. Diseases of the rectum and anus: designed for students and practitioners of medicine. below. Percussion and Fluctation assist in locating tumors, detect-ing fluids, and determining the extent of dilatation of the colonin cases of partial and complete occlusion. EXAMINATION 51 Succussion.—Bouchard has emphasized the value of thismethod in determining the amount of gas and hquid in thebowel. With the patient in the recumbent position, a seriesof rapid taps are made over the sigmoid and colon. If thebowel contains a large amount of gas and liquid, their presenceis revealed by a sensation of spl


. Diseases of the rectum and anus: designed for students and practitioners of medicine. below. Percussion and Fluctation assist in locating tumors, detect-ing fluids, and determining the extent of dilatation of the colonin cases of partial and complete occlusion. EXAMINATION 51 Succussion.—Bouchard has emphasized the value of thismethod in determining the amount of gas and hquid in thebowel. With the patient in the recumbent position, a seriesof rapid taps are made over the sigmoid and colon. If thebowel contains a large amount of gas and liquid, their presenceis revealed by a sensation of splashing. Distension.—Distension of the bowel with fluid or gas issometimes of assistance in doubtful cases (especially invagina-tion) where a diagnosis is to be reached by exclusion. Exploratory Incision should be resorted to in all cases ofsuspected disease in the upper rectum, sigmoid flexure, andcolon where diagnosis is impossible by less radical procedures. Introduction of the Hand into the bowel for the purpose ofexamining the rectum is dangerous, barbarous, and entirely un-. Fig. 16.—Pratts Bivalved Operating Speculum. called for. Formerly there was some excuse for resorting tothis method of examination, but since the advent of the proc-toscope there is none. Several deaths have followed ruptureof the intestine caused by insertion of the hand into the rectum. Inspection. — No examination is complete until the anusand vicinity have been thoroughly inspected. Pruritus, ec-zema, primary tuberculosis, condylomata, chancres, chancroids,fissures, congenital syphilis, and thread-worms can usually berecognized in this way without internal examination. Urine and Blood.—The urine and blood in all grave casesand of persons who are to undergo a tedious operation shouldbe examined to ascertain the condition of the kidneys andproportion of the blood-corpuscles. When the count goes be-low 1,000,000 it means pernicious anemia. Leucocytosis almostinvariably accompanies exudative


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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910