By W.S.Moat, M.D.

      Mr. W.J.B., fifty years of age, medium height, two hundred and fifteen avoirdupois, came to my office. April 14th, 1902, and reported as follows: “Four hundred miles is a long distance for a man in my condition to come for treatment. Nevertheless, here I am, although I can scarcely walk, or even stand. My legs, be low the knees, and feet are swollen, red and very painful, the left worse than the right. I can stand but a few moments at a tive. Must sit or lie down and prop my feet up higher than my body, in order to get any relief. I suffer from pain in back and the most obstinate constipation. I also become so melancholy at times could with ease commit suicide, and no doubt would have done so had it not been for the sake of my small children. Have been under thee care of several good physicians during the last three years. They all say I have rheumatic gout, which no doubt is a fact, but none of them have been able to do me any good worth mentioning. But your letter explaining the probable cause of my affliction and proposed line of treatment has given me more hope, than I had any reason to anticipate. I think the above symptoms would reasonably warrant a diagnosis as that of rheumatic gout.”

      The first thing I did was to carefully examine his urine. Found nothing wrong worthy of special notice, so concluded that constipation was the chief cause of his diseased condition. Then placed him in a horizontal position on operating chair with knees drawn up, so as to take the tension off the abdominal walls.

      While in this position, with hips elevated, explored the rectum with finger and found it prolapsed and contracted, with no faecal matter within reach. But the intestines appeared full from one end to the other. With a bulb syringe forced into the rectum and lower bowel all the warm water he could hold. Then manipulated the bowels by pulling upward from low down in both groins and beneath the pubic bone until he could hold the water no longer. This was repeated from time to time until the pelvis had lost much of its tension. Heretofore, cathartic medicine had little or no effect. But now they began to show required results. Daily manipulations with left hand on abdomen and finger of right in rectum. Warm water injections and an occasional dose of some mild cathartic cured this man in less than one month. At least he called and so reported at my office on the 5th of September, 1904, which was almost eighteen months after having received his last treatment. In cases similar to this is have often found the mesentery crowded down under Poupart’s ligament on both sides, more frequently on the right, producing hernia and strangulation of thee blood vessels and nerves contained within it. Chronic inflammation of the rectum, sciatic rheumatism, and partial paralysis of the legs, difficult micturition and uterine prolapses are some of the afflictions produced by the displacement of pelvic tissues and they can be cured by proper manipulation when all other remedies at my command fail.

Cramps in the Bowels

      J.L.H. of Cape May City; New jersey, called at my office on June 5th, 1900, and made the following statement: “Have been sick almost a year. I suffer at frequent intervals from the most severe cramps in bowels. The pains extend down into both groins and surrounding parts. Bowels very much constipated have taken large doses of castor oil, salts, compound cathartic pills, and injections of warm water. They give only temporary relief, and in a day or two am just as badly off as before. For mouth past have not been able to work. In fact, I am a physical wreck. Have consulted and been treated by several good physicians, but they do not appear to be able to reach my case. Had about concluded to go to a hospital and submit to an operation, but have been persuaded by friends to consult you first.”

     This man had lifted some heavy furnace grate-bars from the hold of a steamship while standing in an uncomfortable position some time before he became afflicted, and might by so doing have strained himself. From this fact, in connection with the symptoms, I suspected bowel displacement, with a pocket or pockets filled with faecal matter, and so it proved to be. Placed him on an operative chair and when the abdomen was laid bare found a globe like body, three inches in diameter that protruded an inch above the surface, and located in left side on line of descending colon and just above sigmoid flexure. By internal and external manipulation I was able to reduce it more than half. Ordered him to inject into the rectum and lower bowel all thee warm water he could conveniently hold, on going to bed, lie flat down on his back and manipulate the bowels with both hands and retain the water as long as possible. Gave him Nux vomica and Rhus tox. Tincture on pellets, to be taken every two hours, and requested him to report in four or five days. Second call at office reported much improved. He got six treatments in June, two in July one in August, one in September, one in November and one in December (twelve in all). He resumed his daily vocation after the first month’s treatment. Have seen and heard from him at short intervals during the last three years and he reports perfect health all this time. No. 10 pellets saturated with the tincture of Nux vomica, Rhus. Tox, Podophyllin, Arsenic and Arnica were the medicines give, from time to time, according to symptoms. Emptying the pockets (distended portion of the bowel) of accumulated and hardened faecal matter by manipulation, as above stated, was in my opinion the only sure remedy to enable him to escape the surgeon’s knife.