Observations on the diseases of the rectum ... / by T.B. Curling.

  • Curling, T. B (Thomas Blizard)
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the diseases of the rectum ... / by T.B. Curling. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    119/292 (page 99)
    from these observations were early carried out, and have been strongly advocated by Mr. Syme, of Edinburgh, in his book on Diseases of the Rectum. Similar views of practice have also been enforced by the late Sir B. Brodie, in the Lecture already referred to. These eminent surgeons also consider that, when a fistula passes for some distance upwards along the side of the rectum, it is not necessary that it should be divided in its whole extent; and that, if the parts intervening between the inner and outer openings below be freely cut through, the sinus above will probably close, and the patient be cured by a simple and slight operation. My own ex- perience does not enable me to coincide altogether in these views, for in many cases I have found that the sinus running up the rectum will not close without a freer division of parts. The wound below is apt to assume an unhealthy aspect, and a free discharge continues. In a case of this kind, with a sinus burrowing close to the mucous mem])rane, I have sometimes passed up to its extremity a straight director, and carried along its groove one of the blunt-pointed blades of a pair of knife-cutting scissors, whilst the other has ascended the rectum, and, by closing them, have divided the intervening membrane and exposed the sinus. I have then lodged a tuft of cotton wool in the gap, which has afterwards healed in the usual way. Thi^ is a simple and easy operation, attended with but Httle risk of serious haemorrhage even when the barrier is divided high up, for the sinus in burrowing close to the mucous membrane detaches it from the chief vessels and parts beneath. A fistula sometimes, however, penetrates into the areolar tissue of the pelvis out- H 2