The treatment recommended for piles will generally effect a cure
If taken early, the treatment recommended for piles will generally effect a cure; but if nothing be done in the first instance, the disease when established is apt to prove intractable. The intestine should be sopped with cold water until every particle of dirt is removed. It should then be dried with a soft cloth, and afterwards returned. There is never much difficulty in replacing the gut; but there is always considerable difficulty to get it to be retained. So soon as it is restored to its situation, a human stomach pump should be inserted up the rectum, and a full stream of the coldest spring water should be thrown into the bowel for ten minutes. The fluid will be returned so fast as it enters, and it must be allowed to do so, the fingers of one hand being employed against the anus to prevent the disordered rectum being ejected with the water. Cold injection in less quantity must be administered several times during the day, and with each a little of the tincture of galls, or of nux vomica, in the proportion of a drachm to a pint, may be united. The ointment recommended for piles may also be employed, but without opium, for no application of a sedative nature must be used. The constitutional measures will consist of tonics into which nux vomica enters. The food must be light and nourishing, and purgatives on no account must be administered. Cold will do good by invigorating the system, and should always be recommended. Some persons, unable by sedatives and purgatives, which are injurious, to obtain relief, have gone so far as to cut off the projecting bowel, and they have thereby certainly ended the case; for the dog dies whenever this is done. I remember at the Veterinary College, Professor Simonds killed a fine animal by attempting this operation; for he took a heated spatula to remove the part, and carried the incision so high up that he opened the abdomen, and the bowels protruded from the anus. Amputation of any portion of the rectum is not to be thought of; but an operation of a less heroic description will sometimes accomplish what the previous measures failed to effect. With a knife, having not too sharp but a coarse edge, a circular portion of the exposed lining membrane, of a width proportioned to the size of the animal, may be scraped off, so as to induce a cicatrix; or, if the dog be very tractable, and the operator skilful, a piece of it may partially be dissected off; but the knife, when employed in the last method, is apt to cause alarming hemorrhage. When this is done, as the wound heals the edges come together, and the gut is so far shortened as to be thereby retracted. There is, however, some danger of stricture being afterwards established; wherefore this operation, however satisfactory it may seem to be in the first instance, is not so certain in the benefit of its results that it should be resorted to, save in extreme cases when every other means have failed, and the choice at last hangs between relief and destruction.
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