—Cold, like heat, may be used either dry or moist. Bags of rubber or of Japanese paper filled with small pieces of ice are used to apply dry cold. When weight is to be avoided, the bag should not be completely filled. After the bag has been filled and the air has been expelled,
it should be stoppered securely and wrapped in a towel or piece of flannel, since it is possible for an uncovered ice bag to freeze the skin. Ice bags are easily punctured, and care should be taken not to bring pressure upon them especially when filled with sharp pieces of ice. An ice bag not in use should be thoroughly dry inside and out; it should be put away with enough absorbent cotton inside to keep the surfaces from adhering. Bags of Japanese paper are less costly than rubber, but less durable. To close them one should roll the top over and then tie it tightly with string.
Moist Cold.
—Cold compresses for the head are often used for patients with fever or headache; they sometimes quiet a patient who is restless. An old handkerchief or piece of soft linen folded with the raw edges inside may be used as a compress. It should be large enough to cover the forehead. Two compresses at least should be provided, and a large piece of ice in a basin. One compress should be wrung so that it will not drip, and then applied to the head. The other meanwhile should be placed on the ice to cool. As soon as the first compress becomes warm, the second should be applied in its place.
Cold Compresses for the Eyes.—Soft material should be selected for eye compresses. Each one should be cut only a little larger than the eye and
should fit neatly over it. Several compresses should be placed on a block of ice while one is applied to the eye, and every few minutes the compress should be changed. If there is discharge from the eye, each compress should be used but once; when used, they should be collected in a paper and afterward burned. Separate compresses should be used if both eyes are being treated. Definite directions in regard to changing compresses and the length of time the applications should be continued are generally given by the physician.
COUNTER-IRRITANTS
To some extent all hot applications are counter-irritants, but mustard pastes, mustard leaves, and the mustard foot-bath already described are the counter-irritants most commonly used.
Mustard Paste.—To make a mustard paste, mix dry mustard with flour, using for adults one part of mustard and six of flour to make a weak paste; increase the proportion of mustard up to equal parts of mustard and flour, according to the strength required. Use a smaller proportion of mustard for children; one part of mustard with from 6 to 10 parts of flour is generally enough. Add to the mustard and flour enough tepid water to make a paste, which must be absolutely free from lumps. Do not use hot water for this
purpose, because it destroys some of the active properties of the mustard. Spread the paste on thin muslin, apply it to the skin, and remove it as soon as the skin is reddened so that its color resembles that of a strong sun-burn. If the skin is especially sensitive, mix a little sweet oil or vaseline with the paste.