Lectures upon diseases of the rectum and the surgery of the lower bowel : delivered at the Bellevue Hospital Medical College / by W.H. Van Bruen.

  • William Holme Van Buren
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Lectures upon diseases of the rectum and the surgery of the lower bowel : delivered at the Bellevue Hospital Medical College / by W.H. Van Bruen. Source: Wellcome Collection.

    403/460 page 391
    A most important consideration in connection with diseases of the rectnm is their accurate diagno- sis. The means to be employed in order to recog- nize these different affections promptly and certainly are worthy of our best attention. You will readily call to mind the instances I have already mentioned in which eczema of the anus has been denominated pruritus, and irritable ulcer miscalled neuralgia ; a symptom in either case having been mistaken for the disease—the true nature of which not being' rec- ogmzed, failure in its cure was the natural result. In like manner, benign stricture and irritable ulcer have been called cancer, and patients with curable dis- eases thus abandoned to unnecessary suffering. Ac- curate diagnosis is in our profession the unerring test of ripe scholarship and thorough education, and of all the qualities of a physician it is that which most cer- tainly insures success in curing disease, and conse- quent reputation. Imperfect diagnosis, in truth, is a very common fault, especially so, perhaps, in the class of ailments which we are studying; for the seat of them, in the decency of Nature, is hidden away as it were in a recess of the body, and natural modesty is always averse to exposure. Moreover, our means of exploration have been, until recently, veiy defec- tive—entirely insufficient to overcome satisfactorily the jealous sentinelship of the sphincter ani muscle. The different varieties of the speculum ani which I here show you are ingenious in construction and possess a limited value in their application, but practical surgeons have experienced a want of full success in their use in exploring the rectum. The sphincter ani is a powerful muscle, and resists their
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