COSTIVENESS.
The words constipation, obstipation and costiveness are often employed
as if of exactly similar meaning, but it is well to let each stand for
a particular condition. Obstipation implies that the canal of the
intestine is stopped up or closed. Constipation carries the idea that
the canal is completely filled up with refuse matter. In the normal
condition the intestine is divided by transverse bulges or valves or
dams into a number of separate segments, the entire arrangement having
the effect of preventing too rapid descent of the feces. These folds
within the canal may become too much narrowed by disease and thus
prevent the movement of the matters inside; this is obstipation.
Constipation, stuffing of the gut, may be the result of neglecting the
call of nature, and after a time the ability to recognize and answer it
is lost; or it may result from inflammation which itself comes from the
bad habit mentioned.
The author prefers to use the term costiveness for the general debased
condition of the system from auto-intoxication depending upon proctitis
and similar conditions of the intestinal tract. And it must be
remembered that the same patient may have two or more of these
conditions at the same time. Constipation, obstipation and diarrhea may
alternate through the progress of the case.
We would expect people suffering from constipation or obstipation to
pass as fairly well people for a time, but the same is not true of
patients having the other condition, costiveness. As we may speak of
the stages of a disease like consumption, so we may speak of these
three conditions as different stages of one affliction, the worst being
costiveness with its progressive self-poisoning by the products of
intestinal decomposition. Early in the case the system may pass these
poisons out of the body with comparative ease, by way of the lungs,
skin and kidneys. In time the second stage begins to make itself
apparent, vitality becomes less and less, calling for a greater variety
of medicines to correct the condition, as in the second stage of
consumption, and also to arrest the progress of emaciation and anemia
or anemic obesity.
The third stage of auto-intoxication is a most unhappy one. The
impoverished tissues offer a most favorable soil for the development of
diseased conditions. These three stages which are clear to the
experienced eye of the physician may to the patient seem to be
indistinguishable, the one from the other; and it must not be forgotten
that the three conditions do not mean simply that a smaller or larger
part of the intestine is clogged by its contents, but that the whole
system is involved as well.
It cannot indeed be otherwise with the rapid circulation of the blood,
nor need it excite wonder that such patients are thin and debilitated
by the deadening of the powers of absorption, assimilation and
elimination.
As a rule the many thin and puny infants and children of either sex,
with bony points well exposed under a tightly drawn skin, which latter
is clay-colored and pimply; children with headache and languor, without
healthy interest in either studies or play;--these are the victims of
intestinal poisoning as described. If they have inherited a spare habit
of body from their parents such bodily ills will manifest themselves
the more quickly. They ought to be fat and hearty as are the young of
animals, but alas many are not! When the young animal is spare, a few
days of rest with good diet will put flesh on it, demonstrating that
the state of the bowels and the powers of assimilation are intact. Why
does not man take on flesh in a similar way?
If the intelligent animals could talk, they would undoubtedly make all
manner of fun of the intestinal canals which they see walking about,
with a little flesh here and there seemingly by accident, and a skin
which is clay-colored or jaundiced, anemic or flabby, the owner of it
all poisoning himself by decomposition in his intestines!