Diseases of the Anus and Rectum, Part 2

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Longmans, Green, 1905
 

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Pàgina 158 - ... Verneuil should be made. The usual way is, on the finger, to pass a bistoury into the rectum as far as the upper limit of the growth, and then to cut right down to the sacrum and tip of the coccyx, dividing the entire bowel dorsally. 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...
Pàgina 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.
Pàgina 156 - The left forefinger being passed into the rectum, feels for the tip of the coccyx, the curved bistoury, held in the right hand, is passed into the bowel, the point being guarded by the finger-nail ; the handle of the knife is then raised, and, with a little jerk, the point is made to protrude through the skin on a level with the tip of the coccyx and exactly in the middle line. The whole of the intervening tissue between this part and the margin of the anus is cut through. If this cut be made with...
Pàgina 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....
Pàgina 33 - Chloroform 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 thoroughly with wool. A pad must after this be applied outside the anus, and kept firmly in position by strapping-plaster, the buttocks being by the same means brought closely together.
Pàgina 223 - ... they may be considered in the same class of growths as ordinary angiomata. These lesions, like the seborrheic warts, are most frequently situated on the chest, abdomen and back, often very abundantly about the shoulders. The latter lesions sometimes show a bandlike management (Fig. 119). They vary in size from a quarter of an inch to one inch in their long diameter. At first they are light brown in color, but later they become gray or brownish black. The surface is scaly and slightly granular....
Pàgina 156 - The lite of this incision, whether inside or outside the anus, will depend upon the location of the disease, and whether or not the anus is implicated. The cut itself should be made boldly, and deep enough to reach well into the fat of the ischio-rectal fossa. The forefinger in this incision will readily separate the bowel from the surrounding tissue, except at the attachment of the levator ani muscle, which should be divided with the knife or scissors. A piece of sponge is pressed into this cut...
Pàgina 35 - ... 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, as many as six stripes may be made ; the intestine is then oiled and returned within the anus. Having done this, we partially divide the sphincters on both sides of the anus with a sawing motion of the hot iron, and then insert a small portion of oiled wool.
Pàgina 257 - ... 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...
Pàgina 159 - With the finger still in the bowel, and the thumb outside it, one can tell by the amount of the wall of the gut between finger and thumb how near to the rectum one is cutting. If the scissors are kept touching the thumb-nail, and the rectum is drawn backwards while the cut is made, there is no danger of wounding the urethra or bladder, or of incising the bowel.

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