Starting up piles in the first instance
Protrusion of the rectum is also sometimes a consequence of gross feeding, starting up piles in the first instance, and then, from more intense digestive derangement, causing purgation, accompanied with violent straining. The tone of the intestine is destroyed. It becomes lax, and its muscular power is lost. The gut is at first only a little exposed during the act, and when that is over, it is retracted; but after some time, the limit of which is uncertain, it remains constantly protruded. It is not so violently inflamed as might be expected, but it soon gets dry and harsh; cracks appear upon its surface; and the pressure of the muscle which closes the anus preventing the free circulation of the blood, renders it black from congestion.
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