. Clinical gyncology, medical and surgical. dicle is present. Malignant tumors are recognized by the extremelyfetid secretion and the grave alteration of the general health. The treatment consists in the removal of the tumor. Some operatorsdraw it down and twist its pedicle ; this should be carefully done, so as toavoid prolapsus of the rectum. The elastic ligature may be used, and alarge pedicle should be tied in two sections. The safest and most expedi-tious method is to apply a pair of haemostatic forceps to the base of thepedicle, to draw it down, and to cut away the tumor, leaving the for
. Clinical gyncology, medical and surgical. dicle is present. Malignant tumors are recognized by the extremelyfetid secretion and the grave alteration of the general health. The treatment consists in the removal of the tumor. Some operatorsdraw it down and twist its pedicle ; this should be carefully done, so as toavoid prolapsus of the rectum. The elastic ligature may be used, and alarge pedicle should be tied in two sections. The safest and most expedi-tious method is to apply a pair of haemostatic forceps to the base of thepedicle, to draw it down, and to cut away the tumor, leaving the forceps inplace. PROLAPSE OF THE RECTUM. Prolapse of the rectum is a more or less complete protrusion of themucous membrane or of all the tunics of the bowel. The mucous mem-brane is so loosely connected with the muscular layer by cellular tissue that DISEASES OF THE RECTUM AND ANUS. 901 it can slide upon the latter and even protrude from the anus. (Fig. 17.)A slight straining effort, such as accompanies defecation, may be sufficient Fia. Prolapse of all the coats of the rectum. (Busche, to cause such protrusion. This condition can be seen in an exaggeratedstate in the horse. Instead of the mucous membrane only, all the layerssometimes prolapse. (Figs. 18,19.) A cylindrical tumor fromone to three inches in lengthis then formed. When thetumor is small it has at its in-ferior extremity a small roundorifice, and when large it isoften found hollowed out likea horseshoe by the traction ofthe mesorectum. In the de-scent the peritoneal cul-de-sacis ordinarily obliterated and aportion of the small intestinemay be carried down with the naturalpredisposition of the tissues tobecome invaginated, unusual force is necessary to cause extensive active factors may be diarrhoea or chronic dysentery, the presence ofa polypus or hemorrhoids, repeated pregnancies, tumors of the sacrum, andthe efforts of coughing in cases of chronic bronchitis. Symptoms.—Simple p
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