of blood in the hypochondriac region, or when, though originally topical, the disease, by frequent repetition, has become habitual, and has thereby acquired a connection 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 hæmorrhoidal vessels, be increased, and the recurrence of the disease, with all its inconveniencies and danger, be too much favoured. 962. Further, even in the cases stated, (961), 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. 963. The Stahlian opinion, that the hæmorrhoidal 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. 964. In all cases, therefore, of excess, or of any approach towards it, and particularly when the disease depends upon a prolapsus ani (951), I am of opinion that astringents, both internal and external, may be safely and properly employed; not indeed to induce an immediate and total suppression, but to moderate the hæmorrhagy, and by degrees to suppress it altogether, while at the same time measures are taken for removing the necessity of its recurrence. 965. When the circumstances (946), marking a connection between the hæmorrhoidal affection and the state of the stomach occur, the measures necessary are the same as in the case of atonic gout. END OF THE FIRST VOLUME. Printed by Mundell, Doig, and Stevenson, Edinburgh. |