Gulp: Adventures on the Alimentary Canal (31 page)

“It seems likely that most nonruminant species have a voracious appetite for feces,” Barnes bravely continued. “This practice is so normal to their nutritional behavior that the . . . large intestine should rightfully be considered as functionally positioned ahead of the absorptive region of the intestinal tract.” In other words, a second visit to the small intestine is the true end point for absorption.

I will buy that autocoprophagia is, as Barnes put it, “a normal practice for . . . rats, mice, rabbits, guinea pigs, dogs, swine, poultry, and undoubtedly many others.” But Richard: “Most nonruminant species”?

Let’s check in first with our closest cousins. I e-mailed Jill Pruetz, the Iowa State University primatologist whose work with chimpanzees in the Fongoli River region of Senegal I profiled for a magazine in 2007. By coincidence, Pruetz and her colleague Paco Bertolani had just submitted a paper on the topic. “I don’t like to think of the Fongoli chimps as shit-eaters,” she wrote back, “but what are you going to do?” For one thing, you call it “seed reingestion.” Technically speaking, this is accurate. Fongoli chimps don’t, as they say, “consume the dung matrix.” They “excrete a faecal bolus into one hand and then extract the seeds from it with the other hand or with the lips.” You may be pleased to note that when they are done they “clean their lips by rubbing them on the bark of trees.”

Pruetz’s team observed seed reingestion only during the span of weeks when baobab and Fabaceae seeds are too hard to chew. During this time, it takes a second run through the digestive tract to dissolve the hulls and release the proteins and fats in the kernel. Women in the Tanzanian Hadza tribe use a similar technique, harvesting softened baobab seeds from baboon dung, washing and drying them, and pounding them into a kind of flour.

Before you get all high and mighty on the chimps and the Hadza, you should know that the most expensive coffee beans in the world—at upwards of two hundred dollars a pound—are those that have passed through the digestive tract of the civet, a catlike animal native to Indonesia. The animal’s digestive enzymes are said to alter the taste of the beans in a pleasing manner. The trade is lucrative enough to have spawned a market for counterfeit civet dung, crafted from ordinary undigested coffee beans, a dung matrix of similar consistency, and glue.

Though seed reingestion is most prevalent on the savannah, where food is scarcer, it also happens in the rain forest. Pruetz’s paper cites the work of a team of researchers who observed coprophagy in wild mountain gorillas. At a loss to explain the behavior, given the relative bounty of the surroundings, the researchers suggested that it might have been done for the same reason people reach for the Cream of Wheat on a midwinter morning. “They proposed,” Pruetz wrote to me in an e-mail, “that mountain gorillas might like to eat something warm during periods of cold temperatures or heavy rain.”

And now, with all apology, it’s time to move on to
Homo sapiens
. A 1993 study of “humans behaving in a manner similar to nutrient-deficient animals” involved three institutionalized patients, Bart, Adam and Cora, all with profound developmental disabilities. Charles Bugle and H. B. Rubin successfully broke the trio’s autocoprophagia habits by feeding them a nutritional supplement drink called Vivonex. The authors speculated that this population “often has multiple handicaps and something may be missing that makes it more difficult to digest or metabolize all the nutrients in the diet they are served.” Whether or not this is true, a glass of Vivonex is preferable to some of the alternative strategies tried by staff at other institutions. In particular, that of the team who “treated . . . coprophagia and feces-smearing by making a shower contingent upon the absence of feces.” You can see where that could go south pretty fast.

T
HERE IS ONE
class of substances that the rectum, even today, is occasionally called on to absorb. Drugs take effect faster this way than by mouth, partly because they bypass the stomach and liver. Opium, alcohol, tobacco, peyote, fermented agave sap, you name it—it’s been taken rectally. In the case of certain South American hallucinogens, rectal indulgence also allows one to sidestep vomiting that accompanies the oral route. Considerably enlivening the pages of
Natural History
in March 1977, Peter Furst and Michael Coe described the heretofore unrecognized prominence of the “intoxicating enema” in classic Mayan culture. The discovery came about with the examination of a painted Mayan vase from circa 3
A.D.
that had previously been hidden away in a private collection. The decorative embellishments feature a man in an elaborate pointy hat but no pants, crouched like a cat, hind quarters raised, while a kneeling consort holds a tubular object to his anus. Another man squats, administering to himself.

Access to the vase brought a thunderclap of realization. “Previously enigmatic scenes and objects in classic Maya art” suddenly made sense. Furst and Coe give the example of a small clay figurine, found in a tomb, of a squatting man reaching back as though to wipe himself. Experts had been puzzled. Why would family members bury a loved one with the Maya equivalent of Manneken Pis? Now it was clear. The man was on a ritual bender. Images on the vase no doubt also helped crack the enigma of what had appeared to be rustic, hand-hewn turkey basters—hollow bones with animal or fish bladders attached at one end—turning up at archaeological digs all over South and Central America. “South American Indians,” observe Furst and Coe, “were the first people known to use native rubber-tree sap for bulbed enema syringes.”

Is it not possible that the images on the vase depict a simple laxative procedure? Furst and Coe address this, insisting that only partakers of the “Old World enema” were concerned with constipation. (Sometimes to excess. The authors note that Louis XIV had more than two thousand clysters during his reign, sometimes “receiving court functionaries and foreign dignitaries during the procedure.” The Louis passion for the syringe can be traced through the lineage as far back as XI, who had enemas administered to his dogs.)

The southern route has advantages as well for administering poisons. Bypassing the taste buds—and the court taster, if such an entity actually existed—allowed murderers to get away with a higher dose. Some historians believe the Roman emperor Claudius was killed in this manner, at the behest of his fourth wife, the fetching and far younger Agrippina. Ostensibly the motive was political. Agrippina was in a rush to install her son from a previous marriage as Rome’s emperor. There was also this, courtesy of Suetonius: “His laughter was unseemly and his anger still more disgusting, for he would foam at the mouth and trickle at the nose; he stammered besides and his head was very shaky.” And this, from the September 5, 1942, issue of the
Journal of the American Medical Association
: “The emperor Claudius . . . suffered from flatulence.”
^*

By far the oddest reverse delivery on record is the holy-water enema. The first reference I came upon, a passing mention in an art journal, suggested that the holy-water clyster was a routine weapon in the exorcist’s arsenal. This made a certain amount of sense: Why sprinkle the possessed with holy water when you can pump it right up inside them? Seeking to verify the practice, I e-mailed the public relations office of the United States Conference of Catholic Bishops, the stateside headquarters of the Catholic Church. Naturally this went unheeded. Returning to the art journal, I consulted the article’s references, ordered a copy of the cited paper, and hired a translator, as it had been published in an Italian medical journal.

The holy-water enema, by this account, was an isolated case, involving Jeanne des Anges, the mother superior of an Ursuline convent in Loudun, France, in the early 1600s. Des Anges claimed that the parish priest, a raffish, high-ranking charmer named Urbain Grandier, was appearing to her in her dreams, caressing her and attempting to seduce her. He seemed to be having some measure of success, as the contemplative quiet of the convent was being shattered by the mother superior’s nightly shrieks of sexual frenzy. An exorcism was promptly ordered.

Why would one administer the blessed liquid rectally instead of simply having the possessed drink a glass of it? One explanation is that the original Roman Catholic rite for the Blessing of the Holy Water included adding salt to the water. Regardless of the origins of the practice, this had the effect of rendering it undrinkable.
^*

Here’s the other reason: “After many days in which the priest tried to dispel the devil, he learned from the possessed mother superior that the devil had barricaded himself inside . . .” Here my translator stopped. She leaned closer to the photocopied pages and traced the words with her finger. “. . .
il posteriore della superiora
. Inside her butt!”

Sensing that the situation had progressed beyond his expertise or comfort level, the exorcist called for outside help in the form of a pharmacist, “Signor Adam,” and his traveling syringe. (Enemas in those days were the purview of pharmacists and comprised a sizable percentage of their income.) Mr. Adam “filled up the syringe with holy water and gave the miracle clyster to the mother superior, with his usual skill.” Two minutes later the devil had vamoosed.

Books about the Loudun fracas, including a 1634 translation of an account by “an eyewitness,” include no mention of Mr. Adam or rectal exorcism, but they do serve to flesh out the story. Grandier was convicted of sorcery and burned at the stake, and most sources agree he’d been framed by des Anges, acting in cahoots with a rival priest. The “possessions” continued for several years after the execution, spreading to sixteen other nuns and turning the convent into a local tourist attraction, and understandably so: “They . . . made use of expressions so indecent as to shame the most debauched of men, while their acts, both in exposing themselves and inviting lewd behavior . . . would have astonished the inmates of the lowest brothels in the country.”

In the words of my translator Rafaella, responding to the material I had engaged her to read, “I am sorry, but nuns should be allowed to have sex.” Or at least an occasional holy-water enema.

• • •

A
ROUND THE TIME
doctors took to serving dinner through “the other mouth”—as Mütter Museum curator Anna Dhody has called the anus—a phenomenon called antiperistalsis began cropping up in medical journals. This was distinct from the fleeting reverse-peristaltic lurch of vomiting, wherein the small intestine squeezes its contents backward into the stomach, whose sphincters have opened to grant through-passage. That is normal.

This is not. “For eight days this person, at least once and sometimes twice in twenty-four hours, vomited veritable feces, solid, cylindrical, of a brown color and with the normal faecal odor, coming evidently from the large intestine.” The patient was a young woman, admitted to a hospital in Lariboisière in 1867, under the care of a Dr. Jaccoud, for a bout of hysterical convulsions. This was not the first alleged case of “defecation by the mouth.” Writing in 1900, Gustav Langmann summarized eighteen case reports of widely varying plausibility.

Jaccoud assumed his patient had an intestinal obstruction. When digesta backs up to the point that it threatens to burst the pipes, an emergency measure called “faeculent vomiting” kicks in. But the material in that case is highly liquid, coming, as it does, from the small intestine. A well-formed stool does not exit the upper end of the colon.

Besides, the woman showed no symptoms of a life-threatening obstruction. “Apart from the passing disgust which followed the act,” Jaccoud noted, “the patient ate as usual and continued in her ordinary health.” Things simply appeared to be running in reverse. Jaccoud’s colleagues suspected he’d been had. Defecation by mouth was a showstopper in the tradition of stomach snakes or the birthing of live rabbits (which turned out to have been sequestered in the woman’s skirts). Experts would travel great distances to observe a spectacle of this caliber. For the lonely or neglected patient who craves attention, it was just what the doctor ordered.

In 1889, Gustav Langmann put an alleged reverse-defecator to the test. A twenty-one-year-old schoolteacher, identified as N.G., had been admitted to the German Hospital of New York on and off for over a year, with the complaint of repeated spells of vomiting. On May 18 of that year, witnesses reported she threw up “hard scybala” the size of malted-milk balls. “It seemed,” wrote Langmann in his paper, “to be a favorable time to experiment in regard to the carriage of substances from the rectum to the mouth.”

At 11:01
A.M
., Dr. Langmann injected just under a cup of water tinged with indigo dye into the woman’s rectum. “Blue feces took its natural course,” which is to say it emerged from the customary direction. A few days later, a nurse reported having discovered “some hard feces, wrapped in paper,” under the woman’s pillow. Langmann reports that she later tried her “tricks” at two other medical facilities.

Human beings do not defecate through the same orifice they eat with. That is a feat reserved for the cnidarians
^*
—sea anemones and jellyfish being the best-known examples.

Contributing to the confusion about “antiperistalsis” was the fact that the normal waves of intestinal peristalsis run in both directions. It’s a mixing function. The better the digesta circulate, the more nutrients come in contact with the villi. Though the net movement is forward, it is, as Mike Jones put it, a “two-steps-forward-one-step-back phenomenon.”

Look up
antiperistalsis
in the medical literature, and you will come across a brief, curious phase in the history of surgery. In 1964, a team of northern California surgeons took an ambitious and iconoclastic approach to curing chronic diarrhea and improving absorption. To slow forward transit through the small intestine, they removed a six-inch segment of it, turned it around, and stitched it back in place.