494 GENERAL THERAPEUTIC MEASURES 



eased internal organs^ and for application of skin irritants to relieve these 

 conditions, have been mapped out in man. In the case of the chest and 

 belly they are situated pretty nearly over the site of the internal organ. 

 In the head the sensitive skin-sites are not over the diseased part. 



Pain is usually referable to the peripheral ends of an affected nerve. 

 It is good practice to apply counter-irritation directly over a deep-seated 

 inflammation or seat of pain (see above) , but in assuaging superficial pain 

 it is found, that where the treatment can be made over the root of the 

 painful nerve, better results are obtained. In pain in the chest wall a 

 blister should be placed next the spine over the root of the spinal nerve 

 involved; in pain in the head in man, counter-irritation is applied over 

 the back of the neck. Counter-irritation should be done over the temple, 

 in pain in the eye (iritis) ; behind the ear, for pain in that organ. 



In the treatment of enlarged glands and in acute inflammations, as 

 abscess, boils and carbuncles, by counter-irritants, the application should 

 be about the lesions rather than directly upon them. 



Among other actions accomplished by counter-irritants are : possible 

 stimulation of trophic nerves and nutrition of a part; augmentation of 

 tissue change, locally and generally, and dilatation of vessels (when 

 applied after the subsidence of acute inflammation or in chronically in- 

 flamed parts), with renewed activity of the circulation and consequent 

 absorption of inflammatory exudations. The local action of skin irri- 

 tants increases the leukocytes and opsinins in the inflammatory area 

 (acted upon) and leads to bacterial destruction. The toxins are also more 

 rapidly removed by their influence. Futhermore, counter-irritants re- 

 flexly overcome spasm and pain occurring in colic, by stimulating and 

 replacing normal peristaltic action in place of abnormal localized con- 

 tractions. In like manner they excite uterine contractions by stimulation 

 of the involuntary muscular fibres of the womb. To briefly summarize: — 

 the therapeutic action of counter-irritants may be due to: 1. Alteration 

 of the circulation. 2. To the nervous relation between the skin and 

 viscera. 3. To the "counter"-ing effect of a superficial over a deep pain. 



INDICATIONS FOR COUNTER-IRRITANTS. 



1. To overcome congestion and inflammation in remote parts. 



2. To promote absorption of inflammatory products locally. 



3. To relieve pain. 



4. To stimulate the heart, respiration and nervous functions. 



Rubefacients. — In this class are included the volatile oils — turpen- 

 tine, oil of wintergreen, etc. — alcohol, chloroform, balsams, resins, 

 iodine, tincture of camphor, tincture of cantharides, mustard, and heat. 

 These agents are used when it is desirable to stimulate the nervous system 

 rapidly, and to relieve pain and congestion. To attain this end, we em- 

 ploy comparatively mild agents in order that we may apply them over 

 an extensive surface without causing serious or permanent results. Mus- 

 tard is rubbed with warm water into a thin paste (a sinapism), and 

 rubbed over the chest of horses in congestion of the lungs, in acute bron- 

 chitis, or in the first stage of pleuritis, to obtund pain and lessen conges- 

 tion. Sinapisms also relieve obstinate cough, revive failing respiration. 



Digitized by Microsoft® 



