on a wide mattrass, the mattrass lying on a low bedstead. The mustard, which should be prepared in the meantime, by mixing three bottles with meal, in the proportion of one part of the former to five or six of the latter, and made into a thin batter by the addition of hot water, is then poured over the mush, and the whole covered by a thin sheet. The patient is then placed about the middle of the poultice, the sides of which are folded over him-completely enveloping every part except the head. The mustard applied in this way is rendered much more active, and will redden the skin when diluted in this way to one-sixth of its strength, almost as soon as cataplasms of unmixed mustard, and much quicker when applied to cool or cold extremities-consequently, if applied without being blended with some farinacious substance it would be very likely to produce vesication.

When enveloped in this way, I have never allowed any patient to remain longer than from a quarter to half an hour, but have been governed as to the length of time which they were allowed to remain altogether by the impression made upon the disease, and see no reason why they should not be kept on a much longer time, if necessary; for, when combined with the mustard in this way, it is much less apt to produce a feeling of faintness and debility than the warm bath. It will sometimes be found inconvenient to use the poultice in this way, for want of proper and necessary appliances; in the cases of young men, for instance, living in countinghouses and other places where they have but few conveniences. In such instances a less troublesome mode, and one which I have practised in a few instances, is to envelope each limb separately and cover completely the chest and abdomen, from the neck to the pubis, with the poultice prepared in the same way, and spread on large towels. The former mode is much the most powerful, and when practicable, is to be preferred; but I have found the latter to answer a very good purpose in some instances, and from the fact that it can be borne for a much longer time, and with less annoyance to the

patient, I think, perhaps, it might be equally efficacious in cases of a less urgent description.

In illustration of these views, I will append a few cases which occurred in my practice, and in which I used the poultice, prepared in the manner described above.

In the first case which follows, the mustard was left out of the poultice, in consequence of a sufficient quantity not being at hand. It will also be seen in this case, that the application of sinapisms and extensive blistering had been practised previous to the use of the poultice, without producing any favorable impression on the disease.

CASE I-October 5th, 1841, I was called in consultation with Wm. Morris, to Mrs. E, æt. about 24 years, a resident of this city, then on a visit to an adjoining county. Has coldness of the extremities; small, frequent and irregular pulse; excessive nausea, and occasional vomiting; great restlessness and thirst; complains of a sense of oppressive weight and fulness about the præcordial region; tongue white, furred and enlarged. This was the fifth day of her disease, and I was informed by Dr. M. that her symptoms were but little altered since her attack-her extremities had only been warmed by the application of artificial heat. The treatment which had been pursued consisted of mercurial and other laxatives, and stimulants internally, sinapisms to the extremities and epigastrium, &c. The bowels had been pretty freely moved-evacuations thin, and of an indigo-blue color.

The treatment agreed upon after my arrival, was sulph. quinine grs. vi., to be repeated at intervals of four hours, and hydrarg. cum creta grs.vi., pulv. opii gr.ss.; M. to be repeated every sixth hour; warm applications to the extremities.

6th. Had several motions, consisting of the same thin, serous and bluish matter, interspersed with flakes of mucus of the same color; condition in other respects the same. Same prescription continued and warm bath ordered.

7th. Condition unaltered. Applied a blister to the epigastrium and nape of the neck; ordered hydrarg. subm. grs.iv.,

creta prep. grs.iii., to be repeated at intervals of four hours; warm applications and occasionally sinapisms to the extremities. Discontinued quinine and other previous prescriptions.

8th. No improvement; secretions from bowels same; applied blisters to the extremities. Ordered tr. valerian ammon. 3ij. every third hour. Calomel, &c., continued.

9th. Evening.-Blisters vesicated; pulse rather more frequent, but still irregular and weak; has vomited most of the medicine taken in the last 24 hours, and her symptoms generally present rather an aggravated aspect. Fearing the natural tendency, which characterizes some of our diseases, to a crisis on the 9th day, and seeing no indication to a favorable one in this instance, we agreed to envelope the patient in a mush poultice, prepared in the mode described above, leaving out the mustard; which was accordingly soon done. The patient thus covered to the extent of an inch, or an inch and a half in mush, was allowed to remain about 18 minutes, at the end of which time, as the pulse had diminished in frequency and had become more regular, the skin on the forehead and face being covered with a warm perspiration, she was removed to bed. One hour after, her extremities were still warm, and the surface generally covered with a warm moisture, and her pulse manifestly improved in volume and regularity. Gave subm. hydrarg. grs.x. She is to take no other medicine through the night, and be allowed to sleep as much as possible.

10th. Extremities remain warm and skin soft; rested well through the night; pulse regular, and but little above a healthy standard in point of frequency, and also improved in volume; that feeling of fulness and oppression about the præcordia, which has been so distressing throughout the disease, entirely disappeared; after an enema, administered this morning, had two dark, consistent evacuations-in short, there is an abatement of all the violent symptoms, and the patient expresses herself as being much relieved. No medicine given this morning, but directed her to have chicken broth occasionally through the day.

11th. Continues to improve; no directions except as to diet.

13th. Is able to sit up in bed. After this, her convalescence was rapid.

CASE II.-Extracts from notes on A- C- a female child, æt. about 20 months, who had been laboring for seven days under a severe attack of pneumonia, with gastro-enteritic complication.

February 27th, 1844. She continued to get more restless and uneasy until half past 2 o'clock, P.M., when she presented many apparent evidences of the moribund condition. Pulse 164, small and weak; respiration 44 in the minute, and imperfect; (too restless to admit the use of the stethoscope); eyes thrown back and fixed in their socket, with the eye-lids firmly separated; a disposition to throw the head back upon the spine, (as in opisthotonos), with some rigidity of the cervical and dorsal muscles; throwing the arms about, tossing the head, and writhing the body; clawing at the tongue, and at all the clothes that were brought in its way; extremities cold, the lower ones to a few inches above the knee. In this situation the patient was allowed to remain for sometime without a prescription, (more than the sinapisms which had been applied to the extremities) under the belief that if she was not in articulo mortis she was rapidly approaching it, and that all efforts to arrest the immediately fatal termination of her disease would be fruitless. Dr. Sims of this place, was attending the case with me, and we ordered, at length, a hot pediluvium, made strong with mustard, to be applied until a mustard poultice could be prepared, which was accordingly soon done in the usual way, and the entire surface completely enveloped. Up to this time, however, there was no improvement, and the weakness and frequency of the pulse, added to her extreme restlessness, precluded the possibility of counting it with anything like accuracy. She remained in the poultice eleven minutes, was taken out and washed in a tub of warm water, and placed in bed, where she remained quiet and apparently easy; her pulse increased

in volume, and all those alarming symptoms which seemed to threaten immediate dissolution, considerably abated. Examined her two hours after-pulse 138, and manifestly increased in volume; eyes shut, appears to be sleeping quietly; surface generally warm and soft; reaction appears to be permanently established.

28th. Continued to rest well through the night. Pulse

132.

She remained in this condition for a day or two, which seemed to be so favorable, contrasted with her situation on the 37th, that we were inspired with strong hopes of her recovery. But on the evening of the next day, she passed two round worms; meteorism and tenderness of the abdomen, with retention of the urine supervened, and she died at night on the 3d of March, of the complication, her primary disease having been much abated.

Though the case in the end proved fatal, yet the agency of the poultice in allaying that truly urgent train of symptoms which supervened on the 27th was so manifest, that I am disposed to offer it as an additional proof of the power and utility of the remedy employed in this way.

Harrietta, a ne-
Boling and my-

CASE III-Scarlatina. March 19, 1844. gro girl, æt. about 12 years, attended by Dr. self. Saw her a few hours after the first symptoms of her indisposition. Was attacked with chilliness, succeeded by vomiting and febrile excitement. Pulse 147; stomach irritatable; tonsils red and tumefied; skin arid and hot; bowels constipated. Ordered subm. hydrarg. grs.x. and a diaphoretic mixture of spts. æth. nit., &c. &c.

20th. Morning. Pulse 150; had a very restless night; vomiting continues; complains of severe pain in the head. Medicine produced several motions. Diaphoretic mixture continued.

Evening. Pulse 170; tongue dry; great thirst; less irritabilty about the stomach; in other respects the same. Ordered warm bath, and decoction of serpentaria at intervals during the night.