. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. )arture from the normal size in the prostate,and this should be noted carefully, as there occasionallyseems to be an interdependence of bladder irritability andrectal disease. As a further extension of examination by the sense oftouch, recourse must be had to rectal sounds for the purposeof detecting obstructions in the deeper parts of the authors sound consists of a hollowsteel staff of a curve taken fiom repeatedexaminations on the cadaver, and oval bulbsof graded sizes, from 1 cm. to
. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. )arture from the normal size in the prostate,and this should be noted carefully, as there occasionallyseems to be an interdependence of bladder irritability andrectal disease. As a further extension of examination by the sense oftouch, recourse must be had to rectal sounds for the purposeof detecting obstructions in the deeper parts of the authors sound consists of a hollowsteel staff of a curve taken fiom repeatedexaminations on the cadaver, and oval bulbsof graded sizes, from 1 cm. to 4 cm. in dia-meter, which can be screwed upon it. Thisinstrument is used for diagnosis only. Its curve has prov-ed so correctthat it can Fig. 5.—The Adthobs Rectal Sound. 1 ^ 1 ,r ,^r, c. o ieatiii\ |)ciss the sigmoid flexure, and be felt through the abdominal wall without serious inconvenience to the jjatient. The handle, staif and bulbs are perforated for convenience in injecting through METHODS OF EXAMINING THE IIKCITM. 15 Scninds must l)e used with jrreat jjentleness, <is ulceratetlspots iu the iutestiiie are sometimes exceedingly thin andmay be ruptured. The easy passage of a large bulb provesthe absence of stricture as far as it goes, but its arrest doesnot prove the existence of one. The upper rectum and lowercolon have not only j)lications of membrane projecting intothem, but the walls of the gut are liable to fold up over theend of an instrument, so that in deep sounding a mere arrestof progress does not prove the stricture. Tlie hand is sometimes introduced into the rectum fordeep exploration. The operation, liowever, has sometimescaused death, and should only lie resorted to when theemergency is such as justifies incurring some risk. Thehand to be introduced should be small in circumference, welllubricated, and introduced very slowly and carefully, withthe fingers gathered into the form of a cone. Of all explor-atory instruments, the index finger is the o
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Keywords: ., bookcentury1800, bookdecade1880, booksub, booksubjectanusdiseases
