At the height of last fall's scandal surrounding the Brooklyn Museum's "Sensation" show -- a scandal triggered by a painting of the Madonna festooned with dried elephant dung -- New York Mayor Rudy Giuliani delivered an eloquent plea to the public: "I would ask people to step back and think about civilization. Civilization has been about trying to find the right place to put excrement, and it is not on the walls of museums."

People have long assumed that the fate of civilization hangs on proper potty training. In his new book, James C. Whorton suggests civilization has also flourished because of toilet troubles -- specifically, clogged bowels.

"Inner Hygiene" explores the unhappy modern preoccupation with irregularity and the remedies and devices that have been developed for this affliction. One of the many virtues of the book is that it shows, to some extent inadvertently, that civilization may be more compatible with failed potty lessons than Giuliani would have us believe.

Sure, we all grow up learning that "a movement a day keeps the doctor away." But does that mean that freedom from anxiety about pooping is a prerequisite of civilized society? Far from it. As Whorton reminds us, some of the most creative thinkers of the modern era were afflicted by bowel trouble, perhaps even inspired by it. Martin Luther's spiritual meltdown was famously precipitated by intestinal crisis. Later bowel-beclogged notables included John Locke and Ben Franklin, who both rhapsodized on the subject of regularity.

For centuries, the desperate and often humiliating quest for regularity has pushed human ingenuity to remarkable heights of invention, contrivance and rhetoric. In treating this quest as a serious subject, Whorton, a professor in the department of medical history and ethics at the University of Washington in Seattle, follows other recent scholars who have discovered fascinating histories behind modern attitudes toward bodily functions. He performs a valuable service in reminding us that civilization as we know it is unthinkable without bowel trouble and the entrepreneurial spirit it has called forth. Moreover, he does so with elegance and wit.

Source of so much misery, the blocked bowel has also fueled some of the most compelling modern visions of happiness. Visions of an existence free of straining, of an almost virginally pure and obedient intestinal tract, have animated the writings of innumerable scatologists and copromaniacs. Bowel afflictions have been transmuted into pure gold, in works like Rabelais' "Gargantua and Pantagruel."

But Whorton's main subjects are the medical quacks, dreamers and men of dubious science who have unleashed on the modern world myriad patent medicines and contrivances designed to deliver their desperate patients from the torments of intestinal intransigence. The real story of this book lies in the endless stream of purgatives, enemas, irrigation devices, flavored laxatives, rectal dilators, chewing techniques, graham crackers and Kellogg's All-Bran, which people have lavished on themselves in the quest for intestinal bliss.

From the Reformation on, Whorton tells us, Western society has been haunted by the specter of constipation, and worked energetically to rid itself of the ailment. Medical specialists and philosophers theorized endlessly about the causes, and inevitably came to focus on the pathogenic role of civilization itself: the rich diets, the sedentary lifestyles, the upright toilet seating and, most damaging, the curse of being too busy to answer nature's call.

Sign up to receive free e-mail updates from Salon -- now in 17 different varieties!