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. Diseases of the rectum and anus: designed for students and practitioners of medicine. gature, both having many advocates of equal ability. Thewriter is partial to the clamp-and-cautery operation. By theaid of the modern clamps and the Paquelin cautery or cautery-irons (Figs. 144, 148, and 149), the operation is not difficult andcan be performed with rapidity. If ordinary care is observed, it See, Local Anesthesia, Chapter XLI. TREATMENT OF INTERNAL HEMORRHOIDS 437 is not a barbarous procedure, as is often claimed by its opponents,but a scientific surgical operation, whereby only the diseased
. Diseases of the rectum and anus: designed for students and practitioners of medicine. gature, both having many advocates of equal ability. Thewriter is partial to the clamp-and-cautery operation. By theaid of the modern clamps and the Paquelin cautery or cautery-irons (Figs. 144, 148, and 149), the operation is not difficult andcan be performed with rapidity. If ordinary care is observed, it See, Local Anesthesia, Chapter XLI. TREATMENT OF INTERNAL HEMORRHOIDS 437 is not a barbarous procedure, as is often claimed by its opponents,but a scientific surgical operation, whereby only the diseasedtissue is removed. The pain which follows the clamp-and-cau-tery operation is less than that of any other operation for piles. The technic of the clamp-and-caiitery operation as performedunder general anesthesia by the author, is as follows:— First Step.—The patient, having been previously preparedand anesthetized, is placed in the lithotomy position, the limbswell flexed and held by an assistant or by means of a Clovercrutch (Fig. 139). The sphincter is gradually and thoroughly. Fig. 142.—Severing the Mucous Membrane from the Skin. divulsed by making pressure with the thumbs or fingers firstin one direction and then in another (Fig. 140). The hemor-rhoids are then exposed by everting the anus, and theirnumber, size, and location noted. Second Step.—Each tumor is, in turn, firmly grasped withthe authors hemorrhoidal forceps (Fig. 141) and tensionmade while the skin and mucous membrane are incised at themuco-cutaneous junction. The pile is then dissected from itssubmucous attachments (Fig. 142). Third Step.—The authors pile-clamp (Fig. 143) is nowadjusted in the groove made by the incision, and about the 438 DISEASES OF THE RECTUM AND ANUS pedicle of the partly-detached pile. The screw should be welltightened, but not run down too far, as the clamp may besprung. Fourth Step.—The clamp holding the tumor is grasped inthe left hand while that portion of the pile externa
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910