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The essential symptoms of this affection are: - Livid and painful tubercles or excrescences, (Hemorrhoid al. Tumours,) usually attended with a discharge of mucus or blood, (Hemorrhoidal flux, Proctorrhoea, Haemoproctia, Haemorrhoea vasorum. haemorrhoidalium, (F.) Hemaproctie.) The most common causes of piles are a sedentary life; accumulation of faeces in the rectum; violent efforts at stool; pregnancy, &c. The precursory symptoms are: - pains in the loins; stupor of the lower limbs; and uneasiness in the abdomen and rectum, with more or less gastric, cerebral, and indeed general disorder;- constituting the Diathesis Haemorrhoidalis, Motus seu Turba Haemorrhoidalis, and Molimen Haemorrhoidale, of most of the writers of Continental Europe. To these symptoms follow one or more round, smooth, renitent, painful, pulsating, and erectile tumours, around the margin of the anus, or within the anus; some pouring out blood occasionally. After having remained, for a time, tense and painful, they gradually shrink and disappear. The chief symptoms, occasioned by hemorrhoidal tumours, when much inflamed, are ;-constant pain, liable, however, to exacerbations, and to become augmented by the least pressure, or by the passage of the faeces, and obliging the patient to preserve the horizontal posture. Haemorrhoids have generally been distinguished into- Haemorrhoides Fluentes seu Marisco'soe, Proctica Marisca cruenta, Bleeding or Open Piles; and into H. non fluentes, Proctica Marisca coeca, Haemorrhoides caeca seu furentes, Haemorrhoidales nodi, Shut or blind piles. They have, also, been divided into internal or occult, and external, according to their situation; and into accidental or constitutional. Hemorrhoidal Tumours are extremely troublesome, by their disposition to frequent recurrence; and they are apt to induce fistula; otherwise, they are devoid of danger. When anatomically examined, they are found not to consist in a varicose dilatation of the veins of the rectum; but to be formed of a very close, spongy, texture; similar to that which surrounds the orifice of the vagina; and to be erectile, like it. They are surrounded by a delicate membrane, and have no internal cavity. The treatment, in mild cases of hemorrhoidal tumours, is simple. Rest; the horizontal posture; the use of mild laxatives, as sulphur, castor oil, and emollient glysters, will be sufficient. If they be much inflamed, leeches may be applied; and warm cataplasms or cold lotions, according to circumstances, be prescribed, with abstinence, and cooling drinks. Afterwards, an ointment, composed of powdered galls and opium, may afford relief. It is in the relaxed kind, that such ointment, and the internal use of Ward's Paste, can alone be expected to afford much benefit. If, after repeated attacks, the tumours remain hard and painful, and threaten fistula, they may be removed. By Hemorrhoidal Flux, Fluxus haemorrhoidalis, Proctorrhagia, is meant the hemorrhage which takes place from the rectum, owing to hemorrhoids. It is a common affection. The quantity of blood discharged is various: at times, it is very trifling; at others, sufficient to induce great debility, and even death. It is announced and accompanied by the same symptoms as precede and attend hemorrhoidal tumours. Like other hemorrhages it may be active or passive; accidental or constitutional. The prognosis is rarely unfavourable. The affection may, almost always, be relieved by properly adapted means. These resemble such as are necessary in hemorrhages in general. Perfect quietude, - mental and corporeal; light diet; cooling drinks; bleeding if the symptoms indicate it; astringents, (if the disease be protracted and passive,) such as the Tinctura Ferri Chloridi; aspersions of cold water on the anus: astringent injections; plugging and compression. Such will be the principal remedial agents. When the hemorrhage has become habitual, or is vicarious, some caution may be required in checking it; and, if inconvenience arise from a sudden suppression, its return may be solicited by the semicupium, sitting over warm water, aloetic purgatives, glysters, irritating suppositories, &c.; or leeches may be applied to the anus. To the internal bleeding pile, a soft, red, strawberry-like elevation of the mucous membrane, Dr. Houston, of Dublin, gives the name vascular tumour. For its removal he recommends the application of nitric acid, so as to produce sloughing of its surface. Some authors have described a species of Leucorrhoea Analis or whitish discharge from the anus, which often attends ordinary haemorrhoids. This they have called Proctica marisca mucosa, Haemorrhois alba, Haemorrhagia mucosa, Leucorrhois, &c. It requires no special mention. The term Hemorrhoid is applied at times to varicose veins developed elsewhere, as at the orifice of the uterus. See Metraemorrhoides.