Practical observations on important diseases of the rectum and anus ; with numerous cases illustrating the successful practice of an improved mode of curing the prolapsus ani, piles, or haemorrhoidal tumours, and the fistula in ano, without cutting or confinement ; and the treatment of stricture, fissure, excrescences, intestinal concretions, and other inscidental affections. / by E. D. Silver.

  • Silver, E. D. (Ebenezer David)
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: Practical observations on important diseases of the rectum and anus ; with numerous cases illustrating the successful practice of an improved mode of curing the prolapsus ani, piles, or haemorrhoidal tumours, and the fistula in ano, without cutting or confinement ; and the treatment of stricture, fissure, excrescences, intestinal concretions, and other inscidental affections. / by E. D. Silver. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    orifice, directed downward and backward, situated about an inch in front of the extremity of the coccyx, behind the perineum, between the tuberosities of the ischia, but considerably above them in the male, and in the median line between the buttocks. It is covered by fine, soft, pliant skin, furnished with sebaceous follicles, which secrete an unctuous matter of a peculiar odour, and from whose centre hairs grow in the male adult. This integument is cor- rugated by the action of the sphincter ani, and a short distance above the verge of the orifice it gra- dually assimilates in structure with the mucous membrane, disappearing opposite the inferior border of the internal sphincter muscle. The muscles peculiar to the anus are the sphinc- ter and levatores ani. The sphincter ani or externus is a thin, oval, pale muscle, which arises from the tendinous raphe, extending from the apex of the coccyx. Passing downward and forward, it divides into two sets of muscular fibres, which are directed outward at an acute angle, expanding on each side in the middle towards the tuberosity of the ischium, then curving forward and inward, they form the arch of a circle, and unite in front at an angle, similar to that at which they separated, to be in- serted into the common central tendinous point of the perineum and tegumentary raphd. Thus the external sphincter muscle encircles the margin of the anus, and forms two commissures, one anterior, and the other posterior to this opening, which are ren- dered firm by the interlacing of the fibres of each side. In the female, the anterior extremity of this