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.

    176/704 (page 100)
    pressure affords considerable comfort to the patient by giving support to the part, and preventing the desire to strain. Some operators recommend a suppository containing one-third of a grain of morphia to be passed into the bowel immediately after the operation, a plan I do not think very efficacious, and I doubt whether the rectum is in a position to absorb it. I prefer to give no opium till the evening, when I prescribe 20 drops of the liquor opii sedativi. This generally ensures a night free from pain, and con¬ fines the bowels. The dose need not be repeated. If the sphincters have been thoroughly stretched, and no uncut skin included in^the ligatures, there is generally not much pain following the operation. What there is comes on in spasms, and seems to be due to some twitching of the levatores ani muscles, and almost entirely disappears after eighteen hours. On the morning following the operation the large external pad can be removed. Its removal is painless, since it is in contact with no part of the wound. The little pad beneath will be found blood-stained, and ad¬ herent. I moisten this with biniodide solution, making no attempt to remove it. The surrounding parts having been cleaned, a fresh pad of cotton-wool is applied over it. The next day, that is at the second dressing, the pad in contact with the wound is loosened, and as a rule comes away readily enough. If it does not do so, it may be detached by gentle syringing. The subsequent dressing that is required is the thorough cleansing of the part night and morning with soap and water, after which it should have a swill over with 1 in 40 carbolic lotion. The anus is then covered with a piece of lint spread with eucalyptus vaseline, half a drachm to the ounce. The ligatures come away from the tenth to the twelfth day. They should be allowed to separate by them¬ selves, and the temptation to give them a pull avoided, for this always causes pain, and is quite unnecessary.