Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

The heating compress is one of the simplest of the home remedies, and has a wide application. It can be used for pain, for infection, for the common cold and sore throat, for headaches, coughs, and constipation. It is surprising how effective this simple remedy is. The physiologic basis on which the remedy depends is through the neurocirculatory apparatus. The heating compress is applied cold, and the nerves react to the cold compress by sending a message to the blood vessels in the area to dilate, resulting in increased blood going to the area. The fresh blood brings with it new antibodies and blood proteins to fight infection. The increased circulation removes toxins which may be causing pain, or relaxes muscles to assist in reducing congestion, clearing away materials that cause the tissues to be sick. The physiologic reactions occur because of the prolonged application of moist heat.

The technique for applying a heating compress is simple. A strip or square of linen or cotton cloth, or three or four thicknesses of gauze, is wrung from cold water; it must be so perfectly covered by plastic and then a flannel, wool, or synthetic scarf as to prevent the circulation of air and cause an accumulation of body heat. If warming of the cold cloth should not occur promptly it should be assisted by hot water bottles, heat from a heating pad or an electric light bulb. It is left in place overnight or for several hours during the daytime. On removal of the compress the part should be rubbed with cold water or alcohol to "close off the pores."

The effect of a heating compress can be varied from tonic (stimulating to the general tone) to sedative to derivative (drawing blood to the part for the purpose of removing congestion from another area), or sweating. The various effects are determined by the amount of the surface of skin covered, the location of the heating compress, the thickness of the coverings, and the amount of water left in the wet cloth. Of course, the duration of the application is also an important determinant. If the compress is left on for only an hour, it will tend to be a tonic, that is, to tone up the tissues in the area. If it is left on for several hours it will be sedative. If it is applied to the feet, it can reduce congestion in the head, the chest, or the pelvic organs. If numerous coverings are applied to prevent any escape of body heat, the compress may cause sweating. If the pack is allowed to dry out before it is removed, accomplished by using wool directly over the wet piece instead of plastic, it will have a mild derivative effect.

The uses of the heating compress are as follows: around the neck for a sore throat, over the chest for cough or bronchitis, across the forehead and eyes for a headache, on the abdomen for a stomachache or constipation, and on the feet for headache, cough, or chest congestion, and pelvic pain or congestion. A heating compress may be applied to a part of the body to relieve pain.‍

Two examples of the heating compress will be given:

‍(1) The heating chest compress. Cut a strip of bed sheet or roller gauze 8 to 10 inches wide and 6 to 8 feet in length to make the inside piece that goes next to the akin. Loosely roll the linen or gauze and wring it nearly dry from cold water. Start under one arm and begin to unroll the wet piece against the skin, carrying it diagonally across the front of the chest and over the left shoulder, then obliquely across the back, again under the right arm and directly across the front of the chest, under the left arm and diagonally across the back and over the right shoulder, ending on the front of the chest. This piece must be snugly applied at all places, but not so tight as to restrict movement of the chest. Next is the plastic piece which can be a large garbage bag with a hole cut for the head and two holes cut for the arms and taped snugly in place with adhesive or scotch tape, in such a fashion that not even a tiny air hole is capable of allowing evaporation from the wet piece. The third layer is a snug-fitting sweater, heavy athletics shirt, or other garment designed to hold the heat in. After this piece is in place, the person should put on pajamas or other bedclothes, dress warmly, and go to bed. The pack should feel comfortable and should warm in a short time.

A variation of the heating compress given above is somewhat simpler, and may be used in a pinch. Wring a washcloth almost dry from cold water and lay it on the front of the chest beginning below the collar bones. Cut a large piece of plastic from a bread bag sufficient to overlap all edges of the washcloth by at least one inch. Hold in place by a long scarf wrapped around the chest, beginning under the right arm, going obliquely across the chest and over the left shoulder, across the back, the chest and again under the right arm, straight across the chest and under the left and obliquely across the back of the chest and over the right shoulder, ending in front. Again, make certain that there is no portion of the wet piece allowed to have air circulating around it. There should be no evaporation, and by morning the compress should be as moist as when applied.

It is easy to see that a heating compress can be readily applied to the abdomen by using a towel which is pinned in place to hold the moist piece and the plastic covering. To make a heating compress for an extremity, use the same principle.

(2) A heating compress for the throat is made by cutting a strip of linen or gauze about 2 x 14 inches, squeezing it loosely from cold water, applying it to the skin surface, covering with a piece of plastic 3 x 14 inches and wrapping a scarf or large wool sock around the throat and pinning it securely in place with safety pins. Care must be used that no part of the wet piece works its way to the surface to become a "wick" to carry off heat. Use this remedy for sore throats, hoarseness, tonsillitis, or cough: It should be applied every night as long as the sore throat last. The wet piece should extend upward about to the lower part of the ear. A broad piece of plastic should be carefully applied over it, and, then a warm fitting flannel to prevent loss of heat.

A heating compress can be applied over a joint for sprains, arthritis, bruises, etc. The skin may be rubbed with medicated Vaseline before the application of the compress. The use of a counterirritant of this nature increases the effect of the heating compress. Turpentine may produce a blister, and should not be used.

Poultices are very similar to heating compresses in effect. They are made by using some substance about the consistency of watery oatmeal, applied hot or cold. For this purpose flaxseed, charcoal, comfrey leaves, aloe vera, etc. may be used, or the old-fashioned white clay and glycerine. Compresses may be applied hot or cold, the active material spread about one-fourth inch thick over a cotton cloth or folded paper towel and applied directly to the skin. Charcoal poultices are used on ulcers or wounds, for toxicity such as mosquito, ant, wasp, bee, spider, or other venomous bites.

The moist abdominal bandage may be used in insomnia, nausea of pregnancy and other gastrointestinal disturbances, constipation, and central nervous system exhaustion. At first when the cold, wet cloth is placed on the skin, there are a few minutes of strong contraction of the blood vessels accompanied by a reflex action in the same area internally. When the reaction takes place, however, heat begins to accumulate and the blood vessels dilate, increasing with the accumulation of heat. The dilatation of the blood vessels is at first an active or tonic dilatation in which there is an increased movement of blood to the skin, causing the temperature of the skin to rise above the normal temperature of the skin. The highest degree of heating effect is produced when plastic is used rather than wool to cover the wet piece. When an impervious covering as plastic is applied, heat accumulation and derivative effects are most marked, but if a wool covering is used, a strong tonic and powerful fluxion (washing) effect occurs.