H^EMOIIIUIAGIES. 2(J9 



especially when recently formed, frequently contain fluid blood; 

 but after they have remained for some time, they are commonly 

 of a firmer substance. 



DCCCCXXXIII. From a consideration of their causes, to 

 be hereafter mentioned, it is sufficiently probable, that hsemorr- 

 hoidal tumours are produced by some interruption of the free re- 

 turn of blood from the veins of the lower extremity of the rec- 

 tum ; and it is possible, that a considerable accumulation of 

 blood in these veins may occasion a rupture of their extremities, 

 and thus produce the haemorrhagy or tumours I have mentioned. 

 But considering that the haemorrhagy occurring here is often 

 preceded by pain, inflammation, and a febrile state, as well as 

 by many other symptoms which show a connexion between the 

 topical affection and the state of the whole system, it seems 

 probable, that the interruption of the venous blood, which we 

 have supposed to take place, operates in the manner explained 

 in DCCLXIX, ; and therefore, that the discharge of blood 

 here is commonly from arteries. 



DCCCCXXXIV. Some physicians have been of opinion, 

 that a difference in the nature of the hsemorrhois, and of its 

 effects upon the system, might arise from the difference of the 

 haemorrhoidal vessels from which the blood issued. But it ap- 

 pears to me, that hardly in any case we can distinguish the ves- 

 sels from which the blood flows; and that the frequent inoscula- 

 tions of both the arteries and veins which belong to the lower 

 extremity of the rectum, will render the effects of the haemorr- 

 hagy nearly the same, from whichsoever of these vessels the 

 blood proceed. 



DCCCCXXXV. In DCCLXIX. I have endeavoured 

 to explain the manner in which a certain state of the sanguifer- 

 ous system might give occasion to an hsemorrhoidal flux ; and 

 I have no doubt, that this flux may be produced in that manner. 

 I cannot, however, by any means admit, that the disease is so 

 often produced in that manner, or that, on its first appearance, 

 it is so frequently a systematic affection, as the Stahlians have 

 imagined, and would have us to believe. It occurs in many per- 

 sons before the period of life at which the venous plethora takes 

 place ; it happens to females in whom a venous plethora, deter- 

 mined to the hsemorrhoidal vessels, cannot be supposed ; and it 



