TO judge by my experience, there must be something in the atmosphere of the Houses of Parliament, or in the habits they engender, conducive to the production of haemorrhoids as well as influenza, and the first case I will mention here is that of a prominent politician who consulted me some years ago.
CASE I. BLEEDING HAEMORRHOIDS.
The patient was a tall, spare man, dark complexioned, between fifty and sixty years of age, who had travelled much about the world, undergone a good deal of exposure in open-air sports and without indulging to excess, was fond of a good dinner and his pipe. For five years, and especially for the last two, he had been much troubled with piles, which protruded, bled periodically, discharged continually a mucous fluid, and occasioned much heat, bearing-down sensation, and discomfort. The motions were at times constipated and light-coloured. The urine was thick after taking any wine. Without having actual pain in the liver he was often conscious of possessing that organ.
Before coming to me he had consulted his ordinary medical man, a well -known consultant in town., who had told him there was nothing for, it he wished to be relieved of his trouble, but to make up his mind to lie up for three weeks and undergo an operation. As it was not convenient to lie up for three weeks just then not to mention a possibly longer period my patient, who had some acquaintance with homoeopathy, determined to give it a trial. It was near the end of March when he called upon me and I put him on Nitric acid 12. A month later he called again, and reported that he had been quite free from any inconvenience until a few days before his visit. He had been dining out, and had a little return in consequence, with constipation, but no bleeding and no bearing down.
Rx Nux v. 30.
After this I saw nothing of him till the following September, when he had a slight reminder of his trouble after a fishing expedition in which he had done a good deal of wading.
Rx Calcarea c. 30, in powders, one night and morning. This kept him right till the following April, when Lycopodium was given, and he has had hardly any trouble since.
I will now give the case of the patient referred to in my introductory chapter.
CASE II. -OBSTINATE CONSTIPATION; MARGINAL PILE.
This patient was a lady of very gouty family, past middle life. She had always been of a constipated habit, and had dosed herself freely with pills and other kinds of aperients. She had, however, partially escaped from the dominion of the latter by the aid of a domestic work on homoeopathy, from which she learned the virtues of Nux and Sulphur, after which she had very little trouble in that way. I was called to see her for an attack of perityphlitis, and after she had got quite well of this, attack of piles developed without any symptoms of constipation. There was a large protrusion, but in its origin it was partly external and partly internal, with great pain and discomfort.
There was also some ulceration.
When I discovered the extent of the disease I came to the conclusion that it would take a long time to cure, and I then made the suggestion that an operation would be the most satisfactory way of riding her of the trouble. But my patient, who was of a very sensitive temperament, was so terrified by the idea that I did not venture to repeat the advice, and though the complete cure did take sometime, the acute symptoms were subdued in a few days by the internal and local use of Hamamelis, so that she was soon able to return to her ordinary avocations. Aesculus was given later with good effort. What remained of the pile was not so important as a return of the constipation, and it was whilst under treatment for this that the pile finally disappeared.
The origin of this patient’s constipation is instructive, and may serve as a warning to those who have the care of young girls. When about fourteen years of age, she was sent to some friends on a visit. Whilst there, she was dreadfully constipated, and being very timid, said nothing about it. On this occasion she went eight days without an action. On another occasion when again on a visit, but to another place, the same thing happened; but this time she fainted, and when she revived she confessed what was the matter. Purgatives were there and then administered, and had to be continued ever after, till she came under the influence of homoeopathy.
The medicine which I found give the most help was Natrum mur., indicated by the largeness of the motions, and the feeling as if something remained in the bowel after the action. Magnes. mur. Hydrastis, and Lycopodium also did good service, but it was not till Natrum mur. 200 was given that the condition was completely mastered.
I advised, in addition, the use of whole-meal bread, but that by itself had no effect, and moreover, it had been tried before.
CASE III. CONSTIPATION AND BLEEDING PILES.
A governess, aged 30, consulted me at the Homoeopathic Hospital on Nov. 9, 1887. She had been suffering from bleeding piles for nine months. She had never had them before, and attributed the attack to excessive walking and overwork. She was inclined to be constipated before the attack came on, and had been much so the last six weeks. Before coming to me she had attended at the Westminster Hospital. The bowel was then prolapsed, and had been returned by the doctor who attended her He said, however, there was nothing to be done further but an operation. This so terrified her that she never returned, but came to the Homoeopathic Hospital instead.
There was much aching pain of the bowel, worse at night, preventing sleep. The stools were large, hard and knotty. Before the prolapse occurred she had taken a strong pill. The bowel remained in that condition for a fortnight.
Rx Ac. nit. 12, gtt, 1 quarter die.
Nov. 22. Very much better.
After this there was no more thought of operation. The medicine relieved her so completely that I saw nothing of her till the end of the following June, when I made this note:-
June 30, 1888. Has been much better. Now only feels the piles when out of health. Motions regular. Feels weak, and is sleeping badly, waking at 4 A.M. Is constipated, which is very unusual; is very nervous. Frontal headache.
Rx Ignat. 12 gtt. I ter die.
July 4. Very much better; feeling quite different. Feels worse in damp weather.
Repeat. After this she saw me at rare intervals, and had Nitric acid 12 again and Dulcamara 12 (which always relieved her when feeling the effects of damp weather). She complained at times of pain in the left ovarian region. In February 1889, an abscess formed near the anus and broke but healed rapidly under Silica 30. On April 10 of that year she had constipation, small green stools; this was relieved promptly by Phosphorus. All the time she continued to discharge her duties, which were heavy, and eventually she got quite well.
I will now relate two cases of an acute character.
CASE IV. PILES FOLLOWING INFLUENZA.
A lady, who had recently recovered from an attack of influenza, suddenly, after stool, experienced great pain accompanying haemorrhage and the appearance of a pile. The case being quite recent, and there being no complications, a short course of Hamamelis, given internally and applied as a lotion, completely relieved and permanently cured the patient. The lotion gave immediate relief.
CASE V. ACUTE PILES. This patient was so impressed with the relief obtained in her own case, that she came to consult me a short time after on behalf of a friend. This was a young unmarried lady who was subject to headaches, which had formerly been greatly relieved by Lycopodium. The attack of piles had come on suddenly apropos of nothing definite. There was, according to the account I received, a good deal of protrusion, with bleeding and pain. I did not see this patient, but I prescribed Hamamelis, and in a very short time she was well.
I may here say that Hamamelis, or Witch Hazel, has a very wide range of usefulness, in conditions of varicosis and piles. It has a very definite relationship to the venous system, and is one of the first medicines to be thought of where the veins are at fault. Of course it must be used with judgment, and cannot be expected to cure, in all cases. Those cases which depend for their origin on some deep constitutional dyscrasia will require the appropriate remedies. Hamamelis may be given in almost any attenuation with good effect. For a lotion, twenty to thirty drops of the strong tincture to the pint. It may be used either cold or warm.
CASE VI. RAPID RELIEF OF AN ACUTE CONDITION. As an example of what may sometime be done in an emergency, I will mention the case of Lord, who came to me one morning in great distress, suffering from prolapsed piles, with excessive soreness and discharge, he having an important engagement to address a political meeting in the country the same evening.
Now there is one remedy which in my experience is more useful than any other where excessive soreness is the leading symptom, and that remedy is Causticum.
This I ordered him, with directions to take a dose every half- hour till relieved, and then less often until he returned. With this assistance he soon obtained relief, and was able to make a long journey and fulfil his engagement with very little inconvenience.
CASE VII. PILES IN AN INFANT.
Prolapse of the bowel is not at all an uncommon occurrence in children, and is generally associated with constipation and straining. But it is by no means common to have a genuine attack of piles in an infant. This, however, did occur in an infant girl, aged thirteen months, whom I was asked to see. The little patient had been constipated since her birth, but the mother was greatly alarmed by the appearance of the swelling. When the case was described to me I expected to find prolapse, but on examination I found it was genuine pile. Sulphur 30 was prescribed and in a very short time the pile disappeared.
CASE VIII. BLEEDING PILES WITH IRRITATION.
An elderly gentleman, who consults me in the city sometimes, had an attack of bleeding piles some year or two ago, He is of a scrofulous habit, and as a child lost the sight of one eye from inflammation, and many years before I saw him he had fistula, which was operated on. When he first consulted me he was suffering from bleeding piles with a good deal of irritation about the parts, and constipation at the same time. His general as well as local symptoms pointed to Sulphur, and this gave him great relief. An attack of influenza interrupted the progress of the case, and when he was getting better of this a severe attack of bleeding came on and continued. Taking into consideration the constitutional habit of the patient, I prescribed a single dose of Bacillinum 100; the bleeding stopped at once, and though I have since prescribed for him for other ailments, he has never been further troubled with this.
When piles have continued for a number of years the tissues of the part skin and mucous membrane covering the varicosities become largely hypertrophied, and it is not always possible to reduce the hypertrophy by medicines. But it is almost always possible to combat the attendant sufferings, and reduce them to a minimum. If the power of the sphincter muscle of the orifice has been lost, it will be necessary to wear some kind of support, provided it cannot be restored. I will now mention a case of the kind.
CASE IX. A CHRONIC CASE.
A gentleman, between 30 and 40, from the eastern counties, consulted me in the city a year or two back about his general health, and especially an indescribable lassitude impelling him to lie down frequently, even out of doors. In addition to this there was great sensitiveness to cold. Naturally active and athletic, he had never taken any care of himself. As a boy he had been troubled with ascarides. At school he used to over-eat, and would go for days without going to the closet, He also contracted other bad habits at school. His father had suffered from piles, and for five or six years the patient had suffered
c from them severely, with copious bleeding at times. His heart was not sound, being hypertrophied, and he was always conscious of having a heart. He had had a great variety of medical treatment. One doctor gave a strong preparation of nitric acid and purgatives. This treatment had the effect of causing severe haemorrhage after every stool. The piles were large, and with every stool there was prolapse of the lower bowel. There was constipation. He contrived to have the action at night, so that the bowels might recover themselves when the horizontal position was maintained, but in the morning the protrusion had to be replaced and held in position by a support during the day.
Though now regarding his diet carefully, he suffered a good deal from symptoms of indigestion, especially flatulence. He had a tendency to bronchial cough. Most of the year he had wheezing at the chest, inclination to draw a deep breath, and a pretty constant expectoration of clear phlegm, which accumulated in the throat. He also suffered from weakness in the back.
Rx Psorinum 30, four times a day. Unguent Hamam.
This medicine had the effect of restoring his energy to a remarkable degree, the bowels acting fairly well whilst under its influence. In fact, the patient frequently remarked whilst under treatment that my medicines (which were all in infinitesimal preparations) had a marked tonic effect on him, without any of the penalties attaching to ordinary so-called tonics.
After this, Causticum 30, Sulphur 30, Graphites 30, Lycop. 30, Alumen 30, and some others were given with more or less benefit; but the prescription which gave most help was one of Muriatic acid 200 and Graphites 200 in succession, with occasional doses of Bacillin.
The result of the treatment was that though the piles had not been removed, the bowels were enabled to act satisfactorily without the help of purgatives, the piles were more manageable, and the general health very greatly improved.
CASE X.-AN ACUTE CASE OF PAINFUL PILES.
A young lady, Miss C., wrote to me from the country on April 25, 1902, to send her something for piles, which she had had for ten days, but only for one day severely. They came on after riding horse back. I sent her Hamamelis I, every 4 hours and a lotion of Hamamelis O. Two days later I heard that she had had a good night but there was still a great deal of stitching pain through the anus to the left side, which was worse when sitting or lying, and better when standing. I sent discs of Causticum 30, to be taken every hour if the pain continued.
April. 28, 1902. “Ever so much better, but the pains came on so badly at lunch that I began the discs. Cannot sit up for long without pain.” Continue.
April. 30, 1903. “Much better, but pain came on badly in the middle of the day. Bowels act regularly, but cause a good deal of pain. Period began on 28th, but has hardly come on at all. Cannot sit up for long.”
Rx Sulph. 30 every four hours.
May I, 1902. (This report was written the day before the Sulph. arrived.) “Much the same as yesterday. Swelling gone down much in last two days. Pain comes on rather badly in middle of day, with intervals, from 11. 30 A.M. to 2. 30 P.M., but practically none before or after.”
May 2, 1902. “Very much better. Had very little pain. Sleep splendidly. Feel more like an ordinarily person.” Continue Sulph.
After this the patient was well.
CASE XI.- PAINFUL. PILES.
Miss P., 30, consulted me in November 1903 for painful piles, which had troubled her since the previous April. The patient came of a gouty family, and had had a severe accident ten years before, which had caused prolapse of the uterus and swelling of the whole left limb, and when the swelling subsided it left a varicose condition of the veins of that limb which still persists. She had been vaccinated a second time two years before. She was a very active lady, but the condition of the left limb and the piles made it difficult for her to get exercise
Rx Thuja 30, at bedtime; Hamamelis O, for lotion.
December 27, 1903. PIles have not troubled except on one day, when she did a lot of walking. Does not feel the leg at all. Veins better.
March 8, 1904. Very much better in all respects.
From this time the patient was practically well till the autumn.
August 25, 1904. For the last four to five days has been losing a slight quantity of blood with each motion. This has not occurred since last winter.
September 14, 1904. Has been better. No more bleeding. Very much better; does not feel the piles at all now.
December 15, 1904. Going on well. There is only a slight puckering discernable where the piles were.
Rx Thuja 30 and Sulph. 30 on alternate months.
July 6, 1905. Practically well. Has been able to do a lot of walking in Switzerland. Veins not noticeable now.
Thuja has a very marked influence on rectum and anus; but in this case it acted as much by remedying the vaccinal element in the case as by its local action on the affected veins.
CASE XII. RECURRENT PILES. R.K. a barrister, 35, was cured by me of sciatica in the early part of 1904. In September of the same year he developed an attack of piles. He had some years before suffered from piles, which had been cured under homoeopathy. He was very gouty, much influenced by damp. Had been three times vaccinated, the last time in October 1901; the vaccination had not taken.
September 27, 1904. Has been troubled with piles for a fortnight.
They are aggravated by walking. Good deal of stiffness in back and some pain down sciatic nerve.
Rx AEsculus hip. 3x three times a day. THuja 30 at bedtime. A lotion of Hamamelis 6 to be used after stool.
November 3, 1904. Has been much better. Lately, there has been a return of pain in the back and down the left hip. Very hungry at 3 A.M.
December 6, 1904. Has been much better. One day when there was snow he had pain. Piles bleed a little. 3 A.M., hunger gone.
Rx Aescul. three times a day. Sulph. 30 at bedtime.
January 19, 1904. Has kept free from piles, and was well till the last three days, when there was a relapse brought on by indulgence in wine.
I may say I had to reduce the allowance of alcohol for this patient to a minimum. He again received Thuja and later Lycopodium 30 and Urtica urens O. These kept him right, but indulgence in wine would always remind him of his troubles.
One great indication for Aesculus in these cases is “aggravation from walking.” Thuja has also the same aggravation. It is also indicated when vaccinosis is an element in a case. The 3 A.M. aggravation is a further indication for this antisycotic remedy.
CASE XIII.- A VERY CHRONIC CASE OF PILES.
Genl. R., aet. 56, consulted me first in June 1897. He had had piles for twenty years. They came first when he was stationed at Gibraltar. For the past three years they had given him much trouble, and in addition to the piles he had much mental depression. He had been treated with Iron, and one medical adviser suggested starvation diet, which did no good. There was a finally history of suppurating cervical glands, and the patient had been vaccinated four or five times. There was a history of attacks of tonsillitis, and I found the pharynx congested. Appetite good. His drink is whisky and soda. Has smoked a good deal, but does not smoke now to excess. Is troubled with flatulence. Pulse irregular and intermittent. Heart sounds normal. Is chilly, and feels the cold much. Feet cold and damp. Sweats easily. Sleep good. He is better in summer, worse in cold weather; worse by walking, and worse after stool. I found a large purple pile protruding on the right side of the anus. This was sore when he sat down.
I ordered a course of Sulphur 30, followed by Causticum 30, and a lotion of Hamamelis.
July 27, 1897. There is a good deal of protrusion. Piles come down on any extra very good deal of protrusion. Piles come down on any extra exertion. Spirits fair. Sleep very good. Pulse 84, regular.
Rx Acid nitricum 12 ter die. Bacillinum 100, every ten days at bedtime.
After this date the patient removed from London and I did not see him again till May 1901. He had had a very trying time the previous winter. Walking and standing bring on the prolapse. I found the piles again very much in evidence.