TREATMENT-Hot fomentations to the skin over the inflamed part to encourage pointing on the skin surface. As ischio-rectal abscess ought to be incised from the cutaneously surface before it bursts the bowel. otherwise a troublesome fistula result which usually requires operative interference by a surgeon.
The following are he chief medicines the choice from which must be made according to the general symptoms and conditions of the patient;-Silicea, Calc-Phosphorus, Lycopodium Causticum, Nux V., and Sulph. At the same time and applications of Hydras. of Calendula are useful to assist the curative process.
167.-Haemorrhoids-Piles.
DEFINITION-Small Tumours consisting of varicose veins of the anal region. they take the form of fleshy purple masses inside the anus, some being thick, firm and fleshy, and to thin-walled and easily bleeding. They very from the size of a pea to that of a damson or walnut, are often intensely painful, and constitute the most frequent disease of the anus.
VARIETIES-Piles are classified as (a) internal and (b) external, according a they are situated within or without the sphincter The external are situated within or without the sphincter. the external are covered by skin; they vary in number from one to several clustering together like a bunch of grapes. The internal are covered by mucous membrane, and are always within the bowel; they are very liable to bleed, especially during the passage of faeces. If Haemorrhage be long continued, an anaemic condition is induced, that is highly prejudicial to the constitution.
Piles that do not bleed are called blind; this variety is prone to Inflammation, when they become tense, appear ready to burst, and are so excessively sensitive that the patient can scarcely sit, walk, or lie.
SYMPTOMS-These vary considerably according to the amount of inflammation present. When the piles are indolent, the chief in convenience arises from their bulk and situation; or from their getting within the sphincter muscle, occasioning more or less pain when the bowel is acting, prolapse, and often a sense of weight and discomfort which quite unfit the mind for continuous through. But when inflamed, or, in common language, ‘during a fit if e Piles,. there are pricking, itching, shooting, or burning pains about the anus, increased ongoing to stool, and a feeling as if there were a foreign substance in the rectum. After emptying the bowel, there is often painful straining, as if it were not emptied, occasioned by the pile or the elongated mucous membrane to which hey are attached being protruded during the expulsion of faeces, and, not being replaced sufficiently quick, are grasped and constricted by the sphincter and, the function of which is to close the aperture of the bowel after defaecation. the condition is greatly aggravated if the patient stand or walk much after going to stool,. of if the bowels are constipated, so that the rectum is much distended or the faeces become hard. If proper remedial measure be not adopted, the in conveniences and suffering become seriously augmented and the general health implicated, the patient loses flesh and strength, and the countenance wears a careworn expression.
CAUSES-The predisposing cause are-any circumstances which determine blood to, or impede its return stands which determine blood to, or impede its return from, the return such as sedentary habits; luxurious living, especially the use of high-seasoned food, wines and spirits;light-lancing; pregnancy; confined bowels and disease of the liver. Straining at so tool or during micturition are exciting causes.
EPITOME OF TREATMENT
I. Ordinary cases and from luxurious or sedentary habits-Nux V., Sulphur, Podoph.
2. From Constipation.-Sulph., AEscul., Nux V., Collinsonia, Carbo V.
3. During Pregnancy.-Aloes, Collinsonia, Nux V.
4. Bleeding-piles-Hamamelis, or sulph. (dark Blood); AEscul., Aloes., Aconite (excessive bleeding)China (after losses of blood).
5. Blind-piles-Nux V. ion alternation with Sulph Aconite (great pain); caps. (burning and itching).
6. White-piles-discharges of mucus-Mercurius (with excoriation_; Aconite (frequent discharge of white muscles).
7. Chronic-ARs. in emaciated persons); Ferrum (cachectic constitutions); Ac-Not., Sulphur, HeparS.
8. Suppressed-Aconite, Pulsatilla, sulph.
LEADING INDICATIONS.
Nux Vomica.-Piles in patients of sedentary habits, or from luxuries living, indulgence in stimulants, or depressing mental emotions;l Constipations with ineffectual organ; Prolapsus, or loss of power of the muscular structure of the bowel. Sulph. may advantageously follow the this remedy,, a dose being given morning and night for four or give day’s; or Sulph. and Nux V. may be given in alternating, the former in the morning and the latter at night.
Hamamelis-Bleeding-piles or only a varicose condition for the haemorrhoidal veins, particularly with a varicose state of the veins of the lower extremities, for cases in which there is considerable loss of blood,. it should be used both internally and externally, a lotion being made by adding thirty drops of the strong tincture to four ounces of water, and applied by means of two or three folds of linen, covered with oiled silk, and renewed several times daily.,
AEsculus-Little bleeding, with much pain in the rectum, and also in the back and loins. Constipation. Also inform of ointment.
Collinsonia-Piles associated with Constipation.
Aconitum-An inflamed condition, with feverish restlessness, a sensation of heat, and discharge of mucus or blood. For the excessive pain often association with Piles, besides its internal use, Aconite may be sued as a lotion.
Arsenicum-Burning sensation, and sometimes a feeling compared to passing red-hot needles through the Piles, with intolerable pain in the back, protrusion of the Tumours, and prostration of strength.
Sulphur-This remedy is justly regarded as one of the most valuable in every variety of Piles, especially in chronic cases, associated with Constipation, or thin evacuations mixed with blood.
DIET AND ACCESSORY MEANS-Patients should avoid coffee pepper. space,.s stimulating, highly-seasoned or indigestible food of every kind, and the habitual use of beer, wine, and spirits. Light animal food, brown bread, a liberal quantity of well-cooked vegetables, and rope and wholesome fruits, from the most suitable diet. A full tumbler of very hot water should be sipped first thing in the morning and last thing at night. During an attack of piles, animal food should be sparingly used. Over-eating or sinking cause engorgement of the portal vein, and Piles are the common result. The application of this remark is self-evident.
Sedentary habits and much standing, on the one hand, and extreme fatigue on the other, are prejudicial; as also is the use of cushions and feather beds. The pain attending Blind-piles may be relieve by drinking hair a number of cold water, and then lying down for an hour. The horizontal position should be maintained as much as possible that being most favorable to recovery. When Piles protrude, the use of Hamamelis of AEsculus ointment is recommended.
INJECTIONS-Relief and permanent benefit will follow an injection of about a pint of tepid water up the lower bowel, but is not desirable as a routine practice.
When Piles are excessively sensitive or painful, the patient should sit over the steam of hot water, keep his bed, or recline during a great part of the day on a couch. The foot of the bed or couch should be raised, so that the buttocks are higher than the rest of the body. STrict cleanliness is also essential. the parts should frequently washed with soap and cold water; or, when be frequently washed with soap and cold water; or, when the Tumours are inflamed and painful, with tepid water. A piece of sponge and tepid water should in such cases be substituted for paper. A warm or vapour-bath (see Secale26), may be occasionally used at night, when the liver is inactive and the skin dry and harsh. It should be followed in. he morning with a cold bath, or the body should be rapidly rubbed, first with a wet cold towel, and then with a dry one.
Another important point for patients troubled with Piles is, that the habit should be acquired of going to stool at night, immediately before retiring to bed, instead of morning, so that the horizontal position may favour the early subsidence of the Tumour, instead of its remaining in and inflamed and prolapsed condition to the great annoyance and distress of the patient, and to the permanent injury of the parts.
Surgical measures are sometimes necessary. the curative treatment we advise is the injection into each pile of a mixture of Carbolic Acid and Hamamelis in water. If properly performed, this causes little or not discomfort to the patient, and does not necessitate his lying up. It is followed by shriveling up of the haemorrhoids.
168.- Fissure of Anus.
DEFINITION-A longitudinal ulcer at the anal margin. It is similar to the crack which occurs in. he lower lip of the mouth, and like the later, is exquisitely painful.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."