Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

There are certain standbys of simple remedies that every person who uses them for the treatment of common ailments should know. The fomentation is such a standard treatment.

A fomentation means simply the application of a compress such as a folded towel, which has been squeezed from hot water or made hot by steaming. The simplest possible use of a fomentation is merely folding a towel to make a square, dipping it in hot water, squeezing it nearly dry, and laying it on the chest for a cough or on the abdomen for indigestion. Change the compress every 2 minutes to keep it hot. The effectiveness of the heat can be greatly increased by simply making every fourth compress a brief (45 seconds) cold compress made by squeezing a bath towel from ice water. Continue the alternation of heat and cold for 10-30 minutes. When the patient begins sweating, put a cold cloth to the forehead and sponge the face every minute or two.

I prefer using the steaming method, however, as it is easier; still, it does require some rudimentary, but generally available, equipment. A large canner, which can be purchased from a hardware store is the main item required.

Fold the canning rack together, and turn it upside down. Put approximately 2 inches of water in the bottom of the canner, but it should not come up high enough that when the water is boiled it will splash up on the fomentation cloths. The fomentation cloths may be prepared from thick laundry flannel folded over to 3 thicknesses, making a pad approximately 1/2 to 1 inch in thickness, or, in a pinch, a towel may be folded. A piece of thick wool flannel may also be folded 3 times with a large Turkish towel folded into the center and fixed together with a quilting stitch so that the towel will not slip: this will make a very functional fomentation pad. Four pads will be needed. Sprinkle the pads with water to dampen the fabric about as one would dampen clothes for ironing. Fold the fomentation pads fairly loosely and stand on end in the canner on top of the rack. Place the lid on the canner and bring to a boil for about 20 minutes before removing the first fomentation pad. A fomentation cover can be made of a piece of synthetic blanket about 30 x 36 inches wide. Remove the hot, sprinkled, and steamed fomentation pad, open it out on the fomentation cover and quickly fold over the fomentation cover to make a nice pad. This fomentation can be placed on the abdomen, chest, around a thigh, across the back, or used in any way to bring heat to an area. It can be placed over the sinus area to treat sinusitis, or it can be wrapped around the feet of a person who needs a hot foot bath but cannot sit up.

Use the fomentations for pneumonia, bronchitis, coughs, arthritis, colitis, peptic ulcer, systemic diseases such as lupus, infectious mononucleosis, or influenza. It should not be used in tuberculosis or heart attacks. The fomentation is usually used in the following way: apply the fomentation pack to the skin after placing a layer or two of towels to protect the skin from overheating. Cover the entire pack with another towel and then spread a sheet or blanket over the person, depending on room temperature. After about five minutes, change the pack by removing all of the materials, towels, etc., and placing a cold towel on the chest, having first frictioned the skin with the cold towel. After 30 seconds of cold, replace the pack with a fresh hot one that has been wrapped as previously described and the skin protected with a towel as before. Repeat this process for three changes or more if needed, ending with the cold. Dry the area. If the patient is not sweating, he can simply be covered and left for 30 minutes in his bed to rest, so his body can fully react to the treatment. If he is sweating, he should be given either a brief warm shower or a cold mitten friction. The cold mitten friction is a brisk friction rubbing of the skin with a washcloth wrung from tap or ice water, beginning with one arm, proceeding to the next, both legs, the back, chest, and abdomen. During the treatment when the patient begins to warm up, place a folded cold washcloth on the forehead, and refresh with cold every 1 to 3 minutes. Do not forget this part, as it prevents a sense of languor or dizziness after the fomentation. A hot footbath or a heating pad wrapped around the feet is a good way to increase the sweating reaction. Keep the person completely covered by a sheet or blanket if there is any draft or sensation of chilling. Since the person may sweat copiously give water by straw during the treatment, or just before and afterward.

‍BOILING WATER METHOD with towels

1. Fold large bath towels lengthwise and twist as much as possible. Place the middle three-quarters of the towel into boiling water, and let it thoroughly soak.
2. Lift the towel out of the water, and pull ends tightly away from each other to wring out. Untwist by dropping one end.
3. Lay wet towel over dry towel, wrap, place on 1-4 thicknesses of towel on patient.

‍STEAM METHOD with fomentations or towels

1. Soak in water and wring out 5 towels or fomentations.
2. Place rolled up towels or fomentations on grid in large canner.
3. Boil for 20 minutes (NOT touching water).
4. Lay hot towel or fomentation on dry blanket or towel, wrap, and place on 1-4 thicknesses of towel on patient.

‍MICROWAVE METHOD with towels or fomentations

1. Soak large towel in water and wring out well.
2. Place in plastic bag.
3. Microwave on high 4 minutes.
4. Lay hot towel or fomentation on dry blanket or towel, wrap, and place on 1-4 thicknesses of towel on patient.

‍OVEN METHOD with towels or fomentations

1. Soak towels in water and wring out well.
2. Bake in oven at 350 degrees F for 20 minutes.
3. Lay hot towels or fomentation on dry blanket or towel, wrap, and place on 1-4 thicknesses of towel on patient.

‍HYDROCULATOR PADS METHOD

1. ‍‍Boil 20 minutes.
2. Wrap towel, place on 1-4 thicknesses of towel on patient.
3. Freeze when not in use.

‍THERMOPHORE METHOD

Use purchased electrical moist heating pad as directed.