. Elements of pathological anatomy. Anatomy. 286 LARGE BOWELS. [chap. vn. pends upon the presence of hemorrhoids. In the second variety, (Fig. 62,) there is a descent of all the coats, the whole on the greater portion of the rectum falling through the external sphincter muscle. The extent to which the protrusion occurs varies from a few lines to six or ten inches. In cases of the latter kind, it is proba- ble that there is a real invagination of the sig- moid flexure of the co- lon ; for it is difficult to conceive, as has been justly remarked by Pro- fessor Syme,* of Edin- burgh, how the rect
. Elements of pathological anatomy. Anatomy. 286 LARGE BOWELS. [chap. vn. pends upon the presence of hemorrhoids. In the second variety, (Fig. 62,) there is a descent of all the coats, the whole on the greater portion of the rectum falling through the external sphincter muscle. The extent to which the protrusion occurs varies from a few lines to six or ten inches. In cases of the latter kind, it is proba- ble that there is a real invagination of the sig- moid flexure of the co- lon ; for it is difficult to conceive, as has been justly remarked by Pro- fessor Syme,* of Edin- burgh, how the rectum could suffer the requi- site displacement, even supposing that it pos- sessed the necessary length. When the pro- lapsion is complete, as in the form of the lesion we are contemplating, the tumor is commonly of an irregularly, glob- ular figure, and varies from the size of an egg to that of the two fists, the mucous membrane is of a dark livid color, from the constriction of the capillary vessels, and affords a thin, bloody secretion, which has been compared, not un-. * Principles of Surgery, p. 294. Edinburgh, Please note that these images are extracted from scanned page images that may have been digitally enhanced for readability - coloration and appearance of these illustrations may not perfectly resemble the original Gross, Samuel D. (Samuel David), 1805-1884. Boston, James Dow
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