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. 1890 edition. Excerpt: ... FISSURE OF THE ANUS. Fissure is reported to be a disease in infants and children. Bokai, Esmarch, and St.. Germain in his recent work on the Surgery of Childhood, are agreed on that point. Daniel Moliere in his' Diseases of the rectum, p. 155, expresses the same opinion, reporting but a slim literature on the subject, and quoting Ducloz, Allingham and Miller as his authority. A. B. Kelsey in "Diseases of the Rectum and Anus," N. Y., 1884, p. 267, has but a brief note on the occurrence of fissure in children. In it he refers only to Kjellberg, who emphasizes the fact that it is much more frequent than is generally assumed. Kjellberg's figures are as follows: 9098 children were presented in the Dispensary of Stockholm; in 128 there was fissure of anus; 60 of the patients were boys, 68 girls; the majority were less than a year old, 73 less than four months. Thus, only Kjellberg claims that fissure is frequently found in the first year of life. When the nates are gently parted, fissure is not visible, or but rarely so. Pulling harder upon the anus, to the right or left, it becomes perceptible as a narrow cut, red and clean, or sometimes grayish, and ulcerated, one-half, two, or even five, lines in length. Very seldom does it extend beyond the sphincter. Handling it as described a little blood may ooze out, but there is never much loss of blood. The slightest touch is exceedingly painful. The surrounding skin is wholly normal, and the anus itself on anything but very close inspection looks so healthy that the fissure is very often overlooked altogether. On examination, however, not infrequently a contraction of the neighboring part takes place. It is partly voluntary, partly spasmodic. Thus, while the two, that is, fissure and contraction, ...
