In movies, the hero is often nursed to health by sponging his face with a wet rag. How true is this to actual history?

Question

We've all seen this type of scene before in period dramas; think Gladiator or The Last Samurai. We have a valiant hero, killing many men on the field of battle. After dispatching hundreds, in climax he is grievously stricken with injury delivered by the other side's champion, or perhaps in an unsporting play like a treacherous arrow from afar. He enters delirium and fever, as a result of say infection/shock/blood loss. Then, it's usually up to his love interest to nurse him back to health — which she does by repeatedly wiping his face or the wound in warm water. Most of the time he fully recovers.

I understand why directors and screenwriters love these sort of scenes; it gives them a chance to bring the love interest into close physical proximity with the hero, so they can proceed to liplock through the caressing action of sponging off of the face. But JUST doing that seems decidedly primitive to me, for any historical era — is there any reason that would be effective? I would expect herbs, or poultices, or even quack medicines, but the commonness of this trope leads to me wonder whether it has any historical basis at all. Was a common prescription in the old days, "wipe down the treated man's face"? How in accordance is this sponging off with water with historical records of the manner wounded men were treated after injury in battle?

Let's recapitulate my question for the TL;DR folks: Is there any evidence that the method for treating injury in olden times was sponging of the injured party's face with water and rag?

Answer 1

Actually, for fever (as opposed to physical injury), the wet towel is an officially recommended useful thing to do (please note the difference between that and "remedy").

Source: at least 3 different pediatricians when my kids had virus-originated fevers. (NOTE: this is somewhat tongue in cheek, but is based on sound evidence as linked to below)

This serves 3 medical benefits:

• Depending on the temperature of water, it cools down the person if it is below the skin temp. Source: NIH

• By wetting down the face and then allowing the water to evaporate, it allows the person to cool down faster/better. Source: http://hyperphysics.phy-astr.gsu.edu/hbase/thermo/sweat.html

• It removes eeky sweat generated when one has a fever. if nothing else, that makes you feel less unpleasant and thus has non-negligible contribution to well being.

• Add an overall sense of being cared for, AND a calming effect of doing something helpful for a parent - both are important. Source: Managing childhood fever and pain – the comfort loop, Jacqui Clinch and Stephen Dale, Child and Adolescent Psychiatry and Mental Health

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On the other hand, I found at least one study which contradicts this on some level.

to whit, the study showed

1. It improves the fever short term (1 hr). SUPPORT

2. Has no effect longer term (2+ hr). NO Support, but the claim didn't specify time period

3. Study showed correlation between bath and discomfort. See my opinion of that below.

http://www.ncbi.nlm.nih.gov/pubmed/9115527

The efficacy of tepid sponge bathing to reduce fever in young children. Sharber J. College of Nursing, University of Arizona, Tucson 85721, USA.

Abstract : Tepid sponge baths distress febrile children, and their efficacy at reducing fever has not been established. This study compared fever reduction and with (1) acetaminophen alone and (2) acetaminophen plus a 15-minute tepid sponge bath. Twenty children, ages 5 to 68 months, who presented to the emergency department or urgent care center with fever of > or = 38.9 degrees C were randomized to receive (1) acetaminophen alone or (2) acetaminophen plus a 15-minute tepid sponge bath. All subjects received a 15-mg/kg dose of acetaminophen. Tympanic temperature was monitored every 30 minutes for 2 hours. Subjects were monitored for signs of discomfort (crying, shivering, goosebumps). Sponge-bathed subjects cooled faster during the first hour but there was no significant temperature difference between the groups over the 2-hour study period (P = .871). Subjects in the sponge bath group had significantly higher discomfort scores (P = .009).

Based on my own experience, the final conclusion of the study may plausibly be wrongly attributed (the child may be discomforted because they don't like sponge baths in the first place, especially when in fever and wants to be held still or not bothered) - once my kids were older and could consciously consent to it, the exhibited discomfort went from 50% of cases to 0%. The abstract didn't specify any details discomfort-wise, so i don't know if they bothered with adjusting for that effect.

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Here's a second study showing the same results:

Comparative Effectiveness of Tepid Sponging and Antipyretic Drug Versus Only Antipyretic Drug in the Management of Fever Among Children: A Randomized Controlled Trial S THOMAS, C VIJAYKUMAR, R NAIK, PD MOSES AND B ANTONISAMY; From the Department of Child Health Nursing, *Child Health Department and **Department of Biostatistics, Christian Medical College, Vellore, India.

Results: The reduction of body temperature in the tepid sponging and antipyretic drug group was significantly faster than only antipyretic group; however, by the end of 2 hours both groups had reached the same degree of temperature. The children in tepid sponging and antipyretic drug had significantly higher discomfort than only antipyretic group, but the discomfort was mostly mild.

Conclusion: Apart from the initial rapid temperature reduction, addition of tepid sponging to antipyretic administration does not offer any advantage in ultimate reduction of temperature; moreover it may result in additional discomfort.

Answer 2

I used to be a St John first aid volunteer and attended children's sporting events, where we were instructed to stay off the field until the referee summoned us.

Typically, after a tackle left a young player lying on the ground, we would watch carefully as the coach would come out with a wet sponge, wipe the kids face and/or injury, and the kid would get up and get back into the game, perhaps limping slightly for effect. (The limp had generally disappeared a minute later, when the player was running for the ball.)

The ritual of the "magic sponge" (as we first aiders knew it) was effective as it included the elements of a placebo: some attention, a little bit of rest for the pain and adrenaline to recede, and (by wiping away the tears, and giving an excuse for being better, despite the initial dramatics) gave back some dignity to the child.

Of course, if the injury was more serious, we were standing by with some non-placebo remedies.

I appreciate this does NOT directly address your question of movies and "olden times" medicine. However, it provides some anecdotal support that sponges can be effective placebos.