Torn and Mangled wounds should not be handled much. If they bleed, the blood must be stopped as in any other case. If they are dirty, warm water may be gently applied to cleanse them. The wound should be covered with some soft cloths, and kept constantly wet in Arnicated water of the strength of four drops of the tincture to a pint of water.
Piles—Hemorrhoids.
One important matter in all cases of habitual piles, is, to keep the bowels regular. Much can be done for this purpose by diet and regimen. On rising from bed in the morning drink freely, from a gill to half a pint of cold water, at least half an hour before breakfast; use such diet as is easily digested, and drink no alcoholic beverages. To relieve the bowels when costive, take a dose of Nux Vomica at night, and Podophyllin in the morning. This may be repeated from day to day until the proper effect is produced.
To relieve from a severe attack of Piles, use Bell. and Podophyllin in alternation every four hours, and apply to the tumors when inflamed, cloths wrung out of hot water, or sit in hot water for a time.
A poultice made of fine-cut Tobacco wet in hot water and crowded firmly up against the pile-tumors, secured by a T bandage, will relieve the most desperate cases for the time, and is attended with no danger or disagreeable symptoms except in rare cases, when it produces sickness at the stomach, which soon subsides on the poultice being removed. Oil of Arnica is an excellent application for inflamed Piles.
A most important point in the management of Piles, and one often neglected, is to replace the prolapsed tumors. The tumors will be protruded from within the anus by the act of evacuating, and if left in that condition, will be pressed upon by the external parts, chafed and inflamed. In all such cases, the patient should take particular pains to return the tumors into the rectum; and to aid in that process a little oil may be applied when they will be easily pushed back, and the sphincter of the bowel will close below them, preventing any chafing, and the consequent inflammation.
For Bleeding Piles, Ipecac and Bell. are very efficient remedies. They may be alternated every half hour, or oftener if the bleeding is severe, or at longer intervals when it is only slight.
Hamamelis V., (Witch Hazel,) will in nearly all cases arrest the bleeding at once. It should be applied to the parts and taken internally at the same time. Drop doses to be put on the tongue once in fifteen or twenty minutes.
An infusion of the Hamamelis may be taken internally in doses of half a teaspoonful, and the same injected into the bowel with excellent effect.
The most effectual way, and the best for obtaining permanent relief from Piles when the tumors have become hard, and remain all the time so as to pass out of the anus at every evacuation, being constantly more or less tender and painful, and often becoming inflamed, is to have them taken off. But never let that be done with a knife. The bleeding would, in such a case, be very excessive, and most likely fatal. The history of knife operations for the excision of Pile tumors is written in blood, and the tombstone stands as a monument of condemnation of the practice. No trustworthy surgeon will at this day attempt it.