Weekly national intelligencer., 1854-11-25
ON THE REMEDIAL AND ANEsTHETIc USES G
INTENSE COLD.
BY JAMES ARNoTT, MD, LONDON.

Although the subjects Of the remedial efficacy Of
gelaon and local anasthesia from cold have been for
some years before the public, they Jet but little
understood and appreciated This has resulted partly
from their having been imperfecty explained in conse-
quence Of the publications respecting them being several
y incomplete and partly from the strength OF the prsJu-
dice against extreme cold Dr. Rowley, who, in his at
tack cowpox declared that the accounts which he had
heard of The terrible effects Of communicating the cruel
and bessty" disease enough 10 "freeze the SOUL
was probably horror-sfricken than some nave
been by the proposal freeze the body and the intro
ducer of vaccination hardly more abused than the
proposer of congeaon has been 1t in the hope that
this prejudice may be thereby abated ana ,he suo]ect
rendered better understood that the following bre state
meDt is published Even in France where both the re-
medal and anmsthetic Of intense cold have been
turned TO account for some time by M epeau ana
leading practitioners there is still much doubt about the
best mode of applying the agent In paper IN tne Du-
etin de Therapeutique of the 18th ultimo, NJ kchet
Surgeon Of the Hospital Saint-Antoine in Paris reports
thirteen operations in which local anasthesa had been
produced BY the very imperfect means Of the quick eva
poration Of ether.
AS no remedy has been longer in and Few are more
valued than the local application Of moderate degrees OF
cold temperature ranging from that OF dssoving ice
about zoe Of Fahrenheit i may at hrst appear
lar that greater powerful remedial enect should
not have been sought by increasing the dose OF the agent
or employing lower temperature, in tho same manner
as haze sought and found much greater bene-
lit In many eases by using mercury, antmony, quiIihe
and other drugs In larger doses than had been cnstoma
ry The reason Is that medical men We're under most
impression respecting the efects oI very low
temperatures the body. because q Temperature OF
zero stops the circulation, and because the ytay OF
part has been by its longconsd congelaon Whe-
her caused by exposure to severe cold winter or y tue
ncautious of ice in hernia and other diseases was
hastily aud enormously inferred that there was danger
OF loss of vitality from short continued con9eauon Inc
mistake would not be greater to infer from tne ac pc
long stoppage Of the through
limb from improper application Of bandage mas 90
casoned gaEgrene that wouls be dangerous 70 use Ing
tourniquet in operations. ~,
The correction Of this will be deemed Oh no niue
importance when is considered that IN
congelation, judicousy applied, we nave an uniahng
means of Immediately arresting Inflammation Wherever ~
can be reached BY tie remedy Of not only giving speedy
relief from pain in many diseases butt IN oi
the organic changes produced by IT, OF obviatg ne re-
turn pain and in malignant disease Oh producing an
amount of benefit much exceeding that yet accomplished
by other means although much inferior IN Importance
to these results yet another great beneht conferred
by intense cold that the pain which would be oherwse
caused by the greater number OF surgical eau
be prevented it with perfect safety and not only can
pain prevented but the Inflammation proceeding from
the surgeons knife that 50 often proves fatal may also
be obyated by the means, and with almost equai
certainty. Il will be proper TO consider the anu
doing So is necessary to mention how this aegree Oh
cold is produced and applied well as to attempt an e1-
PLANTATION OF Its mode OF operation
That degree Of cold may De called intense wnicn
atcy benurnbs the part to which it is applied speedily
stops the circulation through It, and conseas the apose
matter have usually produced these effects oy placing
what are termed frgorc mixtures either mmedatey
contact with the skin or mucous membrane oy means O
net Of thin gauze containing them, or by allowing them
through thin badders or metallic vessels o. aPPro
pirate form but there various other ways oi enecung
the object OF whish are preferable ior certain
purposes Substances passing rapidly from the SOLID 70
the uid or from the fluid to the aeriform state, strongly
abstract caor from other bodies in contact Win the
and substances either solid 4uid, or aeritorm ALREADY
sufficiently cooled by artificial means, may ps plsceu IN
contact with the parts the tis as sod metaic oas -
appropriate shane the latter two when forming strong
currents When cold produced By the common lngori
&c mixture Of ice and SALT and applied oy means OF
gauze bag net, the following is convenient mcoe o.
proceeding Ii the congeaton is not TO pe extensive OF
piece of ice Of the size Of large orange
will be sufficient, This is well pounded in coarse ciotn
bag and the powder being placed upon
paper is thoroughly mixed by means o
with about half Its weight of common saat Inc mixture
is then put into about four inches diameter ana
it begins dissolve is READY to De appnea
The net is not kept motionless the part but IS fre
quenty raised in order that fresh particles oi she
may be brought in contact with the ssn ana the wafer
that escapes from may be absorbed hy sponge or al
lowed to fall into basin placed underneath II tne sur
face to be acted upon is of small extent very thin ana
large copper spoon containing the mixture, or soma
brass bali Of about pound weight, which has been i'm
msrsed in ice and SALT will often answer and De neaer
mode than the net. IL
The moment gauze net or thin metallic Tesss con
tanning ice and salt is applied to the skin Is oenumo
ed There is hardly sensation of cold produced aud no
tnglng or smarting IL the contact Of tue igoruc e
continued few seconds longer the surface becomes sud
denly white consequences doubtless OF the arrest OF
the circulation and this change OF color is ATTENDED Win
slif ht smartng like that produced by mustard IheTe
Is now complete aIashesia which, If the frgorihc were
removed would remain complete for several minutes.
But If the rigoric be allowed to act another changc Is
producedthe adpose matter under the skin congeaed
aud the pars becomes hard well as white The depth
to which the benumbng influence Of cold will extend de-
pends upon variety crcun as the degree Of
cold the duration OF the application, the vascuary OF
the part whether is used or the circulation is
suspended &c. After the usual application OF cold Tor
ssthesa the circulation returns TO the part and
the skin color which lasts for several hours
II the congelaton has been considerable there is now
some smarng felt unless the natural heat be more gra
duay restored by pouring cold water on the part or by
placing it little pounded ice, ora bladder containing
iced water If the application hos not exceeded the hrst
stages there no smartng and necessity therefore,
for such precautions. .i.
The redness produced does not as might at hrs sght
be supposed indicate nhammatcry condition. but the
very reverse The .oncy of the small arteries appears
be esened suspended for trne and instead OF be-
ing inamed the part is rendered unsusceptbe ofnfam-
nation Parts after copgslaon heal by adhesion or
the first intention quickly than they otherwise
would and has already bsen said We possess in this
expsdent certain and prompt remedy for every nham-
nation accessible to its complete Ahuenoe.
l. Remedial Uses of Iatense ColdThe remedial quali-
ties of intense cold may be described antphiogsc
ano5yne or sedsve and speci6c and il is useful in the
diseases for which other remedies possessing these quail
ties have been employed viz in indammaory, painful
or rritative and malignant diseases The creu
which limits its application IN these is tie imposshility
of extending its influence beyond certain extent or
" . A. -.