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.

    30/288 (page 10)
    This ulcer seldom heals under the influence of local applications. The treatment necessary is a longitu- dinal incision through its centre, including the super- ficial fibres of the sphincter muscle. The object of the operation is to place this muscle at rest for a time, and to enlarge the passage and displace the sore; thus removing those sources of irritation which prevent its healing. An incision, it is true, is not invariably required; but in all cases in which the pain is con- siderable, and in which there is much spasm of the sphincter, the attempt to procure the healing of the sore by local applications so often protracts the pa- tient’s sufferings, and so constantly ends in failure, that it is not desirable to make it. The credit of originating the operation of incision for the cure of this painful complaint is due to the distinguished French surgeon Boyer. His operation was a free division of the sphincter muscle, a pro- cedure unnecessarily severe '. Dupuytren practised a slighter incision than the operation performed by Boyer, and the late Mr. Copland was content to make a simple superficial incision of the part. In describ- ing the operation to me, this excellent practical sur- geon spoke of it as merely a division of the mucous membrane. I am convinced that on this point he is in error; at any rate this is not sufficient; and that however slight and superficial the incision may be, a few, at least, of the fibres of the sphincter must be divided. I had occasion to pxamine the rectum of a lady suffering from this affection, whilst she was under 1 A serious objection to the free division of the sphincter, an operation still practised by surgeons in this country, is a deficiency in the retentive power of the muscle, which sometimes distresses the patient after the part has healed.