§ 123. Chilblains, perniones.

Chilblains are a sort of chronic erysipelatous inflammation, which does not become acute unless excited by some additional cause, change of weather, or some kind of morbid action which becomes concentrated in the region of the chilblains. This kind of erysipelatous inflammation takes place on the feet, hands and at the tip of the nose. If the inflammation be slight and superficial, with slight, bright-red swelling and burning itching in warmth; if the swelling crack and bleed readily, it- is speedily and safely removed by a few small doses of Nux vom., especially when the disposition of the patient is suitable to that remedy. Carbo anim. and veg., Arnica, Petroleum, Acidum nitr., Phosphor., Lycop., Crocus, etc., are likewise useful in this disease.* If the chilblains should be very painful, Nitri ac, Petrol., Phosphor., will be found efficient. Arnica is a certain remedy when the inflammation of the chilblain is caused by pressure, friction, etc.

If the frozen limbs should be blue-red and swollen, with throbbing pains, Pulsatilla and Belladonna are indicated, the former more particularly by a meek or phlegmatic disposition, the latter by a sad, indifferent and at times vehement temper. For these blue-red and violently itching chilblains. Kali carb. is likewise an excellent remedy, whereas Sulphur is suitable only when the itching occurs during warmth. If blisters should show themselves on the inflamed parts, with a tendency to gangrene, Arsenic should be used; whereas China deserves a preference, when symptoms of humid gangrene have actually set in. Opium is, in the latter case, sometimes indicated by the accompanying symptoms.

* Also Agaricus. - Hempel.

Bryonia. Rhus t., Ledum, Merc, and Sulphur, are generally sufficient to cure this kind of erysipelatous inflammation. Acidum nitr. and Petroleum are the best remedies, when the inflammation sets in with very cold weather.