The practice of surgery / by James Gregory Mumford ... with 682 illustrations.

  • James Gregory Mumford
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: The practice of surgery / by James Gregory Mumford ... with 682 illustrations. 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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    sensitiveness, the surgeon may pass his forefinger within the sphincter, where he will detect a smooth, rounded induration, which may be grasped between the thumb and finger, and feels like a thickened sphincter. Sometimes there is bleeding from distended and eroded hemorrhoids. In some cases the suigeon may be unable to distinguish between a mass of hemorrhoids and a beginning ischiorectal abscess; indeed, the two may l)e associated; but the patient's account of throb- bing, boring pain and extreme distress on sitting down, with fever and rapid pulse, confirms the diagnosis of abscess. Fig. 36.—Ischiorectal abscess. Dotted lines indicate burrowing fistulae. More deeply seated abscesses are characterized by an exaggeration of the symptoms I have described. The constitutional disturbance is graver. Pulse and temperature may run high, and the patient's condition may be alarming. Generall}', obstipation is complete, and there is a high leukocytosis. In advanced cases there may be present the signs of a local or general peritonitis. Examination of these cases may be difficult, but a glance at the buttocks usually is enough to convince the surgeon that a serious inflammation is ])rescnt. In acute cases one sees a deep purplish injection of the skin, with fullness about the anus and edema of the parts. The finger introduced into the rectum lights upon the more or less elastic or doughy, constricted canal.