. Diseases of the rectum and anus: designed for students and practitioners of medicine. e best operation, except-ing colostomy, in cases of threatened obstruction, accompaniedby extensive ulceration. On the other hand, Mathews, Crede,and others %\^t preference to the simple internal division ofthe stricture at different points. Ouenu and Hartmann have collected 32 cases of stricture, 372 DISEASES OF THE RECTUM AND ANUS including 6 of their own, treated by external proctotomy;but 1 patient was cured, 21 relapsed, 3 died from the operation,and 4 died at a later period from cachexia or phthisis.
. Diseases of the rectum and anus: designed for students and practitioners of medicine. e best operation, except-ing colostomy, in cases of threatened obstruction, accompaniedby extensive ulceration. On the other hand, Mathews, Crede,and others %\^t preference to the simple internal division ofthe stricture at different points. Ouenu and Hartmann have collected 32 cases of stricture, 372 DISEASES OF THE RECTUM AND ANUS including 6 of their own, treated by external proctotomy;but 1 patient was cured, 21 relapsed, 3 died from the operation,and 4 died at a later period from cachexia or phthisis. In the authors experience, posterior proctotomy has manyadvantages over the internal division and other operations,and is a most valuable substitute for colostomy in all bad casesof non-malignant, ulcerating stricture. The advantages of poste-rior proctotomy are : 1. It permits of free drainage through thedeep triangular incision. 2. Any hemorrhage that might occurcan be readily detected and arrested. 3. It allows free dis-charge of accumulated feces, immediately doing away with all. Fig. n7.—Waless Soft-Rubber Rectal Bougies. Straining, pain, diarrhea, and tenesmus. 4. It permits of easyirrigation and medication both above and below the — The operation is performed as follows: Withthe patient in the lithotomy position, the limbs well flexed andheld in position by means of a Clover crutch, the anus and sur-rounding parts are cleansed, shaved, and the rectum straight, probe-pointed bistoury of good length is thenselected, placed flat upon the finger, then introduced withinthe anus and passed upward until the constriction is felt; theknife is then thrust through the stricture aperture and madeto pass backward to or near the sacrum. It is then withdrawn, NON-MALIGNANT STRICTURE 373 cutting the stricture and all intervening tissues, including thesphincters, downward and outward to a point opposite the tipof the coccyx, thus making a long and deep
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
