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tends to maintain and increase the heat in the inflamed parts.

Inflammation means that there is already too much heat in the affected part or organ. Common sense, therefore, would dictate cooling applications instead of heating ones.

The cold packs and compresses, on the other hand, have a directly cooling effect upon the seat of inflammation and in accordance with the Law of Action and Reaction their secondary, lasting effect consists in drawing the blood from the congested and heated interior to the surface, thus relaxing the pores of the skin and promoting the radiation of heat and the elimination of impurities.

Both the hot-water applications and the use of ice are, therefore, to be absolutely condemned. The only rational and natural treatment of inflammatory conditions is that by compresses, packs and ablutions, using water of ordinary temperature, as it comes from the cold water tap.

By means of the simple cold-water treatment and fasting all fevers and inflammations can be reduced in a perfectly natural way within a short time without undue strain on the organism.

The Whole-Body Pack

The whole-body pack is most effective if by means of it the patient can be brought into a state of copious perspiration. The pack is then removed and the patient is given a cold sponge bath.

It will be found that this treatment often produces a second profuse sweat which is very beneficial. This aftersweat should also be followed by a cold sponge bath.

Such a course of treatment will frequently be sufficient to eliminate the morbid matter which has gathered in the system, and thus prevent in a perfectly natural manner a threatening disease which otherwise might become dangerous to life.

How to Apply the Whole-Body Pack

On a bed or cot spread two or more blankets, according to their weight. Over the top blanket spread a linen or cotton sheet which has been dipped into cold water and wrung out fairly dry. Let the blankets extend about one foot beyond the wet sheet at the head of the bed.

Place the patient on the wet sheet so that it comes well up to the neck, and wrap the sheet snugly around the body so that it covers every part, tucking it in between the arms and sides and between the legs. It will be found that the sheet can be adjusted more snugly and smoothly if separate strips of wet linen are placed between the legs and between the arms and the sides of the body.

The blankets are now folded, one by one, upward over the feet and around the body, turned in at the neck and brought across the chest, the outer layers being held in place with safety pins.

The patient should stay in this whole-body pack from one-half hour to two hours, according to the object to be attained and the reaction of the body to the pack. If the pack has been correctly applied, the patient will become warm in a few minutes.

The Bed-Sweat Bath

If the patient does not react to the pack, that is, if he remains cold, or if, as is sometimes the case in malaria, the fever is accompanied by chills or if profuse perspiration is desired, bottles filled with hot water or bricks heated in the oven and wrapped in flannel should be placed along the sides and to the feet, under the outside covering.

This form of application is called the bed-sweat bath. It may be used with good results when an incipient cold is to be aborted.

After the pack has been removed, the body should be sponged with cold water, as already stated. Use a coarse cloth or Turkish towel for this purpose rather than a sponge, as the latter cannot be kept perfectly clean. Dry the body quickly but thoroughly, and finish by rubbing with the hands.

In the meantime the damp bed clothing should be replaced by dry sheets and blankets (a second cot or bed will be found a great convenience), and the patient put to bed without delay and well covered in order to prevent chilling and also to induce, if possible, a copious aftersweat. The patient is then sponged off a second time, put into a dry bed, and allowed to rest.

If the patient is too weak to leave his bed, the cold sponge may be given on a large rubber sheet or oilcloth covered with an old blanket, which should be placed on the bed before the pack is applied. After removing the pack, put a blanket over the patient to prevent chilling and wash quickly but thoroughly first the limbs, then chest and stomach, then the back, drying and covering each part as soon as finished. Remove the rubber sheet from the bed and wrap the patient in dry, warm blankets, or lift him into another bed.

How to Apply the Short-Body Pack

A wide strip of linen or muslin, wrung out of cold water, is wrapped around the patient from under the armpits to the thighs or knees in one, two or more layers, covered by one or more layers of dry flannel or muslin in such a manner that the wet linen does not protrude at any place.

Similar packs may be applied to the throat,* the arms, legs, shoulder joints or any other part of the body.

The number of layers of wet linen and dry covering is determined by the vitality of the patient, the height of his temperature and the particular object of the application, which may be to lower high temperature to raise the temperature when subnormal to relieve inner congestion to promote elimination.

If the object is to lower high temperature, several layers of wet linen should be wrapped around the body and covered loosely by one or two layers of the dry wrappings in order to prevent the bed from getting wet. The packs must be renewed as soon as they become dry or uncomfortably hot.

If the object is to raise subnormal temperature, less wet linen and more dry covering must be used, and the packs left on a longer time, say from thirty minutes to two hours. If the patient does not react to the pack, hot bricks or bottles filled with hot water should be placed at the sides and to the feet, as explained in connection with the whole-body pack.

If inner congestion is to be relieved, or if the object is to promote elimination, less of the wet linen and more dry wrappings should be used.

When packs are applied, the bed may be protected by spreading an oilcloth over the mattress under the sheet. But in no case should oilcloth or rubber sheeting be used for the outer covering of packs. This would interfere with some of the main objects of the pack treatment, especially with heat radiation. The outer covering should be warm but at the same time porous, to allow the escape of heat and of poisonous gases from the body.

Local Compresses

In case of local inflammation, as in appendicitis, ovaritis, colitis, etc., separate cooling compresses may be slipped under the pack and over the seat of inflammation. These local compresses may be removed and changed when hot and dry without disturbing the larger pack.

In all fevers accompanied by high temperature, it is advisable to place an extra cooling compress at the nape of the neck (the region of the medulla and the back brain), because here are located the brain centers which regulate the inner temperature of the body (thermotaxic centers), and the cooling of these brain centers produces a cooling effect upon the entire organism.

Enemas

While ordinarily we do not favor the giving of injections or enemas unless they are absolutely necessary, we apply them freely in feverish diseases in order to remove from the rectum and lower colon any accumulations of morbid matter, and thus to prevent their reabsorption into the system. In cases of exceptionally stubborn constipation, an injection of a few ounces of warm olive oil may be given. Allow this to remain in the colon about thirty minutes in order to soften the contents of the rectum, and follow with an injection of warm water.

Just How the Cold Packs Produce

Their Wonderful Results

(1) How Cold Packs Promote Heat Radiation

Many people are under the impression that the packs reduce the fever temperature so quickly because they are put on cold. But this is not so, because, unless the reaction be bad, the packs become warm after a few minutes’ contact with the body.

The prompt reduction of temperature takes place because of increased heat radiation. The coldness of the pack may lower the surface temperature slightly; but it is the moist warmth forming under the pack on the surface of the body that draws the blood from the congested interior into the skin, relaxes and opens its minute blood vessels and pores, and in that way facilitates the escape of heat from the body.

In febrile conditions the pores and capillary blood vessels of the skin are tense and contracted. Therefore the heat cannot escape, the skin is hot and dry, and the interior of the body remains overheated. When the skin relaxes and the patient begins to perspire freely, we say the fever is broken.

The moist warmth under the wet pack produces this relaxation of the skin in a perfectly natural manner. By means of these simple packs followed by cold ablutions, the temperature of the patient can be kept at any point desired without the use of poisonous antifever medicines, serums and antitoxins which lower the temperature by benumbing and paralyzing heart action, respiration, the red and white blood corpuscles, and thus generally lowering the vital activities of the organism.

(2) How Cold Packs Relieve Inner Congestion

In all inflammatory febrile diseases the blood is congested in the inflamed parts and organs. This produces the four cardinal symptoms of inflammation: redness, swelling, heat, and pain. [Rubor, tumor, colar and dolar.] If the congestion be too great, the pain becomes excessive, and the inflammatory processes cannot run their natural course to the best advantage. It is therefore of great importance to relieve the local blood pressure in the affected parts and this can be accomplished most effectively by means of the wet packs.

As before stated, they draw the blood onto the surface of the body and in that way relieve inner congestion wherever it may exist, whether it be in the brain, as in meningitis, in the lungs, as in pneumonia, or in the inflamed appendix.

In several cases where a child was in the most dangerous stage of diphtheria, where the membranes in throat and nasal passages were already choking the little patient, the wet packs applied to the entire body from neck to feet relieved the congestion in the throat so quickly that within half an hour after the first application the patient breathed easily and soon made a perfect recovery. The effectiveness of these simple water applications in reducing congestion, heat and pain is little short of marvelous.

(3) How Cold Packs Promote Elimination

By far the largest number of deaths in febrile diseases result from the accumulation in the system of poisonous substances, which paralyze or destroy vital centers and organs. Therefore it is necessary to eliminate the morbid products of inflammation from the organism as quickly as possible.

This also is accomplished most effectively and thoroughly by the application of wet packs. As they draw the blood into the surface and relax the minute blood vessels in the skin, the morbid materials in the blood are eliminated through the pores of the skin and absorbed by the packs. That this is actually so is verified by the yellowish or brownish discoloration of the wet wrappings and by their offensive odor.

One of the main causes of constipation in febrile diseases is the inner congestion and fever heat. Through the cooling and

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