Murphy drip
Encyclopedia
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
Hypodermoclysis
Hypodermoclysis, which can also be called interstitial infusion or subcutaneous infusion, is the subcutaneous administration of fluids to the body. This would often be in the form of a saline or glucose solution....
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 a U.S. state located in the north-central United States and is 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 north. Wisconsin's capital is...
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
Saline
Saline may refer to:* Salinity, the salt content of a solution** Saline water, water containing significant concentration of salts* Soil salinity, salt content of soil* Saline , a liquid with salt content to match the human body...
infusion per rectum in the treatment of peritonitis
Peritonitis
Peritonitis is an inflammation of the peritoneum, the serous membrane that lines part of the abdominal cavity and viscera. Peritonitis may be localised or generalised, and may result from infection or from a non-infectious process.-Abdominal pain and tenderness:The main manifestations of...
.
History
The Murphy drip was invented by WisconsinWisconsin
Wisconsin is a U.S. state located in the north-central United States and is 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 north. Wisconsin's capital is...
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 and replenishment of electrolyte
Electrolyte
In chemistry, an electrolyte is any substance containing free ions that make the substance electrically conductive. The most typical electrolyte is an ionic solution, but molten electrolytes and solid electrolytes are also possible....
s, via a sodium
Sodium chloride
Sodium chloride, also known as salt, common salt, table salt or halite, is an inorganic 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 salt of calcium and chlorine. It behaves as a typical ionic halide, and is solid at room temperature. Common applications include brine for refrigeration plants, ice and dust control on roads, and desiccation...
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
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...
. 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 infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...
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.
Catheter
In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...
for bladder
Bladder
Bladder usually refers to an anatomical hollow organBladder may also refer to:-Biology:* Urinary bladder in humans** Urinary bladder ** Bladder control; see Urinary incontinence** Artificial urinary bladder, in humans...
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
John Walter Lord, Jr. , 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 six 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 atoll in the North Pacific Ocean, near the northwestern end of the Hawaiian archipelago, about one-third of the way between Honolulu, Hawaii, and Tokyo, Japan. Unique among the Hawaiian islands, Midway observes UTC-11 , eleven hours behind Coordinated Universal Time and one hour...
) 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 potentially 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 CourtKansas Supreme Court
The Kansas Supreme Court is the highest judicial authority in the state of Kansas. Composed of seven justices, led by Chief Justice Lawton Nuss, 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."