BATHING.
ous, and to occasion indolent tumours of the absor bent glands belonging to the parts concerned.
If we admit that baths are ever, strictly speak ing, either diluent or nutrient, we must suppose the cutaneous absorbents to be the channels of these actions ; and the majority of authors, both ancient and modern, have certainly considered the skin as imbibing, with great facility, not only wa ter, but also any kind of substance capable of being dissolved in it; nor is there any doubt that, under some circumstances, the cutaneous absorbents have been found to possess such a power in a certain degree ; but Mr Seguin and Dr Currie have shown that, in common cases, very little or no effect is to be expected from this absorption ;* that the strongest medical agents, when dissolved in the water of a bath, exhibited no operation on the system while the skip was entire ; and that no perceptible advantage was ob .
tained from a continued immersion in a bath of nutritive fluids, notwithstanding the extreme exhaustion of the system, in a case of completely obstructed deglutition ; and they suppose that where weight has been gain ed during immersion in a bath, the absorption oc casioning its increase has been principally per. formed by the lungs, retaining the moisture, which they receive in abundance with the air inhaled.
The other immediate effects of bathing must de pend on the contact of the fluid with the skin, either as simply moistening and softening the cuticle, or as exciting a peculiar sensation in the cutaneous nerves, whether of touch only, or of heat or cold, or, in some cases, of slight pain, where the skin has been previously in a of irritation, especially if the water contains a saline impregnation ; or, lastly, as altering the state of the circulation by any of these means, especially by the change of temperature ; this effect being also often modified by the change of the position of the body, and by the distribu tion. of the pressure or resistance which supports its weight throughout almost the whole surface, in .
stead of its being• confined, as usual, to the parts on which we sit or stand. The excitement of the nerves of the skin appears to be salutary in many cutaneous diseases, which are benefited by warm bathing, whether in fresh or in salt water, or in sul fureous or other mineral waters, as at Harrow gate, and at Baden, and Pfeffer and Leuck in Swit• zerland; the bathers sometimes remaining whole days ip the water for weeks together, until a peculiar efflorescence has appeared on the :kin, and has again disappeared.{ The mud baths in the north of Italy are of a nature somewhat similar, and are said to be of con siderable advantage in some paralytic cases. But if we allow the truth of the opinion of Seguin and Currie, we must infer that there are few instances in which the effects of bathing on the system in general can de ' Rend much on the impregnation of the water; and we ought perhaps to attribute the acknowledged ad vantage of sea bathing in a variety of diseases, in great measure, to the mildness and equability of the temperature of the sea. It is true, that persons ac cidentally wetted with salt water are but little lia ble to take cold ; and this fact has been supposed W indicate some stimulant property in the contests of the fluid ; but it may be explained, with greater sim plicity, from the slower evaporauoa of salt water, which causes it to carry off heat much less rapidly than fresh, the cooling process being also retarded by the greater moisture of the sea air.
In order to determine how far any kind of bathing may properly be called a stimulant or calefacient, must consider what are the tests by which we judge of the increased rapidity of the circulation of the blood. The term calefacient is, indeed, somewhat objectionable, as implying, that animal heat depends solely or principally on the motion of the blood, which is not, in the present state of our knowledge, the most probable opinion ; and besides this etymo logical inaccuracy, the definition of the term, as hp. plying an accelerated circulation, involves a con siderable difficulty, since we have no means of as certaining whether increased frequency of pulsation compensates, or not, in any particular instance, for diminished fulness and strength. On the other hand, the operation of almost all medical agents is such as to relieve us from this ambiguity in the application of the definition ; for we can scarcely mention any remedy which materially accelerates the pulse, with out, at the same time, increasing its strength. There are, indeed, many medicines which are often designat ed by the vague denomination of stimulants, and which have no effect whatever on the circuletion, but either simply awaken the nervoms in general, or excue local sensations of heat or pia, and this multiplicity of aignificationa is a sufficient reason for rejecting the torn' from a. correct classifi cation. It happens, howexer, not unfrequendy, that astringent febrifuge medicines, mill reduce the frequency of the pulse, and increase its fulness ; and it becomes necessary, for an accurate analysis of the operation, of remedies which affect the circulation to distinguish the accelerants of the pulse from ths; augmentative: and the intensities, all of which may possibly be independent of the production of an in crease of temperature ; and, this increase may also in some cases be produced, at least in the extremities and the superficial parts, and apparently also in the whole system, without any change in the circulation, by the operation of certain remedies, which might be called thaiptics, if it were necessary to distin guish them as independent agents : and to them four classes we might add, fear others of an exactly opposite nature, which might be called. retardants,
diminutives, and k and of the pulae, and pays**, direct refrigeranta; and the last four classes would belong to a general division of remedies com prehending those which lessen the force of animal actions ; a division which it has not commonly beep found necessary to establish, for any practical classi fication of the materia Now, it appears that a hot bath, of a temperature exceeding 98°, the usual heat of the human body, Will coilutonly set both as an aceeletailt and an sagriaentative of the pulse, but probably not as an in sensitive ; it may, however, very properly be classed as a calefacient, if ouch a description of remedies be admitted. Dr Parr* says, that it bath of 100° rendered the pulse fuller and more freqtrept ; but that, after the bath, it was slower than usual ; at higher temperatures, the effects were still more marked ; and in Marcard's experiments (p. 71) the results were nearly similar. Dr Haygartit observed (Mareard, p. 67), that in a bath of 114° the pulse was' rendered more frequent, and the arteries were evi dently dilated: In Finland, according to Martin (Marcard, p. 223), the Vapour baths are usually heated to about 120°, and they often increase the frequency of the pulse from 70 in a minute to 110 Or 120. Fourcroy mentions a bath of 66° degrees which must have been of the centigrade scale, making 151° of Fahrenheit, and not 181°, as Mar card supposes (p. 216), which wail followed, an hour afterwards, by a fatal apoplexy. Whatever exagger ation there may be in this report, it may, still serve to explain to us the excesses which *ere frequently committed in the use of baths by the Greeks and Romans, and the pernicious effects attributed to them by the ancient physicians. Hippncrates Observes (Apt. v. 16), that the too frequent employment of het bathing causes a softness and debility of the 'ades, a want of flrmneas of the nerves, and a d'aiiiella of the faculties, with occasional firemorrhiges and fainting', sometimes eeen terminating iti death add in the Clouds of Aristophanee, we have a mock defbnee of warm bathing deduced fl-inn the usual dedication of hot springs to Hercules, which implies a perfect confidence in the Opinion of the pernicious tendency of the practice, accompanied, or followed, as it frequently was, by other induigenciel, to which it has too often given occasion. This traditional condemnation of hot bathing has been erroneously transferred by some of the moderns to warm or tepid bathing ; and since it has been asserted by authors of high celebrity, that air above 60° will generally occasion a sensation of warmth, it seems to have been inferred that water above 60° must constitute a warm bath, and consequently produce enervating and debilitating effects. The fact is, however, that a bath below 100° is scarcely ever heating in any material degree ; and even at 100°, pulse, though somewhat accelerated, is often not at all augmented in fulness, nor are the subsequent effects materially different from those which usually result from an equal acceleration produced by any kind of mode rate exercise. It is observed by Galen in his Treatise on the Pulse (Opp. Vol. III. p. S. Ed. Bas.), that " baths, when moderately warm, cause the pulse to be full, and strong, and frequent ; when excessively hot, small and obscure, but frequent and hard, sometimes, however, after a time, becoming slow, though still feeble." Of this retardation of the pulse in a very hot• bath we have no eXperiente hr modern times ; it is obvious, that what Gales calls moderate ly warm, we should at present term a hot bath ; and` probably his excessively hot baths somewhat re sembled that which is mentioned by Fourcroy. " Cold baths," he says, " at first make the pulse slow and weak ; afterwards, if they disagree, and produce torpor, the pulse remains weak ; but if the bath is likely to strengthen the system, producing a salutary glow, then the pulse beconies full and strong, and natural in point of frequency." It is, however, remarkable, that the cold bath not uncommonly renders the pulse very considerably more frequent at the first immersion ; a eirchmstante which was particularly observed by Athill, f and which, notwithstanding Marcard's doubts, has beer since fully confirmed by Dr Stock. t This increase of frequency seems principally to depend on the painful sensation of cold occasioned by the first immersion, especially while it is incomplete ; it is commOnly very transitory, and is succeeded by a retardation, while the fulness of the pulsations is diminished from the first: The sttdorifte effect of the hot bath seems to be, in great measure, the natural consequence of the acce• leration of the circulation, and to be nearly propor tional to this acceleration, being also favoured by the softening of the cuticle, and perhaps by the dilata tion of the cutaneous exhalants. It is principally re commended in rheumatism, and it is also considered as COhdacive to the cure of some cutaneous affec tions ; and when this effect is thought particularly de sirable, it is usual to take the bath late in the evening, and to promote its operation by going into a warm bed immediately after It.