Alternate Hot and Cold Lung Compress

SYN: Alternate to the Chest, Hot and Cold to Chest


from Hydrothermic Remedies...

"The expression 'alternate hot and cold' is used... to describe treatments in which the duration of the cold application is from one quarter to one half that of the hot.. and in which three or more changes from heat and cold are made." Physical Therapy in Nursing Care, p. 72.



The use of alternate applications of heat and cold to the chest to relieve congestion by vascular stimulation. If heat is applied to the lower extremities, systemic derivation will also be achieved.

Physiologic Effects

  1. Markedly increases local and reflex blood flow
  2. Stimulates respiration (especially inspiration)


If very painful, use as a Revulsive i.e. one change, very hot to very short, very cold.

  1. Chest Cold with Pulmonary Congestion, (after treatment a strong patient might benefit from a Cold Bath)
  2. To prevent Pulmonary Congestion Post-Surgery in some cases
  3. To prevent Atelectasis after and during Surgery and in bed-ridden patient.


  1. After eye Surgery, tonsillectomy, mastectomy, chest surgery and genitourinary surgery
  2. Malignancy
  3. Children under 12 years of age
  4. Areas with impaired sensation or impaired circulation
  5. Paralysed parts
  6. Persons who are unconscious
  7. Pleurisy - any cold applications makes pleurisy worse


  • 5-8 Turkish towels
  • 2 compress cloths
  • 2 pieces rubber or plastic sheeting a little larger than the fomentations
  • 5 Fomentations and 5 fomentation covers
  • Bath blanket
  • Basin with a large piece of ice
  • Microwave or container for heating fomentations, canner or other large container with a rack on the bottom


Important Considerations

  • Use special care in treating older patients and diabetics

Preparation for Treatment

  1. Explain procedure to patient
  2. Assemble materials
  3. Protect bed and drape patient with a bath blanket


  1. Assist patient to turn to side
  2. Place rubber sheet, one fomentation and bath towel (in that specific order) lengthwise as close as possible beside the patient's back
  3. Have patient turn back onto the towel covering the Fomentation; rub hand under the shoulders and hips to make certain the fomentation is smooth and not too hot
  4. Cover the chest with towel, over this place a fomentation; be careful that the fomentation is not too hot over sensitive areas; cover patient with a bath blanket.
  5. Place a rubber sheet, a fomentation and a Turkish towel under the patient's feet, wrap well, cover with a bath blanket - OR - use a Hot Foot Bath
  6. Remove the fomentation from chest when it begins to cool (depending on what is being used for the fomentation, this would be about 1-3 minutes); covering the area about two times
  7. Dry the area thoroughly and apply the next fomentation
  8. Make three applications of heat and cold to the chest, finishing with cold
  9. Remove fomentations from the feet and back and cool parts with alcohol; dry thoroughly

Completion of Treatment

  1. Leave the patient comfortable, dry and free from perspiration
  2. Remove the equipment and leave area tidy
  3. Make record of treatment and condition after treatment
  4. Encourage patient to rest for at least half an hour


from Dr JH Kellogg's Hydriatic Techniques...

  • Thick, very hot Fomentations to the whole back,
  • Cold Compress to whole front of chest, neck to lower ribs
  • Do not allow to warm up
  • Optional Fomentations to legs and arms 30min 2-3x a day

Use in:


from Dr GK Abbott's Prescriptions...


Collateral Fluxion - ie blood drawn form heart and lungs to the actively dilated skin blood vessels


Requires 2 attendants: