cases;
while in others soothing lotions, and ointments or suppositories are
needed.

The lead and laudanum wash is always reliable.

Lead and Laudanum Wash.--

Solution of Subacetate of Lead 4 drams
Laudanum 20 drams
Distilled water enough to make 4 ounces

Mix thoroughly and apply constantly ice cold on cotton to the sore parts.

The following ointments, lotions, and suppositories to be used freely
within the bowels and to the piles, are effective in relieving the pain,
reducing inflammation and diminishing pain and spasm in the sphincter.

1. Ointment of Stramomium 1-1/2 drams
Ointment of Belladonna 2-1/2 drams
Ointment of Tannic Acid 1/2 ounce

Mix thoroughly and apply inside and outside the anus.

2. Camphor Gum 1 dram
Calomel 12 grains
Vaselin 1 ounce

This must be thoroughly mixed. Apply freely within the anus and to the
piles. Good for the pain.

3. For External Piles cleanse them well with a sponge dipped in cold
water, and then bathe them with distilled extract of witch hazel.

4. If there is much itching with the piles use the following salve:--

Menthol 20 grains
Calomel 30 grains
Vaselin 1 ounce

Mix and apply to the piles.

5. I use quite frequently the following for sore external piles:

Chloroform and Sweet oil in equal parts

Apply freely with cotton or on to the piles. Ten cents will buy enough to
use.

[DIGESTIVE ORGANS 149]

Operation for Piles.--When these measures do not relieve the pains or the
piles become inflamed from slight causes and often, it is best to operate.
This can be done in a few minutes with a local anesthetic and the patient
frequently goes to sleep afterward, almost free from pain. Inject a three
per cent solution of eucaine, or six per cent solution of cocaine.
Thoroughly cleanse the part and hold the buttocks apart, pierce the pile
at its base with a thin sharp-pointed curved knife, laying it open from
side to side. Remove the clot with a curette, cauterize the vessel and
pack the cavity with gauze to prevent bleeding and to secure drainage.

Cutaneous (skin) piles are operated upon as follows.--Each one is grasped
in turn with a pair of strong forceps and snipped off with the scissors,
or removed with a knife. Close the wound with sutures, if necessary, and
dress it with gauze. Small ones