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Show 93 ormmnoxs UN Inc A); vs AM) nec‘rein. laxative should be given; and upon its beginning to operate, a warm anodyne, 01' the injection of a thin starch clyster; with laudanum, to subdue the irritability of the gut. Some surgeons have been in the practice of cutting oh" the lnemorrhoidal tumours, when they have become permanent, with a pair of seissars, or at least the most prominent and painful of them, in Consequence of which the others collapse. This may be done in many instances with ease and success but still there are objections to the practice. There may fols low luemorrhagy, from Opening a vein; and it will be remembered, that from the anus to the sinus of the liver, there are no valves. The operation is incomplete, unless the whole diseased parts are taken away, and the extremity of the gut consoli» dated by inflammation. This intention is best lulliiled b" the use of the ligature. 1‘ . "a 7 ‘7 4.130 W \\ rw- - «‘ ' 1 "HM ~-.-_ tag OPERATIONS on THE ANUS AND nice/rear. 9%) of the ligature, BC, and tying the ends CC, under the lowest portion, and BB also, close upon the anus, including the other portion, the tumour is completely strangulated, and drops off in a longer or shorter time, according to the thickness and firmness of its base. If the ligatures are drawn with difli‘ culty to the due degree, and the swelling of the tumour seems to prevent the ligature from drawing the base of the tumour into a narrow neck, the ianret may be thrust into it. This, far from being painful, is a reliefs. In other cases, where the form or magnitude of the tumour is different, we thrust the common hair lip pin, D, through the base of the tumour, and tie a ligature behind it, embrac- ing the whole base of the tumour. After tying piles, or the descending inner coat of the rec-tum, we may look for much pain and irritation in the neck of the bladder, and even such obstruction of urine as may occa~ sion the necessity of using the catheter. When the tension is very great, and on examination the tu~ , As preparatory to this Operation, the patie nt should be put loi some tune over the steam of warm water . an (i. made to 1 {flufx q \ c incur is much swelled, it is best to run a laneet into it, and tighten the light ure. .1 ..1 i, .e as 10910‘1lli‘etlle tumours in their full extent. rumours sometimes form so for within the got, that it i: only in very violent straininijr and evacuation that they are pushed down without the anus ; and the surgeon has to operate on the base of a tumour situated some inches within the gut. Such tumours ol this kind as I have met with, were nearly as soft and as easily bruised as a strawberry; but i know that they are not always so. Introducing the fore and middle finger of the left hand into the rectum, we grasp the root of the tumour, and betwixt the two fingers we direct the point of the needle used by Sharpe \‘ . _ nupposmg I) that weV have p to operate on the . .i , _ ‘., .i ~ [Ullif‘tl' thrust the common eloolted needle through the liiitiillc ol‘ the » . g out the needle. 1"‘6 separate the. l‘JO on . .C . tlull cuttin m {h for the extirpation of the tonsils, or any similar instrument, and pierce the root of the tumour. We must now ti); upon the point of the needle :1 bit of cork or was. The next part (it " See farther. Home on l'ieers, n. 37"- |
