. Clinical gyncology, medical and surgical. Prolapse of the rectum. 902 DISEASES OF THE RECTUM AND ANUS. Subsequently it is covered with pus, or has a grayish hue, showing superficialulcerations. The membrane assumes the character of the skin, losing itsflexibility and sensibility, while its natural furrows gradually disappear.The tumor may attain the size of an orange. It is difficult to reduce it,on account of the hardening and thickening of the submucous tissue, whichprevent it from slipping back. In cases of this degree the sphinctersdilate, lose their tonicity, and no longer prevent the e
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. Clinical gyncology, medical and surgical. Prolapse of the rectum. 902 DISEASES OF THE RECTUM AND ANUS. Subsequently it is covered with pus, or has a grayish hue, showing superficialulcerations. The membrane assumes the character of the skin, losing itsflexibility and sensibility, while its natural furrows gradually disappear.The tumor may attain the size of an orange. It is difficult to reduce it, on account of the hardening and thickening of the submucous tissue, whichprevent it from slipping back. In cases of this degree the sphinctersdilate, lose their tonicity, and no longer prevent the escape of faecal matter.Complete prolapse may result in the formation of a very large mass, whichmay be more or less globular and of a pink or red color. Its external sur-face still bears the traces of the transverse folds, which indicate the points Fig. 19.. Prolapse of invaginated intestine. (Esmarch). at which the membrane Avas in most intimate relation with the musculartunic. At the most dependent portion of the tumor an orifice will befound communicating with the intestine. The base of the tumor is sur-rounded by the anus. The prolapsed intestine tumefies and becomes theseat of an acute inflammation which may continue until it sometimesproduces repeated hemorrhages that endanger the life of the patient.Peritonitis may be a complication, and finally symptoms develop whichindicate strangulation of the intestine. The progress of prolapse is gener-ally slow but continuous, and if the affection is neglected or is badlytreated it becomes excessive, and renders not only walking but even theerect position painful. Diagnosis.—The diagnosis of prolapse is readily determined. In hem-orrhoids there are projections more or less independent of one another and DISEASES OF THE RECTUM AND ANUS. 903 separated by small furrows. Polypi are smooth, pedu