On villous growths and the common affections of the rectum / by Thomas Bryant.

  • Thomas Bryant
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: On villous growths and the common affections of the rectum / by Thomas Bryant. Source: Wellcome Collection.

    39/60 (page 35)
    expenditure of time in being oured. Tho practice cannot, how- over, be strongly recommended on account of its uncertainty. W here internal haemorrhoids have prolapsed and become extruded from the anus so as to be nipped or possibly strangu- lated by the external sphincter, the surgeon has a painful and difficult case to deal with. If the strangulation be recent, the hemorrhoid of medium size, and the parts are swollen from oedema and inflamed, any attempt to reduce the prolapsed hemorrhoid will without doubt fail, even though the surgeon may succeed in putting it for a time out of sight, for the hemorrhoid is certain to come down again within a brief period. Such cases had better be left alone and a lotion of lead and opium applied to the part, unless the surgeon is prepared to attempt a curative measure, and with the patient under an anesthetic to stretch the anus and reduce the hemorrhoid, with the hope that the inflammatory condition caused by the constric- tion of the hemorrhoid by the sphincter will speedily subside and the hemorrhoid itself subsequently wither and disappear. I have employed this treatment on many such occasions as these and been well pleased with the result. I am sure it is better than any expectant method. If when this measure has been employed the rectum is found to be loaded, it should be emptied by means of a full enema, and when the oper-ation is completed a morphia suppository should be introduced and belladonna ointment applied to the anus. If the strangulated parts have already become gangrenous or have sloughed (Fig. 15a) the treatment I have alluded to is inapplicable. In such cases the parts must be kept clean and treated locally as required. Prolapsus Recti. Prolapse of the rectum to variable degrees of severity is so frequently associated with hemorrhoids that one affection is often mistaken for the other, and where the prolapse is not severe it is as amenable as hemorrhoids to local treatment. When the case is so mixed the presence of the hemorrhoids is the probable cause of the prolapse, and from this connection of the two affections it is always to be remembered that however troublesome prolapse of the rectum may be it is rarely an affection by itself, but is the result of some definite cause which has to be made out (Fig. 17). Hemorrhoids and polypus are the more common causes of this