HEMORRHOIDS (Greek, haima, blood, and Theo, to flow), literally, a flow of blood. Until the time of Hippocrates this word was used, conformably to its etymology, as synony mous with hemorrhage. It was afterward used in a narrower sense, to indicate the flux of blood at the extremity of the rectum, and in some other cases which were considered analo gous to it; thus it was applied to the flow of blood from the nostrils, the mouth, the bladder and the uterus. It is at present used to signify a particular affection of the rectum, although the disease is not always attended with a flux; in this sense the affection is also called piles. Certain general causes may produce a predis position to this disease; in some cases, it ap pears to be the effect of a hereditary disposition; in general, it manifests itself between the period of puberty and old age, although infants and aged people are not entirely exempt from its at tacks. Men are oftener affected than women, in i whom it is sometimes produced by local causes. It often shows itself in subjects who pass sud denly from an active to a sedentary life, or from leanness to corpulency. Any circumstance which produces a tendency to pressure on the venous return of blood in the pelvis is to be reckoned as a local cause. The accumulation of fecal matter in the intestines as in habitual con stipation; efforts to expel urine; thepressure produced by polypi; the obstruction of any of the viscera, especially of the liver; worms; use of drastic purges, particularly of aloes; long continuance in a sitting posture; riding on horseback; pregnancy ; the accumulation of water by ascites ;— such are some of the ordinary causes of hemorrhoids.
Several varieties of hemorrhoids are dis tinguished. They are known as external when apparent at the anus; internal when concealed within the orifice; blind or open,. regular or ir
regular, active or passive, periodical or anoma lous, etc. There is also a great difference in the quantity of blood discharged; it is usually inconsiderable, but in some cases is so great as to threaten the life of the subject. The quality, color, etc., of the blood, also differ in different cases. The number, seat and form of the hem orrhoidal tumors likewise present a great variety of appearances, When the disease is purely local it is cured more readily; but in the greatest number of cases it is connected with some other affection, or with the constitution of the sub ject. In these cases, if the piles are not trouble some on account of their size or if the bleeding is not very considerable, cure of the primary affection should be attempted. The best mode of treatment is then to recur to hygienic rather than medicinal influences. The subject should avoid violent exercises, but moderate exercise will be found beneficial. The standing position is to be avoided as much as possible, especially following defecation. The constipation (q.v.) with which the subjects of this disease are liable to be affected should be remedied by hygienic dieting. If the pain is considerable, recourse should be had to sedatives and local application of hot 'water. If the disease appears under a more severe form, more violent reme dies will become necessary. If the discharge of blood becomes excessive, particular care must be taken to regulate it. If the tumors acquire a considerable volume, surgical operations are necessary. At the present time the operative treatment of persistent hemorrhoids is both safe and efficacious.