3255. In Rigidity Of The Os Uteri During Labour, Dr

Tyler Smith § recommends the use of warm-water enemas. "They act," he says, " on the uterus as a local fomentation, and they excite another salutary reflex action; namely, that which exists between the sphincter ani and the os uteri. The dilatation of the sphincter ani, and even of the sphincter vesicae, exerts a sensible influence upon the os uteri when its closure is simply, or chiefly, sphineteric." Dr. Scanzoni* advises, in preference to all other means, a continuous douche of warm water upon the os and cervix uteri, by means of an appropriate instrument.

* Dispensatory.

Diseases of the Urinary Organs, p. 110.

On Stomach and Renal Diseases, p. 312. § Lancet, Nov. 25, 1848.

3256. In Scarlatina, Mr

Bulley advises hot-water compresses to the epigastrium. They are said to prove useful. He also wraps the patient in blankets, in order to produce copious perspiration. The last piece of advice is not likely to be generally adopted, nor indeed is it advisable that it should. The vapour of hot water to the throat is very serviceable.

3257. In Eczema, M

Trousseau states that he found the application of water, as hot as can be borne, to the eruption, very efficacious. At first, the local irritation seems to increase; but this is only temporary, and improvement is rapidly observed.

3258. To Ulcers, Wounds, Inflamed Surfaces, &c., the application of what are called water dressings was first recommended, of late years, by Dr. Macartney,§ of Dublin; and they have in many instances been substituted with great advantage for poultices. Mr. Liston,|| who entertained a great aversion to the latter application, observes, that heat and moisture, by which qualities a poultice produces its soothing and beneficial effects - by which the surface is relaxed, its capillary circulation encouraged, and the discharge promoted - are amply afforded by water dressing, without any of the weight, putrefactive fermentation, stench, and filth, which is inseparable even from the best and most scientifically contrived cataplasms. Water dressing is exceedingly simple, consisting only of a piece of lint, of thick texture, and of sufficient size to cover the wound, soaked in tepid water. This is placed on the affected part, and the whole enveloped in an ample piece of oiled silk, so as effectually to prevent evaporation. In some cases cold water may be substituted for tepid. The sensations of the patient are here the best guide. For Abscesses, the warm-water dressings, as advised above, prove, in many instances, an effectual substitute for poultices, but the latter are generally more soothing and agreeable to the feelings of the patient. For Phagedenic Ulcerations, few applications are more serviceable than that of water poured from a small height in a stream, by the process called Irrigation. Mr. E. Cock¶ appears to have first advocated its employment. This treatment has proved most successful in the hands of Dr. J. Sutherland amongst the natives of India.**

* Rev. Med Chir., Dec. 1848. Med. Times, Aug. 26, 1849. Ibid., vol. xviii. § Treatise on Inflammation, Lond. 1888, 8vo.

|| Pract. Surg., 4th Ed., p. 32. ¶ Med. Times and Gaz., April 12, 1856.

** Indian Annals of Med. Science, April 1857.

3259. In Remittent and other Fevers, the treatment by wet- I sheet packing, originally introduced by the hydropathists, has been resorted to by regular practitioners in India and elsewhere. I Dr. Morehead,* from observation of numerous cases treated on this plan, draws the following conclusions: - 1. In the conditions which justify cold affusion, it is possible that the wet sheet 1 renewed every ten or fifteen minutes, for two or three times, may 1 be a convenient and effective mode of reducing the temperature of the body. Should there, however, be tendency to hepatic or 1 splenic congestion, the wet sheet is likely to do harm by increasing the congestion. 2. With regard to its use during the height of the exacerbation, it is not denied that moisture of the surface of the body may somewhat modify this state, by inducing diaphoresis; but it is now well understood that this is not a leading-indication in the cure of the disease, and that means which merely aim at this can never occupy other than a subsidiary position. 3. Employed towards the close of an exacerbation, it is not improbable that the increased diaphoresis caused by it may increase exhaustion, and may produce it when it would not otherwise have occurred. 4. Its routine employment, by directing the chief curative means to the reduction of febrile heat, must tend to withdraw attention from those methods by which local inflammation, &c, may be detected. Whilst the value of causing the skin to perform its share in the elimination of morbific matter is admitted, can there, asks Dr. Morehead, be a greater error in practice than that of acting on the skin alone, and neglecting the other important excretory organs? It is evidently one of those measures which, though beneficial in well-selected cases, is capable of great abuse when employed without due discrimination.

* Disease in India, &c., p. 137.