A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

    179/554 (page 167)
    pain, and, if kept in longer contact with it, deep inflammation and slough- Cantharis in some of its various preparations is the most rehable means of producing vesication. The effect varies with different persons, depending upon the condition of the skin and the part to which the bUster is applied. The primary action of a blister is to of a stimu- lant to the body generally and to the individual organs m the neighbor- hood of which it is applied, but if allowed to remain long enough to produce much vesication it depresses the bodily powers m proportion to the amount of serum withdrawn from the vessels. Precautions are necessary in ordering blisters: in pregnancy ; m per- sons of scorbutic, purpuric, or other hemorrhagic disposition; in general debility ; in very young or very old persons. They should never be applied over an acutely-inflamed joint, to the chest in the first stage of pneumonia, over some specialized skin-surfaces, as the scrotum or the skin of the mamma, over bony prominences or where the healing processes are apt to be retarded. A blister should never be permitted to remain for more than twelve or twenty-four hours. As a rule, it is removed at the end of six or eight hours, even if vesication is not marked, and a soft flaxseed poultice applied. With good material the selected surface will be found covered with large blebs. These should be carefully pricked at their most depen- dent part and the serum allowed to drain away, thus permitting the raised cuticle to settle back to its old place on the true skin. The part should then be dressed with a layer of dry cotton, kept in place with a few strips of adhesive plaster. If treated in this manner, the healing of a blister is almost painless. The use of flying blisters, after the method of Brodie, is preferable to keeping a single blistered surface raw with irritants. In some persons Strangury may arise from very slight contact with any form of cantharides. To obviate this condition, a blister should always be removed as soon as decided pain is felt, and the part dressed with a soft, moist dressing as above stated. A thin piece of paper or muslin may be applied between the blister and the skin. When using a blister, the patient should drink freely of demulcents, and the action of the kidneys be encouraged. In very sensitive persons, where a blister is indicated, it maybe produced without pain by painting with cantharidal collodion. Previous to the application of the poultice the part may be sprinkled over with a little morphine rubbed up with starch. In Pneumonia and Pleurisy blisters are frequently employed with great advantage, although authorities are at variance, as to the stage of the disease in which they are useful. Some writers assert that blisters during the febrile stage increase fever. In our experience such is not the case. Care must be exercised in the applications,—not permit- ting them to be too large, or to remain on long enough to give the I