Fissure of the anus is usually single and situated in the middle line posteriorly. Below it there is a tag of he mucous membrane called ‘sentinel pile.
SYMPTOMS-Severe burning pain during and after defecation with great spasm of he anal sphincter muscle. the faeces may be streaked with blood.
TREATMENT-(See P{lies and Fistula in Ano.) -the bowels must be regulated, copious hot enemata being used when necessary, and ointment of calendula, Hamamelis, or AEsculus applied.
In many cases a small operation under anesthetic is necessary.
169.-Pruritus Ani-Itching of the Anus.
DEFINITION-A peculiar itching of the anus, at first of a voluptuous character, but afterwards violent and almost unbearable.
SYMPTOMS-Crawling, tingling, irritating sensations about the anus, often most troublesome at night, as the patient gets warm in bed, and preventing sleep. It is frequently complicated with an excoriated or fissured condition of he anus.
CAUSES-Irritation of Piles; worms; Pediculi; habitual taking of opium or Chloral; lodgment of faeces; suppressed period., or any suddenly-suppressed discharge of cutaneous eruption. Frequently, itching of he anus is only a symptom of disease of the liver, of some portion of he digestive apparatus, especially the rectum, or of some apt immediate proximity thereto. The primary cause must, therefore be removed or relieved.
The patient must strenuously endeavour to avoid scratching the part, as this invariably aggravates the condition.
TREATMENT-Sulph., Ac.-Nit., Lycopodium, Ant.-C., ARs., Nat. Mur. and ointments of Hamamelis, Calendula and AEsculus. The selection of the remedy must be guided by the cause of the affection by the symptoms present. The local use of dilute Carbolic Acid(five drops to the ounce of water), generally gives great and speedy relief.
170.-Prolapsus Ani-Falling of the Bowel.
Definition-A protrusion of the rectum though the anal orifice. If the mucous membrane is alone prolapsed the condition is called prolapsus ani; if the entire thickness of the rectal wall is involved the term ‘Prolapsus recti is applied. the order is commonly associated with pile sin adults, and the latter is more common in children.
CAUSES-Long-continued Constipation or diarrhoea, purgatives, straining excited by the presence of worms, enlarged prostate, Stone in the bladder, etc. General laxity of structure may predispose to the complaint, or at any rate aggravate the causes already indicated.
TREATMENT-Ignatia-Is often specific, and i generally the first to be used, especially for infants and children. The indications are-frequent ineffectual urging to stool, straining, difficult passage of faeces. itching, and Prolapse of bowel. A dose thrice daily, for two or three days; afterwards, morning and night.
Nux Vomica-Prolapsus, with costiveness, and straining at stool, for patients of vigorous constitution.
Mercurius-Prolapsus, with itching, discharge of a yellow mucus (White Piles), and Diarrhoea;hard, swollen abdomen.
Podophyllum-Prolapsus accompanying diarrhoea, with training and offensive stools; irritation rom teething, etc.
Lycopodium-Obstinate cases, and when other remedies only partially cure.
Sulphur-For similar conditions.
Gamboge, Calc-C., Sepia, Arsenicum, and Bryonia, are additional remedies.
ACCESSORY MEASURES-Two points must be steadily kept in view- The return of the Prolapse, and the removal of the cause. the protruded part should be replaced with the forefinger, previously lubricated, carrying it beyond the contracting ring or sphincter tones, the patient should lie down, with buttocks elevated above level of the body, for a short time after the action of the bowels, so as to favour the complete return of the protruded parts, or may defecate in a lateral position last thing at night. Children must not be allowed to sit staining ineffectual at stool. If the bowel comes down after being replaced, the child may be left in its cot with body low, and buttocks, elevated, until the anal sphincter regains its tone.
Bathing the parts, and the body generally, every morning in cold water, help to impart tone to the relaxed structures. The diet should be plain and nourishing, and include such varieties of roof as favour the healthy action of the bowels. If, as is most frequent the case, Indigestion, Constipation, or Worms cause the complaint, t the treatment recommended in. the Section devoted to those disorders should be carried out.
171-Disease of the Liver Inflammation – Cirrhosis.
Inflammation in the substance of the live occurs either in the form of solitary abscess see Section on Tropical Disease), or as a result of general septic poisoning, with formation of small multiple abscess The fibrous capsule of the organ may become inflamed (perihepatitis). This disease is best classed with Cirrhosis.
Cirrhosis-There are various varieties of Cirrhosis due to various cause. The commonest form result from chronic alcoholism, but other poisons, such as lead, occasionally cause similar changes, and it can occur from generally disease, such as gout, diabetes, rickets, and especially from malaria or syphilis.
Alcoholic Cirrhosis (hob-nailed liver-This disease is characterized by the development of fibrous tissue between the liver cells, causing their destruction. The organ is usually much diminished inside, but if there is a fatty degeneration present as well it may be increased wherein there is always an enlargement of the liver., and also of the spleen.
SYMPTOMS-Chronic catarrh of the stomach with nausea and vomiting, especially in the morning. haemorrhage from the stomach is frequent, and black stools from the presence) of altered blood in them. Enlarged veins on the abdomen and gradual accumulation o fluid in the abdominal cavity. Jaundice as a rule is slight. See of discomfort in hypochondrium, often a little fever, and scanty urine.
TREATMENT-If taken early and if the use of alcohol is given up, the disease can be arrested. Established cases are incurable, but can be relieved. Expert treatment is advisable, but the remedies most likely to be useful are Phosphorus, Arum, Lycopodium, Nitric Acid, Berberis and Mercurius. the Liver may be found to be enlarged as a result of cancer (Hydrastis, Chelidonium, Lobelia Erinus. Ornithogalum), usually secondary to malignant growth elsewhere, and is enlarged in the late stages of heart disease. the underlying general condition must then be treated.
172-Simple Enlargement of the Live-Congestion of the Liver.
SYMPTOMS-Fullness on he right side in the region of the false ribs; sense of weight on assuming the upright posture; uneasy sensation when the apart is pressed upon; the complexion may be pale, sallow, or dusky; the tongue coated; the bowels constipated; the appetite faulty; and there may be nausea, vomiting, headache, languor, lassitude, and depression of spirits. The pulse is usually slow and irregular.
CAUSES-Sudden chills; too abundant, highly seasoned, stimulating diet the habitual use of alcoholic drinks; anger, or other mental influences;excessive bodily exercise in the heat of he sun. It is a very common disease, and Dr. Budd thus accounts for its frequency- amid the continual excesses at table of persons in the middle and upper classes of society, the portal blood that should never the present in it, and the mischief which is calculated to produce is enhanced by indolent or sedentary habits. the consequence often is, that the liver becomes habitually gorged. the same, or even worse effects result in the lower classes of our larger towns, from their inordinate consumption of gin and porter.
Functional derangement, with suppressed secretion, sometimes accompanies congestion of the gland.
In some parts of India, entozotic influence may be at work in the production of hydatid disease of the liver.
EPITOME OF TREATMENT.-
1. Enlargement of the liver-Phosphorus, Mercurius, Ac.-Nit., Agaricus, Arsenicum, China. (after fever and ague.).
2. Hepatalgia pain in the liver)-Aconite (hard, aching or shooting pains after exposure); Bry, (tensive and burning, or singing pains, and in rheumatic persons); Mercurius (dull pain); sabad (dull scraping sensation.
3.Biliousness-Bryonia (vomiting of bile and mucus);Nux V. (from stimulants and overfeeding; also when associated with Piles); Sulph. (Constipation); Mercurius (white costive stools, and depression); Aconite (bilious attack from cold); Chamomilla (from anger); iris. sick headache); Lyco., Hepar sulph., Pulsatilla, Podoph., Chelidonium, Tarax.
4. Bilious Diarrhoea-Podoph. (with biter taste and dark urine); iris (in hot weather with vomiting; (china (simple cases;a nd in summer) Chamomilla(in children and females, also when caused by passion.
5. Drops of the abdomen from, Cirrhosis-Crot-Tig Arsenicum,., Ac- Nit.
LEADING INDICATIONS
Bryonia-Enlargement ad hardness of the liver. with shooting, s stinging, or burning pans, increased on pressure and constipation, without inclination for stool.
Mercurius-Dull, perceive pain, which prevents the patient from lying along on the right side; yellow tinge of he white of the eye’ sallow skin; shivering followed by profuse clammy perspiration; loss of appetite; foul taste in the mouth; Constipation of the bowls with white stools; or relaxation, with medicine in simple cases. (See also Bry). But patients’ who have been dosed largely with mercury should select Hep-S., especially when the stools are clay-coloured.
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."