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January 5, 1924


JAMA. 1924;82(1):33. doi:10.1001/jama.1924.26520270004011e

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About fifteen years ago, in a German publication called "Excerpta Medica," a suggestion was made for the relief of a certain form of constipation which has proved of the utmost value in my experience and practice.

Although, at the age of 65, I have been so fortunate as to have required a cathartic but twice in my life, evacuation is not always easy because of the condition of the fecal mass; and the long continued straining thus required in past years has not only been very annoying, but has also resulted in several attacks of hemorrhoids. Since the adoption of the manipulation described, such attacks have never recurred.

The procedure is applicable only to the evacuation of a fecal mass in the lower rectum, close to the anal sphincter, but hard to move because of its size, or density, or both. It consists in a remolding of the mass by

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