APPENDIX.

I. POULTICES.

A LINSEED-MEAL poultice is the one which is most commonly ordered by the doctor. It is very desirable that it should be applied to the patient as hot as he can comfortably bear it, and that the heat should be retained as long as possible. To this end the water must be boiling hot, the basin in which the meal is mixed scalded out, and the spatula or knife used dipped in hot water. A piece of oil-silk or mackintosh rather larger than the poultice should be laid over it after it is applied. To make the poultice, a piece of linen about two inches larger each way than the requisite size of the poultice should be spread out on a board. Then the meal should be thrown into a basin and boiling water poured upon it, a little at a time, and the mixture stirred together till it is brought to a thick consistence. The meal must now be spread upon the piece of linen with the knife or spatula to the thickness of a quarter to three-quarters of an inch, according to the character of the case. The margin of the linen should be turned over the poultice, and it should be applied as quickly as possible. It is a bad custom to put a layer of muslin between the skin and the meal, as it spoils to some extent the effect of the poultice. A little olive oil can be spread upon the surface of the poultice to prevent the meal adhering to the part to which it is applied.

Bread poultices do not retain heat and moisture so long as linseed-meal, but they are sometimes ordered

when a milder effect is required. The bread should be stale, and cut up into little squares and placed in a basin. Boiling water should then be poured on the bread, and the basin covered with a plate and set by the side of the fire for a few minutes. After the water has been poured off, the bread must be lightly beaten up with a fork and spread on a piece of linen. The same care should be taken to scald out the basin before beginning as was observed in making the linseed-poultice.

Mustard-poultices are used as counter-irritants. The water should be cold or tepid, for if hot the active principle of the mustard is set free, and much of the strength lost. If vinegar is added, it only weakens the mustard. The mustard, being made into a paste, should be spread upon a piece of linen and covered over with a layer of muslin or tissue paper. This poultice should be kept on from fifteen to twenty-five minutes, as the patient can bear it. When the poultice has been removed, the skin should be gently sponged with lukewarm water and a layer of cotton-wool applied. Sometimes combined linseed meal and mustard poultices can be made; the ingredients being either in equal quantities, or the mustard merely sprinkled on the surface of the meal.

II.-FOMENTATIONS.

These applications are directed to be used for the purpose of allaying inflammations, pain, and spasm. A piece of coarse flannel should be folded eight times or so to the size required. Boiling water should then be poured upon it, and it should be wrung as dry as possible in a towel. The flannel should then be shaken gently, so as to let a little air get between its folds, after which it should be applied, a piece of mackintosh large enough to overlap it on all sides by at least an inch being placed over it. It should generally be changed once every hour or so, the skin being wiped dry each time, and the surface not left exposed.

III.-COLD LOTIONS.

These lotions should be applied by dipping a single fold of linen in them, which when it has been laid on the skin should be left uncovered and changed as soon as it becomes dry.

IV.-ICE.

When applying ice to the head, or elsewhere, it should be broken up and enclosed in a gutta-percha bag or bladder obtained from the butcher. The best way of breaking the ice is to wrap it up in a towel, and either strike it against the hearthstone or with a hammer. The bag should not be more than half full of ice, so that it may lie closely to the part to which it is applied.

V.-MOIST ATMOSPHERE.

Among the means employed by the doctor in the treatment of many cases of bronchitis, croup, and diphtheria, is surrounding the patient with a moist atmosphere. A few words as to how this may best be done may here be given. A kind of tent should be constructed around the patient, as he lies in bed, made of blankets, etc., hung upon clothes-screens. The steam from a kettle boiling on the fire should be conveyed within the covering of the tent by means of a piece of indiarubber tubing.

VI.-INHALATIONS.

There are various instruments by means of which inhalations can be given, some of which are excellent. But if none of these can be procured, an inhalation may be given by the patient leaning his head over a jug of hot water and breathing the steam, which is directed into his mouth and nostrils by a folded towel held round the mouth of the jug.

Any drug that the doctor wishes the patient to inhale can be dropped into the hot water in the proportion he directs, and thus administered.

VII.-BEEF-TEA.

Beef-tea may be prepared in various ways. If the doctor wishes his patient to have some beef-tea as soon as possible, it should be made in the following manner : The beef having been cut into small pieces, should be placed in a saucepan, and enough water poured in to cover the meat, to which a little salt should be added. For about ten minutes the saucepan should be kept near the fire, the beef juice being squeezed out by means of a spoon or fork. Then, the meat having been removed, the beef-tea should be raised for a second or two to the boiling-point, after which it will be ready for use.

When there is no immediate hurry, the beef (about a pound) should be cut up as before into small pieces, and placed in a covered jar with a pint of cold water and a little salt. It should then be allowed to simmer for two hours, and raised to the boiling point three or four minutes before removing it from the fire.

VIII.-BRANDY AND EGG MIXTURE.

This most valuable combination of food and stimulant is frequently ordered by some doctors, and may thus be prepared:

Beat up the yolks of two or three eggs with four ounces of water and the same quantity of brandy. To flavour it, a little cinnamon or nutmeg may be added.

GLOSSARY.

ABNORMAL-Unnatural.

ACUTE-A term applied to a disease which is sharp and rapid in its course.

ALBUMEN-A nitrogenous organic principle found in most
of the tissues of the body. The white of an egg con-
sists of albumen.
ALIMENTARY CANAL--The whole passage for food, includ-
ing the pharynx, the gullet, the stomach, and intestines.
ALTERATIVES-Medicines which produce certain changes
throughout the system.

ANESTHETIC-What produces loss of sensation, as, for in-
stance, chloroform and ether.
ANODYNE-What relieves pain.
ANTISPASMODIC-What checks spasm.

APHASIA-Partial or complete loss of speech, due to imperfect action of the brain.

ARTERIES-Vessels conveying the blood from the heart to other organs and tissues of the body.

ASPHYXIA-Suffocation.

ATROPHY-Wasting.

BRONCHITIS-Inflammation of the bronchial tubes. CATARRH-Inflammation of the mucous membrane, with increased secretion, as occurs in a cold in the head. CATHARTICS-Brisk purgatives.

CAUSTICS-Substances which destroy the parts with which they come in contact.

CHRONIC-Of long duration.

COLIC-Spasmodic contraction of the intestines. COMPLICATIONS-Secondary disorders occurring during an

illness.

CONGESTION-Fulness of the blood-vessels of an organ or part.

CONJUNCTIVA-The mucous membrane covering the white of the eye, and lining the inside of the eyelids.