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muscular, intestinal, treatment, water, insufficient, result and symptoms

CONSTIPATION, a condition in which the normal number of evacuations from the intestinal canal does not take place, or one in which the farces are extremely hard and painful in passing. Constipation affects all ages, being prevalent in childhood, youth, adult life and old age. It can for the most part be regulated by proper hygienic living, but by reason of extreme carelessness in this regard is very prevalent.

The symptoms of constipation vary consider In infants there is always pain ; the child cries, especially on attempts to defecate; there is usually much colic; there may be fever. In adult life the symptoms are fairly well marked. There is the time element, which is known; there is pain on passage, due to hardness of the traces; and there may be feelings of bloat ing, coated tongue, headache or backache, all of which are characteristic of this condition. In fact the symptoms which are described very widely in patent-medicine circulars as due to disease of the kidney, brain, lost manhood and vague menstrual irregularities are the usual symptoms of ordinary constipation, and the patent-medicine business succeeds largely be cause it ascribes to this extremely common malady names of very much more dangerous illnesses. Practically most patent medicines are hardly more than cathartics.

The causes of constipation are in the main two,— lack of water in the intestines and lack of muscular tone of the unstriped muscle of the intestinal walls. Lack of water may result from insufficient drinking of water. It may also result from increased elimination of water, as in excessive sweating. It may also be the result of diminished secretions of the normal juices of the intestines,— the gastric juice, the bile from the liver and the pancreatic and intestinal juices.

These are all essential in adding fluid to the intestinal canaL Insufficient muscular power in the intestines may be due to a number of causes. Lack of tone of the body in general, resulting from insufficient exercise and insufficient food, is one of the most important Bad dressing is a second cause for this loss of muscular tone. It may be a symptom of a nervous disorder such as is very frequently found in paraplegia, in locomotor ataxia and other grave spinal dis orders, in which case the motor paralysis is more or less permanent. Ladc of muscular

power may also be the result of taking fluid diet; thus the intestine has less of the proper type of stimulus and the muscular power is not invoiced. A frequent cause of constipation is tea-drinking. The most frequent cause of con stipation is unconscious hate. This causes too much tension in the muscles of the lower bowel with the retention of the traces.

The treatment of constipation is self-evident if one talces into consideration the two under lying causes and remedies them. The drinidng of water, outdoor exercise, sunlight, the eating of food that has plenty of residue, such as bread, spinach, lettuce, cabbage, celery, etc.; these are very helpful. The first absolute neces sity, however, in the treatment of constipation is to establish a habit of regular daily move ment In orcler to do this it is essential that a time should be talcen which is ordinarily not interfered with, and the individual should con sider a certain 15 minutes of the day to be sacredly devoted to this duty. So far as drugs are concerned in the treatment of constipation, they are best left alone; but if it becomes ab solutely necessary that a drug should be used, it is a cardinal principle to remember that alternation of drugs is advisable. The same drug used day. in, day out, and week after week, tends to diminish the power of the intestine and habituate it to a given drug. This results in some frightful cases of constipation. In a few cases of constipation in which the cause is due to some obstruction, as some solid body situated near the intestinal canal and pressing upon it, surgical treatment is imperative. The use of external massage is largely useless. The normal stimulus to muscular action comes-from within—it is largely of unconscious nerve origin. It does not come from without Con stant use of enemas for constipation is a form of intestinal masturbation and leads to serious forms of neuroses and psychoneuroses, even to psychoses— or insanities, in later life. Hence the best type of treatment for most chronic constipations is mental. See CATHARTIC.