PROPER TREATMENT FOR DISEASES OF THE ANUS AND RECTUM VERY ESSENTIAL.
No doubt the readers of the preceding chapters on proctitis and its
numerous symptoms--noted under separate headings--would like to know
something about the home treatment for such an insidious and grave
disease. Every sufferer wants to be a self-doctor. This commendable
desire it is usually impossible to put into practice. If physicians so
often fail to cure the ailments I have described, what can be expected
of those who have no knowledge at all of diagnosis and treatment?
A skilful physician is the choicest gem of civilization, and an
intelligent patient its worthy setting. Surely it is a moral crime, an
inexcusable folly to tolerate a disease with its inevitable train of
dire consequences, up to the point when the discomfort compels one to
seek treatment. There are patients, of course, who have good and
sufficient excuses for their painful predicament; they have, for
example, tried persistently for relief and cure, but have failed to
find a physician competent to treat their particular case. How many
unskilled prescribers there are, and how glaring their shortcomings!
Some hold out taking inducements to sufferers; their one object being
to transfer their patients' cash to their own pocket. 'Twere charitable
to consider these ignorant; but alas! many of them are poisoned by the
"fakir" germ. Stuff is sold by the conscienceless, claiming to cure
"piles," to "give instant relief," and promising "a complete cure in a
few days"; and as to itching piles, why! "only a few applications are
necessary for a cure; six boxes for five dollars"! etc.
No remedy that sufferers apply themselves can be more than a temporary
relief: it cannot really cure piles, polypus, fistula, tabs, pruritus
(itching)--all of them consequences of proctitis. Of course one should
be thankful for the little relief to be got temporarily from advertised
and drug-store drugs; nothing more than relief can be expected of them.
There are indeed times when a palliative treatment will serve to tide
the sufferer over a few days until he is able to consult a competent
physician. But how strange it is that so many sufferers regard their
anatomy and physiology so lightly as to think of using remedies, even
for relief, without first undergoing a thorough examination by a
competent physician. In troubles of a rectal character it is
exceedingly foolhardy to allow any one to prescribe without insisting
upon a thorough examination to ascertain whether there be any disease
of a cancerous nature present, or what the trouble actually is, and its
progress. To expect one remedy or prescription to meet all the
requirements for the cure of a chronic disease of the anus and rectum
and of the many complications accompanying it is hardly sensible, but
that is just what a great many do expect. No one remedy in the market,
or any number of them combined can effect a cure, for the simple reason
that proper local treatment by a physician is of paramount importance.
Unless of a traumatic (externally produced wound) origin, diseases of
the anal and rectal canals are usually of fifteen, twenty or more
years' incubation before the annoying symptoms become apparent. This
accounts for the slight attention to the maturing trouble and for the
fact that such attention can afford nothing more than a palliation or
postponement. A real cure requires a combination of means, all working
harmoniously for the proper length of time. Proper treatment and the
proper time are the two prime requisites; and the third and final
requisite is, of course, a sensible patient.
Before home treatment is to be thought of it is accordingly advisable
to have an examination and a prescription for the specific local
treatment necessary for a trouble like piles, fissure, polypus, tabs,
itching, fistula, varicose veins, abscess, ulcer, granulation,
hypertrophy, or atrophy as the case may be. The local treatment can
best be aided by a combination of remedies with suitable instruments
for their use between the periods of local attention by the physician.
The writer of this has no cure-all to send the sufferers, although it
might be to his financial advantage to have one; he is, however, always
ready to advise and relieve those who cannot visit him immediately. The
relief afforded often facilitates the cure by permitting a more
extensive local treatment at the first visit.
_The Use of Instruments for Injecting Water._
To do something at home for one's self for relief from soreness and
pain due to anal and rectal diseases, a few suitable instruments are
required with which specific remedies may be used, especially that
excellent remedy--water.
It is unfortunate that the anal and rectal canals cannot be given rest
when invaded by disease. Daily elimination of feces is a very important
factor to health and to treatment. To accomplish this the very best
means is water in various quantities as the case demands. It does not
irritate the diseased canals--as cathartics do--but aids in the escape
of imprisoned feces and gases which lodge above the region of the
morbid process. Evacuation should be accomplished twice a day, by the
injection at first of three or four quarts of water--thus obtaining a
good daily flushing of one's sewer--and then, if advisable, gradually
lessening the quantity at subsequent injections to one or two pints at
a time. The temperature should be 100° to 105° or more. Some people
have an idea that water at the temperature named has a remedial effect
on an inflamed anus and rectum. It has none whatever; all it does is to
wash away the deposits which might irritate the inflamed surface. Water
at a temperature of 100° to 105° is not an especially good antiseptic;
and its intestinal use should not be continued longer than to bring
away the effete and fetid material which may be lodged in the colon,
sigmoid flexure and rectum. In the majority of cases its use should be
limited to aiding the feces to escape from their normal receptacle--the
sigmoid flexure--whenever proctitis does not extend beyond the rectum.
But many persons are deceived by the conduct of proctitis and are thus
likely to omit the regular irrigation twice a day. They believe
themselves to be in pretty good condition and do not realize that their
old, implacable enemy may be excited into riot any day; in which case
the insurrection may last for months and then slowly settle down to
semi-quiet again, reaching finally the point of its best behavior for a
short period or until again provoked.
_The Use of the Recurrent Douche._
Water at a temperature of 120° to 130° properly applied is a good
therapeutic agent in the treatment of proctitis. At that temperature it
is an excellent antiseptic and astringent. Its continuous use for half
to one hour applied with a recurrent douche brings about a contraction
of the engorged and dilated blood-vessels; and accompanied by local
treatment and by other remedies is the best means known for restoring
the nerves to their normal function of controlling the proper
circulation of blood in the diseased organ. Treatment with the
recurrent douche is of course to follow, not to precede, the evacuation
of the bowels; but at any time when there is a tendency toward
additional evacuation on the admission of the hot water, the new douche
is easily adjustable to the contingency without removal from the anal
canal; it will facilitate the escape of the feces with the return flow
of the water. The new recurrent douche has therefore the great
advantage of promoting simultaneously both the thorough evacuation of
the bowels, and the therapeutic effect of hot water.
_Sitz-Bath._
There are patients who, because of years of neglect of their local
ailments, are taken with severe attacks of inflammation of the anus and
rectum, involving considerable prolapse, much swelling around the anus,
and general local soreness and pain; all of which is often accompanied
by a general disrelish of life. For this condition nothing is so good
as a very hot sitz-bath, if properly adjusted to the parts and
continued for about an hour at a sitting. The alleviation afforded is
so decided and the local and prolonged application of hot water so
restorative that it may be left to the sufferer to determine how often
this bath is to be repeated. It may be taken as often as there is an
inclination to do so. The sitz-bath apparatus should be scientifically
adapted to the parts so that the bather will not sit lower than ten or
twelve inches, thereby avoiding a straining position. During the bath
there should be more or less pressure against the anal tissues, which
assists the hot water in expelling the blood from the inflamed parts.
From the beginning to the end of the bath the water must be as hot as
the tissues will tolerate. Only a small portion of the buttocks need be
immersed in the hot water.
_Spring Water the Ideal Beverage._
Those who suffer from disease of the rectum, with rare exceptions, are
constipated or semi-constipated, which condition in turn aggravates or
disturbs the inflamed parts. To overcome this constipated condition all
sorts of laxatives are taken, which will in the end do grave harm not
only to the whole system, but especially to the inflamed parts,
irritating them still more. There is a valuable therapeutic agent
seldom taken by the constipated; in fact, it is never thought of;
unfortunately the remedy is not easily to be had in its pure state by
most of us, boxed as we are in cities. Sold under various names as
mineral water, it is too often adulterated. 'Tis a simple remedy, and
yet it has a wider range of healing power than any other; a universal
solvent, applicable to all diseases and all states of health. I would
write it at the head of all remedial agents: pure spring water! We do
not drink enough water. If we were to imbibe at least two quarts of
pure water daily we would be healthier and have better movements of our
bowels. Water may be taken freely during mealtime; not, however, for
the purpose of washing down half-masticated food. Alcoholic drinks,
coffee and tea would better be dispensed with, also tobacco. The
nervous system has enough to bear without the use of avoidable
irritants.
_Other Hygienic Agencies._
Too much cannot be urged as to the advisability of a proper amount of
exercise, sleep, rest, food, breathing, cleanliness (internal and
external), as well as and above all, pure, high-minded thoughts and
serene temper--the outcome of the habit of viewing life
philosophically. Care should be taken to protect the feet and body from
sudden climatic changes, thus avoiding catarrhal troubles, especially
of the lower bowels.
As to the wise and proper use of nature's pharmacopoeia, nothing need
be said here. However, I may be within my limits when I advise patients
to use a little sense and not neglect disease of the lower bowel any
more than they would neglect that of the eye, ear and throat. In the
latter case they submit at once to an examination. Why not in the
former? Let them bear in mind that the cure of chronic proctitis is no
holiday job; that it is, on the contrary, a task which requires
constant attention. To merely relieve the annoying symptoms that
accompany it cannot be called a cure. But on the other hand relief may
be the commencement of a cure. Of course the true way of looking at the
subject of this disease is to regard the cure of proctitis as
necessarily leading to the disappearance in time of all the other
troubles that were the outcome of that ailment. Through the harmonious
efforts of patient and physician, marvellous results are often
obtainable.