224 DISEASES OF THE RECTUM AND ANUS 



discharge. Thus a fistulous tract may form. Painful defe- 

 cation is noted, or, if the pain is great, severe constipation 

 results. There are frequent attempts at defecation, and 

 pruritis. Direct examination reveals the presence of a hot, 

 sensitive, fluctuating enlargement or there may be a fistula 

 present. The discharge is noted when it collects on the hair 

 around the anus and tail which it stains, and an offensive 

 odor is emitted. 



Diagnosis. Usually not difficult as a direct examination 

 will reveal the condition. 



Treatment. When the enlargement is present, the contents 

 of the sac should be expelled by pressure with the thumb and 

 finger. This should be repeated daily for several days in 

 case the sac shows a tendency to refill. If necessary to stop 

 the discharge, Lugol's solution or tincture of iodin should be 

 injected with a hypodermic syringe, enough of either to 

 slightly distend the sacs. This treatment can be repeated 

 in a few days if necessary. 



Should a fistulous tract be found, it should first be 

 thoroughly cleansed with an antiseptic solution (boric acid 

 2 per cent.) to remove all of the secretions, etc., then injected 

 with Lugol's solution to destroy the secreting membrane. 



This treatment should be repeated every few days until the 

 discharge ceases. 



