66 HEALTHY ANATOMY.
From a patient of Dr. S., that died at the age of eigh- teen months. A bristle marks the circumference of the orifice ; and the intestine above is seen to be considerably dilated. 1858.
Dr. Joel Seaverns, of Jamaica Plain.
676. Imperforate anus. Case treated by Dr. Y. Operation with the trocar on the third day ; canula left in for a week, and the opening then dilated with sponge. In six or eight weeks opening enlarged with the knife ; and a tube, f in. in diameter, having been introduced, was kept in for about a year. This was occasionally removed ; and, once or twice, when it was obstructed, the faeces passed through the penis ; this being first noticed when the child was about six months' old. Three or four months before its death, the parents removed the tube without Dr. Y.'s knowledge ; the faeces soon beginning to pass through the penis, and continuing to do so ever afterward. For a time they passed alsb through the artificial anus, but for the last two months not at all. The child continued quite healthy, and died, at the age of eighteen months, from the effects of a fall a few days before.
On dissection, some liquid faeces were found in the rec- tum, and a quantity of foreign matter. The intestine it- self was much enlarged, and moderately thickened ; but, excepting a little excrescence a few inches above its termination, it was healthy. Opening between the rec- tum and the membranous portion of the urethra just in front of the verumontanum, direct, and about two lines in diameter. The bladder contained some liquid faeces, but was itself perfectly healthy. Through the opening made by Dr. Y., air could be forced before the parts were cut open, but the head of a very small pin would not pass. A piece of whalebone has been passed through the congeni- tal opening, and the parts are fully displa3 r ed. Case quo- ted by Mr. Ashton, in his work on Dis. etc., of the Rec- tum, p. 64. 1850. Dr. J. H. York.
For a statistical record of one hundred and four cases of " Anal and Intestinal Malformation," by Dr. Geo. H. Gay, see Boston Med. & Surg. Jour. Vol. LVII. p. 397.
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