Haemorrhoids (Gr. blood, and to flow), or Piles, tumors situated near the anus, generally commencing by a varicose enlargement of the hemorrhoidal veins of the rectum, and frequently complicated with, if not arising from, erectile tumors, blood-filled cysts in the submucous areolar tissues, and dilatation of the capillary vessels'. By whatever caused, the mucous membrane becomes irritated, sensitive, disposed to bleed, thickened, and more or less obstructing the rectal canal. They have been divided into internal or external piles, according to their situation within or without the anus; the former are generally within the last three inches of the rectum, of firm texture, varying in size from a pea to a walnut, pale when indolent, and dark red when congested or inflamed; the latter are found on the margin of the anus, of firmer texture, often covered half with skin and half with mucous membrane. Hemorrhoids are also divided into open, or bleeding, and shut, or blind piles.

The tumors are rarely single, generally spherical, with a large base, but occasionally pedunculate; their surface may be either smooth or irregular, rough, and ulcerated; when indolent and internal, they produce simply the inconvenience of bulk and consequent trouble in defecation; when irritated, either internal or external, they cause a sense of heat, tension, and itching, pain and straining during evacuation of the bowel, accompanied by more or less bleeding, frequent mieturition, and weight and pain in the back and thighs. When external, the friction of the clothes often renders standing, sitting, or walking exceedingly painful; when just on the verge of the anus, the act of defecation is accompanied by tenesmus and excruciating pain, rendered more intense by the usually present constipation. By constant efforts, the mucous membrane becomes prolapsed, adding another source of discomfort. Haemorrhoids, though generally a local disease, may be the channel by which a periodical flux or a constitutional plethora finds relief; in such cases the bleeding is preceded by the general and local symptoms of excess of blood.

All ages and both sexes are subject to this disease, though it is comparatively rare before puberty, and females are more frequently sufferers from it than males, especially during gestation, and plethoric persons more than the anaemic. The predisposing causes are such as produce fulness of the hemorrhoidal veins and impede the return of blood from them, such as sedentary habits, city life, constipation, pregnancy, the use of corsets, the weight of heavy garments suspended from the hips, and diseases of the thoracic and abdominal organs interfering with the circulation. The exciting causes are anything which irritates the lower portion of the intestine, as the presence of pin worms, the use of aloetic medicines and injections, and, in warm climates especially, the use of too nourishing food, with its tendency to produce plethora, and its accompanying luxurious habits. The prognosis is generally favorable, unless the disease be of long standing, in a debilitated constitution, or accompanied by malignant affection of the rectum; in some cases the hemorrhoidal flux may be positively advantageous, and its sudden and complete suppression may subject the patient to more grave disease. - The general principles of treatment are, according to the evident causes, to diminish the amount of blood sent to the parts by active habits, abstemious living, avoidance of constipation, and attention to other hygienic rules.

In case of irritation, leeches or cupping in the neighborhood, fomentations, poultices, enemata, refrigerant and soothing lotions, are of advantage. Strict observance of cleanliness, astringent applications like tannin ointment, pressure by bandage and pad, ice, and antiphlogistic measures will suffice in many cases. A surgical operation is often necessary for a radical cure. This consists in excision, either by knife, cautery, or ligature, usually the last. It is excessively painful, unless the patient is placed under the influence of anesthetics.