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Murphy drip

Murphy drip

Overview

A Murphy drip is a rectal infusion apparatus to administer the medical procedure of proctoclysis, also known as rectoclysis. During the procedure, an end of the Murphy drip is inserted into the rectum
Rectum
The rectum is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. The human rectum is about 12 cm long...

 and large quantities of liquid are infused into the rectum drop-by-drop. Prior to fluids or medicines being given intravenously, the Murphy drip and hypodermoclysis were the prime routes to administer fluids such as for replacement
Fluid replacement
Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced via oral administration , intravenous administration, rectally, or hypodermoclysis, the direct injection...

 when patients could not be fed by mouth.
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Encyclopedia

A Murphy drip is a rectal infusion apparatus to administer the medical procedure of proctoclysis, also known as rectoclysis. During the procedure, an end of the Murphy drip is inserted into the rectum
Rectum
The rectum is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. The human rectum is about 12 cm long...

 and large quantities of liquid are infused into the rectum drop-by-drop. Prior to fluids or medicines being given intravenously, the Murphy drip and hypodermoclysis were the prime routes to administer fluids such as for replacement
Fluid replacement
Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced via oral administration , intravenous administration, rectally, or hypodermoclysis, the direct injection...

 when patients could not be fed by mouth. Wisconsin
Wisconsin
Wisconsin is one of the fifty U.S. states. Located in the north-central United States, Wisconsin is considered part of the Midwest. It is bordered by Minnesota to the west, Iowa to the southwest, Illinois to the south, Lake Michigan to the east, Michigan to the northeast, and Lake Superior to the...

 surgeon John Benjamin Murphy
John Benjamin Murphy
John Benjamin Murphy, born John Murphy , was an American physician and abdominal surgeon noted for advocating early surgical intervention in appendicitis appendectomy, and several eponyms: Murphy’s button, Murphy drip, Murphy’s punch, Murphy’s test, and Murphy-Lane bone skid...

 introduced the drip method of saline infusion per rectum in the treatment of peritonitis.

History


The Murphy drip was invented by Wisconsin
Wisconsin
Wisconsin is one of the fifty U.S. states. Located in the north-central United States, Wisconsin is considered part of the Midwest. It is bordered by Minnesota to the west, Iowa to the southwest, Illinois to the south, Lake Michigan to the east, Michigan to the northeast, and Lake Superior to the...

 surgeon John Benjamin Murphy
John Benjamin Murphy
John Benjamin Murphy, born John Murphy , was an American physician and abdominal surgeon noted for advocating early surgical intervention in appendicitis appendectomy, and several eponyms: Murphy’s button, Murphy drip, Murphy’s punch, Murphy’s test, and Murphy-Lane bone skid...

, for the purpose of administering a proctoclysis for hydration
Rehydration
Rehydration is the replenishment of water, or water and electrolytes, lost through dehydration.In humans, methods of rehydration include oral rehydration therapy or intravenous therapy. As oral rehydration is less painful, less invasive, less expensive, and easier to provide, it is the treatment...

 and replenishment of electrolyte
Electrolyte
In chemistry, an electrolyte is any substance containing free ions that behaves as an electrically conductive medium, usually when in a solution...

s, via a sodium
Sodium chloride
Sodium chloride, also known as salt, common salt, table salt, or halite, is an ionic compound with the formula NaCl. Sodium chloride is the salt most responsible for the salinity of the ocean and of the extracellular fluid of many multicellular organisms...

 and calcium chloride
Calcium chloride
Calcium chloride, CaCl2, is a common salt. It behaves as a typical ionic halide, and is solid at room temperature. It has several common applications such as brine for refrigeration plants, ice and dust control on roads, and in concrete...

 solution. This would be used when administration by mouth was not possible because of the condition of the patient. The Murphy drip was described in the April 1909 issue of the Journal of the American Medical Association
Journal of the American Medical Association
JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association...

. By as early as July 1928, the Murphy drip was considered an auxiliary method of injection behind intravenous therapy
Intravenous therapy
Intravenous therapy or IV therapy is the giving of liquid substances directly into a vein. It can be intermittent or continuous; continuous administration is called an intravenous drip. The word intravenous simply means "within a vein", but is most commonly used to refer to IV therapy...

 and subcutaneous injection, the two principal methods of injection
Injection (medicine)
An injection is an infusion method of putting fluid into the body, usually with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body...

 at that time.



The Murphy drip can be used for administering drugs by this route and the apparatus is also used in conjunction with a catheter
Catheter
In medicine a catheter is a tube that can be inserted into a body cavity, duct or vessel. Catheters thereby allow drainage, injection of fluids or access by surgical instruments. The process of inserting a catheter is catheterization. In most uses a catheter is a thin, flexible tube , although...

 for bladder
Bladder
Bladder may refer to:* A bladder is a pouch or other flexible enclosure with waterproof or gasproof wallsIn Anatomy:*Urinary bladder, which collects urine for excretion*Gall bladder, which stores bile for digestion...

 irrigation.
The term can even be applied to apparatus used to administer fluids intravenously.

A curious anecdote involving the Murphy drip is related by Walter Lord
Walter Lord
Walter Lord was an American author, best known for his documentary-style non-fiction account A Night to Remember, about the sinking of the RMS Titanic.- Early Life :...

 in his book on the Battle of Midway
Battle of Midway
The Battle of Midway is widely regarded as the most important naval battle of the Pacific Campaign of World War II. Between 4 and 7 June 1942, approximately one month after the Battle of the Coral Sea and seven months after Japan's attack on Pearl Harbor, the United States Navy decisively defeated...

. On 4 June 1942 Pharmacist's Mate Edwin Miller was stationed on Sand Island (part of the Midway Atoll
Midway Atoll
Midway Atoll is a 2.4 mi² atoll located in the North Pacific Ocean , about one-third of the way between Honolulu and Tokyo. Midway Atoll is an unorganized, unincorporated territory of the United States...

) and was making ready for the expected Japanese attack. Miller prepared undrinkably strong coffee which, he claimed, was to be used in an "old fashioned
Coffee enema
Coffee enemas are the enema-related procedure of inserting coffee into the anus to cleanse the rectum and large intestines. This procedure, although well documented, is considered by most medical authorities to be unproven, rash and possibly dangerous...

" treatment for shock - administration of strong coffee through the rectum via a Murphy drip. When the attack got underway, Miller was joined by his commanding officer and doctor in charge, Lieutenant Commander A. E. Ady, who did not appear to know the medical purpose of the coffee and asked for some to be poured. Miller thought that it would be amusing to let his commander drink it, but made the mistake of also drinking some himself. Dr. Ady continued to tell jokes throughout the attack. Miller, however, paid for his practical joke and was sick.

Set up


A description of a Murphy drip set up is contained in the 1932 Kansas Supreme Court
Kansas Supreme Court
The Kansas Supreme Court is the highest judicial authority in the state of Kansas. Composed of seven justices, led by Chief Justice Robert E. Davis, the Court supervises the legal profession, administers over the judicial branch, and serves as the state court of last resort in the appeals...

legal case, Ratliffe v. Wesley Hospital and Nurses' Training School:
On February 14, 1929, "Dr. Horn directed the nurse to use the proctoclysis, known as the “Murphy drip.” While the operation was in progress a student nurse in the employ of the hospital prepared the room for the return of the appellant. The proctoclysis set was a part of the equipment of the hospital and was assembled and placed at or near the foot of the bed by the student nurse. The proctoclysis set consists of a standard which is an iron pole setting on a tripod containing hooks at intervals, and on these hooks by means of a chain, tape, string, or piece of gauze is hung a can containing hot water and soda solution. From this can a tube extends which is inserted in the rectum of the patient to whom the proctoclysis is administered. It was necessary to keep the solution hot in order that it would have a body temperature after dropping through the tube and entering the body. ... It was not unusual for the vessel holding the water to be fastened to the standard by gauze, string, or other bandage, although a part of the vessels were equipped with chains."