Part 7

TREATMENT OF HÆMORRHOIDS.—Mr. J. Christophers, of Wadebridge, Cornwall, sends us the following note:—“The pain and risk attending operations for the removal of hæmorrhoids, whether by knife, ligature, cautery, or caustic, render valuable any less heroic mode of treatment, whereby the necessity for using the means alluded to may be dispensed with, or even rendered less frequent. The term hæmorrhoid or pile being used to signify a tumour caused by enlarged or varicose veins at the lower part of the rectum, the definition of the disease would seem to indicate its treatment—pressure and support. The benefit resulting from pressure on tumours, and from pressure and support applied to varicose veins situated on the surface of the body, is manifold and manifest. The same good results often attended pressure internally applied in cases of hæmorrhoids, and frequently in cases of prolapsus also. Occasionally after having introduced the finger into the rectum, in cases of hæmorrhoids, for the purpose of exploration, I have heard with surprise the patient affirm that the examination had temporarily relieved the severity of his pain. Continuous pressure exercised by means of the rectum plug, of a size, form, and material suited to these cases, in many instances, affords immediate relief, and often effects ultimate cure; the rectum plug being nothing more than a simple cone or peg, terminating in a short stem or disk, having a hole bored through its long diameter formed of metal, ivory, wood, membrane, or of other material capable of inflation. Any of these substances answer the purpose, some being suited to one kind of case, some to another. Those formed of wood have in my hands answered well, and have often achieved a success that has exceeded my expectations. The shape and size best suited to individual cases experience soon teaches. A not unfrequent obstacle in treating cases by the rectum plug will be found to consist in the intolerance by the rectum in some patients at first of its presence; perseverance in its use gradually and surely overcomes this difficulty. After a short probation all discomfort ceases, and the plug can be worn by day and by night, sitting, riding, walking, or standing, with the best results, and that not only in cases of hæmorrhoids, but in bad cases of prolapsus also. So much is this the case that many who have worn a rectum plug, though with difficulty at the beginning, give up its use, even when the malady that demanded its application is cured, with reluctance and regret, saying that they derive comfort and support from its presence. These circumstances induce me to think that this safe and simple means of treating hæmorrhoids has been too much neglected, and for this reason I venture to bring it under the notice of the _Practitioner_.”

Bibliography.[14]

Les Eaux thermales de Mont-Doré dans leurs Applications à la Thérapeutique médicale. Par M. Mascarel.

Prophylaxie Internationale des Maladies vénériennes. Par MM. Croq et Rollett.

Considérations sur les Résultats de la Paracentèse dans la Pleurésie purulente. Par le Docteur A. Attionent.

Du Collodion riciné appliqué en badigeon sur toute la Surface du Ventre, considéré comme Agent de Calorification générale et comme Moyen héroïque de Traitement dans le Cholérine, le Choléra, etc. Par M. A. Drouet.

Études sur quelques Points d’Hygiène hospitalière. Par M. G. Chantreuil.

Traitement du Croup par les Inhalations de Vapeurs humides de Sulfure, de Mercure. Par M. le Docteur Abeille.

De la Médication antipyrétique. Par M. le Docteur A. Ferrand.

Mémoire sur les Dissolvants et les Désagrégéants des Produits pseudo-membraneux et sur l’Emploi du Brome dans les Affections pseudo-membraneuse. Par M. le Docteur Ch. Ozanham.

De l’Administration de Quinite dans les Fièvres d’Accès comme succédané du Sulfate de Quinine. Par M. le Docteur Halmagrand.

Monatsschrift für Ohrenheilkunde. 3 Jahrg. 1869.

Klinische Beiträge zur Psychiatrie. Von Prof. Dr. Lombroso.

Zeitung allgemeine balneologische. Herausgegeben von Dr. H. Kisch.

Die Transfusion des Blutes in physiologischer und medicinischer Beziehung. Von Belina-Swiontkowski.

Footnote 1:

_Boston Medical and Surgical Journal_, May 21, 1868.

Footnote 2:

“The Restorative Treatment of Pneumonia.” Third Edition. Edinburgh: Black, 1866.

Footnote 3:

_British Medical Journal_, December 28, 1867.

Footnote 4:

_British Medical Journal_, February 22, 1868.

Footnote 5:

See also some Lectures on Pneumonia by Dr. Waters, of Liverpool (_British Medical Journal_, October 1867), whose views and treatment, allied to those of Dr. Sieveking—I hope he will excuse me for thinking—are very unsatisfactory, when compared with the results obtained by a restorative practice.

Footnote 6:

_Practitioner_, November 1868.

Footnote 7:

Read at the third Quarterly Meeting of the Medico-Psychological Association, held at the Royal Medico-Chirurgical Society, April 29, 1869.

Footnote 8:

Extract from Nineteenth Annual Report of the Somerset Asylum:—“One female maniac, C. L., aged 35, single, most obscene in her conduct and language, noisy, destructive, and dirty, got rapidly well after the employment of the hypodermic injection of a solution containing half a grain of acetate of morphia.”

Extract from Twentieth Annual Report of the Somerset Asylum:—“The hypodermic injection of about half a grain of acetate of morphia in ♏︎x. of distilled water has been useful in cases of maniacal excitement with sleeplessness.”

Footnote 9:

The gas used in the following instances was supplied to me by Barth, of London, and administered in his apparatus. I would wish, in this place, to thank Dr. Birch, of Kensington, for introducing it to my notice, and for his kind communications on the subject of this paper.

Footnote 10:

In estimating the value of oxygen in these cases of phthisis we must bear in mind the mechanical effect of deep and steady inspiration through a long tube; this, _per se_, has a tendency to expand the lung vesicles and to hasten the healing of cavities, as has been fairly shown by Ramadge, in spite of his absurdities.

Footnote 11:

Cf. Birch on “Action, &c. of Oxygen,” 2d edit. p. 33.

Footnote 12:

Our own experience is very favourable to petroleum.—EDS. PRACT.

Footnote 13:

The Editors, being desirous of making this department a useful medium of communication between practitioners, will be glad to receive short notes on theoretical or practical points in therapeutics,—brief jottings on those numerous queries which suggest themselves from time to time to a medical man as he “goes his rounds,” but which he has neither the time nor, in some cases, the opportunity of answering. The Editors do not pledge themselves to reply to every question addressed to them, but they hope to make the “department” the means of supplying the information required; and this they can only effect by the hearty assistance of their readers.

Footnote 14:

Any of the foreign works may be procured by application to Messrs. Dulau, of Soho Square, W.C.; or Williams & Norgate, of Henrietta Street, Covent Garden, W.C.

TRANSCRIBER’S NOTES

1. Silently corrected typographical errors and variations in spelling. 2. Retained anachronistic, non-standard, and uncertain spellings as printed. 3. Footnotes have been re-indexed using numbers and collected together at the end of the last chapter. 4. Enclosed italics font in _underscores_.