3. Treatment. When the inflammation called chilblain has attacked any part, it should be considered whether it is a mere local affection, or whether it shows a constitutional state, which renders the hands or feet, or both, more liable to the attack than those parts ought to be. If hands and feet are both attacked in several spots at the same time, and this without any very evident cause, constitutional treatment is pointed out, in addition to the use of remedial agents locally ; where, however, there is only a single spot on the hands or feet, and a cause (such as warming the feet at the fire) is remembered, only local treatment is necessary. The hands and feet enjoy different conditions, however, and require slightly different management. The treatment, therefore, resolves itself into three parts: A. Constitutional.
B. 0f the hands.
C. Of the feet.
(A.) Constitutional Treatment Aperient medicines may be used to relieve the overloaded blood-vessels, and lessen the pressure upon the coats of the capillaries, or hair-like blood pipes of the parts affected. After this has been done, small doses of tartrate of antimony wine (which seems to con-stringe the enlarged vessels) may be taken With advantage. This treatment (without local means) acts as a sort of charm, and relieves full crops of chilblains on hands and feet. A drachm of the wine may be added to half a pint of water, in which a drachm of saltpetre has been dissolved. Dose : for an adult, one or two table-spoonfuls every four hours; for a child, one or two tea-spoonfuls three times a day. It should not be given in such doses as to produce vomiting. The head, neck, and chest, should be washed in cold water every morning, and brisk exercise taken at regular hours. Persons of a scrofulous habit should be particularly attentive to their general health in winter. The addition of salt to the washing water is recommended in their eases. It is not an uncommon practice for persons, after exposure to cold, to drink hot elder wine, or not negus, or warm spirits and water; all such measures, having a tendency to produce rapid and violent reaction, are likely to rentier persons liable to chilblain.
(B.) Treatment of the Hands. Wash in cold water every three hours, and lather well with Windsor soap. When the hands are nearly dried with the towel, pour a little eau-de-Cologne, or milk of roses, into the palm of one hand, and rub it over the whole of both ; lastly, polish with the towel till every part glows with warmth, and is so completely dry, that the lint from the towel does not stick to the skin.
(C.) Treatment of the Feet. All the plans for prevention are curative. Chilblain in the feet often assumes a more serious form than in the hands, and the application of cold water is inadmissible, especially in the care of females. The three degrees of chilblains in the feet are . - 1st. The skin is red in patches, and slightly swelled, with more or less itching or tingling, with slight tenderness. 2ud. Small blisters appear, surrounded by ft livid skin. 3rd. Ulceration and mortification take place. For the first two cases, which are most common, the frequent application of tepid water, (using plenty of soap,) gives relief. A leech is a useful remedy to unload the overcharged blood-vessels; or the part may be pricked with a needle, or punctured with a faucet; in such cases a soft bread and water poultice should be kept on during the night, applied warm, so as to encourage the flow of blood.
If this plan is objected to, the application of the following liniment is likely to be beneficial. Take of common soap liniment, or opodeldoc, six drachms; of compound tincture of camphor, and tincture of can-tharides, each one drachm. If there are no blisters, a little of this must be rubbed in sharply with the hand ; but where vesications appear, it must be applied with a feather, and care must be taken not to break the skin.
Chilblains. Get a saucer half full of good vinegar, with a handful of salt in it; cover the saucer and let it stand till hot over a saucepan of water on the fire; the steam rising from the boiling water will Boon heat the vinegar and salt; when hot lift the whole off the fire and fix it so that spots of chilblain can be dipped into the saucer. This must be used as not as can be borne, even to smarting, and when the liquid cools a little, the toe or other part aflected must be kept immersed for a few minutes, then wipe gently with a soft towel. Keep the feet always warm. If the chilblains are broken, the best cure is tincture of myrrh (the best and strongest), which entirely heals the spot in three days. Wrap the sore in soft old linen doubled, which tie on with a worsted thread, not to be removed till the chilblain is healed; saturate this linen by dropping the tincture of myrrh over the sore till it smarts violently, this will subside in about half a minute; thru bandage it up, and repeat morning and evening.