HYDROTHERAPY 



857 



when the abstraction of heat is gradual or prolonged or when the individual 

 is already cool or remains quiescent during and after the bath; it is in- 

 creased when the application of cold is rapid and when a mechanical stimu- 

 lus is added. 



A transient fall in body temperature, even several degrees, may follow 

 a cold bath and the effectiveness of a bath only slightly below body tem- 

 perature in reducing fever temperature has long been known (Palmer). 

 The contrary findings of different investigators (Liebermeister(6) ; Le 

 Fevre(c) ; Durig and Lode) often of ti single investigator on the same 

 subject, are evidence that body temperature is not a simple resultant or 

 that physical regulation does not behave uniformly, a possibility suggested 

 by the ability of adaptation to repeated cold. Jiirgenson found the great- 

 est lowering of temperature by a cold bath not during but after the bath, 

 a "primary after effect" that has been found by others (Mattill(o.)) 

 and may be due in part to evaporation of water retained on .and in the 

 epidermis, in part to the failure of physical regulation during the active 

 hyperemia and its increase of heat loss. After the cooling period (5-8 

 hrs.) the temperature may rise higher than the corresponding daily tem- 

 perature and remain there some hours as a result of the "after-effect." 

 The duration ^and extent of these variations in body temperature are ex- 

 tremely variable (Loewy, M tiller, et aL ; Hoffman). Local applications 

 of cold may markedly lower the temperature of the part treated as well as 

 of the underlying tissues and organs (Riehl). 



The effect of cold baths on heat production is marked and the small 

 magnitude of body temperature changes is in fact very good evidence of 

 the efficiency of the thermoregulating mechanism. Widely quoted figures 

 (Matthes(fr)) for the effect of bathing on heat production appear in 

 Table I. 



TABLE I 



EFFECT OF BATHING ON HEAT PRODUCTION 



Similar results were obtained by Ignatowski who, in a bath at 17 C. 

 lasting 2.5 minutes found heat production 14 times normal. Of the 65 



