Definition And Description

This affection, so common in cold climates, affects, by preference, the feet, hands, nose, and ears, and consists in a condition of chronic congestion, accompanied with lowered local vitality, resulting from partial congelation of the parts. It is characterized by redness, usually with a purplish tinge, together with more or less pain of a burning character. In severe cases fissures and ulcerations sometimes form. The affection, or rather the disposition to it, often lasts for years, giving little or no trouble during the summer, but causing inconvenience and suffering as cold weather sets in.

Etiology

The affection is due, in most cases, to a partial freezing of the tissues, followed by a rapid thawing out; as, for instance, a person, after prolonged exposure to cold, imprudently enters a heated room, and seeks a place nearest the fire. Tramping about in melting snow may reduce the temperature not quite to the freezing point, but sufficiently near it to materially retard the circulation. If now the feet be gradually and slowly warmed by friction, etc., little harm may result, but if rapidly warmed and overheated before a hot fire, the reaction will be too sudden, and chilblains are apt to result.

Treatment

Remembering that the condition is one of lowered local vitality, the chief indication will be to employ stimulating applications. Those most in vogue are frictions with camphorated oil, turpentine, capsicum, and the like. For a number of years the author has employed the galvanic current with the utmost benefit. When the feet are affected, the patient is seated so that one buttock rests on a sponge-covered plate connected with the positive pole of the battery. The corresponding foot is then placed in a basin partially filled with salt water, and into the basin the other electrode is placed. The current is now permitted to flow, and its strength is so regulated that the patient shall just perceive a slight sensation of warmth. The seance usually lasts for about ten minutes for each foot, and is repeated two or three times a week. The current seems to more or less completely restore the vitality of the part; and under its influence I have seen obstinate pernial ulcerations heal without the employment of other treatment. In milder cases the relief of the itching and burning is sometimes very striking. Possibly the faradic current would act as well as the galvanic, but on this point 1 cannot speak from experience.

The following drugs may also be considered: Acidum Tannicum, 12; Arnica, 22; Hyoscyamus albus, 69,