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214

OF THE BLEEDING AND BLIND PILES.

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In the management of the patient, regard must be had to his habit ofbody, his age, strength, and manner of living. A discharge whichmight be extensive and prove hurtful to one, may be very moderate andeven salutary to another. That only is to be esteemed dangerous whichcontinues too long, and is in such quantity as to waste the patient'sstrength, hurt the digestion, nutrition, and other functions necessaryto life.

When this is the case, the danger must be checked by a proper regi-men and astringent medicines. The diet must be cool but nourishing,consisting chiefly of bread, milk, cooling vegetables, and broths. Thedrink may be chalybeate water, orange-whey, decoctions or infusions ofthe astringent and mucilaginous plants, as the tormental root, bistort, themarsh-mallow root, &c.

Old conserve of red roses is a very good medicine in this case. Itmay be mixed with new milk, and taken in the quantity of an ounce threeor four times a-day. This medicine is in no great repute, owing to itsbeing seldom taken in such quantity as to produce any effects : but whentaken as here directed, and duly persisted in, I have known it performvery extraordinary cures in violent haemorrhages, especially when assist-ed by the tincture of roses; a tea-cupful of which may be taken aboutan hour after every dose of conserve.

Cinchona (the Peruvian baik) is likewise proper in this case, bothas a strengthener and astringent. Half a drachm of it may be taken ina glass of red wine, sharpened with a few drops of elixir of vitriol, threeor four times a-day.

The bleeding piles are sometimes periodical, and return regularly oncea month, or once in three weeks. In this case they are always to be con-sidered as a salutary discharge, and by no means to be stopped. Somehave entirely ruined their health by stopping a periodical discharge ofblood from the haamorrh/jidal veins.

In the blind piles bleeding is generally of use. The diet must betight and thin, and drink cool and diluting. It is likewise necessary thatthe body be kept gently open. This may be done by small doses of theflower of brimstone and cream of tartar. These may be mixed in equalquantities, and a tea-spoonful taken two or three times a-day or oftenerif necessary. Or an ounce of the flower of brimstone and half an ouncof purified nitre may be mixed with three or four ounces of the electuaryof senna, and a tea-speonful of it taken three or four times a-day.

Emollient clusters are here likewise beneficial; but there is sometimessuch an astrictiop of the anus, that they cannot be thrown up. In this<;ase 1 hav^ known a vomit have a very good effect.

When the piles are exceeding painful and swellei., but discharge no-thing, the patient must set over the steams of warm water. He maylikewise apply a linen cloth dipped in warm spirits of wine to the part,or poultices mad« of bread and milk, or of leeks fried with butter. Ifthese do not produce a discharge, and the piles appear large, leeches mustbe applied as noar them as possible, or if they will fix upon the pilesthemselves, so much the better. When leeches will not fix, the piles maybe opened with a lancet. The operation is very easy, and is attendedwith no danger.

Various ointments and other external applications are recommended in