278 PRACTICE OF PHYSIC. 



the mind, excess of cold, intemperance in venery, and other 

 causes seemingly taking down the tone of the stomach, and 

 thereby producing an haemorrhagic effort, in consequence of the 

 reaction of the system." 



DCCCCLVII. With respect to the further cure of this dis- 

 ease, it is almost in two cases only that haemorrhoidal persons 

 call for the assistance of the physician. The one is, when the 

 affection is accompanied with much pain ; and of this there are 

 two cases, according as the pain happens to attend the external 

 or the internal piles. 



DCCCCLVIII. The pain of the external piles arises espe- 

 cially when a considerable protrusion of the rectum has happen- 

 ed ; and when, continuing unreduced, it is strangled by the con- 

 striction of the sphincter ; while, at the same time, no bleed- 

 ing happens to take off the swelling of the protruded portion 

 of the intestine. Sometimes an inflammation supervenes, and 

 greatly aggravates the pain. To relieve the pain in this case, 

 emollient fomentations and poultices are sometimes of service ; 

 but a more effectual relief is to be obtained by applying leeches 

 to the tumid parts. 



DCCCCLIX. The other case in which haemorrhoidal per- 

 sons seek assistance, is that of excessive bleeding. Upon the 

 opinion so generally received, of this discharge being salutary, 

 and from the observation that upon the discharge occurring, 

 persons have sometimes found relief from various disorders, the 

 most part of persons liable to it are ready to let it go too far ; 

 and indeed the Stahlians will not allow it to be a disease, unless 

 when it has actually gone to excess. I am, however, well per- 

 suaded, that this flux ought always to be cured as soon as pos- 

 sible. 



DCCCCLX. When the disease occurs as a purely topical 

 affection, there can be no doubt of the propriety of this rule ; 

 and, even when it has occurred as a critical discharge in the 

 case of a particular disease, yet, when this disease shall have 

 been entirely cured and removed, the preventing any return of 

 the haemorrhois seems to be both safe and proper. 



DCCCCLXI. It is only when the disease arises from a ple- 

 thoric state of the body, and from a stagnation of blood in the 

 hypochondriac region, or when, though originally topical, the 



