Antipyretics are remedies which tend to reduce the temperature in fever. The reduction of temperature may be brought about by cold or by drugs.

Cold

Some of the methods for applying cold are the cold bath, the cold-pack, and the drip sheet; and for local use the cold compress, the ice-water coil or ice-bag, rectal irrigation with ice-water, the cold spinal douche, etc.

The cold bath is employed in typhoid fever. In the tub-bath the patient is covered with a sheet and lifted into a bath containing water at about 700 F. The primary shock is less if he is placed in the bath at 85° or 900 F., and the water cooled rapidly to 700 F. by the addition of ice. The head should be cooled with ice-cold compresses, and the body rubbed vigorously during the bath. A preliminary dose of whisky tends to dilate the cutaneous vessels and increase the output of heat. The bath is continued for from ten to fifteen minutes. The bed-bath is made by having the patient on a large piece of rubber sheeting, of which the edges are raised over pillows or rolled-up sheets. Cold water is poured in around the patient, ice added, and the patient's body soused with the water by means of a large sponge.

In the cold-pack one or two sheets are wrung out of cold water and wrapped around the patient, the first layer of sheet passing beneath the arms and being tucked between the legs. The patient lies on a blanket, in which he is then completely enveloped up to the neck. After fifteen minutes these coverings are removed. If desired, the sheets may again be wrung out of cold water and the process renewed. When the drip-sheet is used as an antipyretic measure the patient is wrapped in a sheet in the same manner as above, but sits up and has cold water poured over him. These methods of applying cold, whether followed by a good reaction or by shivering, cause an increase in the viscosity of the blood (Determann, Austrian).

Antipyretic Drugs

The group known as antipyretics includes only those drugs whose most pronounced property is to reduce the temperature of fever. It does not include aconite, alcohol, digitalis, phenol, and other drugs which possess the power to lower temperature in fever, but have other important activities that lead us to class them elsewhere. For convenience, the essential antipyretics may be divided into three therapeutic groups, viz., the analgesics, the antimalarials, and the antirheumatics.