814 



HERBERT-S. CARTER 



4. Enematu should be given mlh the patient on the left side, or 

 with the foot of the bed raised an 8koc1cblocks f which are left in place 

 for an hour after the injection. 



5. In certain cases of excessive peristalsis, it is necessary to use 

 5 to 10 dro/M of deodorized tinrture of opium in the enemata. 



6. Injections should be given slowly, the rectal tube luJjricaied 

 and passed not more than 6 to S inches, and the reservoir containing 

 the solution should not be more than 18 inches or two feet above the 

 level of the patient's back. 



7. All fluids should be as nearly blood temperature as possible 

 on entering the rectum. This can be facilitated by placing an electric 

 light bulb in the reservoir and placing a hot water bag over the feed 

 tube just before it enters the rectum. 



If the Murphy drip method is used, Kemp has devised a special heat 

 retaining bottle to use and has worked out the following table for deter- 

 mining the temperature: 



Summary of Results of Rectal Feeding. 1. Only about 25 to 35 

 per cent of nourishment required to maintain nitrogenous equilibrium 

 and weight is absorbed per rectum. 



2. Metabolism experiments show that even under the best of con- 

 ditions this method, although the best we have, results in subnutritiou, 

 and is really semi-starvation. 



3. As a practical method, it should not be relied upon to bring up a 

 patient's condition as, e. g., for an operation except where there has been 

 actual starvation as in a marked esophageal or' pyloric stenosis. It is a 

 false prop. 



4. It is useful in tiding over short periods when from one reason or 

 another it is necessary to give the patient water, salts, and some nourish- 

 ment in the form of protein and carbohydrates. 



5. Its usefulness is, therefore, limited, more so than many people 

 suppose. 



Subcutaneous Feeding. There are occasions when this form of feed- 

 ing would be of great value even for a few days if 'it could be done com- 

 fortably and efficiently, but as yet it has not been possible to accomplish 

 this with any degree of satisfaction. Although considerable experimenta- 

 tion has been done towards this end, at present the rectal method is much 



