HJEMOBRHAG1E8. 279 



disease, by frequent repetition, has become habitual, and has 

 thereby acquired a connexion with the whole system, that any 

 doubt can arise as to the safety of curing it entirely. Even in 

 these cases, however, I apprehend it will be always proper to 

 moderate the bleeding ; lest, by its continuance or repetition, 

 the plethoric state of the body, and the particular determination 

 of the blood into the haemorrhoidal vessels, be increased, and 

 the recurrence of the disease, with all its inconveniencies and 

 danger, be too much favoured. 



DCCCCLXIL Further, even in the cases stated (DCCCCLXI.) 

 in so far as the plethoric state of the body, and the tendency to 

 that state, can be obviated and removed, this is always to be 

 diligently attempted ; and if it can be executed with success, 

 the flux may be entirely suppressed. 



DCCCCLXIII. The Stahlian opinion, that the haemorrhoi- 

 dal flux is only in excess when it occasions great debility, or a 

 leucophlegmatia, is by no means just ; and it appears to me, 

 that the smallest approach towards producing either of these 

 should be considered as an excess, which ought to be prevented 

 from going farther. 



DCCCCLXIV. In all cases, therefore, of excess, or of any 

 approach towards it, and particularly when the disease depends 

 upon a prolapsus ani (DCCCCLL), I am of opinion that as- 

 tringents, both internal and external, may be safely and proper- 

 ly employed ; not indeed to induce an immediate and total sup- 

 pression, but to moderate the haemorrhagy, and by degrees to 

 suppress it altogether, while at the same time measures are taken 

 for removing the necessity of its recurrence. 



" Alum is the only astringent, I think, employed with con- 

 siderable advantage. I know many who have employed the 

 Saccharum Saturni, either as an astringent or as a sedative, to 

 obviate the pain, and it seems to be useful both ways : but on 

 account of its powerful sedative effects, I think it is attended with 

 bad consequences, and at length rather increases the relaxation. 

 I have hitherto, therefore, confined myself to the use of alum, 

 joined to some of the vegetable astringents hi decoction." 



DCCCCLXV. When the circumstances (DCCCCXLVI.), 

 marking a connexion between the haemorrhoidal affection and 



