On diseases of the rectum and anus / by Harrison Cripps.

  • William Harrison Cripps
Date:
1907
Catalogue details

Licence: Public Domain Mark

Credit: On diseases of the rectum and anus / by Harrison Cripps. Source: Wellcome Collection.

    126/704 (page 52)
    in the mucous membrane of the bowel within the sphincter. Certainly it often happens that internal piles of long standing become habitually extruded beyond the sphincter, and can be seen surrounding the anal outlet. Never¬ theless, they are still internal piles in the clinical nomen¬ clature, since they originate within the bowel, their protrusion being merely accidental. Both forms of piles are frequently associated, and it may happen at times that there is a well-marked narrow line or sulcus between the two, but sometimes the line of separation is indefinite, the swelling extending in direct continuity from the one to the other, so that a tumour will be seen, the outer surface of which is covered by skin, the inner by mucous membrane. The difference in colour between the two forms of piles is well marked, the rose-red opaque tint of the external pile contrasting strongly with the shining vascular surface, either red or claret-coloured, of the internal. The external pile, being covered by a true skin, has a somewhat rough, dry feel, while the internal is soft and velvety in texture, similar to the mucous membrane. An exception to this rule must be made in some cases of old prolapsed internal piles, for here their covering becomes dry and thickened, having more the appearance of skin than mucous membrane. In an earlier part of this work the anatomy of the rectal blood-vessels has been duly considered, but I may here repeat that the arteries in the lower part of the rectum running in a longitudinal direction beneath the mucous membrane terminate in capillaries, from which the veins take their origin. These veins commence in a plexus round the lower half-inch of the rectum, emerging from wliich plexus, they run upwards by four or five main trunks, eventually merging into the inferior mesenteric, thus forming part of the portal circulation. It is in morbid states of these terminal blood-vessels that the hsemorrhoidal condition originates.