318 
ON THERAPEUTICS. 
end of that time to have scarcely a drop of blood in the 
vessels of the skin. 
The therapeutic action of refrigerants is usually very 
decided, and should only be sought under peculiar conditions. 
1st. When inflammation is impending. After the occur¬ 
rence of an injury, a certain period, often a very limited one, 
precedes the inflammatory stage; at any time during this 
short period, cold water, iced if possible, continuously applied, 
is productive of most satisfactory results, often preventing 
inflammation entirely, or otherwise moderating the violence of 
the attack. The instances in which cold applications may be 
used with this view are numerous; contusions, sprains, 
fractures, wounds, and burns, under ordinary circumstances, 
may be advantageously so treated, before the symptoms of 
inflammation present themselves. 
After inflammation is once fairly established, however, 
refrigerants are in every way injurious; they occasion much 
unnecessary suffering, they render the surface hard and tense, 
and, by lessening its power of expansion, prevent swelling 
and exudation, and thus offer a serious obstruction to the 
natural method of relief for the distended vessels, and diminish 
the chances of an early resolution. 
2d. When inflammation has nearly or quite subsided, 
leaving a morbid sensibility or relaxation of the tissues, or a 
sluggish ulcerating surface, cold will be beneficial in lessening 
the irritation, and strengthening the weakened parts; in such 
cases, cold water poured from a height, or dashed on the part, 
is very effective. 
3d. In subacute inflammation or simple irritation, refrige¬ 
rants are indicated, medicated or not, as the state of the part 
may require. Cold acts quite as effectually when the irrita¬ 
tion is beneath the integument, as in subacute or chronic 
laminitis, or the excitement succeeding a slight sprain. The 
constant application of cold water diminishes not only the 
heat, but, what is of more importance, the extreme sensibility 
of the injured textures. 
4th. For the purpose of arresting slight haemorrhage, cold 
is a valuable agent; in cases of bleeding from small points, 
not to be grasped b}» forceps, or encircled by ligature, and 
where the actual cautery is unnecessary, cold water, poured 
upon the bleeding surface, or applied by means of lint or fine 
tow, or even a stream of cold air from the tube of a bellows, 
will effect contraction of the wounded vessels, and lessen 
the amount of blood in the part. 
Under whatever conditions it may be desirable to tempo¬ 
rarily repel the blood from the surface vessels, refrigerants in 
