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Introduction
Enema is an injection of fluid into the rectum. This is also known as rectal irrigation.
Requisites: Enema can.
Water temperature: Only lukewarm water.
Procedure: The patient lies down on his right, extending his right leg and folding the left leg at the right angle. The enema nozzle, which is smeared with oil or Vaseline, is introduced into the rectum. Slowly the can is raised to a height of 3 ft. from the patient and water is allowed to enter the rectum. If the patient feels pain during this process, the height of the can should be reduced and the flow of water stopped for a while. The pain will then subside. The enema can is again raised to 3 ft. Generally 2 to 4 pints of water is injected into the rectum. Great care should be taken to avoid entry of air into the bowels as this may cause severe colic pain. When there is pain due to gases, while giving enema, a gentle massage over the colon region will relieve the same. Large quantities of water should not be injected as this may sometimes cause damaged by distending the colon. The water has to be retained for at least 5 to 10 minutes. The patient should take a short walk while retaining the water and then to the toilet where he should slowly expel the water along with accumulated morbid matter. The patient should not hasten to release all the water at once.
Uses: A warm water enema is helpful in cleansing the rectum of the accumulated fecal matter. This is the safest system known to the medical world for cleansing the bowels. This also improves the peristaltic movements of the bowels and there by relieves constipation. Cold enema at 18°. is helpful in inflammatory conditions of the colon especially in dysentery, diarrhea, ulcerative colitis, hemorrhoids and in fever.Hot enema at 40–42°. is helpful in relieving irritation due to inflammatory pain of the rectum and pain of hemorrhoids. It is also helpful in dysmenorrhea and leucorrhoea. In some cases, where there is an infection in the colon, such as amoebiasis, infective colitis or worm infestation, enema may be administered with neem water (a decoction prepared by boiling neem leaves in water).
Graduated Enema
This is a procedure adopted to discontinue the habit of taking regular enema. On the first day the person is given enema with 3 pints of water at body temperature. On the succeeding days the amount of water is reduced by 1/2 pint per day. During the last 3 days the person may be given enema with 1/2 pint of water just to stimulate the activity of the rectum.
Vaginal Irrigation
It is commonly known as Vaginal Douche. Here water is introduced in the vaginal canal, with very little or no pressure.

Requisites: For giving this application a special type of nozzle is used. This nozzle may be attached to an enema can or to a tube connected to a rubber bag.
Water temperature: cold, neutral or hot.
Procedure: The patient lies on the back with the hips slightly elevated. A proper receptacle is placed to collect the water as it flows out from the vagina. Care should be taken to introduce the nozzle at the back of the uterus and the water circulates through the vagina, bringing all the parts of it under the thermic influence of the application. The reaction occurs not only in the mucous membrane of the vagina, but also reflexively influences the circulation in the pelvic organs.
Cold Irrigation
It is useful in Menorrhagia, especially when there is inflammation in the genital organs. When the cold application is continued for 10 to 15 minutes, it stimulates uterine activity. The cold irrigation is helpful in burning micturation and in reducing irritability of the vaginal canal in urinary tract infections.
Neutral Irrigation
It is said to relax the irritability of the vaginal canal and uterus in conditions like leucorrhoea and vaginal pruritus, especially in diabetes. It is proved in several cases that the application of vaginal irrigation will regulate menstruation when applied along with other treatments like hot hip bath.
Hot Irrigation
Uses: Hot irrigation at 40°C. relieves pain and stimulates blood circulation in diseases like salphingitis, cellulitis, chronic metritis, oopheritis and endometritis. Hot irrigation must be avoided during pregnancy as it may induce miscarriage. But after the beginning of labor, hot irrigation induces prompt dilatation of the cervix. Hot and cold alternate vaginal irrigation is a powerful stimulant for pelvic organs.