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In this review of Useful Cathartics, published under the auspices of the American Medical Association, Fantus presents the alternatives in a reasonable way. The back to nature cry of the faddist, he writes, need not lead us to the habitual admixture of sawdust, bran or similar substances to our food. When, however, there is constipation, the question whether increase in cellulose is indicated is important. Unless the patient is of the type characterized by excessive digestion of cellulose, with flatulence, and unless the patient suffers from gastric motor insufficiency or intestinal stenosis, cellulose in the diet should be favored. There are three forms in which cellulose may be added to the diet: fruits, vegetables and bran. Of these, Fantus concludes, bran is the richest in cellulose and is one of the most effective prophylactics of constipation.In view of this it becomes important to ascertain more precisely what the potent components responsible for the laxative efficacy of bran actually may be. Crude bran contains as much as 18 per cent of indigestible cellulose, or the so-called crude fiber of the analytic chemist; one sixth of the substance may consist of protein so located that ordinarily it is extremely resistant to digestion in the human alimentary tract. Furthermore, the laxative action of bran in cattle, in the rationing of which species it has long enjoyed a deserved vogue, has been ascribed to certain specifically active chemical ingredients. In the laboratories of physiologic chemistry at Yale University and the Jefferson Medical College, Williams has studied the physiologic effects of bran and some of its components in considerable detail on animals. His experiments show that cellulose prepared from paper pulp was laxative when given in an amount equivalent to the crude fiber content of washed bran. The crude fiber of bran was even more laxative than the cellulose from paper pulp. The crude fiber of bran was laxative even when fed in the small quantities corresponding to the crude fiber content of 3 per cent bran in the food. The crude fiber of wheat bran was feces-forming; i. e., it had the power of producing more than its own weight of feces. This increase amounted on the average to more than three times the weight of the fiber intake. In general, bran did not possess feces-forming power to this extent. Williams believes that the crude fiber of wheat bran is an important contributory factor to the laxative effect of the bran, and, gram for gram, is a much more powerful laxative than bran itself. This conclusion presumably takes bran out of the category of drugs and properly relegates it to the kitchen. Indeed, Fantus has suggested that only through use in the more palatable forms of cooking does bran really cure or take care of constipation. Even so, it has many limitations.

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