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Treatment of hemorrhoids, and other non-malignant rectal diseases cover

Treatment of hemorrhoids, and other non-malignant rectal diseases

Chapter 24: PROCTITIS.
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About This Book

A concise clinical handbook addressing non-malignant rectal conditions, chiefly hemorrhoids, offering practical guidance for general practitioners. It explains classification of internal and external lesions, diagnostic maneuvers including positioning, warm enemas, digital and specular examination, and techniques for reducing prolapse. The author advocates carbolic acid injection as a simple, safe office procedure, describes indications, operative steps, postoperative care, and potential complications such as marginal abscesses, and emphasizes conservative measures and patient instructions to minimize irritation. The tone is pragmatic, aiming to equip non-specialists with clear, applicable treatment rules.

PROCTITIS.

Inflammation of the rectum, like any other phlegmasia, may arise traumatically or idiopathically; by contiguity of structure or continuity of surface. The acute symptoms are very much like acute dysentery, which disease, in my opinion, nearly always extends to the rectum, causing the characteristic symptoms of weight, tenesmus and straining at stool.

Irritable rectum in the absence of diarrhœa is diagnostic of the complaint. The bladder and prostate may be affected through sympathy, and colicky pain reflected to the small intestines or stomach. In the more chronic forms, constipation, tenderness and the cul-de-sac partially filled with mucous are distinguishing features.

Carbolized hot water irrigation, prepared hot corn starch, slippery elm water, bismuth, etc, together with a suppository of iodoform, bismuth and opium, or bismuth, opium, belladonna and calomel, will be found serviceable in the acute stage. About a half tumbler full of a saturated solution of chlorate of potash, injected slowly and retained for ten or fifteen minutes, is said to effect a cure by one or two injections.

Chronic proctitis, also called irritable rectum, and sometimes rectal catarrh, with symptoms that might be expected to emanate from a disease of the mucous membrane, rarely amounting to a diffuse thickening of the rectal walls, is treated similarly, except less palliative. Combinations of eucalyptol, iodoform and bismuth; or eucalyptol ½ dr., oxide of zinc 1 dr., vaseline 1 oz., are highly recommended after the rectal douche.

Some physicians hold that chronic inflammation of the rectum is a disease of more frequent occurrence than all other rectal diseases combined. And equally as pernicious, causing many functional and even organic troubles through reflex action.