Treatment of hemorrhoids, and other non-malignant rectal diseasesAgnew, W. P. (William Penn)
Science
Treatment of hemorrhoids, and other non-malignant rectal diseases
Agnew, W. P. (William Penn)
Hemorrhoids; Rectum -- Diseases
It is always desirable, when operating on external hemorrhoids, to see
that quite a goodly portion of the cutaneous surface, especially at
the summit, is effected by the preparation applied inside the capsule;
otherwise it will become inflamed in order to let out the interior
coagulum, which I have often seen come out on the third day intact, and
in one unbroken cystic-looking mass, Fig. 5. The same rule obtains
regarding internal hemorrhoids, having thick, unyielding coats.
Puncture the tumor at the most accessible point, preferably with the
needle, nearly parallel with, or at an acute angle to its base, carrying
the point of the needle to about the center of the tumor, if it be globe
shaped, or equi-distant from base to apex, if it be elongated, with the
face or opening of the needle toward the apex. Be sure the needle is
inserted beyond the proximal end of its opening, which is not always
observable in treating small growths; but may be tested by forcing the
piston of the syringe a little, and if the end is not sufficiently buried
the medicine will show around it on the outside.
Inject the first few drops the same as you would a hypodermic of morphia,
then slowly, drop by drop, watching its action by change of color on the
surface of the pile. This change of color on the surface is quite marked
with hemorrhoids of delicate covering, less so with those possessed
of more tough and fibrous coats. Hold the needle in position a moment
and if the quantity injected does not appear sufficient, turn the nut
on the piston with which you have previously gauged approximately the
quantity to be injected, back a few rounds and throw in more. Puncture
large elongated tumors in two, three, or four places. The compound
diffuses itself slowly and no doubt extends some farther than is always
apparent at the time of operation. Withdraw the needle carefully; it may
be necessary to force out a few drops of the preparation at the point
of entrance, for the purpose of sealing up the puncture to prevent the
escape of blood and medicine together, which, however, never amounts
to much. If, after withdrawing the needle, some of the injection fluid
runs out, unmixed with blood, take it up with absorbent cotton, since it
indicates that the quantity at that particular part is superfluous. Now
dry the surface of the tumor or tumors with absorbent cotton, smear with
vaseline and return within the bowel.
A tumor properly injected immediately becomes hard. There are septa or
compartments in elongated growths which do not permit the medicine to
pass through readily, and if a soft section is noticed, it has not been
penetrated, although will doubtless break down with the general mass.
I have seen a liberal injection into the middle one of three tumors
connected and arranged in a row, so cut into those on either side that a
single reddened column like appeared afterwards on the extreme outside,
(Figs. 6 and 7).
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