HOSE DOUCHE.
In this bath, water under pressure is thrown upon the patient from a hose, through a small nozzle. The bather turns his body while the attendant directs the stream upon different parts. It is a less pleasant bath than the spray or other forms of douche. Its general effects are the same as those of the baths mentioned.
This bath is simply an imitation of rain. Water is allowed to fall upon the body after being divided into a number of small streams by passing through a vessel with a perforated bottom. Its effects depend upon the size of the streams and the height from which they fall, together with the temperature of the bath and its duration. Although formerly much employed in water cure establishments, this bath is now little used, because its place is supplied by other more convenient ones which produce the same results, as the spray and douche. The best manner of administering it is to commence the application with tepid water, and gradually cool it. The temperature may range from 70° to 92°. The water should not usually be allowed to fall upon the head, but should be received first upon the hands and arms, then upon the feet and limbs, and afterward upon the back and shoulders, the body being well rubbed during the application.
The cold shower bath, formerly so common almost everywhere, has been productive of much injury by its indiscriminate use, and has brought much reproach upon the use of water as a curative agent. None but the most vigorous can enjoy the bath at a lower temperature than 70°, and no advantage is gained by its employment at a lower temperature than that, while considerable harm may be done in many cases.
This bath consists in a number of fine streams of water thrown upon the bather, with considerable force. It may be produced by connecting a hose with spray attachment to a force-pump or reservoir from which to obtain water under a sufficient pressure. The best form of attachment consists of a hollow double-convex brass or copper piece, one side of which is perforated with fine holes, the other side carrying a rim for attachment to the hose. It is preferable to have an arrangement by which the temperature may be readily and gradually changed from warm or tepid to cool without interrupting the bath. In the absence of a proper spray attachment, the apparatus elsewhere described for the hose douche may be made to answer a very good purpose, the stream being broken by placing the thumb or finger over the nozzle in such a way as to partially obstruct the flow.
This is an excellent bath to follow the pack, vapor bath, hot-air bath, sitz bath, or any other general bath which induces perspiration. It is very agreeable to most persons, and can be applied to feeble patients who would be unable to take any more severe form of treatment. The alternate hot and cold spray is very successful as a means of reducing local inflammations. The warm bath is very grateful and soothing to swollen and rheumatic joints; in gout, also, and illy defined, wandering pains, it is an admirable remedy. It is very successful, also, in the treatment of tumors, abscesses, and chronic ulcers, when thoroughly applied.
The use of water as a local application is not less important, and is much more varied, than its general application. There is no other topical remedy which will produce such a variety of effects and such prompt results. In removing local congestions, subduing local inflammations, allaying circumscribed pain, and restoring activity to inactive parts, the appropriate applications of water give results which afford both physician and patient a degree of satisfaction which no other single remedy can rival, even electricity, an agent of acknowledged power, not being excepted.
SITZ BATH.
The sitz bath, also known as the hip bath, is one of the most useful baths employed in hydropathic treatment. Its utility was fully recognized by the earlier practitioners, who sometimes kept their patients so long in the bath that they became almost literally water-soaked, and were so numb from the long-continued application of cold water as to possess almost no external sensibility. It is said that in some cases the skin could be rubbed off in the attempts to obtain reaction, without the patient’s knowledge.
For this bath a common tub may be used, by placing a support under one edge to elevate it two or three inches; but it is better to use a tub made for the purpose, which should have the back raised eight or ten inches higher than the front, to support the back, the sides sloping gradually so as to support the arms of the bather. The bottom should be elevated two or three inches. The depth in front should be about the same as that of a common wash-tub.
Enough water is required to cover the hips and extend a little way up the abdomen; four to six gallons will suffice. Any temperature may be employed, being suited to the condition of the patient. The duration of the bath will also vary according to circumstances. A short cool bath is tonic in its effects, like all short cool applications; a more prolonged one is a powerful sedative.The hot sitz is very exciting in its effects if long continued. The warm bath is relaxing. The hips and trunk should be well rubbed during the bath by the patient or an attendant. The bather should be covered with a sheet or blanket during the bath. If it is desirable to produce sweating, several blankets may be used.
The sitz bath should seldom be taken either very hot or extremely cold. A very good plan for administering it, and one which will be applicable to most cases, is this: Begin the bath at 92° or 93°. If a thermometer is not at hand, pour into the bath-tub three gallons of fresh well or spring water, and then add one gallon ofboilingwater. This will give the desired temperature. After the patient has been in the bath ten minutes, cool it down to 85°, which may be done by adding a gallon of well water. Continue the bath five minutes longer, then administer a pail douche or spray, at about 85°, and wipe dry, as directed after a rubbing wet-sheet.
The sitz bath is useful for chronic congestions of the abdominal and pelvic viscera, diarrhea, piles, dysentery, constipation, uterine diseases, and genital and urinary disorders. In treating female diseases it is an indispensable remedy. It is very valuable in various nervous affections, especially those which immediately involve the brain.
There is no better remedy for a cold than avery warm sitz bath taken while fasting, and just before retiring. It should be continued until gentle perspiration is induced.
The sitz may be converted into a general bath by rubbing the whole body with the wet hand while in the bath, and may thus be made to answer the purposes of the half and shallow baths.
For this bath a vessel deep enough to receive the limbs to the middle of the thighs is required. The bath may be taken at any desired temperature; but it is usually employed somewhat cooler than baths which involve the trunk of the body. It is a powerfully derivative bath, and is found very useful to prevent wakefulness in nervous persons, and to relieve cerebral congestion in epileptic patients. It is especially applicable to chronic ulcers of the leg, swollen knees and ankles, and limbs which have suffered by exposure to severe cold. It gives much relief in gout; there is no danger of causing a metastasis of the disease by the application of this bath.
Any vessel sufficiently large to receive the feet, and enough water to cover them to the ankles, is suitable for this bath. The feet should be rubbed during the bath. If the temperature is cool, only an inch or two of water should be employed.
Thewalking foot bathis an excellent remedy for cold feet. It consists in walking in shallow water five or ten minutes.
The alternate hot and coldfoot bathis another valuable remedy for cold feet, and is a certain remedy for chilblains. It is given thus: Place the feet in hot water—100° to 110°—three or four minutes. Then withdraw them and plunge them quickly into a bath of cold water—60° or less. After two or three minutes, restore them to the hot bath. Thus alternate three or four times, and conclude by dipping the feet quickly into cold water and wiping dry. This bath produces most powerful reaction.
The foot bath is applicable in the treatment of headache, neuralgia, toothache, catarrh, congestion of abdominal and pelvic organs, colds, and cold feet. It is very useful as a preparatory for other baths, and as an accompaniment of other local applications.
This bath is given in the same manner as the wet-sheet pack, except that the wet sheet extends only from the armpits to the hips. The blankets are wrapped about the patient in the manner described for the full pack. All the precautions given in connection with the description of that bath are applicable to this.
This bath is frequently employed in cases ofpatients who are too feeble to bear the full pack, or as a preparatory treatment for that bath. It is much milder than the full pack, and is usually more agreeable to the patient, as it does not confine him so closely. It is a very useful remedy in all inflammations of the abdominal organs, gastralgia, pleurisy, acute bronchitis, croup, and pneumonia. When a hot application is required, it is well to use a woolen sheet instead of a cotton one. It requires the same after-treatment as the full pack.
This application is made in the same manner as the half pack, allowing the wet sheet to extend only from the armpits to the navel. It is especially applicable to diseases of the chest. The general directions for the full and the half pack apply to it. It is a very mild application.
The pack may be applied to the legs with great advantage in cases of habitual coldness of the feet and limbs or knees. The same principles mentioned in relation to other packs apply to this. The application should be made either cool or cold, and should extend from the hips downward. It should continue from half an hour to an hour and a half.
CHEST WRAPPER.
This consists of a jacket made something like a vest, reaching from the neck to a little below the navel. It should be made of double thicknesses of soft toweling. To protect the garments or bedding from moisture, it should be covered with another jacket made like it but a little larger. In applying it, the wrapper should be wet in tepid water, and should then be applied as snugly as consistent with the comfort of the wearer. It should be re-applied every two or three hours, as it becomes dry.
If properly managed, the chest wrapper is a valuable remedy; but it has been greatly abused. It should not be worn more than a week without intermission. The practice of some in continuing it until it produces an eruption of the skin, and even longer—to promote a discharge—under the idea that a vicarious elimination is thus performed, is highly reprehensible, and has no sound physiological principle to support it. Such treatment is damaging to the skin, and does the patient no good in any way. The better plan is to allow the wrapper to be worn during the night, but omitted during the daytime. If worn during the day, it should be changed often, and should be removed so soon as the patient becomes chilly. Whenever removed, the surface of the skin should be washed or sponged with cool or tepid water. Feeble patients with defective circulation shouldwear the wrapper only while walking or riding on horseback.
This appliance may be profitably employed in a large number of chronic diseases. In chronic bronchitis, pleurisy, pleurodynia, asthma, and the early stages of consumption, it gives relief.
This was a favorite remedy with the early German hydropathists, and it is a very useful appliance when properly employed, though it has been much abused by excessive use, as in the case of the chest wrapper. To apply it well, a coarse towel about three yards long is the most convenient for use. Wet one-half of this, in tepid water, wring it until it will not drip, and apply it to the abdomen, placing one end at the side, and bringing it across the front first, so that two thicknesses of the wet portion will cover the abdomen. After winding the whole tightly around the body, fasten the end securely. The remarks made in reference to the wearing of the chest wrapper apply with equal force to the wet girdle. For feeble patients it is better to wet only that portion of the towel which covers the abdomen.
This a very efficient remedy for constipation, chronic diarrhea, and most other intestinal disorders. It is equally valuable in dyspepsia, torpid liver, enlarged spleen, and uterine derangements.
ASCENDING DOUCHE.
This modification of the douche is simply an ascending instead of a descending stream. It can be readily managed by constructing a reservoir in such position as to give the water ten or twelve feet fall, when the requisite force cannot be more easily secured. The water is conducted through a hose, and is allowed to issue through a nozzle near the floor. The patient sits or lies just over the nozzle, and a few inches above it.
This is a valuable remedy in treating piles, prolapsus of the bowels or uterus, and constipation.
In applying this bath, a vessel with a small opening in the bottom is elevated to a considerable height, water placed in it being allowed to drop upon the part to be treated. The aperture in the vessel should be only sufficiently large to give egress to a single drop at a time. The bath may also be given by placing in an elevated vessel one end of a skein of cotton yarn, the other being allowed to fall over the edge of the vessel and hang below it. By capillary attraction the water will be drawn up into the yarn and will drop off at the lower end very slowly.
This is a very convenient way of applying water where its cooling effects are required for a considerable length of time, as in wounds, bruises, sprains, and similar cases. It will “keep downinflammation” in a wonderful manner. It is not commonly necessary that the water should be very cold, as evaporation will keep the part sufficiently cool in most cases.
This is simply holding the arm in water of proper temperature. It is extremely useful in such painful affections as felons, sprains, and nearly all injuries of the hand and arm. Ulcers and acute and chronic skin diseases of the hands and arm are usually benefited by this bath. If cold water is painful, its application should be preceded by that of hot water, or alternated with it. Cold hands should be frequently rubbed in cool water, and alternately immersed for a few minutes each in hot and cold water. In case of painful felons, the arm must be immersed to the elbow to relieve the pain, although the disease is only in the finger.
The patient should lie upon his back, resting his head in a shallow basin of cool water. The attendant should bathe the forehead, face, and temples during the bath. The bath may be continued until the heat is removed or lessened.
The pouring head bath is often preferable to the preceding. The patient should lie upon a bed or sofa, face downward, allowing his headto extend outward over a tub or other wide vessel, while the water is poured upon the head from a little height, by an assistant. The water may be either hot or cold, according to existing conditions. Very cold water is not usually advisable, as its application soon becomes painful, and produces powerful reaction. It should be tepid or temperate. Some cases require very hot water for a few minutes, followed by a slight affusion of tepid water.
In hysteria, epilepsy, apoplexy, sun-stroke, acute mania, delirium tremens, and cerebral congestion from any cause, the head bath is a promptly efficacious remedy.
Water may be applied to the eye in various ways. A convenient method when only a brief application is necessary, is to lave the eye with water dipped by the hand. A gentle spray may be applied, or the eyes may be opened and closed in water, thus bringing them freely in contact with the element. Small glass cups made for the purpose may be filled with water and placed over the eye, the water being frequently changed; or wet cloths may be laid upon them.
In applying water to the eye, it is important to be able to first distinguish the exact nature of the difficulty, as much damage may otherwise be done by a wrong application. As a general rule,inflammations of the conjunctiva andexternalstructures of the eye requirecoolorcoldapplications, while inflammations of the cornea, iris, and otherinternalstructures, requirehotapplications. This rule is often violated in hydropathic establishments through ignorance of the structure and diseases of the eye.
Cool applications are best made by laying upon the eyes thin folds of linen cloth wet in cold water. Not more than two or three thicknesses should be used, as a thick compress soon becomes warm, while a thin one is kept cool for a longer time by evaporation. The compress should be changed every five minutes, at least, when there is much inflammation. The fomentation is as good as any method of applying hot water to the eyes. The application, when hot, should be as hot as the patient can well bear. If it affords relief, continue half an hour or more; if it increases the pain, desist at once. The same may be said of cold applications also.
Alternate hot and cold applications will give most relief in some cases. After a hot application, a slightly cooler one should always be applied for a few minutes.
A little milk, quince-seed mucilage, or other bland substance, added to the water, makes it more agreeable to the eye in bathing it.
The eye bath is applicable in all inflammations and injuries of the eye, and is infinitely superior to all other eye washes.
Daily bathing the eyes in tepid water is a good practice for those who use them much in reading, writing, or other work requiring close attention. Many eyes are ruined by neglect and maltreatment.
Water applications are made to the ear by means of fomentations, compresses, the douche, or the spray. Compresses and fomentations are useful in inflammations of the structures of the ear, including abscesses which often form in the walls of the external canal. Alternate hot and cold applications are useful in causing the absorption of inflammatory deposits, and thus restoring the hearing. The douche, administered with the fountain syringe, is a valuable means of removing foreign bodies and insects. The warm douche has proved very serviceable in restoring the hearing by removing hardened ear-wax. In administering the douche, the head should be inclined over a basin, while the stream of water is allowed to issue from the nozzle held close to the external opening of the ear. Violent syringing of the ear should never be practiced, as it may occasion irreparable injury.
This bath is administered either by drawing water into the nose while the mouth is closed, or by injecting it by means of a fountain syringe.Great care should always be exercised to apply the water gently, as a forcible application will cause pain and irritation. Injection should never be practiced with a piston syringe, as there is liability of forcing the water into the Eustachian canals and producing deafness. The temperature of the water should be warm or tepid for most applications.
Much benefit may be derived by the proper use of this bath in case of acute or chronic catarrh. The addition of a slight portion of salt to the water does no harm, and a slightly saline fluid is sometimes less unpleasant than pure water, probably because it is more nearly like the mucous secretion of the nasal mucous membrane. Drawing cold water into the nose is sometimes recommended for hemorrhage from the nose; but it is of doubtful utility, because the application cannot be continuous, and transient applications of cold water are always followed by an afflux of blood to the part so exposed. There are better remedies for nose-bleed.
The compress is a wet cloth or bandage applied to a part. The object may be to cool the part under treatment, or to retain heat. The compress may be used with equal success for either purpose. When the part is to be cooled, a compress composed of several folds should be wet incool, cold, or iced water, as required, and placed upon the part after being wrung so it will not drip. It should be changed as often asevery five minutes. This is often neglected to the injury of the patient. A very cold compress may be prepared by placing snow or pounded ice between the folds of the compress. This will not need renewal so frequently; but its effects must be carefully watched, as injury may be done by neglect. In applying cold to such delicate parts as the eye, a very thin compress is better. It should be renewed once in five minutes, at least.
When accumulated warmth is required, a thick compress is applied, being wrung out of tepid water, and covered with a dry cloth to exclude the air. Soft, dry flannel is an excellent covering. Rubber or oiled silk may be employed when the compress is not to be retained more than a few hours; but if it is to be worn continuously, they will be injurious, as they are impervious to air and thus interfere with the function of the skin. The effects of a compress thus applied are identical with those of the poultice, and the application is a much more cleanly one.
Compresses are applicable in all cases in which poultices are commonly used. They may replace the old-fashioned plasters with profit and comfort to the wearer. The wet-sheet pack, half pack chest pack and wrapper, leg pack, and wet girdle are all large compresses.
When applied continuously in the same place for a long time, the compress occasions a considerable eruption of the skin, and sometimes boils and carbuncles. There is no particular advantage in these eruptions, and they sometimes do much harm by producing a great degree of general irritation. The notion that they purify the system, though a very popular one, has really a very slight foundation. The discharge is largely made up of elements which would be of great utility if retained in the system, and the amount of foul matter eliminated in this way is certainly infinitesimal compared with the amount thrown off by a few inches of healthy skin. The skin can always do more and better work when healthy than when diseased. The eruptions are no doubt due to debility of the skin, produced by a too long continuance of the very abnormal conditions supplied by the compress. Yet, strange as it may appear, there are those claiming to be physicians who directly aim to produce inflamed and irritated surfaces by the continuation of the compress for months and even years.
Thewet head capis a compress made to fit the head. It should consist of several thicknesses of cotton or linen cloth, so as to retain moisture for some time. It is a good temporary appliance in diseases of the scalp, and for headache; but it should never be worn continuously for the purpose of relieving congestion, as it will have aneffect just the opposite of that desired. In eczema of the scalp it may be worn until the disease is cured, being frequently rewetted. It is an excellent means of preventing sun-stroke and other effects of heat when worn beneath the hat in summer; but even for this purpose its use should be temporary, the cap being worn only during the hotter portion of the day.
The fomentation is a local application analogous to such general appliances as the hot pack, vapor bath, and hot-air bath. It consists in the application of a cloth wet in hot water. It may be considered as a hot compress. Fold a softflannelcloth twice, so that it will be of three or four thicknesses. Lay it in a basin, pour boiling water upon it, and wring it dry by folding it in a dry towel. Or, if only one end of the cloth is wet, it may be wrung by folding the dry portion outside of the wet; in wringing, the whole will become equally wet. Apply it to the patient as hot as it can be borne. The second application can usually be made much hotter than the first. Frequently dipping the hands in cold water will enable the attendant to wring the cloth much hotter than he would otherwise be able to do. The most convenient way is to heat the cloths in a steamer; by this means they are made as hot as boiling water, and yet they are more easilyhandled, not being saturated with water. When no hot water is at hand, a fomentation may, in an emergency, be quickly prepared by wetting the flannel in cool water, wringing it as dry as desired, folding it between the leaves of a newspaper, and laying it upon the top of the stove, or holding it smoothly against the side. The paper prevents the cloth from becoming soiled, the water protects the paper from burning, and the steam generated quickly heats the cloth to boiling heat. For a long fomentation, the heat may be made continuous by applying over the wet cloth a hot brick or slab of soapstone.
The hot cloths should be re-applied once in five minutes. Two cloths should be employed, so that the second may be applied the moment the first is removed. To retain the heat, a dry flannel, rubber, or oilcloth should be placed over the fomentation. The application may be continued from ten minutes to half an hour, or longer in special cases. This appliance is very powerful, and should not be employed to excess. Alternate hot and cold fomentations are frequently more efficient than the continuous fomentation. Hot applications should always be followed by a cool or tepid compress for four or five minutes, at least.
The uses of the fomentation are very numerous. It is indicated whenever there is local pain without excessive heat, or evidences of acute inflammation. Local congestions, neuralgia, toothache, pleurisy, pleurodynia, and most local painsvanish beneath its potent influence as if by magic. For indigestion, colic, constipation, torpid liver, dysmenorrhea, and rheumatic pains, it is a remedy of great power, and is used with almost uniform success. In relieving sick headache by application to the head, neck, and stomach, its efficiency is unrivaled.
When applied to the head for some time without intermission, it will often occasion faintness; hence, a cooler application should be made after the use of the hot cloths for fifteen or twenty minutes.
If the applications must be continued for a long time, it is well in most cases to apply them at a temperature slightly lower than when they are to be used for only a few minutes.
This remedy may well replace the blisters, plasters, cataplasms, scarifications, rubefacients, and other irritating measures so long used for relieving pain, local congestions, and inflammations.
A freezing mixture which will reduce the temperature to 4° is made by mixing equal parts of salt and pounded ice. The ice and salt should be stirred together very quickly and applied at once to the part to be frozen. Two parts of dry snow and one of salt make an equally good mixture. Freezing is more conveniently performed by the rapid evaporation of ether or rhigoline.
Freezing is a useful process in numerous cases. By its use, excrescences—as warts, wens, and polypi—fibrous tumors, and even malignant tumors, as cancer, may be successfully removed. Small cancers may sometimes be cured by repeated and long-continued freezing. Their growth may certainly be impeded by this means. Felons, if treated early in their course, may be cured by two or three freezings.
For freezing a felon, place the finger in a mixture ice and salt, or surround it with cotton, saturate the cotton with ether or rhigoline, and blow it very strongly with a pair of bellows. This is a very good method when an apparatus for producing a fine spray is not at hand. The latter instrument facilitates the freezing very much if used with the bellows.
No harm results from repeated freezing if proper care is used in thawing the frozen parts. They should be kept immersed in cool water, or covered with cloths kept cool by frequent wetting with cold water, until the natural feeling is restored.
The application of ice is found extremely serviceable in many inflammatory diseases, and in some nervous affections. In inflammation of the brain, the ice cap is of inestimable value. Ice applied to the spine will check the convulsive spasms of chorea and hysteria when other remedies fail. In putrid sore throat, or malignant diphtheria,ice is a sovereign remedy. It should be applied to the neck externally, and held in small bits in the mouth. Small bits swallowed will sometimes relieve the pains of gastralgia.
Rubber bags are very convenient for applying ice or iced water; but their place can be very well supplied by dried bladders filled with pounded ice. The ice cap is a double head cap stuffed with pounded ice.
Some physicians recommend the application of ice to the spine in cases of congestive chill and paralysis, and in inflammation of the stomach, kidneys, uterus, and other internal organs. The real worth of such applications in these cases has yet to be determined by careful and repeated observations. We would not recommend an unskillful person to attempt to relieve a violent ague chill by rubbing ice on the patient’s back, and we have some fears that a very skillful operator would hardly succeed to his entire satisfaction and that of the patient.
The snow bath, applied by rubbing the part vigorously with snow, is a useful application for restoring the circulation to frosted parts. In cases of extreme chilling or absolute freezing, there is perhaps no better remedy. Powdered ice may be used when snow cannot be readily procured.
MISCELLANEOUS BATHS, ETC.
This bath can be readily and successfully administered with such conveniences as every family possess. Place the patient in a cane-seat chair, having first taken the precaution to spread over the seat a dry towel. Surround the patient and the chair first with a woolen blanket, and then with two or three thick comfortables, drawing the blankets close around his neck, and allowing them to trail upon the floor so as to exclude the air as perfectly as possible. Now place under the chair a large pan or pail containing two or three quarts of boiling water. Let the blankets fall quickly so as to retain the rising vapor. After a minute or two, raise the blankets a little at one side and carefully place in the vessel a very hot brick or stone, dropping the blankets again as soon as possible avoid the admission of cold air. Before the first brick or stone has cooled, add another, and so continue until the patient perspires freely. The amount of perspiration must be judged by the face and forehead, as much of the moisture on the skin beneath the blankets is condensed steam. Should the bath become at any time too hot, a little air may be admitted by raising the bottom of the blankets a little, being careful to avoid chilling the patient in so doing. The bath should seldom be continued more than half an hour,and fifteen to twenty minutes will usually accomplish all that is desired by the bath. If too long continued, it induces faintness. A too high temperature will be indicated by a strongly accelerated pulse, throbbing of the temples, flushed face, and headache. The head should be kept cool by a compress wet in cool water and often changed. The temperature of the bath should be from 100° to 115°. Unpleasant effects are sometimes produced at 120°.
After this bath, apply the tepid spray, rubbing wet-sheet, pail douche, or full bath. No time should be allowed to elapse after the blankets are removed before the concluding bath is applied, as the patient will chill. He should not be allowed to become chilly by exposure to cool air before the application of the spray, douche, or other bath, which should be followed by vigorous rubbing.
For “breaking up a cold,” relieving rheumatism, soreness of the muscles from overexertion, and relaxing stiffened joints, this is a valuable agent. It may also be used to advantage in chronic diseases in which there is torpidity of the skin; but great care must be exercised to avoid excessive use, as too frequent repetitions of the bath produce debility.
This is a milder application than the hot-air bath, unless employed at a high temperature, 120° or more, when it becomes more severe.
In institutions where the bath is in daily requisition,a permanent arrangement for giving the bath is usually employed. It sometimes consists of a box in which the patient sits upon a stool, his head being allowed to remain outside by a suitable opening. A wet towel is placed around the neck to prevent the steam from rising about the head. Others prefer a box or small room large enough to admit the whole person, the whole body being subjected to the warm vapor. An opening guarded by a curtain is made in one side to allow the bather to inhale cool air if he should wish to do so, and to give the attendant access to the patient without chilling him by the admission of a large quantity of cold air. As in the simpler form of vapor bath, the head should be kept constantly cool by a cool wet compress often re-applied. Patients troubled with “rush of blood to the head,” should be further protected by a large cool compress placed around the neck and the upper part of the chest.
Steam may be generated for these larger baths by boiling water in the box with a spirit-lamp or a gas-burner, or it may be conducted into the box by a rubber tube connected with a tight boiler.
This is essentially the same in effect as the vapor bath. It consists of a room filled with vapor, and so arranged that by transferring the patient from one point to another the heat may be gradually increased. It has no advantagesnot afforded by the simpler vapor bath. It is now much used in the larger cities. Probably as much harm as good results from the indiscriminate and reckless manner in which it is employed. Patients have been known to die in the bath of apoplexy induced by the excessive heat. It is followed by shampooing and cooling baths of various sorts.
In administering this bath, prepare the patient precisely as directed for the vapor bath. Instead of placing under the chair a vessel of hot water, place a large alcohol lamp or a small dish containing a few ounces of alcohol. When all is ready, light the lamp or alcohol, and carefully exclude the air. It is hardly necessary to suggest the propriety of putting the lamp in such a position as to insure safety from fire. If alcohol is used in an open dish, it is important to wipe the outside of the vessel quite free from any trace of the fluid, as otherwise it might be communicated to the floor or carpet. Also avoid spilling any portion in putting it in place, for the same reason. It is a very good precaution to place the dish containing the burning alcohol in a plate or shallow vessel containing a little water.
This bath should be conducted in the same manner as the vapor bath. A temperature of 140° to 160° is not at all disagreeable to the patient.At 170° or 180° the same effects are produced as in the vapor bath at 120°. The bath should be followed by cooling baths as directed for the vapor bath.
This is a very valuable remedy for the same class of diseases for which the vapor bath is recommended. It is of very great service in cases of dropsy, Bright’s disease with poisoning from retained urea, and all cases in which a vigorous elimination by the skin is desired. It should not be continued longer than the vapor bath, and much harm may result from its too frequent employment. Like the vapor bath, this may be conducted in a suitable box with an opening for the head.
This is entirely analogous to the hot-air bath, though on a much more elaborate plan. The patient is gradually conducted from a temperature of 120° to that of 160° or even much more than 200°. The bath is concluded by shampooing, rubbing, cooling baths, and gradual cooling in a room maintained at a temperature of 70°.
The uses of this bath are the same as those of the hot-air bath. It has no advantages over it of very great importance, and is much more liable to produce injury by prolonged and frequent application. It generally occupies an hour, and by those who resort to it as a luxury, as did the ancient Romans, it is often prolonged to several hours.
The long-continued application of excessive heat to the body is a very unnatural process. It tends to produce permanent relaxation and debility of the cutaneous tissues, and the manner in which this bath is administered in Turkish bath establishments is productive of great harm. It is often presented to invalids as almost a panacea; and is given alike to the strong and vigorous, and the weak and debilitated.
The bath is certainly good in its place, but it is decidedly bad when abused. Many consider the hot-air bath greatly preferable since it obviates the necessity of inhaling superheated air, the effects of which upon the lungs are said to be injurious. The hot-air bath is doubtless safer.
Electricity may be more efficiently applied in connection with water than by itself. Water is a better conductor of electricity than the dry skin, and hence facilitates its communication to the body. The ordinary method of applying electricity is by attaching one pole of the battery to a metallic plate, placed in contact with some part of the body, while the circuit is completed by the application to the patient of a moist sponge connected with the other pole. The operator often holds one pole in his hand and applies the other hand, moistened, to the part to be treated. He is in this way enabled to judge very accurately of the strength of thecurrent applied. The metallic plate is frequently placed at the feet of the patient, sometimes in a foot bath. The sponge may be applied to various parts of the body while the patient is in a sitz bath. For a general application of electricity the full bath is most convenient.
This bath is applicable to a very large variety of conditions. To describe them all would be to give nearly all the uses of electricity as a remedial agent, which does not come within the scope of this work. The electric full bath has been strongly recommended for the removal of mineral poisons from the body. Just how efficacious it is in this respect, we cannot confidently affirm. Probably its value has been somewhat exaggerated. Only the primary or galvanic current could be of any service in this direction.
Electricity is generally acknowledged to be a powerful remedial agent; but its use requires costly apparatus and much skill in application. It is necessary that the operator should not only understand the nature of diseases and the proper methods of applying electricity in treating them, but he must also thoroughly understand the general laws of electricity. The electric bath is as badly abused by quacks and charlatans as the Turkish bath. It should not be employed by unskillful persons; and for this and other reasons given, it is not well adapted to home use.
ELECTRO-VAPOR BATH.
This is a combination of the electric and the vapor bath, the electricity being applied to the body by means of the sponge, and metallic plates covered with moistened cloths. It is a valuable appliance if carefully used; but, like all effective modes of treatment, it is very liable to excessive use, which becomes abuse. It has been very highly lauded by certain specialists, and doubtless its value has been unstintedly exaggerated. It is perhaps not well proven that its effects are greatly superior to the effects of the vapor bath and electric bath administered separately; and the latter mode would be more convenient, though consuming a little more time.
Cover the patient with a soft, dry sheet in the same manner as directed for applying the wet sheet in the rubbing wet-sheet bath. Then rub lightly but briskly upon the outside of the sheet with the flat hand. Do not rubwiththe sheet, but over it. Continue the rubbing ten or fifteen minutes, going over the whole body several times, and not neglecting the arms, the hands, and the feet. This application may be administered daily with profit to nearly all patients. It should always follow any form of general bath in which water is employed, as a means of drying the body. It promotes activity of the skin, and equalizes the circulation.
DRY HAND-RUBBING.
This application is much the same in effect as the preceding, though a little more soothing, and hence better adapted to nervous patients. It consists in rubbing the body gently with the palm of the dry hand. The force of the rubbing should be nicely graduated to the condition of the patient. When employed to excite considerable activity of the skin, the rubbing may be accompanied with kneading of the abdomen, and light percussion of the surface.
Gentle rubbing of the skin is a very soothing process. It will frequently induce sleep when other means are ineffectual. Rubbing the back and limbs downward, and gentle rubbing of the temples, are very soothing to children and nervous invalids.
The air has a very soothing effect upon the body when allowed to come in contact with the entire surface. It answers a very valuable purpose when a water bath is impossible, or when the patient is too feeble to endure the application of water. A sleepless person will often fall into a sound and refreshing slumber after walking a few minutes in his room with the whole body exposed to the air. The effects of night labor upon literary people may be partially counteracted by the air bath. Benjamin Franklin was accustomed to pursue his writing to a latehour after divesting himself of his clothing, and he recommends the practice to others compelled to labor late with the pen.
The value of sunlight as a hygienic agent is so universally recognized—theoretically if not practically—that we need not devote space to its consideration in this connection. Sunlight is essential to the healthy performance of the vital functions, and must be equally important as an aid to remedial processes. This fact has been amply demonstrated by hospital experience, which shows a much larger percentage of recoveries in rooms abundantly exposed to the sun than in those secluded from its rays.
That the sun has a powerful influence upon the skin is shown by the great increase of pigment in that structure when freely exposed to the sunlight. This results from an increased activity of the cutaneous tissues.
Experience has shown that the sun bath can be employed to advantage in most chronic diseases. The patient simply lies in a position in which the naked skin can be freely exposed to the rays of the sun. The head should be shaded. The bath should not be continued so long as to produce unpleasant effects either upon the skin or the general system. It may be accompanied and followed with the dry hand-rubbing.