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Image from page 326 of “Diseases of the rectum and anus: designed for students and practitioners of medicine” (1910)

Image from page 326 of “Diseases of the rectum and anus: designed for students and practitioners of medicine” (1910)
Heart Disease
Identifier: diseasesofrectum00gant
Title: Diseases of the rectum and anus: designed for students and practitioners of medicine
Year: 1910 (1910s)
Authors: Gant, Samuel Goodwin, 1869?-
Subjects: Anus Diseases Rectal Diseases
Publisher: Philadelphia : F. A. Davis
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Text Appearing Before Image:
tgut sutures, after the main tracthad been divided and the wound left open, a good result wasobtained in several instances. The sinuses between the exter-nal openings healed by first intention, while the main tract,leading into the rectum, healed by granulation. A great ad-vantage of the excision operation is that, when successful, onlyone or two weeks are required for a cure even in extensivecases. This operation is not universally successful, because oftension on the sutures, activity of the sphincter-muscles, strain-ing during defecation, and the great difficulty experienced inkeeping the rectal end of the wound from becoming infected.It is best suited to fistula cases fa) in which the internal open-ing is at or near the anal margin and fb) in tubercular patients,in whom a speedy convalescence is especially desirable. Division.—Of the various operations devised for the cureof fistula, complete division of the sinus is the simplest and 1 oo o ^tg fei ^ a (1^ feg2 •*) ^^• p a O

Text Appearing After Image:
TREATMENT OF ANO-RECTAL FISTULA 257 most reliable. When the fistula is short and superficial, generalanesthesia is not necessary, because the skin and structuresoverlying the sinus can be divided with little, if any, pain afterfreezing them with liquid air, ether-spray, ethyl chloride, or afterbeing anesthetized by the injection of sterile water, or a weaksolution of eucaine or cocaine. Eucaine is preferable, becauseit can be sterilised, and, in the authors experience, fewer dan-gerous and unpleasant symptoms have followed its use. In persons who object to general anesthesia or confinementto bed and also in those afflicted with serious disease of the heart,kidneys, or lungs, the sinus may be satisfactorily divided underlocal anesthesia. When a general anesthetic is necessary, the operator

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