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But ir muO be noted, that, whcn the patient is plethoric,
, he bleediog mur! 001 be r!opped har!ily. if al all; nor
when the menres in women have beco fupprdfed, or the
lochia, or the bleeding piJcs in meo accu!tomed {heTero ;
mueh lefs mur! a 1I0ppage be attemp,ed wheo Ihe bleeding
ilfelf is periodi....1.
In perrons of a biliolls conllitution, coJd water alone,
draok freely. has had a good e!feét.
T be eaeheét,e Chould perfill loog io , he taking of rhu·
barb, either alone, oc mixed with digdlive Calts, fuch as
l an ar· vi.triol:ue. Ir ,here is an'y rcorbutic diforcler in lhe
"ifeera, befides rhubarb, Ihe patien' lhould driok pleoli–
fully of whey.
If any d,fcafe proeeeds from Ihe ccrfatioo of Ihis eu–
Ilomary b",morrhage, it Chould be promoted with a 'Pen
or a IIraw IhruH into Ihe nolb.
Sorne recommend rhe weaker [pifit of vitrioJ, and
\Vould have eight or ten drops of it be given in every
d rallght of liquor. B UI perh. ps the bell melhod of all
in obftinate };¡remorrhages is rh ar recornmended by Mead
iD Ihe bloody · pox ; or ,he P eruvian bark a10ne will
generally be fuflieient.
Oj'/h_ Bleeding and Bliod P' LE •.
A FL u x of blood from the hxmorrhoidal verfels is
called ,he bleediog piles ; when Ihe verfels ooly fweJl
.ólnd difcharge no blood, bUl are exceediog painiul, rhey
are termed [he blind piles.
AII copious fluxes of blood from ,he aous are not 10 be
teekooed of Ibe morbous kind. F or Ihe habit of bod1,
{lrength. age, and tem perament, are lO be conGdered.
T hat which is eDormaus 2nd exceffive ID one perron,
m.y be be moderate aod (alulary 10 ano,her. That only
is lO be etleemed peroicious, which cantinues too long,
2nd cnfeebles (he patient ; wht:reby digeftion . nutritioo ,
and other funétioos are hurt, and rhere is rearan to fear
,he produélion of dangerous ehronical difeafes.
An exeeflive hremorrhoidal flux is generally preceded
by a hea"y prefliog pain of Ihe back and loins ; fome, imes
a numbnels of the legs 2nd thighs; a conClriétion of lhe
external pans, with a Oight fhiveriog, and a (ubúdence of
, h. ,·.rfels ,herein; a hard cootraéted pulfe; a drynefs of
[he momh and fauces; lhe urine di:ninifhed in qUdntity,
aod ' moll commonly pale; a fenfe of weighl ahoul ,he
anus extending la lhe perina:um; a \veaknefs oC [he llo·
mach; a 8<Hulcncy in lhe lower belly; a fr equenr delire
l O make water and tO go tO flool, with rometimes aD
cxclufiun of white bilious mucus ; the oId and weak have
4-pro~ideotia aoi .
lo ,his c. fe, ,he blood is generaJly al firll blRek aod
.very grumous. and fometimes comes aUJay in Iarge cJots
(rom the varicous veffels : aCterwotrds it becomes red, and
at Jan ferous: rometimes it is pilUUOUS, or Jike the white
oC an e~g T hcre are infi-an.:es of voiding a piDe or a
quart of blood daily; it ofeeDcómioues long, f:-oro t\VeD~
Iy to thirty. or eveo forty days.
T bís flux entire1vproceed .. flom the hzmorrhoidal vef.
T he external or blind piles feldom bleed. bUlluro
iD painful varices; WhlCh belng opeocd weep a hule. but
will nOI yicld much blood BUI Ihe io,ernal piles, whieh
are ,be olf,p' ing of Ih fplcorc braoeb, a~d are eX'-énded
e N E.
to Ihe inner fublbnce of ,he reélum, and as far as ,he
fphioéter of ,he arrus, togelher with the fmaJl arteries de–
rived from ,he 10IVer mefaraic, not only bleed plen,ifullr,
but, when the flux is foppreffed, create di(eares of tho
liver, fplecn. pa.ncreas, mtrcntery, and incenines .
The perfoos fttbje~ 10 Ih is difeafe are thofe of a loofe,
fpongy lexlure. of a bulky fize, who live high, and load
a feden~Jry Jife j or tO whom it is hercdítary. Sharp
purges, aloetics, high.fe.fooed food, free drinkiog of
fweet wines, negleét of cuflomary bleediog, anger. fad,
Defs , hard riding, and ,he like, wiJl uCher in Ihis diforder.
This hremorrhage is dangerous, becaufe it decay.s [he
Iheng,h, waOes the body, aod produce...a feofe of weigh t
in the thighs. The {leep is laborious, and the prrecordia
opprerfed; ,here is a rumbliog in Ihe belly, and a weak.
pulfe. When il cootinues long, the ancles fwell, and Ihe
countenan~e is gha(lly; there is a firait-neCs of breathing;
and lall of all i, lerminate. in a cachex y, dropfy, or ..
flow and het'lic f~ver.
Ir ,he patien, is ple,horic, bleed; and let his drink be
cold waler of the chalyb: ate ktnd, or whey ,urned wilb.
orange.juice; o.rjuleps made with tinclpre of rofes, cool ..
ing waters, and ly..-up of rofes ; likewiCe nitre in pow–
der, with abforbems and arengtheners ; and, to appeafe.
the fpafms, ~piates of the mildell kiod .
If it continues long. and (he flux begins to be {ereus,.
theo give rhubarb Wilh curants or tamarinds, or, which
is much lhe Carne, with Cream of tanar. Then gentle
diaphoretics may be compounded of burot hart{h.orn,
calx of antimony, wioe.vioegar mixed with crab's·eyes,
wa.ter of elder·flowers. limpie alexit~real w'ater, and dia–
fcordium; or hOI decoétions of yarrow . veroDica, 6c.
may be tokeo io bed, in order to fwea,; alfo half a graio
of carophor, mixed with nitrous and bez.oardic powders.
In [he BL I N D PI L E S there is a mon inteoCe paio, er–
pecially atthe time ofgoiog (Q naol. and the excrements
are tinged with brood. Sometimes tumours like warts
lie hid in the fphinéter, or appeariD the \'erge of the anus.
Somctimes lhe veíos, in the bliDd piles, are fo much
dilated wi,h blood as 10 be very painful and raife luber–
cles as large as peas , ,g"pes, or eggs: Th ey appear Ii–
vid, and blaek, the Ilagnation \lf a ,hick blood, aod,
when prerfed wilb Ihe fiogers, fe.1' like a bladder 6f1ed
with tiquor. Sorne are rpft and iodoleot; others hard,
inBamed, and paínful ; render the patlent uDable to walk,
fland, or lit; and produce ruch a fpaCm in the anus as
no[ to ·admit a clyn~r. Sometimes they bleed. or tum
to troul.,leCome itching ulcers, and occaGoo 3D abfeefs Or a
6I1ul• .
L ineo dipped in warm fpirits of wine, ar:d emollients,
:lire onen of infinite fcrvicej and, when they faíl, Jeeches
may ue applied 'o exhaull Ihe blood: If they. are OOt
at hand . and the pan s are inftamed. the lance[ muH be
u red; then dreffiogs mua be made with I¡nt, with compretres
aod ,he T Theluberclcs, IVbieh are fulJ aod large,
may be removed bY.j! llgature, unlefs inflamed. Sometimes
thev are high in the rc8:um; and lhen a fpeculuOl ani
mull be ufed; iD IVhicl> "fe Ihey mull be ei,her fearified
with a lancet, or divlded with fciffars, that the [hick
noxious blood may be difcharged, and ,hepaiDsreliel'ed.
Oj'