This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol2", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
As a local remedy, cold is often very serviceable in inflammation. it operates by diminishing the quantity of blood in the part, and depressing the nervous irritation, which jointly constitute the main elements of the disorder. it may be used in all superficial inflammations of a fixed character, which are attended with increased heat, redness, and swelling. in the readily transferrible inflammations, in which the local affection depends on a constitutional disorder, and, if removed, might be followed by the occurrence of a more serious attack upon one of the vital organs, it should be used with great caution, if at all. Such are the local affections of gout, rheumatism, and certain cutaneous diseases of constitutional origin. The remedy will often act promptly in relieving the inflammation in these cases, and perhaps in the majority of instances might do no serious mischief; but there is always danger; and it is unjustifiable to incur the risk of serious consequences when there is no urgent necessity. Sometimes, however, when the inflammation is very great, with much redness and vascular distension, it may be proper to use the remedy in moderation, with the view of diminishing the violence of the affection, not of subverting it. The cold for this purpose should never be intense. Death is said to have resulted in gout, from introducing the inflamed foot into ice-cold water. The refrigerating plan by means of evaporating lotions is more especially applicable to such cases; and alcohol is preferable to ether for the purpose, as it is less liable to reduce the temperature too far. it should usually be diluted with water, camphor water, or some demulcent liquid, and applied on thin compresses, so as to admit of evaporation. Two or three parts of the diluent may be mixed with one of alcohol. I have sometimes used in this way a mixture of tincture of camphor and milk, the latter of which acts as a demulcent as well as diluent. Scudamore employed in gout an evaporating lotion consisting of one part of alcohol and three of camphor water. Demulcent liquids, such as infusions of slippery elm and flaxseed, act partly by the cold they occasion through the conducting property of the water. These are used with great advantage in erysipelas, and severe cases of erythema, such as E. nodosum. The inflammation from burns or scalds, wounds, sprains, and bruises is very usefully treated by cold water, applied to the part on compresses, and kept cold by frequent renewal. The degree of cold should, in such cases, be regulated by the sensations of the patient, and should not be lower than is agreeable to him. When productive of general chilly sensations, it should be omitted. Subcutaneous phlegmonous swellings, and inflamed glands, may be treated in the same way; but, generally speaking, emollient applications answer better in these cases. Few remedies are more efficient than cold water in inflamed piles; and, when they are internal, frequent injection of the same remedy into the rectum is often beneficial. in inflammation of the conjunctiva, cold water applied by compresses over the eye is usually very grateful to the patient, and beneficial so long as it continues grateful. in some instances, warm water is more soothing, and may be preferably used. The inflamed throat of scarlatina, with much swelling externally, is treated by some with ice-cold water, applied on compresses over the parotids and submaxillary glands, and with asserted advantage. irrigation with cold water is strongly recommended in recent wounds, in which it appears to obviate inflammation; and when this constitutes a source of danger, as in punctured wounds of the knee-joint, the measure is peculiarly applicable. Dr. Wm. Newman, who has especially called attention to this subject, recommends that from a vessel containing cold water, fixed in a position three or four feet above the patient, a steady dropping of water upon the injured part be maintained, by putting one end of strips of flannel or of patent lint into the vessel, and allowing the other end to hang down on the outside, below the level of that in the water. The effect of a syphon is thus obtained; and a constant dropping may be kept up for a week if necessary. if the measure be resorted to sufficiently early, there will be no heat, swelling, or redness; and the parts will heal without any untoward result. (Am. J. of Med. Sci., April, 1865, p. 510, from Brit. Med. Journ.)
Of the internal inflammations, that of the meninges of the brain especially calls for this remedy. With or without shaving of the hair, large compresses thoroughly soaked with ice-cold water, or bladders filled with pounded ice, or cloths enveloping a layer of snow, should be applied over the whole scalp, and renewed from time to time; care being taken not to freeze the skin. inflammations of the chest and abdomen are not generally treated with cold externally; and 1 have no doubt that when the parenchyma of the organs is affected, it might prove injurious by sending the blood into the inflamed tissue; and the same is probably the case with the serous inflammations of these parts. But in inflammation of the mucous coat of the stomach, bladder, and uterus, it is not impossible that the sympathy between the external surface over the part affected, with the mucous membrane, may cause the latter to be favourably impressed by cold applied to the former. I confess, however, that I never myself employ cold in these cases, preferring the sedative effect of emollient cataplasms in all the internal inflammations of the trunk of the body.
Internally cold may be employed with much benefit in acute gastritis. The burning pain and the great thirst of this affection call for cold drinks, and nothing is more grateful to the patient. I believe that nature here points out the true proceeding. But water should not be drank copiously, as, by distending and weighing upon the stomach, it may prove mechanically injurious, and is liable to provoke vomiting. it should be taken as cold as possible, in very small quantities, one or two swallows for example, at a time, and very frequently. An excellent plan is to let the patient swallow frequently small pieces of ice, without allowing them to dissolve in the mouth. Their solution in the stomach, through the absorption of free caloric, creates a much greater degree of cold than would be occasioned by the same bulk of water; and the stomach may in this way be kept constantly refrigerated. There is little danger of proceeding too far, if the pieces be swallowed separately at short intervals, and no longer than they prove comforting to the patient.
In acute dysentery, the plan of injecting ice - water has also been recommended; but, unless the injection were very often repeated, which in itself would be objectionable, there would be risk that the reaction in the intervals would quite balance the direct sedative effects of the remedy; and ice, if introduced, would be too local in its operation, not being capable, as in the stomach, of diffusing itself when dissolved over the whole inflamed surface.
A new method of employing cold in inflammation has been introduced into notice by Dr. James Arnott of London. it consists in freezing the part by a mixture of pounded ice and salt. I have myself had no experience of this method, and can, therefore, say nothing of it of my own knowledge; but the extraordinary results obtained by Dr. Arnott are certainly entitled to attention. Of the mode of forming and applying the mixture, and of its effects, I shall treat under the anaesthetic application of cold. it is sufficient here to say that, in the experience of Dr. Arnott and his friends, no injury has resulted from the use of the remedy in any case. He considers it capable of promptly curing any inflammation the seat of which can be reached by the freezing influence, and of benefiting internal inflammation through the sympathies connecting the surface with the interior. The affections in which Dr. Arnott has found the remedy successful are erysipelas, eczema, impetigo, prurigo, glandular inflammation of the neck and groin, acute lumbago, sciatica in most instances, most cases of chronic rheumatism, ordinary inflammation of the joints, painful nodes, and the inflammation of sprains, bruises, and burns. in acute rheumatism, the inflammation of the joints is invariably and completely relieved, and the disease shortened to a week. Rheumatic gout is also promptly relieved; ophthalmia has been immediately cured by a frigorific mixture in contact with the closed eyelid for three or four minutes; the beneficial action of the remedy in orchitis is very prompt; and Dr. Arnott has employed it with "speedy and excellent effects" in a case of meningitis, and in another of peritonitis. (Ed. Month. Journ. of Med. Sci., July, 1854, p. 35.) Dr. T. Spencer Wells states that the freezing process is of great service in external cancer, allaying pains, checking growth, reducing the size of the tumour, and sometimes bringing it into an indolent condition. (Med. Times and Gaz., July, 1857, p. 31.) Even uterine cancer is said to have been usefully treated in this way.