SECT. XLIV.—ON CLYSTERS.
In constipation of the bowels, when the stomach is naturally weak, and cannot bear purgatives, recourse must be had to clysters. When phlegm is contained in the intestines, the clyster may be composed of the decoctions of dried figs, and of beet, nitre, the root of the wild cucumber, honey, and the oil of chamomile or dill. But when the complaint proceeds from dryness they may be composed of those of marsh-mallows, fenugreek, chamomile, oil, and a small quantity of honey. And sometimes oil alone, injected to the amount of half a hemina, will produce the desired effect; but even this must not be repeated constantly, lest nature, becoming accustomed to these things, should forget to perform the evacuation spontaneously.
Commentary. Hippocrates frequently recommends the administration of clysters. Herodotus mentions that the ancient Egyptians had recourse to clysters at stated periods every month. (ii, 77.)
Oribasius has treated of the composition of clysters, and the cases in which they are to be applied so fully in the eighth book of his ‘Medica Collectanea,’ that he may be said to have exhausted the subject. It appears, from his account, that the ancients used a syringe for throwing up injections. A large clyster, he says, amounts to three heminæ, a small one to one hemina, and a moderate one to two heminæ (two pints). (Synops. i, 19.)
Celsus, after some very appropriate observations on the cases which are benefited by clysters, concludes with the following directions for the composition of them: Plain water may be injected, if the case be slight; or honied water, if stronger means be required; if emollients be indicated, the decoction of mallows, of fenugreek, or ptisan may be used; or if astringents be proper, vervain. Acrid clysters may be formed of sea-water, or with the addition of some salt, and their strength may be increased by boiling. Such a clyster may be rendered still more acrid by the addition of oil, nitre, or honey. He remarks that the more acrid a clyster is, the greater will be its purgative effect, but the more difficult will it be to bear. He says it ought to be neither hot nor cold. After the injection has been thrown up, he recommends the person to remain quiet, and to resist the first desire to go to stool. (ii, 12.)
Aëtius treats of clysters very fully. He prefaces his account of the mode of administering them, with a correct detail of the evils arising from constipation, which, he justly remarks, is the precursor of most of the ills which break out in the human frame. (iii, 159.)
See a long list of prescriptions for clysters in Serapion. (De Antidotis, tr. vii, 26.) Rhases and Avicenna give a full account of the nature of clysters, but supply no additional information on the subject.
SECT. XLV.—ON SUPPOSITORIES.
We often use suppositories for the discharge of scybalæ, or when injections are not properly evacuated. Suppositories are formed of roasted salt, honey, and nitre; or thyme may be mixed with boiled honey. They are also formed of turpentine rosin, and nitre, and sometimes with a moderate quantity of the seeds of the thymelæa (granum cnidium); but it irritates the parts, which, therefore, ought to be rubbed with oil. Pellitory and pepper are also added, and are particularly fitted for paralytics, and for the relief of flatulence from cold. Centaury is also mixed with pitch and cerate, and is very applicable for paralysis of the genital organs. For infants a lump of salt is applied. Figs also are mixed up with nitre.