“The cold towel rub is applied thus: wring a towel as dry as possible out of very cold water, and spread it quickly and evenly over the surface; rub vigorously outside until the skin begins to feel warm; then remove, dry the moistened surface, rub until it glows, and make the same application to another part; and so on until the whole surface of the body has been gone over. The procedure should be rapid and vigorous.
“If the cold trunk pack is employed, a sheet of not more than one thickness should be wrung as dry as possible out of very cold water, and wrapped quickly about the body, after first dipping the hands in water, and rubbing the trunk vigorously. In cases of extreme cardiac weakness, very cold and very hot applications may be alternately applied over the region of the heart. The duration of the hot and cold applications should be about fifteen seconds each.
“Any one who has ever witnessed the marvelous effects of applications of this sort in reviving a flagging heart will never doubt their efficacy, and will have no occasion to resort to alcohol, or any other intoxicant, to stimulate a flagging heart. The writer has employed these measures for stimulating the heart for more than twenty years, and might cite hundreds of instances in which their efficiency has been demonstrated. They are applicable not only to the cardiac depression encountered in the adynamic stage of typhoid and other fevers, but in cases of heart failure from hemorrhage, of surgical shock, collapse under chloroform or ether, opium poisoning, coal gas asphyxia, drowning, etc.”—Dr. J. H. Kellogg, in Bulletin of the A. M. T. A., Jan., 1899.
Dr. N. S. Davis tells of a case of threatened collapse where he was called in consultation. Patient was in a small, unventilated room.
“It was easy to see that what she needed was fresh air in her lungs. Instead of giving alcohol in any form she was moved into a large, well-ventilated room. All symptoms of ‘heart failure’ disappeared. Had she begun to take whisky or brandy, physician and friends would have attributed her recovery to that, when in fact it would have retarded recovery by hindering oxygenation of the blood.”
“It would also be a very great mistake to suppose that when reaction follows collapse, in cases in which alcohol has been given, this result is always due to the alcohol. I have seen so many cases of severe collapse recover without alcohol that I cannot but be skeptical as to its necessity, and even as to its value. I was much struck many years ago by a case of post partum hemorrhage which was so severe that convulsions set in. I should then have given brandy if there had been any to give, but there was none in the house and none to be got. I administered teaspoonfuls of hot water and the patient revived and recovered; next day, except for anæmia, she was as well as ever, with no reactionary fever or other disturbance, as would almost certainly have been the case if brandy had been given.
“In collapse from hemorrhage, we have learned the value of injections of warm saline water, either into the veins, the skin or the rectum, and the same treatment is available in other cases of collapse with contracted vessels.
“Another measure which has proved most efficacious is the inhalation of oxygen gas. This is especially useful in cases in which alcohol is decidedly injurious, namely, those in which there is increasing congestion of the lungs, which the heart, though doing its utmost, is unable to overcome. Alcohol only increases the congestion, and the heart is already over-exerted and nearly exhausted. The effect of the oxygen is apparent in a few seconds, and cases have been rescued in which death appeared to be inevitable and imminent.”—Dr. Ridge.
Heart Stimulants:—“The advantage of beef extract over alcohol as a stimulant was demonstrated on a large scale in the Ashantee war.”—Dr. Ridge, London.
For those who must have a drug: aqua ammonia, 8 drops to ½ cup of hot water, or 20 grains carbonate ammonia to ½ cup water. Hot water alone is a useful stimulant; also water, hot or cold, with a few grains of Cayenne pepper added. The latter is good, not only to start the heart’s action in collapse, but also to relieve violent pain. Hot milk is a most valuable stimulant. Many persons to whom hot milk has been given during the extreme weakness of acute disease have testified afterward to its good effects in comparison with the wine formerly administered. The wine caused an after-feeling of chilliness and weakness, while the milk gave warmth and added strength.