“Cleanliness of body was ever esteemed to proceed from a due reverence to God, to society, and to ourselves.”—Bacon.

The International Congress on School Hygiene ended its fourth meeting at Buffalo recently to meet two years hence in Brussels. In the interim the Board of Education in this city, the Department of Health, and the New York School Luncheon Committee will continue their investigations as vigorously as in the past, and the information thus gained will be an important contribution to the next Congress.

Too much attention cannot be given to the question of hygiene, diet, and excretion to meet the psycho-physical requirements of the mind and body in normal health. As a rule, diet is prescribed for the purpose of relieving the various annoying and painful symptoms caused by chronic impairment of the functions of the stomach and bowels, but when we find the cause of these various symptoms arising from a disturbed gastro-intestinal tract, the question of diet will receive less attention. Why has not the subject of normal intestinal excretion received as much attention as diet in health or ill-health? As our knowledge of the human psycho-chemical laboratory increases, we are able definitely to locate a diseased organ and account for the symptoms caused by the pathological condition of that organ; and when the diagnosis is properly made these symptoms become a secondary matter of treatment.

The chief enemy of health among school children (and older persons as well) is the accumulation and retention of waste matter and gases in the intestinal canal, where are generated ptomaine, toxic, and other poisons which enter into the system, resulting in self-poisoning or auto-intoxication.

What do we mean by school hygiene? Is it only the school building, or the external appearance of the children, their eyes, teeth, mouth, nose, hands? What about the coated tongue, foul breath, fouler stomach, and putre­fac­tion of the contents of their intestines? A human being is only an extension of his gastro-intestinal apparatus, hence it is very essential that such apparatus should be in a hygienic state to ensure his physical and mental resistance and efficiency being at their normal strength. There is one symptom that causes more sickness and suffering from infancy to old age than all others combined—that is, con­sti­pa­tion with its attending putre­fac­tion and foulness of digestive organs. Only a small percentage of people escape its baneful effects or the secondary diseases induced by fecal and mucus auto-intoxication. Such a common primary symptom must have, necessarily, a common exciting cause or origin. Through many years of clinical experience as a gastro-enterologist and proctologist, we have found that inflammation of the anus, rectum, and sigmoid flexure is the frequent or common cause of con­sti­pa­tion. Observation has demonstrated that a soiled diaper is the exciting cause of Proctitis and Sigmoiditis in the beginning. Examination of one hundred children of the “defective class” would show most of them suffering from chronic Proctitis and Sigmoiditis, with some degree of con­sti­pa­tion and auto-intoxication, and even of those classed as “healthy school children” a large percentage would show the same conditions. The continuous invasion of the neighboring tissues by the disease, the increasing auto-intoxication and con­sti­pa­tion, the on-coming malnutrition, and anemia, the gradual emaciation, are all the while lessening the vitality and power of bodily resistance of their victims. The early inception of the malady and its insidious progress, with the symptoms and diseases resulting, easily deceives the victim as well as the parents and medical advisers, until the long-pent-up virulence breaks forth, showing itself in every part of the tabernacle of the spirit of man, when the removal of the primary cause does little or no good.

The Department of Health, in examining the sanitary or hygienic condition of a school building, would not devote all its attention to the top story to overcome unhygienic conditions; it would probably direct its attention to the trap and vent of the sewer of the building to see that there was no retention and filling up of the pipe to befoul the atmosphere of the structure. Why then so much attention to the head or top story of the human temple, and so little to the trap and vent of its sewer? Are modesty and ignorance to defeat the progress of hygienic measures dealing with the stomach and bowels of our school children? How long will those abdominal incubators of poisonous microbes and gases be allowed to infect not only a school building but all its occupants as well?

The absorption into the system of serous, fibrinous or albuminous mucus exudations from the invasion of chronic inflammation through all the layers of the tissues of the anus (Figure1), rectum, and sigmoid flexure, as well as through the adjoining fatty tissue in the pelvic space around the organs (Figure5), under the skin and between the muscles of the buttocks, goes on continuously, creating an extensive inflammable area and source of exudation of broken-down tissues. (See Chapter III.) It is a grave pathological condition and the source of mucus auto-intoxication, and its symptoms ought to be differentiated from those of fecal auto-intoxication. This mucus exudate has an intensely irritating effect on the nervous system, especially when an acute intestinal mucus storm has developed, torturing its victims and unfitting them mentally to attend to the ordinary duties of the day. Very often this is accompanied by more or less pain or muscular soreness. These annoying symptoms occur very early in the history of Proctitis and Sigmoiditis, and clinical experience has demonstrated to me and to my students the necessity for infants and children being examined in order to determine whether inflammation exists in the anus and rectum, and thus early cut short the progress of the disease and its numerous and familiar symptoms, which I may here enumerate, to wit: indigestion, flatulency, coated tongue, foul breath, bad taste in the mouth, capricious appetite, nausea, intestinal colic, cramps and pains, diarrhea, headache or band of pain encircling the head with sense of constriction, neuralgia, pain about the heart, cold hands and feet, malnutrition, anemia, emaciation, dry skin, seborrhea sicca, carbonic acid toxemia, sallow complexion, liver spots, jaundice, acute bilious attacks, drowsy states, mental torpor, bad temper, night terrors, irritability, melancholia, vertigo, dizziness, loss of memory, insomnia, drawn face, tired feeling, unrestful sleep, easily fatigued, subject to colds, catarrhal affections of the ears, eyes, nose, throat, etc., decay of teeth, dry cough, loss of hair, impaired vision, sterility, impotency, mucus and membranous cords and casts from the bowels, sediment in the urine, irritability of the bladder, premature age, reduced physical and mental efficiency, inability to concentrate the mind, morbidity, suicidal notions with a view to ending mental and physical suffering.

I am pleased to inform such sufferers that their ills can be properly diagnosed and treated; and the earlier in life they seek treatment, the sooner they will escape the accumulative ills that make existence so painful to endure.

We have mentioned Proctitis and Sigmoiditis as the primary cause of intestinal stasis in the majority of cases; later, other sections of the intestinal canal may be invaded by inflammatory process, causing a more serious intestinal stasis, not infrequently bringing about dislocation of the stomach, intestines, and other abdominal organs. We have enumerated the symptoms and maladies that are now, in the light of latest medical science, traceable directly or indirectly, to this primary cause; in short, it may be said that, with the exception of a few diseases caused by toxic agents, most of the illnesses that cause so much invalidism, cutting short our lives, can be traced to mucus and fecal auto-intoxication.

The purpose of this book and others I have published is to educate my fellow beings as to how to prevent or avoid the many diseases and symptoms that afflict them from the cradle to the grave; already I feel that I have accomplished something in helping humanity, and I trust others will do their part to lessen the ills that flesh is heir to through neglect and ignorance.