In 1901 Mr K had a problem,

he was fartu fulla feaces !

Transcribed from the pdf

   Mr K
   Journal of the American Medical Association May 17, 1902 pp. 1304-1305
   Clinical Report 
   D. Geib, MD., and J.D. Jones. M.D 
   Groton, S. D. 
    This case, reported in the South Dakota State Medical society, June, 1900 and 
   to the Aberdeen District Medical Society, June, 1900, by Dr. D. Geib, was 
   further described in a communication to the Aberdeen District Medical Society, 
   September 1901, by Dr. J.D. Jones and concluded by review of the case to time 
   of death, January 8, 1902, with autopsy, by Drs. D. Geib and J. D. Jones.
    The patient, Mr K, having enjoyed good health previous to the age of 11, began 
   at that time to be constipated and was treated for three months by Dr. Nicholas 
   Senn, then of Dodge County Wisconsin, no bowel movement being secured. The 
   result of cathartics and laxatives was severe pain. The constipation continued 
   until death. It was a common occurrence for him to go three weeks or as many 
   months without a movement of the bowels. At the age of 20 he did not have a 
   movement for three or four months at a time. He consulted a homeopathic 
   physician, who prescribed for him two drops of croton oil, to be doubled in two 
   hours, tripled in four and quadrupled in six hours. This produced no result but 
   after a period of several weeks, his bowels moved again. 
    For seven years following his bowels were fairly regular. At the age of 29 he 
   contracted a severe cold and five months and three days passed without an 
   evacuation. After a few months of regularity, his bowels did not move for six 
   months and fourteen days. At this time he consulted Dr. Stamm of St Paul, 
   without immediate benefit, but during the next six months his bowels were 
   regular. In February, 1900, the constipation returned. The patient had no 
   movement from June 18, 1900 to June 21, 1901.
    During these periods of costiveness he could eat full meals and do a good days 
   work. His respiration was always normal the urine was normal when he was free 
   from pain, but highly colored when in pain. The evacuation of his bowels left 
   him very weak and was greatly troubled with gas so that he had to lie on his 
   right side to relieve himself and was partially disabled for work. 
   His abdomen was greatly distended so the liver and the stomach crowded up the 
   diaphragm and the floating ribs were visibly pushed out. there was tenderness 
   in the sigmoid flexure, but over the remainder of the abdomen he could bear 
   heavy pressure.  

    He was not troubled with gas when regular. The administration of valerian, 
   sumbul and asafetida by Dr. Geib gave him considerable relief.
   On June 19, 1901, Dr. Jones was called in with Dr. Geib to relieve the patient 
   from his painful condition. The abdomen was greatly distended. The colon, on 
   palpation, seemed to be as large as a six-inch stovepipe. From the head of the 
   sigmoid flexure to the rectum, the bowel seemed to be perfectly straight and 
   hard. On digital examination the rectum was found filled with a mass of fecal 
   matter so hard that no impression could be made on it. The anus was dilated and 
   the mass removed from the rectum with a bone curette and hot water. Further 
   operation was postponed because of the pain suffered by the patient, and olive 
   oil enemas were ordered. 

    June 21, on further attempt to evacuate the bowels, it was found that the olive 
   oil had softened the hard mass so that about two pounds of feces could be 
   removed before the patient complained of pain; his weakened condition prevented 
   further operation. The circumference of the patient at this time at the 
   ensiform cartilage was 39 in., at the umbilicus, 38.5 in., and at the crest of 
   the ileum, 39 in. 
   On arrival at the house on the morning of June 22, the report was received that 
   he had passed an ordinary pailful of feces since the day previous. There was 
   much rejoicing in the family. The patient was very weak and sore, so no further 
   operation was attempted at this time, but the olive oil enemas were ordered 
    The patient, when next seen, on June 25, was feeling comfortable; the gas had 
   ceased to trouble him and he had passed about three quarts of feces that 
   morning. His measurements at this date were, at the ensiform cartilage 34 in., 
   umbilicus 33in., and at the crest of the ileum, 30 in.
    The enemas were ordered continued, Mr. K. estimated that he had passed about 
   eight gallons of feces since the beginning of the treatment. On June 29, he was 
   cheerful and pleased at his progress. The measurements at the ensiform 
   cartilage were 34 in., umbilicus 30 in., crest of ileum 29 in. From that date 
   he received massage treatment given by Dr. Geib, twice a week for three weeks, 
   and improved in strength so that he was able to ride to town and walk about. 
   One July 8, after his massage he suffered considerable pain for about three 
    His bowels moved frequently. The contents were described as resembling soft 
   soap and during this period of discomfort he passed a hard mass about the size 
   of a ducks egg, containing grape seeds. He had not eaten grapes since the fall 
   before. After this he had little trouble and gained in strength and weight. The 
   only treatment then given was massage, iron and strychnia.
    The history of the case subsequent to the above report to the Aberdeen District 
   Medical Society is as follows: Since the treatment in June, 1901, the bowels 
   regularly; occasionally he was obliged to take an enema, but he was well 
   nourished and weighed more than he had for years. He was very sensitive to cold 
   this winter, chilling on the least exposure.
    On the second day before his death, which occurred Jan. 8, 1902, he rode to 
   town, a distance of eight miles. He retired at 11 p.m. apparently as well as 
   usual, and awoke about 5 a.m. with pain. He arose about 8 a.m. built the fires 
   and did part of his morning's work. The pain, however, became very intense and 
   he went to the house and suffered more or less all day. There was a great 
   desire to evacuate the bowels, but it was impossible. At 2 o'clock the 
   following morning, he died while sitting on the stool. No medical aid was 
    The autopsy showed the abdomen greatly distended with gas and fecal matter. On 
   making an incision along the linear alba, the tension was sufficient to tear 
   the flesh apart; the omentum was very thin and the colon was brought at once 
   into view. The position of the colon was as shown in the photograph, save that 
   the extra loop overlaid the normal colon. The splenic flexure, transverse colon 
   and descending portion of the extra loop were very much thickened, containing 
   much more muscular fiber than normal. The parts most distended were the splenic 
   flexure, the transverse and descending portion of the extra loop, but the whole 
   colon was much larger than normal.
    The most distended portion measured 19 1/4 inches in circumference. The 
   rectum contained a hard mass of feces shaped like a goose egg, measuring about 
   4 inches in the shortest diameter and 6 inches its longest. This was pressed 
   tightly against the sphincter and acted as a valve. The remaining portion of 
   the colon contained soft feces; the total contents were an ordinary bucketful. 
   The stomach and small intestines were empty. The diaphragm was crowded up to 
   the level of the forth rib on the right side; the heart and lungs were both 
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