As I have explained in previous newsletters that much of my learning about alternative medicine has come from my patients. To them, I shall be eternally grateful. Learning about colonics is no exception. Patients have told me how their health, their malaise, their fatigue, their abdominal distention, their chronic bowel disturbances, and their dermatitis cleared up through the use of colonics. The first few times I heard the story I knew that the patients were either crazy or the improvement was coincidental. How many times can you hear of such an account and continue to avoid the obvious out of sheer obstinacy? In my case, it was about half a dozen times. My resistance to quackery was diminishing through my experience with chelation, nutrition and, of course, mostly through my experience with orthopedic medicine. Was it conceivable, was it perhaps even possible, that this rather unsavory business with the dirty end of the bowel had something to do with health? I think I resisted recognizing the benefit of colonics longer than my resistance to recognizing other alternative medicine as therapeutic tools because of what I would like to call the sewage aspect of the bowel. It is strange to have to admit that the conversion and the prejudice occurred when I read a non-medical book, Erewhon, by Samuel Butler (1898), describes a topsy-turvy world where people are ashamed to eat, and do so in privacy, while they deal with and discuss their financial matters in public - the exact opposite of our own habits. Even Samuel Butler did not deal with the sewage aspects, but he did point out that the habits we have are not always quite logical. Once one overcomes the sewage aspect, or what I should really call the sewage prejudice, it actually is rather obvious that just as we clean our skin in bathing, our teeth with brushing, our nails with clipping, our hair with shampooing and combing, it is perfectly logical to clean our colon with irrigation. One might argue that it is not natural in some Wordsworthian or mystical primitive sense, but the same can be said for bathing with soap or using a toothbrush. Having dispensed, therefore, with the prejudicial aspects of this issue, we now need to ask more seriously what do colonics do, when it should be used, what evidence exists, if any, that it is effective, and if there is a benefit from colonics, how might it be useful? Dentists will tell us that keeping the teeth clean protects the hygiene of the mouth and reduces the incidence of cavities. I think they are probably right. I do know that in people with certain illnesses, enhancing excretion of water and electrolytes through the kidneys can improve their health. The most important example of that is when dealing with fluid accumulation, anasarca or edema, for instance in heart failure. It is also quite obvious that if a person is unable to move his bowels, flushing the inspissated (dry and hardened) contents can open the passage so, here, we have a clear indication. If the person's bowels are blocked due to dried up feces, flushing them out will obviously restore the ability of the bowels to move; and, it goes without saying that without bowel movements, obstruction and illness will ensue.