THERE, are few complaints more common than the piles, and scarcely any which cause more trouble and misery. They consist in a fullness of blood, and languid circulation in the lower portion of the lower bowel or rectum. In consequence of this congestion, either the veins of the gut become enlarged or varicose, or the blood gets infiltrated into the cells beneath the mucous membrane, and collects, so as to form bloody tumors.
These tumors, which are seldom absent, are the leading features of the piles. They sometimes appear externally, around the anus; this is external piles. At other times they are within the bowel ; the complaint is then called internal piles. They are called bleeding piles when blood is discharged, and blind piles when it is not.
Symptoms. Usually there is a sense of weight and weakness in the lower part of the back and lions, with a painful itching about the anus. On going to stool, there is a burning, cutting pain experienced, which is followed by bearing down and tenesmus. If it be bleeding piles, the little tumors will bleed at every motion of the bowels. There are frequently disagreeable sensations in the head, general lassitude, an irritable state of mind, and a sense of fullness and anxiety in the stomach. The pains experienced range all the way from the slightest twinges up to the most terrible sufferings, which appear like tearing the body asunder.
Causes. Everything that irritates the lower bowel, and causes a determination of blood to the part. All drastic physic has this effect, particularly aloes, which acts especially upon the rectum. Habitual costiveness, straining at stools, riding much on horseback, sitting a great deal, tight lacing, high seasoned food, and stimulation generally, lifting and carrying heavy weights, and indurations of the liver, as well as a bilious indigestion.
Females during pregnancy are much affected with Piles, which are induced by the costiveness so peculiar to their condition, and by the pressure of the enlarged womb upon the veins of the pelvis.
Treatment. This should be medicinal and dietetic.
Great care must be observed not to push medication too far. Active purging will do great mischief. Yet costiveness must in some way be corrected. For this purpose, no remedy that I have ever tried has done better in this complaint than an electuary composed of confection of senna, flowers of sulphur and cream of tartar (6),. taken in doses just sufficient to procure one natural motion of the bowels each day. Pills made of extract of thoroughwort are said to do well. If the liver be in a congested state, take some of the articles recommended in the chronic inflammation of that organ.
For the local treatment, nothing is better than two ounces of lard and one dram of the flowers of sulphur mixed, and rubbed between two plates of lead until they are well blackened. This ointment is not only soothing but curative, both in the bleeding and blind piles. An ointment of almost equal excellence may be made from one handful each of witch hazel bark, white oak bark, and sweet apple tree bark, boiled together in one pint of water down to one third of a pint. Then strain, and add two ounces of lard and simmer away the water, stirring continually before and after removing from the fire, till it cools. Witch hazel suppositories are excellent, as is also an ointment composed of 1 ounce stramonium ointment, 6 grains pulverized opium, and 5 grains tannin.
If there is much inflammation and distress, an emollient and soothing poultice should be applied, composed of slippery elm bark and stramonium or poke leaves. Steaming the parts is sometimes useful, by sitting over a hot decoction of hops, stramonium, and poke.
Piles may often be cured by the use of the domestic syringe. Daily injections of cool or cold water will do much to strengthen the bowel, and restore the dilated veins to their natural condition.
The food should be of a laxative nature, cornbread, rye pudding, bread of unbolted wheat flour, mealy potatoes, ripe fruit, pudding and milk, buckwheat cakes, broths, and a little tender meat once a clay.
When the piles are very painful an ointment of cocaine, ten grains, Vaseline, one-half ounce, smeared well over them, LB exceedingly grateful. Five grain iodoform suppositories are very effective in reducing piles; its odor, however, is quite objectionable to many. Surgical treatment is often the only resource left for their cure.
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