Now the temperature may be reduced in two (1) By baths, (2) By medicines (anti-pyretics), and it will save a good deal of repetition in discussing such treatment under each separate fever if all that need be said be said here.
The Use of Baths in Fever.
The bath may be used in fever for one of two purposes, either (1) for its effect upon the temperature and the excited condition of the patient, or (2) for disinfecting purposes, or for both together. In the former the bath may be warm or cold, in the second case always warm.
The Warm Bath (temperature 98° Fah r.) is one of the most valuable methods of treat ment in infectious fevers in young children, relieving the restlessness and irritability, sooth ing the irritated skin, and inducing sleep. Care should be taken that the temperature of the water is maintained at 98° by the addition every now and again of hot water to the side. The child should lie, its head supported com fortably, and as quietly as it can be prevailed on to do.
The bath should last 8 to 10 minutes; thereafter the child should be carefully but quickly dried, a woollen or flannel gown put on, and placed in its bed, which has been previously warmed. It should not be tightly tucked in, but just properly covered to main tain comfortable warmth, and loosely rather than tightly, to permit natural invisible per spiration to -go on.
Every infectious eruptive fever of childhood may be treated in this way, and in cases such as measles and chicken-pox, where the irritation of skin is frequently intolerable, the relief is most marked.
The Warm Lysol Bath.—In such fevers with rash in children as have been mentioned, the value of the bath is increased by adding a table-spoonful of lysol to the bath of the child's size—say 10 gallons. This not only further soothes the irritated skin, but acts as a disin fectant. There are few cases of such infectious disease in children where such a daily warm lysol bath is not entirely suitable and of great value.
The Hot Paek ie given by means of a woollen blanket rung out of very hot water by two persons twisting it, one at each end. On the
patient's bed a dry blanket has been spread above the ordinary sheet. The hot blanket is now laid on this, and the patient laid on it, his arms raised. One side of the blanket is now carried over and tucked under the opposite side of the body, and a fold placed between the legs; the arms are then lowered and the other side of the blanket tucked round. The dry blanket is next folded over the hot one, first one side and then the other. In this the patient remains for an hour, getting drinks of cold water and having his face bathed with cold water, after which he is quickly sponged with tepid water, dried, and his bed clothes put on.
The Full Hot Bath is given at a tempera ture of 95 to begin, gradually raised by the addition of hot water till the temperature is as high as can be comfortably borne. During it the patient may get cold water to drink, and have his face bathed with cold water. The temperature should reach 105° or even 110', and the bath should last about 20 minutes. When the patient is about to be lifted out, two dry warmed woollen blankets are laid on the bed. On these he is lifted, and wrapped up in them, and allowed to remain sweating for an hour or two, cold water being given him to drink. This is called a dry pack. He is then quickly sponged down with tepid water, dried, and his usual bed clothes put on.
These varieties of warm bathing are occasion ally useful in fevers, specially in complications of scarlet fever, kidney disease in particular.
The Cold Bath is used in fever for the reduction of temperature, and the symptoms of restlessness, delirium, &c., that occur when the fever runs high. The temperature of the bath must vary with the age and vigour of the patient, and should be somewhere between 65' and 90° Fahr. The typical use of it is in typhoid fever, and it is frequently called the Brand bath, because so vigorously advocated by Ernest Brand of Stettin.
The full detail of the cold bath will be giver, here, because it is on scrupulous attention te the de'^ll that its safety and usefulness lie.