INTERNAL HEMORRHOIDS. 
517 
vascular. Neither upon pressure, however, nor during defe- 
cation, did there appear to be much, if any, pain. Sometimes, 
after these violent efforts, a few small, hard dung balls would 
be evacuated, at times slightly coated with mucus, and gene- 
rally, but not invariably, tinged with sanguineous fluid. 
Upon two separate occasions a considerable flow of blood 
occurred. This proceeded, I have no doubt, from the piles 
themselves, and not from varicose veins ; for the blood was 
arterial in character, and was squirted from the anus. Two 
or three of the piles were retained, each only by a very slight 
pedicle, and were easily disengaged by the fingers. 
One of them, of a pale brownish-pink hue, I examined, 
and found a well-marked seam or cicatrix of a florid colour, 
where the tumour, during the straining and pressure, no 
doubt, had burst, and produced the copious discharge of 
blood on orje of the two occasions already noticed ; nature 
attempting, by this means, her own relief. 
The chief and almost sole source of annoyance appeared 
to be the mechanical obstruction to the passage of the faeces, 
no constitutional disturbance scarcely being present. 
Treatment . — This consisted in the application of two dozen 
leeches around the anus. The region of the liver was blistered, 
and cold-water enemas were constantly employed. Twice 
daily, viz., morning and evening, an opiate suppository was 
introduced. The suppositories were continued for nine 
consecutive days, with the cold-water clysters in the mornings 
and evenings before their introduction, and once at mid-day ; 
when only one small tumour, and that very much flattened 
and reduced, remained. A few days afterwards this likewise 
had disappeared. A few alteratives were also exhibited, 
commencing on the fourth day from the application of the 
leeches. On the day following the use of the opium paste, 
the lining membrane was less vascular, and the piles became 
every day less in bulk, and softer, until they vanished. The 
bowels were likewise on the same day opened, without any 
concomitant straining, eight times freely, and continued to 
be so subsequently, acting several times both night and day. 
The appetite also became very speedily quite healthy. 
The diet consisted simply of green grass, lucerne, and cold 
water. Bran mashes the animal always refused. 
The above is the first case of hemorrhoids that I have met 
with in the equine species, and as I believe them either to be 
of rare occurrence, or but seldom noticed, I have therefore 
transcribed it for your disposal from my case-book. 
I remain, gentlemen, very faithfully yours. 
Jaulnah; June 21 , 1856 . 
