Affections of the Digestive Organs
by Herbert M. Shelton
DP ND DC DNT DNSc DNPh DNLitt PhD DOrthop
THE HYGIENIC SYSTEM
There are so many "diseases" of the digestive tract, it is difficult to decide just how to begin our discussion of them. We shall follow the regular routine of taking up the various symptom-complexes that present themselves in the various parts of the digestive system in alphabetical order. It is thought wise to again caution the reader against regarding these symptom-complexes as specific "diseases."
Digestive "diseases" range all the way from a "cold" to cancer. The stomach is the most abused organ of the body. Almost immediately after birth the child is enervated from fondling and overfeeding. Meddlesome midwifery enervates both mother and child, rendering the mother's milk, if there is any milk at all, unfit as food. When a child becomes enervated, elimination is checked producing toxemia; and when the accumulation of toxin is great enough to arouse resistance, compensatory elimination is instituted at some point of the mucous membrane made sensitive by indigestion or constipation.
Very soon after birth, due to enervation and overfeeding, symptoms of indigestion appear in the child, and as often in the mother, which automatically starts a cinema of infant-feeding and care that competes in exquisite torture with those described in Dante's Inferno. Here is laid the foundation for the gastro-intestinal catarrh that extends on and on, involving more or less all the mucous membranes of the body, becoming the mother of all the "diseases peculiar to children," all the "diseases" recognized as catarrhal.
The stomach being the most abused organ of the body, indigestion, or catarrh of the stomach gastritis is one of the first toxemic crises biogonies. Indigestion is not often repeated before the mucous membranes of the mouth, throat, intestine, etc., begin to suffer crises. In time the submucous tissues and glandular system become affected. The various symptom-complexes that arise in this gradual spread of pathology, are named according to their locations.
When organs, because of defective anatomism, or organic change due to inherent weakness, or because of being stressed either by the habits of living or by frequent crises, fail to function properly and undergo structural changes, we have what are called "organic diseases" ulcer, cancer, etc.
AFFECTIONS OF THE MOUTH
LUDWIG'S ANGINA (Angina Ludovici)
Definition: A grave and acute phlegmonous inflammation of the tissues of the floor of the mouth and sides of the neck.
Symptoms: Painful inflammation of the floor of the mouth and neck, with difficulty in talking and swallowing, and fever, are followed by break-down and suppuration of the glands of the mouth and neck.
Etiology: It may occur in the course of various so-called "specific fevers," or it may result from traumatic injury, or it may be caused by carious processes at the roots of the teeth. It is obviously of septic (putrescent) origin.
Prognosis: Under Hygienic care practically all cases recover. Under regular care cases frequently end in abscess-formation or gangrene, and frequently lead to general septicemia.
Care of the Patient: Dr. Weger says "usually the pus must be surgically drained. It is a rather infrequent disease and the under-lying toxic state must be adequately treated." This means all causes of enervation must be corrected and all food withheld until the toxemia is eliminated.
Definition: Sore mouth, aphthae, thrush, canker stomatitis, is inflammation of the mouth and is divided into seven different kinds of stomatitis; these kinds representing degrees of severity.
Symptoms: Catarrhal stomatitis is a simple inflammation of a part or of the entire surface of the mouth. It occurs most commonly during the period of the first dentition and results from wrong feeding and uncleanliness. It may also be present in fevers, and is quite commonly present in gastro-intestinal disorders. The mouth is dry, hot and red with an Increased flow of saliva. The tongue is coated, there is constipation or diarrhea, thirst, and slight fever. Nursing is quite painful and should be omitted. The condition lasts from three or four days to a week.
Aphthous stomatitis is a little worse stage of catarrhal stomatitis. There is hyperemia (excess of blood) in the mucous membrane of the mouth, with the formation of small, yellowish-white vesicles commonly called fever-blisters. It is a self-limited affection and is caused by bad hygiene, improper feeding and lack of cleanliness.
Ulcerative stomatitis differs from the above only In that it is severe enough to produce ulceration. Ulcers may form anywhere in the mouth, but form chiefly on the gums. The gums are red and swollen and there is considerable pain. There is a profuse flow of acid, irritating and offensive saliva (salivation), a foul breath and hemorrhages from the mucous surfaces on pressure. This condition develops in scurvy and other severe types of malnutrition, and in the so-called infectious "diseases." Mercury is a potent cause, improper feeding, and uncleanliness are chief causes where mercury can be excluded.
Gangrenous stomatitis (noma, vancrum oris) is a still more severe type of the above condition and develops in greatly debilitated children and in maltreated cases of "infectious" fevers. In these cases there is gangrenous destruction of the tissues of the cheeks and perhaps also of other adjacent structures.
Gonorrheal stomatitis is a gonorrheal infection of the mouth occasionally seen in children who have been infected at birth and in adults addicted to cunnilingus.
Symptoms: The condition is marked by catarrhal inflammation and the formation of a whitish deposit on the tongue, gums and cheeks.
Cleanliness of the mouth and general care of the body are all that are required. The condition speedily clears up.
Parasitic stomatitis (Thrush) is a catarrhal inflammation of the mouth and tongue. The membrane is dotted with flake-like patches which are claimed to be due to the presence of a vegetable parasite (a mold fungi) called by such good English names as Saccharomyces albicans and oidium albicans. It is due to faulty feeding and lack of cleanliness.
Mercurial stomatitis, commonly called salivation, is inflammation of the mouth, tongue, and salivary glands, due to calomel or other forms of mercury taken internally through any channel.
Its symptoms are fetid breath, swollen and spongy gums, sore and loosened teeth, a profuse tenacious saliva, Inflammation of the membranes of the mouth, a strong metallic taste in the mouth, headache, insomnia and emaciation. Severe cases go on to ulceration of the jaw bone and the falling out of the teeth. Gangrenous stomatitis is frequently due to mercury.
Tilden says: "I began to practice my profession long enough ago to witness little children pick their own teeth out of their sloughing gums, made so by the use of calomel." He tells us that "fear of water drinking by sick people was developed in those days" and that "water was forbidden all fever patients because their systems were filled with mercury (calomel) - and when mercury is in, water must stay out if not, salivation mercurial poisoning takes place." All of this is the result of "curing one disease by producing another," and of the principle that "our strongest poisons are our best remedies." The destructive effects of mercury are not confined to the mouth.
Etiology: "Diseases of the mouth or any part of the gastro-intestinal tract may be looked upon as representing much more than a local condition," says Dr. Weger. "Almost invariably mouth diseases are indicative of a constitutional disturbance having its origin in the digestive tube lower down. No child or adult with a sweet stomach and healthy bowel ever developed catarrhal, aphthous, or ulcerative stomatitis. The same may be said of thrush, gangrenous, and mercurial stomatitis.
"In the latter disease we have, in addition to a disordered digestive tract a mercurial poisoning which must be considered accidental even though the drug be used for a definite purpose with -this contingency in mind."
Prognosis: Dr. Weger says: "diseases of the mouth prove to be conditions of relatively minor importance when treated rationally by withholding food for a short time and then feeding according to individual needs as determined by previous food excesses or deficiencies."
Care of the Patient: All forms of stomatitis are to be treated alike, with assurance that all cases, except perhaps many cases of the gangrenous type, will recover. Many cases of mercurial poisoning will leave the teeth permanently loosened and injured. Many cases of pyorrhea are due to mercury.
The mouth should be frequently cleansed with plain water or with diluted lemon juice. The calomel and alkaline mouth washes, boric acid and sodium salicylate, mouth washes made of salicylate of sodium or hydrogen dioxide, advised in the various stages of stomatitis should be religiously avoided, as should, also, potassium chlorate, commonly administered internally.
All, food should be withheld until the inflammation has completely subsided. In mercurial poisoning little or no water should be taken.
If there is fever or malaise, the patient should be kept in bed and made comfortable.
Follow this with a fruit diet for a few days after which, return to a normal diet. Fruit juices are the best remedies for the dyscrasia back of the sore mouth.
Definition: Pyorrhea means a flow of pus. Pyorrhea alveolaris is a purulent inflammation of the dental periosteum. There is usually more or less involvement of the gum tissue as well.
Symptoms: It begins with inflammation of the dental periosteum and gums and an accumulation of tartar at the base of the teeth. The gums recede causing the teeth to appear longer. In the next stage the bony processes begin to recede and pus pockets form. As the degeneration advances, the pus pockets grow larger and the bony processes break down, so that the whole jaw may become almost one continuous pus pocket. The bony processes of the jaw which hold the teeth may waste away until there is not enough left to support the teeth which become loose and even fall out. It has been estimated that a man with a bad case of pyorrhea may lose as much as a gallon of blood in a year by leakage through the gums. As much as a pint of pus may be produced in this time.
Etiology: A prominent cause of pyorrhea is mercury, taken as medicine, or absorbed in work. Loosening and rotting of the teeth and jaw bones and destruction of the gums was a frequent result of the mercurial courses of our fathers' and grandfathers' days.
A chief cause of pyorrhea is a deficient diet and indigestion. Injury to the jaws may start up pyorrhea in the heavily toxemic. Pyorrhea should be recognized as being merely part of a systemic condition. Abuse of the teeth either during mastication or by accidental stress, or by nervous grinding of the teeth, cannot cause immediate break down of tissue and subsequent infection. If this could occur, the slightest trauma anywhere would lead to dire results. Injury plus toxemia, plus sepsis, leads to pyorrhea.
Prognosis: Recovery may be expected in all cases if proper measures are employed before the destruction has gone beyond repair. Loosened teeth will become fixed again; though little or nothing can be done to rebuild the receded gums.
Care of the Patient: Locally, cleanliness is essential. The pus may be expressed by gentle pressure upon the gums, care being taken not to bruise these. The tooth-brush should be discontinued at once.
Fasting should be continued until toxemia is eliminated. It is the rule that the pus clears up and the teeth become fixed in their sockets during the fast. After the pus and inflammation have cleared up, proper food and good general care of the body will prevent & recurrence.
RIGG'S DISEASE (Alveolodental Periostitis)
Definition: This is a progressive necrosis of the dental periosteum meaning death of the outer covering of the teeth.
Symptoms: The process is most active under the margin of the gums and, therefore, the accumulating pus drains badly and is not readily cleansed by ordinary measures. The gums recede and the teeth become loose. The condition is practically identical with pyorrhea.
Etiology: The cause of Rigg's "disease" cannot be entirely local. There exists an appallingly tragic ignorance of the constitutional derangement leading to pyorrhea and Rigg's "disease." For that matter, we need not confine our statement to these conditions, since they are but two of twenty thousand names for local states growing out of toxemia and gastro-intestinal decomposition.
Care of the Patient: same care as for pyorrhea.
AFFECTIONS OF THE TONGUE
Definition: This is inflammation of the tongue.
Symptoms: Redness, swelling and painfulness with difficulty of movement of the tongue.
Etiology: Inflammation of the tongue is always associated with digestive derangements, often with such secondary conditions as pyorrhea, abscessed teeth, tonsils, sinusitis, chronic catarrh, septic bronchitis, etc. Back of all of these are enervation and toxemia.
Prognosis: Rapid recovery follows removal of the basic causes.
Care of the Patient: Local measures, mouth washes, etc., are only palliative. Attention should be directed to the removal of cause. This is comparatively easy for those who are willing to forego some of their pet table indulgencies and give proper consideration to the hygiene of the entire digestive tract. Fasting should rule until the inflammation has subsided.
Definition: This is chronic glossitis marked by whitish patches on the surface.
Symptoms: There are slightly elevated, smooth, opaque, whitish plaques on the mucous membrane of the tongue and often of the mouth. There is no pain or other subjective symptoms.
Etiology: "Excessive" smoking is a common cause. It is sometimes associated with chronic affections of the skin, notably psoriasis. Digestive derangements are basic.
Complications: Epithelioma of the tongue or mouth is a not uncommon sequel.
Prognosis: This is good in the early stages.
Care of the Patient: Care must be directed toward the removal of the cause. A fast, followed by good intestinal hygiene proper food, properly combined, eaten in moderation and under proper conditions will result 1n recovery.
SYPHILIS OF THE TONGUE
This may be anything from a "fever blister" to an ulcer on the tongue. If there is such a thing as syphilis, there is no way of knowing it. Conditions labeled syphilis should be cared for as for all similar conditions with no thought of syphilis.
ULCERATION OF THE TONGUE
Ulcers of the tongue are likely to be small and painful and are associated with digestive derangements. Intestinal hygiene will prevent and remedy them.
AFFECTIONS OF THE SALIVARY GLANDS
Hypersecretion of Saliva is marked by excessive flow of saliva and drooling.
Hyposecretion of Saliva is marked by a lack of saliva and dryness of the mouth.
Etiology: These conditions are never local, but are always symptomatic of conditions elsewhere in the body.
Drooling, for instance, may occur as part of the symptom-complex of Parkinson's "disease" or in other nervous affections. Dryness of the mouth may be due to emotional -or psychic conditions.
Prognosis: Recovery depends on correction of general derangements.
Care of the Patient: Dr. Weger says "a normal blood chemistry can be relied upon to effect a cure in these abnormalities which are dependent almost entirely upon conditions other than local." Blood chemistry is normalized by fasting, rest, natural food, exercise and sunshine.
AFFECTIONS OF THE PHARYNX AND TONSILS
Definition: an acute catarrhal inflammation of the membrane of the pharynx, soft palate, and uvula frequently associated with tonsilitis (tonsillitis) and laryngitis.
Symptoms: Chilliness, slight fever, stiffness and tenderness of the muscles of the neck, soreness of the throat, pain upon swallowing, dryness and tickling of the throat and a hacking cough are the chief symptoms. The throat is red and the membrane swollen.
Complications: Extension of the inflammation to the larynx may cause hoarseness; to the ear through the Eustachian tube may result in deafness.
Etiology: Gastro-intestinal indigestion superimposed, upon a primary of metabolic toxemia gives rise to this catarrhal crisis. It often follows exposure to cold or to wet, and to other influences that overtax the enervated and toxemic.
Prognosis: Speedy recovery follows in all cases cared for hygienically.
Care of the Patient: These cases need rest and toxin elimination. Nothing gives more prompt results than fasting. There is no need for the antiseptic gargles commonly employed. Gargling the throat is at all times a practice based on delusion.
Definition: This is a chronic "sore throat" which follows upon repeated acute crises. Chronic "disease" is due to chronic provocation.
Symptoms: Two forms are described namely; (1) hypertrophic and (2) atrophic.
In the hypertrophic form (glandular sore throat, clergyman's sore throat, chronic follicular pharyngitis) the throat membrane is thick, swollen, traversed by dilated veins, and studded with numerous elevations which correspond to distended follicles and overgrown lymphatic tissue.
In the atrophic form (pharyngitis sicca) the membrane of the throat is pale, smooth, glossy and dry.
In both forms the voice is husky, its use is followed by distress; secretion (mucus) is increased, so that there is a constant desire to clear the throat, and there are frequent disagreeable sensations, such as fullness and tickling.
Etiology: This is an extension of chronic gastro-intestinal catarrh and indigestion and, follows upon, the heels of repeated acute crises. Irritation of the throat from overuse or wrong use of the voice, tobacco smoke, alcohol, etc., predispose the membrane to affection.
Care of the Patient: As in all other affections, the removal of the cause toxemia and indigestion is of primary importance. All sources of local irritation smoking, use of the voice, mouth-breathing, irritating eructations from the stomach must be corrected or removed. The practice of hawking and scraping to clear the throat is very irritating and should be forbidden.
Fasting, a discontinuance of all enervating practices, and the adoption of healthful habits will result in early recovery.
Definition: This is a suppurative inflammation of the paryngeal lymphatics, and is often called Retropharyngeal Lymphadenitis.
Symptoms: Pain in the throat, inability to swallow (dysphagia) difficulty in breathing (dyspnea), alteration in 'the voice and a swelling projecting from the back pharyngeal wall are the chief symptoms.
Etiology: This condition develops usually as a complication of follicular tonsilitis, suppurative rhinitis, otitis media, caries of the cervical vertebrae, or one of the "specific fevers." It occurs largely in children. It is of septic origin.
Prognosis: This is good.
Care of the Patient: The abscess will usually drain spontaneously but may be surgically drained. Otherwise the care should be the same as for all other acute, suppurative processes.
Definition: this is the popular name for enlargement (hypertrophy) of the pharyngeal tonsil. Adenoids are also frequently referred to as "adenoid growths" and "adenoid vegetations."
Symptoms: Adenoids usually accompany chronic follicular tonsilitis. The membranes of the nose and throat are passively congested and thickened. Besides the enlargement of the pharyngeal tonsil, there is a concomitant swelling of the thousands of lymph nodes and nodules adjacent to the tonsil.
In young children (under fifteen) "adenoids" are frequently so much enlarged that they obstruct the nasal passage, resulting in the habit of breathing through the mouth. Due partly to the interference with oxygenation, but largely to the systemic condition that gives rise to this condition, such children are flat-chested, thin, anemic and often mentally dull. The nostrils are pinched and coughing commonly accompanies the condition. Sleep is interfered with and these children become dull, listless, and chronically tired. Frequent "attacks" of bronchitis are not uncommon concomitants.
Prognosis: The "adenoids" normally shrink in size after puberty and are seldom the seat of trouble thereafter. They rapidly shrink under Hygienic care.
Definition: This is inflammation of the tonsils and may be either acute or chronic. Any or all of the tonsils faucial, pharyngeal, tubal, lingual and larnygeal may be involved.
Acute Fossulitis, erroneously called Acute Tonsilitis, is inflammation of the mucous membrane which covers the outer surface of the faucial tonsils and dips down into and lines the tonsillar crypts or fossulae. This is the most common form of tonsilitis or "sore throat."
Chronic Fossulitis, or chronic follicular tonsilitis, is a persistent, low grade catarrhal inflammation. The condition is characterized by the constant presence of dirty gray or yellow plugs of "cheesy" matter hanging from the fossulae. When these are thrown out they have a foul taste and a foul odor.
Hypertrophy of the Tonsils: This is the term applied to enlarged (as distinguished from) large tonsils. It accompanies chronic catarrh of the throat.
The Lingual Tonsil (the tongue tonsil) seems to be inflamed less commonly than the faucial, and pharyngeal tonsils, though this may occur more often than is generally supposed. When it becomes in-flamed the whole base of the tongue sometimes becomes inflamed also. The tongue becomes tender on pressure and both talking and swallowing become difficult. Breathing may even be affected.
The Tubal Tonsils often become enlarged and inflamed. This is usually accompanied with the swelling of the thousands of nodes and nodules in the immediate neighborhood, and also by a passive, non-inflammatory swelling of the mucous membrane lining the cavity back of the nose and this may, in turn, partly close the Eustachian tube resulting in catarrhal deafness. This catarrh may even extend up into the Eustachian tube and into the middle ear. Most such cases are remediable by the plan of care later to be described.
Symptoms: Acute fossulitis (follicular tonsilitis) usually sets in suddenly with a rapid rise of temperature which may range from 101 F. to as high as 104 F. The throat is sore, hot, dry, scratchy and swallowing is difficult. The tongue is coated and the breath foul. The tonsils enlarge, the surrounding tissues become congested and inflamed, the glands under the jaw and down on to the throat become swollen and sore. One or more gray or yellow spots or patches form on one or both tonsils. These spots are composed of a cheesy matter in the crypts or fossulae. They are not composed of pus. Headache, backache, etc. may be present.
Quincy presents these same symptoms, often aggravated, plus the formation of the abscess.
Inflammations and enlargements of the various tonsils are usually associated with other conditions of the mouth, nose and throat, such as catarrh, colds, sinus inflammation, inflammation in the antrum and posterior nares, abscessed teeth, etc.
Etiology: These troubles develop in children and adults who suffer with gastro-intestinal indigestion and who habitually overeat on milk, bread, cereals, and other starches, sugar, cakes, pies, preserves, syrups, pancakes, candies, ice-cream and the like. Add these factors to faulty elimination and such persons will develop trouble every time a drop in temperature, an unusual exposure, or an environmental stress places a heavier tax upon their nervous energies and, thus, puts an added check to elimination. "Adenoids" are less frequent in the breast-fed than in bottle-fed infants. Cereals with milk and sugar, fruits with starches and sugar; frequent between-meal eating these will cause enough digestive derangement to produce tonsilitis.
A primary catarrhal condition, due to toxic saturation, is always in evidence preceding tonsillar troubles. Recurrent acute crises of catarrhal laryngitis, pharyngitis, or tonsilitis eventually lead to a depraved or weakened state of the mucous membranes and to chronicity. Scrofulous children, who are constantly in ill health, merging from one septic state to another, have frequent or continuous tonsillar trouble.
Care of the Patient: In acute tonsilitis, quincy, etc., no food should be taken until all acute symptoms are gone, after which a fruit diet should be fed for from three to five days. If the condition is chronic a fast or a diet of juice may be employed until the throat is clean and breathing is free and easy. Thereafter a fruit diet or fruit and vegetable diet should be fed until the tonsils are normal, after which moderate quantities of proteins and starches should be added to the diet. In enlarged (hypertrophied) tonsils the fast is sufficient to reduce the tonsils to normal. Care should be exercised not to attempt to reduce normally large tonsils.
Definition: Erroneously called abscessed tonsil, but really a peri-tonsillar abscess, quincy is an abscess which forms in the tissues surrounding (usually above) the faucials. This may form on one or both sides of the throat.
Symptoms: Quincy begins as common "tonsilitis" or acute or chronic fossulitis and, due to improper care, or to overwhelming of the lymph glands, extends to adjacent and underlying tissues and nodes and nodules, culminating in abscess formation. The abscess usually ruptures into the throat. Thus, these "two diseases" are really one.
Care of the Patient: Surgical removal of the tonsils is the present vogue. It removes affected organs, not the cause of the affection. Dr. Harry Clements, of England, an esteemed friend of the author, remarks in his Children's Ailments: "When parents and guardians become enlightened as to the proper function of the tonsils, they will not turn to surgeons for help, they will turn on themselves with reproach." Rare cases require to be lanced, most cases rupture spontaneously and drain. Care should be the same as for acute tonsilitis.
ULCERATION OF THE PHARYNX
Definition: This is the formation of one or more ulcers in the
Symptoms: These are the same as those of pharyngitis plus the presence of the ulcer.
Etiology: Pharyngeal abscess may accompany acute pharyngitis or may be the result of chronic pharyngeal inflammation. Its causes are identical with the causes of these conditions.
Care of the Patient: Same as for acute pharyngitis.
AFFECTIONS OF THE ESOPHAGUS
CANCER OF THE ESOPHAGUS
Cancer may develop in the esophagus, as elsewhere in the body. Its chief local symptom is obstruction so that swallowing is interfered with or prevented altogether. Dr. Weger says: "Cancer of the esophagus is invariably fatal and requires palliation before the end." Prevention is possible only by right living. See "Cancer" in this volume.
Definition: This is a catarrhal inflammation of the esophagus which accompanies catarrh of the throat or of the stomach. It represents merely an extension of catarrh from these other parts and requires no care other than that given for pharyngitis or gastritis.
STENOSIS OF THE ESOPHAGUS
Definition: This is obstruction of the esophagus and is divided into two general forms, as follow:
Esophagismus (spasm of the esophagus) is seen in hysteria and chorea, or it may be due to the irritation of a fissure, or an ulcer. It is often seen alone in neuropathic subjects.
Symptoms: These are difficulty in swallowing which is often paroxysmal or periodic, regurgitation of food, and in a few cases discomfort or actual pain while eating. Dilatation of the esophagus may develop as a result.
Care of the Patient: These cases represent nervous troubles and should be cared for as described under the care of nervous troubles.
Organic Obstruction: Stenosis of the esophagus may result from (1) external pressure produced by a tumor, an enlarged gland, an aneurysm, etc., or (2) by cicatrization (scar formation) of an ulcer produced by corrosive acids or alkalis; or (3) by cancer of the esophageal wall.
Symptoms: Slowly increasing difficulty in swallowing with regurgitation of food, is the chief symptom. The esophagus is often much dilated above the point of obstruction so that food may collect in the pouch thus formed. .
Care of the Patient: Constitutional care to remedy the local catarrhal condition, reduce the enlarged gland and the aneurysm, consists of rest, fasting and a strict dietetic regimen. Locally, stretching (dilatation) of the esophagus may be essential. If the tumor cannot be autolyzed it should be removed surgically.
AFFECTIONS OF THE STOMACH
ATONY OF THE STOMACH
Definition: Also, known as motor insufficiency and myasthenia gastrica, this, condition consists in relaxation of the muscular coat, of the stomach and a lack of its propulsive powers.
Symptoms: As a rule there is neither vomiting nor pain and the sufferer considers himself to he otherwise in good health. He has a good appetite and may habitually overeat. In simple atony a sense of fullness and discomfort after eating, especially if the meal has been large, and frequent belching of gas are the chief symptoms. The severity of the symptoms is often proportioned to the quantity of food taken. Fluids are as likely to cause discomfort as solids. The symptoms cease when the stomach empties itself.
An exact diagnosis can be made only by an examination of the stomach contents.
Complications: Atony frequently leads to gastrectasis. Where there is also atony of the intestines, there is likely to be marked nervous symptoms headaches, vertigo, and paresthesia and considerable disturbance of nutrition.
Etiology: Motor insufficiency represents marked enervation of the stomach and may follow upon any profound enervating influence. It often appears in acute form after intense emotional excitement or traumatism. It may follow severe fevers, or accompany adynamic biogonies in which there is much malnutrition. It is often seen in neurasthenics. Intemperance in eating and drinking is a frequent cause. The use of tobacco causes a relaxation of the stomach. It may exist as a complication of gastroptosis, chronic gastritis, nervous dyspepsia, and hypersecretion. In a few cases it seems to be congenital.
Prognosis: This is good in all cases if the patient will follow instructions.
Care of the Patient: Nothing so quickly restores normal tonicity of the stomach as rest. A fast, therefore, is essential in all these cases. Equally important is the correction of all emotional and physical habits that produce enervation. Overeating, drinking, smoking, etc., must be discontinued. The diet must be radically changed. Natural foods should be substituted for the conventional diet of denatured foods. A general health-building regimen of exercise, plenty of rest and sleep, sun baths, etc., should tone up the whole system, for gastric atonicity is only part of a general lowering of tone.
Definition: This is impaired or imperfect digestion. It is divided into acid dyspepsia which is marked by excessive acid formation; atonic dyspepsia in which there is insufficiency of gastric juice or impairment of the gastric muscles; catarrhal dyspepsia in which there is gastritis; intestinal dyspepsia which is due to defective or deficient pancreatic, biliary, or intestinal secretions; nervous dyspepsia which is marked by gastric pain and palpitation.
Nervous dyspepsia is a symptom-complex characterized by pronounced discomfort during the period of digestion, out of all proportion to the disturbances of gastric secretion or motility and apparently due to excessive irritability of the nerves of the stomach.
Symptoms: The tongue may be heavily coated, though it is often not coated. The appetite varies greatly sometimes absent, at other times inordinate, sometimes perverted, the subject craving unusual articles of food. A prominent symptom is pain during digestion. In intensity the pain varies from a feeling of discomfort to the most violent distress. The skin over the abdomen is often very sensitive, though tenderness is rare. Acid eructations and gas are complained of by some. The eructations tend to grow more distressing as the condition develops and may even result in disturbed sleep and vomiting. Periodic headache is often seen. Nervous vomiting or spitting of food is common. Pain before meals is often seen.
Complications: Migraine, ulcer, cancer, enlargement of the stomach, intestinal indigestion, colitis, constipation, anemia, palpitation of the heart and other troubles may follow in the wake of dyspepsia.
Etiology: Rapid eating, overeating, the use of tobacco, alcohol, tea, coffee, various drugs, overworked emotions, lack of sleep, over-work in a few words, exhaustion of the nervous system by too much pleasure seeking are back of this condition.
Prognosis: This is good if the subject can be taught moderation.
Care of the Patient: Cut out all causes of enervation. Stop all food until complete comfort of mind and body returns. Enjoin rest for recuperation. Feed properly thereafter and build up the general health with a wholesome mode of life.
Definition: This means pain in the stomach and is applied to violent paroxysmal, or neuralgic, pains in the stomach occurring "independently of any organic disease and any disturbances of secretion or motility."
Symptoms: Paroxysms of intense pain, occurring suddenly and at irregular intervals, radiating to the chest and back, apparently bearing no definite relation to eating, and lasting from a few minutes to several hours, are characteristic of gastralgia. Rarely, there is vomiting. Eating, or pressure over the stomach may relieve the pain. It is essential to distinguish between gastralgia and the gastric pains accompanying gastric ulcer, gastric cancer, hyperchlorhydia, tabatic crises, angina pectoris, renal colic, biliary colic, and dyspepsia. See these affections for their symptoms.
Etiology: This condition may be a symptom of neurasthenia and is likely to be seen in neuropathic individuals. It is more common in women than in men. Overwork, worry, tobacco, sexual excesses, anemia and reflex irritations help to produce the condition. Basically enervation and toxemia cause the trouble.
Prognosis: This is good if the patient will follow instructions.
Care of the Patient: All enervating influences must be corrected. Emotional poise must be cultivated. Rest until the nerves are quiet is essential. Usually a short fast is sufficient, but if the patient is very toxemic the fast should continue until this is eliminated. Care in eating should be exercised thereafter.
Definition: This is dilatation of the stomach. It is not a common condition.
Symptoms: The condition is characterized by nausea and vomiting, which may come on suddenly, surprising the patient by the amount of vomitus ejected. The large amount is due to an accumulation, of material in the stomach. Perhaps the only conclusive evidence of dilatation, except that of X-ray picture, is that found by the doctor upon examination revealed by a splashing of the fluids or contents of the stomach.
Etiology: True dilatation is a chronic condition resulting from years of irritation from overeating, wrong eating, drugs, condiments, etc. The irritation causes a hardening of the tissues and ulceration, producing a strictured condition of the pyloris. In some cases the pyloric obstruction is due to cancer.
Prognosis: Dr. Weger says: "Gastric dilatation almost invariably recovers by proper treatment." This can refer only to those cases not resulting from pyloric cancer.
Care of the Patient: It is first necessary to stop all food until the thickening, irritation and inflammation of the pyloris is removed. This will restore the opening into the duodenum. All enervating habits must be discontinued and correct feeding adhered to after the fast. If the pyloric obstruction is due to cicatrical stenosis or to cancer, the above measures will not remedy the dilatation. Surgery may be of value in these later cases.
Symptoms: What are the symptoms of cancer of the stomach? For the most part they do not differ from the usual symptoms of the simpler forms of stomach affections pain, tenderness in the pit of the stomach, vomiting, hemorrhage. These may also be the symptoms of gastric, or, even of duodenal, ulcer.
Etiology: Cancer of the stomach is one of the endings of a chain of symptoms starting with irritation, and followed by catarrhal inflammation, thickening or swelling, induration (hardening), ulceration, and finally, fungation or cancer. Cancer is the end-point in a pathological evolution that started with the first "cold of the stomach" (gastritis) in infancy. Tilden thus traces the evolution of gastric cancer: "The same chain of symptoms precede both ulcer and cancer, except at the end one ending in ulcer, the other ending in cancer. The ulcer, at its base, may or may not have a slight induration, and drainage of the surface is so thorough that there is no absorption of the septic discharge causing infection. In those cases where there is a tumor-like thickening and the ulcer (necrosis of tissue) strikes deep, drainage is not perfect, and there are absorption and systemic infection, cachexia. In cases of induration and tumor-like enlargement of the pyloris there will be symptoms of obstruction vomiting of food every few days.
There may not be an ulcer of the surface, but an increasing hardening, which in time chokes the arterial circulation, cutting off nutrition and oxygenation of the tumor after which interstitial tissue decay takes place, and septic absorption, causing septic poisoning cancerous cachexia. At this stage there is no hope. Pernicious anemia, or cachexia, when established, reigns supreme. This is cancer. It can truthfully, but regretfully, be said that all who enter this stage leave hope behind. Restoration can take place in every stage, from initial cold to ulcer; but when cachexia (the defining symptom of cancer) is reached, the best and poorest treatments are all the same." For further details see chapter on cancer.
Prognosis: Dr. Weger says, "Cancer of the stomach is incurable."
Care of the Patient: This is largely palliative. See chapter on cancer. .
Definition: This is irritation and inflammation of the stomach accompanied by fever. It is in reality acute gastritis.
Symptoms: It starts with vomiting of undigested food; the tongue is red and the breath pungent sometimes called the "ether breath." Fever is not high except in young children.
Etiology: The irritation and inflammation are induced by over-eating, frequent eating and imprudent eating, or it may result from eating spoiled food.
Prognosis: The condition is evanescent and unless added to by more eating will not last more than a few hours to a day or two.
Care of the Patient: Same care as given for gastritis.
Definition: A circumscribed loss of tissue in the stomach, usually involving both the mucous membrane and the deeper structures. An ulcer differs from a wound in the following ways: A wound arises from some external source; an ulcer has its cause within the body. A wound is always idiopathic; an ulcer is always symptomatic. The tendency of the wound is to heal because its cause is removed: the cause acted but momentarily. An ulcer persists and often enlarges, because its cause persists and often increases. The healing of an ulcer therefore depends primarily upon the removal and correction of the internal condition of which it is but a symptom. This done, the ulcer quickly heals.
Symptoms: Pain, usually paroxysmal, severe and localized, though it may radiate to the back or sides, is usually present. In many cases taking food induces or aggravates the pain and this lasts until the stomach is emptied, either by vomiting or by emptying into the intestine. Localized tenderness is often felt. Vomiting, usually of undigested food and acid fluid, which is quite frequent, usually comes on from one-half hour to two hours after eating. Hemorrhage into the stomach with vomiting of blood occurs in more than half the cases and, is said to cause death in about twenty per cent of all fatal cases of ulcer. There is an excessive secretion of hydrochloric acid (hyperacidity). Symptoms of indigestion (dyspepsia) precede most cases, though in some cases there are few symptoms until sudden perforation into the peritoneum, pleura, pericardium, or intestine, with hemorrhage, occurs.
Complications: Perforation occurs in from 8 to 10 per cent of cases. General or circumscribed peritonitis results from perforation. The peritonitis is a conservative process resulting in adhesions and walling up of the perforation. Sub-phrenic abscess sometimes follows the formation of adhesions. Stenosis, either of the cardiac or pyloric orifices, or hour-glass constriction of the stomach may result from contraction of the cicatrices scars. About 20 per cent of ulcers become malignant cancerous.
Etiology: As gastric catarrh evolves, the catarrh passes to inflammation, from inflammation to induration (hardening), and from induration to ulceration. Stomach ulcer is the end of a chain of stomach disorders beginning with irritation indigestion from imprudent eating or drinking which, when very severe, or oft repeated causes inflammation (catarrh); and when the abuse of the stomach is continued, ulceration follows, or induration (hardening), then cancer.
Decidedly nervous individuals who consume much starch bread, cake and pastry are more inclined to develop ulcer. Where there is a decided acidity of the secretion, inflammation and ulceration are almost sure to develop. Discomfort and often great pain accompany this condition.
It is not uncommon to see a patient whose stomach is so sour that, on drinking water and vomiting, the returned water and diluted acid are strong enough to sear the throat and paralyze the epiglottis so it can not close, and an attempt to drink water will cause the water to run into the nose. Even gases eructated from such a stomach burn the membranes of the nose and throat.
Prognosis: This is very favorable in all early cases. Many persist for years, then recover. Relapses, so common under regular care, are due to failure to remove causes. Advanced cases, in the profoundly enervated may end fatally in spite of the best of care.
Care of the Patient: The palliative treatments in vogue are so unsatisfactory that a noted American surgeon recommends that ulcers be removed after they have been cured nine times. As in all other troubles, the first necessity is the removal of the causes immediate and remote of the trouble. All enervating habits must be discontinued and sufficient rest in bed secured to permit of restoration of full nerve energy. A fast, both to hasten elimination of toxemia and to give the stomach an opportunity to heal, is essential. Chronic provocation by food, indigestion and drugs prevent healing. Food also keeps up the excessive gastric secretion. Fasting soon stops gastric secretion so that, while it often increases the pain during the first two or three days, it speedily establishes a state of comfort so that satisfactory healing may proceed. The fast should last until the body is free of toxemia.
Feeding after the fast should be, in most particulars, exactly opposite to the feeding commonly employed in cases of ulcer. Instead of the highly acid-forming diet in vogue, an alkaline diet should be employed. Fruits and vegetables, and these raw, should make up the bulk of the diet. If, at first, there is sensitiveness to the roughage in these foods, raw juices of the fruits and vegetables, and purees and strained vegetable soups may be used. Cooked fruits are never to be used.
Every health building agent sunshine, exercise, etc. should he employed as early as possible.
Operations are notoriously unsatisfactory in ulcers. First, the operation does not remove the cause of the ulcer. Second, the ulcer is in a field of inflammation in the mucous membrane, which inflammatory field may be quite limited or may involve much of the gastric mucosa, and an operation will remove the ulcer, but there is always quite an area of inflamed mucous membrane left after the ulcer is removed and this inflamed membrane tends to ulcerate. Two, three, four, five and even more operations are performed for the removal of ulcers, as these persist in developing. There is nothing to restore an inflamed mucous membrane to health when the causes of the inflammation are left operative.
Definition: Gastritis is inflammation of the stomach. It is gastric catarrh and may be either acute (acute gastric catarrh) or chronic (chronic gastric catarrh, or catarrhal dyspepsia).
Symptoms: Acute. The condition may be mild or severe. In mild cases there are anorexia, nausea, a feeling of discomfort, and, perhaps, vomiting. The tongue is heavily coated and the breath foul. In severe cases the nausea and vomiting are much more marked, there is likely to be moderate fever, thirst, herpes, distention of the upper part of the abdomen, tenderness over the stomach, and considerable prostration. At first the vomitus is composed of sour, fermented food; later, of mucus and bile. Should the catarrh extend to the duodenum and bile-ducts there will be jaundice. If it extends to the intestines there will be diarrhea.
What is called toxic gastritis presents more severe symptoms. There is intense burning pain in the throat, gullet and stomach, persistent vomiting of food remnants mixed with blood and mucus. These cases often die. If they do not die there often follows atrophy of the lining membrane of the stomach and obstruction of the openings of the stomach by the formation of the scar tissue.
Chronic: The chief symptoms of chronic gastritis are burning of the tongue, bad breath, lack of appetite, though in some cases there may be an inordinate appetite, discomfort in the stomach, especially after eating solids, belching, eructations, heartburn, constipation, headache, vertigo, and heart palpitation. Nausea and vomiting are not uncommon, if the vomiting occurs upon arising, the vomit consists of frothy mucus; if it occurs after meals it consists of undigested food well mixed with less ropy mucus. The whole of the upper part of the abdomen may be sensitive to pressure.
Chronic gastric catarrh sometimes evolves into atrophic gastritis (achylia gastrica) the chief symptoms of which are paroxysmal pain, more or less persistent vomiting, constipation alternating with diarrhea, emaciation, severe anemia, and absence of free hydrochloric acid and of the digestive enzymes from the stomach secretions.
Etiology: Enervating habits, the use of stimulants, excesses in eating and pleasurable enjoyments, using irritating substances like salt, pepper, vinegar, spices, and hot sauces, alcohol, tobacco, cathartics, etc., lack of emotional poise, overwork or any natural or unnatural expenditure of nerve energy beyond the power of recuperation. Chronic gastritis is the culmination of a number of recurrences of acute gastritis with a continuous abuse of the stomach between crises.
Prognosis: These cases will all recover if they can be induced to reform their habits.
Care of the Patient: In acute gastritis all food, even water, should be avoided, until the nausea and vomiting are gone. Feeding may be resumed twenty-four hours after the patient is again able to take water without producing nausea and vomiting. Feeding should be light fruits the first day, fruits and vegetables the second day, and full freedom in eating thereafter.
Chronic cases will profit by a longer fast followed by careful eating. The eating habits must be corrected and all enervating habits discontinued. Emotional abuse, lascivious habits, tobacco using, alcoholism, the use of tea and coffee, sugar and candy eating, condiment using, overeating and all other enervating and locally irritating practices must be discontinued at once and permanently.
Definition: This is hemorrhage from the stomach (hematemesis).
Symptoms: Vomiting of blood and loss of blood through the bowels is the characteristic symptom. The amount of blood lost varies considerably. Rarely there is loss of a quart or more. The blood is usually dark, is often mixed with food, has an acid reaction, and may be fluid or clotted. Acute anemia may develop if the hemorrhage is severe, producing such symptoms as pallor, weakness, vertigo, ringing in the ears, dimness of sight, syncope, and convulsions.
Etiology: Hematemesis is a symptom rather than an affection and may result from (1) traumatism, (2) gastric ulcer or erosion, (3) gastric cancer, (4) acute gastritis, (5) obstruction of the gastric vessels by an embolism, (6) rupture of an aneurysm, (7) blood dyscrasia, as in scurvy, purpura, grave anemia, etc., (8) venous engorgement of the stomach consequent upon enlargement of the spleen, or hardening of the liver. Sometimes it is seen in hysteria and what is falsely called "vicarious menstruation." Swallowing of blood from the nose, mouth or throat is not a gastric hemorrhage, this is commonly listed as a cause of hematemesis.
Prognosis: Hemorrhage from the stomach is rarely great enough to cause death and recovery depends upon recovery from the causative pathology. The most dangerous hemorrhages result from cirrhosis of the liver, aneurysm and splenomegaly.
Care of the Patient: Immediately rest in bed and absolute quiet, without food until the hemorrhage has ceased, are essential. Food, thereafter should be liquid and non-irritating, until the stomach is again able to take regular food. Care for the causitive pathology as instructed under their various heads cancer, ulcer, aneurysm, etc., etc.
This is popularly known as "fallen stomach" and is due to a general weakening or loss of tone in the whole organism, from enervation and toxemia. It is necessary to correct all causes of enervation. For care see Volume IV, page 240.
Definition: This is a partial failure of the digestive function. Simple indigestion is not much regarded in medical text-books.
Symptoms: Gas, gastric discomfort, or pain, eructations, "heart burn," vomiting, headache, diarrhea, and other symptoms may all be seen in simple indigestion. In infants and young children there may be fever, skin eruptions, convulsions, gastritis, colic, etc.
Pain, fever, nausea, vomiting, diarrhea, foul breath and loss of appetite, with listlessness are the chief symptoms of indigestion in infants and children.
AFFECTIONS OF THE DIGESTIVE ORGANS
It is said that many of the acute "diseases" begin with these symptoms, and so they do; they would also end with these if feeding and drugging were not resorted to. Most serious illnesses are the results of feeding and drugging simple ailments.
Etiology: It is customary to blame indigestion on food "something I ate." This is rarely true. The subject's own reactions, mental shocks, emotionalism, irritations, supplementary reactions, and eating habits overeating, eating wrong combinations, eating when fatigued, eating too soon before working, hurried eating, drinking with meals, etc. and all enervating influences are the chief causes of indigestion.
Infants and children are fed too much and too often, they are fed varieties of food that should not be given to them until they are older, they are fed fried foods, mushes, soaked cereals, etc. Infants are fed starches before they are two years old. They are handled too much, are excited, overheated and enervated in a variety of ways. All these things result in gastric irritation and a weakening of digestive power. Sugar, candies, cookies, etc., frequently result in indigestion in children as well as in adults. If a child "loses its appetite" know that it is either sick or fatigued. The lack of appetite is a saving measure. Do not coax it to eat.
Care of the Patient: Simple indigestion is an evanescent crisis and will never develop into anything serious if all food but water is withheld until complete comfort is established and its causes are avoided thereafter. This rule applies to infants and children as well as to adults.
AFFECTIONS OF THE INTESTINES
Definition: This is an acute inflammation of the appendix vermiformis, a worm-shaped process of the cecum. It is part of typhilitis (inflammation of the cecum) or perityphilitis (inflammation of the investing membrane of the cecum) and never exists alone.
Symptoms: Sudden pain, often generalized at first, but later most marked in the right side, with circumscribed tenderness, most frequently felt over McBurney's point midway on a line between the navel and the anterior superior iliac spine, mark the beginning of the affection. The abdomen is tense and the right thigh drawn up. There is fever ranging from 100 to 103 F. Nausea, vomiting and constipation, rarely diarrhea, are seen.
Complications: Bowel obstruction and peritonitis, due to rupture of the appendicular abscess into the abdominal cavity, are the chief complications. There is likely to be much scar tissue and adhesions left. Rupture of the abscess into the peritoneal cavity has three sets of causes (1) the use of morphine, (2) the use of the ice-bag (3) deep digging into the abdomen by physician and surgeon in making the diagnosis. The first two of these prevent formation of the protective wall nature throws around the evolving abscess; the last breaks down the wall after it is formed.
Chronic Appendicitis: This either does not exist or is so rare surgeons never see a case. Cases operated on for chronic appendicitis prove to he colitis, or neuritis, or neuralgia, or gall stones, or kidney stones, or cystitis, or ovaritis, or metritis, or pregnancy, or a rotated innominate, or other such conditions.
Etiology: Colitis, putrefaction and constipation precede and lead up to the development of every case of appendicitis. It is impossible to imagine a perfectly healthy cecum with a diseased appendix. There is first enervation and toxemia with its consequent gastro-intestinal catarrh. Then much gastro-intestinal decomposition infects the cecum and appendix setting up severe inflammation with possible abscess formation. There is no appendicitis without habitual intestinal indigestion, and this habit is built and continued by overeating, and wrong food preparation.
Prognosis: This is good if hygienic measures are instituted at the outset.
Care of the Patient: Tilden says, "The treatment for appendicitis amounts to a wise letting alone." The patient should be put to bed and a hot water bottle placed at the feet. No food but water should be allowed. If food of any kind is given vomiting will occur and intense pain will follow almost immediately. If food is not taken the patient will soon become comfortable. Anyone who feeds, even a little, in appendicitis will not have the success we do. When we say "do not feed," we do not mean to give the patient a little fruit juice, or an occasional sip of milk, or a little taste of ice-cream, or little lumps of ice to cool the stomach. Little driblet meals are enough to work havoc.
Cathartics and laxatives induce forceful peristalsis and keep the inflamed part of the colon in agony. Their use is now condemned, even by the medical profession. The violent peristalsis induced by laxatives is likely to cause perforation of the abscessed bowel. In appendicitis, with abscess, the bowel movements are cut off from above by abscess pressure and the muscle fixation that nature provides to protect the parts and prevent rupture taking place in any direction except into the bowels; hence no attempt should be made to move the bowels. Page says: "Never do I badger the bowels, either by physic or enema, since this sort of thing tends to increase inflammation. The bowels will take care of themselves in due time I find."
If pain is intense a hot towel may be placed on the abdomen over the region of pain, but no drugs or ice bag should be resorted to. The ice bag hastens the development of gangrene.
Do not dig into the patient's belly with your fingers, nor allow other doctors to do the same to confirm the diagnosis. If we can get these cases before the examiners have done irreparable damage by their barbarous and unscientific digging into the belly on the pretext of diagnosing the "disease," we do not have any trouble in caring for them.
The tendency of the abscess is to rupture into the colon and the pus passes out in the stools. When nature opens the appendicular abscess she does so in a way to favor drainage into the gut; whereas operation provides for drainage against gravity. In rare cases it ruptures into the bladder. Tilden says: "Nearly every case of rupture of the appendiceal abscess (into the abdominal cavity) has been 'brought about by the surgeon in his zeal to diagnose the disease and determine if the usual tumor-like development pus sac can be found."
Dr. Richard C. Cabot, of Harvard, says: "People who cannot get operated on at once for acute appendicitis may get through by starving themselves in the attack." A doctor who is capable of piloting a case of appendicitis to a successful natural cure should be able to teach the recovered patient how to prevent a recurrence.
Definition: This is inflammation of the colon. Two types of colitis are described as follow: (1) mucous colitis, a catarrhal condition characterized by colic, diarrhea, and passage of membranous threads in the stools; (2) ulcerative colitis, which is merely the distal end of mucous colitis.
Mucous Colitis: Colitis may be very mild and somewhat obscure for a long time. The abdominal distress of which the sufferer is conscious, may be attributed to gas and constipation. Colitis may not be suspected until considerable mucus appears in the stools. There may be mucus masses of jelly-like consistency or suspicious-looking ropy shreds, like casts of the bowels, or the feces may be coated with mucus, and it is sometimes streaked with blood.
Constipation, almost always of the spastic kind, is the most outstanding symptom. Indeed there is almost always some colitis in all cases of chronic constipation. In colitis accompanying inflammation of the ilieum, or small bowel (ilieitis) or in ulcerative colitis, there may be diarrhea, or diarrhea alternating with constipation.
Colonic spasm is almost invariably present in colitis and there is almost always a sagging of the colon enteroptosis. There may be enteroptosis without mucus and there may be mucus without enteroptosis, but, usually, they coexist. Spastic constipation seems to be an unfailing accompaniment of either or both these conditions. The medical opinion that the spastic constipation causes the colitis is as ridiculous as would be the opposite opinion that is, that the colitis causes the spastic constipation. They are merely two parts of the same condition and both depend upon the same underlying cause.
One of the most prominent features of advanced colitis is the negative or depressive psychosis the colon complex. This complex, seen in chronic cases, usually involves the emotions. The depressed mentality seen in these cases is likely to be dismissed as neurasthenia by the average physician, because he does not understand the connection that almost invariably exists between colitis and the mental and emotional depression.
Dr. Weger gave it as his opinion that a chronically diseased colonic mucous membrane forms the basis of more mental and physical derangements than any other single functional abnormality. All of the thoughts of such a sufferer become introverted and center around his digestive tract and his constipation. No matter how hard he tries he cannot divert his thoughts from their center of interest.
Some try bravely to repress their feelings, while others no longer attempt to conceal their constant state of apathy. They are irritable, grouchy, nervous, excitable and sometimes they border on melancholia or actually become hysterical. As Dr. Weger expresses it: "Few diseases can compete with colitis in developing obsessions."
The subjective symptoms presented by the sufferer from colitis are uniformly consistent. Certain feelings are more marked in some than in others in one person the digestive disturbances seem paramount; in another nervous symptoms predominate.
Constipation, usually measured in years, is almost always present. The purgatives, laxatives, teas, oils, enemas, diets, etc., that have been used, have seemed to give temporary relief in some cases and have aggravated the condition in others.
All of the sufferers complain of gastric and intestinal indigestion with gas and rumbling in the intestine of a colicy nature. Nausea and uneasiness are common and there is often a sense of fullness. Dull and constant or sharp and recurrent headache is usually complained of. There may be a feeling of stiffness and tension in the muscles of the neck. A sub-occipital pain or drawing sensation is quite common. There is a feeling of extreme exhaustion, and a lack of ambition and initiative.
Objectively these cases are likely to be thin and undernourished, though colitis may be seen in overweight individuals. Most cases appear anemic and dysemic. There is usually a coated tongue, offensive breath and an unpleasant taste. The nausea experienced immediately preceding the expulsion of a large accumulation of mucus is followed by a feeling of great relief. Misery and dejection are written all over the face of the sufferer and this is frequently combined with anxiety.
I quote the following resume of the many objective and subjective symptoms that color the picture of chronic colitis, from. Dr. Weger "insomnia, nervousness, shortness of breath, premonitions of impending evil, disturbing and fearsome dreams, bloating, fullness, gas, reverse peristalsis, loss of appetite, bilious spells with occasional nausea, headache, weakness, cutaneous hyperesthesia, mouth cankers, bad breath, backache, pain and weakness in the legs, varying aspects of malnutrition, pessimism, irritability, and an unwillingness to think or talk of anything but the ever present misery intensified, of course, by the never-ending hypercritical speculation and the habit of inspecting the stools. The most trivial intestinal movement or unrest is often seized upon as an excuse for complaining. Pains in the arms, legs, shoulders and chest, even pseudoanginal seizures, often occur in the nervous and hypersensitive type, especially during those periods when large quantities of mucus form."
The reader will understand that all of these symptoms are never present in any one individual and that many of them are present only in advanced or long standing cases. Many cases are mild and often require years to reach the advanced stage seen in the worst cases.
Ulcerative Colitis: A long-standing catarrhal condition in the nose (rhinitis) may culminate in ulceration of the nose; a long-standing catarrhal condition of the stomach (gastritis) may end in gastric ulcer; a chronic catarrhal condition of the colon (colitis) may result in ulceration of the colon ulcerative colitis. Cancer is the next and final step in this process of pathological evolution.
Symptoms: Constipation, a spastic sphincter, pain upon defecation and blood in the stools are the chief symptoms.
Proctitis: During the course of chronic colitis, the more tense inflammation may be localized in one or more circumscribed areas of the colon. This more acute phase of the inflammation is usually named after the section of the colon in which it is located. Hence, if it is in the sigmoid flexure it is called sigmoiditis; if it is in the rectum it is denominated proctitis. The line of demarkation between sigmoiditis and proctitis is an imaginary one. Such distinctions are misleading.
Etiology: Colitis is an extension of gastro-intestinal catarrh involving usually the sigmoid flexure, cecum and transverse or splenic flexure of the colon. It is a very common condition, nine people out of ten having more or less chronic inflammation of the mucous membrane of some part of the colon. "We are convinced," says Dr. Weger, "that the development of colitis and the retention of the toxic waste in the blood and lymphatic system are concomitant. They go together, belong together, and must be considered and treated together."
Prognosis: This is good if the subject can be taught self control.
Care of the Patient: Complete recovery cannot be expected without physical, mental, sensory and physiological rest. It is best to get away from friends and relatives and from the old environment. It is necessary to cultivate poise and tranquility and to emancipate oneself from the tyranny of symptoms. The gas, mucus, constipation, spasticity, etc., are not the cause and should be persistently minimized. Removal of cause is essential and is not always easy. Old habits must be broken up and new ones cultivated. Accumulated toxins must be eliminated and nerve energy restored. In mild cases of short duration, four weeks of rest are often sufficient. Most cases, being chronic, require from six to eight and more weeks of care. When the development of pathology has covered a period of years it cannot be eradicated and a normal state established in a week or a month. Great care in eating and living is essential after the rest and fasting and this will have to be carried out long enough to fix the good habits so that there will be no return to the old. People troubled with colitis and constipation are always enervated. Rest gives the organism an opportunity to recharge her battery and store up a good amount of energy.
Definition: Constipation is sluggish action of the bowels intestinal stasis infrequent or difficult evacuation of the feces.
Symptoms: Difficult and infrequent bowel movement, hard, usually foul, stools, gas and occasionally pain or discomfort in the abdomen are the characteristic symptoms of constipation. Sometimes nausea is present. Headaches and other symptoms attributed to constipation are due to other causes. Toxemia antedates constipation and is not caused by constipation. Two general types of constipation are described as follows:
Spastic Constipation, in which the stools are likely to be small, hard, round balls. In this form there is a spastic condition of the muscles of the colon.
Flaccid Constipation, in which there is a loss of tone (flaccidity) in the walls of the colon.
Etiology: Dr. Page says "In common life, it is rare indeed that constipation is the result of a deficient diet, although it often arises from lack of nourishment consequent upon excess, or an unwholesome variety of food, or both. Usually it may be regarded as the 'reaction' from over-action. The not uncommon experience, in regular order, is this: excess in diet, diarrhea, constipation, physic or enema, purgation, worse constipation, more physic and so on. The term reaction here means simply that the organs involved having been irritated by undigested food, and having by means of increased action cleared away the obstruction, now seek restoration by the most natural method, as the name itself implies rest. What are commonly called diseases are in reality cures; and the common practice with drug doctors, of controlling the symptoms is like answering the cries of a drowning man with a knock on the head." The Natural Cure, p. 112.
"Passing Enervation and Toxemia which are basic causes and omnipresent where there is any departure from the normal health standard, overfeeding is first, last and all the time the cause of constipation in children," says Dr. Tilden. Overfeeding is followed by imperfect digestion, flatulency, bowel discomfort, loose movements with curds in the stools. The amount of the curds increases as the digestive impairment becomes greater and, finally, the stools may become hard, dry anti even lumpy. Children that are properly, cared for and properly fed never have constipation.
Care of the Patient: Constipation will end when nerve energy is restored and the causes of enervation are removed. We should keep in mind that it is good health that insures daily movements and not daily movements that insure good health.
There should be no resort to laxative, cathartic or purgative drugs; to force bowel movement. As Tilden puts it: "Nature cleans out the bowels in her own way when she is ready indeed she often cleans them out with such force and vigor that the human doctoring habit decides they must be checked. If checked it may mean death. Why, then, not be patient when the bowels are not inclined to move of their own volition?"
Physic may produce enough irritation of the bowels to produce a copious outpouring of fluid and vigorous action in expelling the feces and the drug, but this same irritating effect inhibits elimination proper. This is the opposite of what is intended. Irritant drugs further enervate, oppose excretion, and make the constipation worse. Forcing the bowels to move voids what is in the bowels, but it does not secure elimination.
Does the drug cure constipation? No. The supposed beneficial effects of purgatives and laxatives, whether mild or violent, do not extend beyond the period of excitation; after which the whole digestive tract lapses into its previous inertia. Nothing worth considering has been gained. The hysterical and impatient grab a pill or a bottle as soon as their bowels fail to act, and give them the lash. The drugs, being powerful irritants, occasion rapid, forceful contractions of the muscles of the stomach, intestines and colon, and the pouring out of large quantities of secretions to wash away the irritant drug. The dupes of such practices secure the bowel action they desire, but at a frightful cost. There is now greater need for rest than before the drug was taken. There is now less of the normal lubricants of the intestine and bowel than before. There must, of necessity, be a longer period of rest following such violent activity. But the rest is not allowed. Another dose of the drug is taken, resulting in another period of over-work, necessitating more rest. This process keeps up until chronic constipation results and, if it goes on, permanent weakness, and ultimately, atrophy of the muscles and glands of these organs, with a thickening and hardening of their lining membranes and derangement of secretion.
Dr. Page truly says: "Next to the mistake of resorting to drugs in these cases, is the quite common one of swallowing special kinds of food for the same purpose, and there is some question as to which of the two evils is the least. An excessive quantity of rye mush, wheaten grits, or oat groats, with a generous dressing of butter, syrup, milk or honey to wash it down in abnormal haste, will often purge the bowels like the most drastic poison." The Natural Cure, p. 114.
To many doctors and dietitians, the main object of diet seems to be to prepare foods or food mixtures that will increase peristalsis.
This is a misuse of food. It is not the function of the digestive tract to be constantly filling up and emptying out again. The purpose of food is to nourish the body. Overworking the bowels with olive oil, wheat bran, agar agar, psyllium seed, and other bulky and roughage articles of diet robs the organism of part of its nerve energy.
Feeding bulk and roughage secures movement on the well-known principle of the hay bailer that of pushing one bale of hay out with the one behind. Dietitians push one meal out with the next.
It is well known that the effects of all laxative and cathartic drugs "wear out." The size of the dose must frequently be increased and the drug must occasionally be exchanged for a different one. But it is not generally understood that the laxative foods also "wear out." One must eat more and more of them; even then they will finally cease to occasion action. Eating quantities of "roughage" or "bulk" will not cure constipation. Of more importance than the thing to be moved (the bulk) is the motive power the power of movement.
Tired (constipated) bowels need rest, not work; more nerve energy, not more expenditure; better nutrition, not more bulk. Enemas, colonic irrigations, rectal dilators, etc., are every bit as evil in their effects as drugs and roughage and they have no more effect in removing cause than these other things. The same is true of mineral oils.
The chief cause of chronic constipation is the constipation cures. Nobody ever gets free of this functional failing so long as these are employed.
DIARRHEA IN CHILDREN
Children are more inclined to diarrhea than adults; first because they are more inclined to excessive eating and, second, because their digestive tracts have not acquired a toleration for decomposition products. Three forms of diarrhea in children are recognized, as follow:
Simple or Dyspeptic Diarrhea: In this form the stools are offensive and, usually contain undigested milk curds, but little or no visible mucus. Vomiting frequently occurs and fever ranges between 100 and 103 F. There is no marked prostration and emaciation unless the diarrhea is long continued. The diarrhea is likely to be frequent and may lead to ileocolitis.
Etiology: Diarrhea in infants may be due to a number of causes. Overheating, chilling and over excitement are often causes. In such cases the stools are likely to be normal in all other respects except diminished consistency. Diarrhea is, in most cases, the result of indigestion brought on by the stuffing process. An over supply of milk or of some part of the milk will produce a diarrhea. An excess of fat causes stools to be yellow or yellowish green and often to look oily. They are apt to be rancid, and are acid in reaction. They are prone to irritate the buttocks. The stools often contain mucus and soft curds. An excess of sugar (any kind, even milk sugar) causes the stools to be more or less green, and gives them an acid odor. They are acid in reaction and also irritate the buttocks. Mucus and small, soft curds are often present. Diarrheas produced by starch are similar to those produced by the maltose-dextrines except that they usually do not contain mucus or curds. Protein excess produces brown or yellowish-brown stools, with a foul or musty odor and an alkaline reaction. The curds are plentiful and large. The stools may, but usually do not, cause irritation of the buttocks. Blood and mucus in the stools indicate an acute inflammation
Ileocolitis: The symptoms are more intense in this form of diarrhea. The stools are numerous, contain much mucus and are sometimes streaked with blood. The abdomen is distended and tender; the temperature ranges from 103 to 105 F. Vomiting often occurs but is usually a less conspicuous feature than in the dyspeptic form. Colicy pains may precede evacuation and often there is pronounced painful straining at stool. Exhaustion and emaciation rapidly ensue and, in severe cases, the child sinks into a state of complete collapse or passes into a marantic state which persists for several days.
Complications: Bronchopneumonia and acute nephritis are not uncommon complications under regular care.
Prognosis: Medical authorities say: "The disease is always a serious one, especially in young infants, and even in favorable cases convalescence is likely to be tedious." "Death is frequently preceded by extreme apathy, stupor or even coma (spurious hydrocephalus)." This is medical experience with feeding and drugging. Hygienic measures produce no such evils.
Care of the Patient: When nature revolts against the digestive abuses to which infants and children are subjected and a diarrhea is instituted to get rid of decomposing food she is heading off convulsions, ptomaine poisoning and a host of other troubles. More feeding in such a state is criminal. Equally as criminal is the use of drugs to check the conservative or protective measure the diarrhea.
Fasting should be instituted at once and no food should be given until complete comfort has returned. Premature feeding may start up the diarrhea afresh.
If curds appear in the baby's stools, or if the color and consistency are not normal, the amount of food should be reduced. If cutting down the amount of milk, to get rid of curds in the stools, requires so great a reduction that the amount that can be given is too small to support life, it indicates that digestive power is low. Enervation from overfeeding, overexcitement, or other cause is back of this.
If these signs of indigestion have been ignored until diarrhea has developed, all feeding must be immediately stopped. No food should be given to the child until the bowels are normal again. If there is no fever and the child demands food, fruit juice may be allowed. If there is fever, nothing but water should be given to the child. Castor oil, milk of magnesia, soda, enemas, etc. should not be given. Mucus and blood call for perfect rest and quiet and warmth; no food and, neither last nor least, no drugs.
Warmth and rest are the other great needs. The child should be allowed to lie quiet and not be disturbed every few minutes to count its pulse, take its temperature, etc. Proper care and feeding after the symptoms have subsided will prevent frequent necessity for diarrhea.
Cholera Infantum: The third form of diarrhea is an inflammatory condition of the alimentary canal of infants which prevails in the summer months. This disorder was formerly much more prevalent than now and in some localities was the occasion for more, dread and anxiety among parents than any of the "diseases" peculiar to children. The death rate in this "disease" in children between the ages of one and two years was once fearful.
Symptoms: The trouble comes on apparently very suddenly, with great restlessness, fever ranging from 102 to 104 F. There is much diarrhea, the bowel discharges are accompanied with "bearing down," straining at stool, and considerable pain. Preceding the bowel movement, the child will gag or retch.
The sickness of the stomach and all of the other symptoms gradually increase until vomiting becomes frightfully severe. There is very rapid emaciation and parents and friends usually give up hope of saving the little one not knowing that the rapid emaciation is one of nature's most potent saving measures.
The bowels are filled with gas, the abdomen is very sensitive and, where there is much gas accumulation, there is rapid pulse, rapid, oppressed breathing, and a rise in temperature. There is extreme thirst, which alas, was and sometimes is yet, mistaken for hunger. The stools are yellow or whitish-yellow, or they may be tinged with green at the outset, becoming grass-green, with white lumps of milk curd, as the condition grows worse.
Children may die in twenty-four hours in this condition or the symptoms may abate after the first twenty-four hours and convalescence sets in. Dr. Tilden says: "Cholera infantum proper is of twenty-four hours duration; after that, if the child remains sick, the disease assumes one of the types given in the nomenclature" gastro-intestinal catarrh, gastro-enteritis, summer complaint, summer diarrhea, gastritis, entero-colitis, ileo-colitis, diarrhea, dysentery. He also says: "After twenty-four hours, if the disease has spent its force and the child is still alive, the bowel movements continue in frequency and contain more mucus, and at times specks or very delicate streaks of blood, and the fever remains about the same. The thirst is consuming; the child puts anything into its mouth. The restlessness is marked by rolling of the head from side to side and throwing the arms and legs from one place to another.
"Occasionally these cases start with convulsions and quickly sink into a stupor or comatose state, from which they gradually sink into death. Again, stupor may be light, the eyes partly closed, the child becomes more restless and cries at every bowel movement."
Etiology: Cholera infantum is a case of septic poisoning; the putrescence arising from gastro-intestinal putrefaction. It is a ptomaine poisoning brought on by wrong care and wrong feeding.
In health, the body is potentized with "immunizing" power and, can, to a large extent, render innocuous, deleterious substances taken into the stomach. The secretions of the stomach and intestine take care of such substances for us every day that we live. But by wrong eating and poor hygiene we break down the body's resistance and derange digestion and decomposition produces poisons in excess of the "immunizing" power of these secretions.
Babies are often born with a predisposition to digestive derangements. Mothers do not realize, or if they do realize it, they sometimes don't seem to care, that the further they depart from an ideal standard of health, before and during pregnancy, the less resistance their children will be born with.
After birth, with its meddlesome midwifery, babies are handled, too much; fed too much and too often, bathed too much, overclothed, kept in poorly ventilated rooms, over excited, not permitted to sleep enough, subjected to many influences which weaken them and lower their resistance. These are frequently fed from the family table, whatever the older members of the family eat. They are given bad milk from an overworked, overexcited, overfed, sick mother. They are brought up in crowded cities with all their heat, filth, foul air, constant noise and nervous irritations. They enter a world where almost every influence is opposed to them.
Add to all this, the abuses of treatment to which they are subjected laxatives, purgatives, castoria, paregoric, drugged milks, serums, vaccines and all the rest of the evil influences of voodooism, and that glorious state of life which we know as health is seldom assured them. They are forced to be content with half-health and lowered resistance.
Against the poisons resulting from the decomposition in the digestive organs in these little children, the body puts up a fight that is all too often a losing fight. When the decomposition overwhelms the "immunizing" power of the digestive juices, the body is poisoned and a real battle begins. The vomiting and purging, so commonly regarded as enemies, are conservative measures. These are nature's means of expelling the decomposing matter. The putrefying contents of the stomach and intestine are not absorbed. The absorbents, instead of taking up the fluid contents of the digestive tract, reverse their functions, and pour a large amount of fluid blood-serum into the stomach and intestine to dilute and neutralize the decomposing matter, and wash it away in vomiting and purging. This great quantity of fluid flushes the entire alimentary canal and the, poison is washed out. It is this great pouring out of the great amount of serum that causes the great and rapid wasting of the child and the great thirst.
There is no absorption from the stomach and intestine under such conditions. To feed in these cases is to make the child worse. There is no possibility of nourishing such a child. Digestion and absorption are impossible. No doubt some of the worst of these cases will die under the best of care, but undoubtedly most deaths are due to the murderous methods used in treating these cases. Food to sustain the patient, drugs to relieve pain, dope to make them "rest" and "sleep," calomel and salines to increase the purging followed by opiates and other drugs to check or suppress the diarrhea, drugs to depress the nerves how murderous!
Prognosis: Many of these cases, particularly if badly treated, pass into gastro-enteritis. This is, or was, particularly true in the middle states where summers are hot. Cases where gastro-enteritis has followed a severe cholera infantum, are liable to relapse if they are not handled very carefully. Such children are sick and are liable to relapses every few days or every week or two. Dr. Tilden says: "The doctors of thirty years to forty years ago (now longer) did not pretend to cure these children; they congratulated themselves on being very successful if they could keep the little ones alive until the frost came in the Fall."
It was not uncommon in those days to see these miserable little sufferers reduced to veritable skeletons, waiting for frost to come, but often, unfortunately, dying before the weather became cold enough to frost. The "disease," as previously stated, ranges in severity from a light case of indigestion to a severe case that culminates in death in twenty-four hours. They are all the same and distinctions are those of degree only.
Care of the Patient: Stop all food at the first sign of trouble. This is the remedy par excellence. Indeed, it often means the difference between life and death. The parent or doctor who stops all food at once fights a winning fight from the start. Fasting is the great pain killer, sleep producer, and life saver. There is no danger of starvation and no possibility of nourishing the child.
Isolation and quiet will secure rest. Drugs to force rest only depress the nervous system, weaken the body, lower resistance, and assure chronic after-effects, where they do not result in death. Separate the child from the rest of the family and give it quiet.
Give it all the pure, cool water it desires and it will demand much of this, but never give it food until all acute symptoms are gone and the bowel movements are normal or ceased. Keep the child warm. Never permit a doctor to administer heart tonics (really atonics), for these only help to kill the child. Few people die who are not killed by the efforts to save them.
Dr. Tilden says: "When the child is very sick, with blanched countenance and almost imperceptible breathing, slip the pillow out from under the head, elevate the feet (by raising the foot of the bed), if possible, without disturbance, place artificial heat around the body, secure plenty of air, and let the child alone. Further than this is malpractice."
Children that are sick for days and weeks are fed and drugged. These should be fasted until the stomach and bowels are cleaned out and the decomposing milk curds are gotten rid of, then fed according to their powers to digest.
Dr. Page says of such cases: "Cases are on record where a change in the mother's diet the avoidance of meat, pastry, spices, hot sauces, tea, chocolate and the adoption of a generous diet of plain wheat-meal bread (varied with rye, corn, and oatmeal), milk and fruit has rapidly restored infants dying of cholera infantum without aid from any other source.
The old Frost Cure, was simply a waiting until the passing of hot weather, which favors decomposition, and the coming of cold weather, which checks decomposition. But it allowed many children to die, because it did not correct the cause of the trouble. Even after the frost had come, and the diarrhea had ceased, the real etiological factors were still present and these children frequently died of "diseases peculiar to children" and if they did not die young, but grew up, they later had all the "diseases peculiar to adults." The same general fact is still true for the very obvious reason that no efforts are ever made to correct the real causes of the affection.
Definition: This is an ulcer of the duodenum. The term peptic ulcer is given to ulcers of the esophagus, stomach and duodenum surfaces that come in contact with the gastric juice.
Etiology: As intestinal catarrh evolves, the catarrh of the duodenum passes to inflammation, and from inflammation to ulceration. The cause of duodenal ulcer is the same as that of gastric ulcer.
Complications: See gastric ulcer.
Prognosis: See gastric ulcer.
Care of the Patient: Care for the patient as described for gastric ulcer.
Definition: This is a distressing inflammation of the mucous lining of the colon, an acute colitis, attended with fever of the "typhoid" form. The bowel is affected by an agonizing bearing down sensation, termed tenesmus, and accompanied by bloody stools commonly called flux. Four types are described as follow:
Acute Dysentery: Dr. Tilden says: "This is a disease that is strictly a type of constipation." There is frequent desire for evacuation. The first symptoms are a slight diarrhea with much bearing down. The patient leaves the commode unsatisfied, that is with a feeling that there is more to pass. This sensation is almost continuous, no matter how often evacuation is attempted. In this acute state the condition is really proctitis. Bacillary dysentery is merely a severe type of acute dysentery.
Amebic Dysentery: This is a form of acute or chronic colitis seen in Eastern countries, Egypt and Europe, but not frequently in this country. It is a "tropical disease" and derives its name from its supposed cause the ameba (amoebae). It is a very intractable condition and is especially likely to result fatally in greatly enervated subjects.
In mild cases the condition may exist for months before the patient is aware of its existence. There are vague symptoms of headache, tired feeling, weakness, slight pain in the intestines, occasionally diarrhea. In severe cases or in advanced stages there is great suffering and much emaciation. The patient will spend hours out of each twenty-four on the stool; for, though there is great desire for evacuation, there is very little stool. Although the straining at stool proves injurious, desire compels them to attempt evacuation. Rarely is there more than a tablespoonful of mucus at a stool. There are, of course, occasional bowel movements.
Chronic Dysentery: Tilden says: "This is the remains of a badly treated case of acute dysentery."
Diphtheritic Dysentery: This is the name given to a severe type of acute dysentery in which there is much congestion and necrosis of the intestinal membrane. It is often seen as a complication of pneumonia or of chronic heart and kidney affections.
Etiology: This condition is a colitis, or rather, a proctitis and perhaps some sigmoiditis and is produced as all forms of colitis are. Chronic constipation usually precedes and alternates with the periods of diarrhea. So-called amebic (amoebic) dysentery involves more or less of the whole colon, especially the cecum and the sigmoid flexure. Ulcerations, edema of the membrane and more or less sloughing indicate a more virulent type of poisoning and account for the more violent symptoms.
Care of the Patient: Weger says: "As in other intestinal derangements, no treatment can compare with complete physiological rest and suitable diet afterwards. Tubercular diarrhea can be relieved at least seventy-five per cent even in advanced cases in which complete cure is out of the question because of chronicity, general depletion, and constitutional involvement."
In amebic dysentery the subject should be induced not to wear out the nervous system by repeatedly and needlessly going to stool and straining in a futile effort to evacuate when there is nothing to pass.
A bed-pan or cloth will save him much energy while ignoring or mentally repressing the morbid urge will prevent straining.
Definition: This is a catarrhal inflammation of the intestinal mucous membrane. Several forms are described, as acute enteritis, cholera morbus, diarrhea, croupous enteritis, chronic enteritis. The differences between these forms are more imaginary than real. However, we shall discuss them under their respective heads. If confined to the duodenum it is called duodenitis.
Acute Enteritis: This is an acute catarrhal inflammation of the intestinal mucous membrane.
Symptoms: There are frequent stools three or four to twenty or more a day which are watery, brownish and, as a rule, more or less offensive. Unless the colon is also affected the amount of visible mucus is not usually great. If the upper part of the small bowel is chiefly involved, undigested food may be present. Colicky pains, abdominal soreness, distention of the abdomen with gas, noises in the bowels, and more or less fever usually accompany the diarrhea. If the stomach is involved (gastritis) nausea and vomiting may be marked. Sometimes the inflammation extends into the bile duct giving rise to jaundice. If the colon is involved (colitis) there will be painful straining at stools.
Cholera Morbus (cholera nostras): This is a very severe form of acute enteritis caused by food poisoning.
Symptoms: Frequent watery stools, persistent bilious vomiting, violent abdominal pains or cramps, marked fever, great prostration, or in extreme cases, collapse, characterize this condition. Death rarely results except in the aged and extremely debilitated.
Croupous Enteritis: This is an aggravated form of acute enteritis and is also known as membranous enteritis. It is characterized by the sloughing off of the intestinal mucous membrane.
Chronic Enteritis: This may follow acute enteritis, after one or repeated crises, or it may develop gradually with little or no acute crisis.
Symptoms: Constipation or diarrhea may, either one, be persistent, or they may alternate. If the colon is also affected much mucus is secreted. In many cases anemia, emaciation, and various nervous symptoms depression, hypochondriasis, and neurasthenia are present.
Diarrhea: This is a frequent discharge of loose, often watery stools. It may precede and accompany serious illness, such as typhoid or typhus fever, cholera, intestinal tuberculosis; or, it may occur independent of other illness.
Symptoms: The characteristic symptom of diarrhea is frequent evacuations of loose, watery stools. In ordinary cases there is little or no colic. There may be mucus or undigested food in the stools. The egesta may be greenish due to presence of bile, or they may be watery, or serous, or fatty, purulent from ulceration, or black from the presence of blood. Diarrhea may be either acute or chronic.
Enterocolitis: This is inflammation of both large and small intestines and presents the symptoms peculiar to both intestines, as described above.
Etiology: Acute or chronic enteritis in any of its forms is a catarrhal inflammation and represents an extension of gastric catarrh into the intestine. Acute, painful crises come on usually after dietetic indiscretions, or copious water drinking, or drinking ice beverages while over heated. Warm weather seems to favor their development.
The diarrhea that always accompanies these crises always represents an intolerance of the digestive tract for substances of an undesirable character drugs, irritating or decomposing foods or nerve shock that renders even agreeable foods intolerable. The diarrhea represents unusual activity on the part of the intestines and colon, sometimes even the stomach, in ridding the digestive tract of unwanted substances.
Care of the Patient: Acute enteritis calls for the immediate withdrawal of all food. Rest, quiet, and fasting should be enforced until complete comfort has returned. Chronic enteritis is best cared for in the same manner.
The best remedy for diarrhea is to do nothing this is to say, cease eating, rest, and let the bowels alone. Dr. Richard C. Cabot, an "orthodox" authority says: "'Simple diarrhea' or acute colitis of adults gets well as a rule in a week to ten days. The important remedies are rest, warmth and starvation." No effort should be made to check the bowel action. Giving opiates or other drugs to check the diarrhea or stop the pain is very unwise for these lock the irritants and toxic substances in the bowels, producing more irritation and forcing absorption, thus leading to worse troubles. Bear in mind, too, that cathartic drugs will often close the bowels as tight as a clam.
Definition: A fistula near the anus which may or may not communicate with the rectum. A fistula is a deep sinus ulcer, often leading to an internal or hollow organ.
Symptoms: Pain, especially upon bowel movement, in the rectum, inflammation, pus and the presence of the fistula are the leading symptoms. One or more fistulas may be present.
Etiology: Fistulas develop from abscesses that form as a result of inflammation. They are seen chiefly in colitis (proctitis) and hemorrhoids.
Prognosis: This is usually good.
Care of the Patient: Fistulas heal when the underlying toxemia is removed. Fasting and rest and a corrected mode of living constitute the requirements.
Definition: This is gas in the alimentary canal. It is a symptom seen in many conditions ranging all the way from simple indigestion to cancer of the stomach or rectum.
Etiology: Gases are always present in the stomach from the air swallowed from the CO2 set free from saliva and from the reaction on sodium carbonate in the pyloric secretions which pass back from the duodenum. Gases also result from decomposition of food. Vegetables give off more gas than animal substances meat gives off liquid poisons more injurious than gases. Gastro-intestinal decomposition of food is the chief source of flatulence.
Care of the Patient: The remedy is apparent to all who have read these pages physiological rest until secretions are normal and proper eating and living thereafter.
INTESTINAL COLIC (Enteralgia)
Definition: This is intestinal pain of a spasmodic character. It is also called Tormina.
Symptoms: The outstanding symptom is paroxysmal pain of a cramp-like character which centers around the navel and is relieved by pressure. The abdomen is usually distended. Severe colic may lead to collapse, indicated by vomiting, feeble pulse, pinched features and cold sweats. The paroxysms last from a few minutes to several hours and usually end by a discharge of gas.
Etiology: Overeating, profuse water drinking, irritating food, and fecal accumulations are the chief causes. Any cause of indigestion and gas accumulation may bring on colic. Coffee drinking will do it in some. Colic is also seen in enteritis, dysentery, appendicitis, intestinal obstruction, lead poisoning, locomotor ataxia and as a reflex from pathology in the ovaries, uterus, liver, vertebrae, etc.
Care of the Patient: All that is needed is abstinence from food until the crisis is well passed and proper eating thereafter. If the colic is due to gas, it is possible to hasten the expulsion of the gas by massage of the abdomen.
Colic in Infants and Children: This is a very common complaint in overfed children and causes anxious parents to walk the floor night after night.
Symptoms: The symptoms of colic are pain, flatulence, expulsion of gas, diarrhea, or constipation, green or curdy stools, eructations and perhaps vomiting.
Drawing up the legs when crying is not an evidence of colic in babies. Most babies draw up their legs when they cry from whatever cause and one that is crying vigorously will always draw up the legs and arms.
Have you ever watched the tossing and listened to the agonizing cries of the baby with colic? Have you ever watched anxious parents walk the floor nearly all night with such a baby in their vain efforts to stop its crying? If you have, you know that colic is no laughing matter at least, not with the child and its parents. Dr. Page says:
"When a vast audience is convulsed with laughter over Mark Twain's witty description of the experiences of parents with colicky babies, it may be well for them to forget, for the moment, the thousands of little audiences of two, or three, or four, gathered about the death-beds of emaciated little ones dying in convulsions, not of laughter, and that provoke no laughter, either on earth or in heaven. More than eight hundred such audiences in one city, in a single week, who can force even a smile to their wan countenances, except it be, perchance, a smile of resignation to what seems to be a token of the chastening, though loving hand of God."
Etiology: Besides over feeding (the most common cause), colic may be induced by getting cold or over-heated or by any other influence that deranges digestion. Babies that are fed properly, kept dry and warm and not handled too much and not over-heated do not have colic.
It was and is yet to some extent, the custom to cram babies full of milk every two hours and feed them every time they cried between feeding times, and keep them purging and puking, until they finally became constipated, after which they would writhe and shriek with colicky pains. Then mother or nurse or even father would wrap them in hot clothes turn them on their little bellies across the attendant's knees and try to jounce the wind out of them. Paregoric, castoria, cathartics and other forms of drugging are frequently resorted to.
Tilden says: "Feeding starchy foods before the completion of the second year is the cause of stomach derangements. The sugar that is put into cereal foods causes children to fatten; the fermentation from starch and sugar fills the bowels with gas, and is one of the causes of pain in the abdomen, restless nights, the bed-wetting habit, and, in the nervous temperament, chorea or St. Vitus dance; and, neither last nor least, constipation."
Care of the Patient: The remedy for colic is: stop all feeding until comfort has, returned. Thereafter feed and care for the child properly. Relief can usually be induced by resting the infant on its abdomen.
Definition: This is a failure of the processes of digestion in the intestine and is often associated with gastric indigestion, though it may exist alone.
Symptoms: The only real symptoms of this condition are gas and distress in the abdomen, with perhaps diarrhea and constipation, and foul stools. The poisoning resulting therefrom is likely to cause symptoms anywhere in the body. Unless the indigestion is great no symptoms are likely to be felt.
Etiology: Gastric neurosis, diminished gastric tone, gastric dilatation, wrong food combinations, and emotional states that impede digestion may start up indigestion in the stomach. A failure of liver or pancreatic function or dilatation and lack of tone in the intestine, intestinal neurosis, emotional states, enervation and toxemia may result in indigestion in the intestine.
Indigestion means fermentation and putrefaction of food in the stomach and intestine. In the digestive tract, as elsewhere, these decomposition processes are results of bacterial activity and give rise to powerful poisons, which, if and when absorbed, cause trouble.
An excess of carbohydrates, if these undergo acid fermentation in the intestine, will give rise to symptoms of acid poisoning. Carbohydrate fermentation, with the formation of organic acids (such as acetic acid) and alcohol, is most likely to occur in the stomach. Lactose and maltose do not ferment so readily as sucrose and glucose. Yeast bacteria possess enzymes that break down the monosacchardies into alcohol, carbon dioxide, acetic, lactic, and butyric acids, and under certain conditions, hydrogen, methane, etc., gases.
Gastric neurosis is the chief cause of eructations, although these may occur from over distention of the stomach and from irritation of the stomach by the products of fermentation.
Protein putrefaction is most likely to occur in the intestine and colon. Putrefactive toxins are more virulent than those originating out of fermentation the first are septic, the latter are irritative.
Putrefactive bacteria break down proteins into amino acids and then further decompose these into simpler substances which cannot be utilized by the body and some of which are harmful if absorbed in considerable quantity.
Simple and septic infections are the chief results of indigestion. Starvation results from the failure of digestion to properly prepare the food for use. Starvation and Poisoning result from indigestion, whatever its cause.
Care of the Patient: it is necessary to remove and correct every cause of enervation, secure sufficient physical and Physiological rest to restore nerve energy and digestive tone and, thereafter, feed and live properly. Indigestion is usually quickly overcome.
Definition: This is obstruction of the intestine or colon. Two forms are described:
Acute Obstruction: This is caused by (1) strangulation, (2) intussusception (a slipping of a portion of the intestine telescope-like into the part immediately below it), (3) volvulus (a twist or knot of the bowel), (4) impaction of foreign bodies or gall-stones, (5) paresis of the intestine, (6) congenital malformation or stricture.
Symptoms: Sudden, distressing pain in the abdomen, at first paroxysmal, but later becoming continuous, constipation, which soon becomes absolute, vomiting persistent and ultimately of a stercoraceous character, abdominal distention, visible peristaltic waves, collapse, indicated by pinched features, sunken eyes, a cold clammy surface, and a frequent feeble pulse with death in forty-eight to seventy-two hours.
Chronic Obstruction: This may be due to (1) impaction of feces, (2) stricture, (3) tumors of the bowels or neighboring organs.
Symptoms: These usually develop gradually, acute symptoms occurring only when occlusion of the bowel is complete. The chief symptoms are abdominal distention, colicky pains, intractable constipation, and a gradual failure of health. Vomiting is rare. The stools are either ribbon shaped or in bard masses, and are sometimes coated with mucus and blood.
Care of the Patient: Acute intestinal obstruction is a definitely surgical condition or soon becomes so. A few cases are relieved by inflating the bowels with air, or by copious water or oil enemas. Most of them require immediate operation. For, unless the obstruction is speedily removed, death is certain.
Dr. Weger says: "In the chronic form, surprising results may .be looked for and cures are of common occurrence when intestinal fermentation and irritation are overcome by well-regulated diet and proper rest, plus exercise." The weight of intra-abdominal fat is an important factor in all obese persons. In such cases reduction of weight is essential to recovery. Fecal impactions may be removed by enemas; their recurrence may be prevented by removing the causes of constipation. Tumors are absorbed by fasting. A tendency of the bowels towards intussusception is overcome by restoration of good general health.
These are the same as those seen in the nose in catarrhal states and develop in prolonged chronic colitis. They are the result of chronic inflammation from toxemia. Fasting and a corrected mode of living remedy polyps in the rectum and colon the same as in the nose and vagina.
PTOMAINE POISONING (Botulism)
Definition: Poisoning by an alkaloid or basic product of putrefaction ptomaine. It is now customary to deny the reality of ptomaine poisoning and to blame germs for the "disease."
Symptoms: These usually start with a feeling of languor, perhaps headache, aching all over, and vomiting. Griping pains in the bowels are sometimes present, at other times there is a real cholera morbus. In some cases there is trembling almost equal to that of ague. There may be difficult breathing, a feeling of faintness and oppression over the stomach area. There are a coated tongue, foul breath, lack of desire for food, prostration and fever.
Etiology: Poisoning may result from taking decomposing food into the body or from decomposition of good food after it is taken in. It results from decomposition of animal foods.
Though ptomaine poisoning is commonly thought to be due to eating spoiled foods, the very best foods, if eaten too rapidly, or badly combined, or in too great quantities, or by one who is fatigued, or when overwrought emotionally, or greatly enervated from eroticism or any form of sensualism, are liable to decompose and produce ptomaine poisoning. It not infrequently happens that when wholesale poisoning follows a banquet, analysis of the food served fails to show anything wrong with the food. In all cases, only part of the eaters are poisoned. In such cases, the wrong food is examined. The spoiling of the food occurs after it is eaten. Autogenerated botulism (intestinal sepsis) is common, but is named something else. A large percentage eat too much, eat wrong combinations and eat when they should not. The resulting food poisoning passes unidentified. Tilden says: "Right combinations, and quantity within digestive limitations, are always safe, even if the food should be tainted. Much tainted food is eaten daily without poisoning; or the poisoning is so slight that it is not thought of. A cold, a slight sore throat, or a diarrhea may be the only inconvenience, and these will not show up except in the toxemic."
Meat Poisoning results from eating spoiled meats, or from decomposition of meat after it is eaten. Sausages, blood-pudding, "ripened" poultry, canned meats, etc., and especially imported sausages, are likely to produce ptomaine poisoning. Imported sausage has been known to produce death after lying in the bowels for a week after it was eaten. As a rule the poisoning comes on rapidly.
Ice Cream Poisoning: This occurs frequently during the summer months when large quantities of ice-cream are consumed. It is milder than meat poisoning nausea and vomiting, preceded by a chill, and sometimes diarrhea, are its chief symptoms.
Prognosis: Some cases of ptomaine poisoning are so virulent that the patient dies in a few hours. Most cases will recover if given proper care.
Care of the Patient: If the stomach does not empty itself by vomiting, the stomach pump should be used to empty it. The patient must be kept warm and no food allowed until the symptoms have entirely disappeared. Food given too soon sets up more poisoning, and a relapse, possibly with death, will follow. Or, some vulnerable organ will become chronically impaired. Tilden says, "if feeding is begun as soon as the patient is relieved, the symptoms may lead off into chronic gastro-intestinal disease, which may break down the constitution to such an extent that the patient will die in a year or two."
We have found no need for enemas and other means of "cleansing" the bowels. Discussing a case of ptomaine poisoning in a woman, Tilden says: "attempts at clearing the bowels had been very unsatisfactory until the seventh day; then the movement came because secretions were reestablished."
Definition: This is a condition of prolapse or falling of one or more of the abdominal viscera and is sometimes called "Glenard's disease." Prolapse of the intestines is known as enteroptosis; of the colon as coloptosis; of the liver as hepatoposis; of the spleen as splenoptosis; of the kidneys as nephroptosis.
"A pronounced general physical and nervous let-down is present in most cases," says Dr. Weger. "There is a lack of muscle and nerve tone, due to lack of exercise, to dietetic abuse, and incorrect habits of living. Prolapse of the stomach and intestines can be readily overcome when these habits are corrected, the burden of daily excess food lightened, and gaseous distention avoided by properly combining food. Normal tone must first be established by physiological rest."
Faulty positions in sitting and standing allow the organs to sag. Corsets weaken the abdominal support and permit sagging. Tilden says, "those who carry too much fat in the abdomen will after a time cultivate a sagging of all the contents of the abdomen and pelvis. The habits of wearing corsets too-close fitting is one of the leading causes. The habit of eating rapidly, and of too much starchy foods, ends in stomach dilation and depression." The use of laxatives, cathartics and large quantities of bulk in the diet is a cause.
In addition to the measures suggested above and the cultivation of proper posture, the exercises given in Vol. IV of this series should be faithfully followed.
AFFECTIONS OF THE LIVER
ABSCESS OF THE LIVER
Symptoms: Locally there is usually severe pain in the liver region and right shoulder. A circumscribed bulge may sometimes be seen below the ribs, though the enlargement of the liver is more often upward than downward. The liver is tender. Slight jaundice sometimes develops but is often absent. Constitutionally, chills, remittent or irregular fever, profuse sweating, marked anemia, and leukocytosis result from sepsis. Rupture into the lung is characterized by severe coughing and the expectoration of large amounts of pus, often of chocolate color, often mixed with blood. In some cases the condition runs a latent course and perforation offers the first symptom.
Complications: Perforation into the lung, peritoneum, stomach, pleura, pericardium or vena-cava, intestine, or externally, may occur.
Etiology: This affection is rare in the United States, as it is seen chiefly in the tropics. It may result from traumatic injury, embolism, or pyemia, the pus being brought to the liver from abscesses elsewhere in the body. Parasites are supposed to pass from the intestine through the gall duct to the liver and cause some cases, while stones give rise to other cases. Probably many cases evolve out of the extension of gastro-intestinal catarrh to the liver. In all cases enervation and toxemia brought on by wrong life, are primary.
Prognosis: Death results from septic poisoning, or from perforation into the lung, peritoneum, stomach, pleura, pericardium, or vena cava. Recovery may follow spontaneous rupture into the stomach, bowels, lungs or externally. Recovery also sometimes follows surgical drainage. Dr. Tilden says he has seen cases discharge "pus through the lungs for fifteen years before they died of pyemia or some other disease induced by pus poisoning."
Care of the Patient: "While it is an up-hill affair," says Tilden, "and takes years, yet, if the patient is not too old when the disease takes hold of him, he may live to see the end of it." We have found that physical, mental and physiological rest bring great relief in these cases, while nothing but benefit comes from efforts to relieve the body of the ever-present encumberance of toxemia. Aside from this, "diet and surgery are the only treatment."
ACUTE YELLOW ATROPHY (Icterus Gravis)
Definition: A very rare and grave pathology of the liver characterized anatomically by rapid destruction of the liver tissue.
Symptoms: The early symptoms are those of catarrhal jaundice. Nervous symptoms (cholemia) severe headache, maniacal delirium, stupor, and coma soon follow. The urine is scanty, hemorrhages from the mucous membrane and into the skin are common, fever is rare.
Etiology: This pathology develops largely between the ages of twenty and thirty, more often in women than in men, and most often during pregnancy. It appears to grow out of a preceding severe acute inflammation of the liver or to be grafted onto cirrhosis (hardening) of the liver. Alcohol and emotional disturbances seem to help produce the condition. As it never develops in, a healthy liver we may say the general causes of ill health produce it.
Prognosis: This condition is said to rarely last longer than a week or ten days and recoveries are extremely rare. Weger says, "if the entire organ is not involved in the degenerative process, fairly satisfactory function may be maintained in that part not broken down. "
Care of the Patient: Doubtless the suppressive (symptomatic) treatment employed helps to account for the rarity of recovery. It is an "organic disease" and Weger says, "absolute cures are impossible in organic liver disease."
Complete physiological rest is all that can be employed until the symptoms have subsided, then "right living stays the process of degeneration, and comparative comfort and long life may be anticipated by those who recognize and respect their food and other limitations."
AMYLOID LIVER (Waxy Liver)
Definition: This condition, also, called lardaceous liver, is an enlargement of the liver due to the deposition therein of a peculiar albuminoid substance.
Symptoms: The chief symptoms obvious to the layman are pronounced anemia and emaciation. Jaundice and ascites are rare. The examiner finds the liver to be uniformly enlarged, smooth, firm and pointless, with a rounded edge. The spleen and kidneys almost always share in the degeneration, so that the spleen is enlarged and hard and the urine contains albumen and tube-casts.
Etiology: This condition develops as a complication of some prolonged suppurative process, especially that resulting from tuberculosis, and involving the bones. It is sometimes seen in malarial cachexia.
Prognosis: Recovery depends upon recovery from the suppurative process or the malaria. Recoveries are not frequent.
Care of the Patient: Primary attention must be given to remedying the primary pathology see tuberculosis, and malaria.
CARCINOMA OF THE LIVER
Definition: This is cancer of the liver.
Symptoms: Digestive disturbances are a prominent feature and usually precede the hepatic symptoms. Jaundice is common, but rarely intense. Cachexia is pronounced and develops rapidly. The liver is enlarged and painful and often presents one or more smooth, hard nodules. Ascites sometimes results from obstruction of the portal circulation. Toward the end, hepatic intoxication manifested by slight fever, delirium, stupor, and coma may develop.
Etiology: See cancer.
Prognosis: In the writer's opinion this is one of the most rapidly fatal forms of cancer. It is also our opinion that fasting in this condition hastens the end.
Care of the Patient: See cancer.
Definition: This term is used to designate a grave intoxication which sometimes develops in severe forms of jaundice and in the terminal stages of pathology of the 'liver, even in the absence of jaundice.
Symptoms: These symptoms are supposed to be due to retention in the blood of poisons that are normally rendered non-toxic by the liver. They may result from intoxication from any source.
CIRRHOSIS OF THE LIVER
Definition: This is hardening of the liver due to an increase and thickening of its connective tissue. Several forms are described as: atrophic cirrhosis, which is hardening with wasting of the liver; hyper-trophic cirrhosis, which is hardening with enlargement of the liver; alcoholic cirrhosis, which is hardening caused by alcohol; capsular cirrhosis (chronic perhepatitis), which is hardening of the investing membrane of the liver; "syphilitic" cirrhosis, which is hardening accompanied by the formation of gummata, or little tumor-like masses attributed to "syphilis."
Symptoms: Medical authorities tell us that this, like many other pathologies of the liver often reaches full development without presenting many symptoms; but it is the Hygienic position that the premonitory or primary symptoms have been present for years but have been ignored or unnoticed. For years there have been furred tongue, irregular bowels, occasional vomiting of mucus, gastritis with symptoms of indigestion, engorgement of the blood vessels in the region of the stomach and liver, even hemorrhage from the stomach and esophagus. How can one drink alcoholics for years, or use pepper (which hardens the liver quicker than alcohol) for years without showing symptoms of irritation of the stomach and tumefaction of the liver? Years of over eating of starch, sugar and fat also help to build cirrhosis of the liver and. this form of imprudence always presents symptoms for years before the hardening develops.
Complications: Ascites, general dropsy, hemorrhages into the skin and mucous membranes, hematamesis, enlargement of the superficial abdominal veins, with such symptoms of "hepatic intoxication" as delirium and coma, are common in advanced stages of cirrhosis.
Prognosis: Perhaps all cases end fatally, in one way or another, but the course of the affection may run from five to ten years.
Care of the Patient: Tilden says: "There is not much to be done. Patients may be tapped and water taken off, which will give relief for a short time; but the water certainly will return. The time for curing the case has passed, perhaps many years ago. When the liver is so organically disorganized and the auxiliary organs of the body are so deranged as in these cases, there is nothing to be done, except whatever palliation may be required to give the patient temporary relief." It is obvious he is talking of the late stages of the pathology. It is fortunate, to quote Weger that "if the entire organ is not involved in the degenerative process, fairly satisfactory function may be maintained in that part not broken down. Right living stays the process of degeneration and comparative comfort and longer life may be anticipated by those who recognize and respect their food and other limitations," who give up alcoholics, pepper, etc.
CONGESTION OF THE LIVER (Hyperemia)
Definition: Hyperemia of the liver means simply an excess of blood in the liver short of inflammation. Two varieties are described as follow:
Symptoms: Active. This results from an excess of blood being sent to the liver. The liver is enlarged, somewhat tender, there is a sense of fullness or actual pain in the region of the liver and there may be slight jaundice. Such digestive symptoms as nausea, flatulence, anorexia, headache, and pain in the stomach region may also exist.
Passive. This results from obstruction to the venous circulation so that blood is not carried away from the liver fast enough. It is seen in chronic heart and lung affections. The symptoms are much the same as active hyperemia, but frequently there is ascites. The liver is quite large and in extreme cases, such as follow certain heart impairments (tricuspid regurgitation), the liver may pulsate.
Etiology: Active hyperemia may be due to over eating, especially of sugars and fats, gastro-intestinal autointoxication, alcoholic indulgence, etc., or it may be present in "infectious fevers." Passive hyperemia, as pointed out above, depends upon circulatory obstruction by pathology elsewhere. Hence, its basic causes are those enervating factors that produce toxemia and the primary pathology.
Prognosis: In simple congestion (active hyperemia) the prognosis is good. In the passive form the prognosis depends upon the curability of the heart or lung condition.
Care of the Patient: For simple congestion, fasting followed by proper eating and abstinence from alcohol are all that are required. In passive hyperemia care for the patient as described under heart and lung affections.
Definition: This is a condition due to fatty infiltration or to fatty degeneration of the liver.
Symptoms: It is said of these that they may be absent and are never marked; but it is highly improbable that this condition can develop without many symptoms preceding and accompanying it. They are probably not recognized for what they are. Stools may be light colored due to lack of bile, but this would not be so in the early stages of the development. There is no jaundice and only rarely are there signs of portal obstruction. The liver is uniformly and often greatly enlarged.
Etiology: Fatty infiltration is seen in obesity. Fatty degeneration develops in cancerous and tubercular states, or in chronic wasting pathologies, severe anemia, prolonged use of alcohol, and other poisons such as phosphorus, and in acute yellow atrophy of the liver.
Care of the Patient: Since this condition is always secondary to other pathologies, care must be directed to the removal of the causes of these pathologies. See these "diseases" under their own heads.
HYDATID CYST OF THE LIVER
Definition: This is a cyst formed around the dog tape worm taenia echinococcus. The condition is common in Iceland, Australia and certain parts of Europe, but is rare in America.
Symptoms: Small cysts produce no symptoms. Large ones produce an irregular enlargement of the liver with a sensation of weight or fullness in the liver region. Fever, pain, and jaundice are usually absent.
The cyst may become quiescent after attaining, a certain size; or a trifling injury may convert it into an abscess; or it may rupture into adjacent organs terminating either in death or in recovery.
Etiology: The eggs of the worm find their way into the stomach through food or drink, where, if secretion is impaired, they hatch, liberating the embryos in the digestive tract. From here they are supposed to find their way through the gall ducts into the liver, where they are encapsulated and rendered harmless. It is this capsular wall and its worm contents that constitute the cyst.
Prognosis: Good in most cases.
Care of the Patient: Other than general health-building measures to increase resistance, surgical removal of the cyst is all that can be done.
This condition, seen more often in women than in men, occurs largely as a part of enteroptosis.
SYPHILIS OF THE LIVER
According to medical superstitions about this protean monster, "syphilis" "attacks" every tissue in the body. We may ignore this fiction and direct our care of the patient without reference to "syphilis," but to the removal of the causes of all pathology present in his body.
AFFECTIONS OF THE BILE PASSAGES AND GALL-DUCT
Definition: This is inflammation of the bile ducts. Two forms are described as follow:
Catarrhal Cholangitis (catarrh of the bile duct, catarrhal jaundice) may be either acute or chronic.
Symptoms: Acute. Symptoms of gastro-intestinal catarrh coated tongue, foul breath, loss of appetite, pain in the stomach region, vomiting, perhaps diarrhea usually precede symptoms of obstructive jaundice which is indicated by yellow skin and conjunctiva, light stools and dark urine. In some cases there is slight fever with swelling and tenderness of the liver.
Chronic. Often jaundice is chronic, usually developing gradually without pain and increasing steadily from week to week, while the gall bladder increases in size, are seen in compression of the common duct by a tumor or by scar tissue. Persistent jaundice of varying intensity, preceded by colicky pains, and accompanied by ague-like paroxysms of fever, chill and sweat is seen in obstruction of the common bile duct by stones.
Etiology: Acute cholangitis is met with largely in young adults as an extension of gastro-intestinal catarrh and after so-called "infectious" fevers. It is, in other words, the outgrowth of toxemia and indigestion. Chronic cholangitis sometimes results from repeated acute crises, but is thought to more often result from obstruction of the common bile duct by stones, scars, tumors, etc. As these are of toxic origin, we may regard toxemia as the basic cause.
Prognosis: Acute cholangitis usually recovers in two weeks or less. The chronic form may last for years. Recovery depends upon removal of its exciting cause.
Suppurative Cholangitis: This is suppurative inflammation of the biliary ducts.
Symptoms: Fever, chills, sweats, with jaundice, local discomfort or actual pain, enlargement of the liver, perhaps also of the spleen, and emaciation with, generally, distention of the gall-bladder from concomitant cholecystitis, accompany this condition.
Etiology: Suppuration of the gall-duct is generally a sequel to gall-stones or to obstruction of the gall-duct by tumor. It occasionally follows maltreated pneumonia or typhoid or a similar biogony.
Prognosis: This affection is considered grave and surgery is thought to offer the "only chance of cure." This is not Hygienic experience.
Care of the Patient: Cholangitis is, primarily, a catarrhal condition, an extension of gastro-intestinal catarrh, growing out of toxemia, and care should be directed to elimination of the toxemia and clearing up of the catarrhal condition. Fasting, rest and a corrected mode of living will accomplish this. Even suppurative cholangitis will, in most instances, terminate in recovery when the toxic load is taken off the organism and normal metabolism restored.
Definition: This is a catarrhal inflammation of the gall-bladder.
Symptoms: In simple catarrhal cholecystitis the symptoms are slight fever, pain in the liver region, tenderness and enlargement of the gall-bladder, occasionally jaundice. In the suppurative form, severe paroxysmal pain, vomiting and fever of the septic type chills, fever, sweats are added to the above symptoms.
Etiology: This represents an extension of gastro-intestinal catarrh and is founded on a basis of toxemia.
Suppuration may result from irritation by gall-stones or it may follow or accompany so-called "acute infectious fevers."
Prognosis: Catarrhal cholecystitis ends in from one to two or, at most, three weeks, sometimes leaving adhesions, Suppurative cholecystitis requires longer time for recovery.
Care of the Patient: Dr. Weger says, "Mild cases terminate rapidly under rational treatment. No food should be given. Severe cases may terminate in the formation of an abscess which rarely ruptures. If correctly handled the tendency is toward resolution and recovery." Elimination of toxemia through fasting and rest, followed by a correct mode of living assures recovery.
Definition: These are stones that form in the gall bladder or gall ducts. They are also called biliary calculi, or cholelithiasis. There may be one or several hundred. Their sizes range from that of a grain of sand to that of a large walnut.
Symptoms: Gall stones may give rise to no symptoms. A large number of people examined at autopsy are found to have gall stones of which they bad never been aware. In other cases there are merely continued or recurring indigestion with ill-defined pains in the upper part of the abdomen.
Most stones cause no trouble; they are small enough to pass out without causing pain. Others, being too large to pass out, remain in the gall bladder. Others, small enough to pass into the bile-duct, but too large to pass with ease are, in consequence of violent expulsive efforts excited by irritation of the gall-bladder, extruded into the intestine, intense pain (biliary colic) marking their passage through the ducts. A stone may easily travel through the common duct, but may be forced, with extreme difficulty, through the small opening of the duct into the intestine. This causes severe pain. As soon as the stone drops into the intestine the pain ceases and the sufferer is sure that it was the last treatment he employed that cured him.
Symptoms of Biliary Colic: Intense pain sets in suddenly and radiates from the liver region to the right shoulder. Tenderness and rigidity are usually present over the gall-bladder. Chill and fever (102 - 103 F.) are often present at the beginning. Anxious face, cold sweat, feeble pulse and vomiting indicate the intensity of the pain. Jaundice may follow obstruction of the gall duct, but it is often absent. The pain may last from a few hours to several days.
Complications: Stones may become impacted in the cystic duct, or, more often in the lower part of the common duct, causing obstruction. Putrefaction may occur causing the stone to pass into the duodenum, peritoneum, lung, stomach, or kidney, or externally. Perforation into the duodenum is often a cause of intestinal obstruction. The irritation of the gall bladder caused by the presence of stones may result in suppurative cholecystitis or cholangitis. Or, the prolonged irritation may lead to cancer of the bile passages.
Symptoms of Obstruction of the Cystic Duct: The subjective symptoms are slight and there is no jaundice. The chief symptom is a pear-shaped, elastic movable tumor (the gall-bladder), projecting from the lower margin of the liver.
Symptoms of Obstruction of the Common Duct: In typical cases there is chronic jaundice which shows marked variation in intensity, pain, which is also subject to distinct exacerbations, recurrent crises of intermittent fever, chills and sweats. The liver is not enlarged, the gall bladder is rarely distended, but is often atrophied from prior catarrhal crises (cholecystitis). The obstruction may persist for, years and not infrequently leads to suppurative angiocholitis, to obstructive biliary cirrhosis, or to acute or chronic pancreatitis.
Etiology: As intestinal catarrh increases, it extends up the bile duct into the gall-bladder where catarrh, then inflammation of the gall-bladder, develop and then gall-stones form. In the liver and gall bladder as in the lungs, kidneys, pancreas, etc., stone formation is the end-result of inflammation and probably serves some useful purpose.
The patient with gall stones has a general catarrhal state, involving the liver, and perverted digestion and assimilation. The liver function is so impaired that the chemistry of the bile is changed, allowing precipitation of its mineral elements, forming stones. When the liver and kidneys fail in their chemical, functioning and minerals are no longer held in solution or excreted, they are deposited, causing, arteriosclerosis, gall stones, kidney stones, and stones elsewhere in the body. The general health of the person gradually declines, the stomach complains more and more, the skin manifests more and more of the dysemic condition of the blood and, if the condition and its cause is not recognized in time, a stage of pathology is reached where no care will help.
A mild, but continuous pathological process going on in the liver or gall-bladder may result in the very slow and unrecognized formation of stones until the gall-bladder is so full of stones that there is no room for more. The inflammation may be so light that there is no attempt to expel them, hence the usual pain may be absent.
A metabolic perversion growing out of wrong life is back of every case of gall stones. People who over-eat and neglect exercise tend to have gall stones. The obese are much more likely to have gall stones than thin persons. Their love of carbohydrates, and especially of sugars, tends to build the catarrhal condition of the gall bladder that forms the local condition essential to the formation of stones. Women past middle life are more likely to develop stones than men, perhaps because they are less active.
Prognosis: In the absence of the above complications the prognosis is usually good.
Care of the Patient: Tilden says: "When the catarrh of the liver is overcome, secretions become normal and stones disintegrate and pass out through the gall-ducts into the bowels, and then out of the body. No treatment, no surgery, is necessary." "A correct treatment," he says, "will be directed to removing the cause or causes of toxemia."
Removing the stones does not restore normal liver function, hence more stones will form after their removal. Draining the gall-bladder does not improve the body's nutrition. Removing the gall-bladder does not correct the catarrhal inflammation that caused the stone formation.
There can be but one cure for gall-stones. This is: restore the normal functioning of the liver so that normal bile will be secreted; then the normal bile will cause the stones to disintegrate and pass out. Correction of the inflammation makes gall-bladder drainage or extirpation unnecessary. Correction of gastro-intestinal catarrh renders surgical exploitation of the whole digestive canal unnecessary. The undesirable finish pictured under etiology may be avoided by correct living. Although physicians and surgeons are so unfamiliar with cause that they believe surgery alone can help and usually recommend this, the great army of post-operative invalids one sees everywhere attests that no real cure comes from this spectacular treatment. Operations leave cause at work, hence more pathology develops.
Weger says: Given proper assistance the chemistry of the body can be so altered that stones soften, disintegrate, and pass out with but slight discomfort. We have treated many cases and. seldom have we found it necessary to resort to surgery. It is a remarkable fact that softening occurs very rapidly on a complete fast. Frequently patients coming for treatment for different ailments develop hepatic colic from the eighth to the tenth day of fasting. In these the presence of gall stones may never have been suspected. The same is true of stones in the kidney. In recurrent attacks there is no treatment in the intervals to equal a diet restricted to fresh fruits, salads and cooked non-starchy vegetables. It can be safely predicted that there will be no recurrences in those patients who follow instructions as to diet and exercise. In most instances if the gall stone is not larger than a small olive it will become soft and pass out without resort to surgery and its consequent risks. The exceptions are in those run-down people who have no reserve vitality or courage left to sustain them for a reasonable time while nature is establishing a normal chemical balance. Extreme caution and conservatism on the part of the physician is necessary in determining the proper course in a given case. The process of recovery may seem slow but it is in reality marvelously rapid, compared with the long time it takes for the stones to form. * * * Without recourse to olive oil, bile salts, and the one hundred and one remedies that are generally prescribed, our percentage of non-surgical recoveries is so high as to warrant a favorable prognosis if the patient cooperates in the removal of the first cause."
Definition: This is a symptom, not a "disease," and consists of discoloration of the skin, conjunctiva and other mucous membranes and the urine and secretions with bile. Four types are described as follow:
Obstructive Jaundice: This is jaundice resulting from obstruction of the gall ducts from within by catarrhal or suppurative inflammation of the wall of the duct, or of the intestinal mucosa at the mouth of the common duct, stricture or occlusion of the duct, gall-stones or parasites, tumors of the wall of the duct, or by pressure from without by tumors of the liver, pancreas, stomach, kidney, lymph nodes, or uterus, or aneurysm, or impacted feces.
Symptoms: The skin and conjunctiva vary from pale lemon-yellow to dark olive or greenish-black. There may be slight or intense itching especially in chronic cases. Sweating, often confined, to the palms, axillae, or abdomen, is common. The sweat and less often the saliva, bronchial mucus, tears and milk may be yellowish, even before the skin and conjunctiva become discolored. If more than a trace of bile is present it colors the urine light greenish-yellow to blackish green. Due to lack of bile, the stools are of a pale slate color, are often pasty, of offensive odor and accompanied with flatulence and constipation or diarrhea. The pulse is slow sometimes 40 or even 20, the respiration is normal, or it may be slowed in proportion to the pulse. Languor, depression, irritability and headache are common.
Complications: Boils, urticaria and other skin affections may develop and, in chronic cases, distention or dilatation of blood vessels in the skin and mucous membranes occurs. In chronic or severe cases hemorrhages into, the skin or mucous membranes are more or less serious. Visual disturbances may occur. In persistent cases coma, convulsions, or delirium may occur.
Etiology: Jaundice is a symptom depending upon a great variety of obstructive causes, as pointed out above. Catarrhal inflammation of the intestine and bile duct may cause enough obstruction to cause jaundice. Stricture caused by inflammation may cause this symptom to develop. The tissues of the entire body are involved in the coloring. Basically it all goes back to toxemia and its forerunner, enervation. When these are removed, most cases of jaundice get well.
Prognosis: Acute cases may recover in a few days or weeks; chronic cases may last for years; Recovery depends upon removal of the obstruction.
Toxemic or Hemolytic Jaundice: This is a form of jaundice due to destruction of the red blood cells.
Symptoms: These are likely to be less marked than in obstructive jaundice, but in some cases cerebral symptoms, jaundice and hemorrhage are intense. Fragility of the red cells may be increased.
Hemolytic jaundice Is blamed upon excess functioning of the spleen, which is supposed to pour out its chemicals in such excess that it results in rapid demolishing of the red cells. The rapid break-down of red cells sets free a large amount of hemoglobin in a short time. The hemoglobin is utilized in producing bile pigment. The spleen is only slightly swollen, but a blood-check will usually show the red cells to number between one and two million less than normal.
Etiology: Hemolytic jaundice is due to a septic state which develops out of mal-practice. If typhoid fever, yellow fever, malaria, relapsing, fever, pneumonia, scarlet fever, etc., are drugged and fed, septicemia will develop and jaundice will follow as a complication. Arsenic, phosphorus, snake venom, toluylendiamin, and other poisoning will also produce hemolytic jaundice.
Prognosis: This depends upon removing the causitive factor.
Icterus Neonatorum: This is jaundice of the new born, or infant, and often develops within the first week after birth. Approximately twenty per cent of babies develop jaundice in the first week of life. Two types, (1) physiologic and (2) pathologic, are described.
Symptoms: Physiologic. In a day to a few days, from the second to the fifth being the usual time, after birth the baby begins to turn yellow and the parents become alarmed. The eyes become yellow and the urine is discolored. There are rarely other symptoms. The discoloration gradually grows greater, then gradually disappears. Its average duration is three to four days, although it may last longer, even two weeks. The general health of the baby is unimpaired and jaundiced babies fare as well as others.
Prognosis: The condition is not serious, is never fatal and requires no treatment.
Pathologic: This form is very marked and is very frequently fatal.
Etiology: The physiologic type is thought to be due to the passage of a part of the portal blood rich in bile pigments directly into the vena cava, which remains open for several days after birth. It is our opinion that it is a true obstructive jaundice and is due to a catarrhal condition of the bile duct. The pathologic form is due to congenital strictures of the bile duct, or results from septic infection.
Alcholuric Jaundice: This is the term applied to a form of jaundice in which there is discoloration of the skin and conjunctiva but no bile in the urine.
Symptoms: Besides the persistent discoloration there is enlargement of the spleen, moderate anemia, recurrent acute indigestion or abdominal pain, with but little or no enlargement of the liver. The stools are well colored.
Etiology: This condition is thought to be due to increased fragility of the red cells and may first appear in adolescence. The fragility of the red cells must be accounted for and toxemia, perhaps, complicated by dietary deficiency must be back of this.
Prognosis: This condition is rarely fatal, but often very persistent.
Care of the Patient: As jaundice is only a symptom, care must be directed to removing the causes of the pathology that is responsible for the jaundice. Fortunately, in most instances this will effect a cure. In the advanced organic pathologies cancer, stenosis, abscess, etc. this is not always possible. Surgery may sometime aid in some cases of obstructive jaundice.
Tilden says: "In gall-stone obstruction the feeding of eliminating foods, such as fruit and raw vegetables, will in a reasonable time bring about a disintegration of the stone in the gall-bladder. Then there will be a passing into the bowels of the sand that results from the disintegration; and, if this style of eating is persisted in, that patient will make a complete recovery. Where the obstruction is due to catarrhal inflammation of the gall-duct, proper feeding will overcome it."
In severe cases, fasting will be necessary. There need be no fear of fasting babies if jaundice is severe.
AFFECTIONS OF THE PANCREAS
CANCER OF THE PANCREAS
Pancreatic cancer is seen most frequently in males past forty. Its symptoms are digestive disturbances, rapid loss of weight and strength, anemia, severe deep-seated pain in the stomach region, and the presence of the tumor. The pain often occurs in paroxysms, especially at night, and may be associated with symptoms of collapse. Frequently there is enlargement of the gall-bladder with progressively increasing jaundice, resulting from pressure upon the bile duct. Pressure on the portal vein may cause ascites. Sugar is sometimes found in the urine and in some cases much free fat and numerous undigested muscle-fibres are found in the stools. The above symptoms belong to the terminal stages of cancer, at which stage the condition is incurable. See chapter on cancer.
CYSTS OF THE PANCREAS
Cysts of the pancreas are divided into three groups as follow:
Retention Cysts resulting from impaction of a calculus, stricture or tumor.
Traumatic Cysts resulting from hemorrhagic extravastation.
Proliferation Cysts formed by carcinomatus are edenomatous tumors.
Symptoms: These vary. The most common are deep-seated pain in the stomach region, digestive disturbances, vomiting and emaciation. If the cyst presses upon the bile duct, jaundice occurs; if it presses upon the portal vein ascites develops. Sugar is sometimes found in the urine and free fat and undigested muscle fibre may be present in the stools. A smooth, round, fluctuating tumor may often be felt in the upper part of the abdomen.
Etiology: The immediate causes are given in the classification above. Toxemia and chronic pancreatitis are back of these immediate causes.
Care of the Patient: Fasting and a complete revolution in the mode of living will sometimes result in the absorption of the cyst. In other cases it will be reduced and the symptoms end. Where this fails, surgery is the only other recourse. It should be the last, not the first, recourse.
Definition: This is inflammation of the pancreas and is divided into hemorrhagic, gangrenous, and suppurative varieties. It may be either acute or chronic. It is comparatively rare.
Symptoms: Acute. Symptoms begin very suddenly, with violent pain, like colic, in the upper part of the abdomen. This is followed by nausea and vomiting. There is distention of the stomach region, localized tenderness and rigidity, vomiting of bile-stained mucus, or occasionally, of bloody material and symptoms of profound collapse. There is slight jaundice and often diarrhea, though constipation is the rule.
Death usually occurs in from one to three days, but occasionally the severe symptoms diminish and necrosis (gangrene) or suppuration sets in and may last several weeks or months. This change is indicated by irregular fever, progressive weakness and emaciation and a tumor mass in the stomach region. Jaundice and chills may also occur.
Suppurative pancreatitis may develop gradually and for many months the only symptoms may be abdominal pain and digestive disturbances.
Chronic. Symptoms are obscure. Dyspepsia, gas, paroxysmal pain in the stomach region, a tendency to diarrhea, slight jaundice, and progressive emaciation are the usual features. If the Islands of Langerhans are involved symptoms of diabetes develop, otherwise sugar in the urine is rare.
Prognosis: Chronic pancreatitis runs a slow course and, unless complicated with diabetes, may end in recovery.
Etiology: Intestinal catarrh extends up the pancreatic duct into the pancreas giving rise to pancreatitis and, finally, diabetes. Acute pancreatitis is doubtless a septic infection; this is to say, sepsis generated by gastro-intestinal putrefaction sets up severe inflammation in the pancreas. Inebriety and the use of coffee, tea, tobacco, etc., may be considered as causes. It is thought that injury as from a blow on the abdomen may be a cause in some cases. These cases must be heavily toxemic for a blow to result so seriously.
Chronic pancreatitis may also result from extension of intestinal catarrh or pyloric ulcer, it may follow acute pancreatitis, or result from obstruction of the pancreatic duet by stones, from alcoholism, or from sclerosis of the pancreatic arteries. Toxemia and autointoxication are present in all cases.
Prognosis: This is not very favorable. Recovery may occur upon rupture of the abscess into the bowel or it may subside into chronic pancreatitis. Perhaps surgery will be of assistance in a few cases.
Care of the Patient: If fasting does not bring immediate relief from symptoms in acute pancreatitis, a surgeon should be called.
The care in chronic pancreatitis must eliminate toxemia, restore normal nerve energy and correct digestion and assimilation. So long as there is pain and discomfort no food should be taken. After toxemia has been eliminated and comfort has returned, fruits and vegetables should constitute the diet.
It may truly be said of pancreatitis: it is better prevented by right living than cured by any kind of program.
Definition: This is stones in the pancreas.
Symptoms: Pancreatic colic, which resembles biliary colic, except that the pain is more likely to radiate to the left and is usually unattended with jaundice, develops when the stone is forced through the pancreatic duct. Sugar in the urine, fatty stools and the discovery of stones containing chiefly carbonate or phosphate of lime in the stools confirm the diagnosis.
Etiology: Catarrh of the pancreatic ducts, an extension of gastro-intestinal catarrh, with stagnation of the pancreatic secretions, results in stone formation.
Care of the Patient: Same as that for gall-stones, which see.
AFFECTIONS OF THE PERITONEUM
Definition: An abnormal joining of parts to each other.
Symptoms: Pain and discomfort are the usual symptoms complained of. Most adhesions produce no symptoms.
Etiology: Adhesions result from inflammation. They frequently follow abdominal and pelvic operations in the thoracic, abdominal and pelvic cavities
Care of the Patient: Every operation for adhesions leaves more adhesions than it finds. Most of the symptoms complained of are due to indigestion and gas. These should be cared for as directed elsewhere. The claim that adhesions may be broken up by massage is not well founded. Fasting has been known to cause adhesions to end it is well to know that adhesions rarely cause any trouble.
Definition: This is an accumulation of serous fluid in the peritoneal cavity dropsy of the abdomen.
Symptoms: General enlargement of the abdomen, sometimes starting with puffiness of the feet and ankles is the characteristic symptoms. Care must be made to distinguish between ascites and pregnancy and ovarian tumor in women.
Etiology: Ascites is due to blockage of the portal vein by hardening or enlargement of the liver, pressure by tumor or cancer, inflammation, etc. It is a byproduct of pathology of the liver, pancreas, peritoneum, etc. It develops largely at the distal end of these pathologies, hence is usually hopeless.
Prognosis: A reasonable degree of health may be restored only in cases that have not evolved to a desperate stage of Pathology. Others will all die. Where it is due to cancerous extension there is no hope.
Care of the Patient: In non-cancerous cases that have not evolved to a hopeless stage, fasting will give relief; in fact, fasting offers the only hope of restoring health. Surgical drainage of liver abscess, if this is the cause, or surgical removal of tumor or cyst may help to restore health in a few apparently hopeless cases. If due to peritonitis recovery will follow recovery from peritonitis. Opening the peritoneum and washing it out is said to offer small hope if peritonitis is extensive in hopeless cases drawing off the fluid gives temporary relief. The abdomen will fill up again.
See Volume IV of this series.
Definition: This is inflammation of the peritoneum or membrane lining the interior of the abdominal cavity and surrounding the viscera. The inflammation may be general or localized.
Symptoms: Intense abdominal pain and tenderness are the most prominent symptoms. Breathing is shallow and costal. The features are pinched and the expression is anxious; The abdomen is distended and its walls rigid. To relieve the tension on the abdominal muscles, the subject lies motionless on his back with the legs and thighs drawn up. Moderate fever (102 to 104 F.) with small, rapid and "wiry" pulse, are usually accompanied by constipation, while vomiting and hic-coughing are common. In severe cases rapid collapse, indicated by fall in temperature, rapid, feeble pulse, suppression of the urine and a cold, clammy surface, ensues.
Etiology: Primary peritonitis is very rare and may result from trauma, or a "rheumatic" state, superadded to toxemia.
Secondary peritonitis is an extension of inflammation elsewhere of any of the viscera of the chest, abdominal cavity and pelvis. Simple inflammation, or abscess, of the liver may extend to the peritoneum. Cancer of any part of the three cavities of the trunk may result in peritonitis. Peptic ulcer, ulcer of the bowels, colitis, muco-colitis, appendicitis, typhilitis, ovarine and uterine inflammation, septic inflammation of the uterus following childbirth or abortion, may extend to the peritoneum. External abdominal wounds may perforate the peritoneum. The condition is also seen in some severe forms of typhoid.
Prognosis: This is usually good in localized peritonitis. In generalized peritonitis the outlook is always grave; perforative cases are particularly grave. Tilden says: "In septicemia, following childbirth or abortion, intense pain in the abdomen, quick pulse, flushed face, preceded by rigor, means a fatal case, unless it is quickly comprehended and the right treatment used immediately."
Care of the Patient: Peritonitis means septic infection of the peritoneum. The general care must, therefore, be the same as for sepsis infection elsewhere rest, fasting, warmth. Since peritonitis is almost always secondary to other inflammations, care must be as directed under these other affections.
In general it is felt that perforation by an ulcer of the stomach or intestine, or the rupture of an abscess of the liver or of the appendix into the peritoneal cavity will cause a fatal peritonitis unless the abdomen is opened immediately and thoroughly washed out. In 1927 Dr. Win. Howard Hay wrote me that he had "had nothing but complete recoveries in approximately 250 cases (of appendicitis), which list includes thirteen perforations with abscess," and this without resort to surgery. Weger says of peritonitis, "here again, we emphasize the rarity of such diseases in people who live normal lives, who keep their resistance high and their toxins low."
Symptoms: There is slight, or no, fever; pain is not severe, but is frequently paroxysmal. More or less diffuse tenderness is present. Often there is marked anemia and emaciation. The abdomen is usually distended.
Etiology: Most cases are supposed to be tuberculous or cancerous. Some cases are sequels to acute peritonitis. A few cases result from extension of inflammation in the pelvis. Many cases follow abdominal operations.
Prognosis: Simple peritonitis usually ends in recovery, especially in children. Tuberculous peritonitis often recovers. Cancerous peritonitis is always fatal.
Care of the Patient: Care must depend on the primary trouble cancer, tuberculosis, uterine and ovarine inflammations, etc. See these affections.
| Success of DETOXIFICATION = failure of drugs and other toxins |
To learn more about drug-free healing, and the failure of drugs - read this article by Dr. Shelton: HOW DISEASES ARE CURED|
"What does the average individual know about keeping well? Almost nothing."
| Examples of Remarkable Recoveries |
Free download:- Dr. S Bass: REMARKABLE RECOVERIES FROM SEVERE HEALTH PROBLEMS - booklet presenting how raw foods and juices have been used clinically in medical institutions for over 150 years to help patients detoxify, and recover from cancer and other diseases.
(Note: this detox method is excellent for self-help. While fasting requires professional help for optimal results.)
| SELF-HELP NOTE |
This summary of diseases by Dr. Shelton is somewhat technical, and mainly compiled for doctors. For the basics of self-healing click here, or read the articles on this website. For self-help, read what doctors of Natural Hygiene & Orthopathy have written for 175 years, much of it is online. E.g. at soilandhealth.org (the Health Library) and non-profit INHS..
About the newest developments in drug-free healing & Natural Hygiene - e.g. primitive diets and the insulin mechanism - click here.
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