Bibliographical Notices On the Diseases, Injuries and Malformations of the Rectum and Anus, with Remarks on Habitual Constipation . By T. J. Ashton, Surgeon to the Blenheim Dispensary, &c. &c. From the Third and Enlarged English Edition. With Illustrations. Philadelphia: Blanchard & Lea. 8vo. pp. 292. 1860

1860 Boston Medical and Surgical Journal  
to the Blenheim Dispensary, &c. &c. From the Third and Enlarged English Edition. With Illustrations. Philadelphia: Blanchard & Lea. 8vo. Pp. 292. 1860. Mr. Ashton's work, since its first publication, has enjoyed a high reputation, and we are glad that it is now given to the American profession in so good a dress, and that, too, without being saddled by any jump-up-behinder with his notes and prolixities as editor. The scope of the work embraces all surgical affections of the anus, together with
more » ... anus, together with irritation and itching, as well as inflammation and excoriation of that vent. It goes up the rectum as far as cancer does, and takes a sweep around it extensive enough to include abscesses ofthat region. The last chapter is devoted to Habitual Constipation, which, furnishing the cause of so many other affections requiring surgical interference, comes very properly within the limits and purposes of the book. Tho wood-cut illustrations are sufficiently numerous for full elucidation of the subject, and are both original and well executed. As regards tho importance of tho subjects treated of in this work, the author well remarks that " in the whole range of surgical pathology, no class of diseases among civilized communities is so prevalent, causes more suffering, or induces so many varied and distressing sympathetic affections as those of the Rectum." To this we doubt not that every one who has a " mens conscia recti," and has arrived at that age of " fool or physician "-forty-will heartily respond. In looking through the work, we find very few omissions to note, and but little to comment on, as differing from our own views on the subject. The stylo and method of the book commend themselves to us greatly-being clear and simple-giving nothing more than is necessary for a full exposition of the subject. In speaking of enema syringes, Mr. Ashton urges, with great propriety, that the nozzle should be of some elastic substance, and not of ivory or metal, as is now the case. This is a necessity that has forced itself upon our attention, and we have made great efforts, though hitherto in vain, to meet it. The French make a nozzle in the same way they do bougies and catheters-of some woven foundation covered with boiled oil. The defect of these is, that they are too slender and apt to bend when meeting with any resistance, and they are affected, softened and dissolved by oil and many other things used as injections. They do admirably well, however, as long as they last, and are the only things that women should use in the later stages of pregnancy. We have tried in vain to have some made like these of vulcanized India-rubber, but the monopolists of that material are too well satisfied with their existing profits, and have not enough of bowels of compassion, if they have any others, to embark in a new article. One great defect in the syringes now used is the size and shape of the nozzles. They arc too small and too pointed. The consequence is, they often cause intense pain by catching in the folds of the rectum, particularly when used in dysentery. They are also, as a general thing, too short, and do not carry the injection high enough, but deposit it in the most irritable part of the rectum, and below the scybalffi which it is intend-
doi:10.1056/nejm186010040631004 fatcat:rqmvqs6g4newlaqhneintk2jny