An essay on the use of nitric acid, as an escharotic, in certain forms of hemorrhoidal affections; illustrated by cases / by John Houston.
- Houston John, 1802-1845.
- Date:
- 1843
Licence: Public Domain Mark
Credit: An essay on the use of nitric acid, as an escharotic, in certain forms of hemorrhoidal affections; illustrated by cases / by John Houston. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![She had always menstruated regularly, and had been married at the age of 40; but had never borne children. At first she suffered under her infirmity without complaint, regarding it as “ only” piles; but, latterly, she has been almost entirely confined to her house, and sometimes even to her couch. She complains of a partial falling down of the rectum on every exertion of the body, accompanied often with an escape of some of its contents, such as faeces or muco-purulent discharges. s Whenever the bowels are allowed to be confined, she suffers pain and hemorrhage; and, when relaxed, she is distressed by ^ ])rolapse, tenesmus, and an irresistible inclination to sit long at the water-closet, from which she is only relieved by lying down ^ and pressing up the tumour within the sphincter. Her health ; shows all the ill effects arising from oft-repeated losses of blood, ; local irritation, and distress of mind. On an examination of the anus in the horizontal posture, no outward appearance of disease presented itself; but as soon as the patient stood up, and made a slight effort of coughing, two tumours, one from each side, protruded from within—soft, red, and perfectly distinct from eachother. They admitted of being re- turned with the same readiness as they had descended, on account of an unusually patulous state of the anal opening, induced by their oft-repeated presence in that passage. The tumours, when fully out, looked as if they formed a complete ring around the opening, like a simple prolapse of the mucous membrane; but, during their return, were observed to separate, so as to constitute two distinct points of disease. On being followed by the finger, the great bulk of the tumours was found to have fallen away, and only a flat, soft elevation, occupied the place of each. The dis- 5 j ease, in fact, appeared as a tumour, only when protruded. The J subsidence of the congestion in the vessels, which followed their * liberation from the sphincter, became the cause of the disappear- j ance of the tumefaction. The general hemorrhoidal veins were | varicose, but not to any serious or inconvenient amount. 'I’liis f](https://iiif.wellcomecollection.org/image/b2172782x_0026.jp2/full/800%2C/0/default.jpg)
