F. temperature, were allowed to pass into the bowels; and after being retained for five or ten minutes, or until the patient experienced uncomfortable sensations, it was made to pass out through the tube by simply lowering the reservoir to the level of the floor.  A new supply of water of a proper temperature being introduced into the reservoir, it was again raised to the proper height, and the operation so continued until six quarts of water had been used.  Then the patient was allowed to rest half an hour or an hour, according to the height of the fever, and the same process was repeated.  Careful record was made of the temperature of the patient just before the treatment and immediately after.  It was found to be invariably reduced from one to one and a half degrees by each treatment.  The temperature, which had been exceedingly obstinate previous to the employment of this method, ranging from 104 deg. to 105 deg., during the intervals between the treatments would, of course, rise somewhat; but each time it stopped short of the point reached during the previous interval, so that in the course of a few hours the fever was brought down to very nearly a normal temperature.  The temperature of the water, when taken after passing through the bowels, was found to have risen each time from 10 deg. to 13 deg..

The great capacity of water for absorbing heat renders it one of the most useful of all substances for lowering the temperature; and it is readily apparent that, by the means described, heat may be abstracted from the body almost ad libitum, and the temperature may thus be controlled with a rapidity and a degree of certainty which cannot be approached by any other method.  In a still more recent case, in which the same treatment was employed, the temperature of the patient had reached 106 deg.  F., in spite of the vigorous application of ordinary measures of treatment, such as cold compresses, etc.; but it was, in four or five hours, brought down to nearly 100 deg. by the use of the cold enemas.

The advantages of this method are:  1.  It may be employed without wetting or moving the patient; very frequently a patient will sleep continuously during the administration of the treatment. 2.  It seldom causes chilliness, which is frequently a disturbing symptom, especially in fevers of a low type, and even, when the temperature is alarmingly high, causing the patient to dread the employment of sponging with cool or tepid water. 3.  It is not necessary to employ cold water, a temperature of 80 deg. or even 85 deg. being thoroughly efficient.  In the majority of cases, however, water of 70 deg. or even 60 deg. may be employed without danger.  The water comes in such immediate contact with surfaces filled with large blood-vessels that a temperature but a few degrees below that of the body is more effective than very much colder water applied to the surface.

In cases in which the use of the cool enema is attended by chilliness, this uncomfortable symptom may usually be relieved by the application of a hot bag or fomentations to the spine or to the pit of the stomach.