. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. of the anus,where the skin ioins the mucousmembrane the subcutaneous con-nective tissue is somewhat denserthan above or below, binding theintegument there closer to theinner edge of the external sphinc-ter. This circle of denser tissueresists the distention of the veinsat that line, so that we usually findthe internal piles above separatedby a narrow groove from the ex-ternal piles below. However, thedense tissue does not always main-tain its grij), and we often find internal and external piles run
. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. of the anus,where the skin ioins the mucousmembrane the subcutaneous con-nective tissue is somewhat denserthan above or below, binding theintegument there closer to theinner edge of the external sphinc-ter. This circle of denser tissueresists the distention of the veinsat that line, so that we usually findthe internal piles above separatedby a narrow groove from the ex-ternal piles below. However, thedense tissue does not always main-tain its grij), and we often find internal and external piles running i^^^^^^^ ./j ExIbbnai. each other with no groove to mark the boundary between them. In short, the same pilemay be both internal and external. Physicians often speakof suspected internal piles high up in the rectum. This isan error. There are no internal piles so high uji that theynever show during defecation. They rarely occur more thanan inch above the verge. External piles are specially liable to Itecome obliteratedby thrombus, suppuration, etc., in wliicii case they leave. 24 RECTAL AlVn ANAL SURGERY. sundry projecting tabs and folds of skin which are stillcalled external piles, though no longer containing enlarged veins. Most of thetemjjorary piles form-ed by estravasatedclots are also in the
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Keywords: ., bookcentury1800, bookdecade1880, booksub, booksubjectanusdiseases
