Diseases of the Rectum and Anus

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W. Wood & Company, 1882 - Intestine, Large - 299 pages
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Page 29 - From a study of the literature of this question, and from the results of dissections and experiments which we have personally been able to make, we are led to the following conclusions: 1. What has been so often and so differently described as a third or superior sphincter ani muscle is in reality nothing more than a band of the circular muscular fibres of the rectum.
Page 32 - The anus is normal in appearance, but ends in a cul-de-sac, and the rectum ends in a blind pouch at a variable distance above this point.
Page 105 - ... is very slight. There are no objections to this method which do not apply equally to others. He has once seen considerable ulceration result from it in the hands of another ; but he has seen an equal amount follow the application of the ligature ; and he does not consider this as a danger greatly to be feared when injections of proper strength are introduced in the proper way.
Page 234 - Although there have been a few cases of cure, such a result is so rare as not to justify the exposure of the patient to the risk of immediate death which attends the attempt to remove extensive cancerous disease.
Page 51 - October, 1881, which contains several valuable suggestions and the description of some methods which are original. After referring to the many errors which arise in this department of surgery from the lack of care and proper examination, he goes on to answer the question of how to make a rectal examination which shall be at the same time thorough and as free from pain as possible. In his own practice he uses an artificial light of his own arrangement and a forehead mirror, which enable him at all...
Page 18 - ... she was free from pain in the foot in the morning ; that the pain attacked her as soon as the first evacuation of the bowels had occasioned a protrusion of the piles ; that it was especially induced by an evacuation of hard faeces; and that if she passed a day without any evacuation at all the pain in the foot never troubled her. Having taken all these facts into consideration, I prescribed for her the daily use of a lavement of cold water ; that she should take the Ward's paste (confectio piperis...
Page 174 - ... cancer. The patient will tell you that the instant he gets out of bed he feels a most urgent desire to go to stool ; he does so, but the result is not satisfactory. What he passes is generally wind, a little loose motion, and some discharge resembling "coffee grounds " both in colour and consistency ; occasionally the discharge is like the " white of an unboiled egg "or " a jelly-fish ;
Page 175 - After this condition has lasted for some months, more or less, as influenced by the seat of the ulceration and the rapidity of its extension, the patient begins to have more burning pain after an evacuation, there is also greater straining and an increase in the quantity of discharge from the bowel ; there is now not so much jelly-like matter, but more pus— more of the coffeegrounds discharge, and blood.
Page 40 - ... trocar as an aid in finding the rectal pouch before or after incision through the perineum is not sanctioned by modern surgical authority. (4) The results of attempts to establish an outlet for an imperforate rectum through the perineum are not favorable as regards the production of a useful anus. (5) In case of failure to establish a new anus in the anal region, colostomy should at once be performed.
Page 26 - He says the faeces, in their passage through the colon, are lodged in the sacculi during the pauses between the peristaltic waves. Arrived at the sigmoid flexure, they are supported by the bladder and the sacrum, so that they do not press on the sphincter ani. Defecation is a composite act, being superficially the result of an effort of the will, and yet carried out by means of an involuntary mechanism. The voluntary effort is composed of two factors — a pressure effect produced by the contraction...

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