Interstate medical journal . is applies particularly to cases in which quitean amount of blood may be lost, as in hysterectomies, myomectomies orsalpingotomies. In order that we may be forearmed, on the morningof the operation, one, two or three hours prior thereto, a copious soap-suds enema is given for the purpose of the removal of the remaining fecalmatter, so that should it be desired to give a copious saline enema in caseof shock from great loss of blood or otherwise, you have a better ab-sorbing surface in the colon. In this same article I called attention tothe efficiency of large quant
Interstate medical journal . is applies particularly to cases in which quitean amount of blood may be lost, as in hysterectomies, myomectomies orsalpingotomies. In order that we may be forearmed, on the morningof the operation, one, two or three hours prior thereto, a copious soap-suds enema is given for the purpose of the removal of the remaining fecalmatter, so that should it be desired to give a copious saline enema in caseof shock from great loss of blood or otherwise, you have a better ab-sorbing surface in the colon. In this same article I called attention tothe efficiency of large quantities of water taken by the mouth for thepurpose of preventing prolonged anesthetic emesis. It not only does thisbut it also tends to refill vessels that have been robbed of their fluidelement by the previous catharsis. Since the above was written it has been my practice, after prolongedintra-abdominal operations, whether much or little blood has been lost, Fig. 2.—Mode of snipping vein to admit nozzle of transfusing Fig. 3.—Nozzle tied in vein. TRANSFUSION. 221 to inject into the rectum from one to two pints of normal saline indication for this procedure has most frequently been a weak andrapid pulse and not alone the quantity of blood lost. In puerperal eclampsia, which after all is simply a symptom of pro-found toxemia, there is no better remedy, to my mind, than the intro-duction of normal saline solution into the vein. I would b) no meanslessen the importance of injecting into the cellular tissue beneath themammary glands or elsewhere, but, for the reason that we want quickand definite action. I prefer the intravenous injection. In these casesit is best always to open a vein for the purpose of lessening the quantityof the toxic blood in the circulation and then supplying the quantity taken,by normal saline solution which, as has been stated before, dilutes thetoxines and renders them less potent while it stimulates glandular ex-cretion. In order to
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