632 ADMINISTRATION OF MEDICINES. 



By the Rectum. 



In this country, these injections (enemas or clysters) are gene- 

 rally used only for the mechanical relief of constipation by means 

 of warm water, or for destroying worms by, for instance, oil of 

 turpentine mixed with linseed oil. For this purpose, a Read's 

 enema pump (Fig. 155) is frequently used. The value of an in- 

 jection of this kind in constipation is enhanced by the fluid being 

 sent a good distance into the bowel. 



There is no doubt that an enema given in the ordinary way is 

 almost useless ; because the injected fluid does not penetrate more 

 than four or five feet into the bowel. Colonel Fred Smith has de- 

 vised a good form of enema tube, which is 6 ft. long, and may be 

 used with Read's enema pump. He remarks that " there is no 

 difficulty in passing it ; having been oiled, with gentle pressure, it 

 finds its way along the course of the rectum, and when it refuses to 

 go further no force should be used ; all that is required, should it be 

 necessary to pass it further forward, is to pump in a gallon or two 

 of water, which dilates the bowel in front of it, and the passage is 

 accomplished." A simpler and probably a better plan is that of 

 having the hind quarters raised while the enema is being given, as 

 advised by Mr. Rutherford (p. 423). 



Water for enemas should be but little warmer than the tempera- 

 ture of the body, say, not more than 103° F. It should not be 

 mixed with soap or any other addition. 



An assistant holds up the near fore foot. The operator having 

 filled the clyster pipe and oiled its nozzle, inserts it very gently 

 into the anus. The fluid is then injected. 



Contrary to what is usually thought, the rectum has great power 

 of absorbing water, as we may learn from the fact, pointed out 

 by M. L. Guinard, that it is the place in which the dung assumes 

 its normally dry condition. Hence, it is a valuable route for the 

 introduction into the system of medicines which are dissolved in 

 water. To facilitate absorption by this means, the dung in the 

 rectum should be cleared out by back-raking (p. 638), and the 

 solution should be of small bulk. Unlike the mucous membrane 

 of the mouth, the mucous membrane of the rectum does not 

 excrete sufficient fluid to dissolve ordinary dry medicines, which 

 consequently should not be given in the way. Also, its power 

 of absorbing oils is feeble. When injecting a small quantity of 

 fluid, say, about 1 oz. into the rectum, it is well to use a narrow 

 tube with the syringe, or a catheter made according to Veterinary- 

 Surgeon Desmond's design (p. 656) might be employed. This 



