Local cold applications are most conveniently made by means of ice bags, which are made in several sizes and shapes to accommodate the parts for which they are designed. Cold compresses may be used, that is cloths wrung out of cold water, but they have the great disadvantage of the necessity of too frequent renewal.

Extreme cold, as ice applications, should not be applied too long, especially to any part not having active circulation, as the extremities. Also, an ice cap should be kept only very intermittently on a young child's head, and ice on the extremities of very old people should be used with care.

Ice bags are very valuable in all cases of meningitis, cerebral and spinal, to aid in aborting inflammation of the mastoid, some acute inflammations of the eye (where it should be used with care), laryngitis, pericarditis, appendicitis, orchitis, or epididymitis, acute and local in-llammations of joints, synovitis, and the inflammation from acute injury, as in contusions, sprains, etc.

In some situations the ice coil, although more cumbersome in use, is more comfortable to the patient, and gives satisfactory results. These coils occur in several sizes, but are usually spoken of as the head coil, which is about ten inches in diameter and shaped like a cap, and the abdominal coil, which is about fourteen inches in diameter.

To operate them put one end of the tube into a reservoir containing ice water, placed two feet above the part to be treated, and the other end of the coil into a pail beside the bed. Suction must now be applied to the lower end to start the water running through the coil. Once started a pinchcock should be applied to the tube to regulate the amount of water flowing through it.

Cold Sound

This is simply a two-way catheter completely closed at its extremity. It is introduced the same as an ordinary sound, but to such a distance that the tip of the instrument extends to, and not into the bladder. Always use a full-sized instrument and start with a water temperature of about 70° F., which subsequently may be reduced to 50°. The bladder should be emptied before the instrument is introduced. An average duration of would be ten minutes, and the proper frequency once a week.

Rectal Irrigators are instruments, similar to that just described, designed for use in the rectum. Either hot or cold water may be used in them.