Image from page 1346 of “Modern surgery, general and operative” (1919)

Image from page 1346 of “Modern surgery, general and operative” (1919)
Identifier: modernsurgerygen1919daco
Title: Modern surgery, general and operative
Year: 1919 (1910s)
Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933
Subjects: Surgery, Operative
Publisher: Philadelphia : Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Text Appearing Before Image:
rticles of food whichcause frequent movements of the bowels. If an individual sits a longtime on the seat of the closet or on the chamber the development of prolapseis favored. The condition comes on gradually and is at first painless. Forsome time it reduces itself spontaneously after defecation, but reduction be-comes more and more difficult. A common custom of sufferers is to push itby the fingers above the grasp of the sphincter. Sometimes, but seldom, itbecomes strangulated. A recent prolapse is pink, an older one is angry red;one which is tightly caught is purple; a strangulated one is deep purple and soonbecomes black from gangrene. If the prolapse be of the entire circumferenceit shows radial folds of mucous membrane. It frequently bleeds. Prolapse,be it large or small, tends to recur again and again, and eventually the mucousmembrane inflames, ulcerates, or sloughs. Prolapse of all the coats may ensue(see below). The condition is sometimes confused with hemorrhoids, but in ^^

Text Appearing After Image:
Fig. 866.—Rectal prolapse. prolapse the protruding mass is circular and has a depression in the center,whereas hemorrhoids are distinct masses. Further, hemorrhoids are veryrare in children. Hemorrhoids often exist with prolapse of the mucous mem-brane and frequently cause it. In prolapse of the mucous membrane thereis no sulcus between the sphincter muscle and the anterior portion of the pro-trusion; in complete prolapse there is. Treatment.—Palliative treatment forbids straining at stool and amendsan improper diet. Phimosis must be corrected; stone in the bladder mustbe removed; stricture must be dilated; hemorrhoids and polypi are to beremoved. Give an enema of cold water just before going to stool in orderto hurry the emptying of the rectum. If prolapse occurs, the protrusionmust be bathed with cold water and restored. Constipation must be pre-vented (enemata of water or glycerin may be used), and after each movementseveral ounces of an infusion of white oak bark (i ounce of q

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