Tuesday, May 17, 2016

Constipation and the Germ Theory: "Autointoxication" (excerpt)

By James Whorton

From the late 1700s onward, European and American physicians were convinced that constipation was becoming ever more common because of changes in diet, exercise levels, and the pace of life associated with urbanization. By the beginning of the 19th century, there was a medical consensus that constipation was the “disease of civilization,” a universal affliction in industrialized societies that engendered the full range of more serious human ailments. As a popular American health manual warned in the 1850s, “daily evacuation of the bowels is of the utmost importance to the maintenance of health”; without the daily movement, “the entire system will become deranged and corrupted.”

Surely such simplistic pathology was consigned to the rubbish heap once the modern germ theory of disease came in during the last quarter of the 19th century. In truth, bacteriology only buttressed the ancient intuition that fecal decay triggers physical decay. The discovery that germs cause infection was an outgrowth of Pasteur's studies demonstrating that germs cause putrefaction of animal and vegetable material outside the body. The first practical application of Pasteur's findings, the introduction of antisepsis into surgery by Joseph Lister in the 1860s, further confirmed the germ-putrefaction connection; Lister employed a caustic chemical, carbolic acid, to suppress surgical wound infection because he thought of wound inflammation as a germ-induced putrefaction, and carbolic acid was known to inhibit putrefaction in sewage. But what was the colon if not a sewage pit teeming with bacteria, a cesspit that was not being sanitized with antiseptics nor, in the constipated, being regularly emptied? Might not its germ-infested foulness spread out somehow into the rest of the body?

A more elegant rationale for colonic corruption of the body became available in the mid-1880s, when bacteriologists came to realize that intestinal flora broke down protein residues in feces into several compounds that exhibited pronounced toxicity when injected into animals. Reasoning that putrescine, cadaverine, and similar “ptomaines” generated in the bowel could be absorbed into the bloodstream, late 19th-century medical scientists formulated the theory of intestinal autointoxication, or self-poisoning, from one's own retained wastes. The constipated person, French physician Charles Bouchard declared, “is always working toward his own destruction; he makes continual attempts at suicide by intoxication.”

Autointoxication not only bore the imprimatur of the most modern medical science, it met a clinical need to come up with an explanation and diagnosis for all those exasperating patients who insist that they're sick but are unable to present the physician with any clear organic disease. Thus, even though autointoxication was, to paraphrase Pudd'nhead Wilson, nothing more than constipation with a college education, it became its era's catchall diagnosis, the pigeonhole into which cases of headache, indigestion, impotence, nervousness, insomnia, or any number of other functional disorders of indeterminate origin could be placed. The diagnosis was not restricted to such relatively benign complaints, however, because heart disease, cancer, and other deadly ailments did not always have obvious causes either.

Given enough time, it appeared, toxins absorbed from the torpid bowel could wreak just about any degree of havoc anywhere in the body. Indeed, from 1900 into the 1920s, autointoxication was regarded by much of the medical profession and most of the public as the most insidious disease of all, because it was, in essence, all diseases. In books such as The Conquest of Constipation, The Lazy Colon, and Le Colon Homicide, physicians on both sides of the Atlantic warned that the contents of the colon were “a burden, fermenting, decomposing, putrefying, filling the body with poisonous substances” and creating “sewer-like blood”; that autointoxication “is the cause of ninety per cent of disease,” and that “constipation shortens life.”

From: ncbi.nlm.nih.gov


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