Diseases of the anus and rectum, Volume 2 (Google eBook)

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Longmans, Green, 1905 - 271 pages
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Page 159 - Wells' rectangular pressure forceps are applied, one on one side, and one on the other side, of the gut. When the rectum is removed on the distal side of the clips, a stout ligature is then passed beyond the rectangular part of the clip, and is tightly tied as the clip is slowly slackened. The same is done with the other clip. This secures any large superior haemorrhoidal vessels that there may be in the cut end of the gut. There is generally little bleeding, because the inferior haemorrhoidal vessels,...
Page 158 - In our modification of this, the first finger of the left hand is put into the bowel, and a sharp-pointed bistoury is introduced through the skin a little below the anus, making it travel in the cellular tissue up to the top of the growth, but entirely outside the rectal tube.
Page 159 - Now, with the finger in the rectum and the thumb in the cut, one blade of a pair of long, blunt-pointed scissors is pushed into the posterior cut, and the other blade into the cellular tissue of the ischio-rectal fossa. After this, one cuts through all the cellular tissue between the blades, and repeats this proceeding on the other side, keeping the finger of the left hand in the rectum while the left side is being incised, and the first finger of the right hand while the right side is being cut....
Page 156 - The whole of the intervening tissue between this part and the margin of the anus is cut through. If this cut be made with a clean sweep, as near as possible in the middle line, little haemorrhage will result. The left hand of the operator is now placed on the right side of the buttock, so as to draw the anus outwards and stretch the tissues at the line of junction of the mucous membrane with the skin. The portion of the rectum or anus through which the lateral incision is to be made must depend upon...
Page 33 - Chloro- in chiiform should be given, and the protruded gut well dried. The acid must be applied all over it, care being taken not to touch the verge of the anus or the skin. The part is then to be oiled and returned, and the rectum stuffed with wool.
Page 156 - ... membrane with the skin. The portion of the rectum or anus through which the lateral incision is to be made must depend upon the distance from the anus of the lower margin of the disease, and, if possible, should be at least half an inch from the growth.- The point being selected, the knife is made to cut deeply by using firm pressure, a crescentic incision extending from the margin of the first cut round the anus to a point in the middle of the anterior margin. This cut should be made boldly,...
Page 35 - ... We then, having the intestine held firmly out, with the iron cautery at a dull red heat, \ make four or more longitudinal stripes from the base to the apex of the protruded intestine, taking care not to make cauterization so deep towards the apex as at the base, because near the apex the peritonaeum may be close beneath the intestine, while a deep burn near the base is not dangerous. One should avoid the large veins which can be seen on the surface of the bowel. If the procidentia be very large,...
Page 19 - Showing ulceration at the apex of the protrusion. For instance, Copeland* makes the following statement : " In almost every case of prolapsus ani, it is the internal membrane only of the intestine which descends through the sphincter muscle.
Page 257 - ... passed. 4. That there is constant pain or discomfort in the rectum, and sometimes also in the adjacent parts, from the time of puncture until the foreign body has been removed. 5 That the site of...
Page 257 - That the pain in the rectum comes on suddenly while the motion is being passed. 4. That there is constant pain or discomfort in the rectum, and sometimes also in the adjacent parts, from the time of puncture until the foreign body has been removed.

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