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Show 100 I'ROLAI'SL'S AN]. PROLAPSUS ANI. the operation is to put a ligature over the point of the needle (by carrying the double of the ligature on the fore finger of the right hand), then making the surgeon's knot upon it, draw it tight by means of Sharpe's ring, carried along one of the ligatures. The patient is to be placed easily on his side in bed, so as to relax the belly. At first we press but gently, endeavouring to reduce the general size of the gut, and then attempt to put it up ; and when it is accumulated together, with a cone of paper, made moist and soft at the point, the whole is thrust 101 up, and retained by compressing the nates together. The treatment consists in relieving the irritation of the rec- tum, which had occasioned the prolapsus (frequently in chil». dren the ascarides) and endeavouring for the time, until the parts have recovered their tone, by astringent washes and in- ternal medicines, to prevent the gut from falling, or rather from being pushed down by the action in going to stool. The evacuation must be made in the erect posture, than which I know nothing which more effectually supports the gut. In children from irritation in the bowels, we often see the rectum inverted, and hanging down a very great way; but ., 7" u _ , _ \\ , ' ‘ . ' 5 '~ , 7 p 7 T i‘ in adults the prolapsus ani is of a different nature. 1 ‘ I". " It is the, inner coat of the gut, and loose in its connexions with the w - muscular coat, which, filling with extravasated fluid on going 3 to steel, is pushed down by the same action of the muscular N t t W ,MIHH l librc which evacuatcs the feces. A, The needle, pushed through the root of the tumour s It is often a consequence of piles, of the irritation of the piles, and the frequent evacua tions of blood, which relaxes the parts within the anusa‘si B, The ligature drawn. round the neck of the tumour, by in trodueing the instrument C, along the ligature D, and by What is wanted is the adhesive inflammation, to give union, fixing the ligature (turning it over the fore finger), and push is in fact the same disease we have been treating of under the ing the ring into the gut, drawing at the same time, on the 0th or end of the ligature E, the knot is firmly tied, and the needle head of Piles, and is to be operated upon in the same way If we were to cutaway the folds of the inner coat of the rec: ‘ him, which are permanently hanging from the anus-J", we may be withdrawn. ' 11 * For these relaxations of the gut, astringent washes are used, as limewater, decoction 0t oak bark, Port wine, spirits, 8w. The patient is recom ‘ mended to keep the bowels loose by some mild laxative, as the oleum ricini, PKOLAPSUS AN}. Tm: descent of the gut ought to be immediately reduced. and to take an injection only before going to stool; to go to stool before go ing to bed, rather than in the morning, it' not very much against his habit, If, however, it has een down for some considerable time, the coats become tinged with venous blood, and swell ; and it requires leeches and fomcntation before the tumour can be 1‘6- duced. and to consolidate the coats of the extremity of the gut. .1131 the parts may be more easily and permanently replaced, or draw thr. n..~ MW?) "P ; and when at stool, to keep himself almost in the erect posture, "1" Two small tumours, or often pcndulous flaps, which hang on each 335': ' of the ":3, and v. hich 1'! main after the greager portion 01" t1}: gut "hi: I! |
