Apply freely with cotton or on to the piles. Ten cents will buy enough to
use.
[DIGESTIVE ORGANS 149]
Operation for Piles.--When these measures do not relieve the pains or the
piles become inflamed from slight causes and often, it is best to operate.
This can be done in a few minutes with a local anesthetic and the patient
frequently goes to sleep afterward, almost free from pain. Inject a three
per cent solution of eucaine, or six per cent solution of cocaine.
Thoroughly cleanse the part and hold the buttocks apart, pierce the pile
at its base with a thin sharp-pointed curved knife, laying it open from
side to side. Remove the clot with a curette, cauterize the vessel and
pack the cavity with gauze to prevent bleeding and to secure drainage.
Cutaneous (skin) piles are operated upon as follows.--Each one is grasped
in turn with a pair of strong forceps and snipped off with the scissors,
or removed with a knife. Close the wound with sutures, if necessary, and
dress it with gauze. Small ones need no sutures. Be careful not to remove
too much tissue. Much after-pain can be prevented by placing in the rectum
a suppository containing one-half grain of opium or cocaine before either
of the above operations are performed. The after treatment is quite
simple. Keep the patient quiet, cleanse the parts frequently, and secure a
soft daily stool. Cleanse with tepid boiled water with clean sterilized
gauze and give salts in small doses, one to two drams to produce a stool.
INTERNAL PILES. Symptoms.--The two prominent symptoms are bleeding and
pain. The bleeding is usually dark. It may be slight and appear as streaks
upon the feces or toilet paper; it may be moderate and ooze from the anus
for some time after a stool, or it may be so profuse as to cause the
patient to faint from loss of blood while the "bowels are moving." Death
may follow in such a case unless the bleeding is stopped. The blood may
look fresh and fluid or if retained for some time, it looks like coffee
grounds, sometimes mixed with mucus and pus. Patients who bleed profusely
become pale and bloodless, and are very nervous and gloomy and they
believe they are suffering from cancer or some other incurable trouble.
The first the patient notices he has internal piles is when a small lump
appears at the end of the bowel during a stool and returns spontaneously;
afterwards the lump again protrudes after the stool and others may appear.
They become larger and larger, come down oftener and no longer return
spontaneously, but must be replaced after each stool. As a result of this
handling, they grow sensitive, swollen, inflamed and ulcerated, and the
sphincter muscle becomes irritable. Later on one or more of the piles are
caught in the grasp of the sphincter muscle and rapidly increases in size.
It is then hard to relieve them, and when returned they act as foreign
bodies, excite irritation and they are almost constantly expelled and the
same procedure goes on at each stool. The sphincter muscle contracts so
tightly around them as to cause strangulation and unless properly treated
they become gangrenous and slough off.
[150 MOTHERS' REMEDIES]
Recovery, Pain, etc.--The pain is not great in the early stages, but when
the muscle grasps and contracts the pile or piles it becomes terrible and
constant. Piles rarely end fatally. Palliative treatment does not afford a
permanent cure. They frequently return, but by care and diet many can be
kept from returning so frequently. They should be treated upon their first
appearance when the chances of a permanent cure without an operation are
much better.
PHYSICIANS' TREATMENT for Internal Piles.--What to do first. The cause
should be removed. Restore a displaced womb. Regulate the bowels, liver,
diet, and habits. Much can be accomplished by these measures if properly
used, in allaying inflammation diminishing pain and reducing the size of
the piles. These measures will not cure them if they are large, overgrown
and protruding. When the piles are inflamed, strangulated or ulcerated,
the patient should remain in bed in a recumbent position and hot
fomentations of hops, etc., and hot poultices, of flaxseed, slippery elm,
bread and milk, the ice bag, or soothing applications and astringent
remedies, should be applied to the parts. In some cases cold applications
are the best. The cold or astringent applications give the best results
where the piles are simply inflamed and the sphincter muscle does not act
spasmodically, jerkily. But when the piles are strangulated, "choked
tight" by the sphincter muscle, hot fomentations, poultices and soothing
remedies give the most relief, because they reduce spasmodic contractions
of the muscle and allay the pain. Instead of the poultices and
fomentations, the "sitz" bath can be used. Put in the steaming water,
hops, catnip, tansy, pennyroyal, etc., and the steam arising will
frequently give great relief. This can be given frequently; ten to twenty
drops of laudanum can be added to the poultices when the piles are very
painful.