. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. ion produced in the lips and knu(^kles byexposure to cold.* Sabatier also mentions it in a similar(connection. Molliere, Gosselin, Recamier and Boyer sever-ally aided in the investigation of this disease. The lastnamed, especially, brought out very clearly the importance ofreflex spasm of the sphincter as a symptom. This, ratherthan the fissure itself, he held to be the jiriniary and essen-tial feature of the affection. Maisonneuve and Uupuytrenadvocated and practiced forcible dilatation, the forme
. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. ion produced in the lips and knu(^kles byexposure to cold.* Sabatier also mentions it in a similar(connection. Molliere, Gosselin, Recamier and Boyer sever-ally aided in the investigation of this disease. The lastnamed, especially, brought out very clearly the importance ofreflex spasm of the sphincter as a symptom. This, ratherthan the fissure itself, he held to be the jiriniary and essen-tial feature of the affection. Maisonneuve and Uupuytrenadvocated and practiced forcible dilatation, the former intro-ducing the whole hand. Among English writers Curling and Syme very earlyadvocated the French ideas of treatment. In America stretching as a means of curewas strongly advocated in18P)4 by Van Buren, whoprobably obtained the ideafrom the same sources. Causes.—The predispos-ing causes of fissured anusand its peculiar train ofsymptoms lie in the struc-tural arrangement near theanus and their physiology,especially of nerve control,A word is therefore neces-sary as to the special anatomy. Fig. 30.—Diaobam of Nebve SupplyOF Anus. [After Hilton.^ M. Mucous membrane. C. Skin. S. E. Ex-ternal sphincter. L. Hiltons white I. Internal sphincter. N. A nerve passing « ,-. , between the sphincters, and emerging at the OI tJie line to skin about anus. tt-ij i i i_ Hilton has shown tliatthe line of junction of the skin and miicous membrane atthe anus is also the exact line which separates the external *Les ragades ou fissures sont les petits ulcferes douloureux, piquans etsans grosseur, qui suivent la langueur des rides du fondement, et quiresemblent assez h ces engelures oii crevasses, que le froid produit auxIfevres et aux mains pendant Ihiver. — LemoHnlei; Traite de la Fisfule deLAnus—lGSS. FISSURE OF THE ANUS. 69 from till internal sphincter. This is marked in most casesh\ a line of more condensed connective tissue constitutingthe edge of the fascia a
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Keywords: ., bookcentury1800, bookdecade1880, booksub, booksubjectanusdiseases
