Licence: Public Domain Mark
Credit: The rectum and anus : their diseases and treatment. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![men, but not by any means confined to the male sex, it appears to attack the plethoric and the spare, the rich and poor alike. The patient usually is not much dis- turbed during the day, but when he goes to bed his misery begins. The itching is so intense that it is impossible to avoid scratching, which, instead of giving relief, only adds to the trouble. Sleep at first is impossible, but when at last it comes it is frequently but of short duration, the patient being awakened by the intolerable itching. If an examination be made, the skin around the anus will usually be found devoid of its normal elasticity, and parchment-like. Imme- diately in the neighbourhood of the anus the normal pigmentation will be absent in patches, the skin here being of a dead white. This is considered by Molliere to be a pathognomonic symptom of the more severe forms. I have seen it very character- istically exhibited in several cases. From the multitude of remedies which have from time to time been recommended, the difficulty of cure may be inferred. Local measures which will relieve one case will be found absolutely futile in another. In the first place, oleate of mercury with morphia may be tried, and has often proved successful in my hands ; bathing with very hot or very cold water, either plain or containing carbonate of soda ; the application of tincture of iodine ; painting with solution of nitrate of silver, or even the light application of the actual cautery have been recommended. Yan Buren says that he thinks most relief is given by the constant application of chloroform ointment, and he recommends patients to go to bed with a large bottle of this beside them, and when the itching comes on to smear the ])arts well with the ointment instead of scratching. Allinghani recommends the wearing of a small pessary in the bowel at night. He says this was suggested to him by the fact that some patients are able to go asleep](https://iiif.wellcomecollection.org/image/b21229387_0400.jp2/full/800%2C/0/default.jpg)
