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April 24, 1943


JAMA. 1943;121(17):1352. doi:10.1001/jama.1943.02840170036011

The use of heat versus cold as local therapy for injured or infected tissue continues to arouse debate. Enthusiasms for and diatribes against hot or cold applications date back to the time of Hippocrates. Although exact physiologic studies have shown the relative reactions which follow the heating or chilling of tissue, most physicians are still undecided when confronted with the necessity of making a decision as to whether to advise a hot water bottle or an ice cap.

The problem of heat versus cold reaches a higher plane of clinical importance in the treatment of surgical shock. For decades the shocked patient was surrounded with hot water bottles or even actually heated with various appliances. In a recent editorial1 in The Journal the subject of cooling in shock was discussed at some length and the deleterious effects of warming the shocked patient were evaluated. The discussion was based not