Dr. F.P. Atkinson thus writes in the _Practitioner_, January, 1884: I
suppose there is no derangement of the system we are more frequently
called upon to treat than habitual constipation; and though all kinds of
medicines are suggested for its relief, they rarely produce more than
temporary benefit--and it is difficult to see how the result can well be
otherwise, while the root of the evil remains untouched. Now by far the
more numerous subjects of this disorder are women; and as they do not
seem to know that regularity is essential to the performance of every
one of nature's operations, they appoint no stated times for trying to
get the bowels relieved, but trust to receiving intimation when the
rectal accumulation and distension can be borne no longer. This method
of action may and does answer fairly well for a time; but nature
gradually gets upset, the sensation of the lower bowel becomes blunted,
and at last it ceases to respond to the ordinary stimulus. Then
aperients are regularly resorted to, and although these act fairly
well for a time, they gradually have to be increased in strength
and frequency. Now, as regards the treatment, the first thing to be
accomplished is of course to get the rectum well relieved; the next,
to get the actions to take place at fixed times; and lastly, it is
necessary to get more tone imparted to the muscular tissue of the
bowels, so that the regularity of action may be helped and also
maintained. In order, then, to get the bowels relieved in the first
instance, it is well to give five grains of both compound colocynth and
compound rhubarb pill at bed-time (this rarely requires to be repeated),
then to take a tumblerful of cold water the next morning on waking, and
repeat it regularly at the same time each day. Should the bowels remain
sluggish for some time, the same quantity of water may be taken daily
before each meal. Supposing no action takes place on rising or shortly
after, a small injection of warm water may be resorted to. After each
movement of the bowels, a small hand-ball syringeful of _cold_ water
should be thrown into the rectum and retained. A soup plateful of coarse
oatmeal porridge (made with water and taken according to the Scotch
method, viz., by filling half the spoon with the hot porridge and the
other with cold milk) each night at bed-time, or even every night and
morning for a time, is often a very great help. But above all things,
it is necessary for the patient to _try_ and get relief at a certain
_fixed_ time regularly every day. If these directions are strictly
carried out in their entirety, the evil, even if it has been of long
standing, will generally be corrected, and the patient will improve in
health and appearance. Of course where the constipation results from
exhaustion of the nervous system (such, for instance, as is brought
about by self-abuse), the special cause has to be taken into
consideration, and such treatment adopted as is suited to the particular
necessities of the case.
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