Einhorn considers this measure not only palliative but often curative. It is most valuable in obstinate cases, especially when due to spasmodic contraction of the bowels (Hershell, Lancet, Oct., 04). Methodical oil injections are also most useful in membranous colitis, relieving the constipation and reducing the amount of mucus. Two things are exential to success; the cases must be suitable; and the injections must be properly given. This method is not applicable as a routine procedure. It will not produce cure in cases depending upon improper food, or hard drinking water, or pyloric stenosis or gastric myasthenia. Olive oil injections are applicable to cases depending upon chronic colitis; constipation associated with spasm of the bowel, such as is frequently found in neurasthenia; and to secure a daily action in stony of the intestines whilst the affection is being treated by electrical methods. In these last cases the first fortnight is trying to both physician and patient; for all purgatives have been abandoned, and the treatment has not yet had time to restore sufficient tone for natural daily movements. The method of injection: from three to ten ounces are introduced into the rectum at bedtime; usually there is an evacuation after breakfast the following morning. If the oil is introduced slowly, at a low pressure, by gravitation, it will not produce an immediate stool and the patient should easily retain it. Hershell condemns the Higgins on syringe. When the physician or nurse cannot give the injection, the patient may use her shell’s simple apparatus – a glass funnel of a large capacity relative to its height, provided with a metal loop, by which it’ can be suspended at a convenient height above the patient’s bed. Twenty-seven inches of rubber tube of large caliber terminate in a self-retaining, aluminum nozzle of special construction. This nozzle has a large bore to allow the ready passages of the oil (which invariably clogs the ordinary enema apparatus), and has the end of the bore well rounded so that even when unskillfully used it cannot damage the rectal mucous membranes. The outflow of oil is controlled by a spring clip, which, when opened, will remain so until a catch has been released. The patient heats the measured quantity of oil by standing the beaker containing it in a basin of hot water; it is emptied into the funnel, the clip being closed, hung on a nail; the patient lies directly under it, a pillow beneath his hips, introduces the nozzle, presses the clip and waits until the funnel is empty. A pad of wool had best be applied to the perineum to absorb any oil which may not be retained; after a few times this is superfluous. Five or six ounces should be used at first, and the daily amount reduced until the smallest which will produce a movement is found; and this can be given nightly for two or three weeks.
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March 11, 2019
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