Part 10

25. A patient should never be left chilly after a bath. Rub until warm.

26. It is equally important that the body should not be left in a state of perspiration, for it will soon become chilly.

27. Patients who are able to do so should exercise a little both before and immediately after a bath to insure thorough reaction.

28. An hour’s rest soon after a bath will add to its beneficial effects. It is best to go to bed and cover warm.

29. If a bath is followed by headache and fever, there has been something wrong, either in the kind of bath administered, or in the manner of giving it.

30. Very cold and very hot baths are seldom required. The barbarous practices of half a century ago are now obsolete, or should be, if they are not quite discontinued as yet. No good resulted from them which cannot be attained by milder means, and much harm was occasioned which is avoided by the use of less extreme temperatures.

31. Patients should not be allowed to become dependent on any special form of bath, as an after-dinner fomentation to aid digestion, the abdominal bandage, or any other appliance. Destroy such a habit if it has been formed.

32. Order, cleanliness, dispatch, and a delicate sense of propriety are items which every bath attendant should keep constantly in mind, and which will often contribute in no small degree to success in the use of this agent.

33. Never employ a bath without a definite and legitimate purpose in view. It is somewhat customary, in many institutions where water is employed, to apply it in a routine way. Many baths are prescribed for the sake of producing variety, or pleasing the patient. A faithful and scientific physician will carefully adapt his remedies to the condition of his patient, and will observe the results. It seems to be a prevalent error that it makes little difference how water is applied, provided the patient is only wet. Warm, hot, tepid, temperate, cool, and cold baths are used indiscriminately.

So, also, the different modes of administering baths of the same temperature are disregarded in many cases. In general, each particular form of bath is especially adapted to the treatment of special conditions, and it is the best test of the proficiency of a physician, in the use of water, to observe whether he recognizes the distinctions between the various kinds of baths, and is able to adapt them to the appropriate conditions.

34. Giving too much treatment is likely to be the error into which the inexperienced will fall, rather than the opposite extreme. Nature cannot be forced to do more than she is capable of doing; and as nature must do the healing, if a cure is accomplished, remedies should be of a helping rather than a crowding or forcing nature. The vitality of patients may be expended uselessly by treatment, for baths excite vital resistance, as well as drugs, a fact which many overlook. The dangers of over-treatment are not so great as some imagine, however, who take the opposite extreme, and advocate rest as the great cure-all. We have seen patients who seemed to be quite monomaniacs on the subject of “rest cure,” who needed a good thorough stirring up with useful exercise more than any other kind of treatment.

GENERAL BATHS.

Baths applied to the whole surface of the body are, as we have already seen, among the most powerful means of affecting the human system either in health or disease. Baths of a temperature less than that of the body, 98°, unless of very brief application, uniformly decrease the bodily temperature. That the diminution of temperature is not merely local, being confined to the skin and superficial structures, is shown by the fact that the thermometer indicates a decline of temperature in the interior of the body as well. The bath diminishes the production of heat throughout the whole system, besides abstracting large quantities by its contact with the body, as previously explained. The diminution of temperature continues for hours after the bath, especially in cases in which it was excessively high at the time of administration. Hot baths have, in general, an opposite effect.

SWIMMING.

Swimming is a general bath combined with vigorous exercise, as nearly all baths should be. It is one of the most healthful kinds of exercise, if not continued too long, as it frequently is. The temperature of the water is commonly between 70° and 80° F., which make it a temperate bath. Its effects are not far different from other forms of bath of the same temperature. We have not space to devote to a description of the art, since there are valuable treatises on the subject.

PLUNGE BATH.

The hot baths of the ancient Greeks and Romans were usually followed by a plunge up to the neck in a large basin of water four or five feet deep, and large enough to allow the exercise of swimming. Many hydropathic establishments employ the same bath after packs and sweating baths. A bath of this kind is not always attainable without great expense; and it possesses no particular advantage over other methods of cooling the surface after a warm bath. It is a very severe form of bath when employed at a low temperature. In the days of Priessnitz, it was used at a temperature of 45° or 50°. More harm than good would result from a continuous employment of such treatment. The cool plunge should be of but a very few minutes’ duration, and the patient should rub himself vigorously during the bath. In this, as in all other cool baths, the first contact with the water produces chilliness or shock. After two or three minutes, or less, this will be followed by a partial reaction, even while the patient is in the water, accompanied by a feeling of comfortable warmth. This will shortly be again succeeded by a second chill, which is not so likely to be followed by prompt reaction; hence, the patient should always take care to leave the bath before the occurrence of the second chill, if he would avoid unpleasant after-effects.

SPONGE BATH.

The sponge or hand bath is perhaps the simplest and most useful mode of applying water to the surface of the body; for it requires the use of no appliances which every one does not possess, and it can be employed by any one without elaborate preparation, and under almost any circumstances. A great quantity of water is not required; a few quarts are a plenty, and a pint will answer admirably in an emergency. A soft sponge, or a linen or cotton cloth, and one or two soft towels, or a sheet, are the other requisites. The hand may be used in the absence of a cloth or a sponge for applying the water.

The temperature of the bath should not be above 95°, and 90° is generally better. Most people can habitually employ a temperature of 75° or 80° without injury. The use of a much lower temperature is not commonly advisable, and is often productive of great injury.

Begin the bath, as usual, by wetting the head, saturating the hair well. Wash the face, then the neck, chest, shoulders, arms, trunk, and back. Rub vigorously until the skin is red, to prevent chilling; for even when the temperature of the room is nearly equal to that of the body, the rapid evaporation of water from the surface will lower the external temperature very rapidly unless a vigorous circulation is maintained.

After thoroughly bathing the upper portion of the body, turn the attention to the lower portion, continuing the rubbing of the upper parts at brief intervals to prevent chilliness. As soon as the bathing is concluded, envelop the body in a sheet and rub dry, or dry the skin with a towel. When the surface is nearly or quite dried, rub the whole vigorously with the bare hand.

The bath should not be prolonged more than ten or fifteen minutes. Five minutes is sufficient to secure all the benefits of the bath, and even three minutes will suffice for a very good bath.

Persons who chill easily will find it better to bathe only a portion of the body before drying it. Some will even find it necessary to retain a portion of the clothing upon the lower part of the body while bathing and drying the upper part.

Weakly patients may receive this bath with very little disturbance, even in bed. Only a small portion of the body should be uncovered at a time, being bathed, dried, rubbed, and then covered while another part is treated in a similar manner.

The sponge bath may be administered anywhere without danger of soiling the finest carpet, by using care to make the sponge or cloth nearly dry before applying it to the body. A rug may be spread upon the floor as an extra precaution. When used for cleanliness—as it should be daily—a little fine soap should be added two or three times a week, to remove the oleaginous secretion from the skin.

This bath is applicable whenever there is an abnormal degree of bodily heat, and in such cases may be applied every half-hour without injury. It is useful in cases of nervousness and sleeplessness, and, in fact, whenever water is required in any form, it may be used with advantage.

RUBBING WET-SHEET.