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.

Preventive Treatment.—­This is very important and includes habits and diet and other diseases.  If the patient is thin and pale give tonics.  Correct any disease of any neighboring organ.  Attend to any disease that may be present.

For Constipation.—­Take a small dose of salts or hunyadi water so as to have one semi-solid stool daily.  If necessary remove any feces that may even then be retained, by injections of soap suds or warm water containing oil.  Discontinue injections as soon as a daily full stool can be had without it.

Habits.—­Full-blooded people should not use upholstered chairs as the heat of the body relaxes the tissues of the rectum.  A cane seated chair is best or an air cushion with a hollow center.  It is best to rest in bed, if possible, after stool for the rest relieves the congestion and soreness.  An abundance of out-door exercise, when the piles are not present, or bad, consisting of walking or simple gymnastics may usually be indulged in; violent gymnastics and horseback riding must be avoided.  A daily stool must be secured.

Diet.—­Such patients should avoid alcoholic beverages, spiced foods, strong coffee, and tea, cheese, cabbage, and old beans.

Foods Allowed.—­Potatoes, carrots, spinach, asparagus, and even salads, since they stimulate intestinal action and thus aid in keeping the stool soft.  Stewed fruits, including grapes, oranges, pears, and apples.  Water is the best to drink.  Meats:  tender broiled, boiled or baked beef—­do not eat the inside part to any great amount.  Other meats, but no pork or ham, fresh fish, chicken.  The foods should not be too highly seasoned; vinegar is not to be used to any extent and this excludes pickles, etc.