Inaugural Medical Dissertation on Blind and Open Hemorrhoids

Namely, they were believed to arise from the portal vein and its mesenteric branch, and sometimes also the splenic one. But EXTERNAL ones [arise] from the descending hypogastric vena cava, which is a branch of the iliac ramus. They called the former the evacuators of cacochymia (bad humors), and these latter the depletors of plethora; they established that the former evacuated thicker blood, and the latter purer blood. Casp. Bartholinus proposes eight differences among them in his Anatomical Institutes, page 349, book 1 on the Veins, chapter 4, namely, that they differ in origin, insertion, number, quality of the contained blood, use, quantity of blood poured out, presence of pain, and the accompaniment of arteries, about which consult the Author in the aforementioned place.

Now, however, INTERNAL ones are seen to arise from the branch of the great trunk of the aorta that accompanies the portal vein, the inferior mesenteric branch. EXTERNAL ones are seen to arise from the iliac branch of the same artery, which accompanies the vena cava, and from its hypogastric artery. All these enter the rectum and at the same time irrigate the surrounding muscles of the anus.

III. They also arise from CAUSES, both Internal and External, with the blood erring in quantity or quality, or through a vice of the liver, spleen, or womb. They are hereditary or acquired; habitual or unusual. By reason of the effect, they are healthful (sometimes critical) or unhealthful, about which Petr., aforementioned work, thesis 7. These, by reason of the incident symptoms, [are] with or without pain, or fever, inflammation, ulceration, fistulas, gangrene, etc.

IV. These various differences of hemorrhoids are indeed useful to know for the purpose of cure. We, however, at present, attending primarily to the first difference, will propose the knowledge and cure of those most famous ones, the OPEN and BLIND, which must now be investigated as to how they are to be diagnosed.

CAP. VI.

ON DIAGNOSTIC SIGNS.

I.
The diagnosis diagnosis of hemorrhoids is to be instituted first by reason of GENUS. Their common SIGNS have already been brought forward above in the definitions for the most part: