. Diseases of the rectum and anus: designed for students and practitioners of medicine. the clot has formed, it is soft, pliable, and the color of the sur-rounding skin. There has been considerable controversy as towhether the clot is formed in a dilated vein or in the tissues out- EXPLANATION OF PLATE XXIV At the Tipper margin the dark, irregular line repre-sents the epidermia, which, on the right, one and one-half inches ( centimeters) lower down, thins out intothe stratified mucous membrane of the anus. Thisshortly disappears, having been lost in sectioning, buttwo inches ( centimete
. Diseases of the rectum and anus: designed for students and practitioners of medicine. the clot has formed, it is soft, pliable, and the color of the sur-rounding skin. There has been considerable controversy as towhether the clot is formed in a dilated vein or in the tissues out- EXPLANATION OF PLATE XXIV At the Tipper margin the dark, irregular line repre-sents the epidermia, which, on the right, one and one-half inches ( centimeters) lower down, thins out intothe stratified mucous membrane of the anus. Thisshortly disappears, having been lost in sectioning, buttwo inches ( centimeters) farther down the mucousmembrane of the rectum appears, bounded internally bythe muscularis mucosae, which is seen as a thin, darkishline. Beneath the epidermis, above is a mass of dense con-nective tissue traversed by large numbers of distendedblood-vessels, and beneath this are enormously dilatedvenous channels filled with dark masses of coagulatedblood. There ia no evidence of actual hemorrhage, thecoagulated masses being obviously contained withindefinite channels. FLUTE XXIU. MicroscopicHppearancs of Homorrlioid, [MagrAficatian, ID,-] EXTERNAL AND INTERNAL HEMORRHOIDS 417 side after the vein has been ruptured and extravasation ofblood has occurred. The author has carefully dissected manyof these tumors and has had microscopic examinations madeof many specimens, and he is convinced that the clot mayform either within the vein (Plate XXIV) or in the tis-sue external thereto (Plate XXV). It is probable that,when the clot requires several days to form, it is intra-venous; but, when it appears suddenly after straining atstool, it is likely that a diseased vein has been rupturedand a clot formed in the adjacent tissue. When the clothas become partially organized, it is not difficult to mistakethe capsule formed around it for the dilated vein-wall. Ineither case when the clot is enucleated it leaves a fairlysmooth surface. Such a clot may be entirely absorbed aftera
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
