If no rash appear during the first pack, which will scarcely fail, the proceeding should be repeated, and the patient stay longer in the pack than the first time. In very bad cases, when the patient fails at once under the action of the poison (malignant scarlet-fever) iced water or snow may be resorted too. I know several instances of patients, having been given up by their physicians, reviving again under the influence of a snow-bath, which produced a healthy reaction, when nothing else was of avail. I have never had occasion myself to resort to such extremes, cold water having always answered my purposes; but I would not hesitate a minute to use snow and ice in a case where I could think it useful and necessary. Such proceedings look cruel; but it is decidedly more cruel to let the patient's life be destroyed from want of timely assistance. I distinctly remember a case, which occurred in Cassel, when the physician objected to "tormenting the poor boy," and wanted the father to "let him die in peace." But the father,[33] who had some knowledge of, and a great deal of confidence in hydriatics, put the little patient, a boy of 8 or 9 years, into a bathing-tub filled for the greater part with snow, covered him over with the cold material, and left him there till he became conscious; then he was rubbed all over, placed in a dry pack (without a sheet), and left to perspire, which ensued and brought out the rash. The patient was out of danger in four hours' time, and Dr. S., on calling again in the evening, was quite astounded at seeing him alive, out of bed, and covered with a tolerably bright eruption.
85. WINE AND WATER, IF NO REACTION CAN BE OBTAINED.
Should the patient remain cold in his pack for longer than an hour,—a case, which will seldom occur,—a little wine and water may be given him to assist the organism in producing a reaction; and, in case of need, the dose may be repeated once or twice in intervals of half an hour. The quantity should be adapted to the age and constitution of the patient, and by no means sufficient to affect the head. Instead of water, it may also be mixed with warm broth or tea, or hot water and sugar, to make it agreeable to the little patient.
86. ABLUTIONS AND RUBBING WITH ICED WATER OR SNOW.
In a few very obstinate cases, when no rash would appear after two or three long packs, I have succeeded by washing the patient with ice-water or snow, rubbing him dry with my bare hands, and then packing him in a dry blanket. After staying there for several hours, more or less eruption always appeared.
87. WET COMPRESS.
The wet compress on the throat in torpid cases should not be changed often, but left till it becomes almost dry. Should the feet of the patient be cold, a bottle filled with hot water and wrapped in a piece of blanket or a sheet should be placed near them, either within the pack, or out of it, when the patient is lying in bed. The feet should always be kept warm.