270 PHYSIC 



of the available circulatory factors an incipient haemor- 

 rhoidal condition, local or general, the super-addition of 

 other circulatory difficulties, the ultimate general involve- 

 ment of the entire circulatory machineries of the parts 

 involved, and finally fully evolved pathological conse- 

 quences, circulatory and textural. Prophylaxis must, 

 therefore, be constantly kept in view, and such occurrences 

 or emergencies prevented by the maintenance of free out- 

 lets to all excretory products by unhampered circulation 

 and excretory disposal. 



Mucus is a secretion or excretion much in evidence 

 throughout the alimentary and respiratory tracts and 

 genito-urinary organs, and is formed in or by cells alter- 

 nating often with others supplied with ciliary processes or 

 flagellae, which give the requisite direction and impulse 

 to the mucous material for lubricating and environing the 

 delicate mucosa and sub-mucosa ; inspissation and over- 

 consistence of it sometimes, however, making a patho- 

 logical condition, and leading, it may be, to a specific form 

 of disease of the areas affected, with secondary consequences 

 of a far-reaching and often dangerous character, but seldom 

 primarily in connection with the haemorrhoidal condition. 

 Pituitary matter, as it is excreted from the brain or gravi- 

 tates along the channels of entrance and exit of the great 

 blood vessels and nerve trunks as they pass through the 

 base of the skull, as has already been described in con- 

 nection with some cases of goitre and some other affections, 

 is another substance which lends itself to colloidal inspissa- 

 tion and, it may be, caseation in such affections as 

 enlargement of the tonsils and of the cervical and other 

 associated glands, thoracic and mediastinal, and, it may be, 

 to some extent in the often allied pulmonary tuberculosis, 

 miliary and general. In this relationship with the causa- 

 tion of these diseases, we would again call attention to 

 the importance of a free exit being maintained for the 

 evacuation of all cerebral and spinal debris, and cerebro- 

 spinal effete products, as they have, when admixed with 

 systemic lymph, a most hampering and deleterious effect 

 on the systemic circulatory and excretory vasculatures, 

 eventuating often in mechanical ballooning of glands and 

 vessels, active inflammatory conditions, and subsequent 



