An essay on surgical treatment of hæmorrhoidal tumours / by Henry Lee.

  • Lee, Henry, 1817-1898.
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: An essay on surgical treatment of hæmorrhoidal tumours / by Henry Lee. Source: Wellcome Collection.

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    the part touched, and partly by its direct action on the lining tissue, and partly by coagulating the blood in the veins, it completely destroys its vitality. This action is under ordinary circumstances confined to the mucous mem¬ brane and the vessels which supply it. The acid does not penetrate deeper than this ; and consequently, its action being thus limited in depth, its effects may be regulated with the greatest nicety, according to the extent of surface to which it is applied. This operation, properly performed, I believe to be per ¬ fectly safe; for, although cases have been recorded in which very unpleasant symptoms have arisen after the applica¬ tion of the nitric acid, yet, never having witnessed any such, except in cases where the acid had been injudiciously employed, I am led to conclude that such symptoms may be attributed to the rules concerning the use of this re¬ medy, already laid clown, not having been observed. ii. The cases in which the use of the nitric acid alone has not proved successful, are those in which the mucous membrane has become thickened, and the subjacent parts infiltrated with lymph, as the result of repeated attacks of inflammation ; and those in which the mucous membrane from long exposure has become hardened and altered in structure. The first of these orders of cases is met with usually in the comparatively young and plethoric ; the second, in patients of a languid temperament, or ad¬ vanced in life. The acid, when applied in such instances, does not fairly permeate the structure of the mucous mem¬ brane ; it usually removes a superficial layer only, which is soon replaced, and the diseased parts are left in much the same condition as before. These observations are illustrated by the following cases. Case iv. A lady, of full plethoric habit, and of a florid complexion, who had had several children, wished some¬ thing to be done for some piles, which had caused her some inconvenience for a considerable time. The tumours were found to consist of firm, solid, oval masses, of a bright red colour, covered by the smooth mucous membrane near the margin of the anus. The tumours were touched with the strongest nitric acid in the usual way. At the expiration of a fortnight, they were found to be in very much the same condition as before the acid had been applied. Case v. A clergyman, between 70 and 80 years of age, but in good general health, complained of the constant inconvenience attending a partial prolapsus of the mucous