Evening star. [volume] (Washington, D.C.) 1854-1972, 1882-12-19

3rom the London Practitioner.


Every one k-Srs The relief which a poultice
sao.ds when the finger is infiamed. and has
noticed how the painful throbbing diminishes
after its application. Most people have noticed
also that dipping the finger in cold water has
similar action. and it seems strange to IIauy
that the opposite conditions of heat and cold
should have a similar effect. The reason proba-
bly, is that both heat and cold lessen the force
: OF the impulse with which the blood is driven
Through the diiated arteries of the infiamed
parts against the block which exists in the
capillarieS. Cold cauces the atlCpnt arteries to
contract and lessons the impact of the blood by
dminishin- the quantity sent to the infiamed
part: poult &c lessons the impact by dilating
the capiiiarieS surrounding the seat OF iDfiam-
nation and afurding a ready side outlet into
The veins. In surgical cases we usually use the
warmth and moisture OF the poultice to act di-
rectly On the surface.
We. therefore make the poultice with cruShad
Hnsecd or with linsecd meal and oil. spread it
on some tow and apply it 10 the skin without
anything intervening But useful though this
method may be- for wounds. ulcers and assesses.
it is not the best form of application III eases OF
Inflammation of the tEoracic or abdominal
yiscera. or where sFasn is present without in
famElat:On. In such cases We may. no doubt.
do some good by applying the poutic" to the
surface exactly az in surgical diseases. We
may draw oil some of the blood to the surface.
and we may also exercise reflex action
through the nerves upon the vessels Of the in
famed organ below: hnt this will not be so
great IL We influence the surface only as when
We allow the heat to penetrate to the iniamed
or irritatei organs themselves. If We apply
the poultice directly to the skin it must he
allowed to become tolerably cool before the
patient can bear it, and thus half Its advantage
is lost. In order to relieve spaSIn as in collie
intestinal. hillary or renal: to relieve intlamma-
tion of the peura the lungs. the liver or other
organs, We want to apply the poulticp as hot as
possible, while we protect the skin from being
scalded
In order to do this flannel bag should be
prepared. convenient size being twelve inches
By eight: this should be closed at three edges
and open at the fourth: one side of it should be
an inch or an inch and half longer than the
other: and It Is convenient also to have four
tapes attached at the points which form the cor
ners when the bag is closed in order to keep
the pOultice in position. Besides this another
strip oi iiannei should be prepared. OF the same
breadth as the length of the bag. and long
enough To wrap around it once or oitener
Crushed lnSeed bowl and spoon shOnld then be
got together. and the spoon and bowl thoroughly
heated by means of boiling water: the pouItice
should then be made with perfectly boiling wa
Ter, anu rather soft. As soon as it is ready it
should be poured into the bag. previously
warmed by holding it before the fire: the fap
which is formed by the longest side of the bag
should now be turned down and fastened in its
place By a few long stitches with a needle and
Unread; IT should then be quickly wrapped in
The strip of flannel (also previously warmeN
and fastened in place, if necessary, by means of
the tapes.
Ii may be covered outside with sheet of cot
ton wool In this way the roultice may be up
piled boiling hot To the skin without burning:
the two layers of flannel. which are at first dry
allow the heat TO pass very gradually. indeed.
to the skin. As the moisture of the pOultce
sOaks through them they become better con-
ductOrs, and the heat passes more quickly. but
the Increase is so gradual as not to cause any
painful sensations whatever. but only one of
soothing aD1 comfort. The p0ultice also natur-
ally Keeps much longer hot and the necessity
for changing it arises much less frequently
The difference between the effect of pOultice
made in the ordinary way and one made in the
manner just described is sometimes exceedingly
striking 1t is. perhaps. less marked in cases of
Inflammation than in those of spaSm. We have
Seen patient suffering from intense abdominal
pain at once relieved by poultice made i'm the
way just described. although q succession of
pOuitices made i'm the ordinary way had been
utterly Useless. This way of making pOultices
u one OF the miGuti9 of medical practice appar-
emily extremely trivial, but really, We believe
very important.