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alterations were the effect os electricit ;yet here there as round for suspectinithis es ursi notii de the continuance of it On his account Phave, at east fortite present, discontinued the trial butwith the intention o again returninito the se of it, is circumstances ill allo for I cannot hel p hin king that iis influende in the present a se has been such a tociive opes that it a b apowerfui remed in reneis in circulationthrough diseased paris. I have, in themean time, ut his patient on the se of the cicuta frona hicli I cannot hel pthinhing that in soni cases I have seen very good effects Is there be any appear-ance of ad vantage, I mali illi to persistwith it for ome time; and after a Propertriat, the farther reatinent,illi regula-
ted by circumstances. I must, O e Ver,
conclude, as I have ali eady aid that ne i-ther rom his, nor froni any ther modeos cure, aves an high Xpectations.
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The cicuta was continued with this patient for ome time ithout an obvious good effect She was averse to the repetitionis theselectrici ty and gave u attend-ance at themispensary, o try the effecisos genti di effings, without an other me
of his age, by trade a ardener, o a robust habit and florid complection, admitted Januar 21. 777, complain ofhein constantly affected with muchiainabout the anus, hicli is increased by wallain and when eris a stool. Astereachinoolle generali passes ome blood, Whicli is commoni in a pure and fluidstate. Imali tubercles, lightly inflamed,
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are tot seen externalty at the anus fromwhichae supposies the patia and disicharget proceed Pulse, heat, and appetite, natural eli regular. About ighteen monilis ago, he was affected illi an itchin ove his holes lain, and with pati in his ead, hichwas attended illi sight iddinesse Thesecomplaint continue t for ome weelis, and les himipon the appearance of the present affection; for hicli e nows noother cause H has used ut e medicines, and these have had litile esse R. Florum selphuris, Pu eris cremoris tartari, singulorum uncias duas. Frupi,implicis quantum susscit. m. fiat sectuarium, cibus capiat drachmam imam ter de die. Februar i. The medicine has been ta
ken a directed, and has had the effecit ofkeepin his eli genti open He has stili ome ain abolit the anus, ut it is considerabi diminis hed and there has K a been
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been very litti discliarge of los sinceti hegan the se of his medicine.
Continuetur electuarium ut antea.
Februar 8. He is no fre fro allhis forme complainis, excepi a stigii degre os forenesis Xternalty. et in bedis misse l. CBsERVATION deliGerediebruar I S. The case of this patient assor is subjectbut for se remarks His diseas is nei-ther in iis nature singular nor is there any oom for doubi respectiniit; hile, at the sanie time, there oes no here oc cur an complication o affections Thatthis patient as affected with haemorrhois,can admitis no doubi; ut his is a disse ease, illi regaresto hicli the most eminent pracstitioners stili differ in thei senti-ments. It ma indeed e thought that the present case has not ver characteristi. of the assection, a defined by omenosologisls his patient, lieni came
unde Cur care, ad n complaint of
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headach vertigo, o patia about his lolns. These, however, accordin to D Cullen, are characteristic of this affection: Andhe even ut them in nich a manner, that me ought to conclude they mould constanti be present. Fe nos logists, however, echon o an symptonas essentiat; and the present case at eas correspondsver exacti to the definition of r Sau-
Vages. His Word are, ' fluxus cruentus
ex podice vel recto mariscis ruptis ob Besides bio Ody dis charge and tubercles,pain is ais by sorne considered a a cha racterim of the affection. An it mayeven e remarhed that either the oneno the other of the sympionis mentioned by auu ages are tot considered as esten tiat. Osten, indeed, as in the presentinstance, both are conjoined ut in omecases there is no tumour, and th othersthere is notis charge. his has led to thedis tinctions of the assection into armorrhois caeca, aperta, into interna, Xterna,
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no dependisti an essentia disserenc in the natur of the diseasse, ut meret onsituation and Indition. In the present
cing that the diseas was of the externalhilid, and a theriam time intilled to the appellation of the haemorrhois aperta Itis in generat agreed that his complaint
arises from an assection of the haemorrhoida vesseis It has however, been dispu- ted whether the emorrhag procee is froni arteries o vetias and whether thetiam ouri the effecit os effusion in to thecellula membrane or of the enlargemento the velias. It is the mos common opinion, that both hemorrhagy an tumour
dependisti the eins An this opinion, Iam incline to thinh, is mos generallytrue. It is corroborated both by the disse sections o Morgagni, and by attendingio hos habit usuali subjecto harmorrhois Morgagni, rom dissection, contends, marmorrhoides nihil esse aliud
quam Varices venarum ani. Besides
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bourin unde Venous plethora, or at east fuchos have arrived a that periodis life when his condition is most frequent. Itis not however, tote dented that many circumstances seem to favour the opinionos fruston. It is o b observed that there is frequently no inconsiderable patia; circumstance no arising rom distentionos velias Bessides, there re also dirὰctions in favour of the opinion os effusion. These have demonstrated a lodgmen ofblood in a receptacle formedis condensedcellula membrane and i may also eadded, that the disicharge is sonaetimes very great, and is evidenti prece led by increa- sed impetus and tendencycio hemorrhagyove the whol system. When ali thesecircumstances concur, there is strong pre-λmption that the disicharge procee is from arteries. An this opinion is evensevoured by ome dissections related by Morgagni himself. In ne case, he ob
serves, EXtremum intestinum intus va- ricosis venarum nodis inaequale. Ma-
jorem ex his attente inspiciens miratus sum,
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sum, cum ipso qui non modico alioquin distendebatur sanguinis grumo, non nisi tenuimma sanguifera vascula communi care, ut evidens esset aliquam perexilem venam in eam fuisse amplitudinem dila latam. To me it dem more probabie, that he appearance whicli here astoniss1ed Morgagni, was ather the effect of effusion than of the extraordinar dilatationwhich he suspected. It would seem then that in his assection cases may differ essentiali in their nature: and suci a distinction is osten os consequence in the cure. I naturalty occur here as a question, o whicli of these hin is the present caseris to e referrest know no circumstance, in the instancebefore us, frona hicli, can form a certain udgment; et I mus own I am disse possed to conside illas a venous asseclion. The disicharge of blood is ni to a light degree, and seem to appen principally, is nocentiretu, rom pressure, sin a disse charge of faeces by lool. It is no attended Wit an mark of increased impe'
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tus, nor accompanted with an considerable degre o patia. At these re objections against the supposition of the emorrhag bein froni the arteries, hile the de of iis ein venous is confirmed by the period of life at whicli the patient
Thus thenes have state sm sentiments respecting the natur of the diseas withwhicli his patient is Tected Aster hetermination hicli it has atready ad Ineed a id nothing of the prognosis Thedis eas indeed, revious to his admission,
was of ome duration; et o circum
It is et Enown that hoste ho haveonce been subjecte to this complaint, are very table ora recurrence of the affection; an it is no improbabi that his may happen
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happen illi the present patient: et, when he was disinissed, e was re from
In the treatinent of this case, I found it necessar to do ver litile. Andes may here observe, that harmorrhois is ne filios assections respecting the proprietyos curing whicli there is osten very great doubt. In many cases, particularly hereth disci arge is habituat, it is to e considere Mas salutary and in os instances there is ome ange froni a sudden check, especiali where the discliarge is inconsi1-derable This is particulari the casewhen, as as observed illi the presentpatient, hos subjectedo it have that florid complection hich ives evidence of ple thora. The cure, heres ore, is to eregulated by the appearance of the dis ase; and where there is nothiniver urgent, itis perhaps the est plancio do ut litile, especiali when there is no reason to p prehend