XIII.—The Packing Sheet, and Sweating Process.
Take all the coverings off the bed, arrange the pillows, cover over the bed and pillows with a large thick blanket, then put a small sheet into a pail of fresh cold water; if to reduce fever, let it be wrung out less; if there is no fever, more; the drier the sheet, the sooner the re-action; spread this sheet so wrung out, on the blanket.
The patient extends himself, divested of every thing, upon the sheet, which should be brought over him as soon as possible. The blanket is now brought over the sheet, and the attendant tucks it in, beginning with the neck, as tightly as possible, so that his patient can hardly move hand or foot. Other blankets are then added, separately tucked in, and turned up at the feet. Half-a-dozen blankets are not too many; and to produce immediate heat, a feather bed is superadded, leaving the head free. It is astonishing what an amount of covering one may support without inconvenience.
The great object is so to envelop the body as to exclude the air, and prevent evaporation, in order that its own heat may be concentrated upon itself.
In ordinary cases, the sheet is well wrung out, and covered up as before stated; but in cases of severe fever, the wet is only covered with a single dry one. In cases of very great delicacy, but not in fever, the sheet is put into tepid water instead of cold.
This has by some been called a general poultice, as it performs upon the whole body what a poultice or the bandages effect upon members of it. Dr. Alexander of Newcastle terms it a linen bath.
That wet linen should produce good and evil results appears paradoxical. Damp beds are said to lead to injurious consequences, whilst wet linen applied as a covering to the whole or parts of the body, produces the most happy effects.
Accustomed as Priessnitz is to witnessing none but the best results from the application of damp linen, he could not be persuaded that mischief arose even from lying in damp beds.
In the Hydropathic practice the body is so hermetically enclosed in the wet sheet, that not a particle of heat can escape or external air penetrate, by which means the exhalation is concentrated upon the body; this may be termed a linen bath or fomentation.
In the case of people being accidentally put into a damp bed, none of the above precautions are taken; there is no extra clothing, no binding about the neck to prevent the escape of caloric, and therefore to these causes must be attributed the mischief, if any ensue.
It is, however, a question, where mischief follows, whether one-twentieth part of the cases can be fairly attributed to the damp beds. It is highly probable that Priessnitz’s surmise of its being the development of a disease lurking in the system which under the Water-cure might easily be met, is correct.
Wet sheets are resorted to in all fevers, and changed until the paroxysm is abated. In Typhus, the sheet is changed every ten minutes, and as often as forty or fifty times in a day.
As a general rule, Mr. Priessnitz told me, if unwell, without waiting to know the ailment—to take a packing-sheet, until warm, twice a day, followed by a tepid bath.
Packing-sheets may be persevered in for years in obstinate cases. The usual time employed in their application is until the body is warm, which will be from twenty-five to forty minutes. It is a great mistake to suppose the application of the sheet is to produce perspiration. If a genial heat pervades the body, it is all that is required, unless under peculiar circumstances, previous to immersion in either tepid or cold water.
The following anecdote, told me by Major Beavan, is adduced as corroborative evidence in favour of the use of wet linen to lower the temperature of the body. In 1821, the Major having to pass through extensive jungles to join his regiment in the East Indies, a distance of nearly 300 miles, caught a fever. When at the highest stage of the hot fit, it occurred to him that he might cool himself as they did wine and other liquids in that climate. He accordingly had himself wrapped up in a wet sheet for a quarter of an hour, when, finding himself relieved, he added a number of coverings, and fell into a most refreshing sleep of some hours. On awaking, he found mind, body, and appetite restored, all of which had been prostrated to an extreme degree for several days.
The packing-sheet is the greatest sedative known. It generally occurs that persons who, from pain or nervous excitement, have not slept for nights, doze off immediately on being enveloped in the wet sheet.
The packing-sheet brings morbific matter to the surface, and thereby relieves the capillaries. The ablution which follows acts as a tonic.
The relief afforded to the overcharged system through the pores, by the application of the packing-sheet, may be compared to the emptying of a bason with a sponge; each sheet absorbing a certain amount of morbific matter and superfluous animal heat, until the body is relieved.
In fevers generally, the fœtid odour of the sheet when withdrawn, is hardly to be endured; and in eruptive fevers, the inclination to scratch the body is allayed, and very little inconvenient sensation is felt either night or day.
In the morning, when fever is most felt, wet sheets and tepid baths allay it; and in the afternoon, any return of it is again subdued as before. The discovery of the wet sheet alone is sufficient to render the name of Priessnitz immortal.
But when, by these means, it would be difficult to produce perspiration, recourse is previously had to a dripping or rubbing-sheet, and then the patient is packed up; or the blanket is warmed before a fire, before the body is enveloped in it.
The sweating process, when used, is always succeeded by a tepid or cold bath, or a dripping-sheet: if a tepid bath, cold water is afterwards poured over the head and shoulders; but if a dripping-sheet, it is repeated until the body is cooled.
Every day’s practice at Gräfenberg, and elsewhere, shews that no danger attends going into cold water in a heated state.
But Mr. Priessnitz, whether from having a different class of patients, or from the difficulty of getting servants to understand when the patient had perspired enough, or the conviction that the same or better results attend the packing sheet, we know not, has changed his practice, and no longer resorts so frequently to the sweating process. The following extract is from a letter received by the author from a gentleman who has been a long time at Gräfenberg.
“The object of all Hydropathic appliances may be shortly and intelligibly defined, as assisting Nature to regain that ascendancy by which she of her own accord will throw off what is offensive to her. The practitioner ought therefore to strengthen her in every possible way; and we have the latest discoveries of science as a guarantee that the present (the packing or wet-sheet process) method of carrying out the cure effectuates this end more completely than any other; what therefore is opposed to that, is so much drawn from the strength which it is the object to promote, and inasmuch as sweating, however it may tend to alleviate, undoubtedly weakens, it is a counteracting agency.
“Priessnitz is reaping the benefit of twenty years’ experience. He follows still as he always followed (as far as it was possible for him to read and understand) the mysteries of his great mistress, Nature. Chance, I imagine, has in no way guided his choice; it may have assisted him in interpreting some of the revelations of this great spirit, but he has always had the same unerring basis on which to establish his system. Through imperfect light he may have sweated for a time, but the still small voice of truth has never ceased to whisper in his ear, and it is highly conducive to his honour that he should now have the courage to say that in this point he erred. He does this at the risk of reputation and fortune; he subjects himself to the abuse of high and low; but he acts up to his conviction, which is that the packing sheet, if to be persevered in, is better than the sweating process.”
Though, however, the sweating process is not now so general, it is not entirely abandoned. A lady, a friend of mine, had a cold—she was ordered to sweat lightly twice a day, for two or three days. A gentleman had a swelling in his mouth; he was ordered the same. Others are ordered to sweat once or twice a-week, but the greater part of Priessnitz’ patients never sweat at all.
Priessnitz guards people against the use of hot-air and vapour baths; they weaken and relax the skin. The difference between bringing a great amount of heat to act upon the surface, and causing the body to develop its own heat, must be obvious to every one.