COOLING PATIENTS— LEWIS, RING and ALDEN 401 



have serious infections. On a purely clinical basis. I can't conclude that reduction 

 of the fever caused by infection aided progress of the infection. 



Dr. Jean Henley: I would like to oinlirui this observation. We have watched two 

 patients with temi)eratiu-es up to 107 I", on several separate occasions; patients 

 treated by chemotherapy into the carotid artery because of gliomas. Presumably 

 the fever was due to brain damage. Each time, when all nursing methods had been 

 tried to no avail, chlorpromazine was added intravenously. We could observe an 

 almost immediate response by watching the dial of the thermister type thermometer 

 we were using. We used small doses, repeating them every five to ten minutes until 

 the temperature began to fall. The temperature w^ould return toward normal and 

 could be kept down by the usual nursing methods if chlorpromazine were given in 

 doses of from 25 mg. to 50 mg. every four hours intramuscularly four or five times. 

 When we found that this was efficacious, we tried Phenergan, a close relative of 

 chlorpromazine and also a member of the phenothiazine series. Phenergan works 

 perhaps a little less efficiently, but it has the advantage of not being toxic to the liver. 



Lt. Col. Carl W. Hughes: We have studied the influence of hypothermia on in- 

 fection at the Walter Reed Army Institute of Research. Adult white rats under 

 sodium pentobarbital anesthesia were used. Experimental peritonitis was created 

 in these animals by incising the cecum, expressing its contents and injecting hog 

 gastric mucin into the peritoneal cavity. 



Ninety-six per cent of the unoperated anesthetized animals survived cooling to 

 25° C. for 14 hours. The survival time of the uncooled rat with peritonitis was eight 

 hours while survival time for the hypothermic rat with peritonitis was increased 

 to almost 11 hours. ^ 



In order to evaluate the use of antibiotics in conjunction with cold in the treat- 

 ment of peritonitis, rats were treated with 4 mg./kg. of dihydrostreptomycin ad- 

 ministered intraperitoneally four hours after the induction of peritonitis. In these 

 animals the survival time in the cooled and uncooled rats with peritonitis was 

 increased to 16 hours. 



Our data suggest that cooling may be of value in slowing the development of 

 infection, but that additional therapy is needed for recovery. 



REFERENCE 



1. Balch, H. H., Noyes, H. E., and Hughes, C. W. : Tlic influence of hypothermia on experi- 

 mental peritonitis, Surgery 38: 1036, 1955. 



