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SPITTING OF BLOOD.

third finely powdered galls, and two-thirds hog's lard, is ver/ useful.When the piles are seated high, relief may frequently he ohtainedfrom the injection of lime-water, or of an infusion of galls.

The pain,of the piles is very often removed by an emetic, or be-taking twice a-day thirty drops of balsam of copaiva on a littlemoist sugar. When a pile has a narrow neck, it is best extirpatedby the knife. If the pile be large, or has a broad basis, a doubleligature may be passed through it, and tied on each side.

When piles are neglected, they are very apt to produce a. fistula.This complaint is discovered by a stain of matter on the linen,which, on examination, will be found to proceed from a small ori-fice in the neighbourhood of the anus. Various local remedies arorecommended for this complaint. The utility of all of them de-pends on their power of stimulating the sides of the ulcer into moreactive inflammation, so as to make them cohere together. On thisprinciple, I think I have seen advantage from taking- a wine-glassof sea-water every night for a month or six weeks. Irritatinginjections have been used with similar intentions, and have some-times, when duly persisted in, succeeded.

The only certain radical cure for a fistula is a surgical operation,the object of which is to reduce the ulcer to the state of a simplewound, and as such to heal it. This should never he too longneglected. The disease gradually diffuses itself in various direc-tions through the cellular substance surrounding the rectum ; andnew openings are formed, which render the complaint more diffi-cult to be removed.

There are two ways of performing the operation. One is by-passing a silk thread, or piece of flexible gold wire in at the exter-nal orifice of the fistula, and bringing it out at the anus, and thentwisting the ends together, which is daily repeated till it cuts itsway out. By some timid people this mode of cure is preferred tothe knife : and, though kept a secret by some pretenders to medi-cal knowledge, it is as old as the history of surgery. The incision,however, is the more certain and effectual mode of eradicating thedisease ; and if suffering is to be estimated by duration, the lesspainful also.

Spitting op Blood. (Hœmoptysis.)

We mean here to treat of that discharge of blood from the, lungsonly which is called an hœynoptoe, or spitting of blood. Persons ofa slender make, and a lax fibre, who have long necks and straitbreasts, are most liable to this disease. It is most common in thespring, and generally attacks people before they arrive at theprime or middle period of life. It is a common observation thatthose who have been subject to bleeding at the nose when young,are afterwards most liable to an hœmoptoe.

Causes. — An hsemoptoe may proceed from excess of blood, froma peculiar weakness of the lungs, or a bad conformation of thebraust. It is often occasioned by excessive drinking, running,wrestling, singing, or speaking aloud. Such as have weak lungsought to avoid all violent exertions of that organ, as they value