To accomplish these purposes, enemata or mild aperients should be employed, and the diet must be regulated, the use of bland and unirritating food being enjoined.
All drastic purges should be avoided, as they are more or less irritating to the extremity of the rectum.
In order to establish a daily evacuation of the bowels and to render the movement as painless as possible, I am in the habit of ordering an enema of warm water, or one of rich flaxseed tea, say from half a pint to a pint, to be administered every evening; preference being given to the night-time, as then the patient can assume the recumbent posture, which, combined with the rest, affords the most relief from subsequent pain.
If the first enema should prove ineffective, it should be repeated in half an hour. In order to relieve the pain and spasm of the sphincters attending the evacuation, it is well to use a suppository about half an hour before the enema is employed, consisting of:
| ℞ | Ext. belladonnæ | gr. 1/8 ad 1/2. |
| Cocain. hydrochloratis | gr. 1/4 ad 1/2. | |
| Ol. theobromæ | gr. x. | |
| Misce, | et fiat suppositoria j. |
Or an ointment of extract of conium may be used, as recommended by Harrison Cripps:[[25]]
| ℞ | Ext. conii | ℨ ij. |
| Olei ricini | ℨ iij. | |
| Ung. lanolini ad | ℥ ij. |
A small quantity of this ointment should be smeared on the part five minutes before expecting a motion, and again after the motion has passed.
All ointments used in the treatment of rectal disease may be applied by means of a hard-rubber pipe (Fig. 7).
