This affection is probably as old as mankind and is often mentioned in the Bible.
The name is derived from the Greek aipoppoises, its chief symptom being a flow of blood. Other names are Haimorosis, Proctalgia haemorrhoidalis, Morbus Haemorrhoidalis, piles, Emerods.
Ancient peoples regarded affections of the genitals and anus as divine punishments, thus. “The Lord will smite thee with the emerods” (Deut. xxviii. 27). But it is clear that many different diseases are meant under the name emerods, or haemorrhoids, such as tumours, the morbus ficarius and the endless ills of the pathici (Hippocrates; Aristotle; Rosenbaum’s Geschichte der Lustseuche)
The piles do not usually get well of themselves.
Heart affections imperfect aeration of the blood; liver affections; congestions in the portal system of veins enlarged spleen; abdominal tumours; great accumulation of fat in the omentum, or of faeces in the intestines; in fact anything that disturbs the reflux of blood to the right heart vena cava inferior vena portae tends to hypostatic hyperaemia of th haemorrhoidal veins. The successful treatment of piles involves an accurate appreciation of the topography and of the anatomical relations from the midriff to the pelvic outlet as first ground work and then a consideration of the etiology of each case.
I cannot enter upon such an interminable path in this little tract as I merely put in a plea for the exclusively medicinal treatment of dilated veins by what name soever they may be nosologically baptized. The bulk of my own knowledge on the subject has already been given and I now being together from various sources the remedies most frequently called for together with, more less accepted indications for the same.
REMEDIES FOUND USEFUL IN THE TREATMENT OF DILATED VEINS PARTICULARLY OF Haemorrhoids.
Besides Gilchrist, Hughes, Hale, and Lilienthal, I have culled from a very able article on this subject in the Transactions of the Homoeopathic Medical Society of the State Pennsylvania, vol. II. The authors are the Alleghany Country Homoeopathic Medical Society, and the names of the special contributors are Drs Childs, Martin, Caruthers, and Edmundson, the last-named of whom says… “For the latest and most successful remedies used by the old school for the treatment of haemorrhoids, we refer you to Naphey’s `Therapeutics,’ where a very full and complete resume will be found; many of them you will recognise as well-known homoeopathic remedies.” Well, we had already previously gone to Naphey’s “Modern Medical Therapeutics,”sixth edition, 1879, but did not find anything of the kind, and on again hunting therein we do not find ever the words piles, haemorrhoids, varices, varicosis, or varicocele, anywhere. So, Probably, there must be another Naphey’s Therapeutics.
ACONITUM NAPELLUS.-When a febrile movement accompanies the piles, with dry skin and cephalic congestion. It is not often called for in practice in this affection, but in plethoric subjects in whom there is determination of blood to the head, a prompt use of this remedy may avert apoplexy. When this is done, see to your patient’s diet.
ACIDUM ACETICUM.- Profuse haemorrhoidal bleeding; haemorrhage from bowels after checked metrorrhagia; constipation malignant disease of rectum.
AESCULUS GLABRA.- The greater pathogenic power of this remedy should lead us to think of it especially when there is a paretic state of the legs and the cauda equina is disordered. Carrying the nut on the person is said to cure piles but I will not vouch for it.
AESCULUS HIPPOCASTANUM.- Dr Hale is of opinion that the central point of action of this drug lies in the liver and portal system. It is decidedly one of our most powerful remedies for piles and constipation. My own notion of its applicability points to those cases in which there are liver, portal, rectal, and spinal indications for its use. Hale says the absence of actual constipation differentiates between this and other pile remedies: to this I cannot assent my own pretty extensive experience with it leads me to say with Dr. Hughes that it is indicated in constipation, and that very strongly. That it is a great rectal remedy is undoubted. Dr. Hart’s special indication for it is throbbing in the abdominal and pelvic cavities. Lilienthal puts the following symptoms thus: DULL BACK-ACHE, PURPLE HAEMORRHOIDS. Sensation as if sticks splinters, gravel were in the rectum are said to be characteristic of it.
ALOES.- protruding piles, with constant bearing down sensation and prolapse of the bowel; paralysis of the sphincter ani.
Aloes stood of old in evil repute in haemorrhoidal affections; thus in Nathanael Sforzia’s NEUES ARTZNEYBUCH (Basel, 1684) we read, p.34 Alle purgierende Sachen, son-derlich von ALOE, alle gesalzenen and gewurtzten Sachen seynd schadlich (in piles). So that with our law to lead we know how to use Aloes.
How is it Sforzia was so enlightened? He was in his day heterodox! ALUMINA.- Haemorrhoids worse in the evening; better nights rest; clots of blood pass from anus; stools hard and knotty like sheep’s dung.
AMBRA GRISEA.- Itching smarting and stinging at the anus; increased secretion of urine, much more than the fluid drunk. Worse in the evening also when lying in a warm place, and on awakening Better from slow motion in the open air and when lying or pressing upon the painful part. Presence of cholesterine in the faeces.
AMMONIUM CARB.- HAEMORRHOIDS PROTRUDE INDEPENDENT OF STOOL.
AMMONIUM MUR.-Haemorrhoids sore and smarting after suppressed whites; hard, crumbling stools, requiring great effort to expel them; bleeding from the rectum, with lancinating pains in perinaeum, especially evenings; stinging and itching in rectum before and during a stool; the piles surrounded by inflamed pustules.
ANACARDIUM.-Lilienthal says; Internal piles, especially if fissured; painful haemorrhoidal tumours; frequent profuse haemorrhage when at stool; great and urgent desire for stool, great and urgent desire for stool, but the rectum seems powerless, with sensation as if plugged up; great hypochondriasis.
ANTIMONIUM CRUDUM.-Copious haemorrhoidal haemorrhage accompanying a stool of solid faecal matter; MUCOUS PILES; pricking burning; continuous mucous discharge, staining yellow; sometimes oozing away of an ichorous discharge; feeling of soreness in the rectum as if an ulcer had been torn open.
APIS.-When there is much burning and excessive oedema of the parts.
ARNICA MONTANA.-Blind haemorrhoids, with painful pressure in rectum, constipation and tenesmus; worse when standing and from cold things. In prolapse from over-straining at stool and from violent riding.
ARSENICUM ALBUM.-Haemorrhoids with stitching pain when walking or standing, not when at stool, with burning pain; burning and soreness in rectum and anus; rectum is pushed out spasmodically with great pain, and remains protruded after haemorrhage from rectum, BURNING IN ALL THE VEINS, restlessness and great debility, worse at night and from cold, better from warmth; HAEMORRHOIDS OF DRUNKARDS.
AURUM.-My own use of this polychrest in piles has been confined to syphilitic subjects aggravated by mercurial symptoms. I should consider it especially called for in the aged and in pining youthful subjects.
BADIAGA.-I have put down the river-sponge as an anti- haemorrhoidal remedy, because Hering says it is useful in the complaints of adults who had manifestations of scrofula in their youth, and because it has a reputation in Russia for the cure of piles. Now there is a class of persons who are strumous and haemorrhoidal, and hence it may be worth remembering, especially when the lung or heart symptoms of Badiaga are present.
BELLADONNA.-Bleeding piles; spasmodic constriction of sphincter ani; if it would break; piles so sensitive that the patient has to lie with the nates separated; scanty red urine; congestion of blood to head; red, hot face; thirst and restlessness.
BERBERIS VULGARIS.-Haemorrhoids with itching and burning, particularly after stool, which is often hard and covered with blood; soreness in the anus, with burning pain when touched, and great sensitiveness when sitting; hard stool like sheep’s dung, passed only after much straining; constant pulsating stitches in sacrum; fretful and weary of life.
BRYONIA ALBA.-Hard, tough stool, with protrusion of the rectum; long-lasting burning in the rectum after hard stool; sharp burning pain in the rectum with soft stool; white and turbid urine; sensation of constriction in the urethra when urinating. Worse in the morning, also from motion and from heat.
Better while lying down, or on getting warm in bed.
CACTUS GRAND.-Constipation as from haemorrhoidal congestion; swollen varices outside the anus, causing great pain; itching of anus, pricking in the anus, as from sharp pins, ceasing from slight friction; copious haemorrhage from anus, which soon ceases.
CALCAREA CARBONICA.-Haemorrhoids protruding, painful when walking, better which sitting, causing pain during stool; great irritability of the anus, even a loose stool is painful; frequent and copious bleeding of the piles, or for suppression of habitual bleeding (after sulphur). Perspires a good deal in the head, especially at night. The Calcarea subject is light haired.