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ARTS AND SCIENCES.
AN ACCURATE AND POPULAR VIEW
OF THE PRESENT
IMPROVED STATE OF HUMAN KNOWLEDGE.
BY WILLIAM NICHOLSON,
UPWARDS OF 180 ELEGANT ENGRAVINGS.
VOL. XII. SUR......ZYG.
PUBLISHED BY MITCHELL, AMES, AND WHITE
William Brown, Printer.
likely to allay the constitutional irritation. crooked bistoury. If an obstruction He must then wait until the operations of should be discovered within the gut, it nature have separated the sloughs caus. may be perforated with the trochar, ined by the urine, endeavouring, however, troduced according to the course of the to introduce an elastic catheter, where intestine. The latter species is attended he should allow it to remain. Poultices, with very little hope of saving life. The fomentations, and the warm bath, should surgeon may cut in the situation of the be resorted to, if there are any appear- anus, and follow his dissection along the ances of inflammation; and abscesses, or sacrum, in order to find the end of the accumulations of urine, should be open- gut, which, when found, should be punced early and freely.
tured. Incontinence of urine. Sometimes this Fistula in ano. Any formation of matfluid dribbles away without any sensation ter near the anus is very likely to termi. of the patient. Here paralysis of the nate in this complaint; the suppuration bladder is the cause, and may be induced extends in the fat and cellular substance in various ways, as from injuries of the round the rectum, and sinuses form, havspine, over distension of the organ, &c. ing small external apertures, and seldom In the latter case, the urine should be healing without an operation. The comcarefully drawn off at regular intervals ; mencement of the disorder may be a cold bathing, bark, blistering the sacrum phlegmonous abscess, attended with conor perineum, electricity, tincture of can. siderable sympathetic fever; or it may tharides internally, &c. will be of service. have a more erysipelatous character,
Sometimes the patient can hold his spreading more widely, being more suurine to a certain degree, when an irre- perficial, and attended with depression sistible propensity to evacuate it comes of the powers of the constitution. The on. Here irritability of the bladder is former is seen in young, strong, and the cause, and may be induced by bad healthy subjects; the latter in we: kened, piles, fistula in ano, &c. Opium, the intemperate, and unhealthy constitutions. warm bath, fomentations, diluting drinks, The parts in the neighbourhood of the &c. may be resorted to when no obvious disease are often affected; and hence recause appears.
tention of urine, strangury, prolapsus and Imperforate vagina. Sometimes the la- tenesmus, piles, &c. are produced. The bia have their opposed surfaces grown complaint sometimes begins in an indutogether, leaving perhaps merely a small ration of the skin near the anus without opening, through which the urine is im- pain. This hardness gradually softens perfectly discharged, but marked with a and suppurates. The matter may either line, showing the proper distinction. point in the buttock, at a distance from This may be congenital, or the effect of the anus, or near this latter part, or in the disease. Sometimes a thin membrane perineum. It may escape from one opencloses both the neatus urinarius and va. ing, or from several. Sometimes there gina in newly born children. In both is not only an external aperture, but angthese cases the use of the knife is neces ther internal one, communicating with sary; and lint should be interposed be. the cavity of the intestine. tween the divided surfaces. There is A soft poultice and fomentations are another form of the same mal-formation, the best means of treating these abscessin which the vagina alone is closed ; and es; which, if they are phlegmonous, no symptoms appear until puberty, when should not be opened until the skin bas the menstrual discharge does not flow. become thin; but, when they are of the The uterus swells, and at last a kind of erysipelatous kind, should be punctured labour pains comes on. Here the mem immediately, to prevent any further exbrane must be divided to discharge the tension of the malady.
The general accumulated menses, and the edges of the treatment must correspond with the nacut kept asunder.
ture of the constitutional disturbance. In Imperforate anus. The part may either all abscesses about the anus, the incision be closed by a membrane, or be too con should comprehend all the skin covering tracted to allow the feces to be evacuated. the matter, as the cavity is then most It may be rightly formed at its outer part, likely to fill up from the bottom. The but terminate in a cul de sac; or there dressing should be small in quantity, may be no vestige whatever of anus. In light, and unirritating. If, however, the the first species, a division of the mem case passes into a fistula, it will be neces. brane is the remedy ; and in the second, sary to make it an open wound by cutting a dilatation of the contracted part by the through the rectum from the end of the