S40 



BATHING. 



Cautions. 



Effects of 

 the hot 

 hat*. 



Bathin. protracted to twenty minutes or longer, according to 



' v the feelings of the patient) and after bathing, gentle 



exercise in the open air should be employed. 



Those cases to which the warm bath is less appli 

 cable, are principally affections of the lungs, accom- 

 panied with great difficulty of breathing, and some 

 organic affections of the internal parts. 



The effects of the hot bath differ in several parti- 

 culars from those of the warm bath. The sensation 

 of heat experienced on entering a bath above 98 is, 

 in general, very striking and permanent. The pulse 

 is increased in frequency and force ; the superficial 

 veins become turgid ; the face is flushed ; the respi- 

 ration quicker than natural, and sometimes hurried 

 and laborious ; and the perspiration is increased. * 

 If the heat of the bath much exceed 98, or if the 

 immersion be continued beyond a few minutes, the 

 determination of blood to the head is greatly increa- 

 sed ; the arteries of the neck and temples throb vio- 

 lently ; a sensation of anxiety at the breast, threat- 

 ening suffocation, comes on ; the person grows giddy, 

 and feels a fluttering at the heart. If these warnings 

 of approaching danger be not attended to, the bather 

 soon becomes insensible, and expires of apoplexy. 



Water of this high temperature is scarcely ever 

 employed in the way of affusion ; nor is such an ap- 

 plication likely to be attended with advantage, ex- 

 cept in some paralytic affections of the limbs. In 

 these cases it is not unusual, at Bath and other hot 

 springs, to pump the hot water on the affected limb. 

 By this dry pumping, as it is commonly called, the 

 hot water is applied to the affected parts under a 

 higher temperature than when it is drawn off into the 

 reservoirs commonly employed for bathing. 



From the above account of the effects produced by 

 the hot bath, it appears, that this remedy is a power- 

 ful stimulus, to be employed only in a few cases where 

 the ordinary stimuli are ineffectual. Accordingly 

 it is very seldom resorted to in medical practice, 

 and almost the only cases in which the general hot 

 bath is employed are those of confirmed and obstinate 

 palsy. 



Cautions. In the use of the hot bath, considerable caution is 



required. The patient should begin with the lowest 

 temperature of such a bath, or about 99, and gra- 

 dually increase the heat each successive bathing, ac- 

 cording to its effects. The time of immersion should 

 be short ; and, on coming out of the bath, great care 

 should be taken to avoid sudden exposure to cold. In 

 some cases, attended with fulness of habit, it may be 

 necessary to bleed or purge before attempting the 

 hot bath. 



Effects of Though the vapour or steam bath may be regard- 



the^vapour ed as a modification of the hot bath, its effects are 

 much less violent ; and it has been employed with 

 considerable success in cases where the hot bath would 

 be attended with danger. It therefore requires our 

 particular consideration. 



The most usual mode of employing the vapour 

 bath is, as we have said, to expose the naked body in 

 a room, into which the steam of hot water may be 



Medical 



uses. 



bath. 



History of 

 bathing. 



The air- 

 pump va- 

 pour bath .- 



admitted. This room is generally heated to a tern- B^ih'np. 

 perature considerably above that of the atmosphere, v 



and the body is for some time suffered to remain in 

 this heated air ; the common effect of which is to in- 

 crease <ts temperature, and accelerate the circulation 

 of the blood. After some time the steam is admit- 

 ted, when the former symptoms are removed, and a 

 profuse perspiration is produced. This is usually 

 promoted by friction, and removal to a warm bed. 

 The general effect of this process is, to relax the bo- 

 dy, remove obstructions of the skin, alleviate pain 

 and spasmodic contractions, and promote sleep. 



In the vapour bath, the stimulant power of heat is 

 modified and tempered by the moisture diffused 

 through the air, and as the elastic vapour, like air, is a 

 less powerful conductor or transmitter of heat than a 

 watery fluid, the effect of vapour in raising the tem- 

 perature of the body is much less than that of the 

 hot bath. Its heating effect is also further diminish- 

 ed by the copious perspiration that ensues, so that, 

 on all accounts, the vapour bath is safer, and in most 

 cases more effectual, than the hot water bath. 



For the topical application of steam to the greatest 

 advantage, the air-pump vapour bath was contrived 

 by Mr Smith ; and an account of the apparatus and 

 its effects have been published by Dr Blegborough, 

 in a pamphlet to which we have already referred. 

 His apparatus consists of a vessel of strong copper 

 tinned on the inside, for inclosing the part to which 

 the vapour is to be applied, and having attached to 

 it a bladder, for the purpose of securing it, so as to 

 be air-tight. To one end of the machine is fitted a 

 pipe that communicates with a portable boiler, in 

 which the water is heated by means of a spirit lamp. 

 There is also a small air-pump for exhausting the 

 machine, when the application is to be made in rare- 

 fied air, or after it has continued for a proper time. 

 A thermometer is adjusted to the apparatus, for 

 shewing the temperature of the included air. 



This apparatus acts on the principle of removing 

 the pressure of the atmosphere from the part affected, 

 while moist and heated air or vapour is applied to it. 

 Hence, it combines the actions of dry-cupping and 

 fomentation, each of which is occasionally employed 

 with advantage in several morbid affections. 



The cases to which this vapour bath seems best 

 adapted, are chiefly gout, both acute and atonic ; 

 acute rheumatism, palsy, several affections of the 

 skin, as leprosy and ulcers, and white swelling of the 

 joints. It is also recommended in female obstructions, 

 chilblains, tetanus, and dropsy, and has proved high- 

 ly efficacious in inflammations of the stomach and 

 bowels. The usual mode of application is, to foment 

 the part affected, by means of the steam admitted in- 

 to the body of the machine, for a time proportioned 

 to the nature of the case, commonly from half an 

 hour to three quarters, and then to exhaust the ma- 

 chine by means of the air-pump, which generally oc- 

 cupies another quarter of an hour. 



In the employment of the general vapour bath, it Cauticffi. 

 is evident that its first effects would be attended with 



Medical 

 uses of the 

 vapnur 

 bath. 



The hot bath is described as increasing the perspiration ; but this effect can take place on the immersed part of the body, 

 only in the lowest degrees of the hM bath. The parts exposed to the air, indeed, will perspire, but the general perspiration 

 can scarcely take place till after quitting the bath. 



