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.

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    botli as regards the prolongation of life, and the possibility of complete cure. As to the condition of the patient after recovery from operation, we must remember the horrible disease for which that operation was performed, and compare the condition before and after its removal. When the sphincter has not been removed, the amount of incon- tinence is usually trivial, and it is only when there is diarrhoea that any trouble arises. This is generally easily met by the use of an antiseptic pad. When the entire lower end of the rectum has been removed a considerable amount of control often is maintained, but even in the worst cases of incontinence met with after ablation of the rectum the result compares favourably with the usual artificial anus following colotomy, and is vastly preferable to the state of a patient sufifiering from advanced rectal cancer. A more troublesome sequela of operation than incontinence is stricture, which in many of the re- corded cases appears to have given a very great deal of trouble in those cases where it has been found im- possible to draw down the gut and suture it to the skin. As the extensive surface heals by granulation the orifice gradually becomes constricted, and in the hands of some of the most skilful surgeons treat- ment by means of tubes, incision, or even colotomy has been required. If, however, a small strip of mucous membrane can be retained down to the anus, or the mucous membrane brought down and sutured to the skin, as in the procto-plastic operation of Amus- sat for imperforate rectum, this trouble is not likely to arise. The freedom from incontinence which some of these ]:)atients enjoy is very remarkal)le. In a case of my own there is a slight prolapse of mucous membrane which occludes the anus, and prevents escape of fa?ces, except during defsecation. As O'Beirne pointed out long ago, the rectum in health