Annual and analytical cyclopaedia of practical medicine . INTERNAL. TREATMENT. should be thorouglily Lautcrized withtlie cautery-poiut at a dull-rud lieat. afterwhich the clamp should be loosened tosee if bleeding occur (Fig. 4). If it does,the operator should readjust the clampand cauterize all bleeding-points. After all the piles have been removedin this way the rectum should be irri-gated and a wedge-shaped compressplaced over the anus and kept in placeby a well-adjusted T-bandage. When the piles are small or sitnatedhigh np and cannot be drawn down and the patients suffering is less and re
Annual and analytical cyclopaedia of practical medicine . INTERNAL. TREATMENT. should be thorouglily Lautcrized withtlie cautery-poiut at a dull-rud lieat. afterwhich the clamp should be loosened tosee if bleeding occur (Fig. 4). If it does,the operator should readjust the clampand cauterize all bleeding-points. After all the piles have been removedin this way the rectum should be irri-gated and a wedge-shaped compressplaced over the anus and kept in placeby a well-adjusted T-bandage. When the piles are small or sitnatedhigh np and cannot be drawn down and the patients suffering is less and re-covery is several days earlier than afterthe ligature. When the ligature has beenapplied ordinarily it will not slough offbefore the eighth day; and, when it does,it leaves an ulcer with irregular edges,which not infrequently has a tendencyto become chronic. At best, patients are rarely able to beabout the room before the tenth day, andfrequently not for two weeks; while afterthe cautery method the ulcer wall beclean and smooth shortly after the oper-. Fig. 2.—Dilatation of the sphincter ani. [Gant.) and clamped, the narrow cautery-bladeshould be drawn once or twice acrosseach pile; this will cause them to shrinknp. The cautery may be applied, if usedwith discretion, to any dilated veins pres-ent that might at some future time formpiles. This operation is preferable to theligature; not because the cure is moreeffective, or the operation less difficultto perform, but because of the facts thatthe operation can be performed morequickh, with greater ease and accurac}^ ation, and will be practically healed bythe time the ligature has sloughed can sit up on the third or fourthday, and it is a rare occurrence if theyare detained from business more than aweek. In many cases the time that is savedis represented by the length of time thatit requires for the ligature to come that some healing takes placewhile the ligature is sloughing, it willrequire as long
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