Cold is generally the most efficacious remedy for the relief of pain when it is produced by active congestion or inflammation. Pain accompanied by a great amount of heat generally calls for the application of cold. Some cases of neuralgia are best relieved by ice or cold compresses. The best remedy for the relief of the pain of a felon before it reaches maturity is immersion of the hand and arm in water as cold as can be borne. Probably there is no one remedy of so universal application as a means of relieving pain as heat. It may be applied in connection with moisture by fomentations, or without, by means of bags filled with hot water, heated sand, corn meal, or some similar substance, hot bottles, bricks, etc. Either moist or dry heat is almost always efficacious in the pain of neuralgia. Pain arising from deficient circulation is also generally best relieved by hot applications. The pain of passive congestion yields to heat quicker than to any other remedy. The severe pain of a felon approaching maturity will often be relieved, as if by magic, by a hot spray or a fomentation. Uterine and ovarian pain are relieved by the hot vaginal douche. Bowel pains are relieved by hot fomentations and by large hot enemas. Severe nervous headache is often best relieved by fomentations or sponging the head with hot water. Fomentations to the bowels are most effective in sympathetic headache. The pain of rheumatism, acute sciatica, neuralgia, pleurodynia and pleurisy, yield best to hot applications. Excruciating pain arising from piles or a fissure of the anus may be often dissipated by sitting over a vessel nearly filled with very hot water. The terrible itching of pleuritis and the intolerable pain of earache and toothache also yield to the application of heat. The pain accompanying inflammation of the veins, and the extreme pain and soreness arising from bruises, lacerations, fractures of bones, and many other accidents, are relieved, generally, more readily by the application of heat than by any other means. The warm-blanket pack, and the Turkish, hot-air, vapor and Russian baths, are the most effective means of applying heat. It can be utilized to the greatest advantage in the treatment of cases characterized by pain of a general character. Poultices of various sorts are generally no more effective than fomentations, in some cases less so. Their efficacy is wholly due in the majority of cases to the heat and moisture of the application.

In exceptional cases, cold compresses will relieve the pains of rheumatism more effectively than heat. Iced water is also sometimes essential as a remedy for the relief of toothache. For congestive headache, ice compresses applied to the head and neck are the proper measures. The terrible pain of cancer may often be relieved by freezing when other remedies fail. This remedy also has the advantage in that it checks the progress of the disease as well as relieves the suffering. The injection of ice-cold water into the seat of pain sometimes relieves the severe pain of neuralgia almost magically. We have used it with fair success in a number of cases. Some recommend injection at the analogous part on the opposite side of the body. Injection is made by means of the hypodermic syringe, the most approved form of which is shown in Fig. 318. Intense cold or freezing may often be used to advantage to prevent pain in the performance of slight surgical operations.

Fig. 318. Hypodermic Syringe.

Fig. 318. Hypodermic Syringe.