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Published originally in Fact, Fiction, Fraud
in Modern Medicine
Ancient Origins
Colonic irrigation is an ancient method of healing and it would never have
survived until the present scientific age if it were without value. It is
a curious fact that medical practitioners seem to be either in favor of this
treatment (and usually quiet about it) or vehemently opposed to its use.
The objectors never have any experience of it. Every grown creature probably
has an instinctive dislike of its own waste products, and this may explain
why the physician is generally so remiss in examining the feces of his patients.
There are indications from ancient documents that the Egyptians and the Greeks
practiced colon irrigation therapeutically, although their ideas and the
benefit to their patients are unknown to us. Hollow reeds and gourds were
used to introduce water through the rectum.
The Reputation of Colonics
I first heard the term colonics as
a young doctor while practicing in California. Immediately, I knew
that it was a form of quackery.1 It is self-evident that
the bowel excretes the waste products of digestion regularly, naturally and
automatically. There is no need to interfere with nature. This pre-formed
opinion (and I am uncertain how it came to be so firmly formed in my mind)
was reinforced when I read comments from an official source, that I can no
longer identify, condemning the use of colonics by lay practitioners in the
state of California and, in due course, the medical association lobbied for
its banning through the legislature. This surprised me a little. If something
is useless and harmful, why is it necessary to make laws about it? We don't
have laws against swimming in sewage nor do we lobby our legislators to make
such laws. The only sensible thing any person would do with sewage is dispose
of it as hygienically as practical. This dilemma hung in my mind for a number
of years. Since then, I have assiduously prescribed diuretics to my patients
who retain water, laxative to those who were constipated and, personally,
I brush my teeth every day. Think about it for a moment. Which is the cleaner
part of your alimentary canal? (The alimentary canal is the pipe through
which the food passes in your body from mouth to anus). The mouth is
cleaner than
the rectum, and yet it is the mouth that I clean with a toothbrush, with
paste, and even flossing. Why clean the clean end? I think, in final analysis,
the answer is that it is esthetic. The dirty end should be beneath our dignity;
or should it?
My Own Experience
As I have explained in previous newsletters that much of my learning about
alternative medicine has come from my patients. To them, I shall be eternally
grateful. Learning about colonics is no exception. Patients have told me
how their health, their malaise, their fatigue, their abdominal distention,
their chronic bowel disturbances, and their dermatitis cleared up through
the use of colonics. The first few times I heard the story, I knew that the
patients were either crazy or the improvement was coincidental. How many
times can you hear of such an account and continue to avoid the obvious out
of sheer obstinacy? In my case, it was about half a dozen times. My resistance
to quackery was diminishing through my experience with chelation, nutrition
and, of course, mostly through my experience with orthopaedic medicine. Was
it conceivable, was it perhaps even possible, that this rather unsavory business
with the dirty end of the bowel had something to do with health? I think
I resisted recognizing the benefit of colonics longer than my resistance
to recognizing other alternative medicine as therapeutic tools because of
what I would like to call the sewage aspect of the bowel. It is strange to
have to admit that the conversion and the prejudice occurred when I read
a non-medical book. Erewhon, by Samuel Butler 1898, describes a topsy-turvy
world where people are ashamed to eat, and do so in privacy, while they deal
with and discuss their financial matters in public; the exact opposite of
our own habits. Even Samuel Butler did not deal with the sewage aspects,
but he did point out that the habits we have are not always quite logical.
Once one overcomes the sewage aspect, or what I should really call the sewage
prejudice, it actually is rather obvious that just as we clean our skin in
bathing, our teeth with brushing, our nails with clipping, our hair with
shampooing and combing, it is perfectly logical to clean our colon with irrigation.
One might argue that it is not natural in some Wordsworthian or mystical
primitive sense, but the same can be said for bathing with soap or using
a toothbrush. Having dispensed, therefore, with the prejudicial aspects of
this issue, we now need to ask more seriously what do colonics do, when should
they be used, what is the evidence that they are effective, if any, and if
there is a benefit, how might it be useful? Dentists will tell us that keeping
the teeth clean protects the hygiene of the mouth and reduces the incidence
of cavities. I think they are probably right. I do know that in people with
certain illnesses, enhancing excretion of water and electrolytes through
the kidneys can improve their health. The most important example of that
is when dealing with fluid accumulation, anasarca or edema, for instance
in heart failure. It is also quite obvious that if a person is unable to
move his bowels, flushing the inspissated (dry and hardened) contents can
open the passage so, here, we have a clear indication. If the person's
bowels are blocked due to dried up feces, flushing them out will obviously
restore the ability of the bowels to move; and, it goes without saying that
without bowel movements, obstruction and illness will ensue.
Subtle Conditions
There are many cases where alternative medicine looks at mild degrees of conditions
generally accepted in medicine and enhances the public health through catering
to them — what in a sophisticated way one might call a forme fruste of
an illness. Is constipation good for you? Well, obviously not. How often
should the bowels move? In medical school I was taught that there is no rule
on this matter; that if the bowels move once a week, that is sufficient for
some and normal; contrariwise, two bowel movements a day might be normal
for others. I now know better. Most people are better off if their bowels
move two to three times a day. How do I know? Having developed an interest
in nutrition and the function of the bowel, I have developed the habit of
asking my patients about the frequency of their bowel movements and can assure
the reader that in general those whose bowels move two-three times a day
fare better in their health and nutrition than those who are more constipated.
I do admit, however, that there is no absolutely hard rule on the matter.
I would like to discuss some theoretical considerations regarding what I
propose to you are the benefits of colonics in certain situations. How might
it work?
Effluent Enhancement
Which organ of our bodies is most responsible for waste disposal? It goes without
saying that it is the bowel. Yes, in some ways, waste products are excreted
by the lungs (carbon dioxide), by the skin, (scaling), sweat, by the kidneys
(water and chemicals). The vast majority of waste products of life, however,
are passed through the bowel. Some of this waste product is what I call pass
through. Frankly, however, the majority of what appears in your stool is
excreted, or altered, and therefore not simply a passive 'pass through' product;
but, for the purpose of the 'pass through' products, we can
reasonably think of the bowel as a pipe, for a first approximation.
The Bowel as an Excretory Organ
The large bowel itself serves to concentrate the contents passed into it from
the small intestine, through the resorption of water into the circulation.
Bacterial fermentation occurs in the colon. Several products of fermentation,
some of which are only slightly understood, probably serve as useful nutrients
when reabsorbed. I phrased this concept in a negative way because it is clear
to me that, even in these days of know-all science, a great deal of information
is lacking regarding the details of this process. We do, however, know from
respectable physiological studies, that many products are excreted into the
lumen of the intestines and reabsorbed therefrom to circulate back-and-forth,
usually through the liver via the venous blood system from the intestines
to the liver, called the portal circulation. This enterohepatic circulation,
as it is called, plays a very important role in balancing products between
the bowel and the liver. An excess of these products in the bowel, for instance
bile salts, can provoke diarrhea and, contrariwise, failure of adequate excretion
can lead to the retention of toxicants which, in turn, are dammed back into
the circulation and can be associated with disease. In this context, we often
speak of liver or hepatic failure. We should remember that the liver is the
major detoxifying biochemical factory in our bodies and that its waste products
are passed through the bile passages (and sometimes with temporary storage
in the gallbladder) into the duodenum, thence into the small intestine and
colon. You see, now, how there is an inherent relationship between the excretory
function of the bowel in general, including the colon, and the biochemical
excretory factory, the liver. It is not at all surprising, therefore, that
by enhancing excretion through the bowel we can indirectly enhance excretion
by the liver, the main detoxifying factory of the body. On thinking this
over, these observations make such plain common sense, based on simple knowledge
of anatomy and physiology of the gastrointestinal and hepatic tracts, that
in retrospect, I am amazed at my own stupidity of not working these things
out for myself many years ago. It was, therefore, a salutary experience to
read references about this in some books lent to me by a colon therapist
friend, Dirk Yow, CCT, GOK, that these ideas are by no means new.2-4 We might
next ask how might colonic therapy increase the excretion of waste products
through the pipe we call our colon?
Increase in Peristalsis
We know that a lot of movement in the pipes of the body occurs through peristalsis.
The action of the muscle of the heart is one such example although, of course,
the blood does not go backwards into the chambers because of the action of
the valves. These valves are flaps of fibrous tissue that come together and
stop return flow. Valves are present in the veins, as well, directing the
blood in the appropriate direction. The lymphatic system has valves, and
the term valves is also used in reference to the pipe we call our gastrointestinal
tract, or gut. Muscles contract in a rhythmic manner, causing a wave of contraction
down the pipe. This is seen best on inspecting the movements of the esophagus
and the small intestine; but as these organs do not have one-way valves,
like those in the heart, fluid can travel back-and-forth in spite of these
peristaltic waves. Indeed, the digestive processes in the gut are dependent
on slushing the fluid, the digestive juices, mixing them and churning them
and, therefore, this peristaltic phenomenon is not exclusively unidirectional.
Peristalsis as such, however, is not a prime feature of the large bowel.
Here we speak of contractions of the whole organ or, at least sections of
it, particularly contractions of the longitudinal fibers, and large quantities
of contents are propelled forward, and occasionally backward, through what
is called mass action. Most people are familiar with the phenomenon that
the urge to move their bowels occurs sometimes after a meal, typically breakfast,
and very often after ingesting a stimulant such as coffee. This is an example
of a generalized contraction of the organ (the colon) that propels the contents
into the vestibule where it is held temporarily before evacuation. The contents
of the small intestine pass through the sphincter that separates it from
the first part of the colon, called the 'cecum' (on the left
side of the abdomen), and the circular muscle at the lower end of the terminal
ilium, the small bowel, is indeed mostly contracted or closed. The liquid
contents of the small intestine are squirted in small quantities, following
peristaltic activity, into the cecum. The cecum itself serves predominantly
as a reservoir, the site where the dehydrating process begins and the site
where bacterial fermentation begins and occurs predominantly. The cecum is,
to a certain extent, a dead end; and its appendage, the appendix, is a complete
dead end. It is here, of course, that chronic inflammation and infection
occurs most frequently, hence the disease of appendicitis. It is interesting
that there are accounts of instances in which casts of the lining of a colon
are reputed to be excreted en masse; almost certainly these represent mostly
a combination of shed lining from the cecum with contents which had become
inspissated and adherent to the lining of the cecum, the continuous flow
of contents from the small intestine into the bowel beyond the cecum, passing
through these concretions. There are multiple, though infrequent, accounts
of people passing contents from their bowels that are recognized to have
been ingested a long time earlier. Almost certainly these concretions are
held, therefore, in the periphery of the cecum while the otherwise continuous
flow of contents passes through the center of the cecum into the ascending
colon. It is also not unlikely that some of this phenomenon of sluggishness,
of stasis, at the bowel surface can occur in the ascending and transverse
colons, as well, with the contents merely going through the center and being
propelled through the phenomenon of mass action. Is it an advantage for a
person to have longstanding concretions in this organ? Of course, it is not.
I must report, however, that in the process of inspecting the lining of this
organ with a colonoscope, a procedure that I have had occasion to perform
many times, one does not ordinarily see large residues in this site. How
might this be? How can it be that there are reliable accounts of these casts
that are not seen by the endoscopist? I have come to the conclusion that
the answer is that, in preparation for endoscopy, the patient invariably
is asked to take a strong purgative to clean out the contents of the bowel
so the endoscopist can indeed inspect the lining. Almost certainly these
purgations remove any material that might have been static in this situation
and therefore not observed when the endoscopic inspection is performed.
Stimulation of the Lining
The process of irrigating the bowel can, almost certainly in many instances,
have a stimulatory effect on the cells lining this organ. As the business
of these cells is to provide mucous and facilitate much of the excretion,
it is not surprising that stimulating enhances this effect. Can they be stimulated
merely by contact with water? Probably to a slight degree; but it is more
likely that bringing them in contact with certain herbal, and possibly chemical
agents, enhances this effect. For instance, it is well known in conventional
medicine that the addition of magnesium sulfate to the contents of the bowel
causes the lining to pass more water into the lumen, and the patient develops
diarrhea. This is a purgative effect. A number of herbal agents are known
to have other effects on the linings. Terms such as carminative, mucous enhancing,
relaxing, stimulating, and enhancing excretion, are all used, and a number
of specific herbs have a number of specific actions on these lines. This
is not mysterious. If you were to drop some lemon juice into your mouth,
would you not experience an increased flow of saliva? Does peppermint not
clear the passages by causing shrinkage of swollen lining? Why should these
botanical preparations not have a similar effect on the lining at the other
end of our gut? They, of course, do. Experience in colonic circles is growing
with the use of a number of specific herbal agents that can be mixed gently
into the warm water passed into the colon for irrigation; so that individuals
with a tendency to spasm are given relaxing agents. Contrariwise, individuals
whose bowels are too relaxed might benefit from a mild contractile stimulant.
You see that none of these considerations are particularly mysterious. The
skill and experience of using the right herbs in combination is, however,
still something of an art and not all individuals respond equally to all
herbal stimulants. The skillful colon therapist will, therefore, introduce
small quantities of proposed remedies at a time and evaluate the response
before proceeding with more.
The Use of Ozone
Do the cells of our body breathe? Do they use oxygen to enhance their metabolic
activity? Clearly the answer is affirmative. The large bowel is an environment
that tends to be somewhat deficient in oxidative power. This is associated
with the anaerobic contents. An anaerobic environment is where the concentration
of oxygen is low, or very low. Enhancing the oxidative power in environment
of the colonic cells has an effect that cleanses them of anaerobic bacteria,
at least temporarily, and gives them a metabolic boost. This phenomenon has
an invigorating effect on the cells, just as exercise does on the circulation
in the muscles, where there is temporarily an increase in oxygen utilization.
One hypothesis about the incidence of certain kinds of bowel disease, such
as for instance the appearance of colon cancer, is that it is associated
with a decreased metabolic rate in an anaerobic environment; therefore, it
is quite possible that periodic enhancement of oxygen utilization, such as
occurs with the addition of ozone to the colon enema water, might have a
beneficial effect. This seems to be so symptomatically but, of course, we
do not have enough information to judge whether it has an objective protective
effect against the development of cancer. This will, however (it is hoped)
be a subject for interesting long-term study. Almost certainly the tendency
for toxic materials to accumulate in the cells lining the bowel is reversed
through enhancing the oxidative process. You will gather, therefore, that
the addition of small quantities of ozone-containing oxygen in solution containing
the water used for colonics seems to have a beneficial effect.
Other Bacteriologic Consideration
I have alluded to the nature of the bacterial contents of the bowel. Ordinarily
we carry an enormous load of bacterial species, both quantitatively and in
the multitude of varieties. The fermentative process that occurs in the bowel
bears a relationship to health and disease. The contemporary habit of using
large quantities of pharmaceutical agents that alter the nature of the bacterial
contents, antibiotics in particular, has a strong effect in changing the
composition of these internal residents. It was believed, and in certain
circles is still believed that, with the exception of the bowel, the inside
of the body is entirely sterile. From Enderlein's research, and that
of others, we have come to recognize that the endobiontic relationship in
the cells is more complex and that almost certainly life forms (microzymas
in Béchamp's terminology) are present in fact in most living
cells. They are, however, in a form (or valency, to use Enderlein's
term) that does not encourage independent proliferation. That is why, when
cultures of cells (for instance, of the blood) are taken from healthy people
bacteria do not ordinarily grow out on the culture medium, or the plate.
This contrasts with culturing the contents of the bowel. It is, however,
believed that in certain circles — those that I might reasonably call
the pleomorphic medical subculture — that there is a relationship between
the bacterial forms overtly present in the intestine and those covertly present
in the intracellular milieu. This is one of the reasons that the use of antibiotics,
particularly when they are taken by mouth, is considered to be deleterious;.
It changes the composition of the bacteria in the intestine, probably encouraging
the development of cell-deficient forms that probably interact, or penetrate,
into the intracellular environment with greater facility and thereby probably
accelerate the degenerative process, in Enderlein's terminology raising
the valency of the endobionts. There is little conventional hard research
on the detailed composition of the bacterial contents of the bowel. The problems
relate to the difficulty in culturing the bacteria and separating the species
in an artificial environment and quantifying them on culture plates, etc.
The anaerobic bacteria (those that thrive without oxygen, are fastidious
organisms in the laboratory environment, but the culture of the aerobic bacteria
sometimes give us useful clues about unfavorable changes in the composition.
This, incidentally, is one reason why nutritionally oriented physicians often
ask for bacterial cultures on specimens of stool. What effect do you think
irrigation might have on this zoo of organisms? Almost certainly it dilutes
them, removes concretions of residual material, and probably facilitates
a freshening up of the fermentative process and participants. The introduction
of the bacteria that we ordinarily regard as favorable to the intestine,
such as the Lactobacillus, is best done at this time, and some clinics afford
the colon therapist an opportunity to introduce appropriate instillation
of bacteria, particularly in this category, at the end of treatment.
Other Ways of Manipulating the Colonics
Changes in the volume of fluid, the pH and salinity can, of course, have an
effect on the bowel. The colon therapist can also judge the temperature of
the irrigating fluid, to a small extent, further altering the behavior and
reaction of the cells of the lining of the bowel.
Stretching
When fluid is passed into the colon, and particularly when it is passed in
skillfully, without introducing any gas, such as air, there is a gradual
distention of the organ. It should be remembered that the colon is a flexible,
irregular tube contained within the flexible, irregularly structured abdominal
cavity. An increase in the pressure of the lumen of the bowel has an instantaneous
effect on the pressure of the rest of the abdominal contents. From this point
of view, the relationship to each other is like that of fluid in a hot water
bottle. Is stretching the colon a good idea? My answer is a clear yes. And
here, I take the liberty of making a comparison with stretching the fascial
layers of the body elsewhere. After all, what is the colon? It is a fascial
bag with an outside lining called the 'serosa' and an inside lining called
the 'mucosa'. There are some muscular thickenings within the fascial bag
called 'circular' and
'longitudinal' muscles, (tenia) the action of which we have already discussed
when reviewing the weak
peristalsis of the colon and the strong mass action (longitudinal bands) earlier.
When we stretch the body itself, the fascial layers of the trunk and the limbs,
and those around the axial skeleton improve the alignment of the contents.
The stretching evens out tensions and restores function. We sometimes speak
of the tensegrity model, when discussing this, because there is a relationship
amongst the tension of all the components of the system to all others. Does
this consideration apply to the internal organs? Of course, it does. One way
to improve the overall function and integrated action of the colon is by stretching
the organ, and it is quite plain that the only available way for stretching
is through the installation of water gradually under slight-to-moderate pressure
through the anal canal. Almost certainly this is the reason why colon therapists
report that after these irrigations they retrain the bowel.
Retraining the Bowel
An important benefit of colon therapy is this business of retraining the bowel.
In 'civilized' society there is a tendency to defer the urge
to defecate for social reasons. A person might be in a board meeting or any
other assortment of social engagements. The mass action that might have been
initiated by the mid-morning coffee, loading the rectum, is ignored. The
contents might either stay in the rectum or shift back into the descending
colon. Further inspissation and toxic absorptions are now likely to take
place and, after ignoring the urge to stool repeatedly, the phenomenon of
a regular bowel evacuation occurs less frequently. The bowel is trained in
bad habits. It is true that the fermentation in the bowel is apt to lead
to flatus in the circumstance, but many civilized men ignore that stimulus,
as well. Almost certainly the phenomenon of rehydration and stretching the
colon, particularly when combined with education of the subject that a call
to stool should not be ignored and in fact solicited from the bowel, so to
speak, two-three times a day at regular intervals will restore normal colonic
function and indirectly enhance the person's health substantially.
Accordingly, it is an important role of the colon therapist to educate patients
in combating constipation and generally improving bowel habits. Many of these
benefits can be permanent after a series of, say, 10 treatments at, say,
one-two treatments a week. It is up to the physician, in my opinion, to select
the patients in whose cases this treatment should be recommended.
Colonic Illnesses
Is there a place for the use of colon irrigation (colonics) in patients who
have illnesses such as ulcerative colitis, chronic diarrhea, chronic dilatation
of the bowel (such as Hirschprung's disease), a tendency to spasms
(often called irritable bowel syndrome) and diverticulitis? My answer to
these is affirmative in all the cases. It is, however, true that the colon
therapist needs to be skilled. Excessive distention, in the case of diverticulitis
or ulcerative colitis, may theoretically pose the risk of leakage, although
one has never encountered such a case. The use of remedies in the contents
of the bowel needs to be practiced with skill and experience.
Conclusion
In summary, I have come to the conclusion that colon therapy is not mysterious,
is a useful adjunct to detoxification in a variety of illnesses in which
the accumulation of toxins plays a major or contributory role to a person's
ill health; therefore, washing the lining of the bowel is just as sensible
as maintaining cleanliness in other parts of ourselves and, in the modern
living environment, there is a tendency for the accumulation of toxins, increased
constipation, increased concentration of the residue in the bowel because
of a shortage of roughage in the diet; thus cleaning and irrigation is an
advantage.
Technique
Before concluding this article, a comment about technique. The modern colon
therapist will use an instrument that allows a continuous exchange of fluid
in and out of the bowel, and irrigation. It will allow the therapist to have
continuous inspection, through a glass component of the outflow pipe, to
inspect the contents of the effluent, and the experienced therapist will
learn to recognize when the effluent indicates enhanced excretion from the
bowel proper, from the liver indirectly through the bowel, or merely when
particles of stool are washed out. With modern technology, the procedure
is both comfortable and entirely hygienic without unpleasant aromas or any
spillage. The practical details vary little between therapists, but essentially
a small tube is passed, with the individual in side-lying position, into
the individual's rectum. Most colon therapists then choose to place
the patient on his back, and the irrigation takes place in this position.
Typically 10 colonic treatments, perhaps, at four-six day intervals are recommended
for most conditions, and many people who have significant but not inherently
destructive disease, such as the examples given above, can obtain life-long
benefit from a series of colon therapies without the necessity to follow-up,
although certain individuals do benefit from infrequent follow-up long term.
Correspondence:
Thomas A. Dorman, MD
Paracelsus Clinic
2505 S. 320th St., Suite 100
Federal Way, Washington 98003 USA
253-529-3050
Fax 253-529-3104
TD@Paracelsusclinic.com
www.Paracelsusclinic.com
References
1. Gastrointestinal Quackery: Colonics, laxatives and more. Stephen
Barrett, MD at http://www.quackwatch.org/01QuackeryRelatedTopics/gastro.html.
2. Colon Therapy. J.E.G. Waddington, August 1940.
3. The pH in Colonic Therapy. B.R. LeRoy, Jr., A.B., D.O. Pub. Fidelity
Pub. Co.; Fidelity Bldg., Tacoma, WA 1933.
4. Chronic intestinal toxemia and its treatment
with special reference to colonic therapy. James W. Wiltsie, A.B., M.D. Wm. Wood & Co.
Baltimore 1938.
Resources
Dirk Yow, CHT, GOK
Intestinal Oxidative Therapist
315 Lincoln Ave., Suite D
Mukilteo, Washington 98275 USA
425-348-2266 or 206-459-0102
intestoxidativether@earthlink.net
www.ozonelife.org
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