So why did we hear so much about fiber back then? Because, Jones said, there was money to be made: “things to go out and buy and eat more of.” Walker and Burkitt wrote the tune, but it was the cereal companies that kept on playing it. Jones said that when he sat down and looked at the studies on dietary factors and colon cancer, the thing that stood out as a determinant of risk wasn’t how much fiber you ate, but how many calories. The fewer calories, the lower the risk. No easy profits there.
AND GET THIS. The newest research suggests that slower transit time—that is, longer exposure to your nasty stuff, may in fact be of benefit. Hydrogen sulfide appears to prevent inflammation and its sometime consequences, ulcerative colitis and cancer. In rodent studies, anyway, the gas has a significant anti-inflammatory effect on the walls of the digestive tract: the opposite of what aspirin does in there. Aspirin and ibuprofen combat inflammation everywhere but the stomach and bowel; there they create inflammation. Used in tandem with hydrogen sulfide, says Ken Olson, a professor of physiology at Indiana University School of Medicine and author of multiple papers on the topic, aspirin or ibuprofen may be thousands of times as potent at preventing tumor growth—at least, in mice and in laboratory-grown tumor cells. Human trials have not yet begun.
Hydrogen sulfide is not the devil. Beneath the danger and stench is a molecule as basic and indispensable as sodium chloride. The gas is produced in all of the body’s tissues, all the time, regardless of what was for dinner. (Some recent thinking disagrees.) “It’s a gasotransmitter, a signaling molecule, it has tremendous therapeutic potential,” says Olson. “This is the hottest area in biomedicine right now.”
The moral of the story is this: It takes an ill-advised mix of ignorance, arrogance, and profit motive to dismiss the wisdom of the human body in favor of some random notion you’ve hatched or heard and branded as true. By wisdom I mean the collective improvements of millions of years of evolution. The mind objects strongly to shit, but the body has no idea what we’re on about.
HERE’S THE OTHER hitch with autointoxication. Absorbing things is primarily the business of the small intestine, not the colon. That’s what the smaller tube, with its millions of villi, is for: delivering nutrients to the blood. The autointoxication zealots would counter that, as John Harvey Kellogg put it, “the foul fecal matters in the colon pass back into the small intestine.” But, in fact, they don’t. The ileocecal valve, the anatomical portal between the small intestine and the colon, opens in one direction only.
It is possible to force open the ileocecal valve from the wrong direction, but it does not happen naturally, in the course of day-to-day living. It has tended to happen unnaturally, while dead, on a slab in a nineteenth-century anatomy amphitheater with one end of a flexible tube disappearing up the rectum and the other attached to a pump. No less than five experimenters, representing Britain, France, Germany, and the United States, from 1878 to 1885, tested the competence of the ileocecal valve. “Heschl made a number of experiments on the cadaver and satisfied himself that the ileocecal valve serves as a safe and perfect barrier against the entrance of fluids from below,” wrote the author of one review. W. W. Dawson of the Medical College of Ohio put the ileocecal through its paces on thirteen cadavers; in twelve, the valve held strong. The transcript of the thirteenth cadaver demonstration is printed in an 1885 issue of the Cincinnati Lancet and Clinic. (“From your seats,… you see the colon expanding as the fluid enters.”) This one, he concludes, was an anomaly. “The valve was doubtless imperfect.” But the showmanship flawless.
It seems fair to say that it takes an unnatural volume of liquid, under unnatural pressure, to breach the heroic ileocecal valve and enter the small intestine from the rear. It takes, perhaps, a Joy-Beauty-Life colonic irrigator. In their fervor to rid the body of fecal residues, devotees of internal bathing were flushing the dread residues higher up into the gut, away from the colon—a region of the anatomy that does relatively little absorbing—and right on into the one that evolved specifically for the job, the small intestine.
You may be wondering why the minds of medicine so assiduously concerned themselves with the matter. Were they drawn to it simply as lecture hall spectacle? Not entirely. The experiments aimed to resolve a lingering medical debate over the value of “feeding per rectum.”
15. Eating Backward
IS THE DIGESTIVE TRACT A TWO-WAY STREET?
AS FAR BACK as ancient Egypt and as recently as 1926, patients unable to keep their food down would be given their food up. The “nutrient enema” was a last resort for people who, the thinking went, would otherwise starve. As unlikely as it may sound, the practice was broadly accepted in the medical community, so much so that ready-made preparations were available for purchase. You would see them advertised in the pages of journals, complete with the occasional customer testimonial (as from the satisfied 1859 patient for whom rectal coffee[104] and cream “relieved the sense of ‘famishing thirst’ better than any other injection”).
President James Garfield was the poster boy of rectal feeding. In 1881, Garflield’s liver was pierced by an assassin’s bullet and shortly thereafter inoculated with a dose of bacteria from the unwashed fingers and instruments of Dr. D.[105] W. Bliss. From August 14 to the time of Garfield’s death on September 19, the dwindling, retching head of state, on Bliss’s orders, was fed nothing but nutrient enemas prepared in the dispensary of the United States surgeon general.
Here is the recipe for Assistant U.S. Surgeon General C. H. Crane’s Rectal Beef Extract: “Infuse a third of a pound of fresh beef, finely minced, in 14 ounces of cold soft water, to which a few drops of muriatic acid and a little salt… have been added. After digesting for an hour to an hour and a quarter, strain it through a sieve.” The yolk of an egg was then added, along with 2 drams of Beef Peptonoids and 5 drams of whiskey.
The nice thing about cooking for someone who can’t taste the food is that the same dish can be served over and over without complaint. Or without the usual complaint. A downside to eating rectally is that body heat quickly leads to rot and reek. President Garfield and his nurses endured five days of sulfurous flatus so “annoying and offensive” that egg yolks were stricken from the recipe. Beef blood was likewise to be avoided; one physician lamented that the odor produced by decomposing blood was “so offensive as to pervade the whole house.” Bouillon, another common rectal menu item, also created optimal conditions for bacteria. (Before agar was widely used for laboratory cultures, a medium of choice was beef broth.) The enema-fed rectum was a highly efficient incubator, an in-house petri dish.
What’s worse, proceeding too quickly could trigger the more traditional goal of the enema. (I suppose it wasn’t that far removed from feeding a baby. Though where do you hang the bib?) “I need hardly say,” wrote a learned contributor to the British Medical Journal in 1882, “that the rectum should be empty when a nutrient injection is to be given.” A before-dinner enema of the cleansing variety was recommended.
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But not boiling hot coffee. The contemporary fad for coffee enemas has sent more than one person to the emergency room with a partially cooked colon. I first heard about this from a veteran ER nurse. “You have no idea what people will do to themselves,” she wrote in an e-mail. “Forget to remove the potato that you used as a pessary until you noticed a vine sprouting between your legs? Decided to do your own nose job at the bathroom mirror and replace the cartilage with a leftover piece from last night’s chicken dinner? You have no idea.”
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The