A regular daily movement of the bowels is necessary to health. Much of the illness in the world might have been avoided if the victims had taken better care of the excretory organs. One of the first questions a physician asks a patient is, "How are your bowels, do they move regularly every day?" In some cases that is the first time the patient has thought of them, and he has to think some time before he can remember just when and how often his bowels did move. Then perhaps he is not sure. In a great many cases it is a routine practice with physicians to give a "good cleaning out," that is, to give a thorough laxative. Many times this is all the treatment required and in other cases it only is combined with a little intestinal antiseptic to further carry out the cleaning process.

The most common cause of constipation is irregularity in going to the toilet. When the desire for defecation comes, we are too busy and postpone it until some more convenient time, which time may be too late. Nature is the best judge as to when the bowels are ready to be emptied. If we do not obey her call, we must take the consequences. When the waste material is ready to be voided, it is in a semi-fluid state, but, if it remains in the intestines too long the water is absorbed and the waste material is left in a hard mass which is expelled with difficulty. Not only that, but the desire to expel it soon passes. Nature, finding we do not respond to her call, ceases to notify us.

If the waste material is allowed to remain in the bowels, not only the water is absorbed but with it some of the poisons from the waste material, which are taken up by the blood and carried to all parts of the system, causing a great deal of trouble and pain. This absorption of toxins (poisons) causes headache, loss of appetite, a sense of depression and a lack of energy.

The pressure of the hard material on the tender tissues of the rectum causes hemorrhoids or piles, by irritating the tissues and causing a congestion. Hemorrhoids are enlarged veins which have been so irritated and filled with extra blood that they have lost their power to contract. These enlarged veins may remain inside the rectum and then are known as internal piles. Sometimes they protrude externally and then are known as external piles. Frequently they become tender and cause a great deal of pain. In some cases one of the little veins becomes so engorged with blood that it bursts and allows the contained blood to escape. This is known as bleeding piles. For mild cases of hemorrhoids (piles) the treatment is to correct the accompanying constipation, then take an enema or injection of warm water morning and evening, using the water as hot as can be borne and allowing it to run in and out the rectum for some time. Following this, an astringent and soothing lotion should be applied.

Constipation may be caused by retroversion of the uterus. If the uterus is tipped backwards it presses on the rectum, preventing the passage of the feces (bowel movement). This pressure also causes hemorrhoids. In this case the treatment is to correct the displacement. In many cases all that is necessary is to take the knee-chest position for a few minutes night and morning.

Always in the treatment of constipation, the first item is to discover the cause. We have noted that the chief cause is irregularity in going to the toilet, therefore, the first measure to be taken in the treatment is regularity in going to the toilet. Choose a convenient hour, usually right after breakfast, and always go to the toilet at that time no matter if there is a desire or not. At first there may be no natural movement but if you persist, your efforts will be rewarded. For the first few days it is well to take an enema of warm, soapy water at this time. Every day take exercise that will strengthen the muscles of the abdomen. Bending forward and touching the toes with the fingers without bending the knees is one valuable exercise. This should be done ten or twelve times morning and evening. A daily brisk walk in the fresh air is another good exercise. Fruit or figs eaten with the meals or a glass of water taken before breakfast and upon retiring often proves very beneficial in relieving a tendency to constipation. There is an old saying, "An apple or two before going to bed, and the doctor will go begging for his bread." This really is a practical idea and more nearly true than many old sayings.

Cathartics or laxatives should not be taken except for an occasional dose or during illness upon the advice of a physician. So common is the practice of taking daily laxatives that it has become a "national curse"! People do not realize that they are slaves to this habit, so they continue to take their daily doses of "teas" or "waters." In many cases a patient will tell his physician that his bowels are "all right," that they move every day. Further questionings reveal the fact that he is in the habit of taking some laxative frequently. The bowels are not "all right" if any laxative is required.

Massage of the abdomen usually is very beneficial in treating constipation. It acts by stimulating the muscles and should be given at set times in the day but never until two hours after any meal. The various vibrators act in the same manner as massage. In any massage of the abdomen the thighs should be flexed, as this relaxes the abdominal muscles.

Enemas or injections of warm water may be taken occasionally and then are beneficial, but if long continued are injurious by reason of their irritating effect. At times, when the stomach and intestines have been over-loaded with irritating material, an enema is one of the quickest measures for relief. In obstinate constipation two or three ounces of warm olive oil injected slowly into the rectum at night and allowed to remain until morning will soften the waste material so it can be evacuated easily in the morning.

Constipation never should be neglected as it carries in its train a long line of disorders, as hemorrhoids (piles), abscesses, and intestinal obstruction.

Indigestion and constipation frequently are bosom friends. How often indigestion is a result of nervous strain is perhaps seldom realized. A business man eats his lunch and other meals in a hurry, with his mind on his business. His energies are being consumed by his brain and very little is left to be used in the digestion of his food. One never should eat when tired and nervous. Take a few moments' absolute rest before meals. If possible lie down and relax all muscles for a few moments. Then eat your meal slowly and if possible have some pleasant companion who will talk with you on subjects not connected with your business cares. You will be surprised to note the improvement in your digestion and incidentally in your tendency to constipation.

For the noon meal, office workers should eat only light and easily digested food. Eat your heaviest meal after the work for the day is finished and the blood which has been required by the brain can be spared to the stomach. People doing manual labor that requires physical strength need, and can digest, a heavy noonday meal but the requirements of the brain workers are quite different.

Many girls break down on account of lack of sufficient nourishment. Coffee and rolls for breakfast, ice cream and rolls for lunch and a sandwich and coffee for dinner is not sufficient food for any working girl. And yet that is about the diet of hundreds of girls. Often it is impossible for her to provide more, for when a girl must pay for her board, room, clothes and laundry from her salary of five or six dollars a week, sufficient food becomes an impossibility. Many girls actually are slowly starving on this account. When the wheels of progress make it possible for every working girl to have a comfortable home and sufficient nourishing food many of the social problems will right themselves.