est produce a i ag but the piles appear he saat 
act The operation is easy, and attended with no ue 
on 
ger. 
The pain of the piles is very often removed by an emetic. When 
a pile has a narrow neck, it is best extirpated nd a knife. : wag é 
<= 
When the piles are neglected, they are apt to bring on a FISTULA. 
This complaint is discovered by a stain of matter on the linen, w 
on examination, will be found to proceed from a small o 7 
neighborhood of the anus. This ulcer, or tube, sometimes opens 
into the rectum at its upperend, The RE pe a iy ed 
callus, and form a secreting surface. Therefore, in addition to the 
general cleansing and detergent remedies, we can only inject such 
things into the tube of the fistula, as will break up this callus, 
and stimulate the sides into an adhesion. _ For this purpose the bal- 
sam of life in witch-hazle tea, or bayberry tea, are applicable. These 
may also be tinctured with lobelia ; also white vitriol. 
A surgical operation for the cure of fistula, is very painful, vi 
I consider it altogether preposterous. I have: frequently seen the 
constrictor of the anus entirely destroyed by these ope 
the miserable sufferer forever after discharged his excrements 
luntarily. _What a curgis this! The origins) a disease would be in- 
HEAD-ACH. 
Sometimes the pain is internal, sometimes external ; sometimes it 
is an original disease, and sometimes symptomatic, When the head- 
ach proceeds from a hot bilious habit, the pain is very acute  , ee 
throbbing ; when from a cold phlegmatic habit, the pain nage 
heavy, with a cold sensation in the part. 
Cavusrs.—Whatever obstructs the free circulation of the blood > 
through the vessels of the head, may occasion the head-ach. This 
is the case when the brain is compressed by an enlargement ofthe 
ones of the skull from disease, as inthe venereal, The head-ach 
often proceeds from the suppression of the usual evacuations, as 
sweating of the feet, bleeding at the nose, &c. It may likewise 
proceed from any cause that determines a great flux of blood toward | 
the head; as coldness of the extremities, or hanging down of the head» 
for a long time. Whatever prevents the return of blood from the 
head, will likewise occasion a shead-ach ; asa tight cravat, a new, hat, 
or the like. wage vet 
~ ‘When the head-ach proceeds from the stoppage of a running at 
nose, there is a heavy obtuse pain pressing in the fore part 
head, i in which there seems to be such a weight that the paler 
‘cely hold it up. Sometimes the head-ach is 
ig in of any eruptive disease. is rete» 
