SSsiis'l^Sf?^ 
 
 RC861 .F38'^^^37864 
 
 RECAP 
 
 The non- 
 
 surgical tre 
 
 
 TESTINAL 
 
 lii,l 
 
 STASIS one/ 
 
 ON, M.D. 
 
 
 ii 
 
 !iil 
 
 I' 
 
 till 
 
 ll'i' 
 
 il'liiii 
 
 iiiiiiii 
 
 iillPlil 
 
 ,11 ' 
 
 iiij 
 
 nil'! 
 
 iililiiiiluiiiinlMiu;:.! 
 
 i.'iH'sl'i'^iiii-'"; !"'i 
 
(iDaluntbf a Umbtnsftp 
 mtl)t«itprf3fetogork 
 
 Spfprpnrp SItbrarg 
 
THE 
 NON-SURGICAL 
 
 TREATMENT 
 
 OF 
 
 INTESTINAL STASIS 
 
 AND 
 
 CONSTIPATION 
 
 Compiled by 
 ROBERT H. FERGUSON, M.D., ScD. 
 
 Also an Important Announcement 
 Regarding Liquid Petrolatum 
 
 Published for the Physician and Surgeon by 
 
 E. R. SQUIBB & SONS, NEW YORK 
 
 Medical Department 
 
 MCMXVI 
 
Copyright, 1916, by 
 ROBERT H. FERGUSON 
 
IMPORTANT ANNOUNCEMENT 
 
 REGARDING 
 
 LIQUID PETROLATUM 
 
 tP* ^V ^V 
 
 For the successful treatment of In- 
 testinal Stasis and Constipation by the 
 methods described m the pages of this 
 handbook, the employment of a mineral 
 oil of correct constitution and highest 
 purity is imperative. 
 
 In pursuance of our long-established 
 and well-known pohcy to supply of every 
 product only the best quahty for the pur- 
 pose intended, we have made a thorough 
 and exhaustive study of all American 
 and Russian mineral oils obtainable. 
 After more than three years of such 
 careful investigation and research we are 
 able to announce: 
 
 First: There are two distinct types of 
 mineral oil for internal use offered in the 
 
4 ANNOUNCEMENT 
 
 market, differing greatly in physical and 
 in chemical properties, namely: 
 
 (a) The heavy oils, consisting princi- 
 pally of the naphthene series of hydro- 
 carbons. These heavy oils are derived 
 only from crudes found in California and 
 in certain fields of Russia. 
 
 (6) The light oils, consisting chiefly of 
 the methane or parafiBn series of hydrocar- 
 bons. In this class belong all American 
 mineral oils except certain ones of CaU- 
 fornia. 
 
 In short, numerous comparative tests 
 made by us show the Californian heavy 
 oil to differ in essential respects from 
 other American oils and also to be su- 
 perior to the Russian oils. 
 
 We, therefore, have selected this Cali- 
 fornian Heavy Oil of high viscosity as the 
 best mineral oil obtainable for the in- 
 ternal treatment of intestinal stasis and 
 constipation, and hereafter shall supply 
 it on all orders. 
 
 It is refined for us under our control 
 only by the Standard Oil Company of Cali- 
 fornia, which has no connection with any 
 other Standard Oil Company. 
 
ANNOUNCEMENT 5 
 
 This Liquid Petrolatum Squibb, Heavy 
 (Calif ornian), meets the quality specifi- 
 cations as follows: 
 
 It is a water-white, odorless, taste- 
 less mineral oil, consisting almost entirely 
 of the naphthene series. 
 
 It has the high specific gravity* of 
 0.886 to 0^92 at 15^ C. or 0.881 to 0.887 
 at 25° C. 
 
 It has an exceptionally high natural 
 viscosity, t a point of paramount impor- 
 
 * It is claimed that a heavy hydrocarbon oil of high viscosity 
 does not pass as rapidly through the intestine as does an oil of 
 lower gravity and viscosity. This slower passage permits a 
 more even distribution of the oil, a more complete lubrication 
 of the intestinal wall, and possibly a more thorough inhibitive 
 action on bacteria. Furthermore, if a Hght oil of low viscosity 
 is used there is leakage or dribbling, while under ordinary 
 circumstances no such annoyance is experienced when a heavy 
 oil of high viscosity is employed. 
 
 t In judging mineral oils by their physical appearance, it 
 should be borne in mind: 
 
 First : That high viscosity does not necessarily mean high 
 specific gravity. The former bears no definite relation to the 
 latter. 
 
 Secondly : That apparent high viscosity may not be true 
 viscosity. Certain mineral oils offered in the market with 
 exaggerated claims have apparently a high viscosity, but 
 upon testing show an actual low viscosity. Thus, they are in 
 fact not only low in specific gravity, but also low in viscosi- 
 ty, their appearance to the contrary notwithstanding. 
 
6 ANNOUNCEMENT 
 
 tance, because true viscosity is the chief 
 index of lubricating power. 
 
 Furthermore, it is a pure mineral oil 
 free from paraffins, inorganic matter, or- 
 ganic sulphur compounds and injurious 
 hydrocarbons, such as anthracene, phen- 
 anthrene, chrysene, phenols, and oxi- 
 dized acid or basic bodies. 
 
 It resists oxidizing agents better than 
 do the oils of the methane, ethylene, 
 and aromatic series. It shows a marked 
 stability against chemical agents in gen- 
 eral. It is designated 
 
 Liquid Petrolatum, Squibb 
 
 and sold solely under the Squibb label 
 and guaranty. You are respectfully asked 
 to specify it on your prescriptions in 
 order to make sure that this Califor- 
 nian oil of highest viscosity is furnished. 
 
 E. R. Squibb & Sons. 
 
THE NON-SURGICAL 
 TREATMENT OF 
 INTESTINAL STASIS 
 AND CONSTIPATION 
 
 Compiled by 
 
 ROBERT H. FERGUSON 
 
 M.D., ScD. 
 
FOREWORD 
 
 TTHIS handbook is intended to set forth, 
 in the briefest manner possible, the 
 consensus of opinion of the medical profes- 
 sion concerning the non-surgical aspect of 
 the treatment of intestinal stasis and con- 
 stipation. It advances no novel ideas, 
 but brings together statements of repre- 
 sentative physicians and surgeons. 
 
 Concerning certain aspects of the treat- 
 ment Uttle is said, as, for instance, the 
 orthopaedic — ^the choice of corsets if vis- 
 ceroptosis, etc., exists; the hygienic, since 
 it varies so with temperament, time, and 
 place; also the dietary, which, too, is quite 
 individuaHstic. Enough, however, is ad- 
 vanced to suggest rational non-surgical 
 treatment, while the accurate and com- 
 plete bibUography will enable those more 
 deeply interested to consult the original 
 papers. Furthermore, the full and care- 
 fully constructed index will give easy ac- 
 cess to the whole. 
 
 Just here certain matters which in- 
 volve principles of scientific moment, as 
 well as of every-day practical medical 
 
 9 
 
10 FOREWORD 
 
 interest, should be noted. All the au- 
 thors recommend liquid petrolatum as 
 the internal remedy par excellence. How- 
 ever, this product is called by a large 
 number of different names, such as 
 "mineral oil," "paraffin oil," "Uquid paraf- 
 fin," "petroleum oil," "liquid petroleum," 
 "Russian oil," "Russian mineral oil," and 
 many other designations; but in the United 
 States only one distinctive name is recog- 
 nized, the name established by the United 
 States Pharmacopoeia. Therefore, the 
 attention of the Medical Profession of 
 the United States is respectfully called 
 to the propriety of adhering strictly to 
 the name official in the United States, 
 which is "Liquid Petrolatum." 
 
 In the United States, "paraffin" means 
 the sohd wax-Uke hydrocarbon so com- 
 monly used for candles, etc. "Liquid 
 paraffin" is this sohd substance either 
 melted or in solution. "Petroleum" and 
 "petroleum oil" signify various forms of 
 more or less crude earth oil, as kerosene, 
 certain lubricating oils, etc. 
 
 To use, in the United States, such 
 designations for "liquid petrolatum" is 
 
FOREWORD 11 
 
 not only confusing and misleading, but 
 is against the efforts of the U. S. P. to 
 estabhsh a definite nomenclature. Conse- 
 quently, it should be noted that the official 
 name for the hydrocarbon oil intended 
 for internal use is "Liquid Petrolatum, 
 Heavy." 
 
 In order to avoid confusion in this hand- 
 book, the TJ. S. P. designation has been 
 used instead of the varying names em- 
 ployed by the authors. 
 
 Liquid petrolatum is a mineral oil 
 which must be distinguished not only in 
 its chemical composition but also in its 
 physiological action from the oils and 
 fats of vegetable and animal origin. 
 These latter oils are spht up, digested, 
 and absorbed in the gastro-intestinal 
 tract, and serve various purposes in the 
 human economy. 
 
 Liquid petrolatum undergoes no change 
 in the stomach or intestines, It is not 
 absorbed, and it passes out of the system 
 in the same condition and quantity that 
 it entered. Its primary action is entirely 
 mechanical, merely lubricating the lumen 
 of the gut, and keeping the intestinal 
 
12 FOREWORD 
 
 contents soft. However, the secondary 
 effects of its action are important, such 
 as the reHeving of overworked myenteric 
 ganglia by allowing the intestinal con- 
 tents to pass easily; the hindering of 
 decomposition by preventing stagnation 
 of the contents of the bowel; its indirect 
 bactericidal action by investing the bac- 
 teria so completely as to exclude whatever 
 nutriment is necessary for their propaga- 
 tion; and, because of all this, the permit- 
 ting of a better digestion and absorption 
 of food than are possible when stasis exists. 
 
 The criterion for judging a hquid petro- 
 latum for internal use is bound up with 
 the fact that the primary action of this 
 product is lubrication. High specific 
 gravity is of great value; and of two oils, 
 one heavy and the other light, but alike 
 in other respects, the heavier oil, doubt- 
 less, would be the better for use internally. 
 
 However, the chief index of lubricat- 
 ing power is viscosity; therefore, a high 
 viscosity ought to be the feature sought 
 first, and specific gravity next; of course, 
 not overlooking "purity y which always is 
 essential. 
 
FOREWORD 13 
 
 The London Lancet^ says, "Since it is 
 admitted that the value of liquid petrola- 
 tiun taken internally is chiefly that of a 
 lubricant on the contents of the bowel 
 (although incidentally it may also re- 
 strict bacterial activities), the viscosity 
 of the oil is probably a more important 
 factor. ... It seems pretty safe to say that 
 the effects would be quite different when, 
 on the one hand, a rapidly flowing oil is 
 used and, on the other, an oil travelling 
 slowly through the digestive tract. . . . 
 Oils which flow more rapidly . . . are less 
 Hkely to produce that steadiness of 
 lubrication which is physiologically de- 
 sirable; they frequently produce intestinal 
 pain and they may even escape without 
 lubricating at all. Possibly, also, the 
 disturbing effect on digestion, which some- 
 times occurs, is due to the employment of 
 an oil of too easy fluidity." 
 
 In selecting, then, a suitable hydro- 
 carbon oil for internal administration, it 
 should be borne in mind that choice 
 should be made of a pure liquid petrola- 
 tum which has not only a high specific 
 
 1 The Lancet, London, 1915, Oct. 2, p. 762. 
 
14 FOREWORD 
 
 gravity i but also a high natural viscosity; 
 and since, as The Lancet says, "viscosity 
 is affected much more by temperature 
 than is specific gravity," care should be 
 taken that the oil has the desirable high 
 viscosity at body temperature, 
 
 Robert H. Ferguson. 
 
 East Orange, N. J. 
 
CONTENTS 
 
 PAGE 
 
 Foreword 9 
 
 I. Importance of Intestinal Stasis . 17 
 II. Definition of Intestinal Stasis . 18 
 
 III. Remote Effects OF Intestinal Stasis 19 
 Watson's Classification of Cases . 22 
 
 IV. Cause of the Autointoxication in 
 
 Intestinal Stasis 24 
 
 V. Constipation, Intestinal Stasis, and 
 
 Enteroptosis . . . . . .28 
 
 VI. Possibility of Treating Intestinal 
 Stasis by Internal Lubri- 
 cation .33 
 
 VII. Wide-Spread Existence of Intestinal 
 
 Stasis 42 
 
 VIII. NoN- Surgical Treatment of In- 
 testinal Stasis 43 
 
 IX. Constipation in Infants .... 72 
 
 X. Liquid Petrolatum during Preg- 
 nancy AND Lactation .... 80 
 15 
 
16 CONTENTS 
 
 PAGE 
 
 XI. Liquid Petrolatum fob the Insane . 82 
 XII. Surgical Use of Liquid Petrolatum 83 
 
 (a) As a Prophylactic 83 
 
 (6) For Diagnosticating Surgical from 
 
 Non-surgical Cases .... 84 
 (c) Intra-abdominally to Prevent Post- 
 Operative Stasis (Burrow's 
 
 Method) 85 
 
 Contra-indications for the Intra- 
 abdominal Use of Mineral Oil . 90 
 {d) To Prevent or Mitigate Post- 
 Ansesthetic Nausea and Vomit- 
 ing 91 
 
 {e) As a Post-Surgical Laxative . . 92 
 
 Index 93 
 
The Non-Surgical Treatment 
 
 of 
 
 Intestinal Stasis and Constipation 
 
 I. 
 
 The Importance of Intestinal Stasis. 
 
 OcHSNER,2 of Chicago, calls attention 
 to the fact that ^' every author of note, 
 from Hippocrates to the present day, who 
 has written a treatise on medicine, has 
 insisted on the importance of preventing 
 an abnormal accumulation of excrement 
 in the large intestine, both as a prophy- 
 lactic against future, and as a cure for 
 existing, disease." 
 
 Lane,^ of London, says: *' Chronic in- 
 testinal stasis, which I beheve to be the 
 prime factor in the production of very 
 many diseased conditions, is of enormous 
 importance, and we cannot spend too 
 much time or thought in unravelling the 
 many problems which it presents." 
 
 ^ Surgery, Gynecology and Obstetrics, 1916, Jan., p. 44. 
 3 British Medical Journal, 1912, May 4, p. 989. 
 
 17 
 
18 TREATMENT OF 
 
 RocKEY/ of Portland, Oregon, says: 
 "Careful clinical observation is convinc- 
 ing me, day by day, that the question 
 of intestinal stasis and its consequent 
 morbidity is one of the most important 
 subjects before the medical profession at 
 this time." Accordingly, it is well to 
 ask. What is this important condition? 
 
 II. 
 
 Definition of Intestinal Stasis. 
 
 No better definition of intestinal stasis 
 has been given than that of him who has 
 done more than any other to call atten- 
 tion to the fact, cause, and pathology of 
 stasis, and has demonstrated its treat- 
 ment. "Sir W. Arbuthnot Lane, whose 
 views, as Ochsner says,^ have been fully 
 supported by no less famous a scientist 
 than Metchnikoff," ^ says ^: 
 
 "By chronic intestinal stasis I mean 
 
 * Surgery, Gynecology and Obstetrics, 1913, Dec, p. 737. 
 
 ^ Surgery, Gynecology and Obstetrics, 1916, Jan., p. 44. 
 
 ^ The Nature of Man, Part III, Chap. X, Eng. trans., p. 
 248 et seq. 
 
 The Prolongation of Life, Part II, Chap. Ill et al. 
 
 ' Proceedings of Royal Society of Medicine, London, Vol. VI, 
 Part 1, p. 94; also 
 
 British Medical Journal, 1912, May 4, p. 989 et al. 
 
INTESTINAL STASIS 19 
 
 such an abnormal delay in the passage of 
 the intestinal contents through a portion 
 or portions of the gastro-intestinal tract 
 as results in the absorption into the cir- 
 culation of a greater quantity of poison- 
 ous or toxic material than can be treated 
 eflFectually by the organs whose function 
 it is to convert them into products as 
 innocuous as possible to the tissues of the 
 body." 
 
 m. 
 
 Remote Effects of Intestinal Stasis. 
 
 Lane^ emphasizes the fact that in- 
 testinal stasis means more than "merely 
 the absence of a daily action of the 
 bowels," and that this stasis is important 
 since "any delay in the passage of the 
 contents of this drainage scheme has a 
 threefold result on the organisms found 
 in the intestine. Their multipHcation is 
 facilitated, they extend beyond the Umits 
 of their normal habitat, and extraneous 
 strains are developed. These organisms 
 may extend along the ducts of the organs 
 
 ^Surgery, Gynecology and Obstetrics, 1913, June, p. 600 
 et seq. 
 
20 TREATMENT OF 
 
 which open into the drain pipe, and they 
 or their products, carried into the blood 
 stream, may infect organs which do not 
 directly communicate with the intestine, 
 for example, the kidneys," producing 
 "progressive degenerative changes in 
 every tissue." 
 
 In this way, the disturbance caused 
 by j^ intestinal stasis may be, according 
 to ELane, Bainbridge, and others, most 
 extensive and important, yet apparently 
 remote from any connection with in- 
 testinal toxaemia. 
 
 For instance, it affects the ductless 
 glands. RowELL^ in a "Discussion of 
 AUmentary Toxaemia" before the Royal 
 Society of Medicine, London, reported: 
 "In the case of a very athletic young 
 lady of which I have knowledge, who 
 had a large thyroid and some symptoms 
 of chronic intestinal stasis, after a course 
 of Uquid petrolatum given freely three 
 times a day for ten days the thyroid had 
 diminished to less than haK its former 
 size, and the patient felt perfectly well." 
 
 ® Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1. p. 197. 
 
INTESTINAL STASIS 21 
 
 Lane*° operated on a patient for in- 
 testinal stasis. He says: "For eight 
 years she had suffered from an enlarged 
 thyroid which projected forward in her 
 neck, and which interfered with respira- 
 tion. It contained several large adeno- 
 mata. . . . Within a few days after the 
 operation, it was obvious that the thyroid 
 was diminishing steadily in size, and this 
 diminution continued till, when she left 
 the hospital, it was but Uttle larger than 
 normal. I understand at the present 
 time it is not larger than normal." 
 
 "Also the nervous system is markedly 
 affected." Further," there may be "de- 
 generative changes in the breast associ- 
 ated with stasis, which disappear if the 
 drainage scheme be properly dealt with." 
 
 Lane considers intestinal stasis to be 
 intimately and causally connected with 
 many cases of appendicitis,^^ rheumatoid 
 
 *° Ptoc. Royal Society of Medicine, Vol. VI, Part 1, p. 106. 
 
 ^"^ Surgery, Gynecology and Obstetrics, June, 1913, pp. 600-606; 
 Proceedings Royal Society Medicine, Vol. VI, Part 1, pp. 96- 
 105 (Lane); p. 197 et al. (Rowell); p. 317 (Clark). The 
 Operative Treatment of Chronic Intestinal Stasis, by Sir W. 
 AJpbuthnot Lane, Sd Edition, London, 1915, pp. 53-68. 
 
 12 British Medical Journal, 1911, Apr. 22, pp. 913, 914. 
 
22 TREATMENT OF 
 
 arthritis, and tuberculosis. As regards 
 the latter two, Lane^^ says: "In my ex- 
 perience, a patient cannot develop either 
 of these diseases (except in the case of 
 tubercle by inoculation) unless the re- 
 sisting power to the entry of organisms, 
 or, in other words, the vitahty of the 
 tissues of the body, has been depreciated 
 by the poisons which circulate through 
 them in chronic intestinal stasis." 
 
 Watson^ s Classification of Cases 
 
 Watson,^^ of Edinburgh, says: "Long- 
 continued observation of many cases of 
 chronic disease, and more especially pri- 
 vate cases which I have had the oppor- 
 tunity of investigating by the aid;iof 
 modern methods of diagnosis, has led 
 me to recognize three distinct groups of 
 conditions that arise mainly or entirely 
 from intestinal toxaemia. . . . (1) A 
 neurasthenic group. This includes some 
 cases at present regarded as neurotic, 
 and also a sub-group in which the symp- 
 
 *' British Medical Journal, 1912, May 4, p. 989. 
 ^^ Edinburgh Medical Journal (N.S.)» 1914, February, p. 130; 
 1914, March, p. 220 et seq.; 1914, April, p. 345 et seq. 
 
INTESTINAL STASIS 2S 
 
 toms are mainly mental. (2) Rheumatoid 
 arthritis. (3) A dyspeptic group." 
 
 "From a therapeutic standpoint, cases 
 of intestinal toxaemia may be roughly 
 classified into three main groups. 
 
 Group 1 : Cases in which the symptoms 
 are physical signs which are comparatively 
 trivial and which yield readily to simple 
 medical treatment. Group 2: In which 
 the symptoms are more pronoimced and 
 are accompanied by marked objective 
 indications of an abnormal state of the 
 digestive tract, but which are amenable 
 to careful and prolonged medical treat- 
 ment. Group 3: In which the condition 
 of the digestive tract is so abnormal 
 that medical measures fail to relieve; 
 rehef being obtainable only by surgical 
 treatment. 
 
 "Cases which fall under one or other 
 of these groups are met with very com- 
 monly in the every-day practice of the 
 physician, and I am satisfied that they 
 form a large share of the cases which 
 come under the daily observation of the 
 practitioner." 
 
 The "keynote of successful treatment 
 
^ TREATMENT OF 
 
 is found in the application of antiseptic 
 and aseptic principles, rest, diet, treat- 
 ment of bowels," etc. . . . *'The use of 
 liquid petrolatum is of great value as 
 a mechanical lubricant in many of these 
 
 cases." 
 
 IV. 
 
 Cause of the Autointoxication in 
 Intestinal Stasis. 
 
 It is of use to note how this auto- 
 intoxication has been accounted for. 
 Paul G. Wooley,^^ of Cincinnati, Ohio, 
 states three possibiUties, viz.: Firsts 
 that " during digestion of food-materials, 
 by the normal secretions of the gastro- 
 intestinal tract, toxic substances are 
 formed, and that these substances may 
 enter the blood stream and produce 
 serious disorders." Second^ that "bac- 
 teria resident in the intestinal tract act 
 upon the foodstuJBEs and produce toxic 
 substances which are absorbed and act 
 as intoxicants." Thirds that "the pres- 
 ence of bacteria themselves, which have 
 
 " Journal of Laboratory and Clinical Medicine, 1915, Oct., 
 pp. 47-49. 
 
INTESTINAL STASIS 25 
 
 entered the blood stream from the in- 
 testine, is the source of trouble." 
 
 Dixon 1^ says: "It is by no means 
 certain that true toxins are absorbed 
 from the intact mucous membrane of 
 the intestinal canal," and, for proof, calls 
 attention to the fact that snake venom, 
 diphtheria toxin, and tetanus toxin are 
 harmless when taken by the mouth. He 
 adds: "In general, however, I think . . . 
 that alimentary toxaemia is poisoning pro- 
 duced not by Hoxins ' . . . but by rela- 
 tively simple chemical substances, cer- 
 tainly not of a more complex chemical 
 nature than many of the alkaloids we 
 are in the habit of administering. These 
 poisons are a result of digestion or putre- 
 faction of food . . . chiefly proteins." 
 
 Robert Saundby,^^ however, explains 
 absorption of toxins by traumatism, and 
 emphasizes the importance of constipa- 
 tion in autointoxication on account of its 
 causing lesions in the intestinal mucosa. 
 
 1® Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1, p. 129. 
 
 1^ Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1, p. 43. 
 
26 TREATMENT OF 
 
 He says: "Simple constipation does not 
 lead to any increase of decomposition in 
 the faeces . . . but it is a not uncommon 
 cause of chronic intestinal catarrh which 
 may go on to ulceration and even per- 
 foration, and it is to these inflammatory 
 consequences that must be attributed the 
 varied symptoms which are associated 
 with constipation/' and "nothing is more 
 certain than that many symptoms may 
 result from constipation where altera- 
 tions in the wall of the bowel have taken 
 place. Nor is it inconsistent with this 
 view that thorough emptying of the 
 bowel should be followed by temporary 
 rehef of these symptoms, but, at the same 
 time, we should expect that the simple 
 evacuation of the pelvic colon would not 
 effect a cure." 
 
 N. Mutch, ^8 London, in his epoch-mak- 
 ing work, says: "To put the matter 
 briefly, the upper alimentary tract is 
 speciahzed for aseptic absorption of food 
 
 ^^ Bacterial Activity in the Alimentary Tract — The British 
 Journal of Surgery, Vol. II, No. 8, 1915, April, pp. 608-638 
 (see p. 609, also pp. 623, 624). The Lancet Clinic, 1915, 
 August 14, p. 154; 1915, August 21, p. 172. 
 
INTESTINAL STASIS 27 
 
 and the colon for the bacterial destruc- 
 tion of residues. It is conceivable that 
 disease may arise from infection of the 
 lumen of the upper alimentary tract, 
 with the generation of poisonous decom- 
 position products; or from infection 
 through the walls of the alimentary canal 
 with discharge of bacterial toxins into 
 the circulation. ... 
 
 " In all likelihood, some of the symp- 
 toms experienced in constipation are 
 caused by bacterial toxins generated in 
 the tissues of the ahmentary tract or even 
 in distant tissues infected through this 
 channel. Concerning the pathogenesis 
 of these symptoms, there is Uttle accurate 
 evidence available. . . . 
 
 "Secondary intestinal infections, in 
 which less usual organisms are in the 
 ileum in addition to those commonly 
 present in intestinal stasis, probably 
 give rise to many symptoms which must 
 be ascribed to the action of bacterial 
 toxins rather than to food-decomposi- 
 tion products." 
 
 But what Howell*® says should be 
 
 1* Proc, Royal Society of Medicine, Vol. VI, Part 1, p. 196. 
 
28 TREATMENT OF 
 
 borne in mind, viz., that "the exact 
 nature of the particular poison in any 
 case is a minor point, so far as diagnosis 
 and treatment are concerned." 
 
 V. 
 
 Constipation, Intestinal Stasis, 
 
 AND EnTEROPTOSIS. 
 
 Saundby^® calls attention to a very im- 
 portant matter. He says; "Faecal re- 
 tention is not inconsistent with a daily 
 action of the bowels"; and 
 
 A. F. Hertz 21 emphasizes this fact 
 when he says; "It is well known that 
 the frequency of the stools gives no cer- 
 tain evidence as to the existence of 
 intestinal stasis." 
 
 Sir W. Arbuthnot Lane^^ was the first 
 to emphasize the importance of inter- 
 ference with the "drainage scheme" by 
 "obstruction ... at the points of normal 
 
 2° Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1, p. 43. 
 
 21 Proceedings Roycd Society of Medicine, London, Vol. VI, 
 Part 1, p. 164. 
 
 22 Surgery, Gynecology and Obstetrics, 1913, June, p. 600 
 et seq.; also The Operative Treatment of Chronic Intestinal 
 Stasis, 1st, 2nd, and 3rd editions (London, 1915) . 
 
INTESTINAL STASIS 29 
 
 fixation and by kinks due to acquired 
 bands." In the dependent loops of intes- 
 tine which, are formed, the intestinal con- 
 tents stagnate or move on so abnormally 
 slowly that fermentation and putrefaction 
 produce an enormously large bacterial 
 flora, or form toxins which by absorption 
 are distributed more or less extensively 
 throughout the body. It is necessary, 
 however, to bear in mind that the im- 
 portant fact is not that of enteroptosis 
 with or without kinks, but of autointoxi- 
 cation, whether there are constrictions 
 and a falhng of the intestines or not. 
 
 A. E. IlocKEY^^ says: ''Ptosis is un- 
 doubtedly a cause of stasis in many 
 cases; and stasis, by its interference with 
 nutrition and by its mechanical elonga- 
 tions of the colon, is probably a frequent 
 cause of ptosis. But ptosis is found with- 
 out stasis, and stasis without ptosis. . . . 
 Many symptoms, both gastric and in- 
 testinal, ascribed to ptosis, are symptoms 
 of stasis, and clear up when the stasis is 
 reheved, and do not necessarily clear up 
 
 23 Surgery, Gynecology and Obstetrics, 1913, Dec., p. 737. 
 
so TREATMENT OF 
 
 when the ptosis is relieved." So also 
 "stasis does not necessarily mean con- 
 stipation. There are a few cases of 
 marked intestinal autointoxication with- 
 out constipation." 
 
 J. N. Jackson, 2* of Kansas City, Mo., 
 says: "I have seen a true toxic condition 
 without any interference with peristalsis." 
 
 William J. Mayors says that "about 
 50 per cent, of the fluids and 10 per cent, 
 of the soKds" ingested by the human 
 being "are absorbed by this (the first 
 half) of the large intestine. Beyond the 
 splenic flexure, absorption is Hmited in 
 amount, the bulk of absorbable material 
 placed in the rectum being promptly 
 passed into the proximal colon for ab- 
 sorption. 
 
 "It has been shown by Bond,^® Cannon, 
 and others that there is a fairly constant 
 antiperistalsis in the large intestine which 
 
 ^Journal American Medical Association, 1915, Aug. 28, 
 p. 770. 
 
 ^American Journal of the Medical Sciences, 1913, Feb., 
 p. 157. 
 
 2« New Yorh Medical Record, 1905, Aug. 12, pp. 246-252 
 British Medical Journal, 1906, Vol. II, p. 238. 
 
INTESTINAL STASIS 31" 
 
 passes material back toward the csecum. 
 . . . 'Lyle has aptly compared its stor- 
 age fmiction to the stomach,' but adds 
 that, 'unlike the stomach, which absorbs 
 but a small amount, the caecum absorbs 
 actively. In some animals there is a 
 sphincter In the ascending colon to hold 
 the material in the caecum. In man, a 
 marked physiological activity is shown 
 at this point, although no colonic sphinc- , 
 ter exists.'" 
 
 Leslie 27 says: In intestinal stasis "the 
 pelvic colon and rectum may become 
 greatly elongated (perhaps as much as 
 twice the normal length), sagging along 
 the floor of the true pelvis, and capable 
 of retaining the faecal matter for several 
 days, even though a small piece may be 
 broken off and evacuated daily, thus 
 giving rise to a false impression of bowel 
 regularity. There may even be irritating 
 diarrhea — *the diarrhea of constipation. ' " 
 
 It is admitted, then, that in many ways 
 during the passage of the contents of the 
 intestine, and at many places en route, 
 bacteria and toxins are produced and 
 
 ** American Practitionery August, 1913, p. 410. 
 
32 TREATIMENT OF 
 
 may be absorbed with more or less serious 
 results to the individual. Since this is 
 so, the summary of Bainbridge^^ is well 
 made. He says: "Lane . . . has demon- 
 strated clearly that in health mainte- 
 nance, the question of prime importance 
 is body drainage — ^the non-absorption of 
 poisons and the ehmination of whatever 
 poisonous matter may be produced within 
 the ahmentary canal before there has 
 been inaugurated a vicious cycle of events 
 which may be the forerunner of disas- 
 trous end results." 
 :■ That this importance of "body drainage' ' 
 is not exaggerated is evident from the 
 experiments of Carrel^^ and others at 
 the Rockefeller Institute for Medical 
 Research and at the Laboratories of the 
 New York Lying-in Hospital.^'' These 
 
 ** Maine Medical Journal, 1913, July. 
 
 29 Journal American Medical Association, 1911, Jan. 7, 
 pp. 32, 33; 1911, Nov. 11, p. 1611; 1912, Aug. 17, pp. 523-527. 
 
 Studies from the RockefeUei Institute, 18, 1914, pp. 344-349. 
 
 Journal Exp. Med., 1913, Jan., pp. 14-19. 
 
 ^ Caerel and Montrose T. Burrows, Journal American 
 Medical Association, 1910, Oct. 29, p. 1554. 
 
 Carrel and Montrose T. Burrows, Journal Exp. Med., 
 1911, Vol. Xin, No. 4, pp. 562-570. 
 
 A. Carrel, Journal Exp. Med., 1912, Vol. XV, No. 5, 
 pp. 51&-528. 
 
INTESTINAL STASIS 33 
 
 experiments show **that decay is due to 
 an inability of the tissues to eliminate 
 waste products." 
 
 Also "that under the conditions and 
 within the limits of the experiments, 
 seniUty and death are not a necessary, 
 but merely a contingent, phenomenon." 
 It is this removal of general body waste, 
 and particularly the prevention of addi- 
 tions to the effects of normal waste 
 throughout the body consequent upon 
 the absorption by the intestine of toxins 
 formed on account of the hindrance to 
 normal elimination, that is the aim of 
 the treatment of stasis. The result is a 
 renewed and prolonged vitality of general 
 body tissue." 
 
 VI. 
 
 Possibility of Treating Intestinal 
 Stasis by Internal Lubrication. 
 
 The question now arises: Can intes- 
 tinal stasis be treated by non-surgical 
 means, with any assurance of success? 
 
 ^ a. Carrel, Journal Exp. Med., 1914, Vol. XX, No. 1, 
 pp. 1-2. 
 
 LosBE AND Ebbmng, Joumal Exp. Med., 1914, Vol. XIX. 
 No. 6, pp. 593-602. 
 
34 TREATMENT OF 
 
 The answer of both surgeons and phy- 
 sicians is an unequivocal "Yes," provided 
 a proper selection is made of advanced 
 cases, and incipient or mild cases be cared 
 for promptly; also Uquid petrolatum is 
 the remedy to be rehed upon, and should 
 be tried before deciding on surgical means, 
 provided the product employed is of the 
 required purity, high specijBc gravity, and 
 high natural viscosity. 
 
 Lane 31 says: "We find some difficulty 
 in drawing the line between the cases in 
 which the stasis can be efficiently met 
 by the use of Kquid petrolatum and those 
 in which an alteration in the drainage 
 scheme is advisable. In all doubtful 
 cases we give Kquid petrolatum a thor- 
 ough trial before adopting operative pro- 
 cedures." 
 
 William S. Bainbridge ^^ says: "The 
 
 30 LosEE AND Ebeling, Joumol Exp. Med., 1914, Vol. XX, 
 No. 2, pp. 14Q-148. 
 
 A. H. Ebeling, Journal Exp. Med., 1913, Vol. XVII, 
 No. 3, pp. 273-285. 
 
 A. H. Ebeung, Journal Exp. Med., 1914, Vol. XX, No. 2 
 pp. 130-139. 
 
 31 British Medical Journal, May 4, 1912, p. 989 
 
 32 New York Medical Journal, 1914, Jan. 24. 
 
INTESTINAL STASIS 35 
 
 vast majority of cases should have been 
 prevented. Hygienic and medical treat- 
 ment will cure a large proportion of cases 
 if instituted in the beginning. Certainly, 
 nine out of ten, and possibly nineteen 
 out of twenty, of all cases should not 
 reach the stage which calls for surgical 
 intervention." 
 
 Lane 33 says: "From the surgeon's 
 point of view, the treatment of chronic 
 intestinal stasis consists in f acihtating the 
 passage of material through the several 
 portions of the gastro-intestinal tract. 
 ... In the vast majority of cases, the use 
 of a lubricating material, such as Uquid 
 petrolatum, which precedes the passage of 
 food, appHcation of some spring support 
 to the lower abdomen, which tends to 
 keep the viscera up and to control the 
 delay of material in the small intestine 
 and caecum, and the avoidance of the use 
 of such proteid foods as poison the tissues 
 if retained for an abnormally long time in 
 the intestine, are sufficient for the pur- 
 pose." 
 
 53 Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1, p. 114. 
 
36 TREATMENT OF 
 
 R. Murray Leslie^ says: "In the 
 large majority of instances, if the cases 
 are treated at a comparatively early 
 stage, simple remedial measures such as 
 diet modifications, physical exercises, ab- 
 dominal massage, supporting belts, ape- 
 rient remedies, and lubricants (such as 
 liquid petrolatum) are usually quite eflBca- 
 cious. . . . Liquid petrolatum ought to 
 be given in large doses Q/^ to 1 ounce) 
 two or three times daily." 
 
 William Van V. Hayes ^^ says: "Sur- 
 gery should not be thought of in the great 
 majority of instances, but is indicated in 
 the marked cases failing to respond to 
 persistent competent medical treatment." 
 
 A. F. Hertzes says: "In those cases in 
 which the whole of the colon is involved, 
 medical treatment almost invariably suc- 
 ceeds." 
 
 Robert C. Coffey^^ writes: "The 
 large majority of cases of ptosis may be 
 
 ^^ Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1, p. 272. 
 35 New York Medical Journal, 1914, Feb. 28, p. 172. 
 ^Proc. Roy. Soc. Med., London, Vol. I, Part 6, p. 175. 
 37 Surgery, Gynecology and Obstetrics, 1913, Dec., p. 428. 
 
INTESTINAL STASIS 37 
 
 successfully treated and the patient made 
 perfectly comfortable by medical and 
 dietary measures. Surgery should never 
 be considered for the treatment of ptosis 
 per se. Gastric or intestinal stasis not 
 relieved by medical and dietary measures 
 constitutes the only excuse for surgery 
 in this class of cases." . . . "I wish to 
 reiterate that only a very small per cent, 
 of ptosis cases as they now come to the 
 doctor are surgical." 
 
 W. B. Russ,^^ of San Antonio, Texas, 
 says: "Cases of intestinal stasis, even 
 though infection and toxaemia are pres- 
 ent, are primarily not surgical cases; and, 
 if the patients are properly treated, very 
 few need ever become surgical." 
 
 Rea Smith, ^^ of Los Angeles, Cali- 
 fornia, says: "I wish particularly to 
 endorse the statement of Russ, that most 
 cases of intestinal stasis are medical, and 
 I agree that operation should be reserved 
 for medical failures." 
 
 ^^ Journal American Medical Association, 1915, Aug. 28, 
 p. 769. 
 
 ^^ Journal American Medical Association, 1915, Aug. 28, 
 p. 770. 
 
38 TREATMENT OF 
 
 J. H. Kellogg,^ of Battle Creek, 
 Michigan, says he "feels that his ex- 
 perience has demonstrated that by the 
 systematic use of liquid petrolatum, com- 
 bined with a laxative and antitoxic 
 dietary, a very' large proportion of the 
 cases now subjected to short circuiting and 
 other operations might escape surgical 
 interference altogether; certainly a thing 
 greatly to be desired, especially since we 
 do not yet know what may be the remote 
 effects of these operations, while we do 
 know that the immediate results are 
 often far from satisfactory." 
 
 <c 
 
 N. W. JoNEs,4i Portland, Ore., writes: 
 No patient should ever be operated 
 upon until a local barrier of surgical 
 degree has been determined as such by 
 the failure of medical measures." 
 
 W. Hale White ^^ believes the general 
 practitioner can prevent intestinal stasis. 
 He told the Royal Society of Medicine, 
 London, that in intestinal stasis ''if sur- 
 
 ^ New York Medical Journal, 1914, Sept. 12, p. 508. 
 
 *i Lancet Clinic, 1915, Dec. 4, p. 495. 
 
 ^ Proc. Roy. Sac. Med., Vol. I. Part 6. p. 9. 
 
INTESTINAL STASIS SO 
 
 gical Interference is ever necessary the 
 patient for whom it is necessary is a re- 
 proach to her doctors, if she has con- 
 sulted any in the earher period of her 
 illness, for the condition never ought to 
 be allowed to advance to the stage which 
 requires surgery." 
 
 In this connection, the words of Ochs- 
 NER,^^ of Chicago, Illinois, are significant. 
 He says: "During ... 1914 .. . the 
 cases operated upon by my colleague . . . 
 and myself . . . represent less than 10 
 per cent, of all the cases which came under 
 our care during this period for the relief 
 of intestinal stasis, and still the number 
 operated upon contains some cases which 
 should not have been treated surgically."* 
 He gives ^^ as "contra-indications to sur- 
 gical treatment" "the class of neurotics 
 whose nervous condition has not been 
 caused by intoxication due to intestinal 
 stasis," also "in all instances where care- 
 ful and long-continued hygienic, dietetic, 
 and medicinal treatment results in physio- 
 logical relief." ^ After these cases are ruled 
 
 \*3 Surgery, Gynecology and Obstetrics, 1916, Jan., p. 45. 
 ** Surgery, Gynecology and Obstetrics, 1916, Jan., pp. 47, 48. 
 
40 TREATMENT OF 
 
 out, "only a very small percentage of 
 patients suffering from intestinal stasis 
 will remain who need to be considered 
 from the surgical standpoint." 
 
 Aboiit three years ago, the Royal 
 Society of Medicine in London, England, ^^ 
 had "A Discussion on Ahmentary Tox- 
 semia: Its Sources, Consequences, and 
 Treatment." The reading of papers and 
 the debate occupied six sessions on as 
 many days in three consecutive months. 
 It was a very exhaustive consideration of 
 intestinal stasis, and commanded the best 
 medical, surgical, and dental talent. The 
 printed part of this discussion fills 380 
 royal octavo pages. At the closing of 
 the sessions, W. Hale White,^^ in making 
 the summary of all that had been set 
 forth, said: "It is agreed that in the 
 vast majority of cases medical treatment 
 suffices, and what has been said about 
 treatment in this discussion has come 
 chiefly from the surgeons. ... If the 
 cases that now seem to some to justify 
 
 ^ Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1, 1913, March, April, May, pp. 1-380 
 
 ^ Proceedings Royal Society of Medicine, London. Vol. VI, 
 Part 1, p. 380. 
 
INTESTINAL STASIS 41 
 
 surgical treatment had been treated in 
 the first stages by proper medical means, 
 surgical interference would not have been 
 necessary, so that when this is widely 
 appreciated, cases ought never to become 
 so severe that surgical treatment is con- 
 templated, and we may hope one result 
 of this discussion will be that we shall 
 keep the drainage scheme of our patients 
 in sufficiently good order as to render 
 surgical interference unnecessary." 
 
 And, similarly, A. J. Ochsner,*' after 
 saying that intestinal stasis occurs ''in 
 patients who have suffered severely from 
 digestive disturbances during infancy, 
 with severe gaseous distension of the 
 intestines," adds, '*it seems as though 
 not only the toxic conditions but that the 
 cause of these conditions should be met 
 by proper prophylaxis before the support 
 of the intestines and the muscular struc- 
 ture have been permanently injured. It 
 would, consequently, seem proper to 
 credit the pediatrician and the general 
 practitioner with the elimination of a 
 
 *^ Surgery t Gynecology and Obstetrics, 1916, Jan., pp. 46, 47. 
 
42 TREATMENT OF 
 
 great part of suffering from this cause 
 in the future." 
 
 VII. 
 
 The Wide-Spread Existence of 
 Intestinal Stasis. 
 
 The existence of intestinal stasis and 
 the condition of ahmentary toxaemia are 
 much more common than might seem to 
 be the case on first thought. 
 
 N. W. JoNES,^^ of Portland, Oregon, 
 says that "fifty per cent, of all people 
 possess the general asthenic type of 
 build," that "within this type . • . lies 
 . . . the potentiality for general body 
 weakness which determines • . . the 
 morbid symptoms attributed to ptosis." 
 "Only when mechanical or toxic symp- 
 toms occur ... do patients realize that 
 they are not well." "No patient should 
 ever be operated upon until a local barrier 
 of surgical degree has been determined 
 as such by the failure of . . . medical 
 measures." These are orthopaedic, hy- 
 gienic and dietary, and the internal ad- 
 ministration of liquid petrolatum. He 
 
 «8 Lancet ClirdCt 1915, Dec. 4, pp. 494-495. 
 
INTESTmAL STASIS 43 
 
 says: "When the stasis is severe, and 
 especially when it concerns local ileum 
 or caecum blocking, the patient must be 
 put to bed under control, and the bowel 
 filled as rapidly as possible with a soft 
 vegetable pulp and a variable amount of 
 Uquid petrolatum." 
 
 It is evident that there is a very general 
 belief that intestinal stasis can be treated 
 medicinally. Ochsner's ^^ experience 
 shows how small a per cent, of cases of 
 intestinal stasis is surgical, and Wat- 
 son's ^° careful observations lead him to 
 say that cases which come under his 
 grouping "are met with very commonly 
 in the every-day practice of the physi- 
 cian," and he is satisfied that such cases 
 "form a large share of the cases which 
 come under the daily observation of the 
 practitioner." 
 
 vin. 
 
 The Non-Surgical Treatment of 
 
 Intestinal Stasis. 
 Considering diseases in general, the 
 question of treating any one case is often 
 
 *^ Surgery, Gynecology and Ohstdrics, 1916, Jan., pp. 54-57. 
 50 Edinburgh Medical Journal, 1914, April, p. 346. 
 
44 TREATMENT OF 
 
 perplexing, since not only the various 
 schools of medicine dififer widely in their 
 ideas of medication, but also because the 
 individual members of each school fre- 
 quently have so different preferences. 
 Happily, however, as regards the treat- 
 ment of intestinal stasis there is great 
 unanimity of opinion. Proper diet, ra- 
 tional hygiene, a suitable abdominal sup- 
 port, and Uquid petrolatum constitute the 
 non-surgical treatment. Cases should be 
 cared for non-surgically at first and until 
 such treatment has been found inefficient. 
 Most cases, however, yield to it if it is 
 carried out with patience and persistence. 
 The internal non-surgical remedy "par 
 excellence is heavy Hquid petrolatum. 
 
 William Van V. Hayes" says: "In 
 the way of medication, bland laxatives 
 are the chief medicine to be used, with 
 Hquid petrolatum of superior quaUty 
 occupying the first place in usefulness. 
 This product has the property of render- 
 ing the stools more soft and of hastening 
 the movement of the food through the 
 
 51 New York Medical Journal, 1914, Jan. 24, p. 172. 
 New York Medical Record, 1914, Feb. 28, p. 410. 
 
INTESTmAL STASIS 45 
 
 small and large intestine. It is not 
 always sufficient by itseK, however, and 
 must be assisted by agar-agar, phenol- 
 phthalein, compound licorice powder, a 
 saline cathartic, or cascara. Colocynth, 
 podophyllin, and similar drugs should not 
 be used because of their irritant action." 
 
 J. BiON BoGART^^ considers it best 
 to attack the Goliath at its source, the Ueal 
 affluent; and if the symptoms are unre- 
 lieved by a course of genuine Hquid petro- 
 latum there is nothing left but ileo- 
 sigmoidostomy with or without colectomy. 
 
 Sir W. Arbuthnot Lane^^ says: "As 
 to treatment, it resolves itseK into the 
 operative and non-operative. The non- 
 operative treatment consists in facihtat- 
 ing the passage of material through the 
 gastro-intestinal tract by sufficient doses 
 of liquid petrolatum and by the pressure 
 exerted on the lower abdomen by a 
 spring support." 
 
 Such treatment is of very great value 
 where the stasis is general through the 
 
 52 New York Medical Journal, 1914, Feb. 28, p. 413. 
 63 British Medical Jcnimal, 1912, May 4, p. 993. 
 
46 TREATMENT OF 
 
 drainage scheme or when the passage 
 through part or the whole of the large in- 
 testme is obstructed. He condemns the 
 use of germicidal drugs; tonics, as iron, 
 arsenic, and mercury; purgatives; the re- 
 striction of food; large quantities of water 
 by mouth; massage; gastric lavage and 
 bowel flushing. He says^*: "All these 
 forms of treatment are tedious, danger- 
 ous, and at the best only palhative. 
 Much more benefit can be obtained by the 
 use of pure liquid petrolatum adminis- 
 tered at regular intervals during the day. 
 It cannot be absorbed in the human 
 intestines, while it facilitates very materi- 
 ally the passage of the intestinal contents. 
 The motions cease to be firm, and they 
 are much less bulky than before, for the 
 reason that the amount of organisms, 
 which forms a considerable proportion of 
 normal faeces, is greatly reduced." In 
 addition, he recommends "the use of a 
 spring support controlling the lower ab- 
 domen," and says, "This treatment is 
 
 5* Surgery, Gynec. and Obstetrics, 1913, June, p. 604 et seq. 
 
 Also see The Operative Treatment of Chronic Intestinal Stasis, 
 3d ed., London, 1915, pp. 69-71. Cf. also Strasburger's opinion; 
 The Prolongation of Life, by Elie Metchnikoff, Eng.trans., p. 157. 
 
INTESTINAL STASIS 47 
 
 adequate, providing the mechanical ob- 
 struction produced by one or more kinks 
 is not too great." "In the shghter 
 degrees of obstruction, the use of an 
 abdominal support and a sufficient dose 
 of Kquid petrolatum is enough to coimter- 
 act any defect in the drainage. The 
 abdominal support not only keeps up 
 the viscera, but it prevents the blood 
 puddhng in the large veins in the 
 mesentery." 
 
 "Just how liquid petrolatum ^^ acts is 
 not perfectly clear. In animals it de- 
 stroys the worms that infest the intestinal 
 tract and such parasites as hve on their 
 skin. The eggs of ascaris lumh'icoides, 
 which will go on dividing in glacial acetic 
 acid, when placed in hquid petrolatum 
 die and no division takes place; and skin 
 mycosisy in a large bird which resisted 
 treatment with iodine, has been cured by 
 daily applications of hquid petrolatum 
 forcibly rubbed in. It also cures the 
 dysenteric conditions to which animals 
 are so hable, especially in captivity. Yet 
 liquid petrolatum is apparently perfectly 
 
 55 Guy's Hospital Gazette, 1911, Sept. 30, p. 404. 
 
48 TREATMENT OF 
 
 innocuous to the human subject, and 
 loses none of its bulk in its passage 
 through the intestinal tract." 
 
 "The non-operative treatment of 
 stasis,^® then, consists in facilitating the 
 passage of material through the gastro- 
 intestinal tract by sufficient doses of 
 hquid petrolatum and by the pressure 
 exerted on the lower abdomen by a spring 
 support." . . . Even in cases of "serious 
 obstruction at the end of the ileum, or 
 when the lumen of the duodenum is 
 reduced very considerably by cicatriza- 
 tion of an ulcer, it (liquid petrolatum) is 
 often very helpful in facilitating the 
 passage of the fluid contents through a 
 small aperture. . . . The use of liquid 
 petrolatum reduces the quantity of faecal 
 matter passed, very considerably, prob- 
 ably because it is hurried along the tract 
 and has not added to it the large quantity 
 of organisms which form so much of its 
 bulk in normal conditions. The quantity 
 of urine passed is also much reduced, 
 apparently because the hustling of the 
 faecal contents along the canal reduces 
 
 ^ British Medical Journal, 1912, May 4, p. 993. 
 
INTESTINAL STASIS 49 
 
 greatly the quantity of toxins absorbed 
 by the mesenteric vessels and the products 
 into which they are converted in order to 
 be excreted through the kidneys, etc." 
 
 R. Murray Leslie" says: "During 
 the past year I have been struck with 
 the undoubted benefits from the regular 
 use of Uquid petrolatum in cases of en- 
 teroptosis, even when accompanied by 
 well-marked chronic intestinal stasis. . . . 
 I generally begin with doses of two tea- 
 spoonfuls twice or thrice daily, and in 
 some cases increase to one tablespoonful 
 doses. During the administration of 
 liquid petrolatum, aperient drugs may 
 often be almost entirely suspended, which 
 is a great advantage. In addition to its 
 lubricant action, hquid petrolatum seems 
 to exercise a most beneficial effect on the 
 intestinal mucous membrane, and its 
 value in many cases of mucous coHtis is 
 quite remarkable." 
 
 A. E. RocKEY^ says: *'The dryness of 
 the colonic contents may be avoided by 
 
 •' Clinical Journal, 1912, May 1, p. 61. 
 
 »• Surgery, Gynecology andOhstetrics, 1913, Dec., pp.746-747» 
 
50 TREATMENT OF 
 
 causing the patient to drink large quan- 
 tities of water. . . . Liquid petrolatum 
 is the most effic ?nt lubricant for the colon 
 that can be given by the mouth. ... A 
 dose of from one to three ounces, given 
 preferably in a glass of cold water, at 
 night, is sufficient to overcome many ob- 
 stinate cases of constipation during the 
 time that it is used. As the mechanical 
 causes of the constipation are not in- 
 fluenced by the use of this remedy, it may 
 be necessary to continue it indefinitely, 
 and it is far better to give a daily dose of 
 just sufficient size to produce a regular 
 movement than to cause a spasmodic 
 movement by the use of a large dose for 
 the purpose of clearing accumulations." 
 
 Gerald Blake ^^ writes: "The medical 
 treatment (of ileal stasis) resolves itself 
 into an attempt to restore the inefficient 
 bowel to its normal function. Rehef of 
 constipation, over a long period of time, 
 may of itself be a curative measure, and 
 this has been best accomplished by the 
 use of some of the mechanical agents for 
 moving the bowels, preferably liquid 
 
 68 Boston Medical and Surgical Journal, 1914, Mar. 19, p. 423. 
 
INTESTINAL STASIS 51 
 
 petrolatum in one-half-ounce doses two 
 or three times a day, or agar-agar in two- 
 dram doses three times a day, or both 
 together, with a diet aimed at relief of 
 constipation, and general hygienic and 
 tonic measures to strengthen the weak- 
 ened tissues." 
 
 R. Murray Leslie®^' says: "Liquid 
 petrolatum is extremely useful as a 
 routine remedy in the treatment of or- 
 dinary constipation apart from actual 
 stasis, particularly when associated with 
 flatulence or distension; while the value 
 of its lubricant action in the case of 
 hemorrhoids is obvious." 
 
 Quite recently, A. L. Knight^^ called 
 the attention of the Academy of Medi- 
 cine of Cincinnati to the value of 
 Keith's work, which shows the important 
 connection of the myenteric or Auer- 
 bach's plexus with intestinal stasis. 
 This plexus *'has the power of main- 
 taining tonicity, of originating and con- 
 ducting impulses, and of reacting in a 
 
 ^ American PracUtioner, 1913, Aug., p. 422. 
 81 Lancet Clinic, 1915, Dec. 4, p. 491 et seq» 
 
52 TREATMENT OF 
 
 specific manner to specific stimuli. . . . 
 There are points in the digestive tract 
 where the tissue is particularly well 
 developed, and from which peristaltic 
 movement seems to originate — ^that is, 
 points that are true nodal centers or 
 pace-makers, notably, at least anatomi- 
 cally, that center at the ileo-csecal junc- 
 tion." 
 
 Arthur Keith 62 demonstrates "that 
 Auerbach's plexus (or more exactly the tis- 
 sue which unites the plexus with the mus- 
 culature of the bowel — ^Auerbach's tissue) 
 represents the most excitable musculature 
 of the intestine" and is of the same nature 
 as the auriculo-ventricular bundle of His. 
 "Tawara regarded the nodal tissue at the 
 commencement of that bundle as excitory 
 in nature — muscular tissue with an en- 
 hanced power of initiating rhythmic con- 
 tractions. ... It is this intermediate 
 tissue which is particularly endowed 
 
 62 An Account of Six Specimens of the Great Bowel Re- 
 moved by Operation: With Some Observations on the Motor 
 Mechanism of the Colon, by Arthur Keith, London, in The 
 British Journal of Surgery ^ Vol. H, No.^8, 1915, April, pp. 576- 
 599; — also see The Cavendish Lecture, 1915, Jime 25. See 
 The Lancet (London), 1915, August 21, pp. 371-375, also 
 1915, July 3, pp. 18, 19. 
 
INTESTINAL STASIS 53 
 
 ,••.•■ • -• ■ ■^.. ^ 
 
 with an automatic power of originating 
 contractile impulses and muscular move- 
 ments. . . . Auerbach's collar, which sur- 
 rounds the ileo-caecal junction, is 'nodal' 
 in its true nature; it is the tissue in 
 which csecal and ileo-csecal movements 
 normally take their origin; and it is 
 through this tissue that the central 
 nervous system exercises its control over 
 such movements." He finds Auerbach's 
 plexus and tissue particularly developed 
 at the pylorus — ^the junction of the duo- 
 denum and jejunum — ^the ileo-csecal junc- 
 tion of the proximal and distal colon as 
 well as of the colon and rectum. *'Inthe 
 distal part of the transverse colon and in 
 the descending colon — ^these tracts of the 
 bowel being normally in a condition of 
 hypertonus — ^this tissue is more abun- 
 dant than in the appendix, caecum, or 
 ascending colon." He says: "I am con- 
 vinced that in the great majority of 
 cases which are classified under the some- 
 what elastic term of ' intestinal stasis' the 
 symptoms do not result from an atony of 
 the musculature of the bowel, but from 
 a hypertonicity of those parts which are 
 
54 TREATMENT OF 
 
 normally in a state of tonic contrac- 
 tion. . . . 
 
 "There is no doubt that in all cases of 
 intestinal stasis there is a disorder of the 
 neuro-muscular mechanism of the great 
 bowel, but we cannot explain that dis- 
 order in the present state of our knowl- 
 edge." 
 
 Nevertheless, from this it is easy to 
 understand the value of liquid petrola- 
 tum in all degrees of intestinal stasis, es- 
 pecially in incipient stasis. The oil pre- 
 vents the intestinal contents irritating the 
 intestinal wall, while, at the same time, 
 it allows the contents to pass easily and 
 quickly along. It relieves the exhausted 
 or weakened myenteric ganglia to the 
 extent that ultimately a normal bowel 
 functioning may result. Or it may faciU- 
 tate the passage of the intestinal contents 
 through a bowel in tonic spasm whether 
 such is due to central or peripheral 
 stimulation. 
 
 Ernest Clark^^ recently called the 
 attention of the Royal Society of Medi- 
 
 '^ Proceedings Royal Society of Medicine^ London, Vol. VI, 
 Part 1, pp. 315-319. 
 
INTESTINAL STASIS 55 
 
 Cine in London to the possibility of 
 preventing senile changes in the crystal- 
 line lens by prompt treatment of intesti- 
 nal stasis with hquid petrolatum. His 
 report is too long to reproduce entire, 
 but is valuable to every student of in- 
 testinal stasis, as well as to those inter- 
 ested in ophthalmology. 
 
 The following two cases are examples 
 of those cited: 
 
 "Two females, one aged 153^ and the 
 other 44, had the same accommoda- 
 tive power, viz., 7D. In the girl, this is 
 about 4D worse than normal; and in the 
 woman, 2D better than normal. The 
 girl was too young to show any outward 
 sign of ageing, but she had a most un- 
 healthy appearance and confessed to 
 habitual constipation, and asserted that 
 the bowels were often open only twice 
 a week. On the other hand, the woman, 
 aged 44, looked ten years younger and 
 had always paid the most scrupulous 
 attention to the bowels, and, for some 
 time past, had taken a daily small dose 
 of hquid petrolatum." Clark's cases 
 are so interesting and important that the 
 
56 TREATMENT OF 
 
 temptation to quote at length is great, 
 but the following must suffice. He says: 
 "It bears out, incidentally, Hertz's^ 
 statement that a daily evacuation of the 
 bowels is no proof of the absence of 
 intestinal stasis. A man, aged 48, with 
 an accommodation power below the 
 normal, ^^ who had no suspicion that he 
 was suffering from constipation, had 
 appendicitis . Sir W. Arbuthnot Lane oper- 
 ated and found a very bad state, pointing 
 to many years of habitual stasis. On his 
 recovery, he was made to attend most 
 carefully to the bowels, and especially to 
 take lubricants such as hquid petrolatum. 
 The result is that now, after some years, 
 his accommodative power is three years 
 above the average, and he looks and is a 
 much younger man than his years. This 
 case also shows that by treatment we 
 can give back a patient some of his lost 
 youth by arresting the senile process in 
 the lens and often in other parts of the 
 body. 
 
 ^* Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1, p. 164. 
 
 ^ Proceedings Royal Society of Medicine, London, Vol. VI, 
 Part 1, pp. 318, 319. 
 
INTESTINAL STASIS 57 
 
 €t 
 
 I think I have said enough to prove 
 that premature hardening of the lens is 
 a very constant sequela of intestinal 
 stasis . . . and that removal of the in- 
 testinal stasis tends to an arrest of the 
 sclerosing process. ... I need hardly 
 add that I have an enormous faith in 
 Uquid petrolatum as a lubricant in curing 
 stasis." 
 
 George Rowell^^ emphasized his dis- 
 cussion by clinical cases. He said: "In 
 a case that I saw recently, a young lady 
 who had marked symptoms of chronic 
 intestinal stasis, together with pain over 
 the appendix, was treated by hquid petro- 
 latum for six months, with the result that 
 the whole of the marked objective symp- 
 toms were cured but the pain remained. 
 An operation was undertaken for the 
 pain, and an appendix tightly held up 
 and sharply kinked was found and re- 
 moved." Further, "I know of many 
 cases (of pyorrhoea) in which the cure 
 has been aided by Uquid petrolatum 
 internally. Two of my dental friends, of 
 
 ^* Proceedings RoycU Society of Medicine, London, Vol. VI» 
 P^ 1. pp. 197, 198. 
 
58 TREATMENT OF 
 
 large experience in this disease, make 
 an almost routine practice of prescrib- 
 ing liquid petrolatum for these cases, 
 and one of them has told me that 
 he does not know whether the liquid 
 petrolatum or the local treatment has the 
 largest share in effecting a rapid cure." 
 
 RowELL®^ said further: "In 1901, Eric 
 Pritchard came to the conclusion that 
 disease in infants, and much in after life, 
 is largely due to overfeeding during the 
 first year. This, he held, causes over- 
 development in the length of the bowel, 
 such an overgrowth often extending to 
 many feet for which there is no adequate 
 room, and, therefore, peristalsis is im- 
 peded and delay in the passage of the 
 contents of the intestine results. For 
 the prevention and treatment of this 
 condition, he has given Hquid petrolatum 
 very largely, and, agreeing with Lane,^^ is 
 convinced that the constant exhibition of 
 liquid petrolatum has a marked effect in 
 both the prevention and the cure of 
 tuberculosis." 
 
 " The Practitioner, 1913, XC, p. 294. 
 
 ^Proc. Roy. Soc. Med., Vol. VI, Part 1, p. 114. 
 
INTESTINAL STASIS 59 
 
 R. Murray Leslie^^ says: " The action 
 of liquid ^petrolatum is twofold^ lubricant 
 and protective, and both of these actions 
 are of immense value in intestinal stasis. 
 . . . The value of liquid petrolatum in 
 facilitating the passage of intestinal con- 
 tents in adults can be readily gauged by 
 watching with the X-Ray screen the rate 
 of passage of a bismuth meal in a patient 
 with intestinal stasis, who has been taking 
 liquid petrolatum right up to the date of 
 examination. In such a case the bismuth 
 may be observed actually coursing along 
 the bowel coils, including the segments of 
 the large intestine; while in a similar 
 case where no liquid petrolatum has been 
 administered the passage is slow, irreg- 
 ular and spasmodic. . . . The effect of 
 full doses of liquid petrolatum may 
 shorten the time taken by the passage of 
 the gastro-intestinal contents from the 
 stomach to the rectum by as much as 
 one-half." 
 
 Alfred C. Jordan,^** Medical Radiog- 
 rapher, of Guy's Hospital, London, says: 
 
 ^5 American Practitioner, 1913, Aug., p. 419. 
 '0 The Practitioner, 1913, Feb., pp. 441-454. 
 
60 TREATMENT OF 
 
 *'The most universal remedy, short of 
 operation (for intestinal stasis) is to sup- 
 port the lower part of the abdomen by 
 a suitable shield or belt, and administer 
 pure Uquid petrolatum. . . . The action 
 of the Hquid petrolatum is simple; it 
 enters the caecum mixed with the ileal 
 contents, and keeps the contents of the 
 large bowel soft. Moreover, it accelerates 
 the passage of the faeces through the large 
 intestine, which consequently does not 
 become overloaded. Far less bacterial 
 action goes on, and the faeces are found 
 to contain far fewer microbes. The 
 whole of the ingested Uquid petrolatum 
 can be recovered from the stools, so that 
 there are no absorption of Hquid petro- 
 latum and no possibility of a toxic action 
 from its use — even in large amounts. 
 I am frequently reminded of the genuine 
 eJEcacy of Hquid petrolatum in reHeving 
 intestinal stasis, for, in patients who are 
 taking it — or who have taken it within 
 a fortnight or so of the X-ray examina- 
 tion — I have the greatest diflSculty in 
 obtaining X-ray evidence of the stasis, 
 although it is undoubtedly present 
 
INTESTINAL STASIS 61 
 
 when the patient is not under this 
 treatment." 
 
 J. H. Kellogg'^ writes: "Liquid petro- 
 latum will not remedy every defect in 
 the defecating process, and hence will 
 not cure every case of constipation, but 
 it comes nearer being a panacea than any 
 remedy which has heretofore been found, 
 and does meet a surprisingly large number 
 of indications. After a careful study of 
 its effects in several thousand cases, the 
 writer feels justified in saying, with much 
 confidence, that hquid petrolatum may 
 be rehed upon to accomphsh the following 
 results in the treatment of chronic con- 
 stipation: 
 
 "1. It lubricates the ahmentary canal 
 throughout its whole length. In a large 
 number of cases of constipation there is 
 an excessive absorption of water from 
 the colon, leaving the faeces dry, or pasty 
 and adhesive. . . . The use of half an 
 ounce or an ounce of hquid petrolatum 
 at bed-time and haK as much half an hour 
 before each meal will in two or three 
 days change the condition completely. 
 
 " New York Medical Journal, 1914, Sept. 12, p. 504 et seq. 
 
62 TREATMENT OF 
 
 "2. This mechanical lubricating action 
 of Uquid petrolatum is highly important 
 in overcoming kinks due to redundancy 
 or to Jackson's membrane, adhesions 
 resulting from colitis or other causes. 
 
 "3. The concentrated diet of our mod- 
 ern civihzed life contains so little indi- 
 gestible material that the residue forms 
 a pasty mass which tends to adhere to 
 the intestinal wall. . . . Fats . . . are more 
 or less laxative if taken in suflScient 
 amounts . . . but both animal and vege- 
 table fats are digestible and absorbable, 
 hence (in usable amounts) . . . are not ef- 
 fective in changing the character of the 
 stool. . . . Liquid petrolatum is free from 
 these objections, since it is wholly non- 
 absorbable, and a comparatively small 
 amount serves the purpose required be- 
 cause it all remains in the intestine. 
 
 "4. Liquid petrolatum is useful in all 
 forms of intestinal stasis, no matter what 
 the cause, by preventing the abnormal 
 drying out of the food residues which is 
 the necessary result of too long retention 
 in contact with absorbing surfaces. 
 ' "5. Liquid petrolatum . . . stimulates 
 
INTESTINAL STASIS 63 
 
 activity of the small intestine, . . . great- 
 ly accelerates the passage of material 
 through the small as well as the large 
 intestine. • . . Stagnation in the small 
 intestine is of far greater importance 
 than stasis in the colon, for the reason 
 that both putrefaction and absorption 
 are (in it) much more active than in the 
 large intestine. Even in cases . . • due 
 to . . . Lane's kink . . . great relief may 
 usually be obtained by the regular use 
 of liquid petrolatum. 
 
 • "6. One of the very interesting fea- 
 tures of the many-sided useful activities 
 of liquid petrolatum is its behavior 
 toward intestinal toxins. These toxins 
 consist, not only of bile acids and alkaline 
 wastes of various sorts excreted by the 
 intestinal mucous membrane, but, in addi- 
 tion, of a great variety of ptomaines and 
 toxins produced through bacterial action, 
 especially in the colon and also in the 
 small intestine in cases of incompetency 
 of the ileo-csecal valve. Liquid petro- 
 latum is a highly active solvent and read- 
 ily dissolves these waste and poisonous 
 substances, many of which are more 
 
64 TREATMENT OF 
 
 soluble in liquid petrolatum than in 
 water. The result is that the liquid 
 petrolatum, itself not absorbable, takes 
 up a very considerable portion of the 
 toxins found present in the intestinal 
 tract and thus prevents their absorption. 
 When Hquid petrolatum is used, it may 
 always be seen in the stools, showing a 
 brownish or blackish color, due to the 
 substances which it holds in solution. 
 In a laboratory test made by a com- 
 petent chemist by request of the writer, 
 it was found that when liquid petrolatum 
 was shaken with a watery solution of 
 indol, more than half the indol was 
 quickly taken up by the hquid petro- 
 latum. The use of hquid petrolatum 
 thus affords an effective means of hinder- 
 ing the absorption of intestinal toxins 
 and conveying them out of the body. 
 
 "7. Liquid petrolatum is useful . . • 
 in protecting the mucous membrane when 
 ... irritated, as in . . . chronic colitis. 
 . . . The value of hquid petrolatum as a 
 dressing for wounds is well known. . . . 
 Liquid petrolatum acts in an equally favor- 
 able way upon irritated mucous surfaces. 
 
INTESTINAL STASIS 65 
 
 "8. Liquid petrolatum is a useful 
 protective . . . hindering the absorption 
 of poisons by mucous surfaces which have 
 been deprived of their epithehum. The 
 normal epithehal covering of the intes- 
 tines has remarkable filtering powers, by 
 which toxins, especially colloid poisons, 
 are excluded. This filtering power is lost 
 when the surface is denuded. . . • Liquid 
 petrolatum renders great service in 
 such cases by hindering the absorp- 
 tion of these poisons which occurs 
 with great readiness thi^ough abraded 
 surfaces. 
 
 "9. Li cases of colitis liquid petro- 
 latum not only protects the irritated sur- 
 faces, but also through its lubricating 
 effect and through softening the intestinal 
 contents aids greatly in overcoming the 
 spastic condition of the intestine, which 
 in many cases of chronic constipation is 
 so formidable an obstacle to recovery. 
 Laxatives of all sorts increase the spas- 
 ticity of the intestine''^ and so aggravate 
 the constipation which they are given to 
 
 '2C/, supra. § \^II., p. 53 (Brit. Jour. Surg., 1915, April, 
 p. 581), (Lancet, London, 1915, July 3, pp. 18, 19, Aug. 
 21, pp. 374-375). 
 
66 TREATMENT OF 
 
 relieve. This is one reason why many- 
 are more constipated after taking a laxa- 
 tive than before. Temporary relief is 
 obtained by the production of watery 
 stools which are able to pass through the 
 contracted bowel, but as soon as the first 
 effects of the laxative pass off, constipa- 
 tion becomes worse than before, since the 
 spasm is greater. Liquid petrolatum lu- 
 bricates and protects the sensitive surface 
 of the spastic bowel, and at the same 
 time softens the intestinal contents so as 
 to permit passage through the bowel 
 without mechanical irritation. Cases of 
 colitis are greatly benefited by the regular 
 use of liquid petrolatum. 
 
 "10. Incompetency of the ileo-csecal 
 valve is a very active and frequent cause 
 of serious disease, ... a common and 
 effective cause of iliac stasis. The ex- 
 perience in treating several hundreds of 
 cases has shown that aside from the regu- 
 lation of diet the regular use of liquid 
 petrolatum is the most effective means 
 of combating this condition. Medicinal 
 laxatives cannot be used in these cases 
 for the reason that they stimulate the an- 
 
INTESTINAL STASIS 67 
 
 tiperistalsis by which the reflux from the 
 colon into the small intestine is increased. 
 James T. Case has shown by X-ray ex- 
 amination that liquid petrolatum in- 
 creases the motility of the small intestine 
 while it does not increase antiperistalsis. 
 
 "11. In cases in which the iliac stasis 
 is due to spasm of the ileo-csecal valve, 
 induced by chronic appendicitis, ovarian 
 irritation or inflammation, colitis, or pos- 
 sibly painful rectal disease through reflex 
 irritation, liquid petrolatum proves itself 
 to be an invaluable remedy, since it has 
 the property of increasing the peristaltic 
 activity of the small intestine to such a 
 degree as to enable it to overcome the 
 spasm of the ileo-C8ecal valve without 
 producing irritation which would inevi- 
 tably increase the spasm of the sphincter, 
 as do drug laxatives. The pecuHar prop- 
 erty of liquid petrolatum which enables 
 it to stimulate and facilitate intestinal 
 motility without producing irritation, is 
 invaluable. The regular use of liquid 
 petrolatum very generally relieves hemor- 
 rhoids and fissure even when of some years' 
 standing. These morbid conditions are 
 
68 TREATMENT OF 
 
 usually the result of constipation, and are 
 maintained and aggravated by straining 
 at stool. By the habitual use of hquid 
 petrolatum the stools are made soft, 
 straining is avoided, the sensitive surface 
 is protected, the intestinal contents are 
 rendered less irritating and infectious, and 
 thus the tissues are given an opportunity 
 to heal and return to a normal condition. 
 
 "12. Since adopting the use of Kquid 
 petrolatum the author has found that the 
 number of cases in which operation for 
 hemorrhoids is required is greatly re- 
 duced. Patients who have contemplated 
 submitting to operation for removal of 
 hemorrhoids of many years' standing, 
 often within a week after beginning the 
 use of hquid petrolatum have found them- 
 selves so completely reKeved that an 
 operation was no longer considered. 
 
 ''13. Liquid petrolatum is capable of 
 rendering invaluable service, in cases 
 of intestinal intoxication, by increasing 
 the number of daily stools. The length 
 of time that foodstuffs remain in the 
 intestine is reduced from several days to 
 a few hours. This greatly lessens the 
 
INTESTINAL STASIS 69 
 
 opportunity for development of putre- 
 factive processes and the absorption of 
 putrefaction products. By the use of 
 Kquid petrolatum in connection with an 
 antitoxic diet and antitoxic ferments such 
 as the cultures of the bacillus BulgaricuSy 
 bacillus bifidus, and bacillus glycobacter, 
 it becomes a comparatively easy matter 
 to change the intestinal flora — a task dif- 
 ficult without this aid and very often im- 
 possible. Any one who has made a 
 serious effort to change the intestinal 
 flora, checking up his dietetic and other 
 prescriptions by frequent bacteriological 
 examinations of the faeces and chemical 
 examination of the urine, knows how 
 diflicult a task this is. It is absolutely 
 necessary that constipation should be 
 overcome. Laxative drugs are harmful, 
 as pointed out by Combe long ago, and 
 hence cannot be used to advantage, but 
 liquid petrolatum is harmless; and, by its 
 systematic use in combination with other 
 suitable measures, success may be ob- 
 tained in all cases in which conditions 
 requiring surgical interference do not 
 exist. Indeed . . • experience has dem- 
 
70 TREATMENT OF 
 
 onstrated that by the systematic use of 
 liquid petrolatum combined with a laxa- 
 tive and antitoxic dietary, a very large 
 proportion, probably by far the largest 
 proportion, of the cases now subjected to 
 short circuiting and other operations 
 might escape surgical interference alto- 
 gether; certainly a thing greatly to be 
 desired. 
 
 ''Liquid petrolatum possesses so many 
 advantages that it will be given prece- 
 dence over all laxatives under nearly 
 all circumstances, when its merits are 
 appreciated." 
 
 Bainbridge^^ says: "Liquid petrola- 
 tum is the agent which by common con- 
 sent is pronounced the most satisfactory 
 in the treatment of chronic intestinal 
 stasis. . . . Liquid petrolatum commonly 
 found in the market is not sufficientlv 
 refined to be entirely free from irritating 
 ingredients or to be agreeable to the taste. 
 Some of the products are too thin, and 
 consequently give rise to 'dribbhng,' which 
 is not only extremely disagreeable, but 
 
 ^3 Woman's Medical Journal, 1914, Jan., p. 10. 
 
INTESTINAL STASIS 71 
 
 defeats the purpose for which the oil is 
 given." 
 
 R. Murray Leslie ^^ says: "The nu- 
 merous aperient remedies^ the indiscrimi- 
 nate use of which is directly opposed to 
 the modern view of rational therapeutics, 
 have now been largely superseded by the 
 use of lubricants, particularly liquid petro- 
 latum, which in the writer's opinion is by 
 far the most valuable internal remedy in 
 the treatment of intestinal stasis." . . . 
 
 "As one of the first to systematically 
 administer liquid petrolatum in intestinal 
 stasis, the writer can speak with some 
 authority in regard to its value. As the 
 result of his experience he has no hesita- 
 tion in stating that, in the large majority 
 of cases of early intestinal stasis, the 
 judicious use of liquid petrolatum (in as- 
 sociation with diet modifications, hygienic 
 measures, and, in some cases, with prop- 
 erly constructed supporting belts) is usu- 
 ally quite efficacious in affording per- 
 manent relief." 
 
 '4 American Practitioner, New York, 1913, Aug., p. 418. 
 
72 TREATMENT OF 
 
 IX. 
 
 Constipation in Infants. 
 
 Elie Metchnikoff 75 says: "Infants 
 are frequently seriously ill as the result 
 of constipation. . . . The illness may 
 lead to death, but is generally cured by 
 simple purging." 
 
 Eric Pritchard/^ of the Queen's Hos- 
 pital for Children, London, says: "At one 
 time it was my invariable practice to 
 treat cases of constipation in infants with 
 additional feedings of cream. . . . Unless 
 the evidence from collateral sources 
 is clear that the percentage of fat is 
 below the nutritive requirements, this 
 line of treatment has httle to commend 
 it. This difficulty can be avoided by 
 substituting hquid petrolatum for fat. 
 Liquid petrolatum never gives rise to 
 nutritional or to digestive disturbances; 
 it is an absolutely inert lubricant, which 
 passes out of the bowel in exactly the 
 same condition as it enters the mouth; 
 
 ^■5 £lie Metchnikoff, The Prolongation of Life, Eng. trans., 
 p. 67; DU Pasquier, Gazette des Hopitaux, 1904, p. 715. 
 ''^ The Practitioner, London, 1910, May, p. 594. 
 
INTESTINAL STASIS 7S 
 
 moreover, every trace of it can be re- 
 covered from the faeces. If given in 
 sufficient quantities it will soften the 
 hardest scybala, and substitute soft plas- 
 tic stools which pass with ease through 
 the sigmoid and rectum." 
 
 P. G. Easton" says: "The chronic 
 constipation of children and infants often 
 yields most easily to liquid petrolatum in 
 small doses given regularly three times a 
 day at first, and later reducing the dose 
 to once a day, preferably at bedtime. 
 Thus a breast-fed baby of six months was 
 practically cured of constipation by ad- 
 ministering 15 drops of hquid petrolatum 
 added to a teaspoonful of water and 
 given before its bottle three times a day." 
 
 Eric Pritchard,^^ of London, England, 
 says: "The treatment of constipation 
 resolves itself into the restoration and 
 regulation of the secretory functions. . . . 
 In all cases of constipation the diet must 
 be thoroughly supervised. . . . If no ob- 
 
 '^ Journal Royal Army Medical Corps, London, 1914, 22, 
 p. 443. 
 
 ''^ The Physiological Feeding of Infants, by Eric Pritchard, 
 Srd edition, 1909, pp. 260-267, 434-435. 
 
74 TREATMENT OF 
 
 vious error be discovered in the dietary, 
 a careful examination of the stools may 
 throw hght on the cause and suggest 
 lines of treatment." He distinguishes in 
 constipation three classes of stools: 
 
 " 1. Large, Pasty Stools, Light-Colored, 
 of Foul Odor and of Greasy Consistence. 
 . . . The indications for treatment are 
 to restore the activity of the hver and 
 pancreas and to increase and regulate 
 the peristaltic functions. 
 
 "2. Small, Elongated Stools, very Hard 
 and Brittle, Light-Colored, or even White. 
 ... In cases of this kind an increase of 
 the percentage of fat in the food will 
 often accomplish the desired end; . . . 
 if an infant who passes motions of this 
 kind has an ample allowance of fat in the 
 food, say 4 per cent., if it is putting on 
 weight in a normal manner, say six ounces 
 a week, and if there is no other indication 
 for an increase in fat except the consti- 
 pated condition of the stools, it may be 
 hazardous to run the risk of inducing fat 
 dyspepsia by increasing the amount of 
 the constituent. 
 
 "It was the diflSculty of treating this 
 
INTESTINAL STASIS 75 
 
 variety of constipation on scientific and 
 rational lines that led me to devise the 
 following method, to which, so far as I 
 know, there is absolutely no objection: 
 
 "There is no vegetable or animal oil 
 that can reach the lower bowel and soften 
 constipated stool, unless it is given in 
 such excess that it is neither digested nor 
 absorbed, hence there is danger of fat 
 dyspepsia; but a mineral oil such as 
 hquid petrolatum, in whatever doses it 
 is administered, will always reappear in 
 the motions and soften them to an extent 
 which is directly proportional to the 
 amount given. Liquid petrolatum can- 
 not decompose in the bowel and cause 
 offensive motions like excess of fat. It 
 cannot become absorbed and tax the re- 
 sources of the hver; in fact, it behaves 
 as the most perfect mechanical lubricant 
 of the bowel, and has, as far as I know, 
 absolutely no injurious therapeutic action. 
 I have used it now consistently for two 
 years, both in my private practice and 
 at my infant consultations in Welbeck 
 Street, and I have never had any reason 
 to find fault with it. I find it an excellent 
 
76 TREATMENT OF 
 
 vehicle for a large number of drugs, but 
 more especially for pancreatic extract. 
 The form in which I give the hquid petro- 
 latum is an emulsion, of which I give the 
 formula. 
 
 ''This emulsion is most useful as an 
 intestinal lubricant in cases of constipa- 
 tion or ulceration of the bowel. It may 
 be prepared as follows : 
 
 Pure Liquid Petrolatum 20 minims 
 
 Powdered Gum. Acacia 10 graios 
 
 Essential Oil Almond Vi6 Tninim 
 
 Elixir SaccKarin (1 : 20) J^ minim 
 
 Water to make 1 drachm 
 
 "Liquid petrolatum emulsion is a good 
 vehicle for insoluble drugs such as sulphur 
 and the salts of bismuth, and also for the 
 digestive ferments such as papain and 
 pancreatin. The formula I employ for 
 pancreatin is as follows: 
 
 liquor Pancreatis 10 minims 
 
 Sodiimi Bicarbonate 4 grains 
 
 Boracic Acid 3^ grain 
 
 Liquid Petrolatimi Emulsion to make. . . 1 drachm 
 
 "Adults as well as infants find this 
 emulsion quite agreeable. . . . For in- 
 fants I generally order one teaspoonful 
 
INTESTINAL STASIS 77 
 
 three times a day, after food, but I always 
 tell the mother to begin with quite small 
 doses, say a quarter of a teaspoonful, 
 and then gradually to increase the dose 
 till the full amount is reached. . . . 
 Three teaspoonfuls of the liquid petro- 
 latum emulsion are, as a rule, quite 
 enough to render constipated stools of the 
 kind under consideration amply soft, but 
 if they still remain hard there is no harm 
 in increasing the dose up to six or seven 
 teaspoonfuls a day. 
 
 "3. Small, Marble - Shaped Stools, 
 sometimes with Pieces of Dried Mucus 
 Adherent to their Surface, sometimes 
 with Traces of Blood. . . . 
 
 "The treatment of the condition of the 
 bowel which gives rise to motions of this 
 kind will depend very largely on the 
 symptoms which have preceded the con- 
 stipation." 
 
 Pritchard,^^ in a paper on Some Prac- 
 tical Points in the Management of Breast 
 Feeding, adds: "The mechanism of 
 defecation depends on a somewhat com- 
 
 ^3 Archives of Pediatrics, 1913, March, pp. 165-167. 
 
78 TREATMENT OF 
 
 plicated nervous reflex. . . . The regu- 
 larity and efficiency with which the cen- 
 ters ply their automatic functions depend 
 very largely on the nature and character 
 of early training. There is nothing 
 more damaging to a young center than 
 overstimulation, and there is no worse 
 form of education for the inexperienced 
 centers of defecation than overstimula- 
 tion with castor oil, glycerin suppositories, 
 or soap-and-water enemata. All these 
 violent expedients exhaust the centers and 
 leave the reactionary constipation. 
 
 ''. . . The epithelial lining of the in- 
 testine is a very delicate and sensitive 
 structure, easily damaged, easily torn off, 
 and easily stimulated. Meconium seems 
 most nicely adjusted to preserve and pro- 
 tect so delicate a mucous surface, until 
 such time as it is replaced by the normal 
 constituents of an infant's stool. Per- 
 sonally, I believe that many a colitis is 
 determined in young infants by the pre- 
 mature sweeping out of the meconium. 
 ... So important to my mind is the 
 function of meconium that when it is 
 deficient in quantity or prematurely ex- 
 
DsTESTEsAL STASIS 79 
 
 pelled by accident or undue interference, 
 I always take care that it is replaced by 
 an efficient substitute. The best sub- 
 stitute that I have so far been able to 
 discover is, without doubt, hquid petro- 
 latum emulsion. Liquid petrolatum is a 
 good lubricant, and, hke meconium, it is 
 not assimilated by the epithehal cells, and 
 thus reduced in bulk as it descends the 
 bowel — ^that is to say, it reaches the 
 rectum intact. 
 
 "It is physiologically an inert sub- 
 stance; it is protective, lubricant, and 
 soothing. In fact, so satisfactory does 
 its administration prove that I now give 
 it in all cases in which the infant suffers 
 from tormina, entero-spasm, or dys- 
 peristalsis. When prepared according 
 to the formula following I find infants 
 take it well: 
 
 Liquid Petrolatuia 20 drops 
 
 Benzoic Acid '^Is2 grain 
 
 Saccharin Vss grain 
 
 Oil Cinnamon ^/le drop 
 
 Decoction Irisii Moss to make 1 teaspoonful 
 
 Dose: A teaspoonfiil to a tablespoonful, from three to six 
 times a day." 
 
 "I would here utter a word of caution 
 against the indiscriminate use of some 
 
80 TREATMENT OF 
 
 of the largely advertised petroleum emul- 
 sions, partly for the reason that their 
 flavoring and method of manufacture are 
 not calculated to benefit infants, but 
 chiefly because they may contain supple- 
 mentary bodies, such as hypophosphites, 
 which are not required by infants and 
 which cannot be given safely, except in 
 very small dosage. With an emulsion 
 of the formula here given the dosage may 
 be as large as two ounces a day, divided 
 into as many doses as the baby receives 
 feed, or as small as one teaspoonful in 
 the twenty -four hours. * Such an emul- 
 sion is an excellent vehicle for all the 
 drugs that are usually administered to 
 infants, and it matters little whether such 
 drugs be soluble or insoluble provided 
 the emulsion itself is well shaken before 
 it is poured out of the bottle." 
 
 X. 
 
 Liquid Petrolatum During Pregnancy 
 AND Lactation. 
 Elie Metchnikoff,^^ ten years ago, 
 showed that "Women in pregnancy and 
 
 8° i%e Prolongatio . of Life. Part II, Chap. Ill, Eng. trans., 
 pp. 68, 71. 
 
INTESTINAL STASIS 81 
 
 childbirth frequently suffer much as the 
 result of retention of fsecal matter," but 
 the necessity of caring for the mother's 
 bowels during pregnancy and while she is 
 nursing her infant is so well recognized 
 today that it does not need emphasizing. 
 However, it is often difficult to settle upon 
 the means by which the desired maternal 
 condition may be brought about and at the 
 same time leave the foetus or the nursing 
 child undisturbed thereby. Cathartics and 
 laxatives may extend their influence by 
 means of the placental circulation or the 
 milk so that a more or less serious medica- 
 tion be produced for the child in utero or 
 at the breast. The extent of such in- 
 fantile disturbance and distress depends 
 upon the nature and amount of the drug 
 administered and the general physical 
 condition of the mother the child, or both. 
 Sometimes such indirect treatment of 
 the infant may be desirable, but unless 
 it is indicated by some special condition 
 of the child, it is best to avoid it, and, 
 therefore, in cases in which the bowels of 
 the parturient or the nursing mother 
 demand regulating and those of her child 
 
82 TREATMENT OF 
 
 do not, a remedy that can influence the 
 mother and not the child is desirable. 
 
 Liquid petrolatum meets the demand. 
 To correct the constipation of pregnancy, 
 to avoid the hemorrhoidal condition which 
 so often attends it, to prevent or relieve 
 postpartum intestinal stasis, and for all 
 other conditions for which it is indicated, 
 a pure liquid petrolatum may be used by 
 the mother in any necessary amount, 
 without fear of any influence on her child, 
 since the oil does not enter the maternal 
 circulation, but exercises its influence in a 
 mechanical way in the gastro-intestinal 
 tract alone. 
 
 XI. 
 
 Liquid Petrolatum for the Insane. 
 
 R. Murray Leslie ^^ writes that he 
 *'has had excellent therapeutic results 
 from the administration of Hquid petro- 
 latum in mucous colitis," and says that 
 "there is a great field for the employ- 
 ment of liquid petrolatum in asylums for 
 the insane, as the inmates are par- 
 ticularly prone to mucous colitis." 
 
 ^^ American Practitioner, 1913, Aug., pp. 420-421. 
 
INTESTINAL STASIS 83 
 
 XII. 
 
 Surgical Use of Liquid Petrolatum. 
 
 What has been said up to this point is 
 primarily non-surgical. There are, never- 
 theless, uses for liquid petrolatum in sur- 
 gery directly or indirectly connected with 
 enterostasis. 
 
 Liquid petrolatum has been of use intra- 
 abdominally to prevent adhesions, having 
 been used even when all raw surfaces were 
 covered with peritoneum. For the sur- 
 geon, however, liquid petrolatum has 
 come to be of value from the point of 
 view of intestinal stasis alone. It is now 
 used as follows: 
 
 (A) By mouth — as a prophylactic, begin- 
 ning some time before operating. 
 
 Bainbridge^^ says: "Lane describes: 
 ''1. An abnormal fixation of the pylo- 
 rus" . . . which . . 
 
 "2. may result in the production of a 
 kink, . . . sufficient to interfere with the 
 normal functioning of the stomach and 
 
 82 New York Medical Record, 1913, Sept. 27, pp. 554-556. 
 
84 TREATMENT OF 
 
 the duodenum, consequently areas of en- 
 gorgement of the mucous membrane arise 
 in the front part of the duodenum or in 
 the lesser curvature of the stomach. 
 While the stress sustained at the point of 
 engorgement is a primary factor, the lower 
 resistance power to the entry of micro- 
 organisms, due to autointoxication, takes 
 a large share in the production of the in- 
 flammatory changes in the mucous mem- 
 brane. 
 
 "10. Associated with intestinal stasis, 
 there is a considerable ascent in the level 
 of deleterious organisms in the small in- 
 testines with occasional infections of the 
 biliary and pancreatic ducts, producing 
 gallstones, pancreatitis, and, later, cancer 
 of these several structures." 
 
 Therefore a course of liquid petrolatum 
 before operation prevents compHcations 
 which otherwise might arise. 
 
 (B) Before operating to aid in determin- 
 ing whether the case is surgical or not. 
 
 Lane ^^ says: "We find some diflficulty 
 in drawing the line between the cases in 
 
 8^ British Medical Journal^ 1912, May 4, p. 989. 
 
INTESTINAL STASIS 85 
 
 which the stasis can be met efficiently 
 by the use of hquid petrolatum and those 
 in which an alteration in the drainage 
 scheme is advisable. In all doubtful 
 cases we give liquid petrolatum a thor- 
 ough trial before adopting operative 
 procedures." 
 
 Hayes ^^ says: "Surgery ... is in- 
 dicated in the marked cases (of intestinal 
 stasis) failing to respond to persistent, 
 competent medical treatment." 
 
 Coffey ^^ says: "Gastric or intestinal 
 stasis not relieved by medical and dietary 
 measures constitutes the only excuse for 
 surgery in this class of cases." 
 
 A more or less steady and prolonged 
 use of liquid petrolatum will make clear 
 in a given doubtful case of intestinal 
 stasis whether resort should be made 
 to surgery. 
 
 (C) Intra-abdominally toward the end 
 of the operation for the prevention of post- 
 operative stasis, etc. 
 
 84 New York Medical Record, 1914, Feb. 28, p. 410. 
 
 ^ Surgery, Gynecology, and Obstetrics, 1912, Oct., p. 248. 
 
86 TREATMENT OF 
 
 Waters F. Burrows ^^ says that plac- 
 ing an abdominal case early after opera- 
 tion in the sitting posture avoids many 
 complications. "Intestinal functioning is 
 likewise bettered . . . yet frequently in- 
 testinal disturbance is shown. . . . The 
 pain disturbance and actual dangers re- 
 sulting from post-operative bowel stasis 
 make evident the importance of prophy- 
 laxis. . . . Abrasion of the peritoneal sur- 
 face of the gut is a most common and 
 frequently unavoidable cause of post- 
 operative stasis. The method of over- 
 coming the effects of this traumatism by 
 means of liquid petrolatum introduced 
 within the abdominal cavity at operation 
 has proved effectual and safe." ..." In 
 most simple abdominal operations its use 
 is not required since prophylactic care 
 will limit post-operative distress, but in 
 all others the oil is of the greatest value 
 when employed upon abdominal pads 
 during operation or sponged gently upon 
 intestinal coils previous to closure of the 
 incision, excluding only areas where ad- 
 hesions are desired and having care that 
 
 88 New York Medical Record, 1913, Nov. 1, pp. 795-798 
 
INTESTINAL STASIS 87 
 
 all plastic procedures and intestinal 
 anastomoses are completed before the oil 
 is introduced. In cases presenting ex- 
 tensive adhesions or widespread perito- 
 nitis, large amounts of liquid petrolatum 
 (up to 6 or 8 ounces) are required to pre- 
 vent recurrence or formation of adhesions, 
 to limit the absorption of toxins from the 
 peritoneal cavity, to assist nature in 
 combating infection, and as a prophylac- 
 tic against intestinal stagnation, obstruc- 
 tion, spasm, and final paresis. In the 
 case of more than moderate severitv, 
 intestinal spasm and stasis, together with 
 abdominal pain, are largely ehminated 
 and convalescence is more comfortable 
 and safe, while the indi^'idual in dire 
 straits at the time of surgical interven- 
 tion has, post-operatively, manifold better 
 chances of recovery." 
 
 Burrows condemns the use of iodine, 
 mercuric chloride solution, carboHc acid, 
 alcohol, etc., applied to the peritoneum, 
 also olive oil and commercial hquid 
 petrolatum, but says: "Liquid petro- 
 latum (of the naphthene series) causes 
 none of the changes occiu-ring in the 
 
88 TREATMENT OF 
 
 process of adhesion formation. . . . The 
 oil has no appreciable chemical action 
 upon the tissues nor deleterious effect 
 upon the animal and is slowly absorbed. 
 ... It prevents to a great extent the for- 
 mation or recurrence of adhesions . . . fills 
 the lymphatic channels, thus limiting 
 septic absorption, and . . . prevents ex- 
 tension of destructive processes. It is 
 used to advantage intra-abdominally in 
 place of salt solution, upon abdominal 
 pads, and to protect and lubricate the 
 abdominal contents, thereby eliminating 
 or minimizing post-operative intestinal 
 stasis, vomiting, and abdominal pain." 
 
 Later, Burrows ^^ emphasizes the post- 
 operative intra-abdominal use of liquid 
 petrolatum in his paper before the Hud- 
 son County (N. J.) Medical Society. He 
 says: "After correction of apparent ab- 
 normalities, which in several instances 
 has consisted solely in breaking down 
 adhesions and eliminating kinks, the 
 writer, in selected cases, pours 6 to 10 
 ounces of purified liquid petrolatum, pref- 
 
 87 New York Medical Record, 1914, Apr. 11, p. 656. 
 
INTESTEsTAL STASIS 89 
 
 erably of high specific gravity, into the 
 abdominal cavity. This oil prevents 
 the recurrence of adhesions, lubricates the 
 intestinal coils, straightens out angula- 
 tions and kinks, floats the gas-filled loops 
 of gut out of the pelvic cavity, exerts an 
 intra-abdominal pressure upon the viscera, 
 and is followed by a return of normal 
 peristalsis and bowel evacuation. In the 
 number of cases where this method has 
 now been used the results have been 
 uniformly satisfactory; in some a com- 
 plete elimination of constipation is ap- 
 parent, and in the worst cases this simple 
 safe procedure has given rehef unattained 
 by other means, and abdominal distress, 
 gas accumulations, signs of toxic absorp- 
 tion, headaches, dizziness, insomnia, and 
 the various symptoms of autointoxica- 
 tion, now generally recognized, have been 
 overcome. Particularly following plastic 
 nonseptic operations, the later formation 
 of bands and adhesions is prevented and 
 thereby potent causes of post-operative 
 intestinal obstruction and kinking, ab- 
 dominal pain, and chronic constipation 
 obviated. 
 
90 TREATMENT OF 
 
 "The method commends itself as a 
 prophylactic measure, the oil to be used 
 inmmounts of from 6 to 10 ounces, just 
 before concluding many abdominal opera- 
 tions, especially in those cases where 
 visceral trauma and irritation have been 
 greater than usual and in which the 
 habihty to adhesion formation and 
 kinking exists. Not infrequently con- 
 stipation, absent prior, is present after 
 abdominal procedures and may be at- 
 tributed to these factors which, with 
 the use of oil, are made non-effective. 
 
 "That oil thus used is harmless has 
 been shown by the writer through nu- 
 merous animal investigations, and its ef- 
 fectiveness in the treatment of chronic 
 constipation is proved." 
 
 There are four contra-indications^^ for 
 the intra-abdominal use of liquid petro- 
 latum: 
 
 "1. Infection, whether this be present 
 previous to or occur during operation 
 
 "£. Gall-bladder surgery where a rapid 
 formation of adhesions prevents leakage. 
 
 ^BuBKOWs, New York Medical Record, 1915, July 10, pp. 
 66. 67. 
 
<«o 
 
 INTESTINAL STASIS 91 
 
 3. In operations . . . demanding firm 
 peritoneal union, oil should not be intro- 
 duced until the surfaces it is intended 
 should adhere have been carefully placed 
 in contact and sutured. 
 
 ''4. The use of oil intra-abdominally 
 should not be the means for avoiding the 
 after-effects of crude or careless surgery." 
 
 (D) To prevent or mitigate post-anws- 
 thetic nausea and vomiting, 
 
 Robert H. Ferguson ^^ in his paper 
 read before the New York Society of An- 
 aesthetists, after proving that olive oil by 
 mouth is of no value in preventing or 
 lessening post- anaesthetic ether vomiting, 
 since it is saponified and digested, thus 
 releasing in the system whatever ether 
 it absorbed, calls attention to the value 
 of heavy hquid petrolatum for this pur- 
 pose, since it is not absorbed and, "if 
 given in sufficient quantities (as soon 
 after the anaesthesia as the patient can 
 swallow or by stomach tube before con- 
 sciousness is regained), will slowly but 
 
 ^New York Medical Journal, 1912, June 29, pp. 1359-1360. 
 
m TREATMENT OF INTESTINAL STASIS 
 
 surely pass through the ahmentary canal, 
 and take with it any ether it may meet 
 along its way, holding it in suspension 
 until it is evacuated at the anus. The 
 more slowly the liquid petrolatum passes 
 through the gastro-intestinal tract the 
 better; therefore, the higher the viscosity 
 of the oil, the more satisfactory is the 
 result." 
 
 (E) As a post-surgical laxative. 
 
 Finally, Bainbridge^^ says: "The 
 after-care of the patient is important in 
 all cases, but particularly so when ileo- 
 colostomy and colectomy have been per- 
 formed. . . . An ounce of liquid petro- 
 latum is administered by the mouth 
 three times a day, as long as may be 
 necessary." 
 
 ^" American Journal of Gastro-Enterology, 1913, July, pp. 
 13, 14. 
 
INDEX 
 
 PAGH 
 
 Abdominal pads wet with liquid petrolatum 86, 88 
 
 distress after operations. How to prevent 86, 89 
 
 support in stasis 45, 46, 48 
 
 Abraded surfaces, absorption of poisons by 65 
 
 Absorbable material in rectum 30 
 
 Absorption active in csecum 31 
 
 active in ileum 63 
 
 beyond splenic flexure 30 
 
 boimded by splenic flexure 30 
 
 of fats and oils 11 
 
 of fliiids in large bowel 30 
 
 of liquid petrolatum by peritoneum. . . , 88 
 
 of poisons hindered by Uquid petrolatTim 65 
 
 of toxins when traumatism exists 25, 26 
 
 how to prevent 64, 87 
 
 result of 19, 20 seq., 32 
 
 Accommodative power of lens improved by liquid petrolatum 56 
 
 Acid bodies 6 
 
 carbohc on peritoneum 87 
 
 glacial acetic. Effect of on ascaris lumbricoides 47 
 
 Action of liquid petrolatum in stasis 47, 63 
 
 gauged by X-ray 59, 60, 67 
 
 Adequacy of non-surgical treatment 37, 38, 40, 47, 50 
 
 See "Non-Siirgical" 
 
 Adhesions prevented by liquid petrolatum 83, 88, 89 
 
 Advertised emulsions, Pritchard's warning against 79, 80 
 
 Agar-agar 45, 51 
 
 Agreeable taste desirable for liquid petrolatum 70 
 
 Alcohol on peritoneiun 87 
 
 Alimentary toxaemia due to simple chemical substances .... 25 
 
 Alkahne wastes 63 
 
 Alkaloidal nature of toxins 25 
 
 American mineral oils 4 
 
 Ansesthetic nausea and vomiting. Prevention of 91 
 
 Angulations in intestine. How to straighten 89 
 
 Animal fats are digested 62 
 
 fats and oils vs. liquid petrolatum 11 
 
 Anthracene 6 
 
 Antiperistalsis lessened by liquid petrolatum 67 
 
 shown by X-ray 67 
 
 stimulated by laxatives 66, 67 
 
 in large intestine 30 
 
 Antitoxic diet (See also "Dietetic Treatment") 69 
 
 dietary combined with liquid petrolatum 38 
 
 Antitoxic ferments 69 
 
 Aperient drugs superseded 71 
 
 drugs, suspension of 49 
 
 Apparent vs. true viscosity 5 
 
 Appendicitis caused by stasis 21, 67 
 
 reUeved by liquid petrolatum 57 
 
 Appendix, Auerbach's tissue in 53 
 
 Arthritis 22 
 
 Ascaris lumbricoides, eggs of, divide in glacial acetic acid ... 47 
 
 killed by liquid petrolatum 47 
 
 93 
 
94 INDEX 
 
 PAGE 
 
 Ascending colon, Auerbach's tissue in 53 
 
 sphincter in 31 
 
 Ascent of organisms in intestine 84 
 
 Aseptic absorption of food 26 
 
 Asthenic type of build 42 
 
 Atony not cause of stasis 53 
 
 Auerbach's Ueo-cascal collar 53 
 
 plexus. See "Myenteric Ganglia" 12, 51, 52 
 
 at colonic-rectal junction 53 
 
 at distal colon 53 
 
 at duodeno-jejunal junction 53 
 
 at Ueo-CBecal junction 53 
 
 at proximal colon 53 
 
 at pylorus 53 
 
 function of 51 
 
 nodal centers of 52 
 
 tissue 52 
 
 in appendix 53 
 
 in csBCum 53 
 
 in colon 53 
 
 Auriculo- ventricular bundle 52 
 
 Autointoxication lowers resistance 84 
 
 and constipation 25 
 
 from intestinal tract 18, 19 
 
 how to prevent after operation 89 
 
 in stasis, cause of 24 
 
 without constipation 30 
 
 Avoidance of intestinal stasis a ' ' prophylactic ' ' and ' ' cure " 17 
 
 Bacillus bifldus 69 
 
 Bulgaricus 69 
 
 glycobacter 69 
 
 Bacteria enter the blood stream 24, 25 
 
 from intestine may invade ducts 19, 20 
 
 growth of, inhibited by liquid petrolatum 5, 13, 60 
 
 in intestine. Threefold result of stasis on 19 
 
 production of in intestine 31 
 
 Bacterial action and toxins in colon 63 
 
 destruction of residues ^ 27 
 
 toxins 27, 63 
 
 Bainbridge, Wm. Seaman 20, 32, 34, 70, 83, 92 
 
 Bands, how to prevent post-operative 89 
 
 Basic bodies 6 
 
 Best liquid petrolatum 4 
 
 Bile acids 63 
 
 Birds and liquid petrolatum 47 
 
 Bismuth meal, progress of, with and without liquid petrolatum 59 
 
 salts with Uqmd petrolatum 76 
 
 Blake, Gerald 50 
 
 Body-drainage, importance of 32 
 
 Body-temperature the clinical standard for viscosity 14 
 
 Body tissue, stasis and vitality of 33 
 
 waste. Importance of removal 33 
 
 Bogart, J. Bion 45 
 
 Bowel-distension, relief from 51, 89 
 
 Bowel-flushing 46 
 
 Bowel-movements, how controlled 53 
 
 overgrowth in length from overfeeding 58 
 
 regularity, false impressions of 31 
 
 Bowels of parturient woman. How to regvilate 81, 82 
 
 of pregnant woman, care of 80, 83 
 
INDEX 95 
 
 PAGE 
 
 Breast, degenerative changes in 21 
 
 Bulk of liquid petrolatum imaltered by passage through body 48 
 
 Burrows, Montrose T 32 
 
 BiuTOWS, Waters P 86, 87, 88, 90 
 
 CiBCUM, active absorption in 31 
 
 Auerbach's tissue in 53 
 
 Califomian crude oil 4 
 
 liquid petrolatum 6 
 
 Cancer of pancreas, gall bladder, etc 84 
 
 Care of bowels in pregnancy and lactation 80, 81, 82 
 
 Careless surgery, liquid petrolatum, no substitute for 91 
 
 Carrel, Alexis 32, 33 
 
 Cascara sagrada in intestraal stasis 45 
 
 Case, James T 67 
 
 Cases of ocular change benefited by liquid petrolatxun 55 
 
 Castor oU contraindicated for repeated use 78 
 
 Catarrh, chronic intestinal 26 
 
 Cathartics and liquid petrolatum 49 
 
 and nursing child 80, 81 
 
 in intestinal stasis 45, 46, 69 
 
 Causes of infection in stasis 27 
 
 Central nervous system, how it controls movements of 
 
 bowel 53 
 
 Change of flora and liquid petrolatum 69 
 
 Characteristics essential to a good mineral oil 12 
 
 Child, laxatives for mother afEect nursing 81 
 
 Children, constipation of 73 
 
 Choice of suitable liquid petrolatum. How made 13 
 
 Chronic colitis, Uquid petrolatum for 64 
 
 intestinal catarrh and toxaemia 26 
 
 intestinal stasis. See "Stasis," "Constipation" 
 
 is the cause of disease 17 
 
 Chrysene 6 
 
 Clark, Ernest 54 
 
 Clark's cases of ocuJar changes 55 
 
 Classification of cases of intestinal stasis 22 
 
 Clinical value of Mght and heavy mineral oils 12 
 
 of oils, comparative 12 
 
 Coffey, Robert O 36, 85 
 
 Colectomy, post-operative care of 92 
 
 when indicated 45 
 
 Colitis 67 
 
 cure for 64, 65, 66, 82 
 
 in infants, cause of 78 
 
 in the insane 82 
 
 liquid petrolatum for 62, 64, 65 
 
 mucous 82 
 
 Colloid poisons, intestinal 65 
 
 Colocynth not to be used in stasis 45 
 
 Colon, absorption active in 63 
 
 absorption of water from 61 
 
 destruction of residues in 27 
 
 marked activity of ascending 31 
 
 mechanical elongation of 29 
 
 most efficient lubricant for 50 
 
 normal hypertonus of transverse and distal 53 
 
 relative putrefaction and absorption in 63 
 
 toxic bacterial activity in 63 
 
 treatment when whole is involved 36 
 
 Color of stools, what due to 64 
 
96 INDEX 
 
 PAGB 
 
 Commercial liquid petrolatum not to be used on peritoneum 87 
 
 Com.pound licorice powder in intestinal stasis 45 
 
 Concentrated diet, effects of 62 
 
 Constipation. See also "Intestinal Stasis" and "Stasis" 
 
 after abdominal procedures 90 
 
 aggravated by laxatives 65 
 
 and autointoxication 25 
 
 change flora to overcome 69 
 
 how to prevent post-operative S9 
 
 illness of infants from 72 
 
 importance of avoiding 17, 18 
 
 infants' death from 72 
 
 is not always stasis 30 
 
 liquid petrolatum for chronic 61 
 
 of children and infants 72, 73 
 
 overcome by liquid petrolatima 50 
 
 postpartum , 81, 82 
 
 reUef from, is curative 50 
 
 spasticity in 53, 54, 65 
 
 treatments contra-indicated in 78 
 
 why Increased after laxatives 68 
 
 with daily movements 28 
 
 with diarrhea 31 
 
 Contra-indications for intra-abdominal use of oil 90 
 
 for surgery in s asis 39 
 
 Cream in feeding of infants 72 
 
 Criterion for judging Uquid petrolattun 12, 13 
 
 Crude mineral oil, Cahfomian 4 
 
 Russian 4 
 
 Crude surgery, Uquid petrolatum no substitute for 91 
 
 Crystalline lens, liquid petrolatiun prevents senile changes in 55 
 
 Danger in emulsion with hypophosphites 80 
 
 Dangerous forms of treatment in stasis 46 
 
 Death due to constipation 72 
 
 imnecessary 33 
 
 Decay due to non-eUmination 33 
 
 Decomposition of fcsces not from constipation 26 
 
 Defecation, early training for proper 78 
 
 mechanism of 77 
 
 Definition of intestinal stasis 18 
 
 Degeneration, mammary 21 
 
 Dentistry and Uquid petrolatiun 57 
 
 Denudation, effect on filtration 65 
 
 Descending colon, Auerbach's tissue in 53 
 
 Destruction of parasites by Uquid petrolatum 47 
 
 Diarrhea of constipation 31 
 
 Diet, effects of concentrated 62 
 
 for constipated infants 73 
 
 Dietetic treatment of stasis 9, 35, 36, 37, 39, 42, 44, 71, 85 
 
 Differentiation of cases by Uquid petrolatiun, .34, 36, 37, 84, 85 
 
 Digestion disturbed by oil of low viscosity 13 
 
 of fats and oils 11 
 
 of infants n t disturbed by Uquid petrolatmn 72 
 
 Disease due to overfeeding in infancy 58 
 
 Distension of bowel, reUef from 51, 87 
 
 Distribution of mineral oil in intestine 5 
 
 Disturbance of nutrition and digestion. None from Uquid 
 
 petrolatum 72 
 
 Dixon. W. E 25 
 
 Dizziness, how to prevent post-operative 89 
 
INDEX 97 
 
 PAOB 
 Dosage of liquid petrolatum. . . ,36, 43, 46, 49, 50, 51, 61, 73, 
 
 76, 80, 87, 88, 90, 92 
 
 intra-abdominally 87, 88, 90 
 
 of Pritchard's emulsion 76 
 
 Doses of Uquid petrolatiun for infants and children 80 
 
 Doubtful cases of stasis, how to differentiate 34 
 
 "Drainage scheme," if efBcient, prevents stasis 41 
 
 importance of 28, 41 
 
 Dressing for woimds, Uquid petrolatum as 64 
 
 Dribbling from mineral oils of low viscosity 5, 70 
 
 Drugs, germicidal, tonic, et al., not to be used in stasis. .45, 46 
 
 Duct, infection of biliary 84 
 
 infection of pancreatic 84 
 
 Duodenal kinks 83, 84 
 
 Duodenum, lumen of, reduced in calibre 48 
 
 ulcer of 48 
 
 du Pasquier 72 
 
 Dysentery in animals ciu:ed by liquid petrolatum 47 
 
 Dyspepsia 23 
 
 Dysperistalsis in infants 79 
 
 Early training for efQcacious defecation 77, 78 
 
 Easton, P. G 73 
 
 Ebeling, Albert H 33, 34 
 
 Effects of slowly and rapidly flowing oils 13 
 
 Eflacient "drainage scheme" prevents intestinal stasis 41 
 
 Eggs of ascaris lumbricoides divide in glacial acetic acid ... 47 
 
 killed by liquid petrolatum 47 
 
 Elimination, effect of hindrance to 33 
 
 of waste and longevity 33 
 
 Elongated, brittle stools from infants 74 
 
 Elongation of colon and rectmn 31 
 
 Enteroptosis vs. autoiatoxication 29 
 
 benefited by Uquid petrolatum 49 
 
 Entero-spasm in infants 79 
 
 EpitheUum, effect of liquid petrolatum on abraded 65 
 
 intestinal, easily damaged 78 
 
 of intestine, filtering powers of 65 
 
 Essential characteristics of a good mineral oil 12 
 
 Ether suspended throughout gut by Uquid petrolatum 92 
 
 Excitable musculature of intestine 52 
 
 Eye changes caused by intestinal stasis 55 
 
 F^ajCAL retention coincident with daUy movements 28 
 
 Fseces, decomposition of, not due to constipation 26 
 
 organisms in 46, 48 
 
 quantity reduced by Uquid petrolatum 46, 48 
 
 rapid passage of, reduces urine 48 
 
 reduced ia bulk by Uquid petrolatum 48 
 
 retention in pelvic colon 31 
 
 softening of 11, 12 
 
 FaUure of non-surgical means the indication for surgery .38, 42 
 
 Fat dyspepsia, how induced m infants 74 
 
 how prevented in infants 74 
 
 in infants' food 74 
 
 Uquid petrolatum a substitute for 72 
 
 percentage of, in infant feeding 72 
 
 Fats and oils, digestion and absorption of 11, 62 
 
 vegetable and animal, differ from mineral oil 11 
 
 animal and vegetable do not change stools 62 
 
 laxative nature of 62 
 
98 INDEX 
 
 PAGE 
 
 Feeding of infants, cream for 72 
 
 Ferguson, Robert H 91 
 
 Fermentation from stagnation 29 
 
 Filtering powers of epitlieliiim of intestine 65 
 
 Finai effects of sm'gical intervention unknown 38 
 
 Fissure, new and old, relieved by Mquid petrolatum 67 
 
 Flatulence 51 
 
 Float gas-filled loops of gut, how to 89 
 
 Flora, liquid petrolatum in changing 69 
 
 of intestine, how changed 69 
 
 Flushing of bowel 46 
 
 Foetus affected by cathartics for mother 81 
 
 Food, aseptic absorption of 26 
 
 residues, abnormal dryhiS of 62 
 
 too long retention of 62 
 
 Foodstuffs in intestine, time of, reduced by liquid petrolatum 68 
 
 Frequency of stools no evidence of stasis 28 
 
 GAUi-BLADDEB surgery, oil n:t to be used if adhesions 
 
 desired 90 
 
 Gallstones, why produced 84 
 
 Ganglia, myenteric, effect of liquid petrolatum on 12 
 
 Gaseous distension of infant bowel produces stasis 41 
 
 Gastric lavage for stasis not good 46 
 
 General practitioner can prevent stasis 38 
 
 should ehminate .stasis 41 
 
 Germicidal drugs condemned for stasis 46 
 
 Glacial acetic acid and ascaris lumbricoides 47 
 
 Glycerine suppositories contra-indicated for repeated use . . 78 
 
 Goitre and intestinal stasis 20, 21 
 
 and hquid petrolatum 20 
 
 Hates, WrLLiAii Vaj? Y 36, 44, 85 
 
 Headaches, how to prevent after operation 89 
 
 Heavy mineral oil (liquid petrolatum) 4, 12 
 
 Hemorrhoids of pregnancy. How to prevent 82 
 
 reheved by hquid petrolattrai 51, 67 
 
 surgery for, lessened by Mquid petrolatum 68 
 
 Hertz, A. F 28, 36, 56 
 
 High natural viscosity, importance of 5, 12, 13, 14, 34, 70 
 
 specific gravity, value of 34 
 
 viscosity at body temperature, value of 14 
 
 viscosity prevents dribbling 5, 70 
 
 Hippocrates and constipation 17 
 
 His, bundle of 52 
 
 Hydrocarbons, injiirious in liquid petrolatum 6 
 
 methane or paraffin series of 4 
 
 naphthene series of 4 
 
 Hygienic treatment of stasis 9, 35, 36, 39, 42, 44, 51, 71 
 
 Hypertonicity, hquid petrolatum in 54 
 
 of transverse and distal colon 53 
 
 the cause of stasis 53 
 
 Hypophosphites not necessary for infants 80 
 
 iLEOCiECAL junction, nodal center at 52, 53 
 
 m.ovements, origin of 53 
 
 valve, how spasm of. is overcome 67 
 
 incompetency of 63, 66 
 
 spasm of 67 
 
 Ileo-colostomy, post-operative care of 92 
 
 Ileo-sigmoidostomy 45 
 
INDEX 99 
 
 PAOB 
 
 Ileum, active absorption in 63 
 
 infection from 27 
 
 motility of, increased by liquid petrolatum 67 
 
 obstruction at end of 48 
 
 putrefaction in 63 
 
 toxic bacterial action in 63 
 
 Impurities in some liquid petrolatums „ 6 
 
 Index of lubricating power 5, 12 
 
 Indol, solubility in liquid petrolatum 64 
 
 Infancy and stasis 58 
 
 indigestion during, a cause of stasis 41 
 
 Infantile distress from purgation of mother 81 
 
 Infant nizrsing, effect of purgation of mother on. . . .80, 81, 82 
 
 Infants, classes of stools in constipation of 74 
 
 constipation of 73 
 
 feeding, fat in 72, 74 
 
 illness from constipation 72 
 
 nature of treatment of constipation in 73 
 
 treatment of constipation in 72, 73, 75 seg. 
 
 Infection contra-indicates oU intra-abdominally 90 
 
 from ileimi 27 
 
 from peritonemn, prevention of 87 
 
 in stasis, causes of 20, 27 
 
 not necessarily an indication for surgery 37 
 
 of biliary and pancreatic ducts 84 
 
 of remote organs, how produced 20 
 
 InMbitive action of hquid petrolatum on bacteria 5, 13 
 
 Injurious hydrocarbons in mineral oUs 6 
 
 Insane, liquid petrolatum for 82 
 
 Insomnia, how to prevent post-operative 89 
 
 Internal remedy for stasis 10, 44, 57, 61, 71 
 
 Intestinal functions after oi)eration bettered by sitting 
 
 I>osture 86 
 
 intoxication relieved by liqiiid petrolatum 68 
 
 lubrication for treating stasis 33 
 
 motility, how facilitated 67 
 
 mucosa, result of lesions of 25 
 
 obstruction, prevention of 87 
 
 pain, from a rapidly flowing oil 13 
 
 paresis, prevention of 87 
 
 spasm, prevention of 67 
 
 Intestinal stasis. See also "Constipation" and "Stasis." 
 
 a cause of eye changes 55 
 
 a condition for general practitioner, 38, 39, 40, 41, 42 
 
 and appendicitis, arthritis, tuberculosis, cancer, 21, 22 
 
 and autointoxication 24 
 
 and bowel-distension in infancy 41 
 
 and liquid petrolatum 34, 35, 42 {et al.) 
 
 and pyorrhoea 57 
 
 definition of 18 
 
 drugs in. See also imder the name of the drug, 45, 46 
 
 due to hypertonicity 53, 54 
 
 importance of 17 
 
 in Ochsner's practice 39 
 
 Lane's theoiy of 18, 29 
 
 laxatives for. See also "Laxatives" 44 
 
 lessens accommodative power 56 
 
 liquid petrolatiim first 34, 44 
 
 non-surgical treatment first 35, 36, 37, 43, 44 
 
 non-surgical treatment of, dietetic, hygienic, or- 
 
 thopsedic, by internal lubrication 39, 42, 44 
 
100 INDEX 
 
 PAGE 
 
 Intestinal stasis ought not to become surgical 39, 41 
 
 postpartum 80, 81, 82 
 
 presented daily to the physician 23, 43 
 
 rationale of treatment 35 
 
 stasis. See aZso "Stasis," "Constipation," etc. . , 19 
 
 to be prevented by prophylaxis 41 
 
 toxsemia and remote organs 20 
 
 toxins dissolve in Uquid petrolatura 63 
 
 treated by lubrication 33 
 
 treatment of. See "Dietetic," "Hygienic," 
 "Orthopsedic." 
 
 what to do In doubtful cases 34 
 
 with daily movements 28 
 
 Intestine, intestinal. See also "Bowel." 
 
 rate of passage of mineral oil in 5, 13 
 
 Intoxication, intestinal, relieved by liquid petrolatimi 68 
 
 Intra-abdominal, pressure by liquid petrolatum 89 
 
 use of Mquid petrolatima 83, 86, 89 
 
 Iodine on peritoneum 87 
 
 Irritation not produced by liquid petrolatum 67 
 
 Jackson, J. N 30 
 
 Jackson's membrane 62 
 
 Jones, N. W 38, 42 
 
 Jordan, Alfred C 69 
 
 Keith, Arthur 51, 52 
 
 Kellogg, J. H 38, 61 
 
 Kidneys, influence of toxins from intestine, on. 49 
 
 Kinks and stasis 29, 47, 62, 83, 89, 90 
 
 how corrected 89 
 
 how to prevent post-operative 62, 90 
 
 Lane's 28, 63 
 
 overcome by lubrication 62 
 
 Knight, A. L 51 
 
 Lactation. How to regulate bowels during 81, 82 
 
 hquid petrolatum in , 80, 81, 82 
 
 Lancet (London) and "Viscosity" , 13, 14 
 
 Lane, Sir W. Arbuthnot, 17, 18, 19, 20, 21, 22, 28, 34, 35, 45, 
 
 56, 58, 83, 84 
 
 Lane's kink 28, 63 
 
 Large amounts of hquid petrolatum harmless 60 
 
 Large intestine, absorption of fluids in 30 
 
 Laxative combined with liciuid petrolatum 38 
 
 Laxatives aggravate constipation 65 
 
 and mirsiag child 80, 81, 82 
 
 contra-indicated 66 
 
 Increase spasm of ileo-csecal valve. 67 
 
 Increase spasticity 65 
 
 indirect action of, on foetus or infant 81 
 
 in stasis 44, 66 
 
 liquid petrolatum superior to 70 
 
 produce undesirable antiperistalsis 66, 67 
 
 Leakage from mineral oils 5, 70 
 
 Lens, changes in, prevented by liquid petrolatum 55 
 
 premature hardening of 57 
 
 Leshe, R. Murray 31, 36, 49, 51. 59, 71, 82 
 
 Light mineral oil (hquid petrolatiun) 4, 12 
 
 Liquid paraflQn 10 
 
 Liquid petrolatum. See also " Mineral Oil." 
 
INDEX 101 
 
 PAGE] 
 
 Liquid petrolatum, action of, in stasis 47 
 
 a cure for stasis 57 
 
 agreeable to taste is best 70 
 
 and abraded surfaces 65 
 
 and dribbling 5, 70 
 
 and goitre 20, 21 
 
 and lubrication 12 
 
 and tuberculosis 58 
 
 an inert lubricant 72 
 
 as a protective 65 
 
 as a surgical dressing 64 
 
 a solvent for waste and toxins 63 
 
 as protective of mucous membrane 6-1: 
 
 a substitute for meconium 78 
 
 a vehicle for drugs 76 
 
 before surgei*y in stasis . . . . 45 
 
 best for stasis 70 
 
 "by common consent the most satisfactory" 70 
 
 cannot decompose 75 
 
 colors stools brown or black 64 
 
 dissolves indol 64 
 
 does not affect foetus 82 
 
 dosage. See "Dosage." 
 
 effect of regular use of 49 
 
 first 34, 35, 36, 38, 84. 85 
 
 for brutes 47 
 
 for differentiating cases 34 
 
 for hemorrhoids and fissure , 67 
 
 for infant constipation 75 
 
 for intestinal stasis 33, 42, 43, 47, 48 
 
 and many other pages 
 
 for nursing mother 81, 82 
 
 for pregnant woman 81, 82 
 
 harmless in peritoneal cavity 90 
 
 heavy 4, 12 
 
 how to select one for internal use 13 
 
 impurities of some 6 
 
 in aU doubtful cases 34, 85 
 
 in. constricted gut, duodenum, etc 48 
 
 increases motility of small intestine 67 
 
 in dentistry 57 
 
 in hjrpertonicity 54 
 
 in infancy 58 
 
 innocuous to man 48 
 
 in stasis, value of .46 (e^ al.) 
 
 intra-abdominally 86 
 
 irritating ingredients in many oils 6, 70 
 
 lessens antiperistalsis 67 
 
 light 4 
 
 mechanical action of 46, 50, 62 
 
 most efficient lubricant for colon 50 
 
 no infant nutritional or digestive disturbances ... 72 
 
 no irritation from 67 
 
 no offensive stools from 75 
 
 not absorbed 46, 62, 75 (e< al.) 
 
 of high viscosity for post-an£esthetic use 92 
 
 for stasis and constipation, 3, 4, 5, 13, 14, 70 (et al.) 
 
 of market not sufficiently refined 70 
 
 of naphthene series 87 
 
 only superior quality to be used 70, 92 
 
 passage through intestine 6 
 
102 INDEX 
 
 PAGE 
 
 Liquid petrolatum, physiological working of 44 
 
 prevents ascent of organisms 84 
 
 proper viscosity of . , 14 
 
 pure viscous for peritonemn 87, 88 
 
 pure viscous, safe in peritoneal cavity 88 
 
 relieves irritated myenteric ganglia 54 
 
 shortens time of passage of gastro-intes. contents . 59 
 
 slowly absorbed by peritoneum 88 
 
 Squibb 's 4 
 
 Squibb's, how sold 6 
 
 Squibb 's, quality specifications of 5 
 
 Squibb's, specific gravity of 5 
 
 Squibb's, viscosity of 5, 6 
 
 substitTution for fat 72 
 
 surgical use of 83 
 
 the internal remedy for stasis 34, 44, 45 (et al.) 
 
 the kind best for internal use 4 
 
 thin, not desirable 70, 90 
 
 to be preferred to laxatives 70 
 
 to differentiate cases 45, 84, 85 
 
 unabsorbed in intestine, etc 11, 48 {et al.) 
 
 used early gives permanent rehef 71 
 
 " useful in all forms of stasis " 62 
 
 uses of. See variotis uses — as "infants," "surgical," etc. 
 
 U. S. Pharmacopoeial name for mineral oil 11 
 
 viscous for abdominal use 89 
 
 for internal use 5, 6, 12, 44, 70, 92 
 
 vs. animal and vegetable fats 13, 62 
 
 vs. cathartics and aperients 49 
 
 vs. salt solution 88 
 
 when and how given post-ansestheticaUy 91 
 
 when contra-indicated for peritonetun 90, 91 
 
 when to put into abdomen 87 
 
 when to use it on peritoneum 88, 89, 90 
 
 with a laxative. . , 38 
 
 with antitoxic dietary 38 
 
 Liver, in infants' pasty stools 74 
 
 not taxed by liquid petrolatmn 75 
 
 Longevity and elimination of waste 33 
 
 Lose©, Joseph R 33, 34 
 
 Low viscosity in mineral oil disturbs digestion 13 
 
 pain produced by oil of 13 
 
 Lubricants supersede aperient remedies 71 
 
 Lubricating power, the index of 5, 12 
 
 Lubrication a cure for stasis 36, 45, 60, 61, 71 
 
 by liquid petrolatum 12, 13, 49, 51, 59, 65 
 
 for intestinal stasis 35 
 
 for overcoming kinks 62 
 
 internally a preventive and cure forttuberculosis .... 22, 58 
 
 intra-abdominal 89 
 
 of intestine 11, 13 
 
 of whole alimentary canal by liquid petrolatimi 61 
 
 steadiness of, how produced 13 
 
 the chief value of Mquid petrolatum 13 
 
 the role of Uquid petrolatum 50 
 
 Maeble-shaped stools 77 
 
 Massage for stasis condemned 46 
 
 Massage for stasis recommended 36 
 
 Mayo, Wm. J 30 
 
 Mechanical action of liquid petrolatmn 50, 62 
 
INDEX 103 
 
 PAGB 
 
 Meconium, value of 78 
 
 Medical failures reserved for siirgery 37 
 
 laxatives contra-indicated 66 
 
 treatment in stasis • 39, 85 
 
 Membrane, Jackson's 62 
 
 Mental disturbances 23 
 
 Mercury bichloride to peritoneimi 87 
 
 Mesentery and stasis 47 
 
 Metctmikoff, filie 18, 46, 72, 80 
 
 Methane series 4 
 
 Mineral oil. See also " Liquid Petrolatmn " 4 
 
 an inert lubricant 72 
 
 differs from vegetable and animal fats and oils. . . 11 
 
 heavy 4, 5, 12 
 
 light 4, 12 
 
 of high viscosity best 5, 12, 13, 14, 70, 89, 92 
 
 proper viscosity of 5, 14 
 
 types of, for internal use 3, 4 
 
 Mineral oils, American 4 
 
 light, leakage or dribbling from 5 
 
 properties of 4 
 
 study of, by E. R. Squibb &; Sons 3 
 
 the kind best for internal use defined 4, 12 
 
 Most stasis is non-sm-gical 34 to 41 iet al.) 
 
 Motility of ileum increased by liquid petrolatum 67 
 
 Motions. See also "Stools." 
 
 character of, when Uquid petrolatum is used 46 
 
 Movements of bowel, how controlled 63 
 
 Mucosa intestinal, autointoxication from lesions of 25 
 
 Mucous cohtis, liquid petrolatum for 49, 82 
 
 membrane, changes in intestinal 85 
 
 protected by liquid petrolatum 64 
 
 Musculature, most excitable of intestine 52 
 
 Mutch, N 26 
 
 Mycosis of skin and iodine 47 
 
 cured by Uquid petrolatum 47 
 
 Myenteric ganglia. See also "Auerbach's plexus." 
 
 at ileo-csecal junction 52 
 
 Auerbach's plexus, character of 51, 52 
 
 effect of liquid petrolatum on 12, 54 
 
 function of 51 
 
 liquid petrolatmn relieves irritated 54 
 
 originates and conducts impulses 52, 53 
 
 plexus, nodal centers of 52 
 
 reaction to stimuli 51, 52 
 
 Name, official, in XJaited States for mineral oil 10, 11 
 
 Naphthen© series of hydrocarbons 4, 5, 87 
 
 series, resistance to oxidizing agents 6 
 
 Natural viscosity. See also "True." 
 
 value of 5, 14, 34 
 
 Nausea, post-ansesthetic, liquid petrolatum for 91 
 
 "Nearest panacea" for constipation. 61 
 
 Nervous system and stasis 21 
 
 Neiirasthenia 22 
 
 Nauro-muscular mechanism, disorder of intestinal 64 
 
 Neurotics and stasis 39 
 
 Nodal tissue of auriculo- ventricular bimdle 62 
 
 Non-elimination of toxins, result of 33 
 
 Non-surgical treatment first 34 to 41, 44 (etal.) 
 
 ©f stasis 23, 36, 38, 40. 43, 44, 45, 48, 85 {et al.) 
 
104 INDEX 
 
 PAOB 
 
 Non-surgical treatment recommended by surgeons 40 
 
 sufficiency of 35, 40, 47 
 
 vs. short-circuituig 38 
 
 Normal peristalsis, how restored after operation 87 
 
 Nursing mother, care of bowels of 80, 81, 82 
 
 how to regulate bowels of 81, 82 
 
 Obstruction at end of ileum 48 
 
 Ochsner, A. J 17, 39, 41, 43 
 
 Ochsner's cases, 1914 39 
 
 Ochsner's experience with intestinal stasis 43 
 
 Ocular changes in stasis, cases of cure 55 
 
 OU, use of, after infection 90 
 
 Oils and fats, digestion and absorption of 11, 62 
 
 Oils, vegetable and animal, no use for constipation 75 
 
 OUve OU, post-aneesthetic use is of no value 91 
 
 saponification and digestion of 91 
 
 Oophoritis 67 
 
 Operative procedures for stasis, when to adopt 34 
 
 only after liqxiid petrolatum 85 
 
 visceral irritation, how to care for 90 
 
 visceral-trauma, how to care for 90 
 
 Ophthalmology, use of liquid petrolatum in 55 
 
 Organisms, ascent of, in intestine 84 
 
 in feeces 46, 48 
 
 in intestine, effect of stasis on 19, 27, 84 
 
 Orthopaedic treatment of stasis, 9, 35, 36, 42, 45, 47, 48, 60, 71 
 
 purpose of 35 
 
 Oxidizing agents, resistance of naphthene hydrocarbons to. 6 
 
 Pads, liquid petrolatum on abdominal 86 
 
 Pain from rapidly flowing oil 13 
 
 intestinal, See gZso "Abdominal." 
 
 post-operative abdominal 86 
 
 Pancreas in infants' pasty stools 74 
 
 Pancreatic emulsion 76 
 
 extract in Uquid petrolatum 76 
 
 Pancreatitis, cause of 84 
 
 Paraffin 5, 6, 10 
 
 adulterant of Uquid petrolatum 6 
 
 and apparent high viscosity 6 
 
 series 4 
 
 Parasites destroyed by Mquid petrolatima 47 
 
 Paresis of intestine, how to prevent 87 
 
 Parturient woman, how to regulate bowels of 81, 82 
 
 du Pasqmer 72 
 
 Passage of Uquid petrolatum through intestine 5, 12, 13 
 
 Pasty stools from infants 74 
 
 Patient, post-operative care of, important 92 
 
 Pediatrician should eliminate intestinal stasis 41 
 
 Pelvic colon, elongation of 31 
 
 evacuation of, not curative 26 
 
 Percentage of surgical stasis cases 36, 39, 40, 43, 85 
 
 Perforation of intestine from constipation 26 
 
 Peristalsis and excretion of urine 48 
 
 centers of 52, 53 
 
 how to restore normal after operation 89 
 
 in infants' pasty stools 74 
 
 of Ueima increased by Uquid petrolatmn 67 
 
 origin of movements 51, 52 
 
 Peristaltic overstimulation detrimental 78 
 
INDEX 105 
 
 PAGB 
 
 Peritoneal union prevented by oil 91 
 
 Persistent liquid petrolatum treatment before operating ... 85 
 
 Petroleum 10 
 
 Petroleum oil 10 
 
 Pharmacopoeia, U. S., Mineral oil of 10 
 
 Phenanthrene 6 
 
 Phenol 6 
 
 Phenolpbthalein in intestinal stasis 45 
 
 Plastic non-septic operations, post-operative treatment of 89 
 
 Plexus, fxmction of Auerbach's 51 
 
 Plexus. See "Myenteric." 
 
 Policy of E. R. Squibb & Sons 3 
 
 Podophyllin not to be used in stasis 45 
 
 Poisons, colloid in intestine 65 
 
 Post-anaesthetic nausea and vomiting, liquid petrolatum for 91 
 
 Post-operative, constipation, prophylaxis for 90 
 
 intestinal spasm, how prevented 87 
 
 sitting posture 86 
 
 Post-operative stasis, cause of 86 
 
 surgical absorption of toxins, how to prevent 87 
 
 surgical stasis, prophylaxis for 86 
 
 Postpartum constipation and stasis 80, 81, 82 
 
 Posture after abdominal operations 86 
 
 Potentiality for ptosis 42 
 
 Practitioner, general. See "General Practitioner" 38, 41 
 
 Pregnancy, liquid petrolatum in 81, 82 
 
 Pressure by liquid petrolatum abdominally 89 
 
 Prevalence of intestinal stasis 23, 42, 43 
 
 Pritchard, Eric 58. 72, 73, 77 
 
 Pritchard's emulsions of liquid petrolatiun 76, 79 
 
 experience with liquid petrolatimi 75 
 
 treatment for infant constipation 74 
 
 Prolonged use of liquid petrolatum 50 
 
 Properties of mineral oils 4, 5, 13, 14 
 
 Prophylaxic use of Uquid petrolatum 83 
 
 Prophylaxis for post-surgical stasis 86 
 
 for stasis 41 
 
 Protective action of liquid petrolattun 59 
 
 Protein digestion and toxaemia 25 
 
 putrefaction 25 
 
 Ptomaines from bacterial action 63 
 
 Ptosis, amenable to non-surgical treatment 37 
 
 catise of , 29 
 
 in relation to stasis 29 
 
 surgery not indicated for 37 
 
 Puddling of mesenteric blood in stasis 47 
 
 Pxilp, vegetable for stasis 43 
 
 Purgatives, indirect action of, on foetus or infant 81, 82 
 
 not to be used in stasis 46 
 
 Purity of liquid petrolatum necessary 12, 13, 34, 70 
 
 Purpose of administration defeated by "thin" oil 71 
 
 Putrefaction from stagnation 29 
 
 more active in ilemn 63 
 
 of proteins 25 
 
 Pyorrhoea benefited by liquid petrolatxun 57 
 
 Quality specifications. Liquid Petrolatum Sqmbb 5 
 
 Rapid passage of fseces lessens urine 48 
 
 Rationale of orthopaedic treatment in stasis 47 
 
 Rectal disease 67 
 
106 INDEX 
 
 PAGE 
 
 Rectum, elongation of 31 
 
 Regularity of bowels, false impression of 31 
 
 Regular use of liquid petrolatum, benefit from 49 
 
 Relative solubility of toxios in liquid petrolatum and in water 64 
 
 Relief from constipation curative 50 
 
 Remedy, the best one for stasis 71 
 
 Rem.ote effects of intestinal stasis 19 
 
 of siu"gery for stasis not yet known 38 
 
 Residue, adherent pasty mass of 62 
 
 Residues, bacterial destruction in colon 27 
 
 Result of stasis on intestinal organisms 19 
 
 Results from use of liquid petrolatum 61 seq. 
 
 Rhemnatoid arthritis 22, 23 
 
 Rhythmic contractions of intestiae, where begin 52, 53 
 
 Rockefeller Institute 32 
 
 Rockey, A. E 18, 29, 49 
 
 Royal Society of Medicine, discussion 40 
 
 RoweU, George 20, 27, 57. 58 
 
 Russ, W. B 37 
 
 Russian crude oU 4 
 
 mineral oU 3,4, 10 
 
 SaIvINB cathartics in intestinal stasis 45 
 
 Salt solution replaced by liquid petrolatum 88 
 
 Saundby, Robert 25, 28 
 
 Scybala softened by liquid petrolatxim 73 
 
 Senile changes in lens prevented by Uquid petrolatum. . .55, 56 
 
 Senility unnecessary 33 
 
 Short-circuiting prevented by liquid petrolatum 70 
 
 vs. non-surgical treatment 38 
 
 Sitting posture after abdominal operations 84 
 
 Skin, effect of liquid petrolatum on parasites on 47 
 
 mycosis cured by liquid petrolatum 47 
 
 Small per cent of ptosis cases surgical 37 
 
 Smith, Rea 37 
 
 Soap and water enemata contraindlcated for repeated use 78 
 
 Softening of intestiaal contents 65 
 
 Spasm of ileo-caecal valve a cause of stasis 67 
 
 how overcome 67 
 
 increased by laxatives 67 
 
 Intestinal 67 
 
 Spasmodic movements of bowel to be avoided 50 
 
 Spastic condition of intestine 53, 65 
 
 Spasticity an obstacle in constipation 65 
 
 incresised by laxatives 65 
 
 relieved by liquid petrolatima 66 
 
 Specific gra^'lty, affected by temperature 14 
 
 and viscosity, relative value of 12, 13, 14 
 
 necessity for a high 13, 34 
 
 Sqmbb's liquid petrolatum 5 
 
 vs. viscosity 5, 13 
 
 Sphincter in ascending colon 31 
 
 Splenic flexure, absorption beyond 30 
 
 a boimdary of absorption 30 
 
 Sponges with Uquid petrolatima 86, 88 
 
 Squibb, E. R., & Sons, poUcy of 3 
 
 study of mineral oils 3 
 
 tests of mineral oils 4 
 
 Squibb's liquid petrolatum 4, 5, 6 
 
 See also "Liquid Petrolatum Squibb" 
 
 Stagnation in lleuBi vs. stasis ta colon 63 
 
INDEX 107 
 
 PAGE 
 
 Stagnation favors fermentation 29 
 
 in small intestine, importance of 63 
 
 Standard Oil Company of California 4 
 
 Stasis. See also "Intestinal Stasis," "Constipation." 
 
 Stasis and goitre 20, 21 
 
 and hardening of lens 57 
 
 and infancy 53 
 
 and the general practitioner 3S, 41 
 
 and the pediatrician 41 
 
 and vitality of body tissue 3.3 
 
 best treated by liquid petrolatum. 70 
 
 Stasis, caused by incompetency of Ueo-csscal valve 66 
 
 cause of post-operative 86 
 
 frequency of stools no evidence against 28 
 
 in relation to ptosis 29 
 
 is not absence of daily movements 19 
 
 is not constipation 30 
 
 may begin in infancy 41 
 
 most cases non-surgical 36, 40 (et al.) 
 
 post-operative, how prevented 86, 88 
 
 the most valuable remedy for 71 
 
 with daily evacuations 31 
 
 Steadiness of lubrication, how produced 5, 13 
 
 Stimulation by hquid petrolatimi 62, 63 
 
 of acti\-ity of small bowel 63 
 
 of intestinal epithehmn 78 
 
 Stools, character of with hquid petrolatum 46 
 
 colored by liquid petrolatum 64 
 
 daily, yet stasis 31 
 
 elongated, hard and brittle 74 
 
 foul odor 74 
 
 frequency of, no evidence of stasis 28 
 
 greasy 74 
 
 infants 74: {et al.) 
 
 Ught-colored 74 
 
 marble-shaped 77 
 
 not offensive from hquid petrolatum 75 
 
 pasty 74 
 
 temporary relief from wateiT 66 
 
 Straighten out angulations, how to 89 
 
 Strasburger 46 
 
 Study of mineral oils, E. R. Squibb & Sons 3 
 
 Sufficiency of non-surgical treatment of stasis 35 
 
 Suitable liquid petrolatum for internal use 13, 14 
 
 Sulphur compoimds undesirable in miaeral oils 6 
 
 in liquid petrolatum 76 
 
 Superior quahty of Hquid petrolatmn necessary, 5, 14, 44, 92 
 Supports for intestinal stasis. See "Orthopaedic" 
 
 35, 36, 45, 46. 48. 60 
 
 Suppositories, glycerine, contraindicated for repeated use . . 78 
 
 Surgery for hemorrhoids lessened by Uqxiid petrolatum .... 68 
 
 for intestinal stasis, when to adopt 34 
 
 not for ptosis 37 
 
 not indicated by infection or toxaemia 37 
 
 for stasis 36 (ef al.) 
 
 only after faUm-e of non-surgical treatment 42 
 
 only after non-surgical means fail 38 
 
 seldom indicated ui stasis 39 
 
 Surgical cases, how to differentiate 36, 84, 85 
 
 of stasis 23 
 
 percentage of 39, 40 
 
108 mDEX 
 
 PAGE 
 
 Surgical dressing, liquid petrolatum for 64 
 
 treatment only after medical 41 
 
 use of liquid petrolatum 83 seq. 
 
 Tawaba 52 
 
 Temperature affects specific gravity 14 
 
 affects viscosity 14 
 
 Tests of mineral oils, E. R. Squibb & Sons 4 
 
 Therapeutic action, no iajurious results from 75 
 
 Thin liquid petrolatum undesirable 5, 13, 14, 70, 92 
 
 Thyroid enlarged and intestinal stasis 20, 21 
 
 relation of intestinal stasis to 20 
 
 Time required for action of liquid petrolatum 61 
 
 Tissue, Auerbach's 52 
 
 Tonic contraction of colon 53, 54 
 
 Tonics not of value in stasis 46 
 
 Tormia in infants 79 
 
 Toxaemia and chronic intestinal catarrh 26 
 
 and intestinal stasis 22 
 
 and results of intestinal stasis 20 
 
 and ulceration, perforation, chronic intestinal catarrh, 
 
 constipation, etc 24, 26 
 
 causes of, in intestinal stasis 27 
 
 from digestion of proteins 25 
 
 not an indication for surgery 37 
 
 without interference with peristalsis 30 
 
 Toxic absorption, how prevented 63, 65, 89 
 
 Toxins absorbed by mesenteric vessels, effect of 49 
 
 absorption of prevented by liquid petrolatum. . . 63, 64, 89 
 
 absorption of when traumatism exists 25 
 
 alkaloidal nature of 25 
 
 and bacterial action in colon 63 
 
 bacterial 27 
 
 dissolved by liquid petrolatum 63 
 
 due to bacterial action 63 
 
 from bacterial activity 24 
 
 from normal digestion 24 
 
 from peritoneal cavity 87 
 
 of intestine, nature of 25, 63 
 
 production of in intestine 25, 26, 31 
 
 result of absorption of 33 
 
 result of non-elimination of 33 
 
 Transverse colon, Auerbach's tissue in 63 
 
 Trauma of viscera, how to care for after operating 90 
 
 Traumatism, cause of absorption of toxins 25, 65 
 
 of epithehmn, effect of Uquid petrolatum on 65 
 
 of gut, how to overcome effects of 86 
 
 the cause of toxsemia 25 
 
 Treatment of stasis, dietetic, hygienic, internal, orthopaedic, 
 
 9, 28, 35, 36, 37, 42, 71, 85 
 
 non-surgical. See also " Non-Sm-gical " 43 
 
 non-surgical first 44 
 
 in stasis, dangerous forms of 46 
 
 imanimity of opinion on 44 
 
 True viscosity. See "Natural," "Viscosity" 5 
 
 Tuberculosis caused by intestinal stasis 21, 22 
 
 prevented by internal lubrication 58 
 
 Types of mineral oil for internal use 3, 4, 14 
 
 Ulcee of duodeniun 48 
 
 Ulceration of intestine and toxaemia 26 
 
INDEX 109 
 
 PAGE 
 
 Unanimity of opinion on treatment 44 
 
 United States Pharmacopoeia, mineral oil of ! 10 
 
 '* Universal remedy " for stasis 60 
 
 Urine excretion "of and peristalsis [ 43 
 
 influence of absorbed toxins on 49 
 
 quantity of, reduced by liquid petrolatum 48 
 
 Use of liquid petrolatimi, prolonged 60 
 
 Value of liquid petrolatxmi in stasis 44, 45, 57, 71 
 
 Valve, incompetency of ileo-csecal 63 
 
 Vegetable fats, absorbed 62 
 
 and oils vs. liquid petrolatum 11, 62 
 
 pulp for stasis 43 
 
 Vehicle for drugs 75, 76 
 
 Veterinary use of Uquid petrolatumi 47 
 
 " Vicious cycle ' ' ia stasis 32 
 
 Visceral irritation from operation, how best cared for 90 
 
 Visceral tratmaa, how treated after operation 90 
 
 Viscosity affected by temperature 14 
 
 apparent vs. true 5 
 
 and leakage (dribbhng) 5, 70 
 
 and London Lancet 13 
 
 and specific gravity, relative value of 5, 12, 13 
 
 high for oil for use after anaesthesia 92 
 
 high, low, effects on digestion 13 
 
 high, necessary to prevent dribbUng 5, 70 
 
 natural 5, 14, 34 
 
 natural, importance of 14, 34 
 
 of mineral oil 4 
 
 of min eral oil at body temperature 14 
 
 of Squibb 's Uquid petrolatum 4, 5 
 
 relative pain producing power of oils with high, with 
 
 low 13 
 
 the index of lubricating power 5, 12, 13 
 
 the mineral oil of highest 6 
 
 value of high 13, 92 
 
 vs. specific gravity 5, 12, 13 
 
 Vomiting, post-ansesthetic, liquid petrolatum for 91 
 
 how to prevent 88 
 
 Water, excessive absorption of, from colon 61 
 
 to prevent dryness of contents of colon 49, 50 
 
 Watery stools, temporary reUef from 66 
 
 Watson, D. Chalmers 22, 43 
 
 Watson's observations 22, 23, 24, 43 
 
 Weight, increase in infants 74 
 
 What liquid petrolatmn is best for internal use. . .4, 12, 13, 14 
 
 When to introduce Uquid petrolatum into abdomen 87 
 
 not to introduce Uquid petrolatmn into abdomen. . .90, 91 
 
 White, W. Hale 38, 40 
 
 Wide-spread existence of intestinal stasis 42 
 
 Wooley, Paul G 24 
 
 Worms in intestinal track, effect of liquid petrolatum on. . . 47 
 
 X-RAY and antiperistalsis 67 
 
 and Uquid petrolatmn 59, 60, 67 
 
 gauges action of Uqmd petrolattmi 59 
 
 shows eflQcacy of Uquid petrolatum 60 
 
Our Medical Department 
 is at the service of the 
 medical profession for the 
 furnishing oj information 
 concerning official and 
 non-oficial remedies and 
 kindj^ed subjects. 
 
 All letters will have as 
 early an answer as the 
 subject permits, 
 
 E, R. SQUIBB & SONS 
 
SQUIBB'S 
 
 MATERIA MEDICA 
 
 A Complete Descriptive List of 
 the Squibb products, embracing 
 the articles in the U. S. Pharmaco- 
 poeia and the National Formulary, 
 together with approved non- offi- 
 cial Remedies in general use, 
 including Medicinal Tablets and 
 Biological Products. Setting forth 
 their origin; Latin and English 
 titles; Synonyms; Physical and 
 Chemical Characteristics; Incom- 
 patibilities; Antidotes; Thera- 
 peutic Indications; Doses; etc. 
 
 Squibb' s Materia Medico, ahandy volume 
 of over 400 pages, is sent free to Physicians 
 upon request. A new edition is in course of 
 preparation; if you care to have a copy when 
 it is ready for distribution, please send in your 
 order now, addressing Medical Department, 
 E. R. Squibb & Sons^Beekman St., New York. 
 

mmm 
 mm