PHYSICIANS' TREATMENT for Piles.--What to do first.--The palliative treatment of both varieties of external piles is the same. In all cases the patient should lie flat on his back in bed and remain there for a few days. Highly seasoned foods and stimulants, tea, coffee, whisky, wine, etc., must be discarded. Secure a daily half liquid stool by the use of small doses of salts, Hunyadi or Abilena water. Cleansing the parts with weak castile soap water is essential to allay the pain, reduce the inflammation and soothe the sphincter muscle; cold, or if it is more agreeable, hot applications may be kept constantly on the parts. Hot fomentations of hops, smartweed, wormwood, or poultice of flaxseed, or slippery elm, or bread and milk give almost instant relief in many 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.