es and skin or simple enlarged tags
of skin. Venous piles usually occur in robust persons. They come on
suddenly and are caused by the rupture of one or more small veins during
the expulsion of hardened feces. There may be one or more, and may be
located just at the union of the mucous membrane and the skin. Their size
is from a millet-seed to a cherry, livid or dark blue in color, and appear
like bullets or small shots under the skin. At first they cause a feeling
of swelling at the margin of the anus; but as the clot becomes larger and
harder, there is a feeling of the presence of a foreign body in the lower
part of the anal canal (or canal of the anus). The sphincter muscle
resents this and occasionally contracts, spasmodically at first, producing
a drawing feeling; later these contractions become longer and more
frequent, and there is intense suffering caused by the pile being
squeezed, and this suffering may be so great that sleep is impossible
without an opiate. Because of the straining, irritation of the rectum and
pain in the sphincter, the piles soon become highly inflamed and very
sensitive. The clot may be absorbed without any treatment. Occasionally it
becomes ulcerated from the irritation, infection takes place and an
abscess forms around the margin of the anus terminating in a fistula.

[DIGESTIVE ORGANS 147]

Skin Piles. (Cutaneous).--These are enlarged tags of the skin. They
frequently follow the absorption of the clot in the venous piles where the
skin is bruised and stretched. There may be one or many and usually have
the skin color. These cause less suffering than the venous variety, and
sometimes they exist for years, without any trouble, providing care is
taken; but when bruised from any cause, such as a kick or fall, sitting on
a hard seat, stretching of the parts during stool, or when they become
irritated by discharges from the rectum or vagina, they become inflamed
and cause much annoyance and pain. When they are acutely inflamed they
swell greatly, are highly colored, swollen, painful, and extremely
sensitive to the touch and cause frequent spasmodic contractions of the
sphincter muscle and may finally result in an abscess. The pain is usually
confined to the region of the anus, but may go up the back, down the limbs
or to the privates.

MOTHERS' REMEDIES FOR PILES. Sulphur and Glycerin for.--"Equal parts of
sulphur and pure glycerin. Grease parts." This preparation is very
healing, and will