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December 1, 1900

A THERAPEUTIC PARADOX.

JAMA. 1900;XXXV(22):1416. doi:10.1001/jama.1900.02460480036011

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Abstract

Medicine, like other departments of human activity, is full of curious contradictions which cause the thoughtful physician always to be chary of dogmatizing. Thus, the eating of indigestible food frequently at first produces constipation, but a little later diarrhea. It is customary to say that the preliminary constipation is due to irritation of the intestines, while the diarrhea is its secondary effect; yet we know that some irritating matters, when administered, promptly cause a diarrhea without any previous constipation. From observation of these apparently antipodal phenomena, and especially from our methods of their treatment, has arisen an analogous contradiction in therapeutics. Thus, in the case of an individual who habitually overeats or who eats improper food, there is usually found during the greater part of the time constipation. The even course of the constipation, however, is interrupted at intervals by sharp attacks of diarrhea, for which the physician is frequently

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