ITCHING AT THE ANUS. 373 



in many cases, on examining the part, there is nothing to be seen, but sometimes 

 the skin is thick and rough from the scratching, and sometimes a little eruption may 



.ii.-M-rvfd in the neighbourhood. 



The disorder is met with both in men and women, but it is not of frequent 

 occurrence in young people. In some cases it seems to be a kind of neuralgia, but 

 it is often caused by the irritation of piles, by worms, by confined bowels, and in 

 women by arrest of the periods. It sometimes occurs during the later months of 

 uincy. It is frequently induced, or at all events kept up, by habits of too free 

 eating and drinking, although it is occasionally met with in persons who are strictly 

 ulistemious. It is sometimes induced, too, by particular articles of food; one man 

 gets an attack after eating lobster or crab, another from indulging in salmon, whilst 

 a third suffers only after drinking champagne or ale. Excessive smoking may act 

 as an exciting cause in those who have a tendency to it. 



It must be remembered that itching of the anus is a very intractable complaint, 

 and if you want to be cured you will have to practise a certain amount of self- 

 restraint and self-denial. You will have to follow strictly, patiently, and persistently, 

 the rules laid down for your guidance, for if you do not you most assuredly will get 

 no better. You are a stout, full-blooded, well-to-do, middle-aged gentleman, rather 

 fond of the good things of this life than otherwise. Well, we shall have to cut 

 down your diet. You must give up all rich and highly-seasoned dishes, you must 

 eat but little meat, and live chiefly on fish, poultry, vegetables, and fresh ripe fruit. 

 It is no good saying you will not, for if you want to get better you must. You 

 must knock off your beer and your port and your spirits, and confine your attention 

 to light sherry and claret. You may take Vichy or soda or seltzer water as much 

 as you like. You will have to give up coffee and take tea or cocoa for breakfast. 

 You should take a good long walk every day, and try and get yourself into a slight 

 perspiration. If you are not accustomed to much walking you had better begin with 

 half a mile and gradually increase it, in the course of a week or ten days, to three 

 or four miles, only be careful not to over-do it. You should take a cold sponge-bath 

 every morning, and a warm or Turkish bath once a week. At bed-time well wash 

 the parts with warm water and yellow soap. 



Now as to medicine, get this mixture made up, and take two table-spoonfuls of it 

 two or three times a day : Sulphate of magnesia, an ounce ; carbonate of mag- 

 nesia, forty grains ; colchicum wine, forty minims ; syrup of senna, an ounce ; com- 

 pound tincture of cardamoms, half an ounce ; infusion of cherata to make it up to 

 eight ounces. Then take one of these pills every other night : Plummer's pill, 

 two grains ; compound rhubarb pill, three grains. Mix, to make a pill. 



After the washing at night, apply calomel ointment freely. This is an officinal 

 preparation, and you can get it from any chemist. You will have to persist in this 

 treatment for some time, and if you do you will probably be amply rewarded. 



When itching of the anus occurs in young men or women, a different mode of con 

 stitutional treatment will have to be adopted. When there is much debility, cod-liver 

 oil may be given internally, in addition to the use of the local applications. When 

 there is anaemia, the different preparations of iron will have to be used as recommended 

 when speaking of that complaint. In excitable nervous people, in whom an attack 



