The introduction of the tube has to be performed as above stated, when we spoke of the introduction of the tube for the withdrawal of gastric contents for examination. During the introduction of the tube, it is necessary to have the patient hold his head slightly bent forward (as a rule, patients try to throw their heads far back, which is a great obstacle to the entrance of the tube into the oesophagus). The insertion of the tube has to be done quite rapidly. During the entire procedure it is best to have the patient breathe deeply. It is furthermore of importance to hold the tube with the hand not far from the mouth of the patient in order that the apparatus may not move up and down and in this way cause irritation of the stomach and produce nausea and spells of vomiting. In case the outflow of the fluid is suddenly arrested (by food particles obstructing the opening of the tube), a small quantity of water has to be poured in again, and the siphoning repeated. How long and how often the stomach should be washed out is difficult to define. As a rule, this procedure should be kept up until the water returns quite clear. The appearance of blood in the wash-water necessitates the withdrawal of the tubing.

If, however, only a few blood stains are visible in the water, they are of no import, and the lavage can be continued.

1 J. C. Hemmeter: New York Medical Journal, March 80th, 1895.

Indications

Aside from diagnostic purposes lavage must be performed (1) when there is stagnation of food in the stomach; (2) whenever large quantities of mucus are present in the organ.

Contra-Indications

These comprise all conditions in which introduction of the tube is not permissible, as for instance, hemorrhages, ulcer of the stomach, etc.