The Practitioner. May, 1869.: A Monthly Journal of TherapeuticsVarious
Science
The Practitioner. May, 1869.: A Monthly Journal of Therapeutics
Various
Medicine -- Periodicals; Therapeutics -- Periodicals
All surgeons are familiar with the good results which follow the
application of a poultice to an acutely inflamed surface-part. Quite
recently a woman has been under my care with inflammation of the tissues
about the internal saphenous vein. She has progressed quite well towards
convalescence by keeping the limb at rest, and by having the inflamed
vein-track covered with a large poultice of linseed meal; no other
treatment has been required. It is a common fault, not so much perhaps
in hospital as in private practice, not to give a poultice the chance of
curing a local inflammation by limiting its application to the part
affected. A poultice to be of any use should widely cover the tissues
which surround the seat of inflammation; for example, if the hand is
inflamed the poultice should not only completely envelope it, but should
extend at least half-way up the fore-arm: and this rule holds good
especially when poultices are used for superficial or for subcutaneous
diffused inflammation.
A little girl I saw recently in Sitwell ward had a fierce attack of
inflammation, after measles, which involved one side of her face and
neck. As it threatened to lead to suppuration we made three punctures,
carried deeply amongst the tissues, and then applied a succession of
large poultices to the entire of the affected side. In twenty-four hours
the child, from a condition of great depression, was well enough to
leave the hospital—the swelling was much reduced, probably by the
draining away of serous fluid, but no suppuration was established. I
often direct a bubo to be punctured with a grooved needle, the needle
being carried across so as to make a double opening; poultices are then
applied, and if the parts are moderately rested, the swelling will
usually subside; if the bubo is suppurating the same treatment will
suffice to evacuate the pus, and this having discharged the bubo
disappears, and no trace even remains of the openings through which the
pus has passed out. In cases such as those referred to, some without,
some with a surface lesion, the mischief is remedied without any
suppurative action being set up by the use of the poultices.
It is desirable, when there is much discharge into a poultice, to dust
over the skin about the openings whence the discharge issues some oxide
of zinc, or some other drying powder; if this precaution is not taken
the matter will irritate and probably enlarge the opening, or will
produce vesicles, which break and leave excoriations, or painful papulæ
on the adjacent integument. It should be remembered also that great heat
is not needed with the poultice; it should be comfortably warm to the
patient, and should never be allowed to get, by comparison with its
condition when applied, so cold as to lessen the temperature of the
part.
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