Licence: In copyright
Credit: Royal Army Medical Corps training, 1911. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
412/510 page 376
![CHAPTER XLVIII. ENEMATA. 655. An enema is a liquid prepai'ation which is injected into the rectum. It is chietty given to produce an action of the bowels, to relieve pain, to stimulate, or to feed the patient. Its composition and size vary with the purpose for whichit isused. Nutrientenemata and those prescribed to allay pain are usually small in quantit)', those intended to clear out the bowels are large. 650. Method of administration.—The patient is usually placed on the left side or on the back. It is the more convenient to have the patient lying on his left side, since the large intestine runs backward from the anal aperture in the direction of the left hi]j ; but it sometimes happens that it is impossible to put him in that position—as, for instance, after an abdominal operation, or injuiy to the pelvis. In such a case the enema must be given with the patient lying on his back. This is more difficult, and it is wise to practise giving it in this position so that when necessary it may be done easily and not cause the patient discomfort. When the enema is given with the patient lying on his side, the hips must be brought to the edge of the bed and flexed, also the knees. A warmed mackintosh covered with a towel is then placed under the patient, and the bed-clothes, with the exception of one blanket, turned back. The vessel containing the fluid to be injected should be placed in a convenient position, and the catheter or nozzle of the syringe oiled. The index finger of the left hand should be passed between the buttocks, and laid lightly on the anus, and the tube passed below the finger into the rectum, directing it upwards and backwards. No force must be used, the tube must be carefully passed over the small tongue of integument which is found at the anterior angle of the anus.* If the Higginson's syringe is used the fluid must be pumped in with the right hand. Five minutes should be occupied in injecting one pint. There should be no attempt at hurrying, othervrise the enema may be instantly returned. If the patient may not be turned on his side, he should, lying on his back, be brought as near to the edge of the bed as possible, the right knee flexed, and the anus found as before with the index finger of the left hand. The tube is then gently passed with the right hand, being directed backwards and slightly downwards. When the injection has been given the tube should be gently and slowly removed from the rectum, and firm pressure at once applied upon the anus with a folded towel to assist the patient in retaining the enema. The buttocks being pressed together also assists in this way. 657. Purgative enemata.—Purgative enemata are given either with the object of assisting an easy action of the bowels, e.g., before and after operations, or for the r'alief of conatipation. • Almost immediately the mnsolo will relax and tbe tube slip in.](https://iiif.wellcomecollection.org/image/b21973167_0414.jp2/full/800%2C/0/default.jpg)
