BATH IN.!. 



HATH INC. 



1. The cold-bath, tram 40* to 05* 



3. The cool -.5 75 

 . The temporal* 75 65 



4. The tepid M g 

 6. The warm . M 1)8 

 . The hot 88 112 



We ahall treat first of UM cold-bath, a* applied to the whole surface 

 of the body. 



A healthy penon upon entering a cold-bath experience! a ami nation 

 of cold, followed by alight shuddering, and if the immersion ha* been 

 mddec, a peculiar impression on the nervous system, called a shock. 

 The akin becomes cooler and paler, the respiration hurried and 

 irregular, the action of the kidney* increase* and the bladder contracts. 

 In a few moment* the colour and warmth return to the akin, aud a 

 glow U felt, especially if assisted by rubbing the surface. If the penon 

 remain* more than five or ten minutes in the bath, the glow disappear*, 

 and paleness returns, which again gives place, though les quickly and 

 perfectly, to a leuewed glow. During the existence of the primary 

 action of the cold, the bulk of the whole body, but especially of the 

 more contractile parts, diminishes. Should the stay in the water be 

 greatly prolonged, no reaction ensues, but a general feeling of chilliness 

 prevails, with quick feeble pulse, convulsive breathing, cramp* of the 

 limbs, or fainting. If the person quit the bath after the few lint 

 minutes, as in prudence he should, the blood returns to the surface, 

 accompanied with a sensation of pricking, itching, and sometimes 

 throbbing of the arteries : the elasticity of the muscles being increased, 

 more animal power is felt, accompanied with a general feeling uf 

 enjoyment. 



Very young or feeble individual* are either incapable of bearing the 

 shock, or the re-action is so slight that they cannot endure to stay in 

 the bath beyond a very short time. If they unwisely stay or are held 

 in the bath longer than one or two minutes, the heat never regains its 

 proper height, the extremities remain contracted, and they, as well as 

 the lips, noee, &c., are of a livid hue. In such cases, either artificial 

 means must be used to bring about reaction, or the bath uiuat be relin- 

 quished, as improper for such persons, as we shall show at a future 

 part of our observations. 



The phenomena just described generally accompany cold bathing ; 

 and it is clear that we can recognise in them a series of three or even 

 four distinct actions : namely, 1st, the shock ; 2nd, the cooling effect ; 

 3rd, the contraction or astringent effect ; and 4th, the re-action. Cold- 

 bathing may be employed therefore in such a way as to insure the pre- 

 dominance of one action over any of the rest, according to circumstances, 

 where all are not desired. They vary with the degree of cold aud the 

 fwHTBiff* of the application, as well as fruui the body being plunged 

 into the water, or the water dashed against the body. Where the 

 shock, as a stimulus to the nervous system, is desired, the water should 

 be very cold, and where practicable should be dashed against the body, 

 or, if the contrary, the stay in the bath should be momentary. This 

 mode of using it may be either general or local. It has been employed 

 generally that is, the whole body exposed to the action of the water 

 in mania, with occasional success, and in 'he early stage of the common 

 continued fever (under certain regulations, for which see Currie's 

 * Medical Reports '), sometimes with gr (at success, cutting short the 

 bain of morbid actions which const' Aite the fever. It has been 

 employed also in nervous affections, accompanied with a convulsive 

 action, or deficient action of the muscular system, as in hysteria, in 

 lock jaw (see Paper by Dr. Wright, ' London Medical Observations 

 and Inquiries,' voL vi. p. 148) : in some cases of obstinate constipation, 

 Hyping cold water on the person, or the cold bath frequently repeated, 

 has been of great service. 



Its irtimiiT*ting effect is sometime* best procured by a local appli- 

 cation, in the form of a stream of water falling on the head, from a 

 considerable height. The simplest example of this is the common 

 practice of sprinkling the face with cold water in case of a tendency to 

 faint ; and in many diseases of the most dangerous character it is a 

 remedy superior to any other. It is called the cold doth, or dowJtt, or 

 datuc, and is beneficially employed in fever, particularly when the 

 brain continues the seat of inordinate action of the blood-vessels, after 

 depletion has been carried as far as prudence will allow. (See the 

 instructive case of Dr. Dill in Dr. Southwood Smith's ' Treatise on 

 Fever,' p. 398). It requires to be used with the greatest caution. Also 

 in the state of stupor or coma which occurs in the last stage of hi/tin- 

 crfkaltu uctUut, or water in the brain, it often succeeds in rescuing the 

 patient from <mminnt danger. (See Abercroiubie, ' On Diseases of 

 the Brain,' first edit. 1828, p. 157.) Its utility is well known in the 

 East in rousing drunken soldiers from their stupor so effectually as to 

 enable them to rise up and appear immediately on parade. In the 

 melancholy and mania which overtake habitual drunkards it is of great 

 fficacy, and also in casw of loss of nervous power from excessive men- 

 tal exertion. In apoplectic stupor it has also been very advantageously 

 employed. In the sinking stage of croup, when all other remedies 

 have failed, cold affusion has sometimes restored the functions of life 

 to new action. 



The cooling or refrigerating effect of cold bathing is moat desired in 

 diseases where the animal heat rises above the proper standard, as in 

 fever*, both continued and eruptive, especially scarlet fever; also in 



some local Inflammations, particularly of the brain. For the principle, 

 which ahould regulate onr practice in this application we must refer to 

 Dr. Currie and other writers, only remarking that, in tin- hot and rest- 

 less stage of scarlet fever, when the heat i* steadily above the natural 

 standard, the akin hot and dry, and neither sleep nor perspiration can 

 be procured, a plunge into cold water will be followed by both, to the 

 relief and often recovery of the patient (See lUfanuMi ' On Cutaneous 

 Diseases,' edit 1829, p. 120.) In applying cold locally, as in inflam- 

 mation of the brain, one rule is of the utmost importance to be 

 observed, namely, that the application of the cold shall be continuous ; 

 therefore a second set of cold cloths or bags of ice should be . 

 before the former has become warm. This plan, especially pursued 

 during tlie night, along with judicious internal treatment, will save 

 many children from perishing under the most insidious and fatal 

 disease of childhood water in the brain. 



The cases already mentioned are mostly acute ttiinsim, where the 

 cold affusion is employed to avert an imminent but temporary danger. 

 It is generally in chronic di^H'^^ that the cold bath is employed for a 

 length of time, and in these it is chiefly the secondary effect, the glow 

 or reaction, which U desired. The rules to be observed in order to 

 obtain this effect are founded upon the strength, which U generally 

 inferred from the age, of the individual. The degree of reaction is, 

 for the most part, dependent UIKIU the coldness of the water and the 

 length of time the person remains in the bath. Very cold water, in 

 which the person remains but a short tiuiu, will in general produce a 

 greater degree of re-action than a more moderate temperature in 

 which he remains longer. But here everything depends upon the 

 general power of the individual, the state of the system, especially of 

 the skin at the moment of immersion, aud the nature of the bath, 

 according as it is fresh or salt water, and aim the season of the year. 

 As the immersion of infants aud young children in tubs of water must 

 be considered as bathing, we deem it necessary here to explain the 

 principles upon which the temperature of the bath for them should be 

 regulated, especially during winter. The experiments of Dr. Edwards 

 (see Edwards ' On the Influence of Physical Agents on Life,' London, 

 1832) have proved that " the power i producing heat in warm-blooded 

 animals is at ititninimum at l/irl/i,:au\ incrtata tuecettivdy to adult agt." 

 It is clear therefore that water of a higher temperature than what feels 

 cool to the hand of the nurse should be used, particularly in winter, 

 when the power of regaining a proper degree of heat is necessarily less. 

 The attempt to harden children by exposure to too great a degree of 

 cold is of the most injurious nature ; it either produces acute disease 

 of the lungs, which are then very sensible to external impressions, or 

 disease of the digestive organs, leading to disease of the mesenteric 

 glands, scrofula, water in the brain, or, if they survive a few years, to 

 early consumption. (See an illustrative instance in a young si 

 Southey the poet, in vol. i., p. 28, of his ' Life,' 1st edit, 1849.) Delicate 

 and feeble persona of all ages require a higher temperature of the bath, 

 aud a shorter stay in it than others. If the re-action does not speedily 

 take place, means must be employed to ensure its so doing, or the use 

 of the cold bath must be abandoned. A tepid or temperate bath may 

 be used in the early treatment of feeble persons, and the cold bath 

 gradually substituted for it, or a glass of wine, or, what i far prefer- 

 able, strong coffee or chocolate may be taken before entering the bath. 

 Where the arrangements are such as to admit of it, a brief stay in a 

 warm bath before going into the cold has a good effect Nor, in 

 general, is danger to be apprehended from such a proceeding. Though 

 in most oases moderate exercise is advantageous before bathing, unless 

 the person has an opportunity of springing out of bed into the bath, 

 still he should never think of undressing and going into the water 

 when fatigued, or when the skin is covered with perspiration. It is a 

 good rule to wet the head before taking the plunge. For a person in 

 good health, early in the morning U the best time to bathe ; for one 

 more delicate, f n >m two to three hours after breakfast is preferable ; 

 but no one should bathe immediately after a full meal, particularly if 

 there be a tendency of blood to the head, and a disposition to apoplexy. 

 Epileptics should rarely bathe, least of all in the sea. 



Exercise while in the bath, such as friction of the limbs and chest, 

 or swimming, is advisable, but not even this can prevent evil conse- 

 quences if the bather remain too long in the water. To say nothing of 

 the risk of cramps and convulsive action of the respiratory muscles, 

 from the blood being pent up in the large internal vessels, which may 

 occur while the person is in the water, the foundation may be laid for 

 future internal disease if the blood do not soon revisit the surface, 

 either from the natural powers of re-action, <>r from trillion with 

 coarse dry cloths. Friction should follow the use of tin' Kith in most 

 instances, except where the bath has been in the sea, in which case the 

 salt particles if allowed to remain in contact with the skin, stimulate 

 it more. 



The oases of disease for which cold bathing is a valuable remedy are, 

 morbidly increased irritability and sensibility, accompanied with general 

 il.-l.ility. If the sensibility be extremely high, it is best to begin with 

 the tepid or cool bath, and pass gradually to the cold. When- there is 

 a tendency to colds and rheumatism, the r..M Kith i an ooeili 

 ventive ; for this purpose it should be used continually throughout 

 the year, and the chest should be sponged with cold water, or vinegar 

 and water may be substituted in winter, when there are not facilities 

 for using the complete bath. Before beginning this practice, careful 



