Technicalities Of The Pack And Bath


Categories: TREATMENT OF SCARLET-FEVER.
Sources: Hydriatic Treatment Of Scarlet Fever In Its Different Forms

Let me give you its technicalities, and the rationale of its action:



A linen sheet, (linen is a better conductor than cotton,) large enough

to wrap the whole person of the patient in it (not too large, however;

if there is no sheet of proper size, it should be doubled at the upper

end) is dipped in water of a temperature answering to the degree of heat

and fever, say between fifty and seventy degrees Fahrenheit, and more

or less tightly wrung out. The higher the temperature of the body, and

the quicker and fuller the pulse, the lower the temperature of the

water, and the wetter the sheet. This wet sheet is spread upon a blanket

previously placed on the mattress of the bed on which the packing is to

take place. The patient, wholly undressed, is laid upon it, stretched

out in all his length, and his arms close to his thighs, and quickly

wrapped up in the sheet, head and all, with the exception of the face;

the blanket is thrown over the sheet, first on the packer's side, folded

down about the head and shoulders, so as to make it stick tight to all

parts of the body, especially the neck and feet, tucked under the

shoulders, side of the trunk, leg and foot; then the opposite side of

the blanket is folded and tucked under in the same manner, till the

blanket and sheet cover the whole body _smoothly_ and _tightly_. Then

comes a feather-bed, or a comforter doubled up, and packed on and around

the patient, so that no heat can escape, or air enter in any part of the

pack, if the head be very hot, it may be left out of the pack, or the

sheet may be doubled around it, or a cold wet compress, not too much

wrung out, be placed on the forehead, and as far back on the top of the

head as practicable, which compress must be changed from time to time,

to keep it cool. Thus the patient remains.





The first impression of the cold wet sheet is disagreeable; but no

sooner does the blanket cover the sheet, than the chill passes away, and

usually before the packing is completed, the patient begins to feel more

comfortable, and very soon the symptoms of the fever diminish. The pulse

becomes softer, slower, the breathing easier, the head cooler, the

general irritation is allayed, and frequently the patient shows some

inclination to sleep. When the fever and heat are very high, the sheet

must be changed on growing hot, as then it would cause the symptoms to

increase again, instead of continuing to relieve them. The best way to

effect this changing of the sheet is to prepare another blanket and

sheet on another bed, to unpack the patient and carry him to the new

pack, where the process described above is repeated. Sometimes it is

necessary to change again; but seldom more than three sheets are

required to produce a perspiration, and relieve the patient for several

hours, or--according to the case--permanently. The changing of the sheet

may become necessary in fifteen, twenty, twenty-five, thirty or forty

minutes, according to the degree of fever and heat. In every new sheet

the patient can stay longer; in the last sheet he becomes more quiet

than before, usually falls asleep, and awakes in a profuse perspiration,

which carries off the alarming symptoms.





A few minutes before the perspiration breaks out, the patient

becomes slightly irritated, which irritation is removed by the

appearance of the sweat. I mention this circumstance, to prevent his

being taken out just before the perspiration is started. When he becomes

restless _during perspiration_, he is taken from his pack and placed in

a bathing-tub partly filled with cool or tepid water, (usually of about

70 deg.,) which has been prepared in the meanwhile; there he is washed down

from head to foot, water from the bath being constantly thrown over him

until he becomes cool. Then he is wrapped in a dry sheet, gently rubbed

dry, and either taken back to his bed, or dressed and allowed to walk

about the room. When the fever and heat rise again, the same process is

repeated.





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