The Rectum : its diseases and developmental defects / by Sir Charles B. Ball.

  • Ball, Charles B. (Charles Bent), Sir, 1851-1916.
Date:
1908
Catalogue details

Licence: In copyright

Credit: The Rectum : its diseases and developmental defects / by Sir Charles B. Ball. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    not inaptly compared by Cruveilhier to the overflow of an atonic bladder, may be sufficient to soften and break down the mass, thus permitting its expulsion, but, at other times, symptoms resembling acute obstruction of the bowel supervene. Active peristaltic motions take place, which are unable to expel the accumulation of faecal matter in the rectum, violent colic is often induced, with frequent straining and exhausting efforts to procure an evacuation, profuse sweats break out, the patient becomes cold, the pulse small and weak, and not infrequently vomiting occurs, in fact, the degree of collapse produced may be considerable. If an attempt is made to give an injection, it will be found that there is resistance to the introduction of the tube, and that it is almost impossible to force any fluid in. A digital examination will now reveal the fact that the bowel is blocked by a hardened mass of clay-like faeces, which must be broken up mechanically before the rectum can be emptied. For this purpose a lithotomy scooj), or the handle of a spoon, may be used to aid the finger, and as soon as a tube can be introduced copious injections of hot soap and water may with advantage be used to assist in the dislodgement. This operation is frequently a tedious, and at all times an unpleasant, proceeding, but the relief given is great, the amount of faeces got rid of being sometimes very great. Besides the symptoms detailed, rectal constipation may give rise to other serious complications. Ulceration of the bowel, leading to perforation, may result at any part of the large intestine. Or extensive sloughing of the rectum may supervene, as in a very remarkable case that I saw many years ago, in consultation with Dr. Wright, of Dalkey. A widow aged 65 had what appeared to be an attack of inflamed piles, from which she had suffered before. She stated positively that the bowels had been quite regularly moved. She suffered from retention of urine, and swelling of the vulva came on, followed by diarrhoea. The skin of the buttocks became red, glazed, and erysipelatous-looking, and felt very tense, the inflammation being much more marked on the right side. The skin gave way finally, permitting the escape of a considerable quantity of faeces. Rectal examination now revealed the fact that the entire lower bowel was blocked with faeces. By careful breaking up of the mass, and copious eneraata. Dr. Wright succeeded in evacuating what the nurse described as a ' bucketful' of faeces. When I saw the patient, at the right side of the bowel, about one and a half inches from the anus, the wall of the rectum had sloughed, leaving