st in the function of elimination; if he likes too much
the sense-gratification from stimulation of the rectal nerves and
learns to increase this gratification by holding back the fecal mass;
if he gets the idea that the function is "not nice" and takes the
interest that one naturally feels in subjects that are taboo; or if he
catches from his elders the suggestion that the bowel movement is a
highly important process and that something disastrous is likely to
happen unless it is successfully performed every day; then his very
interest in the matter tends to interfere with automatic regulation,
and to cause trouble.

Just as people often find it hard to let go the bladder muscle and
urinate when in a hurry or under observation, and just as an
apprehensive woman in childbirth tightens up the purse-string muscle
of the womb, so the little child, or the grown up who catches the
suggestion of difficulty in the bowel movement, loses the trick of
letting go. Instead of merely exercising control by temporarily
inhibiting the function, he tries to carry through the process itself
by voluntary control--and fails. Constipation is a perfect example of
the power of suggestion, and of the troublesome effect of a fear-idea
in the realm of automatic functions.

FOOD AND CONSTIPATION

Since the waste matter from all foods finally reaches the rectum, and
since constipation is merely a difficulty in the forces of expulsion,
it is hard to see how any normal food in the quantities usually eaten
could have the slightest effect on the problem. When we remember that
it takes food from twelve to twenty-four hours to reach the rectum,
and that it has during all that time been subjected to the action of
the powerful chemicals of the digestive tract, it is hard to imagine a
piece of cheese, of whatever variety, strong enough to stop the
contraction of the muscles of the upper rectum or to tie the
sphincter-muscle into a knot. It would be difficult to find a food
which could pass without effect through twenty-seven feet of
intestinal tubing only to become suddenly effective on the wall of the
rectum. If the wrong kind of food is the cause of constipation, why
does the rectum prove to be the most refractory portion of the tube?
On what principle could a piece of chocolate inhibit the call to stool
or contract the sphincter muscle? On the other hand, even if it should
be conceded that constipation were the result of lack of lubricating
secreti