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Someone has said, –If a procedure is capable of doing good, it is also capable of doing harm.” The hot water bottle is generally considered a simple home remedy, but precautions are necessary to make it safe and effective.

Patients who are paralyzed or unconscious have an impaired sense of temperature and cannot tell if a hot water bottle is too hot. Those who have cold extremities may likewise have some impairment to the circulation. Burns may result if caution is not exercised in the use of hot water.

Water at 115° to 125° F. can be poured into the hot water bottle making it 1/3 to 1/2 full. Air should be expelled by placing the bottle on one side, until the water reaches the neck. The top is then closed securely and the device checked for leaks. A flannel cover or towel is used to cover the hot water bottle. It should NEVER be used without some protective covering. Avoid placing heating devices in contact with patients who are unconscious or paralyzed, who have poor circulation or advanced diabetes. If used properly, hot water bottles can relieve pain, relax and warm a bedfast patient, and even prolong the effect of fomentations. Congestion is relieved and sleep assisted by the use of this simple home remedy.

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Four principal channels for the elimination of waste products are the lungs, the skin, the urinary tract, and the colon. In illness the elimination of toxic waste products is of primary importance to the healing process. In home care it is sometimes necessary to give an enema for colon cleansing or to stimulate bowel activity.

An enema can be given in several positions. For an extremely weak or sick person, it is best given in bed, with the patient lying on his left side. A salt solution is usually used with 1 teaspoon of salt to 1 pint of water. Tap water can also be effective, but soap suds solutions should be avoided, because of their irritation. In cases of colitis or unusual chronic inflammations of the bowel, a charcoal slurry solution can be made by stirring powdered activated charcoal into water. Then use only the cloudy solution, which results after the liquid has set for a couple of hours. This “slurry enema” will reduce inflammation locally, giving considerable relief.

After inserting the enema tube carefully into the rectum, using a lubricant to aid passage, the container is elevated and the solution allowed to run in slowly. By slowly distending the colon, a normal stimulus to defecation is induced. The height of the can above the bed and the degree of pinching of the tubing regulate the rate of the flow. If a person complains of a desire to expel the enema, stop the flow for a few seconds by clamping the tubing. A small volume of solution repeated is better than a large amount, because an over distended bowel loses the tone necessary for vigorous contraction.

The individual should then be placed on a bed pan or assisted to the commode. If your patient is very ill, he or she should be continually attended to until the evacuation is completed and he or she is comfortable again.

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It was Priessnitz of Austria who first advocated the use of cold compresses after injury. Applications of cold are now given not only to relieve minor injuries but also for anesthesia. In proper situations, applications of cold can be just as appropriate as the use of heat.

For a sprained wrist or ankle, ice packs, snow, or cold water should be applied at the earliest possible moment. Combined with elevation of the injured extremity, the application of cold will prevent swelling and lessen the black and blue discoloration which occurs when blood vessels are injured. Cold contracts these blood vessels and keeps blood from oozing into the torn tissues. If the injured extremity is kept elevated and bandaged with an elastic support, healing will usually take place rapidly.

Applications of heat should be avoided for the first day or two in sprains or bruises. If more blood is drawn to the part by heating, tissue swelling increases. Cold packs should be applied in this type of injury to slow down the circulation and overcome the reaction of the body. Cold also relieves pain. Any application of ice or snow, however, should be removed periodically, so that the body can maintain its ability to react to temperature changes.

Cold is employed by immersing the sprained ankle in ice water or cold tap water for 30 minutes out of every two hours. Do this for at least four to six treatments. If it is difficult to put the sprained limb into cold water an ice bag or ice pack may be applied while the limb is kept elevated. Since an ice bag cannot cover the joint entirely, try preparing the pack as follows:

First, protect the bed or furniture with a piece of rubber sheeting or oiled silk. Then lay down a piece of plastic, such as a section of shower curtain, large enough to wrap the joint. Cover this with a one inch layer of thick towels. Then wrap the joint in a light flannel strip or bandage. Finely crushed ice or snow is then packed around the joint, not directly contacting the skin. A layer of toweling is then wrapped around the joint and pinned into place, finally surrounded with the plastic. This application can be removed after 30 minutes and reapplied every two hours, until the pain and swelling has abated. Between treatments it is helpful to give support by elastic bandaging. Avoid weight bearing, It may be painful.

Movement of the affected joint should begin as early as possible to prevent stiffness. Similar ice packs may also be used in cases of acute joint inflammation, in gout, in rheumatoid arthritis, and in acute bursitis. Burns of the skin should always be treated by immediate cooling with ice or cold water. Often, the extent of a burn can be reduced by this emergency first-aid measure.

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Fevers involving babies and small children respond particularly well to the wet sheet pack. Use it early in the course of an infection before high fever, chest congestion, or vomiting develops. This simple remedy may avoid the necessity for many emergency medical consultations and antibiotic prescriptions.

Before giving the wet sheet pack, however, it is often well to assure complete elimination with an enema. As a preheating measure, give a full hot bath to draw blood to the skin and lessen congestion. Immediately after the hot bath, your child may be placed in the wet sheet pack and wrapped up quickly. This is comfortable and well tolerated, even with a small child.

Several stages of response occur as time progresses. The first stage is one of cooling. To enhance this effect, before the sheet has been warmed to body temperature, the blanket may be folded back and cold water sprinkled on the patient over the sheet. He or she may be fanned then to hasten evaporation and thereby lower the temperature.

The second or neutral stage begins when the temperature of the pack reaches or slightly exceeds that of the skin (about 94° F.). This stage may be prolonged by removing some of the dry coverings after the warming has well begun. The neutral stage has a marked sedative effect, inducing relaxation and sleep. It is especially helpful for those in danger of convulsions or excited and nervous patients.

The third stage of heating begins when the skin temperature rises slightly, and ends with the beginning of a general perspiration. Tonic and heating effects may be prolonged by applying cold water to the head and neck continuously. This helps to check excessive sweating. For a tonic effect, this stage should be continued about twenty minutes.

A fourth stage, of sweating, develops as the pores open and the body attempts to cool itself. Sweating may be increased by applying hot water bottles or fomentations within the folds of the dry blanket. Drinking hot sugar—free lemonade or hot water can promote your elimination of impurities through opening skin pores. Cold compresses on the forehead should not be very cold or renewed too frequently. This eliminating stage is salutary for delirious fevers, alcoholism, infantile convulsions, and many other common ailments. When the subject falls asleep, the pack gradually returns to a neutral stage, going through other stages as it cools.

In giving a wet sheet pack properly, it is important that the wet sheet come in close contact with the skin at all points. A dry blanket applied over the patient must prevent entrance of air or chilling may result. Warming up begins immediately. During the entire treatment the feet should be kept warm. Administer only water—or clear fluids if pack extends through mealtime. The attendance of a sympathetic, interested therapist helps to allay fear and secure cooperation. With these few suggestions, a wet sheet pack will find increasing use in the treatment of infectious illnesses of obscure origin.

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Colds, coughs, and influenza are particularly common during the colder seasons of each year. Significantly, a definite relationship has been found between a person’s resistance to colds and the temperature of his skin, especially the upper chest and back. If your skin does not warm up rapidly after being chilled, the temperature of mucous membranes in the respiratory tract is also lowered. When this occurs, the resistance of these membranes to nose and throat infection is diminished. Congestion follows, and there is a feeling of stuffiness and excessive drainage. In cases of bronchitis or pneumonia, there follows a harsh cough, which becomes deep and raspy, as the sputum loosens.

The steam inhalation is an excellent agent to supply warm, moist air over the congested mucous membranes. A vaporizer which heats water electrically can generate steam most effectively. Care must be taken not to burn the sick person with such a device. However, it most effectively increases the humidity. Water may also be boiled in the kitchen, on a hot plate or a wood stove, to increase the ambient humidity. This is especially important in northern winters, when central heating dries out the air, drying out the skin and also the mucous membranes. When a vaporizer is used, oil of eucalyptus or tincture of benzoin (from a pharmacy) may be added to increase the potency of steam on mucous membranes.

A simple tent can be constructed, using an umbrella over the bed, with a sheet to cover it. Steam may be directed into this tent, increasing its effectiveness.

Precautions must be taken to avoid ALL risk of burning. Drafts in the sick room should also be avoided. Particular care must be given in treating children, so that accidents are prevented.

The steam inhalation or vaporizer effectively relieves cough and inflammation of the mucous membranes in the nose, throat, and larynx. It helps as well in throat irritation and draining sinuses.

People who suffer from acute asthma usually do better using a cool mist humidifier. This device delivers a fine spray into the room, thereby increasing the humidity. It is not used with medication, as a rule, but helps in cases of wheezing or severe allergies. Newer types employ ultrasonic principles (sound waves) to create a fine mist. They are helpful devices, but need careful adjustment to prevent such excessive humidity that will literally take off the wallpaper. Clean these appliances carefully between use to prevent mold or mildew accumulation. Many asthmatic patients are allergic to the spores.

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