3148. Therapeutic Uses

In Insanity, the application of ice to the shaven scalp is sometimes productive of excellent effects. M. Foville employed a cap containing pounded ice, which was closely fitted to the head of the patient, while the body was immersed in a hot bath for two or three hours. This proceeding was renewed twice or thrice daily, according to the intensity of the symptoms. On adopting it only once a day, he found the tranquillity produced by it followed, in some instances, by increased agitation; but on repeating the bath, with the ice constantly applied to the head, it induced sleep and tranquillity in many instances of obstinate restlessness and agitation, and was the apparent means of recovery in several acute cases. (Dr. Prichard. *)

3149. In Inflammation of the Brain and its Membranes, the application of ice, in the manner recommended in the last section, is attended with the best effects. The situation of the cap should be changed every minute or two, both to cool every part of the head, and to prevent the injurious effects which might result from a too protracted application to one spot. By this mode of procedure, observes Dr. Hope, its use may be continued for half an hour or more at a time; when, if the head feel cool, evaporating lotions may be substituted, until a return of heat and flushing demands the re-application of the ice. It must be used with caution in the aged, in coma, and in the advanced stages of the disease.

* Cyc. Pract. Med., vol. ii. p. 859. Lib. of Med., vol. ii. p. 55.

3150. In Delirium Tremens, ice to the shaven scalp, as advised in Insanity, has in some instances an excellent effect, producing sleep and tranquillity, when all other means fail. It should, however, be used with extreme caution, as, if the patient be much debilitated, or the application be long continued, or repeated too frequently, it may depress the vital powers to a dangerous extent. In Acute Hydrocephalus, ice is too powerful a depressant for ordinary cases; but cold water, or evaporating lotions to the head, prove most serviceable.

3151. In Headaches, arising from a morbid state of the nerves of some portion of the forehead and scalp, the freezing mixture (ice and salt) is strongly recommended by Dr. Amott.* " In no disease," he observes, "have the efficiency, safety, and speedy operation of congelation been more conspicuous than in this. It is particularly serviceable when the headache is combined with much heat of the integuments, and when the symptoms appear to threaten secondary local inflammation."

3152. In Apoplexy, ice applied to the head, at the same time that the feet are placed in hot water, is a measure occasionally productive of great benefit. Lallemand states, that the cold acts locally in diminishing the congestion of the head, without greatly depressing the vital powers. Great caution, however, is necessary in its use, particularly in debilitated or old subjects.