In Fever, cold affusion was first brought prominently forward by Dr. Currie;* and, although its value is now generally acknowledged, the many inconveniences attending its use have generally caused it to be superseded by simply spongmg the body with cold water, or vinegar and water, which, though it causes a less shock to the system, produces one of the most beneficial effects of cold affusion, namely, a reduction of the morbid heat.
* Reports on Cold Water.
The mode of applying cold affusion, as proposed by Dr. Currie, is to have the patient stripped naked, and from three to five gallons of water, at 50° or 60o F. in the winter, and 60' or 70° in the summer, thrown over him. Water alone, or salt and water, or vinegar and water, may be employed. When applied with the undermentioned cautions, the effects of cold affusion are to diminish the morbid heat of the skin, to lower the pulse, and to induce subsequent perspiration and sleep. The safest time for its application is when the exacerbation is at its height, or immediately after its declination has begun. Dr. Currie directed its employment at from six to nine o'clock in the evening.
Cautions in the use of Cold Affusion. 1. It should never be employed when there is any sense of chilliness, although the thermometer indicate a morbid degree of heat.
3. It should never be employed when the heat, measured by the thermometer, is less than, or equal to, the natural heat (96° F.), notwithstanding the patient feel no sense of chilliness.
4. It should never be employed when the body is under a profuse sensible perspiration.
5. It should not be employed if the fever be complicated with any visceral inflammation.
6. The earlier in the disease it can be employed, the more benefit will be derived from it; in the more advanced stages, however, it will be found to moderate the symptoms, but in no case will it " cut short " the fever, as supposed by Dr. Currie.
7. The patient should always immerse his hands for a few moments in the fluid before it is applied to any other part of the body. It prevents the shock being too violent.
3235. Sponging the body in Fevers is, in most cases, preferable to affusion, although it fail to induce the same impression on the system. Cold water, either alone or mixed with vinegar, may be used, and the whole body should be freely sponged over, once or twice daily. It reduces the morbid heat of the surface, is extremely grateful and refreshing to the patient, and may be used with perfect safety, unless the skin be high above the natural standard, or there be any greatly irregular distribution of temperature. In the latter cases, tepid water should be substituted for cold. It is equally applicable to Continued Inflammatory and other Fevers as to Small-pox, Measles, Scarlatina, and the Exanthemata generally. The feelings of the patient are the true guide as to the temperature; if cold applications are disagreeable, tepid ones should be substituted, and vice versa. In Typhus and Typhoid Fevers, also, the practice is fraught with benefit. Dr. Murchison* advises that small quantities of Condy's Fluid or Muriatic Acid (3j. ad Oj.) should be added to the water: from this the patient not only experiences the greatest comfort and benefit, but it likewise diminishes the risk to the attendants by preventing the accumulation of poisonous exhalations.
3236. As a drink in Fevers and Inflammations, cold water may be taken ad libitum; but the addition of some mucilaginous agents, as barley, rice, &c, and its being acidulated with lemon-juice or one of the vegetable acids, renders it more refrigerant and agreeable to the palate.