The  cutaneous  consist  of  hypertrophy  of  the  skin,  generally  left
after  absorption  of  the  coagulum  of  the  first  form.  Internal
piles  may  consist  of  one  or  more  dilated  vessels.  Catises, —
Sedentary  habits,  indulgence  at  table,  sexual  excess,  child-bearing,
camel-riding,  hepatic  disorders.  Symptoms. — External  piles  are
liable  to  inflammation  and  suppuration.  Internal  piles  cause
weight,  burning  in  the  rectum,  pain  in  the  loins,  irritable  bladder,
mucous  discharges,  leucorrhoea,  and  many  other  anomalous  sym-
ptoms. They  are  liable  to  bleed,  sometimes  excessively.  Tliey
may  ulcerate,  or  protruding  may  be  constricted  by  the  sphincter
and  mortify.  Treatment. — For  small  piles,  moderation  in  diet,  no
spirits,  exercise,  cane  seats,  avoidance  of  constipation  by  mineral
waters.  For  excessive  bleeding  iced  water,  injections  of  tannic
acid.  When  bleeding  is  frequent  and  the  piles  ulcerated,  operation.
Heart,  Diseases  of  the.  —  1.  AneurUm  is  a  depression  or
sacculus  formed  in  the  walls  communicating  with  one  or  more
cavities.  Catcsea. — Inflammation  may  lead  to  ulceration  and
softening.  Fatty  degeneration  may  yield  to  the  pressure  of  blood.
Partial  rwptxvre  may  take  place  with  haemorrhage,  constituting
cardiac  apoplexy,  with  the  result  of  a  cyst  or  sac,  which  com-
municates with  one  of  the  chambers.  Abscess^  the  result  of
inflammation,  may  terminate  in  a  sac.  Symptoms  of  aneurism
are  pain,  dyspnoea,  lividity  of  surface,  palpitation,  irregular  pulse,
various  murmurs.  But  all  symptoms  may  exist  with  other
lesions.  Treatment — ^Palliation  of  urgent  symptoms.  2.  Atrophy.
