The rules of aseptic and antiseptic surgery; a practical treatise for the use of students and the general practitioner . ge-tube was placed. A pledget of iodo-formed gauze was placed into the anus, andthe wound was dressed with gauze and a T-bandage. No reaction followed. In the after-noon of February 7th, four ounces of sweet-oil were injected into the gut, and the oil-soaked gauze was withdrawn from the anus.^^^MB ? An hour after this a large enema of soap- J^j^^^m^, water was administered, and brought away a liquid stool. The next morning a saline laxa-tive was given, and was continued ever
The rules of aseptic and antiseptic surgery; a practical treatise for the use of students and the general practitioner . ge-tube was placed. A pledget of iodo-formed gauze was placed into the anus, andthe wound was dressed with gauze and a T-bandage. No reaction followed. In the after-noon of February 7th, four ounces of sweet-oil were injected into the gut, and the oil-soaked gauze was withdrawn from the anus.^^^MB ? An hour after this a large enema of soap- J^j^^^m^, water was administered, and brought away a liquid stool. The next morning a saline laxa-tive was given, and was continued every day,each stool being followed by irrigation ofthe anus to free it from excrementitious mat-ter. Februanj lOth.—The silver stitches andrubber tube were removed. The accompany-ing cut shows the condition of the wound onthe tenth day after the operation. The actionof the sphincter was perfect. (Fig. 189.) Fig. 188.—Operation of fistula in ano. Grooved directorpassed through fistula and brought out of the anus,from which is seen depending a thread holding spongepushed well up the rectum. (Simon Schulhofs case.). Fig. 189.—Eesult after excision and sutureof fistula in ano. (Simon Schulhofs case.) Eegarding the management of the first and subsequent evacuation ofthe bowels, the reader is referred to the chapter on hsemorrhoids (page 156). 258 RULES OF ASEPTIC AND ANTISEPTIC SURGERY. In very extensive cases of fistula of long standing, where the innerorifice is very high up, say two inches or more above the anal opening,and where avoidance of hgemorrhage is rendered imperative on account ofthe ansemic condition of the jjatieut, the elastic ligature can he successfullysubstituted for the knife. The grooved director is carried through thesinus into the gut as usual, and, if possible, its point is turned out of theanus. Where this is impossible, a slender, soft, silver probe is armed witha fillet of stout silk, to the end of which a piece of elastic ligature or asmall-sized drain
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