CHILAS

chilas, a hill village in the north-west frontier province of india. it is dominated by a fort on the left bank of the indus, about 50 m. below bunji, 4100 ft. above sea-level. it was occupied by a british force early in 1893, when a determined attack was made on the place by the kohistanis from the indus valley districts to the south-west, aided by contingents from darel and tangir west of gilgit and north of the indus. its importance consists in its position with reference to the kashmir-gilgit route via astor, which it flanks. it is now connected with bunji by a metalled road. chilas is also important from its command of a much shorter and more direct route to gilgit from the punjab frontier than that of kashmir and the burzil pass. by the kashmir route gilgit is 400 m. from the rail-head at rawalpindi. the kagan route would bring it 100 m. nearer, but the unsettled condition of the country through which the road passes has been a bar to its general use. chilblains (or kibe; _erythema pernio_), a mild form of frostbite, affecting the fingers or toes and other parts, and causing a painful inflammatory swelling, with redness and itching of the affected part. the chief points to be noticed in its aetiology are (1) that the lesions occur in the extremities of the circulation, and (2) that they are usually started by rapid changes from heat to cold or vice versa. the treatment is both general and local. in the general treatment, if a history of blanching fingers (fingers or hands going "dead") can be obtained, the chilblains may be regarded as mild cases of raynaud's disease, and these improve markedly under a course of nitrites. cardiac tonics are often helpful, especially in those cases where there is some attendant lesion of the heart. but the majority of cases improve wonderfully on a good course of a calcium salt, _e.g._ calcium lactate or chloride; fifteen grains three times a day will answer in most cases. the patient should wash in soft tepid water, and avoid extremes of heat and cold. in the local treatment, two drugs are of great value in the early congestive stage--ichthyol and formalin. ichthyol, 10 to 20% in lanoline spread on linen and worn at night, often dispels an attack at the beginning. formalin is equally efficacious, but requires more skill in its use. it can be used as an ointment, 10 to 50% for delicate skins, stronger for coarser skins. it should be replaced occasionally by lanoline. if the stage of ulceration has been reached, a paste made from the following prescription, spread thickly on linen and frequently changed, soon cures:--hydrarg. ammoniat. gr. v., ichthyol [minim]x, pulveris zinci oxidi [drachm]iv, vaseline [ounce]ss.