BLEEDING AND BLIND PITIES.

243

The Peruvian bark is likewise proper in this case, both as astrengthener and astringent. Half a drachm of it may be taken ina glass of red wine, sharpened with a few drops of the elixir of vit-riol, three or four times a-daj.

The bleeding piles are sometimes periodical, and return regular-ly once a month, or once in three weeks. In this case they arealways to be considered as a salutary discharge, and by no meansto be stopped. Some have entirely ruined their health by stoppinga periodical discharge of blood from the hœmorrhoidal veins.

In the blind piles, bleeding is generally of use. The diet mustbe light and thin, and the drink cool and diluting. It is likewisenecessary that the body be kept gently open. This may be doneby small doses of the flour of brimstone and cream of tartar.*These may be mixed in equal quantities, and a tea-spoonful takentwo or three times a-day, or offener if necessary. Or an ounceof the flour of brimstone and half an ounce of purified nitre, maybe mixed with three or four ounces of the lenitive electuary, and atea-spoonful of it taken three or four times a-day.

Emollient clysters are here likewise beneficial ; but there issometimes such an astriction of the anus, that they cannot bethrown up. In this case I bare known a vomit have a very goodeffect.

When the piles are exceedingly painful and swelled, but dis-charge nothing, the patient must sit over the steam of warm water.He may likewise apply a linen cloth dipped in warm spirits ofwine to the part, or poultices made of bread and milk, or of leeksfried with butter. If these do not produce a discharge, and thepiles appear large, leeches must be applied as near them as possi-ble, or if they will fix upon the piles themselves, so much the bet-ter. When leeches will not fix, the piles may be opened with alance. The operation is very easy, and is attended with nodanger.

Various ointments, and other external applications, are recom-mended in the piles ; but I do not remember to have seen anyeffects from these worth mentioning. Their principal use is tokeep the parr moist, which may be done as well by a soft pocltice,or an emollient cataplasm. When the pain, however, is very great,some anodyne liniment may be applied.t

Perhaps no other cause of the piles is so frequent as the use ofaloetic purgatives. It is to be observed that aloes forms a consid-erable share of almost all advertised purging pills. A costive habitis more effectually, and much more safely removed, by a spoonfulof castor oil taken occasionally in an evening.

When the piles are very painful, the best external application isa weak solution of sugar of lead with a little laudanum, or an oint-ment composed'of similar ingredients.J An ointment made of one-

* Take Sublimed Sulphur, 1 oz.

Lenitive Klectuary, 2 oz.

Cream of Tartar, 3,drs.

Syrup of Roses ; enough to make thewhole into an electuary. Dose, the sizeof a nutmeg occasionally.

t Take Spermaceti Ointment, 5 0!.

Opium, fine powdered,Make an ointment.

1 drm.

{ Take Spermaceti Ointment,

Cerate of Superacetate of LeaG,of each, A oz.

Opium in Powder, J dim.

Mix for an ointment.