PHYSICIANS' TREATMENT for Internal Piles.--What to do first. The cause should be removed. Restore a displaced womb. Regulate the bowels, liver, diet, and habits. Much can be accomplished by these measures if properly used, in allaying inflammation diminishing pain and reducing the size of the piles. These measures will not cure them if they are large, overgrown and protruding. When the piles are inflamed, strangulated or ulcerated, the patient should remain in bed in a recumbent position and hot fomentations of hops, etc., and hot poultices, of flaxseed, slippery elm, bread and milk, the ice bag, or soothing applications and astringent remedies, should be applied to the parts. In some cases cold applications are the best. The cold or astringent applications give the best results where the piles are simply inflamed and the sphincter muscle does not act spasmodically, jerkily. But when the piles are strangulated, "choked tight" by the sphincter muscle, hot fomentations, poultices and soothing remedies give the most relief, because they reduce spasmodic contractions of the muscle and allay the pain. Instead of the poultices and fomentations, the "sitz" bath can be used. Put in the steaming water, hops, catnip, tansy, pennyroyal, etc., and the steam arising will frequently give great relief. This can be given frequently; ten to twenty drops of laudanum can be added to the poultices when the piles are very painful. 1. For inflamed piles, the following combinations may be used:-- Gum Camphor 1 dram Calomel 12 grains Vaselin 1 ounce Mix thoroughly and apply freely around the anus and in the rectum on the piles. The external parts should always be bathed with hot water, thoroughly, before using. 2. Gum Camphor 2 drams Chloretone 1 dram Menthol 20 grains Ointment of Zinc Oxide 1 ounce Mix and apply directly to the piles. 3. When there is a slight bleeding, water of witch-hazel extract, one to two ounces to be injected into the rectum. This witch-hazel water freely used is good for external piles also. This is good and well recommended. [DIGESTIVE ORGANS 151] 4. If the protruded pile is inflamed and hard to push back, the following is good and recommended highly:-- Chloretone 1 dram Iodoform 1 dram Gum Camphor 1 dram Petrolatum 1 ounce Mix and use as a salve. 5. An ointment composed of equal parts of fine-cut tobacco and raisins, seedless, chopped fine and mixed with enough lard, makes a good ointment to apply on both external and internal piles. 6. Tea of white oak bark, boiled down so as to be strong, and mixed with lard and applied frequently, is good as an astringent, but not for the very painful kind. It will take down the swelling. 7. Take a rectal injection of cold water before the regular daily stool. This will soften the feces and decrease the congestion.