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

  • Curling, Thomas Blizard, 1811-1888.
Date:
1851
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 the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    On examining the nicer, without distending the rectum, the lateral edges only being presented to view, the breach of surface has the appearance of a fissure,—the term com- monly given, but improperly, to this sore, which is ob- viously more than a mere cleft or rent in the mucous membrane of the bowel. Such an ulcer may occur in any part of the lower circumference of the rectum, but it is very generally found at the back part, towards the sacrum. It is quite superficial, and, though sometimes circular, is more usually of an oval shape ; its long axis being longitudinal, and its lower extremity extending within the circle of the internal sphincter. On tactile examination, the breach in the mucous surface and the extent of the ulcer can be easily distinguished by a practised finger, especially when the edges are, as is often the case, somewhat indurated. With the specu- lum, the longitudinal folds being stretched out, the ulcer can be fully exposed, and it is then clearly seen not to be a mere fissure, but a superficial sore, which may extend beyond the edges of the opening in a common-sized speculum. The surface is of a brighter red than the surrounding membrane, and has the usual indented appearance of an ulcer. The amount of suffering produced by this superficial ulcer varies a good deal, but the sore is generally ex- tremely sensitive, and occasions severe distress. It is so situated that the fasces, in their passage outwards, rub over its surface, and the painful contact excites spasm of the sphincter muscle, causing a sharp burning pain, and often a forcing sensation, which lasts for two