Advantage has long been taken of the absorbent power of the rectum as a means of obtaining the peculiar effects of a remedial agent upon the system; and although the rectum, as an absorbing surface, is inferior to the stomach, medicines are frequently introduced into this organ with great benefit in cases of inability to swallow, irritable stomach, and in children's maladies. Unfortunately, the rectum soon becomes intolerant, the mucous membrane irritable, and the medicament may be at once rejected or absorption delayed.b

To introduce a remedy into the rectum, it is inserted either in a suppository, or in a solution by enemata. For suppositories, as a vehicle of the medicine the gelatine capsules are recommended on account of their quick solubility - often the butter of cocao is used. Solutions of medical agents for rectal administration that are injected for absorption, must be perfectly bland and only a few ounces at a time are to be injected to prevent irritation.

There are some remedies that enter the blood more quickly by the rectum than by the stomach. The salts of morphia, atropia and strychnia in solution are absorbed as quickly, and the last named more quickly by the rectum than by the stomach.

aProf. Adolph Gubler. bedmund A. Kirby, M. D.

The most acceptable remedies for the rectum, are the oleates. They are least irritating and easily absorbed. As a corrective to counteract irritability of the rectum, either the cocaine or morphine may be resorted to. However, owing to the untoward effects of morphine in many cases, it cannot be used as freely as cocaine. In painful menstruation, a morphine suppository in the rectum usually gives immediate relief - the cocaine administered in like manner lessens the Agony of parturition.

Sometimes it is necessary to introduce medicine into the rectum to excite irritability - to bring about a general peristalic action of the intestines. This is done to overcome obstinate constipation and intestinal obstruction. Sometimes a powerful rectal stimulant, or very warm water is resorted to, in the treatment of collapse, shock, and inertia uteri. In placenta praevia with inertia uteri, I have succeeded in arousing immediate reflex action, thus securing a hasty delivery by an injection of a strong emulsion of turpentine. The injection of a few drops of croton oil mixed with a little oil, I have found to result favorably in traumatic coma.

One of the most important and reliable objects in rectal medication is to secure its local effects in various diseases of the rectum and lower bowels and even in the anus. Therefore it is an important adjunct in the treatment of dysentery, ulceration of the rectum, prolapsus ani, and fissures of the anus, internal hemorrhoids, etc. Rectal anthelmintics are likewise often resorted to. If twenty minutes be required for the absorption of a certain medicine from the stomach, forty minutes will be usually necessary when it is exhibited by the rectum, and five:minutes when it is thrown into the subcutaneous tissue.b

It not unfrequently happens in the treatment, that the patient is unable to take food into the stomach, and it becomes of the utmost consequence to life to support the patient by supplying nourishment by the rectum. The digestive power, however, of this portion of the colon is exceedingly feeble, and if meat is to be assimilated, it is necessary that it be digested before it be introduced. Pancreatic emulsion, or a solution of pancreatine is to be employed for this purpose.a

Dr. W. O. Leube employs the pancreas of an ox or pig as a ferment; one part of finely minced pancreas being mixed with three parts of scraped meat rubbed well together with warm water, so that the mixture is easily injected. Fat, not exceeding one-sixth of the meat, may be added. This injection is retained from twelve to thirty six hours, and the stools afterwards generally possess an ordinary faecal character. It is evident that by means of injections a considerable quantity of nitrogen can be taken up into the system.

Peptones made into suppositories are also serviceable.

Three to five eggs beaten up with four Ounces of 20 per cent. solution of grape sugar form an excellent nutritive enema. Eggs are absorbed without peptonization.c aedmund A. Kirby, M. D. bprof. H. C. Wood.

cProf. Sydney Ringer.

Flushing the colon and rectum with an enormous quantity of warm water, thus relieving the intestines of effete matter has been favorably recommended for the prevention and cure of many diseases. It appears the system is invigorated on the principle of a bath cleaning the skin, and imparting vigor to the body. If this kind of an enema should do no more than to counteract the bad effects of constipation, it should meet our favorable consideration, for to these are due a large percentage of the etiology of diseases.