. Surgery, its principles and practice . ways stops hemorrhage at once, withoutthe need of applying separate clamps andligatures. Thus it is easy quickly to suturethe edge of the entire amputated prolapseto the skin, without tying any vessel. Thisshortens, simplifies, and makes compara-tively bloodless a method which if carelessly done may be a tedious andtroublesome one. Independent sutures are placed by some about the hne of union,but this increases the time of operation and does not secure the bleedingpoints as well as a continuous suture. The attractiveness of this method is increased by h
. Surgery, its principles and practice . ways stops hemorrhage at once, withoutthe need of applying separate clamps andligatures. Thus it is easy quickly to suturethe edge of the entire amputated prolapseto the skin, without tying any vessel. Thisshortens, simplifies, and makes compara-tively bloodless a method which if carelessly done may be a tedious andtroublesome one. Independent sutures are placed by some about the hne of union,but this increases the time of operation and does not secure the bleedingpoints as well as a continuous suture. The attractiveness of this method is increased by having the line ofunion at the circumference and not within the bowel, where contact withthe outer part of the iodoform gauze-wound tube insures clean primaryunion. The one weak point in the operation is the possibiUty of retraction ofthe wound edges if too soon disturbed. Hence the first movement byenema should be delayed until the fifth to the seventh day, when unionis firm. If the skin- hne separates, a quarter inch of granulation may. Fig. 101.—Whitehead Resection opHemorrhoidal Area PartiallyCompleted. 150 SURGERY OF THE RECTUM AND ANUS. require tedious repair and result in stricture. This, however, will yieldto gentle dilation. Many simplified methods have been tried in hopes of avoiding thetrouble and supposed risk of the methods just described; but they haveattraction only for the practitioners of medicine who do little surgery,and for the itinerant, who seeks patronage for bloodless methods. First among these to be condemned for general use is the injectionof carbolic acid. It is attractive because of its simplicity, but dangerousbecause, more than any other, it has a risk of pyemia and hepatic patients have fallen to the care of practitioners, and have diedpyemic, of whom the advertising quack never heard after he made hiscarbolic acid injection. Nevertheless the method has a value in certaincases in which anesthesia cannot be borne, and where the patien
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