After the sac is opened a portion of lint should be used, to render the part perfectly dry, which may then be lightly pencilled over with lunar caustic, or moistened with some caustic solution. Fomentations of warm water to keep the wound free from dirt, and with no other object, are all that subsequently will be required.
Tumors of a solid nature also form about the anus, and are likewise consequent upon neglected piles. These generally appear at the root of the tail superior to the opening. They feel hard; are glistening; not very tender; but highly vascular, and in some cases pulsate strongly. The dog is generally loaded with fat, perhaps slightly mangy; nearly always old, gross and weak. The quantity of blood that at various intervals is lost from this tumor, which at length ulcerates and bleeds at the slightest touch, or without any apparent cause, is often very great; but it does not, save in the very latest stage, induce obvious emaciation. The health is not good, of course, but to the casual observer the disease does not appear to affect the system. The spirits under excitement are, to all appearances, undiminished, and the appetite is in these cases ravenous. If, however, the dog had to do work, the truth would be soon discovered. After a short space the strength would fail, and no correction could keep the poor animal to its duty.
The treatment must commence with constitutional remedies, if the state of the part permits of the requisite delay. The digestion should be amended, and the piles, which are certain to be present, attended to. After a fortnight, more or less, has been devoted to such measures, a strong ligature should be tied as tight up as possible around the base of the growth, and a fresh one should be applied every second day. There must be no forbearance in the application of the ligature, but the degree of tension must be regulated only by the strength of the operator. This is far more severe than the removal would be if the knife were employed, but I have not seen a case which I dared venture to excise. I do not like the ligature; it is long and torturing in its action; but here there will be no chance, for the vessels are too numerous and large to admit of the speedier process being resorted to. Where it is possible, it is well, however, to cut through the skin before applying the cord; for the operation is expedited considerably, and an important deduction made from the animal's agony.
When the tumor drops off, the surface may be sprinkled thrice a day with the following powder:—
| Camphor in powder, |
| Opium in powder, |
| Grey powder, |
| Powdered galls, of each an equal quantity. |
Or a little of the ointment recommended for piles may be smeared upon the wound in lieu of the above. An unguent is perhaps to be preferred, as giving better protection to the sore, over which the fæces must pass, and also as being more grateful to the feelings of the patient. Powder and ointment may be changed and varied according to the judgment of the attendant: thus, to render the last more stimulating, I mix creosote with it occasionally; or to give it an astringent property I add a portion of galls, catechu, or kino; but these I never pass into the rectum. Astringents introduced upon the sore and ulcerated surface of the intestine of course render it harsh, dry, and corrugated; and as during the exercise of its function the part is necessarily dilated, the animal is, by the pain produced from the stretching of the constringed membrane, indisposed for the performance of that act, on the regular discharge of which its health in no little measure depends. Astringents, moreover, heat and irritate the part; and the sensations induced make the dog draw its anus along the ground, thereby adding greatly to the evil it is the intention of the application to remove. Therefore prudence will approve what humanity suggests; and those who in kindly feeling can discover no motive, will in the colder reason find every inducement for the adoption of the gentler measure.
Protrusion of the rectum is also sometimes a consequence of gross feeding, starting up piles in the first instance, and then, from more intense digestive derangement, causing purgation, accompanied with violent straining. The tone of the intestine is destroyed. It becomes lax, and its muscular power is lost. The gut is at first only a little exposed during the act, and when that is over, it is retracted; but after some time, the limit of which is uncertain, it remains constantly protruded. It is not so violently inflamed as might be expected, but it soon gets dry and harsh; cracks appear upon its surface; and the pressure of the muscle which closes the anus preventing the free circulation of the blood, renders it black from congestion.
If taken early, the treatment recommended for piles will generally effect a cure; but if nothing be done in the first instance, the disease when established is apt to prove intractable. The intestine should be sopped with cold water until every particle of dirt is removed. It should then be dried with a soft cloth, and afterwards returned. There is never much difficulty in replacing the gut; but there is always considerable difficulty to get it to be retained. So soon as it is restored to its situation, a human stomach pump should be inserted up the rectum, and a full stream of the coldest spring water should be thrown into the bowel for ten minutes. The fluid will be returned so fast as it enters, and it must be allowed to do so, the fingers of one hand being employed against the anus to prevent the disordered rectum being ejected with the water. Cold injection in less quantity must be administered several times during the day, and with each a little of the tincture of galls, or of nux vomica, in the proportion of a drachm to a pint, may be united. The ointment recommended for piles may also be employed, but without opium, for no application of a sedative nature must be used. The constitutional measures will consist of tonics into which nux vomica enters. The food must be light and nourishing, and purgatives on no account must be administered. Cold will do good by invigorating the system, and should always be recommended. Some persons, unable by sedatives and purgatives, which are injurious, to obtain relief, have gone so far as to cut off the projecting bowel, and they have thereby certainly ended the case; for the dog dies whenever this is done. I remember at the Veterinary College, Professor Simonds killed a fine animal by attempting this operation; for he took a heated spatula to remove the part, and carried the incision so high up that he opened the abdomen, and the bowels protruded from the anus. Amputation of any portion of the rectum is not to be thought of; but an operation of a less heroic description will sometimes accomplish what the previous measures failed to effect. With a knife, having not too sharp but a coarse edge, a circular portion of the exposed lining membrane, of a width proportioned to the size of the animal, may be scraped off, so as to induce a cicatrix; or, if the dog be very tractable, and the operator skilful, a piece of it may partially be dissected off; but the knife, when employed in the last method, is apt to cause alarming hemorrhage. When this is done, as the wound heals the edges come together, and the gut is so far shortened as to be thereby retracted. There is, however, some danger of stricture being afterwards established; wherefore this operation, however satisfactory it may seem to be in the first instance, is not so certain in the benefit of its results that it should be resorted to, save in extreme cases when every other means have failed, and the choice at last hangs between relief and destruction.
Another affection of the part, to which Scotch terriers of great size are particularly subject, begins with an enlargement below the anus, extending either quite or almost to the testicles; for males are more frequently attacked by this form of disease than females. The dog is generally old, and a favorite with an indulgent mistress, having much to eat, and little or no work to do. The swelling is soft and attended with no pain. On pressure and on percussion it is ascertained to hold fluid, and in fact it arises from dropsy of the perinæum. The health may appear to be good, but on examination debility will be found to be present. The anus also protrudes, and the orifice is thickened; while, possibly, a marked tendency to piles may at the same time be displayed. Should no attention be paid to the case, the swelling will continue without sensibly enlarging; but after a period, hard substances may with the fingers be detected beneath it. These hard bodies are fæces, which accumulate within the rectum, and often in so great a quantity as to seriously inconvenience the animal, rendering it dull and indisposed to feed.
Before attempting to direct the treatment for these cases, it is necessary the nature of the affection should be fully explained. The enlargement, to which attention is at first solely directed, is always of secondary consideration. The dropsy is merely a symptom indicative of the loss of tone of the adjacent parts, of which the rectum is by far the most important. If this circumstance be not observed, but the swelling be treated as if it was all the practitioner had to contend with, he will in the end learn his mistake. The intestine loses its tonicity; it no longer has power to contract upon or to expel its contents; it becomes paralysed, and the dung consequently accumulates within it, distending it, and adding to its weakness by constant tension. The rectum at length retains no ability to perform its function; but the sphincter of the anus, or the circular muscle that closes the opening, appears to gain the strength of which the intestine is deprived. It contracts, and thus shuts up the fæces which the rectum cannot make an effort to dislodge; and in this circumstance the physiologist sees evidence of the sources whence the different parts derive their contractility. The rectum, like the other intestines, gains its vital power from the sympathetic nerve, or that nerve of nutrition and secretion which presides over organic life. The muscle of the anus, on the other hand, is influenced by nerves derived from the spinal column; and thus, understanding the two parts obtain their motor power from different sources, the reader will comprehend how one can be incapable of motion while the other is unaffected, or rather excited; for the presence of the retained dung acts as an irritant, and provokes the anus to contract with more than usual vigor.