Flaxseed-meal, powdered slippery-elm bark, and Indian or corn meal, are most frequently used for the preparation of poultices. Wheat-bread and milk are also occasionally employed for the same purpose.

In the preparation of a poultice, the meal is slowly incorporated with hot water, until a mass of the proper consistency is made. The mixture itself should not be applied immediately to the part, for it dries and adheres with considerable tenacity. A piece of washed muslin of quadrangular shape, and of sufficient size, is selected; the hot mass is spread on one end of the muslin, leaving a margin of one inch on three sides; the long end of the muslin is then folded over the mass, and the free margins are stitched or pinned together. If the poultice is not frequently renewed, to prevent drying, some glycerin should be added to the surface which is to remain in contact with the tissues. Laudanum, or other narcotics, may be stirred in with the meal if the relief of pain be desirable.

A yeast-poultice consists of brewers' yeast, to which sufficient flaxseed is added to give the proper consistence.

A charcoal-poultice differs from an ordinary poultice in having powdered charcoal incorporated with the mass. In order that a charcoal-poultice shall have the proper consistence, the mass should be thin enough to take up a sufficient quantity of charcoal.

Actions and Uses

A poultice is a means of applying continuous heat with moisture, and of softening the tissues. An afflux of blood takes place to the part, the vessels dilate, the tissues, softened by the combined influence of heat and moisture, permit the easy diffusion of the fluids. If the process of inflammation has begun, or is in progress, the stasis is relieved, the tension of the inflamed part is lessened, and resolution is thus favored; or, if the stage of exudation is reached, the migration and multiplication of the white corpuscles are promoted, and the extrusion of purulent elements facilitated. The accumulation of blood in the neighborhood of the poultice seems to -diminish the pressure elsewhere, and thus poultices of large size lower the arterial tension and lessen stasis in internal parts. Poultices relieve the pain of inflamed parts by relaxing the tissues, and thus removing pressure from the sensory nerve-filaments. The impression thus made on the peripheral nerve-endings is transmitted to the center and reflected over internal organs. It is within the range of everybody's personal experience that warm, moist applications relieve pain in internal and distant parts, which have no anatomical connection with the integument to which the applications are made.

Poultices have, therefore, a local and a systemic effect. Their therapeutical uses are based on this conception of their physiological actions. They are prescribed to relieve the tension and to promote resolution or suppuration in boils, carbuncles, and other superficial inflammations, to hasten the healing of irritable ulcers, to favor the separation of gangrenous sloughs, etc. Foul-smelling wounds requiring the use of poultices are best treated with the yeast or charcoal poultice.

Unquestionable benefit is derived from the application of hot poultices externally in acute fanciel inflammations, in pneumonia pleuritis, pericarditis, hepatitis, peritonitis, etc.

The application of poultices sometimes degenerates into abuse. If too long continued, the skin becomes white, wrinkled, and sodden; small abscesses or boils form, and the vessels of the parts very slowly regain their tone. If kept too long in contact with wounds or ulcerated surfaces, the granulations become pale and flabby, and the healing process is retarded. Applied indiscreetly to inflamed joints, they may promote suppuration, and thus permanently injure these structures. If kept long in contact with a large extent of surface, they will lower the general tone and vigor of the system, depress the systemic circulation, exhaust the irritability of the vaso-motor nerves, and thus seriously embarrass the reparative process, if not wholly prevent repair.