occurrence; accompanying this fermentation there is gas distention
of the bowels, and this inflation in time interferes with their
motility and weakens them so that sluggishness is succeeded by
obstinate constipation.

Every step of this evolution shows an increasing toxic state of the
fluids in the bowels. After constipation is established the efforts
at securing evacuations are of such a nature as to irritate the
cecum. Drugs to force movement cause painful distentions of this
portion of the bowels. The drugs stimulate peristalsis of the small
intestine; each wave from the small intestine breaks on the walls of
the cecum, for the colon is loaded with fecal accumulations so that
the onrushing contents of the small intestine can not be received by
the colon; hence the force of the whole peristaltic impact is spent
on the cecum, which must endanger the integrity of the mucosa as
well as the musculature.

This point of the bowels, the cecum is more endangered from diarrhea
than any other. The toxic ptomaines are especially liable to create
a local infection if nothing more.

This state of the intestines--toxic state--is a constant menace to
health; in fact the organism is heavily taxed to maintain its
defense.

The overcrowding of metabolism, as explained above, the chronic
constipation and toxic bowel secretions, I recognize as the chief
factors--the necessary and leading factors--in the building and
maintaining of that constitutional state which I am pleased to
denominate _Constitutional Catarrh. _When this state is established,