CHAPTER Xni. (Part 5)

in blind pouch, 33 ending in bladder, urethra, or vagina, 86 ending of longitudinal fibres, 7 excision of (see cancer) fixed position of, 1 haemorrhage from, 67 imperforate, 88 layers of wall, 5 length, 1 lymphatics of, 19 mucous membrane, 8 muscles of, 10 muscular coats, 6 normally empty state, 27 nerves, 16 operations upon, 62 rules for examination, etc., 48 relations of different divisions, 3 submucous tissue, 7 total absence, 87 upper limit of, 2 variations in position, 3 veins, 13 detention of urine after operation, 65 Retractor recti muscle, 10 Boche. case of fatal rupture of prolapse, 120 liodent ulcer, 165 ulcer, diagnosis, 166 Hupture of bowel in prolapse, 120 of rectum causing abscess, 74 Sarcoma, alveolar, 222 Sarcomatous polypus, 139 Scirrhus, 221 • extent, 222 rarity, 228 Scrofula, as cause of ulceration, 164 Secondary haemorrhage after nitric acid to haemorrhoids, 102 Sigmoid flexure, variations in position, 48 Smith, case of divulsion, 231 clamp for haemorrhoids, 108 removal of severe prolapse, 122 Sodomy, appearance of rectum, 159 cause of ulceration, 159 cause of vegetations, 144 medico-legal proofs, 159 Sodomy (see pederasty) Spasm of levator ani after operations, 13 of sphincter, 277 of sphincters associated with fis- sure, 160 of sphincters associated with im- paction, 279 Specula, varieties of, 58 Sphincter, dilatation, 60 external, 10 functions, 28 internal, 10 nerve control of, 17 third, 7, 19 Spina bifida, 155 bifida, diagnosis, 156 Stimson on cancer, 219 Storer, method of rectal exploration, 53 Strangulation of prolapse. 119 Stricture, attempts at spontaneous cure, 186 bougies for detection of, 192 cause of abscess, 74 cause of fistula, 187 cause of peritonitis, 187 cause of ulceration, 172 congenital, 31 dangers in examination, 55, 57 due to pressure from without, 181 due to hypertrophy of valves, 184 due to gonorrhoea, 167 due to chancroid, 168 due to traumatism, 185 diet for, 197 difficulty in diagnosis when high up, 58 following removal of hemor- rhoids, 108 general treatment, 197 how to measure extent, 57 manual examination for diag- nosis, 63, 193 mechanism of production of flattened faeces, 189 non-malignant, 181 non-malignant, alternate di- arrhoea and constipation, 188 non-malignant, cause of, 181 298 INDEX. Stricture, non-malignant, change in wall of bowel capable of producing, 188 non-malignant, changes in bowel above and below, 186 non-malignant, constitution- al remedies for, 193 non-malignant, dangers of examination, 191 non-malignant, diagnosis of, 191 non-malignant, difficulty in diagnosis, 191 non-malignant, divided into venereal, non-venereal, ci- catricial, and fibrous, 188 non-malignant, pathological anatomy, 186 non-malignan t, probable causes of when extensive, 188 non-malignant, symptoms, 188 non-malignant, treatment by dilatation, 198 non-malignant, usual seat of, 187 non-malignant, value of flat- tened fseces in diagnosis, 188 non-venereal, 184 spasmodic at anus, 181 spasmodic at rectum, 182 spasmodic, explanation of supposed cases, 183 sudden death in, 216 sigmoid flexure, treatment of, 217 syphilitic, but not ulcerative, 183 syphilitic, specific treatment for, 194 use of long cylindrical spec, ulum for examination, 193 treatment by division, 202 treatment by divulsion, 200 value of dilatation, 200 venereal, 183 venereal but not syphilitic, 188 Superior hsemorrhoidal artery, 18 haemorrhoidal veins, 13 Suppositories, nutritive, 288 Sustentator tunicae mucosas, 8 Syme, treatment of fissure, 177 Syphilis and vegetations, 148 diagnostic marks of ulceration^ 171 character of secondary ulcera> tion, 170 tertiary ulcerations, 170 late manifestations causing stricture, 183 Syphilitic stricture, 188 stricture, specific treatments 194 Sympathetic nerves of rectum, 18 hsBmorrhoids, 101 Talma, autopsy on, 186 Tensor fasciae pelvis, 10 Thermo-cautery, 63 Third sphincter, 19 Transversus perinaei, 13 Tubercular ulceration (see ulcer) Tumor, peculiar bleeding (Quain), 186 Tumors, non-malignant, 135 Trousseau on fissure, 160 Ulcer, caused by applications to fissure,. 159 caused by foreign bodies, 258 chancroidal, 167 dysenteric, 166 follicular, 164 of haemorrhoid, 168 scrofulous, 164 simple, 158 tubercular, 162 tubercular, authorities on, 163 tubercu'tir, cause of fistula, 163 tubercular, cause of haemorrhage^ 163 tubercular, cause of stricture, 168 tubercular, characters of, 163 tubercular, course of, 168 tubercular, distinction between true tubercular and ulceration in a tubercular person, 162 tubercular, location of, 162 tubercular, treatment of, 164 venereal, 167 Ulceration, causing abscess, 74 caused by sodomy, 159 diagnosis of, 175 INDEX. 299 Ulceration, diet in, 179 division of sphincter for,« 180 following operation for h£Bmorrhoids, 108, 150 from application of nitric . acid to prolapse, 159 from chUdbirth, 159 from foreign bodies, 159 from hard fsBces, 158 from surgical operations, 159 gravity of, 175 harm done by exercise, 179 local remedies for, 179 non-malignant, 158 non-tubercular, 164 occurring during the course of syphilis, 172 suppositories and enemata . for, 179 syphilitic, diagnosis from tubercular, 172 syphilitic, cases of, 172 symptoms, 174 treatment, 176 treatment by absolute rest, 178 treatment by large injec- tions of nitrate of silver, 179 within rectum, treatment of, 178 Valves of rectum, 21 of rectum, hypertrophy of, 29 Vance, rare case of fissure, 161 Van Buren, operation for prolapse, 117 spasmodic stricture, 183 speculum, 58 Veins of rectum, 18 Vegetations, 148 causation, 144 due to sodomy, 144 relation to syphilis, 144 microscopic anatomy of, 143 Venereal stricture, 183 Venereal ulceration, 167 Vienna paste for haemorrhoids, 102 Vidal, cases of prolapse treated by in^ jections, 116 Villous polypi, 136 tumor, 136 Virchow, on fatty tumors, 151 Vomiting of faeces, 284 Warts, 143 causing symptoms of fissure, 146 diagnosis, 145 due to pregnancy, 144 due to gonorrhoea, 144 due to leucorrhoea, 144 mistaken for syphilitic condylo- mata, 145 non-contagiousness of, 144 non-inoculability of, 144 powerlessness of specific treat- ment for, 144 symptoms, 144 treatment, 145 within rectum, 145 Wounds of rectimi, 281 of rectum, complications, 282 of rectum, treatment, 282 Zappula, case of supposed syphilitic stricture cured by antisyphi- litic treatment, 194 This hook is the property oj COOPER MEDICAL COLLEGE, SAN FRANCISCO. 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