IMPORTANT GENERAL ADVICE.
For use in packs take coarse, previously used and loosely woven linen, which readily absorbs water and clings closely to the body.
After each pack the linen must be rinsed well and boiled and the woollen material or blanket must be thoroughly aired. From time to time the woollen covering must be washed, or chemically cleaned, if possible.
Raw silk is an excellent substitute for linen. It clings well to the body, does not cause any discomfort, and has an excellent absorbing quality for water and other substances.
The proper application of the pack is of course of great importance. Adults can easily apply many of the packs without assistance, but generally speaking a third person is necessary, whether in the case of children or patients. It is consequently advisable for every mother to become thoroughly familiar with the methods of applying packs, and she should always have the necessary material on hand. It should be cut to the proper size, and there should be duplicates of each piece for the necessary changes. The approximate measurements for adults are:
| Width | Length | |
| Neck pack | 5" | 40" to 60" |
| Shoulder pack | 10" | 40" |
| Abdominal pack | 28" | 40" to 60" |
| Breast or stomach pack | 16" | 52" to 60" |
| "T" pack | 16" | 52" to 60" |
| Cross piece alone | 5" | 24" |
| The shawl | 32" to 40" | 32" to 40" |
| Scotch pack (undivided) | 16" | 80" to 100" |
| Same for children | 10" to 16" | 60" to 80" |
| Calf pack | 24" | 26" |
| Leg pack | 24" | 30" |
| Three-quarter pack | 56" | 52" to 60" |
| Whole pack | 68" | 80" |
| The measurements for children are accordingly shorter and narrower. | ||
As to the application of packs, a mother can learn a great deal by experimenting on her own body. Packs at night are by no means detrimental to adults, and the application of a regular abdominal pack, a three-quarter pack, and a whole pack once a week or once every two weeks is decidedly advantageous. Three-quarter and whole packs should be occasionally tried on the body of children with dry linen so that in case of disease the mother will be a well trained nurse, at least in this respect.
To go about the application of the pack quietly and without much talking is very comforting to the patient, who usually grows excited during the procedure.
In case of acute feverish disease the packs and the changes must be applied very quickly, so that the patient will not catch cold. While, as a rule, the patient should not be disturbed in a quiet sleep, unconsciousness or delirium must not prevent change of the pack.
Packs should be applied so as not to cause any creases which may hurt the patient.
The temperature of the water used for packs should be as follows:
For the cooling packs, 59 degrees to 64 degrees.
For dissolving packs, 64 degrees to 71 degrees.
The higher temperature is used in the treatment of infants, nervous and anaemic persons.
In chronic diseases a gradual return to a lower temperature by about 2½ degrees per week is advisable.
No packs or compresses should be put on when parts of the body are cold. In such cases the parts in question must first be warmed.
The linen should be wrung out less for short cooling compresses than for dissolving packs of longer duration.
Cooling compresses must be changed as soon as the patient indicates that he feels oppressed or irritated by the heat.
As a general rule, packs on the legs may be left on feverish patients twice as long as packs on the upper parts of the body.
No fever being apparent, the abdominal pack may be changed after about 2½ hours, the leg pack after 5 hours, and even not at all during the night. Packs should be renewed according to requirements of the individual patient, not in accordance with fixed rules.
Great care must be exercised to fasten the packs well and tightly. This is usually done with good strong safety pins; these should be fastened perpendicularly, or at right angles to the length of the material.
When changing the pack on feverish patients who are to receive an ablution or a bath two or three times a day, all pins must be loosened under the bedcovers so that the pack may be removed quickly.
If ablutions only are to be given, the pack is removed gradually as the respective parts of the body are to be washed.
When the fever is moderate, there should be ablutions morning and evening, or a bath in the morning and an ablution in the evening.
When packs are applied only at night, patients require only an ablution in the morning.
If the packs are not renewed, an ablution must follow the removal. This refreshes and strengthens the skin, closes the wide open pores and prevents taking cold.
Dissolving packs, if annoying at night, may be removed under the bedcovers without an ablution.
If the pack is changed without intervening ablution, the new pack must be ready to be applied before the old, hot one, is taken off.
While in a pack, the patient should not leave his bed, not even for the purpose of urinating or for stool.
GENERAL RULES.
The following general rules must be applied in connection with the directions given anon for packs during different diseases.
In case of inflammation, the inflamed spot is cooled off by local compresses, and diverting packs of longer duration are applied on other parts of the body.
For instance, in case of inflammation of the brain or tonsils.
The first step is to cool off the blood which flows to the neck and head by short-time compresses on the neck and on the cervix. At the same time an attempt must be made to divert it through lengthier packs on the abdomen, the legs and the wrists, thereby to prevent a further delivery of diseased matter to the centre of inflammation. The solution and excretion of diseased matter from other points than the inflamed spots will thereby be effected, and these will be unburdened and calmed accordingly.
In case of inflammation of the organs of the breast (lungs, heart), the blood is diverted to the abdomen, legs and lower arms through long-time packs, and the upper parts of the breast are cooled with short compresses.
If the inflammation has its seat in the abdomen, this must be cooled off, while the diversion with longer-time packs is made to the legs and arms.
Ulcers are treated by applying extremely hot compresses, which are frequently changed, and the surrounding parts are cooled off and diversion is effected through nightly packs on the abdomen and on the legs. The hot compresses dissolve the diseased matter, so that the ulcer opens. Thereupon cool compresses of 71 degrees to 64 degrees are applied and allowed to remain for 2½ to 3 hours, which will effect quick healing without the necessity of an operation.
The main rule is never to divert towards a vital organ of the body, such as the lungs or heart; thus, in case of inflammation of the head, diversion must be attempted, not to the breast, but to the arms and legs.