{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T10:56:14Z","timestamp":1756810574193},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:00:00Z","timestamp":1612915200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>From the 1870s through the early 20th century, physicians frequently relied upon nutritive enemata to succor patients suffering from bowel obstructions and other disorders of the gastrointestinal system. Far from extraordinary or outlandish, this therapy was used on paupers and presidents alike, including on Garfield and McKinley after their assassination attempts. The medical milieu of the late 19th century provided particularly promising circumstances for its practice, with the rise of allopathic medicine generally\u2014and surgery especially\u2014coinciding with flourishing research on the physiology of nutrition. Although ongoing discussions debated the merits of different methods and various ingredients, few in the United States or Europe doubted the efficacy of rectal alimentation. However, in the early 20th century, new studies utilizing biochemistry demonstrated the inability of such instillations to provide significant calories or protein, and the intervention fell from favor. Proctoclysis\u2014or rectal hydration\u2014remained standard of care for the next 20 years, strongly supported by John B. Murphy and other surgeons. Ultimately, intravenous hydration and, much later, total parenteral nutrition replaced the rectal route.<\/jats:p>","DOI":"10.1097\/as9.0000000000000039","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T01:52:17Z","timestamp":1614131537000},"page":"e039","update-policy":"http:\/\/dx.doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Bottoms Up: A History of Rectal Nutrition From 1870 to 1920"],"prefix":"10.1097","volume":"2","author":[{"given":"Justin","family":"Barr","sequence":"first","affiliation":[{"name":"Department of Surgery, Duke University, DUMC 3443, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie B.","family":"Gulrajani","sequence":"additional","affiliation":[{"name":"Trinity College of Arts and Sciences, Duke University, Durham, NC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Hurst","sequence":"additional","affiliation":[{"name":"Trinity College of Arts and Sciences, Duke University, Durham, NC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodore N.","family":"Pappas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Duke University, DUMC 3443, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,3]]},"reference":[{"key":"R1-20241014","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.amjsurg.2013.02.007","article-title":"Did James A. 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