Diseases of the rectum and anus / by Alfred Cooper and F. Swinford Edwards.
- Cooper, Alfred, Sir, 1846-1908.
- Date:
- 1892
Licence: Public Domain Mark
Credit: Diseases of the rectum and anus / by Alfred Cooper and F. Swinford Edwards. Source: Wellcome Collection.
307/388 (page 265)
![ing in the sub-mucous tissue; there is more or less profuse secretion, and bleeding is apt to occur from superficial ulceration—the result of friction against the patient's thighs and clothes. In other cases, the surface loses its velvety condition and becomes dry, hard, and insensitive. Other changes sometimes occur in the protruded part in cases of prolapse of the rectum. Congestion is followed by inflammation, with sloughing as a result. If the patient survive, portions of the intestine become detached, and healing may result, but death from pytemia or peritonitis is the more probable ending. When the portion of peritoneum which is dragged down by the protrusion constitutes a hernial sac, it occupies the anterior part of the tumour. This por- tion on examination is found to be tense and full, and the opening into the bowel is turned towards the sacrum. On making pressure over the anterior part of the tumour, with the pelvis raised, the hernia is reduced with a gurgling sound; the anal orifice is then found to be in its usual position, and the protru- sion can generally be replaced without difficulty. ]VIr. Quain points out that this peritoneal cul-de-sac^ at the anterior part of the prolapsus, exists not only in examples of extensive displacement of the intes- tine, but even where the protruded part measures no more than an inch. When the prolapsus is more extensive, the tumour may be surrounded by peri- toneum (Fig. 57), except where the meso-rectum is attached. When the upper part of the rectum descends through the lower part, but does not appear outside the anus, there is, of course, no external sign of the lesion (Fig. 5-5). The patient usually complains of a constant desire to go to stool, and of various uncomfortable](https://iiif.wellcomecollection.org/image/b20389267_0309.jp2/full/800%2C/0/default.jpg)
