Operative surgery . ctum transversely insections with scissors, closing the bleeding points as they arise with pressureforceps, through which means control of the proximal end of the gut is alsomaintained; syringe and dry out the wound cavity; ligature vessels andcheck oozing; draw the mucous membrane down and stitch it to the borderof the integument if practicable; if not, stitch it to other tissues, all lowdown as feasible, and irrigate, dry and dust the raw surface with iodoform ; introduce a large-sized Rubber tube intothe bowel, and packaround it iodoformgauze; allay pain andirritation wi
Operative surgery . ctum transversely insections with scissors, closing the bleeding points as they arise with pressureforceps, through which means control of the proximal end of the gut is alsomaintained; syringe and dry out the wound cavity; ligature vessels andcheck oozing; draw the mucous membrane down and stitch it to the borderof the integument if practicable; if not, stitch it to other tissues, all lowdown as feasible, and irrigate, dry and dust the raw surface with iodoform ; introduce a large-sized Rubber tube intothe bowel, and packaround it iodoformgauze; allay pain andirritation with opiumfor a few days, main-taining cleanliness;after two weeks in-troduce daily, for amonth, a full-sizedrectal bougie ; allowit to remain for somehours; at each intro-duction pass thereaf-ter daily for a year or more, or so long as contraction is present, the rectalbougie. The Precautions.—Carefully avoid injury of the vagina in the female,and of the urethra in the male; notice if the peritoneal cavity has been. 1223, -Tlie operation of perineal proctectomy, Alling-hains method. 990 OPERATIVE SURGERY. opened, and if so, repair it by sewing, if possible, otherwise introduce agauze tampon; with care, little danger from tliis involvement need befeared. The strong tendency of the opening to close should be observedand actively combated in all instances. Retention of urine is likely to fol-low the operation. All diseased tissues should be removed if practicable,otherwise the operation will be of but little use and possibly do muchharm. The lieinarks.—The needless sacrifice of any part of the rectum or analmargin should be avoided for obvious reasons. When the growth approachesthe posterior wall the posterior median incision should be made, but with adue regard for the presence of the superior hsemorrhoidal artery. If thedisease be high a full bladder often facilitates the operation by raising therecto-vesical pouch. A malignant growth within the rectum of the maleshould be lo
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