We should remember that ulcerative proctitis and colitis have made the use of the enema a necessity; that, accordingly, the diseased, constricted gut or canal must be treated very gently and not irritated in any avoidable way. The least irritation will result in still greater muscular contraction. It stands to reason that the effort to reach the healthy portion of the bowel with a slightly flexible colon tube frustrates its own purpose, and that it is besides a source of serious and unnecessary irritation. While this rubber tube is being forced up one’s bowels it often becomes lodged here and there in the valves and folds of the mucous membrane. It has been found that the effort used to dislodge it sometimes results in a doubling of the tube on itself in the form of a knot, and that the end first introduced comes back to the anus waiting to escape with the next push! We need not argue that this forced looping and knotting of the tube is very injurious to the diseased intestinal region, and that no one would care to introduce it two or three times a day. Does not common sense suggest that the rational way is to open the bore of the alimentary canal by beginning at its _end_; that _liquid_ should be applied directly to the first feces encountered, and that as this impacted mass is removed the progress should be successfully upward? The liquid as it enters dilates the channel, and as it passes on and up it eventually gets beyond the diseased section of the bowels. Here, by a gentle and soothing dilatation, we create at once an impulse in the imprisoned feces and gases to descend and escape. What other method is so kindly, and yet so effectual? We avoid, by this means, irritating the diseased and constricted muscular canal; whereas by the tube method we occasion still greater contraction, the inflamed surface having a tendency to contract and close tightly over the tube. The flood of liquid dilates the canal; whereas the forced rubber tube, by irritation, contracts it. Besides, as has been pointed out, the conduct of the tube working in the dark is most uncertain. Suppose the rubber tube does finally reach the section of the colon free from inflammation; that its passage thither has greatly increased the spasmodic contraction of the diseased portion of the gut, and that, of course, it had great difficulty in circumventing the resistance offered by the valves, curves, and short bends--suppose all this, and an idea of how the contents of the bowel above the diseased zone are imprisoned will dawn upon you. For, after the tube has reached this point of impaction, the distention there is most unduly increased by the sudden gush of water, and, what is of still graver import, the presence of the tube prevents its return flow. Then as the object is being removed the watery feces following closely after are impeded by the increased irritative contraction set up by the tube.