Heat treatment

“ They are very sensitive to heat and cold. When these are applied the child often cries, so that the "treatment" is condemned and given up. What should be condemned is the nurse's want of skill. In every case the cold or hot application should be so managed as to be agreeable. Very gentle heat at first may be succeeded by stronger heat without shock. So mildly cool applications may be followed by colder ones in the same way. There is no sense or benefit in dashing a burning poultice or freezing towel on a delicate person, either infant or adult, and sense is above all our guide in these pages. ”

“ Heat Exhaustion.—This is caused by continued exposure to high temperatures, especially while working hard.
Symptoms.—Prostration with cool skin, temperature often below normal, 95-96, pulse is small and frequent, sometimes restlessness and delirium. The person need not necessarily be exposed to the direct rays of the sun, but the condition may come on at night, or while at work in close, confined rooms.
Treatment of indoor heat exhaustion.—Aromatic spirits of ammonia one to two drams and strychnine; avoid alcohol. If the temperature is below normal, (98.6) a warm bath can be given. ”

“ In our treatment of acute diseases we never use ice or icy water for packs, compresses, baths or ablutions, but always water of ordinary temperature as it comes from the faucet. The water compress or pack warms up quickly, and thus brings about a natural reaction within a few minutes, while the ice bag or pack continually chills and practically freezes the affected parts and organs. This does not allow the skin to relax; it prevents a warm reaction, the radiation of the body heat and the elimination of morbid matter through the skin. ”

“ Hot and Cold Applications
Hot applications are used to relieve pain, to supply heat, and to bring down temperature. Both moist and dry heat are used. Hot water bags, metal heaters, electric pads, hot flannels are the commonest forms of dry heat. Fomentations, poultices, and baths are the simplest forms of moist heat.
In applying heat, one should be ever on the watch to avoid burning a patient. The skin of babies, children, old people, and of those who have been ill a long time, is very easily burned. Again, the same heat that is easily tolerated by one person, may burn another. ”

“ Similarly, fuels in hot coals and ashes can be moved, or the hot material can be scraped away to deprive them of heat.
Water is highly efficient as a cooling agent because of its great heat-absorbing capacity, in both liquid and vapor form. ”

“ The chief points to be considered are efficiency of heating surface and capacity of grate in proportion to surface, strength of parts, tightness of joints, ease of cleaning and effectiveness of circulation—there should be no "dead ends" where the water is not kept in circulation by the heat of the fire. ”

“ Combustion
In parts of the country where the temperature goes below 60° F. it becomes necessary to provide artificial heat to warm houses in order that health may be maintained at the least possible expenditure of energy. ”

“ But the most common mode of warming is by heated air introduced from a furnace. The chief objection to this is the loss of all radiated heat, and the consequent necessity of breathing air which is debilitating both from its heat and also from being usually deprived of the requisite moisture provided by the Creator in all out-door air. Another objection is the fact that it is important to health to preserve an equal circulation of the blood, and the greatest impediment to this is a mode of heating which keeps the head in warmer air than the feet. ”

“ Heating once or twice a week during the cold and damp season is sufficient to keep the apartments fairly dry.”
“Do you not think the heat of the hot-air apparatus injurious to health?”
“The warm air issuing from the heating apparatus is unwholesome, because in becoming warm it has lost a part of its oxygen, and because oxygen is as necessary to us in supporting life as it is to fuel in supporting combustion. We can avoid some of the injurious results to the animal economy arising from the deoxidized air by making it pass over basins filled with water on leaving the heat receiver ”

“ A room warmed by an open fire is more comfortable than a room warmed by hot air from a furnace, assuming the temperature of the air is the same in both instances, because the walls of the room are several degrees lower in temperature in the latter than in the former. For warming walls as well as the air high pressure steam pipes are more efficient than hot-water pipes. The great advantages of radiant heat are that— (1) it heats the body without appreciably heating the air ”

“ At the same time the relative humidity can be controlled and this is very essential, not only as a means of providing air that is most desirable for breathing, but also in point of fuel economy, since air of high humidity is more easily heated and is more desirable in conserving the heat of the body as has already been explained. Steam heating is especially suitable for high and irregularly shaped buildings. The fact that the radiators and pipes are empty when not in use reduces the risk of damage to the house furnishings from bursted or leaky pipes. ”

“ Till modern invention, however, has provided us with this desideratum in the heating of the bath, we must be satisfied with existing methods. And unless something really practical is perfected, it is far wiser to rely upon the system of heating by convection through the air—the principle, generally adopted, of continuously passing large quantities of freshly-heated air through the sudatory chambers; exposing, however, the heating apparatus, so that a maximum of radiant heat may be obtained; and carefully guarding against injuring the air whilst raising its temperature. ”

“ Except for the production of a temporary effect, such as to give time for the reëstablishment of the normal temperature in a body chilled, as by submersion, external heat is useless for vital purposes. The only way in which it can act is by preventing the loss of more heat, and giving a slight aid to recovery by warming the surface of the body. ”

“ In the preceding Section, we learned that many houses heated by hot water are supplied with fresh-air pipes which admit fresh air into separate rooms or into suites of rooms. In some cases the amount which enters is so great that the air in a room is changed three or four times an hour. The constant inflow of cold air and exit of warm air necessitates larger radiators and more hot water and hence more coal to heat the larger quantity of water, but the additional expense is more than compensated by the gain in health. ”

“ But as they must consume food for [24] the purpose of repairing the waste of their nitrogenous tissues, and as every kind of food contains heat-producing elements, an excess of heat is developed within their bodies, which, if allowed to accumulate, would speedily produce fatal results. The means by which nature removes this superabundant heat are admirably simple, as indeed all its contrivances are. The skin is permeated with millions of pores, and through these openings a large quantity of vapor is given off, and carries with it the surplus heat. ”

“ The most common method of producing heat for heating purposes is by combustion. Its obedience to certain physical laws is infallible. Heat is liberated from such material as coal and wood by combustion and is the result of the chemical action of this combustion; it is then transmitted to the rooms to be heated either by air, water, or steam unless the combustion takes place in the room to be heated; then it is distributed throughout the room by radiation from the open fire or conduction from above. ”

“ A temperature of the room as low as 50°, except for such diseases as whooping cough and bronchitis, suffices if the patient is well covered with warm personal and bed coverings.
Convalescents from any acute illness bear low temperatures badly.
The Different Kinds of Heat.—Heat may be communicated by radiation, conduction, and convection. By radiation of heat is meant the process by which heat passes from a fire or other source of heat, through a vacuum, dry air or any other medium, without heating any of the media through which it passes, but only the bodies against which it finally impinges. ”

“ Ventilation and Heating.—The subject of the heating of our rooms and houses is very closely allied to that of ventilation, not only because both are a special necessity at the same time of the year, but also because we cannot heat a room without at the same time having to ventilate it by providing an egress for the products of combustion and introducing fresh air to replace the vitiated. ”

“ There is also no little wise economy in keeping a proper supply of moisture in the air. For it is found that the body radiates its heat less in moist than in dry air, so that a person feels as warm at a lower temperature when the air has a proper supply of moisture, as in a much higher temperature of dry air. Of course, less fuel is needed to warm a house when water is evaporated in stove and furnace-heated rooms. It is said by those who have experimented, that the saving in fuel is twenty per cent. when the air is duly supplied with moisture. ”

“ The warmer will part with its heat to the cooler, and the latter will in like manner reduce the temperature of the former. By covering, then, the surface of the body, it is prevented from giving its heat directly to the air, for the clothes intercept it by absorbing the heat themselves. ”

“ Physiologists point to the evaporation of water from the surface of the human body as being one of the most perfect adaptations of means to ends exhibited in the whole circle of life. The vital activities of the body occasion the constant production of heat. At times the heat is greater than is needed, and would destroy the vitality of certain tissues if it were not speedily conducted away, just as too much heat in a stove would melt the iron of the stove. The evaporation of water from the skin accomplishes this heat dispersal. ”

“ But by the increased difference of temperature between the room and the open air, ventilation rises from 353 to 2,100 cubic feet per hour, and in this way we get rid of more than twenty times as much water as if we left the room unheated.
All kinds of stoves and charcoal-dishes act only as sources of heat, and not as sources of carbonic acid. The only rational and efficient way is the heating of all the chimneys and stoves, and the continual ventilation of all the rooms. All other ways are of no use, or deceptive. ”

“ But as you heat it you enlarge its volume again, and it sucks up the moisture just as this sponge does, and if you do not supply this moisture in other ways it will suck the natural moisture from your skin and your lungs, creating that dry, parched, feverish condition so noticeable in our furnace and other stove-heated rooms. Few persons realize the great amount of water necessary to be evaporated to produce the natural condition of moisture corresponding with the increased temperature given the air in many of our rooms in winter. ”

“ Buildings of all kinds had from the earliest days been heated by open fireplaces, in which logs, and later coal, were burned in considerable quantities, while the larger proportion of the heat escaped up the flue. ”

“ The plan of warming apartments by means of stoves, in its passage through which the air becomes highly heated before it mixes with and raises the general temperature of the air in the chamber, is liable to this inconvenience,—that the portion so introduced, having its vital property impaired by the burning heat through which it has passed, injures, proportionably, the respirable quality of the whole atmosphere ”

“ By what means does Nature supply deficiencies of internal heat and eliminate an injurious excess, and, in either case, restore the organs to the temperature which is most agreeable to the regular performance of the functions of life? The means are various. When food becomes insufficient, calorification is effected at the expense of the tissues of the animal, and it grows lean. When heat is produced in excess, the organism rids itself of it speedily by several outlets. The body may be cooled by radiation, by evaporation, or by conduction or convection. ”

“ In buildings of the second class, such as residences, office buildings and hotels, we have been, as a rule, satisfied with sufficient heat, and have relied upon such ventilation as is secured by the natural circulation methods. In such buildings, therefore, the system of heating most used is that known as "direct radiation," in which radiators, or some form of radiating surface, are located in each room, and connected by an arrangement of piping to a central source of steam or hot-water supply. ”

“ We must remember that the nutriment coming to each part of the body is concocted by the heat appropriate to the part; if the heat is inadequate the part loses its efficiency, and destruction or disease results. (We shall speak more in detail of causes in the treatise on growth and nutrition.) Whenever, then, the hair in man has naturally little heat and too much moisture enters it, its own proper heat is unable to concoct the moisture and so it is decayed by the heat in the environing air. All decay is caused by heat, not the innate heat but external heat, as has been stated elsewhere. ”

“ The simplest mode of warming a house and cooking food is by radiated heat from fires; but this is the most wasteful method, as respects time, labor, and expense. The most convenient, economical, and labor-saving mode of employing heat is by convection, as applied in stoves and furnaces. But for want of proper care and scientific knowledge this method has proved very destructive to health. When warming and cooking were done by open fires, houses were well supplied with pure air, as is rarely the case in rooms heated by stoves. ”