An essay on the use of nitric acid, as an escharotic, in certain forms of hemorrhoidal affections; illustrated by cases / by John Houston.

  • Houston John, 1802-1845.
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: An essay on the use of nitric acid, as an escharotic, in certain forms of hemorrhoidal affections; illustrated by cases / by John Houston. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    their protrusion through the anus, a permanently widened state of that aperture, and a habitual prolapse, not only of the tumour itself, but also of a portion of the bowel. In the early periods of the affection, the tumours are so soft, compressible, and free from pain as scarcely to be discoverable by the finger when in- troduced into the rectum, and scarcely, therefore, to be deserv- ing of the term, tumour ; but, when of long standing, and espe- cially when they have been permitted to remain down for pro- tracted periods at the water-closet, they acquire an increase of firmness and a tenderness which render them easily detected by such manipulations, and give them a tangible and permanent cha- racter. The dragging and pressure to which they are subjected in being pushed out and squeezed by the sphincter in defecation, renders them likewise prominent, and gives to them often a pe- dunculated or polypus-like form. The surface of the tumour is either granulated like a strawberry, or of a villous aspect. It is of a red colour, and, when protruded from the anus, bleeds from every pore as from a sponge. It is easy to satisfy one’s-self on this latter head, by drying the surface of the tumour, when a fresh issue of blood instantly takes place from every point of its surface. The blood discharged, in such cases, is always of the arterial red colour,—a circumstance which often, in itself, indicates the true nature of the affection, and enables us to distinguish it from rup- ture of a varix. But, nevertheless, although this may be true as regards the direct issue of blood from the part, yet this very fluid, may, if allowed to lie in the cavity of the rectum before being discharged per anum, acquire a dark red, and even a gru- mous character. {See Case I.) The bleeding in the former is also of more frequent occurrence, appearing with every effort at defecation, and weakening the patient more by the frequency and persistency of the drain than by the quantity lost at stated pe- riodical intervals, such as usually takes place in the bursting of varices from over-distention. Regarding the pathology of “ vascular tumours,” there are, I believe, two varieties of organic lesion, which, although dif-