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.

    210/704 (page 134)
    In opening a horseshoe abscess, it is best to make an incision in the middle line behind, extending from the abscess cavity to well beyond the anal margin. A lateral cut should then be made at right angles on each side, laving open the abscess cavities in the ischio-rectal fossae, and joining the median incision. These lateral cuts need not extend far, but should be sufficient to ensure good drainage by a tube inserted on either side. The question naturally arises as to whether, by any plan of treatment, the abscess can be cured without degenerating into a fistula. My belief is that, although by judicious management a fistula may generally be prevented, it sometimes happens that, even with the most careful treatment, it is impossible to arrest its formation. It is well to explain this to patients, who might otherwise imagine that their subsequent fistula was in some way due to the operation employed for their relief. The treatment indicated is to secure free drainage from the external opening. For this purpose the original opening should be made fairly free, and I commonly employ a piece of cyanide gauze tissue to keep the,opening patent. It is not sufficient to use a mere narrow strip of single thickness, it should rather be folded seven or eight times, after the manner of a candle-lighter. It must be changed twice daily, and the cavity well syringed out with a weak carbolic solution, or, what is better, with the boro-glyceride lotion, 3 iv. to 5 viij. The little superficial marginal abscesses should also be treated bv incision. These little abscesses, although they may not contain more than a few drops of pus, are often exquisitely tender. If left alone, they will break in a day or two by a small opening just at the anal margin, leaving a little cavity in the connective tissue immediately beneath the muco-cutaneous mem¬ brane. At first, if the probe be introduced, it will be found