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.

    232/704 (page 154)
    recommends the following plan:—A probe is passed along the sinus from the external to the internal opening, and then by cutting down upon the probe an inch from the anus, an artificial opening is made. The portion of tissue between the new opening and the internal opening within the bowel is then laid open in the usual manner, the remainder of the sinus in the buttock being left un¬ touched. The track thus left, relieved from irritating particles escaped into it from the bowel, heals without further treatment. In my own practice I have not hitherto adopted this plan, but should be inclined to try it should the sinuses be very deep, but I think as a rule they will be found to be superficial, and are best laid open. Some writers, particularly Dr. S. Smith, advocate * the practice, after laying open the sinus and thoroughly scraping and cutting away the granulating tissue, of bringing the raw surfaces together so as to obtain primary union. Such a proceeding appears to me to be entirely opposed to sound surgery. The possibility of occasionally obtaining primary union cannot be denied, and in such cases the convalescence would be shortened ; but against this advantage must be set the risk of obtaining union only of the most superficial and vascular part, with a reproduction of the fistula, or the retention of pent-up discharge. Method of Operating.—The patient having been previously prepared (see p. 97), is placed under an anaesthetic in the lithotomy position, and a small probe- pointed director passed gently along the fistula, and, if possible, made to emerge through the internal opening. If this opening be in the usual situation, and only a short distance from the anal orifice, the end of the probe, directed by the forefinger of the opposite hand, can by a little manipulation be made to project from the anus. The whole of the intervening parts are then divided by running a sharp-pointed scalpel along the groove * New York Medical Journal, June 12, 1886.