Licence: Public Domain Mark
Credit: The rectum and anus : their diseases and treatment. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![Chap. XI.] H\'DRA ULIC DiLA TA TION. I 7 3 that they are so soft that it may be found difficult to pass them into the orifice of the stricture. For general purposes those bougies made with an olive-shaped bulb, mounted on a flexible whalebone stem, answer all })urposes admirably. In some cases it may be found advisable to leave a bougie in the stricture for some hours, thus adopting the principle of vital dilata- tion so authoritatively recommended in the treatment of urethral stricture. For this purpose the instru- ment should be short, about four or five inches only in length, and with a stiing attached, so that it can be passed entirely into the rectum, the string hanging out at the anus, and serving to with- draw the bougie when required ; as where the anus is kept dilated for any considerable time great annoyance is given to the patient, and violent expulsive efforts induced. Cripps speaks favourably of conical bougies, by means of which, if gentle pressure is ke-pt up, a gradual and continuous dilating effect is maintained. A considerable amount of ingenuity has heen ex- pended in the construction of elastic hollow bougies, which can be inflated with air, or distended with w^ater after they have been introduced into the stricture. This is a plan of treatment, however, which requires extreme caution, as the surgeon is unable to satisfactorily estimate the amount of force wdiich he is using, especially if water is injected instead of air. In some cases, where there is a great deal of induration and perirectal thickening, this method may answer tolerably well. None of the special instru- ments which have been invented answer the purpose better than the Barnes' bags used by obstetricians for the purpose of dilating the os uteri, the fiddle- shape rendering them less likely to slip out of the vStricture when once they have been introduced, and they can be introduced with the greatest facility while empty. I have treated some cases in this way](https://iiif.wellcomecollection.org/image/b21229387_0191.jp2/full/800%2C/0/default.jpg)
