188 THE TREATMENT OF DISEASES. 



in quantity) as well as too dry and solid. In many instances it is a mere temporary 

 derangement, but in others the bowels are habitually confined. 



There are few who have not experienced at some time or other the inconveniences 

 of constipation. Those who suffer from it only occasionally will be prepared to 

 attach but little importance to it, but people with whom it is habitual know that it 

 is one of the greatest of the minor troubles of life. It may be taken as a rule that 

 persons enjoying robust health have a motion at least once daily. Yet there are 

 many, apparently equally healthy, who have their bowels relieved habitually every 

 two or three days only, or even but once in a week or fortnight. There are, indeed, 

 cases recorded in which fairly good health has been maintained for many years, 

 although evacuations have during that time occurred only at intervals of six weeks 

 or two months. In one instance, that of a lady who indulged largely in opium, the 

 bowels were opened only four times in the course of the year, at intervals of three 

 months. It must not be forgotten, however, that a degree of constipation which is 

 habitual with one person, and in him perfectly compatible with health, may be and 

 often is a source of discomfort if not of positive illness to another in whom its 

 occurrence is exceptional. Thus, to most people whose daily habits in this respect 

 are regular, confinement of the bowels for even two or three days is apt to produce 

 not only local uneasiness, such as a sense of fulness, heat, tendency to piles, and 

 flatulence, but also some degree of general constitutional disturbance, indicated by 

 headache, foul breath, loss of appetite, and indigestion. Even in cases where from 

 long habit constipation has come to be regarded as the normal condition of things, 

 some of the above specified discomforts do actually in some degree co-exist ; but 

 having become, like the constipation, habitual, they cease to be observed, or at all 

 events become tolerable. When a motion occurs after the bowels have been long 

 confined, the expulsion of the faeces is apt, from their bulk and hardness, to be 

 attended with considerable pain, and perhaps even with some loss of blood, and to 

 be followed by prolonged aching and burning. 



What are the causes of constipation? Of all the causes which originate and 

 establish habitual constipation, there is undoubtedly none so common as inattention 

 to the calls of Nature, which are too frequently not only ill-obeyed, but even set aside 

 by every trivial circumstance. How often does it happen that a lady, finding it not 

 quite convenient to retire to the cabinet at the moment she experiences an admonition, 

 defers it to a more favourable opportunity, but this opportunity having arrived, 

 her efforts are powerless, the bowels will not act, and she has perforce to abandon 

 the effort, and retire from the contest disappointed and discomfited. It should be 

 remembered that the evacuation of the bowels is a natural and necessary function, 

 without which health cannot be enjoyed or preserved, and some resolution should 

 consequently be exercised in order to promote this object. Some people never think of 

 going to the closet unless urged by an imperative necessity which they cannot resist. 



The want of proper conveniences has undoubtedly much to do with the prevalence 

 of constipation. As a rule, little or no attention is paid to the situation and con- 

 struction of the water-closet. It is either placed in some out-of-the-way corner, where 

 no one can find it, or it is so prominently situated that it requires a vast amount of 

 manoeuvring to pay a visit without the fact being patent to every one in the house. 



