Counter-Irritants And External Stimulants

The following are the chief agents of this class mentioned in this essay: -

Blistering plaster.

Tincture, liniment, and ointment of iodine.

Compound camphor liniment and turpentine liniment.

Soap liniment (opodeldoc).

Nitrate of silver.

Basilicon ointment.

Citrine ointment.

Belladonna Liniment. Nitrate Of Silver (Lunar Caustic)

Much misapprehension prevails as to the properties of "lunar caustic." It is very commonly said to be used for "burning" the throat, "burning" off a wart, etc. The fact is, that the word " caustic " is here a misnomer. Nitrate of silver does not burn or destroy after the manner of a caustic such as pure potash or quicklime. Applied lightly to the skin, it acts on the surface as an astringent or sedative; entering into chemical combination with the outer skin it forms a hard and horny layer, which compresses the part beneath it. In this way it acts as an astringent, and allays excitement of the minute nerves of the skin, and in this way is useful in sore throats. If, however, it be applied in a strong or saturated solution, or rubbed on firmly to a moistened surface of skin, it will raise a blister.

It is by its astringent and sedative action that it becomes so valuable a remedy in inflammation of the eyes, in erysipelas and other inflammations of the skin and mucous membranes.

Tincture Of Iodine

Iodine may be applied externally in the form of tincture or of ointment.

Its action in the form of a tincture depends upon the strength of the solution.

As a tincture of ordinary strength, it promotes absorption by the moderate degree of stimulation that it possesses. In a stronger form its stimulant action will induce blistering, whereas the weaker solution produces only a peeling off of the skin. The principal uses of tincture of iodine are in chronic inflammation, chronic rheumatism, thickening of bone, enlarged tonsils, chilblains. Its use may be suspended for a day or two if the skin be cracked.

Iodine Ointment

When rubbed in as an ointment, iodine alone, or as iodide of potash ointment, has considerable power in procuring the decrease of glandular swellings, as in strumous cases, and in goitre.

Stimulant Liniments, Camphor, Etc

These forms of stimulating the surface are of great service in chronic rheumatism and in local pains of various kinds.

The compound camphor liniment, or the turpentine liniment, is either of them a strong stimulant.

Opodeldoc is less powerful, and is well suited for use with sedatives, such as laudanum, or belladonna liniment, in neuralgic or rheumatic pains.

Belladonna Liniment is a powerful poison, and requires therefore that it should be cautiously used, being rubbed on gently with the palm of the hand. It is a means of relieving pain when rubbed on the joints in acute rheumatism, but caution must be observed not to apply it upon a raw or blistered surface, as it is readily absorbed under those circumstances.

In neuralgic pains, a piece of lint soaked in belladonna liniment and laid on to the skin will often give relief.

Leeching

When leeches have to be applied, the part should first be carefully cleansed and washed over with milk-and-water before they are applied. If the leeches are then held in a wineglass or box over the part to which they are to be applied, they will readily bite, as they will be confined to a limited space.

For the stanching of leech-bites see Surgical Haemorrhage.

Care should be taken in applying leeches that they be applied over a surface that has bone beneath, so that pressure can be borne in endeavouring to stanch the bleeding.

The bleeding from leech-bites should, as a rule, be checked or stopped as soon as they leave their hold. This is particularly to be observed with children, as they are prone to bleed a good deal; indeed, so obstinate and difficult to stop are children's leech-bites, that we should seldom advise their use.