316 
ON THERAPEUTICS. 
tions and diminishing fever, thereby justifying, in a measure, 
the use of the epithet, but as ordinarily used the term 
‘‘ refrigerant” is meant to designate an external application 
whose direct action is to lower the temperature of the part 
with which it is brought in contact. Whatever difference of 
opinion may exist respecting the action of refrigerants, can 
only affect the question of secondar} T consequences, the direct 
result must be diminution of the temperature of the part, or 
the proper action is not developed. 
The various agents are : water, alcoholic solutions, and 
solutions of acetic acid or the diacetate of lead. Of these, 
water is probably the most usual and most effective, its action 
upon the temperature of a part is due to its own tem¬ 
perature being lower, and its cooling effects, therefore, 
are in direct proportion to the amount of the differ¬ 
ence, consequently whatever lowers the temperature of the 
fluid increases its refrigerant action, and in the form of ice 
we may consider it to be the standard of refrigerant agents. 
Mixtures of ice or snow with water, or soluble salts in certain 
proportions, abstract heat from the fluid in which they are 
being dissolved, and so render it more efficacious. Alcoholic 
solutions occasion the abstraction of heat during the evapora¬ 
tion of the alcoholic portion. Some agents exalt the sensibility 
of the part, and render it more susceptible to the sensation of 
cold ; in this way solutions of acetic acid and the acetates 
exert a sedative influence upon the local excitement, in addition 
to the effect of the cold water to which they are united. The 
choice of either of these forms will depend upon the state of the 
part under treatment. Where the object is to lessen the amount 
of blood, or to prevent determination, ice or otherwise water 
whose temperature is rendered as low as possible are desirable 
from the ease with which any quantity can be applied. Local 
irritation, accompanied with much pain, will require the 
employment of the sedative solution of diacetate of lead ; 
while in cases of chronic and indolent deposits, the debilitated 
vessels will be strengthened, and the circulation improved, by 
the solution of acetic acid. 
During the application of refrigerants of either kind it is 
necessary to leave the part as far as possible exposed, in any 
case using nomorecovering thanisactually necessary to support 
the material saturated with the solution. When consistent with 
the attention which the attendant will probably have to afford to 
other animals, a frequent use of the fluid by means of a sponge 
is superior to any other method of application ; where, how¬ 
ever, this is not convenient, a little lint or fine tow may be 
retained lightly upon the part. The addition of oil-silk or 
