred up by boating, etc., free of charge, and thus convert

a pest pond into a pleasure lake. Pleasure and cleanliness are taxed

to-day for disease and pests. Oh, human imbecility!

As to public baths, there are so many objections to them that I cannot

touch on the subject in this chapter. But let me impress upon the

health-seeker, the public-spirited citizen, and our city officials that

what we urgently need are ample conveniences in our homes for internal

and external cleanliness--conveniences easily accessible several times

a day, every day of the year.

CHAPTER XVII.

PERSONAL CLEANLINESS.

At the close of my last chapter I referred to the ever-recurring

problem of public baths. Annually its agitation is renewed in lectures

and newspapers; public bathing is voted without disagreement the

thing of things needful to render the laity--_i. e._, the labor

population--physically pure. It is the long-felt want; but, like the

longed-for walk of the annual Sunday-school parade, it is soon done

and gone. Still, we must have patience with those dear souls, our

ethical teachers of the press and platform, for taking such a deep,

sentimental, though unscientific, interest in the welfare of the

unclean. Owing to the non-existence of home facilities for cleanliness

among the working class, the accumulations of soil and exudation during

the long fall, winter, and spring months are so great that their

bodies become too rank and malodorous for the nostrils of the refined.

Consequently, as all animals seek the tepid water of the summer, and

as man is no exception to a capacity for laving in the circumambient

fluid, to three-fourths of the population of this metropolis it must be

a glorious perennial treat to dip in the river, bay, or sea; and it

must indeed be a dire necessity to those that have managed to survive

contagious and other diseases during their long immurement. Without

this summer cleansing few animals, bestial or human, would run half

their average careers. It is accordingly not strange that during the

summer a bath in open water is a daily hygienic necessity and source of

joy to thousands of creatures.

Now, it is just because godliness appears in the wake of cleanliness

that I made so strong a plea in my last chapter for ample bath-tubs and

water-closets. For I do not approve, nay, I emphatically condemn, the

system of public baths along the shores of our rivers and bay. Their

waters are contaminated by numerous sewers, and bathers have contracted

many contagious diseases that have become epidemic in neighborhoods.

Note especially the annoying eye troubles that follow in the wake of

such bathing. Of course, the sport and exercise involved in open-water

bathing are highly commendable; but the danger of contracting

contagious disease, and the outrage of the sense of refinement when

contemplating fellow-creatures in the act of stirring up polluted

waters, should call a halt to our encouragement of public bathing in

and around our metropolitan water fronts. These waters are surely

anything but a means of cleanliness.

The water-closet, however, is of far greater importance than the

bath-tub, and especially than the public water-gymnasium--which last is

so much lauded by some of our misguided philanthropists. Intestinal

foulness, as a prolific source of disease, is of far more serious

importance than surface foulness. However, both the bath-tub and the

water-closet are indispensable to every suite of rooms.

Another need imperatively demanded by the exigencies of city life

is the establishment of public water-closets at several thousand

convenient centers throughout this great city. At present the male

population, when away from their residences, are obliged to make

use of a near-by saloon--a most uncertain resort, and one in which

courtesy will generally constrain them to imbibe intoxicants _nolens

volens_. The female population have not even the saloon as a resort,

and can relieve themselves only when in the vicinity of department

stores. American enterprise can improve in many respects on the several

European models of public-relief stations. The public is becoming

conscious of its needs and rights in this respect; and one of the

sanitary evolutions of city life--congested as it is--will be ample and

cleanly public accommodations for intestinal relief.