. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. t symptoms of thisremarkable affection, after theulcer has once been to the immediate causes ofthe fissure, they may originatein cracks of the mucous mem-brane, produced by forcing outindurated fffical masses. Theyoccur in some cases from de-generation of the raw spots leftby the removal of piles, and inother instances from ulcerationcaused by foreign bodies lodgedin the sacculi Horneri. Inshort, any cause, constitutionalor local, capable of causingulcers in other parts, may affectthe v
. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. t symptoms of thisremarkable affection, after theulcer has once been to the immediate causes ofthe fissure, they may originatein cracks of the mucous mem-brane, produced by forcing outindurated fffical masses. Theyoccur in some cases from de-generation of the raw spots leftby the removal of piles, and inother instances from ulcerationcaused by foreign bodies lodgedin the sacculi Horneri. Inshort, any cause, constitutionalor local, capable of causingulcers in other parts, may affectthe verge of the anus in the sameway. The perplexing point isnot the origin of the ulcers, buttheir astounding causes combine to pro-duce this result: 1. The verge of the anus,like the orifices of all othermucous canals, is, even in itshealthy state, extremely sensi-tive to painful impressions. 2. The sphincter, excited by the nerves of the diseasedparts to spasmodic energy, grasps the ulcer very forcibly atevery contraction. 3. The lower extremity of the fissure receives septic. Fig. 3l. — Diagkam of Trunks which aee conoeenedIN PBODUciNG Reflex Spasm. a. Fissure, c. Sensory nerve,d. Motor nerve, e. Ischiadic, g. Lumbar, i. Spinal center. FISSUl^K OF THE ANUS. 71 germs from the external air. -vvhicli proy)aiijate putrescence inthe secretions of the sore and ijive them the same virnhnithii-ritating quality, which putridity generates in the dis-charges of nlcers elsewhere. The facility with whichantiseptics often cure the tissures gives support to thisexplanation. Symptoms.—No disease presents a more distinct cHni-cal entity than fissxire of the anus. From its symptomsalone, without any physical examination, an almost certaindiagnosis could be derived were such a course pain associated with fissure is usually felt after defeca-tion rather than during the act. It is of a dull yet peculiarsickening kind, jjerhaps similar to t
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