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In this case the neck of the uterus was cartilaginous and firmly adherent to the adjacent parts. In seven days after the accouchement the woman had completely regained her health. Vallisneri reports the instance of a woman who possessed two uteruses, one communicating with the vagina, the other with the rectum. She had permitted rectal copulation and had become impregnated in this manner.
Bleeding piles are caused by congestion of the rectal blood vessels. The constant nerve irritation causes muscular contraction, consequently circulation is interfered with, producing a condition of engorgement. Owing to lack of nutrition the structures become brittle and quantities of the varicosed capillaries unite to form pile tumors. The only rational plan is to remove the cause.
It may also be produced by playful repose on the stomach, sliding down banisters, going too long without urinating, by constipation or straining at stool, irritant cutaneous affections, and rectal worms. Sliding down banisters, for instance, produces a titillation. The act may be repeated until inveterate masturbation results, even at an early age.
Cancer of the stomach appears and attains a maximum frequency earlier than cancer of the skin; cancer of the uterus and mamma is more frequent towards the decline of reproductive activity than in the later years of life; rectal cancer is not infrequently met with during the second and third decades.
Woodbury reports the case of a girl of fourteen, who fell seven or eight feet directly upon an erect stake in a cart; the tuberosity was first struck, and then the stake passed into the anus, up the rectum for two inches, thence through the rectal wall, and through the body in an obliquely upward direction. Striking the ribs near the left nipple it fractured three, and made its exit.
He has kindly given me maps of the city, with every case marked down, with street and number, for all the epidemic. Hypodermic injections of atropine and morphine have failed sadly in many cases. Subcutaneous injections of large quantities of salt and water, with some soda, and large rectal injections of tannin and laudanum have been very successful in Italy.
While in many cases of pelvic fracture lameness or abnormal decumbency are the salient manifestations, yet the pathognomic symptoms are crepitation or palpable evidence which may be obtained by rectal or vaginal examination. In fractures of the angle of the ilium and the ischial tuberosity, perceptible evidence always exists.
When the injury is in the dorsal region, there is paralysis of the legs and of the sphincters of the bladder and rectum, but power is retained in the arms and the upper intercostal muscles act, the extent of paralysis depending on the level of the lesion. In injuries to the lumbar region the legs may be partly paralysed, and the rectal and bladder sphincters may be involved.
The positive signs are the change in the volume of the udder; the secretion of milk; the movement of the foetus and presence of the foetus in the womb, as determined by rectal examination or by the feel of the abdomen. The probable signs are not reliable, and should be considered only in connection with some positive sign.
Tartar emetic in one-half to one dram doses may be given with the feed daily until five or six doses are given. Turpentine may be given in one to three ounce doses in a pint of linseed oil. This may be repeated daily for two or three days. Worms located in the posterior bowel may be removed by rectal injections of a weak water infusion of quassia chips.
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