THE ETIOLOGY OF THE MOST COMMON FORM OF DIARRHEA, i.e., EXCESSIVE
INTESTINAL PERISTALSIS.
If you are interested to know why a certain plant does not flourish in
the temperature and light to which it has been accustomed, you
investigate the soil--the source of nourishment--and thus determine why
the downy or velvety appearance has left the flower; why the leaves are
yellow, dry or falling; why the stems are withering. Even the most
ignorant person knows that the symptoms the plant presents did not
bring about the unsuitableness of the soil; that, on the contrary, the
condition of the soil is responsible for the plant's present state.
Would it not be unwisdom, therefore, to treat directly the symptoms of
decay, instead of treating the soil, or changing it? Just so misguided
is the judgment of the physician who prescribes physic or tonics in the
case of a person having a foul intestinal canal, a condition
destructive of the absorbent and the excretory glands. But members of
county medical societies do just such foolish things. Notwithstanding
their prescriptions, a point will be reached by the patient where the
restoration of his millions of small rootlets, or organic feeders, will
be impossible, and like a decaying plant in unfavorable soil he
gradually decays or withers, here and there, until finally he topples
over before he knows it, probably long before maturity has been
reached.
It is not generally known among laymen, nor sufficiently appreciated
among physicians, that the mass of fecal matter normally evacuated from
the bowels comes mainly from the blood; and that this mass is not, as
it is usually supposed to be, the residue of the food that has been
left unassimilated. Embedded in the mucous membrane of the colon are
tubular glands under the control of the nervous system. When these
glands become unduly excited through local inflammation and irritation,
the normal flow from them is increased to such an extent that a rapid
waste of precious tissue occurs throughout the system, and the vital
force--which had taken perhaps years to store--is depleted to the point
of exhaustion, sometimes even in a few hours. Almost every one has had
some experience of exhaustion following diarrhea.
The increased flow of blood to the mucous membrane of the colon
furthers this extraordinary secretion by the glands. As has been
pointed out, inflammation, septic poisoning, intestinal foulness, or
retained feces, act as irritants on the mucous membranes, thereby
drawing the blood to the colon where it is excreted and exhaustion
follows. The great danger in diarrhea, therefore, is the rapid
depletion of the vital force. But when the small intestines are
affected the consequences may be still more deplorable. Then the
unassimilated food is hurried along too quickly for absorption and the
body receives but little nourishment to restore its powers. Thus
another draught is made upon the sufferer's reservoir of vitality, and
hence additional exhaustion. But this waste of tissue, loss of vital
force, non-assimilation and non-supply, are not so grave as the
positive danger of the permanent destruction of the millions of small
absorbing vessels (villi) of the small intestine by a continuance of
this abnormal irritation. Of course the secretory and excretory glands
of the colon also suffer, and we then have costiveness resulting from
lack of absorption and excretion.
Abnormal irritability of the bowels is necessarily involved in the
inflammatory process known as proctitis and colitis. Increase this
irritability to a certain point and diarrhea takes the place of
constipation--a much more alarming symptom. Diarrhea is more alarming
because the intensified local activity of the excretory glands of the
bowels brings on, as has been said, a general exhaustion of the vital
powers.
The severity of diarrheal symptoms is much increased by the character
and abundance of bacterial poisons. Bacteria find a ready medium in
fetid feces, and are absorbed by the excited glands to the degree in
which these glands have time and power for absorption. Of course the
extent and character of the intestinal irritation have a good deal to
do with the severity of the diarrheal symptoms. This irritation is not
infrequently intensified by a catarrhal process, or by a lesion of an
ulcerative nature. All these forms of irritation bring on "excessive
intestinal peristalsis"--which, accordingly, is our definition of
diarrhea. The normal peristaltic action of the intestines propels the
nutritive as well as the effete material through the canal at a rate
that allows of both proper absorption and timely elimination. But when
excessive peristalsis occurs, neither absorption nor elimination will
be normal or suited to the requirements of the system.
Undigested foodstuffs may become an irritant, or increase, as is
usually the case, the established irritation, and thus bring on an
acute attack of diarrhea. The immediate consequence of the acute attack
may indeed be, and often is, comparatively beneficial, inasmuch as the
diarrhea removes the undigested material that occasioned the
irritation. When this removal is accomplished, the diarrhea usually
subsides without treatment. This is the case, however, only when the
patient has committed an infrequent error in diet. When such errors are
habitual the burden on the glands of the intestinal mucous membrane
becomes intolerable, and the chronic inflammation once established has
a tendency to proceed from bad to worse. It will then be observed that
digestion becomes more and more impaired. In such a case diarrhea will
no longer serve a good end, but will on the contrary debilitate the
system. A change to better dietetic habits will then aid, but will not
suffice for cure. Only treatment and time will restore the inflamed
parts to a healthy tone. When, however, the digestive tract is invaded
by any of the many forms of bacteria, treatment will avail little and
serious consequences follow rapidly.
Too much cannot be said or done to secure intestinal cleanliness in
infancy, childhood and maturity. Mothers and nurses cannot give this
subject too much thought and care, since the welfare of future
generations depends largely upon intestinal cleanliness, in view of the
rich and racy life of our hothouse civilization. We are a people
poisoned through constipation and diarrhea: two affections that derange
more lives than all other pathological conditions together. Banish
alimentary uncleanliness and you take most of the poisons from the
human race--poisons that stunt the body and blunt the mind.
The soul of man should dwell in a palace, not in a pest-house; in a
human temple, velvety, lined with down, inside and out; in which there
are hundreds of millions of lilliputian trappings, fittings and
articles of furniture, to carry on the minute and finer functions and
chemistry of the soul. The very multitude of the fine equipments that
decorate the temple give it that beautiful blending of color and form
which its coating has when in normal condition. They adorn this
body-house with health, and supply it with the rich red wine of joy.
The blood is dependent for its richness not only on the digestive
fluids, but also on the proper eliminating powers of the system. If you
would avoid premature decay you must not neglect the reservoir of
vitality, the alimentary canal, but see to it that it be kept clean and
pure. Then will the elixir of life spring from an almost inexhaustible
fountain. To recur to our plant analogy. Keep the soil in your own
vegetable garden sweet, for intestinal cleanliness corresponds to soil
fitness. Purity of the stomach and bowels is more important than
quantity or quality of food. That defecation should occur normally two
or three times in twenty-four hours is more important than that three
meals should be eaten within that time. The conveniences for eating and
drinking are on every hand, but oh, how few, inaccessible, miserably
constructed, and poorly cared for, are the toilet cabinets for the
accommodation of the gourmand! Suspenders and silk hats mark the
progress of our outer refinement; toilet cabinets and flushing
appliances, of our inner. When the _inner_ refinement comes we shall
live longer and be healthier.