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ELEMENTS OF MATERIA MEDICA.

may be in a Worse condition; hence the practice is not often adopted. Ithink the cases best adapted for the use of cold affusion are those inwhich there is great cerebral disorder,—either violent delirium or asoporose condition. My friend, Dr. Clutterbuck, ( Inquiry into the Seatand Nature of Fever, 2d ed. p. 451), says he has seen pulmonic inflam-mation and rheumatism brought on by cold affusion in typhus ; but headds, “ I have not, in general, observed that the situation of the patientwas rendered materially worse by the combination.”

In the exanthemata , cold affusion has been applied during the feverwhich precedes the eruption, as also after this has been established; itlias been used in scarlet fever, and also in small-pox; likewise inmeasles; but its employment in the latter disease is objectionable, onaccount of the tendency to pulmonary inflammation, in which coldaffusion is prejudicial.

Croup is another disease in which cold affusion has been used withadvantage, principally with the view of removing the spasm of theglottis, which endangers the life of the patient.

In inflammatory affections of the brain, especially of children, afterproper evacuations have been made, it is useful. In many cases of nar-cotic poisoning, cold affusion is of the greatest service; as in poisoningwith hydrocyanic acid, and in asphyxia caused by the inhalation of car-bonic acid; so also in poisoning with opium, belladonna, and othernarcotic substances, in intoxication, in asphyxia from the inhalation ofsulphuretted hydrogen gas or of the vapours of burning charcoal, thispractice is most advantageous. In hysteria and epilepsy it is oftentimesserviceable: it diminishes the duration of the paroxysms, and relievesthe comatose symptoms. In puerperal convulsions Dr. Copland relies oncold affusion and blood-letting. In mania it is oftentimes serviceable;as also in tetanus.

2. Cool affusion has been employed instead of the cold; and in weakirritable subjects it is always preferable. Dr. Currie regards it as amilder form of the cold affusion, as a preparatory means to which it issometimes used. It has been applied in febrile diseases and paralysis.

3. Tepid affusion. —The affusion of tepid water is frequently resortedto as a substitute for that of cold water, where great dread is entertainedof the latter agent, or where there is doubt as to the production of aperfect reaction after the application of cold water, or where there is somepulmonary disease. It may be regarded as a safer, though less powerfulmeans. Thus it is very useful in febrile complaints, especially of chil-dren. It is very beneficial in scarlet fever, as I have seen on severaloccasions. Dr. Currie thinks that it reduces the temperature more thancold affusion; first, because the evaporation is greater; secondly, be-cause it does not excite that reaction bv which heat is evolved. Itdiminishes the frequency of the pulse and of respiration, and causes atendency to sleep. The same writer tells us that he has not found itseffects so permanent as those of the cold affusion ; and that he never sawit followed by the total cessation of regular fever. In other words, itproduces a much less powerful shock to the system, and therefore is lessinfluential over disease. In hectic fever, however, the paroxysm issometimes completely extinguished by the affusion of tepid water at thecommencement of the hot stage.

4. Warm affusion excites very pleasant sensations, but which are soon