A 
NEW METHOD 
OF 
RECTAL ALIMENTATION. 
BT 
F. E. STEWART, Ph.G., M.IX, 
NEW YORK. 
Reprinted from The Medical Record, 
January 3, 1880,. 
NEW YORK: 
TROW'S PRINTING & BOOKBINDING~Ca~ 
201-213 East Twelfth Stbelt. 
1880. A 
NEW METHOD 
OF 
RECTAL ALIMENTATION. 
BT 
F. E. STEWART, Ph.G., M.D., 
NEW YOBK. 
Reprinted from The Medical Record, 
January 3, 1880. 
NEW YORK: 
TROW’S PRINTING & BOOKBINDING CO., 
201-213 East Twelfth Stbeet. 
1880. A NEW METHOD OF RECTAL ALIMEN- 
TATION. 
In my article published in New Remedies, Yol. VIII., 
No. 12, entitled “A New Method of Rectal Medica- 
tion,” calling attention to rectal (gelatin) capsules, 
and the oleates of the alkaloids per rectum, the ab- 
sorbent power of the intestinal mucous membrane 
was quite fully discussed. Advantage has long been 
taken of this power for the purpose of alimentation 
as well as medication, and although the rectum as an 
absorbing surface is inferior to the stomach, and for 
obvious reasons not fitted to take its place as the 
organ of digestion, still this power of taking up food 
is of great importance when for any cause the stomach 
is incapable of performing its function. 
For alimentation the rectum can be resorted to as 
an auxiliary organ to the stomach, or it can be used 
for a time as a substitute for it, in supplying the 
system with food. It is to the former we wish to 
call attention, and to desiccated defibrinated blood 
as an agent especially adapted for rectal alimenta- 
tion. 
But, before proceeding, an explanation is necessary. 
For more than a year past the writer has been ex- 
perimenting with defibrinated blood as an aliment in 
disease. The subject was suggested by the popular 
idea that warm, fresh, defibrinated blood, quaffed at 
the butcher’s shambles, is remedial in consumption 
and other wasting diseases. Investigation of this 
singular practice certainly does show that many cases 
are remarkably benefited by it. This, of course, can 
be accounted for in many ways without referring it 
to the blood—the healthy outdoor exercise of a walk, 
or ride, to the abattoir, or diversion of the mind by 4 
so novel a remedy—but it cannot be denied that de- 
fibrinated blood is rich in the elements of nutrition, 
and the resulting benefit of its use is out of propor- 
tion to the novelty of the medicine, or healthy ex- 
ercise in obtaining it. 
To utilize, therefore, what appeared to be a valu- 
able product, a process was devised for drying it, 
quickly to prevent decomposition, and at a low heat. 
After shipping a large invoice of this desiccated blood 
to Detroit, to be used as an aliment, I discovered 
that Dr. A. H. Smith, physician to St. Luke’s Hospi- 
tal, New York City, was also at work with defibri- 
nated blood, and had proved its therapeutic worth in 
more than sixty cases. At my request, Dr. Smith 
substituted the dried article at St. Luke’s, where it is 
now on trial and appears to be of equal worth to the 
blood before preparation. 
This, then, will explain the reason why desiccated 
blood is brought to the notice of the profession as a 
new article for rectal alimentation. 
There are three ways by which blood can be intro- 
duced into the system—per orem, by transfusion, and 
per rectum. The last named seems, for many reasons, 
the least objectionable. Naturally enough, drinking 
blood is disgusting to patients. Transfusion, even 
in the most careful hands, is not devoid of danger. 
But injection per rectum is an easy and safe opera- 
tion, which can be frequently repeated without risk 
of injury. 
Blood per rectum has also the advantage possessed 
by transfusion of not being subject to the changes 
incident to the process of digestion. 
Various articles are used for rectal alimentation— 
milk, albumen, and lately albuminose has been re- 
commended. To be of any use to the system they 
must be taken into the circulation, converted into 
blood, or else substituted for it. Blood is the prod- 
uct of digestion, and it is supposed that before food 
can be converted into blood, the saliva, gastric, pan- 
creatic, and intestinal juices and bile must perform 
their action, absorption must take place, and, finally, 
that wonderful, vital constructive process by which 
the corpuscles are made, and the blood is fitted to 5 
perform its part in nutrition. If this be all true, 
blood cannot be manufactured from these articles 
when injected into the rectum, and their beneficial 
effect must be accounted for in some other way. It 
would seem, therefore, that blood itself, for rectal 
alimentation, if absorbed, would be more suitable to 
meet the wants of the system. 
Blood is the food and air of the tissues. As it is 
the province of the vegetable world to convert the 
elements of surrounding nature into organic forms 
fitted for food, so it is the province of digestion to 
convert food into blood to feed the vital organs. 
Blood is therefore called the vital fluid or the life, 
and its presence in the vital organs is indispensable 
to their function. Only a momentary arrest from 
the brain results in syncope, or fainting away, and 
any organ deprived of it soon loses functional ac- 
tivity. Supplies for the growth and repair of the 
whole body are in the blood. Blood is but the body 
in a liquid state. Being, therefore, perfectly adapted 
to build and construct tissues, and indispensable to 
life, its administration would seem to be indicated 
when tissues are wasted and life is threatened by 
disease. 
Like other vital organs, the nerves depend directly 
on the blood for their functional activity, and depri- 
vation results in morbid phenomena. Close physio- 
logical relations exist between the red globules of 
the blood and the healthy life of the nerves. This 
relation is probably between the hemoglobine—the 
red coloring matter of the blood, which forms the 
principal substance of which the red globules are 
composed (about 25 to 30 per cent, of their weight, 
or 86 per cent, of their solid ingredients)—and the 
nerves. A morbid diminution of the red globules is 
designated anaemia. As the action of every organ in 
the body depends upon the nerves, it naturally fol- 
lows that if they be impaired, there is a general defi- 
ciency of functional energy. All the vital functions 
are languidly performed. The action of the heart is 
feeble, and easily disturbed. Mental energy, strength 
of will, and purpose, are diminished. Neither can 
the action of impaired nerves on the secretory organs 6 
manufacture healthy digestive fluids for the prepara- 
tion of food to be converted into healthy blood, so 
necessary for nerve supply. Then, too, the brain 
sympathizes in this condition, and the mind, becom- 
ing affected, in turn reacts on the nerves to increase 
the disorder. 
Nutrition is directly under nerve control. Every 
secreting cell, every absorbing villi, the inherent 
power of each tissue to select from the blood appro- 
priate matter for its repair, even the muscles for res- 
piration, are supplied by artery and vein, with nerve 
to guide their action, for the purpose of furnishing 
them with blood, to be used for building new tissue, 
and to impart nerve-force to repair that lost in the 
exercise of their functions. 
Desiccated blood is therefore suggested for rectal 
alimentation, when the life-powers are threatened by 
asthenia, due either to loss of blood, loss of nerve- 
power, or to both. It is indicated in all cases where, 
for any reason, digestion is impaired, in cachectic 
states from special constitutional poisons, and in all 
cases when impaired blood, nerves, or digestion 
give rise to the anremic condition, with its resulting 
general debility, hypochondriasis, or other functional 
disorder. 
It is hardly reasonable to infer, and clinical ex- 
perience does not justify us in believing, that blood 
is absorbed from the rectum without a breaking 
down of the corpuscles; but there are good reasons 
to suppose that it enters the system without marked 
chemical change, and it has been satisfactorily proved 
by Dr. Smith, and other scientific physicians, that 
its use is remarkably beneficial to patients. How 
much this is due to the hemoglobine and its action 
on the nerves, remains an interesting matter to de- 
termine. 
Blood for rectal alimentation must be from healthy 
animals. Inflammatory blood from diseased cattle 
wfill not do, or blood from animals fatigued from long 
journeys. None but powerful, vigorous bullocks, 
fed and rested until the heart’s action regains its 
accustomed tone, should be selected for this pur- 
pose. 7 
Killing must be done in a manner to secure healthy 
blood. This can be accomplished only by bleeding 
to death. Striking on the head, or in any other way 
causing death from apnoea, prevents a proper arteri- 
alization of the blood. Blood from animals killed in 
this manner, or the inflammatory blood from diseased 
cattle, is unfit for use in the arts, and therefore must 
be too imperfect for employment in therapeutics. 
Great care also must be taken in the preparation, 
due attention being paid to all chemical and vital 
phenomena. Long exposure to the air in a fluid 
condition, or too high heat, not only decomposes, but 
devitalizes it, and if the heat be raised to 160° F., 
coagulates the albumen. No heat above 110° F. 
should be used in the drying of blood, and the pro- 
cess should be as instantaneous as possible, and with- 
out agitation. 
Desiccated blood, as thus prepared, is completely 
and readily soluble in water at all temperatures be- 
low 160° F., and contains all the elements of blood, 
except water and fibrin. The loss of the latter does 
not seem to impair its nutritive value, being but a 
very small proportion of the nitrogenous constituents 
of the blood. 
A little more than a drachm of the dried article is 
necessary to represent a fluid ounce of blood of ordi- 
nary specific gravity, but it is sufficient to remember, 
in using, to employ a drachm to the ounce of water. 
To dissolve, it should be thrown into water, and al- 
lowed to stand until the albumen becomes perfectly 
soft, to prevent sticking to stirring-rod or dish. 
Gentle agitation will then convert it into a perfectly 
homogeneous fluid, closely resembling fresh blood. 
It is a very difficult matter to dissolve dried blood by 
pouring water upon it, for it immediately adheres to- 
gether in lumps, and sticks to everything brought 
into contact with it. 
From four to six drachms of the powder daily, or 
more, is the dose, which may be given at once, at bed- 
time, or in divided portions during the day, as cir- 
cumstances seem to require. 
If a greater amount than can be absorbed be in- 
jected at once, and decomposition result therefrom, 8 
it is advised to wash out the rectum with tepid water 
before continuing the medication. 
For further information on this subject, the reader 
is referred to Dr. Smith’s paper, read before the New 
York Academy of Medicine, to his paper before the 
Therapeutical Society, and to the minutes of these 
respective societies for their action in the matter. 
The Medical Record and New Yorlc Journal have 
reported on these papers, and are also referred to as 
containing very nearly as full information.