This pack is, in some respects better than the last, since it is less liable to form creases, and the upper portion may be changed more frequently for the purposes of cooling, than the undivided pack. It is used together with the abdominal pack.
[Illustration: No. 6]
[Illustration: No. 7]
Instead of using one strip 4 to 6 inches wide, folded 4 to 6 times, as for the shoulder pack, two strips are taken. One strip is passed across each shoulder, and crossed on the breast as well as on the back. The woollen strips used for covering are of course wider and of double thickness. The ends of the two strips are drawn underneath the abdominal pack, and held by it, and the two shoulder packs may be changed as often as necessary for cooling purposes without necessitating a simultaneous change of the abdominal pack.
(This is an application similar to “Kneipp’s Shawl”)
A large square piece of linen crash from 35 to 40 inches in width is folded into a triangle, dipped in the vinegar-water at 59 to 64 degrees, and after being wrung out, is applied diagonally round the neck. The upper part of the back, the cervix, the neck, the shoulders and the upper parts of the breast are thus covered. A woollen wrap, the ends of which are pinned together on the back, will cover the whole pack tightly.
This pack must be changed if the patient becomes too hot (after 1/2 to 2 hours), otherwise it may stay on all night. In case of feverish catarrh it is used together with the three-quarter pack.
Among other things the “shawl pack” causes the cooling of the blood which streams to the head. Thus its effect in case of congestion and brain trouble is explained.
Neck and shoulder packs, Scotch packs and shawl packs must always be used in connection with a diverting leg, calf or foot pack.
Next to the abdominal pack the three-quarter pack is one of the best applications, especially for children.
A piece of woollen cloth, or a single blanket, as long as the patient and sufficiently wide to reach all around him, is placed on the bed in such a way as to be level with the arm-pits of the patient. A bedspread of about the same size as the blanket is then dipped into cool vinegar-water, wrung out well, and placed on the blanket so that the upper edge of the latter protrudes. The patient is now laid on the bedspread so that it reaches to the arm-pits. The moist spread is then turned up on both sides, part of it is tucked between the legs, and the protruding lower end is laid on or between the feet. Thus the body, from the arms down, is completely wrapped in the wet spread, and the woollen blanket is covered over it as usual and fastened with safety pins. The patient’s shirt is then adjusted. The head, the neck, the uppermost part of the breast and back are not packed. Another blanket is placed over the patient and well fastened on all sides. A pillow must be placed between the feet and the lower edge of the bed. To avoid cold feet the wet spread should reach only to the ankles, and the feet be covered with the woollen blanket, or a hot bottle placed near them.