Cooley's Cyclopaedia of Practical Receipts Volume I Part 206

3. (Demulcent and Emollient.) Decoction of starch, gum, isingla.s.s, glue, &c., either alone or combined with opium, are used to protect the coats of the intestines, and to allay irritation; and also to restrain diarrha, especially when combined with astringents, as logwood, catechu, or oak bark.

4. (Nutrient.) Animal jelly, soups, broths, milks, &c., are frequently used as injections to convey nourishment to the body.

5. (Sedative.) Tobacco infusion or smoke, and tartar emetic (in solution), are employed to relax the powers of the body, to remove spasms, depress the circulation, and to produce syncope.

Enemata or clysters are now very frequently employed in our large towns, especially among the higher cla.s.ses; but a great prejudice exists among many persons against their use, arising from a fastidious and mistaken delicacy. The introduction of improved apparatus of late years, by which the administration of these remedies is attended with less difficulty and exposure than formerly, has removed much of the repugnance which previously existed.

Clysters are invaluable when it is necessary to evacuate the bowels as speedily as possible, and when the stomach will not bear the administration of a purgative by the mouth, as well as in cases requiring a direct medication of the lower bowels, as in dysentery, colic, &c. As a mere laxative, an injection of tepid water, milk-and-water, or water gruel, will generally be found sufficient. By the addition of 1 or 2 table-spoonfuls of common salt, Epsom salts, salad oil, or mola.s.ses, to this laxative enema, it will form an excellent purgative one, which will, in most cases, induce a full discharge. In all cases, the patient should be directed to retain the injection for as long a time as possible, and not to attempt to empty his bowels immediately after the reception of the medicine. "In irritation of the bladder, r.e.c.t.u.m, or uterus, an anodyne injection or enema often affords much relief. In diseases of the lower bowels, clysters are also of almost indispensable utility, as also in the dislodgment of ascarides seated in the r.e.c.t.u.m; nor are they less beneficial in those cases of sudden sinking of the powers of life where deglut.i.tion is impossible, and yet a prompt stimulating impression is requisite to save the patient; under such circ.u.mstances, clysters of some of the diffusible stimuli have proved of the greatest benefit."

The injection of large quant.i.ties of liquid matter into the bowels, as well as the constant use of clysters (even of warm water only), is deemed by the highest medical authorities to be injurious, and occasionally dangerous. The practice should not, therefore, be allowed to grow into a habit. The bowels continually accustomed to a stimulant cease to act without one. The same remarks apply to aperients taken by the mouth.

The following formulae embrace the whole of the enemas (ENEMATA) of the 'British Pharmacopia,' as well as a few others in common use:--

=Enema of Albu'men.= _Syn._ ENEMA ALb.u.mINIS, L. _Prep._ (Ricord) Infusion of linseed, 12 oz.; whites of 2 or 3 eggs; mix. In chronic diarrha, and as a nutritient clyster in debility from stomach diseases. The reason for rejecting the yolks of the eggs is not very obvious, as the preparation is much more effective with them.

=Enema of Al'oes.= _Syn._ ENEMA ALOeS (B. P.), L. _Prep._ From aloes, 2 scrup.; carbonate of pota.s.sa, 15 gr.; mucilage of starch, 1/2 pint. In ascarides, atonic amenorrha, &c. It should not be employed when irritability of the r.e.c.t.u.m, bladder, or genitals, exists; nor in piles, or when there is a tendency to prolapsus ani or prolapsus uteri.

=Enema, An'odyne.= See ENEMA OF OPIUM.

=Enema, Antispasmod'ic.= _Syn._ ENEMA ANTISPASMODIc.u.m, L. _Prep._ From tincture of a.s.saftida, 3 fl. dr.; laudanum, 30 to 60 drops; water gruel or barley water, 1/2 pint. In spasmodic affections of the bowels. (See _below_.)

=Enema of a.s.saft'ida.= _Syn._ FETID CLYSTER, ANTISPASMODIC C.; ENEMA a.s.sAFTIDA (B. P.), E. FTIDUM (Ph. E. & D.), L. _Prep._ 1. (B. P.) a.s.saftida, 30 gr.; water, 4 oz.; rub together until mixed.

2. (Ph. E.) To cathartic enema (Ph. E.), add of tincture of a.s.saftida, 2 fl. dr.

3. (Ph. D.) Warm water, 12 fl. oz.; tincture of a.s.saftida, 2 fl. dr.

4. (St. B. Hosp.) a.s.saftida, 2 dr.; yolk of an egg; barley water, 7 fl.

oz. Stimulant, antispasmodic, and carminative. An excellent remedy in hysteria, flatulent colic, hooping-cough, infantile convulsions, worms in the lower bowels, &c. See ENEMA HOOPING-COUGH.

=Enema, Astrin"gent.= _Syn._ ENEMA ASTRINGENS, L. _Prep._ 1. Tincture of catechu, 1 fl. oz.; barley water, 9 fl. oz.

2. Extract of rhatany, 2 dr.; syrup, or made starch, 2 oz.; water, 7 fl.

oz.

3. Decoction of galls, oak-bark, pomegranate, or other like astringent substance, 3 or 4 fl. oz.; water or barley water, 6 or 7 fl. oz.

4. (Hosp. F.) Electuary of catechu, 2 dr.; water and lime water, of each 4-1/2 fl. oz. In diarrha, &c., arising from a relaxed condition of the coats of the lower bowels; and in fissures of the a.n.u.s, &c.

=Enema of Bark.= _Syn._ ENEMA CINCHONae. Decoction of bark is used.

=Enema of Belladonna.= _Syn._ ENEMA BELLADONNae (Ratier.) _Prep._ Belladonna, 10 gr.; water, 6 oz.; infuse.

=Enema of Cam'phor.= _Syn._ ENEMA CAMPHORae, L. _Prep._ 1. Camphor liniment, 4 fl. dr.; yolks of 2 eggs; water gruel, 7 fl. oz.

2. Camphor, 1 dr.; rectified spirit, 2 dr.; triturate till dissolved, then add, gradually, of simple syrup, 1 oz.; when thoroughly incorporated, further add of thin gruel, 7 fl. oz. Anodyne, antispasmodic, and diuretic.

In difficult or obstructed micturition.

=Enema of Cas'tor Oil.= _Syn._ ENEMA OLEI RICINI, L. _Prep._ 1. (Hosp. F.) Castor oil and mucilage, of each, 1 oz.; gruel, 1/2 pint.

2. Castor oil, 1 oz.; liquor pota.s.sa, 2 fl. dr.; triturate, and add of honey, 1 oz.; when mixed, further add of hot gruel, 1/2 pint; and agitate until cool enough to be administered.

=Enema, Cathar'tic.= _Syn._ PURGATIVE CLYSTER; ENEMA CATHARTIc.u.m (B. P., Ph. E. & D.), E. LAXATIVUM, E. PURGATIVUM, L. These have been already alluded to. By increasing the quant.i.ty of the active ingredients, a mild laxative or aperient clyster is converted into an active purgative or cathartic one.

_Prep._ 1. (Ph. E.) Senna, 1/2 oz.; boiling water, 16 fl. oz.; infuse an hour, then add of Epsom salts, 1/2 oz.; sugar, 1 oz.; when dissolved, further add of olive oil, 1 oz.; and mix them by agitation.

2. (Ph. D.) Epsom salts, 1 oz.; olive oil, 1 fl. oz.; mucilage of barley.

16 fl. oz. Same as enema of sulphate of magnesia, B. P., except that in the latter mucilage of starch is subst.i.tuted for mucilage of barley.

3. (Ph. D. 1826.) Manna, 1 oz.; compound decoction of chamomile, 1/2 pint; dissolve, and add, of olive oil, 1 oz.; Epsom salts, 1/2 oz.

4. Compound decoction of mallows, 1/2 pint; Epsom salts, 3/4 oz.; sweet oil, 2 fl. oz.; mix, as above.

_Obs._ The above are employed in all ordinary cases where the use of an immediate cathartic is indicated.

=Enema of Cevidina.= _Syn._ ENEMA CEVIDINae (Soubeiran.) Cevadilla, 2 dr.; water, 10 oz.; boil to 7 oz.; strain and add milk, 8 oz. To destroy ascarides.

=Enema of Chlo"ride of Lime.= _Syn._ ENEMA CHLORIDI CALCIS, E.

ANTIPUTRESCENS, L. _Prep._ 1. Chloride of lime, 10 gr.; tepid water, 1 fl.

oz.; triturate, then add of barley water, or plain tepid water, 7 fl. oz.

2. (Pereira.) Chloride of lime, 10 to 15 gr., added to a common enema. As a deodoriser, when the alvine evacuations are unusually fetid.

=Enema of Chloride of Soda.= _Syn._ ENEMA SODae CHLORINATae. _Prep._ Labarraque's solution, 24 drops; decoction of mallows, 16 oz.

=Enema of Chloride of Sodium.= _Syn._ ENEMA SODII CHLORIDI. _Prep._ Common salt, 1 oz.; barley water, 1/2 pint; olive oil, 1 oz.

=Enema for Col'ic.= _Syn._ ENEMA ANTICOLIc.u.m, L. _Prep._ From oil of cajeput or peppermint, 15 drops; dissolved in sweet spirit of nitre, 60 drops; laudanum, 35 drops; infusion of chamomile, 1/2 pint.

=Enema of Col'ocynth.= _Syn._ ENEMA COLOCYNTHIDIS (Ph. L.), L. _Prep._ 1.

(Ph. L.) Extract of colocynth, 1/2 dr.; soft soap, 1 oz.; triturate, and add of water, 1 pint.

2. (Ph. L. 1836.) As the last, but using compound extract of colocynth.

3. (Guy's Hosp.) Colocynth pulp, 1 dr.; water, 3/4 pint; boil so as to strain 1/2 pint; and add of common salt, 1/2 oz.; syrup of buckthorn, 1 fl. oz. An efficient enema in colic and obstinate constipation, in the absence of spasms and inflammatory symptoms.

=Enema, Com'mon.= _Syn._ ENEMA COMMUNE, L. Gruel or barley water, either with or without the addition of a little common salt or oil, are generally so called. The first are simply laxative; the latter, purgative. Decoction of mallows, linseed tea, or water gruel, are also commonly used as the vehicle.

_Prep._ 1. (St. Bar. Hosp.) Barley water, 1 pint; common salt, 1 oz.; dissolve.

2. (Guy's Hosp.) Water gruel, 10 to 15 fl. oz.; common salt, 1 oz.

3. (U. C. Hosp.) Water gruel, 8 to 12 fl. oz.; salt, 1 oz.; linseed oil, 2 fl. oz.

=Enema of Copai'ba.= _Syn._ ENEMA COPAIBae, L. _Prep._ 1. From balsam of copaiba, 2 dr.; liquor opii sedativus, 15 drops; yolk of egg, q. s.; barley water, 7-1/2 fl. oz.

2. (Collier.) To the last add, of extract of opium, 1 gr.; oil of turpentine, 4 fl. dr.

3. (Velpeau.) Copaiba, 2 dr.; laudanum, 20 drops; yolk of 1 egg; water gruel, 8 fl. oz. In ascarides, gonorrha, and some affections of the lower bowels and bladder, when the stomach rejects the balsam.