It has been thought that strong nitric acid would supersede all operative interference in this disorder, but its curative power is really somewhat limited.

Its local application is only useful in small granular piles, and in "velvety" conditions of the mucous membrane; it checks the bleeding, but severe hemorrhage may occur when the slough separates. One or two applications ought to suffice for the cure of such a condition, but for large masses, or for haemorrhoids with narrow vascular attachments, other treatment is better. Billroth, however, reports much success with nitric acid in most forms of internal haemorrhoids, but especially in the flat form: after protrusion, he applies the remedy till the part is "stiff and yellowish-gray in color," and then oils it well - he notes the importance of not touching sound parts with the acid, for it causes great pain (Ranking, i., 1872). Dr. Houston first proposed this treatment (Dublin Medical Journal, vols. xxiii. - xxvi.); and Mr. Henry Smith has used it extensively, and written in its favor.

In less severe cases where the parts bleed and are somewhat swollen, Dr. Ringer recommends a lotion containing 1 to 1 1/2 dr. dilute acid to 1/2 pint water.