Herbal-enema colitis and stricture

Herbal enemata are an integral part of traditional African medicine, particularly amongst the Nguni-speaking ethnic groups of southern and east Africa. The constituents of the herbal concoction may include the bark of the marula tree and the Rhodes' violet, the fruit of the Cucumis africanus, various wild herbs, industrial thinner, turpentine, undiluted Dettol, ginger, pepper, soap and finely ground ash (Van Der Horst, 1964; White, 1968). A mixture of herbs boiled with blue-stone (copper sulphate) is considered beneficial for ailments of the bladder and rectum (Collenbrander, 1978). The fluid mixture is introduced rectally by one of a variety of implements including the sawn-off tip of a cow's horn, a hollowed-out reed, a narrow-necked gourd and, more recently, a conventional Higginson-type syringe (Bremner, 1964). The enema is usually self-administered, except in the case of infants, children, the elderly and the infirm, when it is introduced by a relative (Collenbrander, 1978).