The principles and practice of surgery: embracing minor and operative surgery : with a bibliographical index of American surgical writers from the year 1783 to 1860 : arranged for the use of students (Volume 2) . eche; while, in some instances,* thebelly has become enormously distended by flatus, owing to the adhesionsof the side of the anus, the dilatation of which exposed to hemorrhage, andnecessitated the use of the meche to prevent the growing together of theadjacent portions of the orifice of the bowel. Although as a matter of history, and to enable others to judge for them-selves of the
The principles and practice of surgery: embracing minor and operative surgery : with a bibliographical index of American surgical writers from the year 1783 to 1860 : arranged for the use of students (Volume 2) . eche; while, in some instances,* thebelly has become enormously distended by flatus, owing to the adhesionsof the side of the anus, the dilatation of which exposed to hemorrhage, andnecessitated the use of the meche to prevent the growing together of theadjacent portions of the orifice of the bowel. Although as a matter of history, and to enable others to judge for them-selves of the advantages of this so-called new operation, I cite it, it is withno wish to recommend or approve of its repetition. With the safety andbenefits of ligation by the use of threads, or by the application of a wireligature or the sloughing of the tumors by nitric acid, well established, thereis no good reason for substituting a plan that requires a resort to an expen-sive instrument as an addition to strangulation by a ligature previouslyapplied to pediculate the mass; it being well established that the ecraseurcannot be made to act on tumors with broad bases. Chassaignacs operationis as follows:— Fig. H. SCSA. L O Fig. 439.—Two varieties of tiie Ecraseur of ChaRsaignac, showing how the loop of the chain is tightened80 as to excise by slow pressure whatever is included in its grasp. (After KolW.) Operation of Chassaignac by the Ecraseur.—In order to form a pediclefor the tumor, the forefinger of the operator, with a large loop of a ligatureon the knuckle, should be introduced into the rectum, with the last phalanxcurved so as to hook out toward the exterior of the anus the hemorrhoidaltumor, without bringing it entirely out of the gut. The loop of this ligature,being then pushed by an assistant over the convex side of the forefinger asfar as possible to the base of the pile, is then to be drawn tight (Fig 440)around the tumors.^ » v b- j The loop of an Ecraseur being n
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