theless, gradually breaking down
and finally die of what is termed "a complication of diseases," before
living out half their term of life.

How this happens is simple enough--the straining required to produce an
evacuation is out of all proportion with the character of the discharge;
such patients often complain of being constipated when the evacuations
are semi-fluid; this straining is followed by a dilatation and
consequent loss of power of the rectum, which becomes pouched and its
mucous membrane thickened; the whole intestinal tract sympathizes and
digestion is interfered with, and the forcible expulsive efforts affect
all the abdominal and thoracic organs in a more or less degree, laying
the foundation for serious organic diseases. Now, this condition, which
may be said to be no more than one of obstinate constipation, is a far
more reaching condition and a far more injurious state than can be
imagined at a first glance. Constipation is not, as a rule, always
accompanied by the indigestion, either stomachic or intestinal, that
goes with this condition; the contents of the intestines in simple
constipation may simply lack fluidity without undergoing putrefactive
fermentation, but in this condition the undigested and retained
intestinal contents do undergo that change, resulting in the generation
of material whose re-absorption produces a toxic condition of the blood,
from whence begins a series of serious organic changes in the blood, and
from this in the organs.

To the practical physician these changes are evident and their cause
just as plain, and it is just here where the laity lack the proper
education, and where they should understand that the intelligent
physician generalizes the disease and only individualizes the patient;
and it is this ignorance on the part of the laity that gives to
empiricism and quackery that advantage over them, as they look upon all
disease as a distinct individual ailment, that should have an equally
distinct and individual therapeutic agent to cope singly with. The laity
know very little of these things, and in their happy ignorance care
still less for the finer definitions of or of the clinical importance of
toxaemia, or the processes of abnormal conditions that lead up to such a
state, or the results that may follow when that condition is once
reached. To them, dyspepsia is an indigestion ascribable to the stomach,
and a sick-headache is ascribed to something wrong about the sto