The bleeding which sometimes takes place from Piles is more often beneficial than otherwise, unless it becomes excessive, from rupture of a large vessel, in which case, if the wound is external, it may be treated the same as the ruptured varicose vein; if it be internal, the remedies must be injected with a syringe, or a large roll of lint or cotton may be soaked in alum water and passed up the rectum. Frequently bathing the thighs and perineum with cold water will be sufficient. To relieve the pain and swelling, the female should sit over the steam of hot water, and use the warm bath. If the piles are external, they should be bathed with hot milk and Laudanum, or rubbed with any soothing ointment, particularly the _Cucumber Ointment_, mentioned in my Diseases of Woman, or with _Stramonium Ointment_. If they are internal the milk and Laudanum should be injected if possible, or some thin starch and Laudanum, and a stiff roll of cloth may be smeared with the ointment and introduced. In general, ointments or other greasy matters are not so good as the milk or starch. In conjunction with this, the bowels must be kept free, either with enemas or castor oil, or by using a seidlitz powder in the morning. This is indispensable, for if constipation exists, no applications can render much service. The patient must also avoid fatigue, and not remain too long upon her feet, nor sit long, particularly on a hard seat, and if she be of a full habit she must live low, to avoid making too much blood. It is also important, at all times, to avoid using drastic purgatives, such as Aloes, Colocynth, or Gamboge, as they always make piles much worse, or even cause them. ŒDEMA, OR WATERY SWELLINGS. This affection also appears, like the preceding, to arise from obstructed circulation, but instead of the blood accumulating it is merely the serum, or watery portion of it. The swellings are generally whitish, and spread about, and a small pit remains in them when pressed with the finger. They are found on various parts of the lower limbs, and on the groin or abdomen, and also upon the external lips, in which place they are often exceedingly troublesome. As a general rule these swellings are of small account, and as they disappear with delivery, but little attention need be bestowed upon them. Sometimes, however, they become very extensive, and so engorged that they inflame and are extremely painful. They have even been known to mortify, and cause considerable sloughing, particularly when chafed and afterwards wet with the urine. In these extreme cases there may be serious disturbance of the general health, from the constant irritation, and from the patient being unable to walk about. I have often known the limbs and vulva covered with patches of Erysipelas from this cause. Sometimes the swellings even become so large that they interfere with the process of delivery.