Saturday, November 12, 2016

A Shocking Enema Known as the Harris Flush

Before the advent of TPN and tube feedings there were enemas for nourishment, Avertin or pentothal enemas produced anesthesia (Abbot actually produced a prefilled pentothal rectal syringe and it was not prudent to confuse it with a Fleets,) stimulant enemas of various caffeinated beverages  were also used. Would you like cream and sugar in your coffee enema? Neomycin antibiotic enemas were commonly used before prostate biopsies or intestinal surgery, and Kayexelate enemas were a very messy way of reducing blood potassium levels. Anthelmintic enemas were used against pinworms and sometimes included a secret ingredient (dilute turpentine.)

I'm certain I have forgotten some types of these backward treatments, but there was an enema for just about any ailment. Old time nurses often had special enema recipes that they guarded with as much vigilance as a restaurant would with a specialty entrée recipe. When the time tested enema can was replaced by the clear, disposable plastic bag enema in the early 1970's, old nurses were mesmerized by the visible rise and fall of the solution with the patient's respirations. You could not see this phenomenon with the opaque metal can and old nurses thought that watching the enema solution oscillate in the bag with inhalation and exhalation  was more fascinating than open heart surgery.

Carminative or anti-gas enemas were in a class by themselves and this is the procedure for  a "Harris Flush Enema"  as described in a 1930's  AJN article. We did a similar procedure sans the electric light bulb as a heat source and called it a "tidal wave enema." The enema bag was alternately raised and lowered so the solution flowed in and out of the colon. The degree of browness in the enema bag served as a visual indicator of the in and out flow of the solution.  Bubbling in the enema tube or bag was also a good sign that gas was being expelled. Some patients experienced "blowouts" where by the gas was blasted past the inserted rectal tube with frequent unpleasant (for the nurse) results.

The thought behind the heating of the solution was that if maintained at body temperature or above, the enema set up could remain in place for an extended period of time allowing the patient to expel gas. Old time abdominal surgeries disrupted peristalsis and pain from retained gas could be severe. Here is the procedure as outlined by the old AJN, I have inserted a few editorial comments in italics.

                                                          THE HARRIS DRIP
Purpose: To carry off gas and waste

3 feet rubber tubiing
Irrigating can
Rectal tube with Vaseline ( I guess lubafax was yet to be invented. We received demerits if Vaseline got anywhere near rubber tubing because it caused deterioration and could bankrupt the hospital and don't even think about using a pair of  those budget busting gloves!)
Emesis Basin
Extension cord and light (This is where it gets interesting)
1 inch strips to tie the electric light
2 Large safety pins
Fire extinguisher (I added that one. Better to be safe than sorry)

Procedure: Connect the tubing and the rectal tube with the can and clamp off.
Put onto the can sodium bicarbonate 6 drams; water to make 40oz

Place the can on the bedside table. Allow air and solution to run out of the tubing into the emesis basin. Lubricate the end of the rectal tube and introduce it into the rectum.
Remove the clamp.
Raise the can and allow the solution to flow into the rectum. Lower the can about 1 foot and allow the fluid to run back into the can. Gas will also return. Repeat several times.
See that the tubing does not dip down off the bed; it may be held in place by pinning it to the muslin draw sheet.
Place the electric-light bulb in the solution so the metal part does not become wet. (sounds like a good tip, might want to have consult for the burn unit and an anal plastic surgeon as well.)
Place the plug in the wall outlet and turn on current.
Cover the can and electric light bulb with a towel.

Points to remember:
Change the solution as often as it becomes soiled.
Keep at an even temperature.

I think a better name for this procedure would be lightening in an enema can. One false move with that light bulb and it's a tossup; which is a greater risk electrocution or a rectal infusion containing broken glass?


  1. We didn't do the light bulb thing, but I definitely remember Harris Flushes! Awful for both the pt. and the nurses!
    Thanks for the memories Not)!

  2. (In Denmark;) - We used to give soap-water enemas to the women when they came in at the labour-unit (2000- yes 2000 Mililiters of lukewarm water - and 5 tablespoons of soapflakes) - we made it ourself until 2006 - because our matron thought it was cheeper(it was) - and actually the patients that have given birth at another hospital said that it was less painfull than the Fleet-type enemas :) ... also at "old people" we (still make) a supp. of unperfumed handsoap if they have a "ligther problem" - very effective actually...
    Reguards :)

  3. My only OB experience was as a student, but everyone admitted to labour received a 3H enema. High, hot, and a heckuva lot. It never made much sense to me to force something into someone attempting to force something out. Thanks for your interesting comment.

    1. I called it a 5H enema to mess with the older nurses. High, hot, heckuva lot, and hold it till ya holler.

    2. Yes. 40 years ago they gave me an enema right before I had my daughter. They said they do it to make sure you don't poop when you deliver your baby. lol.

  4. My mother was surprised to hear that you don't get enemas anymore for giving birth. Now if you have to squirt one out when you're groaning about the joys of having children, they just use pooper scooper, wipe your ass and keep on going...

  5. 9/9/18: yeah, I remember my nsg school days & OB/LD rounds (89-91). No one ever tells first time moms .. much to their humiliation & embarrassment .. that labor contractions along with pushing EXPEL EVERYTHING. We were taught in the lab how to give Harris flushes, but I never gave one. I did have the opportunity to experience one myself in June 1986, after I had a TAH. (No electrical equipment involved!) I can say it helped immensely. Not as barbaric as some think. Google Harris flush & you'll see Medtronic & other companies are still selling the kits for $90-$115.

  6. You are a mere youngster, Laura, you were in nursing school decades after me. L&D seems so much more civilized today with epidurals and C-sections for problems instead of brutal forceps deliveries.

    When there were few cures available for terrible diseases, nursing "comfort" measures like enemas became popular. I should do a post on the various concoctions used for solutions but I have an innate aversion to even thinking about enemas. It's a very popular google search item and I probably could gain some readers of my foolishness, but at my age, I'm happy if just one person indulges in my foolishness. Thanks for reading!

  7. I got a Harris Flush after my surgery. Immediate relief from that unbearable has pain!!!! Great nurse and I would let her do it again if necessary!!!!!

    1. Enemas were an integral component of old school nursing measures. They were on their way out when I entered nursing, but the stories from the greatest generation were classic.

  8. We called them barnyard deliveries when baby and poop both came out! 😄As long as the baby arrived we didn’t care....

    1. Labor and delivery was one of my least favorite specialties. 3H enemas were thought to promote labor and were widely used. The poor patients were in enough distress without introducing anything else into the pelvis. I can still hear all those pitiful shrieks and screams.

  9. We called them barnyard deliveries when baby and poop both came out! 😄As long as the baby arrived we didn’t care....

  10. Never heard of the Harris Flush, but I had something similar done to me. I had gallbladder surgery in the mid-1980s. I experienced a lot of discomfort from gas a day later, so bad it was pressing out on my incision. The nurse used this thing called a flatus bag. She stuck a tube up my rectum for what felt like half a mile, and taped in place until the gas bled off into the bag. It didn't hurt, but was severely embarrassing having to lie there with a tube up my butt and my wife snickering at the whimsical sounds of gas opening the valve inside the bag. I did get relief though.

  11. I'm glad that worked for you. Nurses from my generation definitely had a bowel fixation that I could never really understand or embrace. There were BM lists that were as carefully monitored as Swan-Ganz catheters and a gazillion different enema recipes.

    Today, thanks to laparoscopic techniques, cholecystectomy is so much easier. Waiting for peristalsis to resume after big open surgeries was a real bummer as you can attest.

    Thanks so much for perusing my foolishness. Comments always make my day!