. Modern surgery, general and operative. ecal. The history should be carefully-inquired into; tuberculosis should be sought for; the question of syphilisshould be investigated. A digital examination enables the surgeon to feel theulcer, and an examination by means of an ordinary speculum or an electricproctoscope brings it into view. Treatment.—In simple ulcer empty the bowel by the administration ofa saljne cathartic, wash out the rectum with hot water after the saline hasacted, introduce a speculum, touch the ulcer with pure carbolic acid or silvernitrate (40 gr. to i oz.), place the patient
. Modern surgery, general and operative. ecal. The history should be carefully-inquired into; tuberculosis should be sought for; the question of syphilisshould be investigated. A digital examination enables the surgeon to feel theulcer, and an examination by means of an ordinary speculum or an electricproctoscope brings it into view. Treatment.—In simple ulcer empty the bowel by the administration ofa saljne cathartic, wash out the rectum with hot water after the saline hasacted, introduce a speculum, touch the ulcer with pure carbolic acid or silvernitrate (40 gr. to i oz.), place the patient in bed, restrict him to a liquid diet,and every day inject iodoform and olive oil fio per cent.) or insufllate iodoforminto the rectum. If this fails, give ether, stretch the sphincter, incise the ulcerthrough its entire thickness, and cauterize with fuming nitric acid, caring forthe case subsequently as we would a patient who had had piles ligated. Intuberculous ulcer improve the general health, send the patient to a genial climate,. Fig. 867.—Papilloma of anus and rectum. or at least into the sunlight and fresh air, prevent constipation, give nutri-tious food, especially fats, wash out the rectum every day with hot water,and insufflate iodoform or inject iodoform emulsion. Touch the ulcer once aweek with silver nitrate (10 gr. to i In syphilitic ulcer give antisyphilitictreatment and treat the ulcer locally, as is done in tuberculous ulcer. Dys-enteric ulcer requires injections of hot water, the touching of the ulcer with purecarbohc acid, insufflations of iodoform, and special treatment of the Tumors of the Rectum and Anus.—These tumors may be ofthe connective, epithehal, or muscular tissue type. Of the first there arefibroma, enchondroma, lymphadenoma, lipoma, and myxoma; of the second,adenoma and papilloma; of the third, myoma and fibromyoma. Many benigntumors appear in polypoid form. A polyp is a tumor with a pedicle. Apolyp may be a fibroma,
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