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WESTERN JOURNAL

OP

MEDICINE AND SURGERY:

EDITED BY

DANIEL DRAKE, M.D.,

AND

LUNSFORD P. YANDELL, M.D.,

PROFESSORS IN THE LOUISVILLE DEDICAL INSTITUTE,

AND

THOMAS W. COLESCOTT, M.D.

NEW SERIES.

VOL. III.

LOUISVILLE:

PUBLISHED MONTHLY BY PRENTICE & WEISSINGER,

PROPRIETORS AND PRINTERS.

THE

WESTERN JOURNAL

OF

MEDICINE AND SURGERY.

JANUARY, 18 4 5.

Art. 1.- Remarks on Mustard Poultices, applied extensively

to the surface. By William O. Baldwin, M.D., of Montgomery, Alabama.

The application of poultices as a remedial agent in many forms of local inflammations, spasmodic pains, &c., has long been practised and highly appreciated, as not the least efficacious among the many sanative agents available in such cases. By some they have been and are still used with reference solely to the specific virtues of the substances of which they are composed, whilst others esteem them all for their one common virtue-attributing to them no other curative effect than that which arises from their capability of retaining warmth and moisture about the parts to which they are applied. Both of these views, as to their modus operandi, are

probably correct; for the results which follow the endermic use of medicine undoubtedly establishes the truth of the former; whilst all can attest the good results which are frequently obtained from the application of simple poultices to inflamed and painful parts, which of course can be attributed to nothing more than the relaxation afforded by the warmth and moisture which they contain. It is for this property of the poultice, added to the increased revulsive effect of the mustard, when combined, that I propose to extend their use to acute diseases, involving the whole animal economy.

From the marked success which has attended the application of mustard poultices to the entire, or greater portion of the surface of the body and extremities, in the treatment of some diseases of an idiopathic character, I am disposed to regard them as a remedy of more value than their hitherto partial use would seem to indicate; for although highly esteemed and extensively employed in certain local affections, so far as I am aware, their application has been restricted to such diseases, or when used in those involving a greater extent of tissue they have been applied only to combat some local symptom.

The experience which I have had with the mustard leads me to look upon it as a remedy peculiarly applicable to diseases of a congestive type, and more especially to congestive fever. I have found it a most prompt and available remedy in one or two instances in which I have used it in convulsions occurring in children; and I have also applied it advantageously in some cases of visceral inflammation. In a case of trismus nascentium in which I used it, there was a considerable abatement of the disease under its influence; but as the violent symptoms afterwards returned and the case terminated fatally, it cannot be considered as furnishing any testimony in support of its efficacy in that class of diseases. I believe, however, that if my directions had been carried out during the twelve hours of remission and comparative ease which the little sufferer seemed to enjoy immediately after the application of the poultice, which would have brought it fully under the influence of opium, it might have succeed

ed. That, however, is a bare supposition, but I was so well pleased with the effect which followed its application, that, though the case proved fatal, taking into consideration the very unsatisfactory results which have generally followed the treatment of that disease, I shall test its efficacy further should a suitable occasion offer.

From its powerful agency in producing diaphoresis, that end so often coveted in the treatment of synochal fevers, I am induced to believe the mush poultice, with or without the mustard, applied in this way, might form a valuable adjuvant in the treatment of that class of diseases.

These remarks are not intended to depreciate the value of free internal medication. Indeed, in most of the cases in which I have used the poultice it has been in conjunction, or at least, not to the exclusion of any other remedy which might have been thought available—so that one who may be disposed to cavil, might with some plausibility, dispute its agency in producing the beneficial results which I have ascribed to it. Nevertheless, in a great majority of the cases in which I have resorted to it, in the diseases alluded to, its ef fect has been so apparent that notwithstanding the administration of other remedies, at the same time, no

one could mistake its promptly favorable influence. And it frequently happens that our only means of making an impression upon the disease is through the agency of external applications. As, in cerebral congestions attended with coma and insensibility, it is always difficult, and sometimes even impossible, to administer medicines internally-in such cases the mustard poultice is entitled to the very first and highest consideration, as the remedy most likely to produce the desired objects.

Though this is a remedy of most singular simplicity, yet a few remarks as to the mode which I have adopted, both in its preparation and application, may not be considered inappropriate.

Supposing the patient to be an adult of the ordinary physical proportions-boil about a bushel of meal to a tolerably consistent mush, and spread upon a sheet which has been placed

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