HJEMORRHAGIES. 



notice of a matter which I can only touch by the by, the 

 morbus niger, which consists entirely in this effusion of blood 

 upon the internal surface of the alimentary canal. Sauv- 

 ages has it, in his Nosology, under the name of Melcena. 

 I have omitted it in my Synopsis, merely because I am a little 

 uncertain how far to consider it as an idiopathic, and how far 

 as a symptomatic disease : but I say now, that if I had been 

 to introduce it in the Synopsis, it would have been by putting 

 it under the title of haemorrhois, agreeably to the explanation 

 which I have given : but I should then have been obliged to 

 make some alteration in the generic character." 



DCCCCXXXVI. These causes of a topical affection are, 

 in the first place, the frequent voiding of hard and bulky fasces, 

 which, not only by their long stagnation in the rectum, but es- 

 pecially when voided, must press upon the veins of the anus, 

 and interrupt the course of the blood in them. It is for this 

 reason that the disease happens so often to persons of a slow and 

 bound belly. 



DCCCCXXXVII. From the causes just now mentioned, 

 the disease happens especially to persons liable to some degree 

 of a prolapsus ani. Almost every person, in voiding faeces, has 

 the internal coat of the rectum more or less protruded without 

 the body ; and this will be to a greater or less degree, accord- 

 ing as the hardness and bulk of the faeces occasion a greater or 

 less effort or pressure upon the anus. While the gut is thus 

 pushed out, it often happens that the sphincter ani is contracted 

 before the gut is replaced ; and in consequence thereof, a strong 

 constriction is made, which preventing the fallen-out gut from 

 being replaced, and at the same time preventing the return of 

 blood from it, occasions its being considerably swelled, and its 

 forming a tumid ring round the anus. 



DCCCCXXXVIII. Upon the sphincter's being a little re- 

 laxed, as it is immediately after its strong contraction, the fal- 

 len-out portion of the gut is commonly again taken within the 

 body ; but, by the frequent repetition of such an accident, the 

 size and fulness of the ring formed by the fallen-out gut, is 

 much increased. It is therefore more slowly and difficultly re- 

 placed ; and in this consists the chief uneasiness of haemorr- 

 hoidal persons. 



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