860 HENRY A. MATTILL 



porarily occasioned by cold baths (Lambert), but the vasomotor changes in 

 the skin, perhaps also in the kidney (Delezenne; Werthheimer), probably 

 influence urine secretion somewhat. An increase in the number of 

 erythrocytes takes place during a cold bath and is maintained for as long 

 as two hours according to Winternitz but this is not confirmed by Tuttle. 

 An increased elimination of urobilin after cold baths has been reported 

 (Siccardi) and leucocytosis has also been observed (Rovighi; Thayer). 

 The occurrence of paroxysmal hemoglobinuria after cold baths is 

 common ; a fairly complete review of this condition is given by Donath who 

 concludes that a hemolytic property is imparted to the plasma by cold. 



Cold baths usually have a refreshing effect ; whether this comes as 

 a result of modifications in the cutaneous sensations (Santlus) or in muscle 

 sense (Vinaj) or as the result of changes in muscular efficiency (Uhlich) is 

 uncertain. That baths produce these changes is also questioned (Tuttlej. 



Hot Baths 



The body possesses no chemical regulation for lessened heat production 

 and when, in surroundings warmer than the body, the utmost heat loss by 

 radiation and evaporation has been secured, the body temperature must 

 rise. Kise of temperature means increased metabolism, as was first shown 

 by Pfliiger on animals and later by Winternitz and others (Ignatowski; 

 Linser and Schmid) on man. Even moderate heating without any change 

 in respiration causes an increase in oxygen consumption in excess of that 

 due to fever ( Winternitz (&)). Some of this increased heat production 

 can be accounted for by increased work of the heart, of the muscles of 

 respiration and of the sweat glands, but Wintemitz's calculation still 

 leaves 30-75 per cent unaccounted for, and it is probable that under these 

 conditions warm-blooded animals, having overstepped the limits set by 

 the heat-regulating mechanism, are subject to the effects of the general 

 law applying to all chemical reactions. 



The after-effects of a hot bath are less* uniform than those of a cold 

 bath. A continuation in the rise of body temperature after a hot or vapor 

 bath is explained (Speck) as a natural result of the higher temperature of 

 the skin and subcutaneous tissues as compared with that of the muscles and 

 internal organs (Ilirsch and Mliller), a reversal of the ordinary condition. 

 A compensating abnormal fall in temperature is seldom observed but in 

 the two hours after a hot bath during which normal temperature is re- 

 gained (Wick) there is a continued loss of heat in the various ways at 

 double or three times the normal rate (Ignatowski). Wintemitz(?>) 

 found oxygen consumption still 29 per cent above normal, 75 minutes 

 after a hot bath. Even in hot baths of short duration without appre- 

 ciable heat disturbance the volume of inspired air, the oxygen in- 

 take and the C0 2 output are increased but to a much smaller extent 



