. Diseases of the rectum and anus: designed for students and practitioners of medicine. cause if a larger amount is used a part of it will remain in thecolon and may subsequently flow down over and soil thefield of operation. The external parts should be thoroughlycleansed, and, if necessary, shaved; but, unless the wound isto be sutured, the writer omits the shaving, because of thediscomfort caused the patient during the period when the hairsare growing out. When a general anesthetic is to be given,no food should be taken for several hours previous. 436 DISEASES OF THE RECTUM AND ANUS The fol
. Diseases of the rectum and anus: designed for students and practitioners of medicine. cause if a larger amount is used a part of it will remain in thecolon and may subsequently flow down over and soil thefield of operation. The external parts should be thoroughlycleansed, and, if necessary, shaved; but, unless the wound isto be sutured, the writer omits the shaving, because of thediscomfort caused the patient during the period when the hairsare growing out. When a general anesthetic is to be given,no food should be taken for several hours previous. 436 DISEASES OF THE RECTUM AND ANUS The following are the operations which have been sug-gested for the relief of internal hemorrhoids^:— 1. Clamp and cautery. 2. Ligature. 3. Excision. 4. Injection of caustic and astringent solutions. 5. Submucous ligation. 6. Cauterization: (1) by puncture, (2) linear, and (3) bygalvanocautery-wire. 7. Divulsion. 8. Crushing. 9. By the ecraseur. 10. Application of chemic caustics. The Clamp-and-Cautery Operation was originated by , of Dublin. It was introduced into London by Gants Hemorrhoidal and Tissue Forceps. Henry Lee, and later was brought prominently before theprofession in England by Mr. Henry Smith, while deliveringlectures before the Medical Society of London, during thewinter of 1864 and 1865. He had previously performed theoperation many times. Up to the date of the origin of thisoperation the ligature was used universally throughout GreatBritain. Through the instrumentality of Mr. Smith many sur-geons were induced to use the clamp and cautery, and themajority who gave it a fair test were much pleased with theresults. It is popular in Germany; but in America it is a ques-tion which is the more popular, the clamp and cautery or theligature, both having many advocates of equal ability. Thewriter is partial to the clamp-and-cautery operation. By theaid of the modern clamps and the Paquelin cautery or cautery-irons (Figs. 144, 148, and 149), the operation is no
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