SOME readers may be shocked to find that we mention that function which is so repulsive to us, because it is concerned with the waste matter of the body, in the same breath as the genital function, which is to lead us to the highest idealism. Science, however, must not be swayed by sentimental considerations of sympathy and antipathy, which have already led us astray far too long. Those of us who are well brought up are only too prone to make a mystery of the one function because the accompanying sensations are so pleasant, and of the other because they are so disagreeable, but this is not right. Science should not make a mystery of anything; on the contrary, it should elucidate everything. Its noblest task is to discover the interconnections between all phenomena.
I consider the intestinal function first, because it offers us the best opportunity for studying the conscious control of our bodily functions. The years in which we had to learn control of our bladder now lie far behind us, but the law of constancy obliges us in advancing years to pay ever more attention to the bowel excretion. Micturition is a trivial matter, especially for the male; it can easily be done anywhere: whereas the activity of the bowel requires far more trouble, self-control, and muscular effort, to produce either a positive or negative result.
It is, therefore, not surprising that the bowel-excretion does not give rise to the emotional and congestive manifestations which are so typical of the seminal secretion; but intestinal colic may sometimes cause as violent phenomena as those of sexual secretion, particularly of the female, and even loss of blood.
It is the peculiar construction of the organ that makes intestinal excretion such an important factor in learning self-control.
We are confronted with the question how it can ever be possible to control such a function. To begin with, we must make a fundatmental change in our conceptions of voluntary and involuntary muscles. This distinction is not absolute, but relative. The greater development of the transversely-striped muscles, as compared with the unstriped membranous muscle fibres, is accounted for by the fret that in the embryo the former develop in full activity, as is evidenced by the mother’s feeling foetal movements, while the unstriped muscles function very little or not at all during, intra-uterine life and are therefore less differentiated from the connective tissue.
Moreover the unstriped muscles work involuntarily because they lie so deep in the interior of our body, that they are outside the sphere of our consciousness. But even this difference is only relative. All our “voluntary” muscles were in the early stages of extra-uterine life just as helpless and involuntary as our “involuntary” muscles still are. Anybody who has watched Iittle children knows what a lot of effort it costs them to develop all these groups of muscles one at a time into voluntary ones. They learn to do this by experience. At first the various groups of muscles are moved involuntarily as if by accident, and the child observes the sensation of the contraction of the muscles involved as cause, and the external phenomena of movement as effect, and repeats the same movements in endless variation as a game, till it finally gains voluntary control of the muscle groups concerned. Now that we are grown up we have quite forgotten these exercises and can no longer remember how our hearts beat fast and our heads grew hot from the exertion. What endless trouble it cost us to learn to walk! As grown-ups we can get only a faint idea of it, for instance, if we learn to swim or to cycle.
This training of our skeletal muscles is always only partially successful, and even that only in the case of those muscles which we can observe and which we use frequently. The various groups of muscles in our back, for instance, almost always remain involuntary, however old we grow. And even with the best training, how relative this control is. Artists, e.g., famous pianists and violinists, and many skilled craftsmen achieve far more. And if at any time spasmodic contractions occur, the best trained muscles are no longer under our control.
All the involuntary unstriped muscles too, which we have laboriously exercised from birth, e.g., those involved in urination, are fairly under the control of our consciousness, though we still notice a certain incompleteness of control; whereas we have studied the control of the skeletal muscles from such an early age and so diligently, that we imagine that they are subject to our “will” and “order” without further consideration of cause and effect.
Yet the whole process follows the same course in both eases, though less smoothly in that of the unstriped muscles on account of their less complete differentiation. We have always begun, consciously or unconsciously, by learning cause and effect; and then later, whenever the same situation recurred, we have applied our experience. Thus we are enabled to make use of this chain of causes and effects in any way we like, by adapting ourselves to it. Here “to rule is to serve,” as the greatest rulers of ancient days knew so well.
This is the great lesson of life at which we have all laboured since our birth, and unconsciously even before it. The progress a child makes in this respect is almost incredible, particularly in the powerful massage of the abdominal wall, compression of the abdominal-cavity with the bent knees while lying on the back, etc. In this way it is possible to simulate the involuntary muscles of the bowel to contract with absolute mathematical precision. With practice it is possible, even in difficult cases, to render the involuntary musculature of the bowel obedient to our commands, though this training takes longer than in the case of the voluntary muscles, because of the greater differentiation of the latter.
The more attentively we study the physiological conditions, the more easily we shall succeed in setting the chain of cause and effect in motion, and ensure the desired result. We shall have to consider the choice of foods in connection with this function.
For this reason some people are very fond of brown bread as a mechanical stimulant to the bowel, others of gingerbread, figs or dates; for this reason, too, many people like vegetables and fresh fruit to ensure a large water and gas content for a longer time during digestion.
I have had hypochondriacal patients whose only interest in life was to choose such foods as would prevent constipation, and even discussed the subject at table, these were poor unfortunates who produced nothing else in the world. But if we want to have complete control we must begin much earlier. Even in choosing an occupation, we must see to it that it is not entirely a sedentary one if we are already inclined to constipation. We must continually remind children not to neglect this function.
Everybody must recognise the importance of the advice given by the doctor to pregnant women to take suitable exercise, advice which favourably influences the movements of the unborn child.
Much of what has been indicated here is always carried out unconsciously in the absence of knowledge, but to’ attain complete victory, especially in difficult cases, we must conform as far as possible to the physiological chain of causes and effects.
1 Our food takes about two days to pass through the whole length of the alimentary canal. If we go to stool once a day, say in the morning, the excreta passed will not be the result of the midday meal of yesterday, but that of the day before. Laxatives, and in sensitive persons, all sorts of influences can expedite the process. Gasses act as pioneers and clear the way.