PARTS TO WHICH MEDICINES ARE APPLIED.

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bowels; to irritate the rectum, and thereby to relieve affections of distantorgans; but more commonly to act as local agents in affections of therectum, bladder, uterus, prostate gland, urethra, &c. I have frequentlyemployed with great advantage a mixture of opium and soap, to preventthe pain of priapism during the night, in gonorrhoea.

Clysters or lavements require to be considered under several points ofview : first, in reference to the material of which they are made, andwhich must vary with the object for which these remedies are employed;secondly, with respect to the quantity of liquid used, and which willdepend on the age of the patient. The average quantity for an adult isabout twelve or sixteen oimces ; and I believe that it is rarely proper touse more than this. I am quite sure that the practice of introducingseveral pints of fluid into the large intestines, with the view of excitingalvine evacuations, is bad. In the first place it often provokes the con-traction of the gut, by which the injection is immediately returned; and,secondly, repeated distension diminishes the susceptibility of the part, sothat the ordinary accumulation of faecal matter no longer acts as a suffi-cient stimulus. Mr. Salmon ( Practical Essay on Prolapsus of the Rectum,1831, p. 24,) has related a case of this kind, where the patient had nearlylost all power of relieving the bowels, except by enemata or purgatives, andhad produced dilatation of the rectum, in consequence of having been inthe habit of introducing into the intestine two quarts of gruel twice everyday. A newly-born infant requires about one fluid ounce; a child of oneto five years, from three to four ounces ; and a youth from ten to fifteen,from six to eight fluid ounces. Thirdly, the impulse with which thefluid ought to be thrown up deserves attention. If too much force beused, the sudden dilatation of the gut may bring on spasmodic action ofits lower part, by which the clyster will be returned. Fourthly, the in-struments by which the injection is effected require notice. The commonpipe and bladder are too well known to require description. I am in-clined to think that the most convenient, safe, and useful apparatus, is theelastic bottle and tube. Any quantity of liquid, however small, may bethrown up with the greatest ease, and without any danger of the impulsebeing too great. Its application is exceedingly convenient; a lustyperson, by placing one foot on a stool or chair, may easily apply it with-out assistance; and its price is very moderate. Another form of enemaapparatus is a narrow water-proof tube, holding about a pint of liquid,about four feet long, narrower at one end, which is furnished with a com-mon injecting pipe, and about two and a half inches in diameter at theother. The fluid being placed in the tube, the pipe is introduced into therectum, and the apparatus held in a perpendicular direction, by which thefluid is propelled into the gut by its own gravity. This apparatus,although very simple, appears to me to be less convenient for common usethan the elastic bottle, and not to be well adapted for the administrationof small quantities of fluids. In the shops are sold syringes of variousforms as enema apparatus.

Gaseous matters have been sometimes thrown into the rectum. Thusthe injection of common air has been proposed in ileus ( Edinburgh Medi-cal and Surgical Journal , vol. xvi.) Tobacco smoke has sometimes beenemployed in hernia: it is injected by a peculiarly constructed pair ofbellows. Carbonic acid gas has been nsed in ulceration of the rectum.

2. Urino-genital membrane: a. Urethro-vesical membrane. — Applica-