Piles, or Haemorrhoids, are small round excrescences appearing on the verge of the anus, without any apparent swelling :—if attended with a discharge of blood, they are termed the bleeding piles; in the contrary case, blind piles.
The piles chiefly occur in persons, somewhat advanced in years, and disposed to corpulency; in the plethoric, and debilitated ; in those who lead sedentary and luxurious lives, especially in men who are addicted to the free use of liquors. If the disorder be inherited, it usually appears at an early period of life : and sometimes during childhood, or even infancy. In the periodical bleeding piles of hysteric, hypochondriac, or gouty patients, no medical assistance will be requisite, so long as the flux continues moderate, for, in such case, it is a salutary effort of Nature.
The pre-disposing causes of the piles are, obstinate costiveness ; voiding of hard feces ; acrid purgatives, especially such as contain aloes ; obstructions in the haemorrhoidal vessels ; the frequent use of highly-seasoned food, and of sweet wines ; the indulgence in violent passions ; and lastly, sitting on damp ground.
Haemorrhoidal patients ought to attend to their habits of body, their strength, age, and mode of living; because such discharges as may prove hurtful to some, may be very beneficial to others. One ounce of rich conserve of roses, mixed with new milk, and taken three or four times in the day, has been found of considerable service, if continued for several weeks, or months, till its effects become evident. Peruvian bark has also proved useful, on account of its invigorating and astringent properties; but, where the piles have originated from obstinate diarrhoeas, small doses of ipecacuanha, or other gentle emetics, have been administered with the greatest success.— If costiveness occasion this complaint, proper attention to that circumstance will be requisite ; but, if the disorder originate from weakness, or want of tone in the rectum (see Abdomen), strong purgatives must be avoided ; the part affected should be bathed twice a-day with a sponge dipped in cold water, and the bowels regulated by the mildest laxatives.
In the blind piles, blood-letting has occasionally been of essential service ; though we are no advocates for artificial evacuations.— Emollient injections may be employed with advantage ; but, where the diseased part is obstructed to such a degree as to render the application of clysters impracticable, gentle emetics have often been eminently useful. If the tubercles be very painful, and no discharge ensue, the patient should sit over the steam, of warm water : and, in case no relief be thus obtained, leeches must be applied to the tumors themselves, or the adjacent parts : if, however, these insects do not adhere, it will often be necessary to employ the lancet.
Among the numerous remedies devised for the cure of this ma-, lady, none appears to be more efficacious in the most inveterate cases, than the internal use of sulphur. Persons of a costive habit may take of this mineral five grains, with half the quantity of rhubarb, two or three times everyday, either in pills, or mixed with conserve of roses: which doses should, according to circumstances, be continued for several weeks, or longer. In plethoric constitutions, a few grains of nitre may be added to each dose; the propriety or safety of which, however, ought to be decided by professional advice.
Various external applications, have been recommended for the piles ; but, as they are either too stimulant and hazardous, or designed only to cool and keep the parts in a moist state, this, object may be effected by means of emollient poultices.—Where the pain is extremely acute, the application of common or fresh linseed-oil, or of juniper-oil, has frequently mitigated the sufferings of the patient.
During the prevalence of this complaint, the diet should be cool and nutritious, consisting principally of milk, bread, vegetable jellies, broths, etc. Fermented and spirituous liquors will be hurtful : hence the patient ought to drink decoctions of the marsh-mallow roots, and other mucilaginous vegetables; orange whey, etc. He should, farther, studiously avoid the influence of the depressing passions, and whatever may tend to aggravate the disorder; especially riding on horse-back, and sleeping in feather-beds.—On his recovery, moderate and daily exercise in the open air will greatly contribute to invigorate the constitution; while his meals are temperate, and his conduct is adapted to the preservation of health, which otherwise will ever be in a precarious state.