The enema, of course, constitutes the chief means and mainstay of relief from obstipation of the bowels, and one by one the other aids are to be omitted. Moreover, when the time comes that the bowel is freed from the disease that occasioned the occlusion and obstipation,--that is to say, when the bowels evacuate themselves naturally three times a day,--then the enema itself may be omitted, or it may be continued without harm by those whose sense of cleanliness would induce them to keep up the practice in preference to the uncleanly habit of using toilet paper as a partial means toward cleanliness. Surely there is no harm in substituting a better habit for a worse one--one, moreover, that we should be ashamed to continue! As no one would think of cleaning his soiled fingers with toilet paper, as already said, so no one with any real sense of decency will continue the attempt to clean his anal orifice with such material when he has learned a better and more effective way. Likewise, after having learned the rational mode of relieving the surcharged bowels, no wise person will continue the use of physic, coarse food, gymnastic exercises, and other futile and foolish practices as remedial measures for intestinal ailments. No one suffering from proctitis and colitis can have a clean and healthy sigmoid flexure and rectum unless these be kept clean by the regular use, three times a day, of the enema. From the day when the disease invades these parts there is and will continue to be a clogged, plastered, or incrusted passage for more or less of the entire length of the colon. This must be so in the nature of things, since these organs are unable to perform their functions while the disease is present. Just think of possessing a filthy, congested intestinal canal, without one day of real cleanliness for twenty, forty, sixty, or more years! It is not the easiest thing in the world to cleanse this channel even by the use of the enema; for the ancient contents refuse dislodgment even after repeated flushings, and it is only after many days of persistent and patient irrigation that the intestines are freed. Some persons are apprehensive as to the quantity of water the large intestine will hold with safety. Let me reassure them. It is capable of holding about three gallons without too great distention. One-third of this amount, however, is quite sufficient to bring away the accumulated fecal mass, and in many cases a much smaller amount will answer the purpose--especially when, as advised, it is used two or three times within twenty-four hours. After a thorough evacuation, water should be injected one or more times until it returns clear and free from fragments of feces. If I were asked to name the greatest curse parents could inflict upon their helpless offspring, I would say _fecal auto-intoxication_. A large volume could be written on the subject, and I trust the hints here given will lead to discussion of this grave matter. CHAPTER XIII.