Although, considered either in a practical or a theo retical point of view, there seems no reason to doubt of the actual existence of venous, as distinct from that of arterial hxmorrhagies ; yet they appear, in most cases, to be rather symptomatic than idiopathic affections, be ing either consequential upon some other disease, or indicating a structural derangement in the organ from which they proceed. This remark will, we apprehend, apply to the discharges of !blood from the stomach, the intestines, the liver, and the bladder, which are, for the most part, either the effect of previous inflammation of these parts, or of actual disease in them, by which their mechanical texture is obviously deranged. The only means of relief, therefore, is to remove the morbid con dition on which the discharge depends, when this can be accomplished ; an object, however, which it is too frequently beyond our power to effect. Various pallia tive remedies have been employed in these cases, but we conceive without much prospect of relief ; deple tion is not indicated by the state of the system at large, nor do we apprehend that any benefit can be exrcted from the usual routine of astringents and tonics. Mild purgatives are useful, both from their local and their general effect, and opium may be given to allay irrita tion and to ease pain ; but beyond these we have little to trust to, except the assiduous application of all those means which strengthen the digestive organs, and through their means tend to establish the general health.
There is, however, one of the venous hxmorrhagies which is to be regarded as an idiopathic disease, and which admits of a more direct and decisive treatment, hamorrhois, or piles, consisting of a discharge of blood from the hxmorrhoidal veins. This disease has excit a considerable share of attention, as appearing to co incide with the pathological hypothesis of the Stahlians, respecting the salutary efforts of the intelligent superin tending principle, or anima. It was supposed that these veins afforded a kind of outlet for the superfluous fluids, when the sanguiferous system was oppressed with too large a quantity of blood, being analogous to the men strual evacuation of the female, of which this was sup posed to be the prime object. We have, however, no hesitation in asserting, that the facts upon which this hypothesis was built were much exaggerated, and that when we view the complaint without prejudice, we shall find it to be, like many others, in a certain degree useful in restoring the balance of the circulation, when it has been deianged by various circumstances, but, like them, always to be regarded as a disease which we must attempt to remove, and which, if suffered to proceed without restraint, lays the foundation for much future inconvenience.
We shall not in this place inquire into the causes which tend to produce congestion in this particular set of vessels ; it will be sufficient to remark, that in cer tain constitutions, and at certain periods of life, the veins about the termination of the intestinal canal are liable to become distended with blood, that they are oc casionally ruptured, and discharge their contents, and produce painful and even dangerous abscesses in the neighbouring cellular substance. When the veins are
become turgid, it is necessary that they should be eva cuated; and it is still more desirable that the turges cence should, if possible, be prevented from taking place. As the disease, although of a local nature, ge nerally depends upon a constitutional cause, we are to use the most effectual means for reducing the plethoric state of the sanguiferous system ; for this purpose the antiphlogistic plan must be employed, but rather in its passive than in its active form, for although bleeding and other depletions may be occasionally proper, we are to expect more permanent benefit from a temperate diet, a due proportion of exercise, and only a mode rate indulgence in sleep. When there is much inflam mation of the parts, leeches are often necessary ; and when the discharge is very profuse, we may apply cold and astringents ; mild purgatives are also indicated, both from their general and their local effect ; and an opinion has very generally prevailed in favour of there being something peculiarly soothing in the operation of sulphur; we frequently find opium necessary to relieve the pain, which is often very severe. \Vhen these means have been neglected, or are found ineffectual, surgical assistance is required to remove the tumours, and to heal the ulcers that are occasionally formed ; but these operations belong to a different department of the art. Although we do not admit the correctness of the hypo thesis which regards Ilxmorrhois as a salutary effort of nature, yet we conceive that where the system has been long habituated to such a discharge, if it be sud denly stopped, and no means of prevention be employed, bad effects may be the result. These, however, are easily obviated by using the necessary remedies against the plethoric state, which is then liable to be induced ; perhaps general bleeding may be required, as well as purgatives, but we are to rely more upon exercise and temperance.
Of the two remaining diseases, which we have placed in this genus, Stomacace and Purpura, the first may ire always regarded as a symptomatic affection, whether existing in the acute form, as e observe it in infants, connected with the disease which is popularly called Thrush, or in that more chronic state, appearing in con nexion with Scurvy, or attacking individuals who have suffered from a long residence in hot climates. In both cases the cure depends upon restoring the healthy ac tion of the alimentary canal, and the organs immediately concerned in the function of digestion.