Bleeding from the Rectum sometimes occurs as the result of piles. The blood may be noticed in the stools, in which case the blood is separate from the faeces, not mixed with them, and is of a red colour.
Treatment.—If the bleeding be not excessive in amount, a course of gentle opening medicine should be adopted, such as the daily morning use of a mineral water like Hunyadi Janos or Carlsbad. Where the blood is spouting, however, it must be stopped. This may be accomplished by pieces of lint pushed up the rectum one after the other. Each piece must, however, be con nected with the outside by a piece of string.or in some such way, so that, on removing them, one may with certainty know that none has been left behind. The lint may, if necessary, be steeped in some astringent solution—glycerine and tannic acid in solution being preferred.
Abscesses near the rectum may be caused by various circumstances, among them by piles. They are attended by pain, throbbing,and swell ing round the anus. If large, they may produce serious disturbance of general health, fever, sickness, &c. They are to be treated on the same lines as any other abscess would be treated (see AnscEss), that is, with hot applications, &c., the abscess finally to be opened and cleaned out.
Fistula in the anus is that condition in which a channel passes from the outside inwards along the side of the anus, and finally opens into the bowel at some distance from the outside. It is thus a canal with two openings, one at its inner end into the bowel, the other on the surface near the anus. Fistula is a common result of an abscess at the side of the anus. A discharge comes from it, and faeces are apt to pass through it, hence the difficulty in the way of its healing. Sometimes there is an opening near the anus from which a canal leads inwards, but terminates without opening into the bowel. This is called a blind fistula. It is a remarkable fact that fistula is common among patients affected with consumption. It is a popular potion that in such a case curing the fistula and stopping its discharge will seriously harm the patient. This is a gross error. The curing of the fistula must benefit the patient's health.
The proper treatment of fistula is by a surgical operation. The fistula is alongside of the anus, and any tendency to heal will be thwarted by the movements of the muscle of the anus. The
operation divides this muscle, opens up the channel, and permits it to be thoroughly cleaned. The part is thus kept at rest and is accessible to proper dressing, so that it is in a good posi tion for healing. Apart from this treatment, cleanliness by frequent bathing, &c., is the only thing that is necessary.
Falling of the Bowel (Prolapse, or Coining Down of the Bowel).—This consists of the pro trusion of the lower part of the bowel beyond the anus. It is common in children (see Dm EASES OF CHILDREN) and in old age. It is caused by straining as a result of costiveness or of diarrhoea, or as a result of the irritation of worms, &c. It may be due simply to want of tone of the bowel.
The part that comes down is of a deep-pink colour, with wrinkles and folds, and is to be dis tinguished from piles, which are dark, swollen, and livid.
Treatment. — The part must he returned after being gently bathed with tepid water. The fingers are well oiled and used to push the bowel back. No force must be exerted, how ever. Usually it slips back easily. If it is swollen and tender it will be more easily re turned after bathing with cold water. To pre vent its recurrence straining must be avoided ; costiveness and other irregular conditions of the bowels must, therefore, be rectified. To restore the tone of the part cold sponging and the administration of tonics, especially iron tonics, are to be employed.
Itching of Anus (Pruritus) is very troublesome, and afflicts elderly people, and specially those of a gouty disposition, those addicted to high living or to drink, or who suffer from want of exercise. The region round the anus may be all scarred and raw with scratching.
Treatment. — First and chiefly let the diet be properly rectified. Let the person be spar ing, and use plain food, free from alcohol, coffee, and seasoned dishes, and let exercise be freely taken. Saline medicines—seidlitz-powder and such aperientia—should be used frequently if necessary. The parts should be bathed regu larly with cold water, and then with a lotion made of corrosive sublimate 2 grains, glycerine ounce, water ounce. Au infusion of to bacco is also a good application. Note that in children worms are a frequent cause of itching at the anus.