Practical remarks upon stricture of the rectum, especially in relation to its connexion with fistula in ano, and ulceration of the bowel, with a new and improved form of bougie for the treatment of this affection / by Jolliffe Tufnell.

  • Tufnell, Jolliffe.
Date:
1860
Catalogue details

Licence: Public Domain Mark

Credit: Practical remarks upon stricture of the rectum, especially in relation to its connexion with fistula in ano, and ulceration of the bowel, with a new and improved form of bougie for the treatment of this affection / by Jolliffe Tufnell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    place, allude. The diet should be varied in kind, but limited in quantity. This is the great secret. The digestion in these cases is weak, and any matters passing undigested, decom- posing in the alimentary canal, will give rise to distention of the bowels from flatulence, and occasion excessive uneasiness, if not absolute pain. The quantity of food, therefore, taken at each meal should be small. For breakfast, tea or chocolate, with honey and a little toast. In the middle of the day a sand- wich ; at four o’clock, fresh, roast, or boiled (but very tender) meat, with a few mouthfuls of well-cooked and tender vege- tables; and at seven o’clock a little tea and toast again. This amount of food is ample for any one, if assimilated, and the hours specified would, I believe, be found, upon the long run, as those most suitable for the majority of cases. Fish, from the amount of excrement it produces, is not generally to be desired; but in this respect, and indeed, as regards the selection of food by adult patients, I am inclined to consult the appetite of the individual, for one person will digest an article under the stimulus of taste, and from it make healthy blood, that another could hardly be induced to swallow, and which his stomach would decidedly reject. As to dinner drink, for those who can afford it I recommend the use of good claret, either plain or diluted with a little water; but in many cases it is better for the individual to eschew fermented liquors altogether. In this respect, however, every case must be separately considered; no general rule can be applied to all. Special rules, as to clothing and exercise, can, however, be laid down for all. The first should, invariably, both for winter and summer, be warm. The dress may and should be light, but it must be warm. I know no disease, not even urinary fistula, in which the patient is more liable to suffer from eold, or to be more annoyed by frequent chills, than this; and during the shivering, the cuta- neous action is arrested, and the internal organs and mucous tissues correspondingly congested. Light but warm woollen clothing should be worn, then, all the year round. As to ex- ercise, It should either be carriage or in a boat, at least until the patient has recovered sufficiently to walk without experi- encing pain in'the pelvic region, and fatigue. Boating will, in general, be found by far the most agreeable to the patient; and for its enjoyment, at all seasons,coupled with salubrity ofclimate, I know of no place so suited to invalids of this class as the vi- cinity of the Cove of Cork. I recommend it in preference to all others. The consequences of stricture of the rectum, then, being so serious; tlie tendency of this disease, when once cstablislicd.
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