The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . with cancerous implication of them. Flatus as wellas faeces thus get entrance into the bladder and vagina; the flatus pass-ing out with a rush, the faeces sometimes olistructing the urethra, andoften very seriously irritating the bladder, producing strangui-y andgreat pain. Death may put an end to the patients sufferings in several ways: byexhaustion from i)ain and continuous discharge, together with constitu-tional cachexy; by pjerforation of the canceroiis mass, which, ulceratingthrough at some
The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . with cancerous implication of them. Flatus as wellas faeces thus get entrance into the bladder and vagina; the flatus pass-ing out with a rush, the faeces sometimes olistructing the urethra, andoften very seriously irritating the bladder, producing strangui-y andgreat pain. Death may put an end to the patients sufferings in several ways: byexhaustion from i)ain and continuous discharge, together with constitu-tional cachexy; by pjerforation of the canceroiis mass, which, ulceratingthrough at some point, opens into the peritoneal cavity, and, by hsemor-rliage internal or into the gut, inducing fatal collapse, rapidly destroyslife; and in otlier instances, though more rarely, by fsecal obstruction,as in the case of simple stricture. The reason why intestinal obstruc-tion is comparatively^ rare in cancer of the rectum is, that the diseasedmass ulcerates and necroses more rapidly than it grows into the bowel,and thus an irregular chasm is left in its centre, through which the Fig. 69o.—Cancer of Upper Part of Rec-tum. At X perforation took place,leading to fatal Peritonitis duringadministration of an Enema. 680 DISEASES OF THE LARGE INTESTINE AND ANUS. T^eatment.—This must necessarily be palliative. The bowels must berelieved b}^ occasional doses of castor-oil or by emollient euemata. Largedoses of opium, or of morphia injected hypodermically, are required aftereach action of the bowels to lessen the patients distress. Little goodcan be expected from more active measures: dilatation only irritates thedisease and would tend to increase the mischief. The application ofcaustics, such as potassa fusa, offers no prospect of advantage, as onl}a superficial slough could in this way be formed without \QYy seriousrisk of perforation ; it is, besides, an excessively painful remedy. Amus-sat has proposed to crush and break down the morbid mass by means oftlie finger
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Keywords: ., bookcent, bookdecade1870, booksubjectsurgicalproceduresoperative
