Counseling Sheet

Agatha M. Thrash, M.D.

Preventive Medicine

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The wet sheet to be used in this treatment should not be left too wet, as it tends to change its temperature too rapidly when a lot of water is left in it.

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‍Indications

‍Use for infections or fevers, mental illness, as a general tonic in chronic illness, chronic eczematoid dermatitis, or other generalized dermatitis.

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‍Contraindications

1. ‍‍Faintness
2. Phlebitis
3. Boils or open lesions on the skin

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‍Equipment

1. Long cotton bandage to bind a washcloth dipped in cold water to the forehead
2. Tub of hot water
3. Cold water at 60° to 70°, or for the hot sheet pack at 104°
4. Sheet
5. Three pails of water: one at 70°, one at 65°, and one at 60°
6. Coarse towel
7. Four to six clothespins or large safety pins

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‍Procedure

1. Tie a cold compress around the forehead at the beginning of the treatment.
2. Have the patient stand in a hot foot bath, if the wet sheet rub is planned.
3. Wring a sheet from cold water at 60° to 70° for a wet sheet rub, or at 104° for the hot evaporating sheet pack.
4. Wind the wet sheet around the patient, beginning under one arm; carry the sheet around the back, under the opposite arm, and across the abdomen. As the wrapping is continued, cover the first shoulder and arm, and tuck it in at the legs and neck. Fasten with clothespins or safety pins.
5. For the wet sheet rub, percuss and friction over the sheet quickly, until the sheet becomes warm from the action of the friction and the body heat. At the end of the treatment, which should cover the entire skin surface, pour a pail of water at 70° over the patient. A second pail at 65° and a third pail at 60° should be used. Two operators are best for this treatment. A cool, forceful shower gradually getting cooler can be substituted for the pail pouring if more convenient. The temperature cannot be as easily controlled however. Friction the skin dry with a coarse towel.

In the hot evaporating sheet pack for treating fevers, follow the same basic procedure as for the wet sheet rub, except that the hot foot bath is omitted. At the end of the pail pour, have the patient sit or lie for a few minutes to reduce the fever, or remove the sheet after one or two minutes and friction dry with a coarse towel, as the condition of the patient permits.