Fomentations and Their Use by A. B. Olsen

Review and Herald Publishing Association · Takoma Park Station, Washington, D. C. · May 5, 1910

Fomentations and Their Use

By A. B. Olsen

A. B. OLSEN, M. D.

ONE of the most simple means of applying moist heat to the body is the fomentation. The ease with which it can be prepared and administered makes it a universal remedy, and it may be also accurately described as a panacea for pain. The fomentation consists merely of a cloth, preferably woolen, wrung out of hot water.

The Fomentation Cloth

A good way to prepare fomentation cloths is to take a large woolen blanket and quarter it; this makes four excellent fomentation cloths, and every home ought to be provided with such a set. Or one can buy thick flannel about a yard and a half wide, and six yards would be sufficient for four cloths. The square size is the most useful.

After fomentation cloths have been used, they ought to be rinsed out in tepid water, using sufficient soap to cleanse them thoroughly. After drying they are ready for use at some future time.

Preparing the Fomentations

Besides the cloths it is necessary to have a pail of very hot or boiling water.

The cloth is folded according to the size suitable for the application. Then both ends of the cloth are twisted in opposite directions. The cloth should be twisted as tightly as possible, after which it is dipped into the pail of hot water, and by crossing the hands the twist is loosened sufficiently to admit of the cloth's being thoroughly soaked with the water. Care is taken to moisten the middle half or two thirds of the fomentation, the ends being kept quite dry. The cloth is twisted still more if possible, and the right hand is drawn up, the left hand resting upon the edge of the pail, so that the water which is wrung out will fall into the pail, and not onto the floor. By a little practise sufficient skill is acquired to enable one to wring out a fomentation cloth without as much as wetting the hands, to say nothing about burning them, or wetting the floor. The cloth is now ready for application.

Preparation of the Patient

Before wringing out the cloth it is necessary to get the patient in readiness for the treatment. As a rule, it is best to have the patient lying down in bed or on a couch; the part that is to be treated should be laid bare, and if it is the chest, abdomen, or back, it is best to have the patient entirely undressed and lying between warm blankets. The room should be well ventilated with plenty of fresh air, but the patient should not be exposed to drafts. Only that part of the body that is to be treated should be exposed, and that only for a moment, while applying the hot cloth. It is a good precaution to have a cold compress applied to the head, but it is not always necessary. If the feet are cold, put in a hot brick or a hot-water bottle.

Applying the Fomentation Cloth

When all is in readiness, a dry fomentation cloth is placed over the part that is to be treated, say the chest, and then the hot cloth, which has been sufficiently wrung to make it almost dry, is placed over the single layer of dry fomentation cloth which covers the patient; the ends are turned back over the middle or moist part of the fomentation cloth, and then the free borders of the dry cloth are folded over the fomentation. This is done for the purpose of retaining the heat. The fomentation cloth may be left on from four to six minutes, after which it is necessary to wring out another cloth from the hot water, and substitute it for the first one. The substitution should be made promptly, so that the treatment will be practically continuous. Two, three, or four fomentations, to be left on about five minutes each, should be utilized, or even a larger number, but the usual number is three, which will require about fifteen minutes.

The After-Treatment

Before removing the last fomentation, get ready a basin of cold water, with a sponge or a piece of Turkish toweling which can be used as a wash-cloth, and have a dry towel in readiness. On removing the fomentation, bathe the surface quickly with the cold water, taking the necessary precaution to avoid getting the water over other parts of the body or on the bedding; then spread over the dry towel, and press the towel on the skin, without friction, so as to dry without injuring the tender skin. The application of the cold water is both refreshing and necessary, for it helps to close the pores of the skin, and thus prevents taking cold. The patient is then covered and left to rest for a while, or, if it is in the evening, to go to sleep.

Temperature of the Water

The fomentation cloth that is merely very warm is of little account. To be effectual it must be decidedly hot. If the precaution mentioned above is taken, and if the fomentation is wrung thoroughly, so that it is almost dry, there will be no danger of burning, even if it is wrung out of water that is boiling. It is the moist, soggy fomentation cloth that is dangerous and most liable to cause a blister or a burn. As the skin is most sensitive at first, it is better that the first fomentation cloth applied should not be quite so hot as the succeeding ones. After the treatment there should be a distinct scarlet glow over the area which has been fomented.

When to Use the Fomentation

It would be impossible in a brief article like this to indicate all the uses to which the fomentation may be put, but we will attempt to mention a few of the most common cases when its use would be advantageous. Generally speaking, the various forms of neuralgia and inflammation are greatly benefited by the fomentation cloth. The same is true of most rheumatic and gouty aches and pains. Stomach-ache and various pains in the abdomen that are associated with indigestion are almost invariably relieved by fomenting. Many injuries and almost all bruises, sprains, etc., are often best treated with the fomentation cloth.

Sore Throat and Laryngitis

The fomentation cloth makes an excellent treatment for the common sore throat that is so often associated with colds in the head, as well as for laryngitis. The cloth is wrung out of hot water as previously described, and wrapped around the throat, and after four or five minutes is replaced by a second, which is followed by a third. After bathing the part with cold water, it is a good thing to apply a cold compress, which is done as follows: Take a suitable linen towel, and fold it so that it is about two or three inches wide, and after wringing it thoroughly out of cold water, wrap it snugly round the neck, fastening it with safety-pins; then apply

two or three layers of flannel, so that the flannel overlaps the moist cloth above and below, to prevent taking cold. The flannel is also carefully fastened with safety-pins. This cold compress may be worn during the night. On removing it in the morning, bathe the neck with cold water, and then dry well.

Toothache and Earache

The intense pain of both earache and toothache can often be ameliorated by the application of a large fomentation cloth to the affected side of the head. In giving this treatment it is necessary to have the patient lying down, and to see that the fomentation cloth is hot. If a dry layer is introduced between the skin and the fomentation cloth, there will be little or no fear of burning. After such a treatment great care must be taken to prevent exposure to the cold or draft, which might aggravate the pain.

Bronchitis and Pleurisy

Simple bronchitis or pleurisy, accompanied by much pain, is greatly relieved by the use of large, broad fomentations applied to the chest, but such treatments should only be given on the advice and with the consent of the attending physician. Great care must be taken in giving the treatments not to chill the patient, and thus aggravate the disease.

Indigestion and Torpid Liver

Various digestive disorders that are due to a dilated stomach or torpid liver can be relieved by applying the fomentation cloth to the abdomen. In treating the stomach, the fomentations should be carried well over the left side of the abdomen, and reach as high as the nipple. The fomentation to the liver should be laid across the abdomen, just reaching to the nipple line, and should extend to the spine. To secure this, it is well to have the patient lying on his left side. Follow the directions given above when applying the fomentation cloths.

Backache

Many suffer more or less from backache, usually in the small of the back, sometimes at the base of the spine, and sometimes elsewhere. This aggravating, dull pain is frequently relieved by the use of a suitable fomentation. Narrow fomentations extending the whole length of the spine, from the neck to the coccyx, are most serviceable; at other times a broad fomentation cloth laid transversely across the hips, and extending a few inches above the waist line, gives greatest relief.

Constipation and Pelvic Inflammation

The common ailment, constipation, is almost always relieved more or less by the use of fomentations daily for a fortnight, or even longer. Large fomentations covering practically the whole of the abdomen and pelvic cavity are most efficacious in treating constipation.

To relieve pelvic inflammation, fomentations should be applied immediately below the navel, reaching well over the pelvic bones. To give even a greater effect, the fomentations may be wrapped round the hips from both sides.

Sprains and Other Injuries

In treating a sprain of the ankles, the fomentation cloth should be sufficiently large to cover the whole foot, and it should be wrapped around the ankle snugly. The patient may be lying down on the couch, or sitting in a chair with the limb resting on another chair. A wrench or twist of the knee may cause great pain, which can be quickly relieved by a hot cloth. Wrap the fomentation around the knee; do not simply place it in front of the knee. Muscular strain sometimes causes pain or annoyance; apply fomentations to the affected part, repeating them every day until the pain has disappeared.

The finger may be crushed, or the hand injured to a greater or less extent. Place the hand in a basin of hot water, or, if preferred, wrap it in a hot fomentation cloth. The relief found is almost instantaneous, and the hot treatment acts most beneficially in producing a cure. If the raw surface is exposed, it ought to be covered with a sterilized towel which has been soaked in some mild disinfectant, such as boric acid solution. It must be borne in mind that the raw surface will not stand so much heat as the unbroken skin.

Caterham, England.