Alum cataplasm. Take the whites of two eggs, of alum a drachm, shake them together so as to form a coagulum. (A common mode of preparing the alum poultices is to rub the whites of two eggs briskly in a saucer with a lump of alum till the liquid coagulates.) The curd produced by coagulated milk with alum is sometimes used as a substitute. The alum cataplasm is sometimes employed in incipient or chronic opthalmia as an astringent application. It is placed over the eye enveloped in folds of cambric or soft linen.
Cataplasm Carbonis ligni. Take a sufficient quantity of wood charcoal red hot from the fire, and having extinguished it by sprinkling dry sand over it, reduce it to very fine powder and incorporate in the simple cataplasm in a tepid state. Charcoal recently prepared has the property of absorbing those principles upon which the offensive odor of putrefying, animal substance depends. In the form of poultice it is an excellent application to foul and gangrenous ulcers, correcting their fetor and improving the condition of the sore. It should be frequently renewed.
Conium Cataplasm. Take of extract of poison hemlock (conium) two ounces, water a pint. Mix and add of bruised flax seed sufficient to produce a proper consistence. This cataplasm may be advantageously employed as an anodyne in cancerous, scrofulous, and other painful ulcers, but its liability to produce narcotic effects in consequence of the absorption of the active principle of the hemlock must not be overlooked.
Sometimes a bag is made to contain a poultice, and such a bag should be used if we desire to apply a large poultice to the chest or abdomen. One can be made for the breast and for the back at the same time, and two straps over the shoulder may unite them. A hop poultice is a thin bag loosely filled with hops and wrung out of hot water.
Dry fomentations are sometimes employed. Thin bags filled with heated sand, ashes, salt, bran, or hops are used, to keep the heat applied to the skin; and to warm the feet and quicken the circulation in the extremities, hot bricks, bottles filled with water, &c., are applied. These should be rolled in hot flannel or at least enveloped in something.
OF THE APPLICATION OF COLD.
Cold applications are sometimes used to subdue inflammation in the early stages. They are not good when matter is forming, or during sloughing. When they are used they ought to be continuously applied so as to keep up a constant cooling effect. Sometimes either water or some lotion is used with the design of cooling by evaporation. If a part is wet with water, alcohol, vinegar, a solution of muriate of ammonia, or other fluid, and left uncovered, the effect will be to cool it. When you design to cool by evaporation do not lay on more than one thickness of muslin or lint, and this must be wet so often that it does not get nearly dry. But a part may be cooled by several folds of muslin wet in ice water, and changed for fresh ones before they get warm. It is important that they do not become warm, and hence they should be frequently changed; alternate cooling and reaction is hurtful rather than beneficial. A steady cold stream of water is one means of cooling, and another device is to carry across a part a long strip of muslin or lamp wicking, having one end in a vessel of cold water higher than the bed, and the other leading to a basin below it. Protect the bed well with India rubber cloth so that both the patient’s clothing and the bed are kept dry.
Rubber bags are made to contain ice, and these are made in different shapes to be adapted to different parts of the body. They should not be more than half filled, and as soon as the ice melts the supply must be renewed. The ice used should be finely broken; this may be done by wrapping it in a fine cloth and pounding it. If mixed with one-third saw dust the ice will keep longer. A fold of muslin should be interposed between the ice bag and the skin, and they should be kept in their place by a bandage or some other means. An ice bladder for application to the head can be kept from pressing on the head by being folded in a napkin, which may be attached to the pillow by a pin. A cup shaped sponge may answer in the place of the ice cap to contain the ice; this must be wrung out before it is saturated, so that the pillow may not become wet.
Collyria are best applied to the eye at the outer angle; a glass dropper or a camel’s hair pencil may be used—this same one should be used for nothing else. Draw down the lower lid, and tell the patient to look up at the same time that the drop of eyewater is slid in. Do not leave moist cloths bound upon the eye as they become hot and may do harm.
If you rub in liniment with your hand, wash the hand carefully before touching a sensitive spot, as some of the ingredients may cause smarting or other injury.