After Operations.—Some part has not healed, and there is left an irritating discharge.

Symptoms.—There is intense itching at the anus, increased by warmth, and contact of the buttocks. The itching grows worse after the patient becomes warm in bed. It may spread and extend to the scrotum, down the limbs and sometimes over the lower back.

PHYSICIANS' TREATMENT FOR ITCHING OF ANUS. Preventive and Palliative.

DIET.—May Take.—Strong drink must be prohibited; tea, coffee, cocoa, if used at all should be sparingly used. A light diet such as bread, milk, eggs, nourishing soups, kumiss and a little fresh fish, broiled steak, etc., may be used.

May Not Take—Hot cakes, pastry, parsnips, cheese, pickles, beans, cucumbers, cabbage, oatmeal, pork, shell-fish, salmon, lobster, salt fish, confectionery and starchy or highly seasoned foods are to be prohibited. Regular meals, no lunches between meals, and the patient must not over-eat at any time. Long course dinners and over-indulgence in highly seasoned foods and wines aggravate it.

Remedies for Bath.—The bowels should move daily and the parts should be kept clean. The parts should be bathed with hot water or weak solutions of carbolic acid, alcohol or listerine, the heat being especially soothing. Bathing the parts with bran, oatmeal, flaxseed, salt, rice, slippery elm teas, or tar water adds much comfort to these parts. Do not wash much with soapy water.

1. Separate the Buttocks with Gauze, a thin layer of cotton or a piece of soft cloth. This eases the soreness, pain and itching by absorbing the secretions and preventing irritations while walking. The patient should not scratch the parts. Direct pressure over the itching parts with a soft cloth, or by drawing a well oiled cloth across the sore parts several times gives relief.

2. Dr. Allingham Recommends the introduction of a bony or ivory nipple-shaped plug into the anus before going to bed. It is self retaining, about two inches in length, and as thick as the end of the index finger. He claims it prevents the night itching by pressing upon the many veins and terminal nerve fibres of the parts. When the rawness is extensive and the parts are highly inflamed, the patient should be kept to bed and kept on his back with the limbs separated until the irritation is allayed.

3. Local Applications.—Soothing remedies: These can be used when the parts are inflamed and raw. Lead and opium wash, or boric acid, or linseed oil, or starch, or cocaine, and zinc stearate with boric acid. This form of zinc adheres to the parts when rubbed on, and is thus more valuable.

[DIGESTIVE ORGANS 145]