For some time the patient feels chilly, a time depending upon his own power of reaction, usually 5 to 15 minutes. Thereafter he be cmnes comfortarde, feels the soothing effect,and is usually unwilling to be disturbed sooner than three-quarters of an hour to an hour.
When the pack is used to reduce temperature, as soon as it has become warm, the patient should be removed from it, and rewrapped in a fresh one, the sheet for which has been wrung out of water 2° higher than the first. If there are two beds in the room, the second pack may be ready and the patient removed from the first to be wrapped in the second. Meantime a third pack is to be prepared, to which the patient is to be transferred as soon as the second has become warm, which is likely to be about 10 minutes, the third pack being prepared with water 2° higher than the second. This process is repeated till the temperature line been reduced to nearly normal. This method has the advantage that the process may be stopped or gone on with according to the indications derived from the condition of the patient. It will require usually four or five such packs to reduce the temperature, and when the patient is removed from the last, his whole body should be rapidly sponged with water about 55°, dried, and his bed-clothing put on.
Cold Sponging is a still milder method of reducing temperature, and is very applicable to children or old or feeble persons. A rubber sheet covered with a blanket, and then with an old linen sheet, is pushed under the patient, whose clothing has been removed. It should be so adjusted that it hangs on one side, when the patient is lying, over the edge of the bed, and on the other side the spare portion is rolled up lengthways. A blanket covers the patient. To the bedside there are brought a large basin tilled with water at a temperature of 65°, a sponge, sponge-cloth, or large piece of gauze, and several old linen towels, or portions of sheets.
One part of the body after the other is ex posed, bathed with the water, dried, and covered. One begins with the face. Then an arm is exposed, water is taken up in the hollow of the hand from the basin, dashed on the arm, and then with the fingers the arm is gently rubbed, more water is dashed on, more friction applied; then the arm is dried and covered, or a dry towel is wrapped round it, it is covered with the blanket, and the same process is applied to the other arm. That heir done
and covered, the chest is next exposed and similarly treated, then the back, next one leg and then the other, but the feet and hands are not wet with the cold water.
Another method is, when the part of the body to be treated is exposed, a thin linen towel with out fringes is lightly wrung out of the water and laid over the part, and water thrown upon it from the hand, friction and patting being employed, over the linen cloth.
The whole body is gone over as rapidly as possible, and either each part is dried at the time or wrapped in the towel, till the other parts are done. Finally the whole body is dried and reclothed.
The height of the temperature, the strength of the patient, and the effect produced on the first application will determine the exact tempera ture at which the water should be used, and the duration of the process.
For in a fever of any duration such a process will, in all probability, have to be employed frequently, perhaps even several times a day, to keep the temperature under control. An intelligent attendant, beginning with the cold sponging, ought quietly to ascertain what the patient needs and can bear, and may from it acquire confidence to go on to the full cold pack, or even the full cold bath.
Remedies for Fever.
In the main, during fever, medicines are given (1) To act on the bowels; (2) To make the skin act, and so relieve its hot, dry, burning character, and thus lower the temperature; (3) To stimulate the kidneys, and increase the flow of urine ; (4) Directly to reduce high temperature ; (5) To diminish excitement and induce sleep.
1. The bowels should always be acted on at the outset by a good clearing-out dose of medi cine. For this castor-oil is best, though, to those who strongly object to it, to 1 spoonful Gregory's mixture may be given, or compound liquorice powder (i to 1 tea spoonful), or any of the bitter waters, Apenta, Hunyadi Janos, Rubinat, or Franz Joseph. Subsequently, as required, one of the mineral waters is best; or fruit salts or saline will be found agreeable, given in cold water, and flavoured, and to children fluid magnesia.