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58 Mechanism of action : mechanical removal of feces; strengthening peristaltic of the intestine. Indications: no effect of cleansing enema, relaxing enema, taking laxatives; poisoning; suspicion of intestinal obstruction (the absence of gas bubbles in the wash water confirms the suspicion). Contraindications are the same as with a cleansing enema. Equipment: funnel 1 l, intestinal tube, control glass connecting tube; 10–12 l of water (temperature 36 °C), bailer, basin, oilcloth, vaseline, spatula, gloves, apron, diaper. The sequence of actions in performing a siphon enema 1. Lay on the couch oilcloth, then a diaper, ask the patient to lay on the left side, put on an apron, gloves, smear intestinal tube with vaseline. 2. Your helper holds the funnel lower patient’s knees. 3. Withyour left hand, spread thebuttocks, andby the right one enter the intestinal tube 3–4 cm to the navel, then up to 30 cm parallel to the sacrum (Fig.24). 4. Pour 1 l of water into the funnel and, holding obliquely, slowly lift it above the patient. 5. As soon as the water reaches the narrow part of the funnel, lower the funnel below the patient and wait for the funnel to be filled with washing water. 5. Drain the contents of the funnel into the basin and pour 1 liter of water into the funnel again. 6. Repeat steps 6,7,8 points until you use all the water (at least 10 liters). 7. If the procedure is not effective, continue rinsing until clean wash water. 8. After the procedure, remove the funnel, remove the intestinal tube. 9. Immerse the device in a 3% chloramine solution for 1 hour. 10. Take the patient to the ward. Hypertonic enema refers to a laxative type of enema. Due to its osmotic action promotes the release of water from the tissues into the lumen of the rectum. Oil enema . It is a kind of laxative enema and is appointed when undesirable muscle tension of the abdominal wall and perineum. After the oil enema, bowel emptying occurs after 10 to 12 hours. Medicinal small enema can be used to administrate drugs for local effects on the mucosa of the lower part of the colon (sea buckthorn oil, chamomile extract) and for the resorptive effects on the body (drugs of digitalis, chloralhydrate, etc.). Flatus tube  is soft thick-walled rubber tube, length 30–50 cm, diameter 3–5 mm, one end is rounded and has holes, the second one is cut obliquely