Coggon, Iowa, July 15, 1902.
To the Editor:
—The recent article in The Journal by Edmund Andrews illustrating the use of strong heat in the treatment of pruritus ani contains some statements to which I wish to direct attention. In considering the principles involved in the treatment of pruritus by strong heat, Dr. Andrews refers to the domestic practice common among people living in northern latitudes of treating pernios or chilblains by holding each chilblain before a fire as hot as can be borne for one or two minutes, and he speaks of this treatment as being successful and entirely satisfactory. My personal experience with chilblains is not in accord with this statement. The strong heat makes the treatment disagreeable and the chilblain is left tender and sensitive. Therefore, I have modified this domestic custom and immersed the chilblains in water of a temperature of 105 to 110 F. for about ten minutes (until the