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.

    207/704 (page 131)
    rectum, for lie had a slight discharge, and the pain which had been increasing entirely disappeared. Upon careful examination I could find no trace whatever of the hard¬ ness previously described. Three months later he again consulted me for the swelling, which had reappeared exactly in the original spot. But, since on this occasion he suffered no pain, he would not have anything done to the swelling, which again spontaneously disappeared after a week or two. Nevertheless, a month later it appeared for the third time, being on this occasion larger and much more painful. On examination under chloro¬ form, I could feel a hard tubular swelling beneath the anterior wall of the anus an inch in length, lying with its long axis in a line with the bowel. As before, the apex of the swelling was most prominent beneath the perinamm, just anterior to the anus. At one point, three-quarters of an inch within the bowel, there was a puckering of the mucous membrane, which appeared to be adherent to the swelling, and was doubtless the point at which it had previously broken into the bowel. A bent probe would not, however, enter it. I incised the swelling, expecting to let out a drop of pus, but nothing escaped. On the following day a small quantity of urine escaped by the bowel. The slight wound made by the incision soon healed, with the exception of a pin-hole aperture at the extreme verge of the anus. From this aperture, each time the patient passed water, a few drops of urine escaped. Suspecting that the patient might have stricture of the urethra, I passed a catheter, but found that if the urethra narrowed at all it was only to a very slight extent. For some months a drop or two of urine would escape from the opening on his making water, but the fistula eventually closed, and he has never had any further trouble. It would be out of place in this work to go into the pathology of urinary fistula, but I mention the foregoing case in some detail as showing how closely at times