Publisher's Synopsis
This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1920 edition. Excerpt: ... in character than hemorrhoids, and when replaced by the finger, go back into the rectum with more or less of a snap, which is somewhat characteristic of this condition. Anoscopic examination shows the polypus to be a small, rounded, hard, fibrous Fig. 141.--Distention completed, showing internal hemorrhoids presenting. tumor, attached by a pedicle narrower than itself, its usual attachment being somewhat higher in the lower rectal cavity than that of a hemorrhoid. Enlarged anal papillae have been diagnosed as connective-tissue piles. The enlarged papilla, however, is small, always triangular, though occasionally long drawn out and somewhat ribbon-shaped. It is pinkish in color and does not contain varicose veins. The point or tip is always downward, and it is attached by its base or widest portion. They are situated at the juncture of the anus and rectum, at the lower edges of the crypts of Morgagni. Venereal warts of large size have been incorrectly diagnosed as external integumentary piles (Fig. 129), but close inspection, after obtaining a history of discharge from venereal disease, should make the diagnosis evident. Occasionally the protrusion of an anal or perianal abscess may simulate an inflamed external hemorrhoid. However, with t he finger of one hand in the rectum and the other Fig. 142.--Method of injecting prolapsing pedunculated internal hemorrhoids. hand on the protrusion, the site of the abscess cavity can be made out, and fluctuation often determined. The sudden onset, accompanied by the intense pain, swelling, redness, and rise of temperature, always points to abscess formation rather than to hemorrhoids. The protrusion which is often mistaken for prolapsed hemorrhoids is prolapsus ani or recti. There are three degrees...
