Hydrotherapy

Hydrotherapy : Alternate Hot and Cold Immersion Bath

Hydrotherapy - Alternate hot and cold immersion bath

While the treatment of blood poisoning or infections should,whenever possible, be directed by a competent physician, yet a simple and most effective home or hospital treatment is that of the alternate hot and cold immersion bath, a form of hydrotherapy. To carry out this form of hydrotherapy treatment, two pails, or better still, two oval-shaped tubs, are needed, one for hot water and the other for ice water. The temperature of the hot water should be about 108° to 110° F. to begin with. Gradually add hot water until the temperature is increased to 115° F or more, as hot as can be tolerated. The infected part, which is usually the hand or arm, is immersed in the hot water for two or three minutes, then in the ice water for twenty to thirty seconds, alternately. Between each change hot water should be added to keep up and increase the temperature of the hot tub. Large pieces of ice should be kept in the ice water.

The effectiveness and results of the hydrotherapy treatment depend upon maintaining the extremes in temperature. The treatment should continue for thirty minutes and be repeated every three or four hours, according to indications. In the interval between the treatments a heating compress should be applied to the part affected. The heating compress consists of a soft towel or several layers of gauze wrung out of cold water and placed around or over the affected area. This is covered with oiled silk or mackintosh and this, in turn, with a flannel blanket to maintain the heat. The moist compress should be large enough to cover considerably more than the affected area, so that the volume of blood will be increased. Also, the flannel should extend well up over the moist compress to more than cover it.

The alternate hot and cold immersion bath produces a revulsive effect, bringing more blood to the part and thus overcoming the infection, as it is by the defense properties of the blood that infection is overcome. The heating compress continues the process during the interval between treatments. Many cases of local infection in the hand, with its significant red streaks extending up the arm, which indicate that the infection is traveling through the lymph channels and tending toward general blood poisoning, have been cured by this simple treatment.

In those cases in which the infection has resulted in abscess formation and the part has been incised by the surgeon to allow drainage of pus, the utensils, water, and dressings should be sterilized to prevent secondary infection of the wound. Here the heating compress also favors the drainage of the pus. In some cases instead of applying the heating compress between the treatments, immerse the part in a continuous neutral bath, temperature 95° to 98° F. This favors the circulation and free drainage of the pus, reduces temperature, and relieves pain.

Hot Food Bath and Cold Mitten Friction

Along with the local treatment of blood poisoning, a general tonic treatment should be given; for example, alternate hot and cold to the spine with a hot foot bath, followed with a cold-mitten friction. The cold-mitten friction increases the number of blood cells in the circulation, especially the white cells, which means increased body defense. The white cells are the active agent in germ destruction. Winternitz and his associates have definitely shown that a cold-mitten friction will increase the number of white blood cells in the circulation 50 to 100 per cent.This tonic treatment may be given twice daily.

Among the diseases with which we should be prepared to deal are the common cold and influenza, which, if not properly treated, too often result in pneumonia.Fever is a symptom common to both, which is usually preceded by a feeling of chilliness. It is during the early symptoms that treatment should be instituted. The chilly feeling means that the blood is being driven from the blood vessels of the skin and is congesting the internal organs and mucous membranes of the body, especially of the respiratory tract. At the first symptom the patient should be put to bed with plenty of warm covers in a well-ventilated room. The room should be warmed preparatory to giving the treatment. If necessary, an enema should be given. While the preparation for the treatment is being made, the patient should be given a drink of hot lemonade or other hot drink. The treatment should be directed toward restoring the unbalanced circulation, and if it is instituted early and is properly given, often the cold may be aborted.

The first step of the treatment is a hot foot bath. In giving this, first place a newspaper or a rubber sheet under the patient's feet. The feet are then placed in a tub of water as hot as can be borne, and hot water is added from time to time to keep up the effect. Fomentations are then applied to the patient's chest. The fomentation should be folded so that it will fit snugly around the sides of the chest, up into the armpits, and well up around the throat. At least three fomentations should be given, and if the patient is decidedly chilly, more than this may be given. A short cold application over the chest, either by means of a cloth wrung from ice water or a smooth piece of ice rubbed quickly over the chest, should be made between the fomentations. The fomentations should be changed every three to five minutes or as soon as they become comfortable to the patient. If the patient is decidedly chilly, a fomentation may be applied to the spine at the beginning of the treatment and the patient allowed to lie on it during the treatment. A cold compress should be placed on the forehead during the treatment, and renewed every two or three minutes.

To complete the treatment a cold sponge bath, or better still, a cold-mitten friction, should be given. The cold-mitten friction has been described in a previous article. The feet are left in the hot water during the cold-mitten friction. They are then lifted, held over the tub while a dash of ice-cold water is given diem, and dried. If a fomentation has been applied to the spine, this is removed last and the cold friction is applied to the back. The heat applied to the feet and the hot applications to the surface of the body will have drawn the blood to the skin and to the extremities away from the congested organs. The cold-mitten friction, by its tonic effect upon the blood vessels, fixes the blood in the skin. If the treatment has been properly given and the desired reaction has been obtained, the patient will have a feeling of warmth and there will be a pink glow to the skin.

This treatment may be repeated two or three times daily as indicated by the symptoms. If there is a tendency to chilling during the cold-mitten friction, you may use tepid or even warm water. Care should be taken that the patient does not chill during this part of the treatment. This is especially true of the aged or debilitated individual. In this case it might be better to give fomentations alone and not the alternate hot and cold. In fact, the aged should be treated very cautiously, extremes of either heat or cold being avoided in their treatment. Seek the advice of your physician whenever possible, especially when dealing with old people.

If it is not possible to give the treatment described above, a full hot tub bath may be given to warm the patient, after which a cold pour over the body may be given, or the patient may be placed in bed and a cold-mitten friction given. A cold compress, renewed every two or three minutes, should be applied to the forehead during the hot bath, which should not be prolonged beyond ten minutes in the average case. However, if the person is vigorous, it may be prolonged to the point of perspiration. Prolonged perspiration in treatment of colds is debilitating and must be guarded against.

The patient should be encouraged to take plenty of fluids, water or fruit juices, either hot or cold, ten to twelve glasses daily. The diet should be light and nutritious.

In dealing with infectious diseases the control of fever is an important matter. Of course, fever can be reduced by drug medication. Drugs of this kind act by virtue of being a depressant to the body functions, and many times they interfere with the body defense mechanism, such as the work of the white blood cells. After all, fever should be looked upon as a symptom that needs only to be controlled, for up to a certain point it is beneficial, as it is an effort on the part of nature to burn up the poisons or toxins produced by disease germs. Of course a prolonged high temperature of 103° to 105° is not only distressing to the patient, but also harmful to the body tissues and organs, and must be brought under control. This is best accomplished by natural methods, and it is here again that the use of water internally and externally is the treatment par excellence.

Anciently it was considered a dangerous practice to give water to fever patients. Today we know that in fevers, water is needed in abundance. Used both internally and externally, it adds much to the comfort of the fever patient, and is an essential factor in his recovery. Water, taken internally, aids in controlling body temperature both by its cooling effect and by its action in the elimination of poisons. Applied externally as a cool sponge, water absorbs heat from the body and thus reduces temperature. It is well to keep in mind that the blood vessels are nearer the surface at the inside of the thigh and the arms, the axilla and the back of the knees, and over the abdomen. Thus a greater reduction of temperature may be brought about by prolonged cool sponging over these areas. Also the bathing of the face and neck, or a cold compress over this area, adds much to the comfort of the fever patient.

Cold Mitten Friction

Too vigorous friction in the application or in drying the patient should not be employed. This will create a reaction and tend to increase the temperature. Even though as a rule there is not much danger that a patient with a high temperature will take cold, yet this must be guarded against. If there is a tendency to chill, the patient may be prepared for the cold sponge bath by a hot foot bath or a hot fomentation to the spine or the abdomen in order to bring the blood to the surface.

In some cases a hot sponge bath may be given. The hot sponge bath brings more blood to the surface of the body, and thus the temperature is reduced by radiation of heat. A hot sponge may be prolonged from twenty to forty minutes. During the treatment it is well to keep the body covered, exposing only the part to which the application is made at any one time.

Care should be taken by proper placing of towels to keep the bed from becoming wet. In treating very high temperatures, in cases in which it is difficult to control the fever and the patient does not chill, the water may be allowed to evaporate from the body. This tends to cool the body. A very useful measure to reduce temperature, especially in children, is the prolonged cool enema. This is best given with a Y tube, so that the water can run in and out and not overdistend the bowel.

In giving treatments it must always be borne in mind that we are dealing with a person as well as with a disease. As we do not all react to treatment in the same way, our hdyrotherapy treatment must be modified to meet the individual reaction and characteristics. This requires good judgment as well as skill. Do not neglect to seek the advice of your family physician in dealing with symptoms which you do not understand.