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To the Editor:—
A few years ago while in charge of a large hospital in South China I saw a man whose bowels had not moved for forty days. The Chinese are very reliable in giving clinical histories and taking a great deal of notice of their excretory functions. I believe implicitly that the man's statement that his bowels had not moved for forty days was no exaggeration.He was addicted to opium, which has a constipating effect. When he came to the hospital he was so weak that he was unable to walk and had to be carried. As a result of the toxic effect of this prolonged gastro-intestinal stasis his eyesight had become seriously impaired and there was a peculiar milky appearance of the cornea. Enemas were not effective and it was necessary to remove the fecal impactions manually. Following this procedure the patient was given daily cathartics
McCandliss WK. FORTY DAYS' CONSTIPATION. JAMA. 1937;109(2):150. doi:10.1001/jama.1937.02780280056023