For application to the rectum. Enemata are sometimes used to 

 produce remote action. This method is only resorted to when the drugs 

 to be given are either too unpalatable to be taken per as or when they would 

 irritate the mouth or stomach of the patient. Drugs given per rectum are 

 usually administered in, roughly, twice the dose in which they would be 

 taken by the mouth. If the drug-stuffs contained in an enema are to ab- 

 sorbed it is necessary that they should not be irritant to the mucous mem- 

 brane nor should its bulk be so large as to mechanically set up movements. 

 Hence watery or weak alcoholic mixtures 1-2 ounces in bulk are usually 

 used. Medicaments which are very readily absorbed may be given in the 

 form of a suppository. Three of the pharmacopceial suppositories con- 

 tain drugs which exert remote actions. These are, Suppositoria Bella- 

 donnae, Morphinse, Plumbi. 



By means of an enema antiseptics may be applied to the surface of the 

 rectum and a part of the colon. If the antiseptic is readily absorbed or 

 powerful in its action on mucous membranes, e.g. Acidum Carbolicum, 

 only a small quantity of it may be prescribed in a large bulk of water. 

 If relatively insoluble, e.g. Argyrol, or Boracic Acid, a much stronger so- 

 lution may be used. Enemata containing bitters and astringents, Quas- 

 sia, Tannic Acid, Kino, are sometimes applied to drive out pin-worms and 

 to act as mild astringents. 



An enema is frequently employed to soften hardened faeces or to bring 

 about defalcation. For these purposes either some bland fluid, e.g. 

 Olive Oil, Normal Saline, or Mucilage of Starch is used in large quantities 

 (2-3 pints) as these mechanically dilate the bowel and set up reflex move- 

 ments. In order to produce defsecation alone a much smaller quantity of 

 fluid may be used if it contains some drug which acts as a local irritant to 

 the sensory nerve endings, e.g. Turpentine, Mustard, Aloes. 



Nourishment is often given to those whose stomach is deranged, by 

 means of an enema. In this case a bulk of more than three or four ounces 

 can rarely be given. The food must be fluid, nonirritant, and highly nu- 

 tritous. Eggs, milk, oil, alcohol, or mixtures of these with water, -are 

 common ingredients of this type of enema. In order to aid in their reten- 

 tion the fluid should be warmed to the temperature of the body, should be 

 given slowly, and the patient kept in a prone position. 



Some of the pharmacopceial suppositories are intended to produce local 

 antiseptic or astringent actions in the bowel, e.g. those of Phenol, lodoform, 

 Tannic Acid, and Lead; that of Glycerin to aid in defaecation. 



For application to the Vagina. Drugs are only given by the Vagina 

 for their local effect. Suppositories for this purpose are usually known as 

 Pessaries, fluid washes as Douches. The most frequently employed 

 vaginal antiseptics are Mercuric Perchloride 1-2000-5000, Silver Nitrate 

 2-1000-500, Argyrol, and Cresylic Acid, Potassium Permanganate 1-1000- 

 5000. Vaginal Tampons impregnated with active drugs in glycerin are 

 sometines employed. 



For application to the Urethra and Bladder. Here also a purely 



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