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Show ornnurons on THE ANUS AND moron. OPERATIONS 0N ‘LIIL' AXES AND ltECT-UM‘ 97' the fibres act, a considerable portion of the inner coats of the gut is sometimes inverted, and swelling, it is in some measure strangulatedse. These tumours being several times produced, will at last become permanent. They form very generally in CHAPTER V . two distinct clusters, on the sides of the anus; and in the mid- dle of these there is a prominent and distinguishable point, or OPERATIONS ON THE ANUS AND REC'I‘UM somewhat of a distinct tumour, hard, livid, and acutely pain- ful. They produce great distress, tencsmus, difficult and painful evacuation, and frequent discharge of blood. They now consist of the turgid veins of the inner coat or margin of O'F HEMORKHOIDS, 0B. TUMOU‘RS IN THE EXTRL‘MITY 0F Till; GUT. "$13va. main 1 A ‘Vnnn we recollect the peculiarities of the circulation of the blood through the liver and intestines, we readily com‘ prehcnd how a costive habit and indolence of the bowels will produce a degree of 1en101a, and surchaige of the venous syS ‘ - 1‘" .uv-e :...g,_-..,..« 2" tem of the intestines, that the efiect of this state of the viscera falls on the veins in the extremity of the rectum; that they are the lowest and most depending branch of that system, and in certain circumstances external, and as it were removed from the general support and pressure which is upon all parts contained within the cavities. We readily acknowledge also their frequent connexion with disease of the liver, and with ascites. the anus, and the cellular membrane filled with lymph or blood, or they have become firm and lieshy. When the hmnorryhay is great, we find it recommended to introduce a "tube of silver, 11rapt properly round 111th soft linen," into the rectum, or a sheep's gut! But when we consider the nature of the action of the rectum ', that these act. as suppositories, and excite the gut; that the action of the rectum is attended with a relaxation of the Fp‘lllslctttl‘, at the W same time that the gut itself is in cont1action; we shall acknowledge thattall this thoughtless ingenuity is misplaced, andmust do harm. W'ith piles there is often combined an inflammation, and tendency to suppuration, in the cellular membrane around the anus, while an accumulation of hardened fecesis formed in the g1eat intestines. This distended and inflammatmy sttae of the paits must be allayed by bleeding, laxatives, But, totally indepcw cly sters, and low regimen, "hile anodyne fomentation and dent of all this, venous tumours form upon the margin of the sott cataplasm, are applied exteinallv. Such a state of the parts requiies care, as it often lays the foundation of fistula anus, as mere local diseases, proceeding from the action of the guta‘s. From irritation in the extremity of the gut, the lax in- , w 1%. __....¢... 1s...-.-..'--'M" ‘ " "" in one. ner coat swells, whilst the muscular fibres, contracting, push it do"n as they would matter111 the,"gut. At the same time, tllC action of the muscular fibres constl1ets the hzemorrhoidal Vein When there is an attack of piles, attended with tenesmus, and the frequent contraction of the gut, a dose of a mild ‘ In this case there follows great pain and fever. above, and the loose cellular coat, which is protuded, is filled with blood. The sphincter, relaxing as the upper portions of eration. This is no time for op‘ The pain and irritation is such, that a heavy foot pacing across the. the room produces a paroxysm of pain. Leeches, tbmentation, mild 11133.- rivcs, which ouerate little on the rectum, astringent and opiate ointments, . 0r:saccldent:11 symptoms {1;OCCedi‘mflom picnnancv, cold hqhgipg‘ long on the id‘t §:.e '11‘1‘iti1 c act orlead, and we.shes, are to be used Aftel movinn‘ the hunt "w '11u1111tat1a11 about. (‘1'.- arm 1emains,an opiate clvster Will "H"."asf 1» F1. (. {t \1‘1 ulnacr |