Hemorrhoidal Varices usually contain coagula of considerable size, which dissolve, without, however, often giving rise to the formation of phlebolites.

The stasis to which we have referred is gradually followed by a thickening and condensation of the surrounding cellular tissue, a condition which is induced in a still higher degree by repeated inflammatory attacks. It often gives rise to inflammation, whose products induce a thickening and sclerosis of the coats of the veins and of the surrounding cellular tissue, and cause their fusion with each other. This inflammation sometimes also simultaneously deposits its products within the vessel, in which case it leads to obliteration and atrophy of the varix.. In rare cases, especially after the application of a ligature to the hemorrhoidal knots, there is a purulent exudation, which extends to the larger veins, and may induce fatal pyaemia. More frequently, however, the inflammation of the surrounding cellular tissue gives rise to suppuration, abscess, destruction of the varix, ulcerous perforation of the mucous membrane, and finally to fistula in ano.

Amongst the consequences of hemorrhoidal disease, we must also mention habitual hyperemia- of the mucous membrane of the rectum, with swelling and blennorrhoea, prolapsus ani, hypertrophy and stricture of the sphincters, sclerosis of the cellular tissue around the rectum with paralysis of the sphincters, and hemorrhoidal ulceration of the rectum.

These ulcers at the extremity of the rectum are analogous to the varicose ulcers which occur on the feet, and often bleed very freely from corrosion of varicose veins, or even of small arteries.

Hemorrhoids sometimes depend on certain obvious impediments in the portal system, in the ascending vena cava, or in the heart; but in many cases no such hinderance can be detected.

We are as unable to give a strict scientific explanation of the connection between hemorrhoidal disease generally, suppressed hemorrhoids, etc, and the various so-called hemorrhoidal anomalies - as, for instance, congestions, hemorrhages, impetigo, catarrh, gout, lithiasis, etc, as we are to comprehend the true nature of what is called the hemorrhoidal diathesis.