. Diseases of the rectum and anus: designed for students and practitioners of medicine. med into fibrous tissue, thusobliterating the vessel (Plate XXIV). Quenu and Hart-mann hold that the most characteristic changes are proliferat-ing endophlebitis in the veins and transformation of the rectalwall into cavernous tissue. EXTERNAL AND INTERNAL HEMORRHOIDS 415 While the venous element always predominates, each tu-mor has an arterial supply. The structure of the arteries is,however, but slightly altered in the hemorrhoidal degeneration. Some authors maintain that there is a form of arterial hem-o
. Diseases of the rectum and anus: designed for students and practitioners of medicine. med into fibrous tissue, thusobliterating the vessel (Plate XXIV). Quenu and Hart-mann hold that the most characteristic changes are proliferat-ing endophlebitis in the veins and transformation of the rectalwall into cavernous tissue. EXTERNAL AND INTERNAL HEMORRHOIDS 415 While the venous element always predominates, each tu-mor has an arterial supply. The structure of the arteries is,however, but slightly altered in the hemorrhoidal degeneration. Some authors maintain that there is a form of arterial hem-orrhoids because of the fact that in some cases the mucosa ishighly colored, pulsations can be felt, and spurting believes that the spurting in such cases is due to theblood being forced by the powerful abdominal muscles as aregurgitant stream through a rupture in the vein. Quenu andHartmann have demonstrated to their satisfaction by differ-ential injections and dissections that there is no such thing as anarterial pile. The same authors, who have made extensive in- ^^^. Fig. 137.—Protruding Internal Hemorrhoids (Schematic). vestigations along this line hold that in these cases the veinsbecome metamorphosed into a sort of cavernous erectile tissue, andsome of the veins assume the structure and functions of arteriesperhaps, but the original arteries remain unchanged or tend towardatrophy, Earle, of Baltimore, in discussing the extent to which thearteries are involved as shown by his original experiments,says: The arteries in places seem to have hypertrophied mus-cular coats and thickened membrana limitans interna; also en-darteritis obliterans; calcification of arterial wall; connectivetissue compressed and atrophied by ectasis of veins. When hemorrhoidal tumors attain such size as to project 416 DISEASES OF THE RECTUM AND ANUS into the lumen of the bowel, they are soon made to pfoirudeas a result of straining and downward pressure exerted duringdefecation. At fir
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
