Page:The American Cyclopædia (1879) Volume VIII.djvu/389

 HAEMORRHOIDS HA&Z 375 anus, generally commencing by a varicose en- largement of the hsemorr.hoidal veins of the rectum, and frequently complicated with, if not arising from, erectile tumors, blood-filled cysts in the submucous areolar tissues, and di- latation of the capillary vessels. By whatever caused, the mucous membrane becomes irri- tated, sensitive, disposed to bleed, thickened, and more or less obstructing the rectal canal. They have been divided into internal or exter- nal piles, according to their situation within or without the anus ; the former are generally within the last three inches of the rectum, of firm texture, varying in size from a pea to a walnut, pale when indolent, and dark red when congested or inflamed ; the latter are found on the margin of the anus, of firmer texture, often covered half with skin and half with mucous membrane. Haemorrhoids are also divided into open, or bleeding, and shut, or blind piles. The tumors are rarely single, generally spheri- cal, with a large base, but occasionally pedun- late ; their surface may be either smooth or regular, rough, and ulcerated; when indo- it and internal, they produce simply the in- ivenience of bulk and consequent trouble in jfecation; when irritated, either internal or Eternal, they cause a sense of heat, tension, id itching, pain and straining during evacua- tion of the bowel, accompanied by more or less bleeding, frequent micturition, and weight " pain in the back and thighs. When ex- lal, the friction of the clothes often renders inding, sitting, or walking exceedingly pain- il; when just on the verge of the anus, the )t of defecation is accompanied by tenesmus id excruciating pain, rendered more intense 3y the usually present constipation. By con- ant efforts, the mucous membrane becomes lapsed, adding another source of discomfort, lorrhoids, though generally a local disease, lay be the channel by which a periodical flux a constitutional plethora finds relief; in ch cases the bleeding is preceded by the eneral and local symptoms of excess of blood. Jl ages and both sexes are subject to this dis- ise, though it is comparatively rare before iberty, and females are more frequently suf- fers from it than males, especially during tation, and plethoric persons more than the ffimic. The predisposing causes are such as )roduce fulness of the ha3morrhoidal veins and 3de the return of blood from them, such as lentary habits, city life, constipation, preg- mcy, the use of corsets, the weight of heavy irments suspended from the hips, and dis- ises of the thoracic and abdominal organs in- jrfering with the circulation. The exciting auses are anything which irritates the lower >rtion of the intestine, as the presence of pin worms, the use of aloetic medicines and injec- ^'ns, and, in warm climates especially, the use too nourishing food, with its tendency to ^ Dduce plethora, and its accompanying luxu- rious habits. The prognosis is generally fa- vorable, unless the disease be of long standing, in a debilitated constitution, or accompanied by malignant affection of the rectum ; in some cases the haemorrhoidal flux may be positively advantageous, and its sudden and complete suppression may subject the patient to more grave disease. The general principles of treat- ment are, according to the evident causes, to diminish the amount of blood sent to the parts by active habits, abstemious living, avoidance of constipation, and attention to other hygienic rules. In case of irritation, leeches or cupping in the neighborhood, fomentations, poultices, enemata, refrigerant and soothing lotions, are of advantage. Strict observance of cleanliness, astringent applications like tannin ointment, pressure by bandage and pad, ice, and anti- phlogistic measures will suffice in many cases. A surgical operation is often necessary for a radical cure. This consists in excision, either by knife, cautery, or ligature, usually the last. It is excessively painful, unless the patient is placed under the influence of anaesthetics. HAFF (Dan. Hav, sea), a word used in con- nection with adjectives to designate three large lagoon-like estuaries on the S. shore of the Baltic, communicating with it by one or more narrow passages. They are all in Prussia, and are called Kurisches Haff, Frisches Haff, and Stettiner or Pommersches Haff. II All/, Mohammed Shems ed-Din, a Persian poet, born in Shiraz near the beginning of the 14th century, died about 1390. He early de- voted himself to Mohammedan jurisprudence and theology, in which he became profoundly versed, and which he taught publicly. He then lived as a dervish, in luxurious pleasure, in the quarter of Shiraz called Mosella, un- der the dynasty of the Mosafferids, whose eulogist he was. The sultan Ahmed Ilkhani vainly invited him to his court at Bagdad. When in 1387 Tamerlane conquered Shiraz, he treated the poet with the greatest distinction. In his old age he abandoned luxury for aus- terities, and employed his talents in cele- brating the unity of God and the praises of the prophet. This conversion did not secure him the pardon of zealous Mussulmans for his previous songs of love and wine, and they per- sisted in deeming him an infidel, an atheist, or a Christian, and after his death denied him the honors of sepulture. His admirers, however, maintained his orthodoxy, and, it being at length agreed to leave the decision to chance, the lot fell on a passage from his odes which avowed his faults, but at the same time affirmed that he was predestined to paradise. A mag- nificent tomb was then erected to his memory ; it stands amid scenery described in his poems, and is still a favorite rendezvous of the young men of Shiraz, who resort thither to sing his verses and to drink wine. His only work is the Divan, a collection made after his death of 571 detached odes, called gazels, and seven elegies. His most licentious and passionate verses are regarded by the Persians as inspired by divine love, and are read as a devotional