st
desire to empty the bowels. Again, irregular time for eating and improper
diet are liable to diminish this action also. Foods that contain very
little liquid and those that do not leave much residue are liable to
accumulate in the bowel and at the same time press upon the rectum hard
enough to produce a partial paralysis.

Deficiency of the Secretions.--Many of the causes that hinder worm-like
motion are also likely to lessen the normal secretions of the bowel. Some
kinds of liver diseases tend to lessen the secretions of the bowel,
because the amount of bile emptied into the bowel is lessened. Sometimes
the glands of the intestine are rendered less active by disease and other
causes.

Sundry Causes.--Diabetes, melancholy, insanity, old age, paralysis, lead
poisoning and some troubles of local origin, like fissure of the rectum,
ulceration, stricture and polypus.

[DIGESTIVE ORGANS 137]

Symptoms.--Headache, inattention to business, loss of memory, melancholy,
sallow complexion, indigestion, loss of appetite, nervous symptoms.
Spasmodic muscular contraction of the external sphincter. The bowel
contents press upon it; spasm of this sphincter muscle is frequently
brought on by the presence of a crack in the mucous membrane, caused by
injury inflicted during expulsion of hardened feces. Instead of aiding a
bowel movement, the muscles now present an obstruction beyond control of
the will and aggravate the condition. The most frequent cause of disease
of the rectum is constipation and anyone of the following local diseases
of the rectum and anus may be a symptom of constipation. (1) Fissure or
crack of the anus. (2) Ulceration. (3) Hemorrhoids (piles). (4) Prolapse
(falling). (5) Neuralgia. (6) Proctitis and periproctitis.

Fissure of the anus is a common local symptom of constipation. The feces
accumulate when the bowels do not move for a few days, the watery portion
is absorbed; they become dry, hard, lumpy, and very difficult to expel,
frequently making a rent (tear) in the mucous membrane and resulting
eventually in an irritable fissure. Ulceration of the rectum and the
sigmoid (part of the bowel) is a symptom of persistent constipation,
because the pressure exerted upon the nourishing blood vessels by the
fecal mass causes local death of the tissues.

Hemorrhoids (Piles) may be produced by constipation in several ways; first
by obstruction to the return of the venous (dark) blood. Second, by venous
engorgement