This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1880 Excerpt: ...tumor, then I think it is advisable to either cut off this, as you would a tab of skin, or, with a bistoury, cut into it and evacuate the blood. If this has existed for a long time, or if there are any flaps of skin that can fall into this cut, with a pair of scissors cut them off. This constitutes the treatment, and the only sensible treatment, for external hemorrhoids. Case 1.--Now, I have told you that external hemorrhoids are liable to become inflamed. I will add, they are also liable to become ulcerated. You will find that as they exist they are liable to be rubbed by the clothing, or possibly there is a discharge from the bowel that, coming in contact with the tab of skin, will inflame it, and therefore there is considerable pain, not only in defecation, but also in walking or any other exercise. This man says he had an attack of piles about ten years ago. Those were probably internal piles, which, ascending above the sphincter, never troubled him again, or one of these tabs of skin that has never since been inflamed. To day he has them, not only inflamed, but ulcerated. When this inflammation has subsided they will be only about one-fifth their present size. Here, at another point, is one of these tabs of skin uninflamed. If it should become so, it would be much larger than this which is now inflamed. Here, bordering upon the perineum, is some superfluous skin that may become inflamed and give rise to the same amount of distress. Now let us apply the treatment to this case. But first let me urge you never to be satisfied with the diagnosis of only one class of trouble, because if you do you may be guilty of operating upon external hemorrhoids when there exist at the same time internal. Besides, in a case like this you may have fissure, or a narrow fi...