The Mother and Her Child

by William S. Sadler; Lena K. Sadler

BATHS USED TO REDUCE FEVER

1. The Sponge Bath. The child, completely undressed but loosely wrapped in a wool blanket, is placed on a table so that the mother or a nurse may conveniently stand while administering the bath. Close at hand have a number of soft linen towels and a large bowl of tepid water which may or may not contain a small amount of alcohol, witch-hazel, salt, or vinegar, according to the doctor's directions. The upper portion of the body is partially uncovered and the tepid water is applied with the hands to the skin surface of one arm. The hands may be dipped in water from one to four times, thus making repeated applications of the water to the arm. These are followed by careful drying—patting rather than rubbing. The other arm is now taken, then the chest, then the back and last the legs.

2. The Wet-Sheet Pack. Two light-weight wool blankets are folded to fit the child; they should extend eighteen inches below the feet and should be wide enough to lap well in front. A sheet just large enough to envelop the body is then wrung out of cold water and spread out over the woolen blankets. The feverish child is entirely disrobed and is placed on the wet sheet, which is quickly wrapped about the body, over the chest, under the arms, and between the legs—coming in contact with the entire skin surface. The dry blankets are quickly brought around and tucked snugly about the patient. This is a cooling wet-sheet pack and will often so relieve the nervousness and irritability of a feverish child that he will go to sleep in the pack. In the very young child, under two years, it is important to put some accessory warmth to the feet such as a warm-water bottle—not hot. The effect of this pack is very quieting, and is indicated when the temperature of the child reaches 103 F. or more.

3. The Graduated Bath. This is usually administered in a large bathtub and is beneficial in the fevers of the older children. The temperature of the water should be one or two degrees higher than the body temperature, for example—if the child's temperature is 103 F. then the bath starts out with a temperature of 104 or 105 F. The temperature is then gradually lowered, about a degree every two minutes, until it reaches 92 or 90 F. A helper should support the head while the mother or nurse briskly rubs the entire skin surface of the body. This friction greatly facilitates the fever-reducing work of the bath because it brings the blood to the surface where it is more readily cooled by the bath. This bath should last ten or fifteen minutes.

4. The Hot Sponge Bath. Often, in combating the high fever of typhoid, the hot sponge bath is valuable. The hands are dipped in water just as hot as can be borne and are applied to the chilly, mottled skin which is so often seen in high fever. This bath is administered just as is the tepid sponge bath. Evaporation is allowed to take place to some extent by delaying the drying. In this instance the child should be wrapped in a warm wool blanket with only a portion of the body exposed at one time.

5. The Hot-Blanket Pack. The hot-blanket pack is indicated at the onset of many fevers such as in typhoid, grippe, pneumonia, etc. Like the wet-sheet pack, the blankets are spread upon the bed, abundant accessory heat is applied—such as a half-dozen hot-water bottles. In the absence of these, glass jars or hot ears of corn may be utilized. Hot bricks or hot stove lids wrapped in paper are also serviceable. A blanket, in size to suit the individual (an adult would use a full single blanket, a child one-half of a single blanket), is wrung very dry from boiling water. This may be done by the means of a wash wringer, or two persons grasping the blanket by its gathered ends may so twist it that it looks very much like an old-fashioned twisted doughnut. The twist is now lowered into boiling water, and as each pulls the twist wrings itself. This is at once quickly spread out so as to let the child lay on the center, and then the hot sides are brought in contact with the skin, just as in the wet-sheet pack. The dry blankets are now brought quickly and snugly about the child. Just outside the second dry blanket the accessory heat is placed to the sides of the trunk, the sides of the thighs, and one at the feet. A wrapped stove lid or a hot-water bottle is placed over the pelvis and one under the back. Cold cloths are put on the face and around the neck, and these should be changed every three minutes. This pack continues for fifteen or twenty minutes, at the end of which time the accessory heat and the wet blanket are removed and the patient is cooled off by a cold mitten friction, a saline rub, a witch-hazel rub, or an alcohol rub; or the patient may be placed in a tub of water, temperature 98 F., after which he should be carefully dried off.

6. Sweating Baths. Another bath which is effectual at the onset of grippe or pneumonia is the sweating bath. The bowels should have moved some time before the treatment. Have ready a large bowl of ice water, two turkish towels, one sheet, and four wool blankets. The bathtub is now filled with water at the temperature of 100 F.; which is quickly raised up to 103 or 104 F. Ice-water towels are applied to the head, neck and heart. The patient remains in this bath for about ten minutes, after which he steps out and at once gets into the four hot, dry blankets previously spread out on the bed. No time is lost, the patient is quickly wrapped in the hot blankets and sweating continues for twenty minutes. The covering is now loosened and gradual cooling takes place. It is well to go to bed at once.