Observations on the diseases of the rectum / by T. B. Curling.

  • Curling, Thomas Blizard, 1811-1888.
Date:
MDCCCLXIII [1863]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the diseases of the rectum / by T. B. Curling. 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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    with one which occurred after the removal of an internal pile by the acid nitrate of mercury in a lady of irritable constitution. The irritable ulcer occurs usually in middle life, and is more frequent in women than in men. It is met with as often in single as in married women; and in persons of an hysterical temperament there are, occasionally, pains of so anomalous a character as some- times to mislead the practitioner. Indeed, it is sur- prising how often this sore is overlooked even in common cases. Tactile examination is not alvvavs J sufficient, for the sore is sometimes so superficial as not to be detected except by the most sensitive and practised finger. In all instances, therefore, of painful defecation for which the surgeon is unable to account, the rectum should be carefully examined with the speculum. On the attempt to separate the margins of the anus, or to dilate the sphincter to get a view of the ulcer, or even to introduce the finger, spasm, with an aggrava- tion of pain, is, in most cases, immediately excited; and the orifice becomes strongly contracted and forcibly drawn in. When this is the case, it is better to de- sist, and to get an assistant to administer chloroform. As soon as the system is under its influence, the sphincter yields completely, and the surgeon is able to make a satisfactory exploration of the part, and. to ascertain the exact seat, character, and extent of the ulcer. In those cases in which there is little or no spasm of the sphincter, or when the muscle is relaxed under chloroform, the surgeon may dilate the anus with his two fore-fingers, so as to get a tolerably good view of the sore. A better examination, however, may be made by the use of the speculum.