Gulp: Adventures on the Alimentary Canal (28 page)

The Devrom company is to be commended for not aggressively pushing internal deodorant on the public at large. Good for you, Jason Mihalopoulos, for not following in the springtime-fresh footsteps of douche marketers and, most recently, the Fleet enema company.
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“Keep your backcountry clean,” says the Fleet Naturals ad copy, over an image of pristine mountain wilderness. “Created specifically for rectal cleansing . . . Mild enough for daily use.”
Really?
On top of gargling, on top of powdering our feet and perfuming our armpits, now we should worry that our assholes smell?

I later stumbled upon a “Tell Your Patients . . .” press release that Fleet had sent out to physicians. (One of them had posted it on his blog.) It turns out that Fleet Naturals is a product “for before or after anal intimacy.” Well okay then.

The simplest strategy for bouts of noxious flatus is to not care. Or perhaps to take the advice of a gastroenterologist I know: get a dog. (To blame.) Barring that, a person might try to steer clear of certain foods,
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the ones that provide bacteria with the raw materials for making sulfur compounds. The main offender is red meat.
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Cruciferous vegetables (broccoli, cabbage, brussels sprouts, cauliflower) can also kick up a stink. As can garlic, dried and sulfured fruit (for example, apricots), certain aromatic spices, and, for reasons unclear, beer. In short, so many delightful things that a sane person would, I like to think, rather have the gas.

• • •

I
TRAVELED TO
M
INNESOTA
with a fantasy that Michael Levitt might be able to whip up a batch of artificial flatus. I’m curious to see how close Science can get to Nature. Levitt smiles one of those placeholder smiles that buy you a moment to phrase your no. He elects to fob me off on his research partner Julie Furne, who has the ingredients downstairs in the lab. I recognize Furne’s name from the pantaloon studies. It turns out she had been one of the odor judges.

Things haven’t changed all that much for Julie Furne. We find her in the lab, syringing gas out of a plastic vial in which a raisin-sized rat turd has been incubating at ninety-nine degrees. (She and Levitt are investigating the relationship between intestinal hydrogen sulfide and colitis. More on this shortly.)

Furne recently arrived at her fifth decade, her brown hair beginning to silver at the hairline but a girlish humor still intact. Instead of a lab coat, she wears a muted orange heather cardigan, vintage from the fifties, I’m guessing. There was probably a time when you could have pressed this sweater to your face and smelled traces of hair spray or homemade pot roast. Probably you wouldn’t have that experience now.

“This is Mary,” says Levitt. “She’d like to sniff some gases. But don’t kill her.”

Hydrogen sulfide is as lethal, molecule for molecule, as cyanide. This may explain why humans evolved such exquisite sensitivity to its smell. Repellent odors are unpleasant but often helpful in terms of not dying. As with any poison, dosage makes the killer. The concentration of hydrogen sulfide in offensive human flatus is around 1 to 3 parts per million. Harmless. Ramp it up to 1,000 parts per million—as can exist in manure pits and sewage tanks—and a couple breaths can cause respiratory paralysis and suffocation. Workers die this way often enough that a pair of physicians, writing in a medical journal, coined a name for it: dung lung.
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Hydrogen sulfide is so swiftly lethal that farm-and workplace-safety organizations urge anyone who enters a manure pit or attempts to clear a blocked sewage pipe to wear a self-contained breathing apparatus. Which may explain the man my husband and I once saw walking along a sidewalk in San Francisco in a wet suit with a toilet plunger over his shoulder. “Hell of a clog,” Ed said.

It is fitting that the Devil is said to smell of sulfur. Hydrogen sulfide is a diabolical killer. Its telltale rotten-egg smell, screamingly obvious at 10 parts per million, disappears at concentrations above 150 parts per million; the olfactory nerves become paralyzed. Without the odor to warn them, coworkers and family members may rush into a manure pit to rescue the fallen. Whole families have been taken out in a catastrophic “chain of death.” One case report included a police photo taken after the victims had been pulled from the mire and laid on the ground. It was a wrenching play on the family portrait, the four adults arranged in a row in matching knee-high muck boots, black bars over their eyes. The farmer had gone in to unclog a pipe. Both he and the worker who tried to rescue him collapsed and died. The farmer’s mother found the two, hurried down the ladder and also succumbed. Then the son came along. And on it went, all the way to a team of pathologists nearly overcome in a poorly ventilated autopsy room.

Hydrogen sulfide is a reliable way to kill oneself—as well as the people who try to save you. In 80 percent of the hydrogen sulfide suicides in this country, emergency personnel or good Samaritans have been sickened by the fumes when they tried to help. One suicide in Japan caused the evacuation of 350 neighbors.

“Ask Julie how she felt,” says Levitt over his shoulder as he leaves. The day of her training as a flatus odor judge, Furne worried that she’d poisoned herself. She was “sick as a dog” and had a headache all that evening. Vegetarian activist John Harvey Kellogg wrote that he had “known vigorous young men” who suffered “violent attacks” of headache from working in a lab with “the bowel discharges of a meat-eater.”

The hydrogen sulfide pulled from the tube that held the fermenting feces of rat E2 clocks in at a concentration of 1,000 parts per million. “You don’t want to smell that straight up,” says Furne. She glances off to the side, reading out an imaginary headline: “AUTHOR KILLED BY FECAL ODOR.” Furne has a homey northern Midwest accent, the voice of
Fargo
’s Margie, diluted to a nonlethal concentration.

But this is hydrogen sulfide off-gassing in a vial smaller than a lipstick. Are there circumstances in which ordinary concentrations can harm you? Are flatulent people a public health risk? The author of
Inner Hygiene
, James Whorton, quoted a nineteenth-century physician who thought so. He admonished the flatulent to hold in their gas for the sake of family and friends, saying, “It is as much a crime to poison a neighbor with gas, as with a poison more tangible.” I wondered if there might be a grain of truth to this—inside a confined space, say. When it’s cold, I tell Furne, I sometimes sleep with my head under the covers. Winter is brussels-sprout season, and they’re Ed’s favorite side dish.

Furne assures me there’s enough air under a comforter to dilute a spouse’s hydrogen sulfide and render it harmless. When I followed up with Levitt by e-mail, he concurred that the “passive inhaler” has no cause to worry.

Especially compared with the perpetrator. He who dealt it incurs a “relatively enormous exposure to hydrogen sulfide via absorption through the colonic mucosa.” Or as John Harvey Kellogg rather more excitably put it, “If the mere breathing of the greatly diluted volatile poisons arising from such putrescent matter will produce highly unpleasant effects, how much more grave must be the effects when through the retention within the body . . . all of their poisonous contents are absorbed and sucked up into the blood and circulated throughout the body?” Levitt had been quick to add that no research has shown that absorption—of hydrogen sulfide or any other colon-residing breakdown component—into the bloodstream is harmful.

In matters of health, however, the public rarely requires proof. Most people trust intuition more than they trust studies. And the theory behind fecal self-poisoning—aka autointoxication—makes strong intuitive sense. “[People] reasoned that if feces are foul, then the body must be in the best condition when freest from such material,” wrote Walter Alvarez in his wise and tide-turning 1919 essay in the
Journal of the American Medical Association
. The less time “feculent” poisons reside in our colons, the thinking went, the less we absorb into our blood, and the healthier we’ll be. Autointoxication was one of the most pervasive and enduring concepts in the long, bloated history of medical pseudoscience.

A
S A DIAGNOSIS,
a health buzzword, autointoxication peaked in the early 1900s. It was a natural offshoot of “miasma” theory. From the early to the late 1800s, before physicians figured out the role of microorganisms and insects in causing and spreading disease, much of the blame was placed on clouds of nonspecific toxic gases—or miasmas—emanating from open sewer flows, garbage dumps, even graves.

If one bought into the dangers of miasmas, it wasn’t much of a leap to buy into the dangers of one’s own internal sewage. Purveyors of laxatives and enema devices played up the connection, referring to the colon as “the human privy,” “an obstructed sewer,” “this cesspool of death and contagion.” Whorton’s book reproduces a magazine ad for the French laxative Jubol, showing tiny uniformed men on their hands and knees with scrub brushes and buckets inside a colon, like workers in the Paris sewers.
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It made no difference that neither the specific poisons nor the mechanisms by which they might be causing harm were known or named. In the realm of quackery, vague is better. “It met a need,” wrote Whorton, “that medicine has felt in every age, providing an explanation and diagnosis for all those exasperating patients who insist they are sick, but are unable to present the physician with any clear organic pathology to prove it.” Autointoxication was the gluten of the early 1900s.

Bogus diagnoses beget bogus cures. Around the turn of the last century, hosing the colon was big business, far bigger than it is today, and nowhere bigger than at 134 West Sixty-Fifth Street, home of Tyrrell’s Hygienic Institute, a three-story New York brownstone dedicated to the manufacture and flatulent hyping of the
J.B.L.
Cascade colonic irrigator.
J.B.L.
stood for “Joy Beauty Life,” suggesting that your $12.30 was purchasing something loftier than a nozzle-topped whoopee cushion.

“The Internal Bath is taken by sitting on the J.B.L. Cascade,” states Charles Tyrrell in the 1936 promotional pamphlet
Why We Should Bathe Internally
. Tyrrell’s prior business had been in rubber medical goods. Aside from the rectal nozzle protruding from its flank, the Cascade looked little different from one of Tyrrell’s old water bottles.

Between businesses, Tyrrell had dabbled in small-press publishing. The experience served him well. He printed up thousands of thinly disguised promotional booklets that he distributed to pharmacists to hand out to patients. The gospel of autointoxication and internal putrescence was laid on thick and spiked with testimonials: from customers, doctors,
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clergy,
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all wordily professing their satisfaction and gratitude. Gone was their insomnia, their fatigue, their melancholia. Here was the fix for acne, bad breath, for lack of appetite and “loss of vim and snap.” An internal bath would rid you of irritability, “outrageous cantankerousness,” “the inability to hold down a job of lumber grading for over six months without quitting or getting fired.” One set of before and after photos seemed to imply that a high colonic could transform an unkempt, drooping moustache into a vigorous, curlicued handlebar.

It seemed there was no medical condition so dire that an internal bath would not fix it. Mr. H. J. Wells of 342 Lincoln Avenue, Detroit, credited the Cascade with relieving his wife of “an accumulation of effete mucous tissue . . . in strips about half an inch wide and from four to six inches long.” Mrs. Cora Ewing of Long Beach, California, waved good-bye to “a sack of pus above the left ovary.” People thanked Tyrrell for curing their asthma, their rheumatism, their typhoid fever, and their jaundice. Paralysis even! Epilepsy! The medical claims were sufficiently far-fetched that Tyrrell felt a need to point out that the “disorders may be due to factors other than . . . autointoxication.”

The American Medical Association’s Bureau of Investigation received so many letters from outraged physicians that it drafted a form letter to send in response. “We plan to get around to this institution after a while,” it promised. The first such letter in the Tyrrell Hygienic Institute file at the AMA archives is dated 1894, and the last, 1931, suggesting that a little more vim and snap might have been applied.

One member rose on his own to the task. In 1922, physician and autointoxication doubter Arthur Donaldson artificially and incontrovertibly constipated three dogs by temporarily sewing shut their anus. After four days, all the while eating regular meals of meat, milk, and bread, the dogs showed no physical symptoms beyond a mild loss of appetite—nothing to suggest a poisoning from within. All three, impressively, “seemed to be in fair spirits.”

Donaldson didn’t rest his case there. He withdrew small amounts of blood from his surgically constipated charges, once at the end of fifty-five hours, again at seventy-two hours, and finally at ninety-six hours. This he injected into the bloodstream of two normal, unconstipated dogs,
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to see whether symptoms suggestive of “fecal poisoning” would develop. They did not.

Donaldson contended that the symptoms people and doctors were so quick to blame on autointoxication were in fact caused by the simple mechanics of constipation: rectal distention and irritation. To test the theory, he packed four men with turd-sized wads of cotton. After three hours, the men began to exhibit the sorts of symptoms commonly blamed on autointoxication. The moment the wads were removed, relief ensued. If fecal blood poisoning had been the culprit, relief would have taken far longer. It takes several hours for the liver and kidneys to clear chemicals from the system. The reek of asparagus pee, Walter Alvarez pointed out, though not in those exact words, doesn’t abate the moment you set down your fork. It lingers through the following morning. The very swiftness with which the enema brings relief itself refutes the premise of autointoxication.