Civilisation and the colon: constipation as the "disease of diseases"

Whorton’s 2000 BMJ essay (321(7276):1586-9) is the secondary source for the disconfirmation of the theory that underpinned Kellogg’s regimen. It traces intestinal autointoxication from its late-19th-century formulation (Charles Bouchard’s image of the constipated person ‘always working toward his own destruction’) through its peak, when from 1900 into the 1920s it was ‘regarded by much of the medical profession and most of the public as the most insidious disease of all.’ Whorton then documents the fall: ‘A number of experimental studies in the 1910s cast doubt on the possibility of bowel toxins leaching into the circulation, and autointoxication slowly faded from professional acceptance during the 1920s.’ He also describes the market the fear generated, including All-Bran, ‘introduced in the early 1900s precisely to combat autointoxication,’ and the trade in enema and colonic-irrigation equipment. Identifiers confirmed against the PubMed record (PMID 11124189) and the Crossref record (DOI 10.1136/bmj.321.7276.1586).