The rectum and anus : their diseases and treatment.

  • Charles Bent Ball
Date:
[1887]
Catalogue details

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.

    296/438 (page 272)
    the surrounding skin, and the mass of metal, even in the most lightly constructed clamps, is such that it will not become unpleasantly heated during the short time that the platinum point is in connection with it. The clamp I always use for this purpose is Lee's pattern (Fig. 32); the narrow and curved blades are readily applied to the anus; and it compresses the pedicle into a smaller space, and consequently leaves a smaller wound than any of the others. In order to perform this operation, the patient should be prepared as before described (page 262), and the same steps taken until each pile to be removed is caught in a catch forceps; they are now drawn down one by one, and the clamp applied to the base, and screwed up tight; the pile may be cut away now, leaving about one-eighth of an inch in front of the clamp to be charred; the cautery, at a dull red heat, is now passed over this several times, until it is completely burnt away down to the clamp; the blades are now gradually relaxed to see if there is any bleeding; if a vessel should spring, the clamp is screwed up, and the cautery brought into re- quisition again ; if no bleeding is to be seen, the clamp is opened completely, and applied in the same way to the other ])iles until all are removed. In per- forming this operation, instead of cutting away the pile with a scissors or knife, it may be dug away with the blunt platinum point of the cautery, and when this is done there is usually less liability to subsequent bleeding. Besides the methods of using the actual cautery above detailed, there are some others which, although not much practised, deserve a passing notice. Woil- lemier,^ after discussing the various operations, re- commends as the best, the making of four vertical linos of cauterisation, involving the anus and extending *L'Union Medicate, 1874 ; and Med. Record, p. 303 ; 1874.