Essays on practical medicine and surgery (Volume 2) . r cir-cular disc, atthe other; which is intended to passthrough the canula, and to be projectedbeyond it, so as to penetrate the rectum,if the fistula has no internal opening; itsdimensions are such that it fills the canulacompletely;—3d, a portion of a fine watch-spring (c), with a lenticular button at oneextremity, sufficiently large to fill the ca-nula, but small enough to glide through itwith ease; and the other end furnishedwith an eye, and armed with a ligature,which Dr. Gibson generally forms from apiece of French braid. The canula h
Essays on practical medicine and surgery (Volume 2) . r cir-cular disc, atthe other; which is intended to passthrough the canula, and to be projectedbeyond it, so as to penetrate the rectum,if the fistula has no internal opening; itsdimensions are such that it fills the canulacompletely;—3d, a portion of a fine watch-spring (c), with a lenticular button at oneextremity, sufficiently large to fill the ca-nula, but small enough to glide through itwith ease; and the other end furnishedwith an eye, and armed with a ligature,which Dr. Gibson generally forms from apiece of French braid. The canula havingbeen passed into the sinus to the desireddepth, the puncture effected, if necessary,and the stilet withdrawn, the elastic nee-dle or spring is introduced; its blunt endpasses into the rectum, and immediatelydescends toward the anus, where it iseasily caught by the finger. The wholelength of the spring is now drawn throughthe anus, the ligature follows, it is thendetached from the eye of the spring, thecanula is removed, the dependent extremi-. 146 ANUS. {Fistula.) ties of the braid are tied as usual, and theoperation is complete. This mode of treat-ment is free from all the objections urgedagainst the ancient plans of the probe andwire; it is simple, rapid, very easily per-formed, and frees the patient from the painproduced by the pressure of the latter in-struments when the surgeon is endeavour-ing to bend them in the rectum. Pre-ferring, as we do, the knife in every caseof fistula not extending above the analcanal, and believing the extensive divisionof the septum in external incompletefistula, to be seldom or never necessary,we should not often employ the stilet inthe above described apparatus; but be-lieving the ligature greatly preferable tothe knife, for dividing the upper part ofthe septum in true stercoraceous fistula,we cannot but esteem the instrument ofDr. Gibson a very valuable addition to theapparatus chirurgica. g. Method by incision. Having alreadyenlarged
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Keywords: ., boo, bookcentury1800, bookdecade1840, booksubjectclinicalmedicine
