. The principles and practice of modern surgery . ugh the sciatic notch. This andthe preceding are exceedingly rare ; — and the tumours are of necessitysmall. If discovered to exist during life, they must be returned and sup-ported by proper apparatus — and if strangulated, the stricture must bedivided by operation. VIII. Diaphragmatic Hernia is generally a result of congenital defi-ciency, or accidental separation of the fibres of the diaphragm. But itmay also be caused by violent falls on the abdomen, or by violent pres-sure of any kind, capable of lacerating the diaphragm, and driving someo
. The principles and practice of modern surgery . ugh the sciatic notch. This andthe preceding are exceedingly rare ; — and the tumours are of necessitysmall. If discovered to exist during life, they must be returned and sup-ported by proper apparatus — and if strangulated, the stricture must bedivided by operation. VIII. Diaphragmatic Hernia is generally a result of congenital defi-ciency, or accidental separation of the fibres of the diaphragm. But itmay also be caused by violent falls on the abdomen, or by violent pres-sure of any kind, capable of lacerating the diaphragm, and driving someof the bov^els into the This form of hernia, if strangulated, willproduce the ordinary symptoms — vomiting, constipation, and pain ; —which are not in any manner to be distinguished from the symptoms ofileus or intus-susception—or from those produced when a fold of bowel isentangled in a rent in the omentum, or mesentery; or when the bowel isconstricted by membranous bands resulting from previous inflammationof the CHAPTER XIX. OF THE SURGICAL DISEASES AND INJURIES OF THE RECTUM AND ANUS. I. Foreign Bodies in the rectum sometimes require to be removed bysurgical art. They may consist either of small bones or the like that have * From a preparation of Mr. Fergussons in the Kings College Museum. j- Reid on Diaphragmatic Hernia, Ed. Med. and Surg. Journ., Jan. and July, 1840. 38 446 DISEASES OF THE RECTUM AND ANUS. descended from above, or of pins, glyster-pipes, or other bodies intro-duced from below. Substances of very extraordinary dimensions (ablacking-bottle, for instance) have been forced into the anus. The grandpoint is first to dilate the bowel well, by passing in several fingers (oiled),or by means of a speculum; — and then a proper forceps, or a lithotomyscoop, may generally be used with success. II. Imperforate Anus (atresia ani) signifies a congenital closure ofthe rectum, and may occur in various degrees. The anus may be merelyclosed
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