To understand this one must have some appreciation of the general character of the great masses of medical books that crowd the shelves of ever-growing medical libraries at home and abroad. Practically all these books are by physicians for physicians and it is almost impossible to find one written down to the comprehension of even the intelligent layman, who cannot understand the medical terms used, many of which are long Greek or Latin derivatives. If the reader stops to consider why this is so, the conclusion will probably be reached that the language of science is frequently not comprehended by the non-scientific, and further that the doctor who makes his living treating diseases can hardly be expected to possibly lessen the value of his services and the dignity of his position by baring his knowledge and its mysteries to his patients.
Of so-called non-professional health books there is apparently no end. They have been rather severely characterized as a weariness of the flesh, frequently written by incompetent people, often for the purpose of exploiting pet theories. So far as we are aware this is the first time an attempt is made to exploit not the theories of a writer but the mature investigations, discoveries and opinions of the most competent investigators and instructors in the medical and scientific world on this subject, each of whom has done something worth while. To go over a broad field of medical research and carefully select the best, which is generally also the latest, re-produce it in understandable, summarized form as a connected narrative, carefully developing the point in each case, so the lay reader can get an adequate comprehension of it, introducing the opinion of the present authors only where it will be helpful, is a task for a medical editor and is the one undertaken in this book.
The medical man has another peculiarity. Although this volume concerns itself in a large measure with one of the gravest physical disorders of civilized man, one that has been truly called “the mother of diseases,” we are informed by so eminent an authority as Sir Arbuthnot Lane, probably the leading English abdominal surgeon, that the average physician considers the subject unworthy of special study until pain or some form of acute disease intervenes, when the books teem with discussions of the proper medical or surgical treatment. The fundamental delusion here of the medical profession, says the report of the president of the Rockefeller Foundation (1921) is that it makes a living from diseases, while the real scientific approach to the problem of human welfare is through their prevention.
The important truth underlying the present book is the recognition of the fact that “intestinal stasis, in one form or another (constipation), afflicts three fourths of the American people whether we want to believe it or not,” and is the greatest single physical ill that besets the modern civilized, highly, specialized, artificial human existence.* It is not classed as a disease or even mentioned in many medical books where the untrained reader expects to find it. Instead of being so listed by the great majority of writers it is mentioned as a condition only. But that fact does not lessen in the slightest degree the very great importance of derangements of the delicately-adjusted intestinal functions as causes of disease. There is no truth connected with the treatment of illness more generally recognized by medical authority than the dictum to “cure disease remove the cause.” Everybody recognizes this truth when it is dragged forth. The amazing thing is that so many people prefer to temporarily relieve a condition rather than to seek the cause.
There is a widespread, almost universal need, for a plain, simple, authoritative discussion of this great subject, full of minute detail, so the wayfaring man cannot go wrong, all from the best sources, duly acknowledged in each case, reinforced by footnotes giving biographical data to show who the authority really is and the credence to which he is entitled, with the latest methods successfully adopted in fighting this scourge, and all for a less cost than for one visit of the family physician.
Such a book could not have been written so late as ten years ago. Some of the most valuable information it contains is not yet two years old. Back of 1907, when x-rays were first used in studying intestinal phenomena, there was little reliable information of many of the functions of the colon. One authority says that up to that time the human intestine was a sort of terra incognitaan unexplored internal organ over four and a half times the length of a six-foot man. Even now there are few competent men who have specialized on this subject. Before an investigator can qualify as an ex-pert many hundreds, even thousands of cases, should pass through his hands and receive the most enlightened study. Relatively few men have had such opportunities and of these a large percentage are also interested in many other diseases that require critical examination.
The professional medical man of large and successful experience would never undertake a work of this character. It requires an editorial survey along medical lines wholly foreign to his methods. He is not primarily an expositor of other men’s writings but a setter forth of his own experiences, discoveries and theories; in other words, he is distinctly a contributor to the general fund of medical knowledge.*
An interesting fact that developed from the study of this subject, that has now extended for a period of over twenty years, is that obsolete and worthless advice is still repeated by authors of good repute. Take cannon-ball massage as an instance. In at least two reputable books printed as late as 1921 the old advice is repeated to roll a covered cannon ball of twelve pounds, or greater weight (one author suggests twenty-five pounds), over the course of the colon as a means of massage in intestinal stasis. In the first place, unless the experimenter is exceptionally well informed, the location of the transverse colon is not known, as it is a common experience to find it looped well down in the abdomen, sometimes reaching the pelvic floor. In any event the cannon ball would do no more than increase the impaction of the contents, thus adding to the affliction from which the discouraged patient is already suffering.
Throughout the book no medical term that lies beyond the common knowledge is used without an accompanying definition so it can be easily understood by lay readers. These definitions are sometimes repeated at intervals but in different terms, on the theory that even intelligent readers are not likely to remember so many definitions of unfamiliar words. The reader who does not need them will keep in mind the large percentage of those who do and the paramount importance of reaching their understanding.
Nothing is of more importance in the study of this subject than a working knowledge of the anatomy of the organs involved. Adequate cuts from the best sources have been inserted in the text wherever they are useful so that the reader can follow it with real enlightenment.
The inference should not be drawn that there are no original observations in the text. Aside from the theory of the book, its scope and the orderly development of the theme there are certain views that, being new, were not derivable from any authoritative source. That the reader may not be misled the more important of them are set out: The superiority of bran to agar and the greater disintegrative power of the former as well as its power to retain much-needed moisture; the non-injurious effects of the wise use of the enema and its differentiation from the coliclyster (colon irrigation), with some basis in authority; the seriousness of the menace of in-complete defecation; harmonizing views on conflicting theories of water drinking; the chapter addressed to youth; a re-statement and extension of the, theory of abdominal exercises in comparison with massage; the very great importance of new discoveries in the use of lactose (sugar of milk) and the development and assembling of important facts that, outside the field of disease and frequently within it, indicate the principal cause of bad complexions, bad teeth and loss of hair.
Lastly, the primary motive behind the work is service; and the earnest hope of the authors is that they may be justified in their labors.