. Diseases of the rectum and anus: designed for students and practitioners of medicine. Fig. 78.—Gorget. and sizes (Fig. 77), which will not bend, to use in operationswhere the sinuses are long and indurated, and where the in-ternal opening is situated so high up in the rectum that thedistal end of the director cannot be brought out at the such cases a piece of soft wood, or a steel gorget (), one-half inch ( millimeters) wide and eight inches (2decimeters) long, is introduced into the rectum after the direc-tor is in proper position. The knife is then made to followthe direc
. Diseases of the rectum and anus: designed for students and practitioners of medicine. Fig. 78.—Gorget. and sizes (Fig. 77), which will not bend, to use in operationswhere the sinuses are long and indurated, and where the in-ternal opening is situated so high up in the rectum that thedistal end of the director cannot be brought out at the such cases a piece of soft wood, or a steel gorget (), one-half inch ( millimeters) wide and eight inches (2decimeters) long, is introduced into the rectum after the direc-tor is in proper position. The knife is then made to followthe director along the fistulous tract until its point enters the. Fig. 79.—Allinghams Scissors and Grooved Director. rectum and is pressed into the piece of wood. Both shouldthen be withdrawn together, thus severing all the interveningtissues. Allinghams scissors and director are especiallyadapted for such cases (Figs. 79 and 80). There is a knobon the under-surface of the lower blade of the scissors whichis made to follow in the oval groove in the director, cuttingthe tissues from without inward. Another and a better waywhen the sinus reaches high up in the bowel, or when othersinuses are suspected, is to dissect slowly from below upward,following the director until the end of the sinus is reached; 260 DISEASES OF THE RECTUM AND ANUS then any diverticula from the main sinus will not be over-looked. The sphincter-muscles. should not be severed in fistulaoperations oftener than is absolutely necessary; they may becut one, tzvo, or three times, however (Fig. 93), when neces-sity demands, and incontinence will not follow, especially if theincisions a
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
