Or not. In a 1992 University of Munich study, nine sessions of “colonic massage” failed to speed colon transit time in constipated subjects and nonconstipated controls. The subjects’ sense of well-being was monitored throughout the three weeks of treatment, and this too failed to improve. It might have gone differently had the masseuses incorporated some techniques from Anders Gustaf Wide—“anal massage,” for instance, wherein “small circular strokings are made to each side alternately with tremble-shaking round the anus.”
Surgeons, too, advocated the use of the hands to dislodge an impaction, though here it was less of a laying-on than a reaching-in. “I propose this evening to demonstrate upon the cadaver some phases of bowel exploration,” began our friend W. W. Dawson, the professor of surgery from the Medical College of Ohio, whom we met in a previous chapter. The year was 1885. Dawson introduced his assistant, Dr. Coffman, to the gathered crowd and then turned to face the examining table. “The subject, you see, is a female.” We’re going to skip ahead to item 2 on the agenda: “How far can the hand be introduced?” The “patient” was rolled on her back with the thighs raised and the knees bent. The position is known as the lithotomy position, or the missionary position, depending on whether you are taking things out or putting them in. In this case, it was a bit of both. “Dr. Coffman now introduces his hand through the anus and presses gently onward and upward.” Here Dawson invited the spectators to watch closely, because it was possible to see the bulge of Coffman’s hand moving below the body’s surface, like a cartoon mole tunneling under the lawn. “Dr. Coffman is able to move his hand with great freedom. You will recognize at once how it would be possible to dislodge . . . impacted feces.”*
For the most part, the historical treatment of obstructed bowels took its cues from the world of plumbing. There were, as there are with bathroom pipes, two main strategies: blast it free with water or air (plunge it), or break it up with something metal (snake it). The June 1874 Atlanta Medical and Surgical Journal describes Dr. Robert Battey’s “safe and ready” method of dissolving “accumulations of hardened feces” by injecting water, as much as three gallons, up the rectum. “So great was the abdominal tension that the water spouted from the anus when pressure was removed,” writes Battey of one memorable case, “in a bold stream” two feet high. Battey’s lecture was accompanied by a demonstration. A haphazard perusal of the medical journals of the day seemed to indicate, among surgery and anatomy professors, a keen spirit of one-upsmanship that drove lecture hall demonstrations ever farther in the direction of spectacle.
The digestive tract is an intricate, flexuous pipe not easily snaked. Patients had to more or less swallow the snake. For more than a hundred years, swallowing lead shot or metallic mercury, as much as seven pounds, was thought to be a good way to break up an obstruction. The patient was then rolled or shaken, in hopes that the heavy stuff would work its way through the clog. The problem was that the stomach releases its contents gradually, no matter how swiftly they’re swallowed. Rather than pushing through the gut in a cohesive front, the metal shot would journey forth in dribs and drabs, appearing on X-rays like an ingested strand of pearls. Just as well. A physician named Pillore, writing in 1776, describes an autopsy he performed on a patient whose small intestine was so weighed down by the two pounds of mercury that had collected in a lump, that a loop of the organ had stretched and sunk down into the pelvis. The man died a month later. Between the mercury, the unresolved obstruction, and the taffy-pulled gut, it’s anyone’s guess what ultimately did him in.
For a brief span of years, the plumbers stepped aside and the electricians got to work. Like radioactivity in its day, electricity was new and exciting and presumed to cure whatever ailed a person. Galvanic therapy for obstinate constipation—or “obstipation”—entailed passing a mild electrical current through the abdomen. “Efficacious?” an 1871 British Medical Journal contributor is quoted in reply to a dubious colleague. “I could hardly get out of the way in time.”