Bathing

The salutary ante of cold applications, in some cases of gout, were well known to Hippocrates, and have been more lately extolled by Bamberg, Player, and Pieteohen Marcard (p. *66) very properly stater the objections to their employment, and, notwith• standing all that Dr Kinglake has done to reema. mend them, they have not been adopted by pro lent practitioners, except in very receat cams, and in young and unbroken constitutions. Anitaeus pre• scribes the effusion of cold water for giddiness and headache, and it has certainly been successful In some obstinate eases of this kind (Alaroard, p. 263); and has even appeared to be a powerfui paibative is seine descriptions of mania. In Ceram, Dr Carrie fount its effects more permanent than those of the tepid sif fusion, although not always so speedy We have ample experience of the rottis powers of bathing in more than one of its forms; although no more than thirty or forty years ago, the great majw. rity of practitioners in Great Britain were disposed to confine these powers within the limits of the cold, ore& most of the tepid bath. But travellers in warmer countries had often informed us of the invigorating effect of a warm bath taken after fatigue; and Bruce, in particular, extolled its comforts and its salubrity, from having used it in Egypt. The opinions of Mar card on the same subject were partly made through Beddoes: Count Rumford, in his thirteenth Essay, has exhibited, in a popular point of view, the benefits which he himself derived from taking the warm bath habitually in the middle of the day ra ther than at night; and Dr Alexander Buchan, in his work on sea bathing, has assisted in dissipating the remaining prejudices against its employment as a mild tonic. For feeble or enervated constitutions, and for persons who have suffered from great fa tigue, it is decidedly preferable to the cold bath ; but as the strength is gradually recovered, it may often increase its efficacy to lower the temperature by degrees. We may begin, for instance, with a warm bath at 96° or 98°, and lower it by degrees to 90° or a little less ; and hence the transition to the open sea in the middle of a summer's day will not be too abrupt, the water being often heated to 70° or more on a coast well suited for bathing ; and if the constitution appears to acquire strength under the experiment, the hour of bathing may be made earlier and *girlies, until the temperature is no hi er thee about 60°. The time of remaining in t water may also be modified according to the powers of the constitution ; a single immersion being the most easily supported, and a longer continuance in the water, till the sensation of cold has subsided, calling forth the faculty of generating heat into fuller action; observing always not only how the health appears to be afibcted, but which mode is the most conducive to the pleasure or comfort of the indi vidual, which will often throw some light on the operation of the remedy. In most cases it will be found, that whose either warm or cold bathing agrees with the constitution, it is followed by a sense of yunsh, and vigour, and self complacency, which is equally agreeable and salubrious. We must also make allowances. for peculiarities of constitution, which may require a deviation from the temperature usually recommended. Thus, there are some persons who have so singular a sensibility, as to feel a bath of 110° not too warm, and to be absolutely chilled by a Oath, of 100° ; and, in such cases, it is probable that at 105° the pulee would not be materially accelerat ed. In other instances, the cold bath produces headache and dejection of spirits. This inconvenience is sometimes obviated by proper evacuations, which denikl also always be premised to bathing, where there is any appearance of visceral disease, or of congestion of any kind. The sea water will answer this purpose sufficiently well, either alone or mixed with warm malk, or with some chamomile flowers in foaled ia it ; but it has no material advantage over may other mithartia which may be preferred by the regent. It is, also recommended by all authors on cold Whin, to Flange in head foremost, and this precaution is highs proper where there is any up, leaaine of Itesuls,cba, but in other cases it is of Bede moment. If, after all the cold bath continues to disagrees,. it will he generally advisable to exchange ii flu the warm; and after a time it may be proper us give the cold a second trial.

It is ;innermosty to antes into a minute detail of the diseases in which bathing is useful as a tonic. It is, however, particularly indicated in a variety of complaints which are peculiar to females ; and to weekly children,. especially such as are ricketty and

serofitioue, sea, bathing is most essentially n Oa the other hand, cold bathing is almost ly to be avoided where there is any consumptive disease, or any inffammatory affection of any of the internal poets ; aid exception which is easily un durseood, Grow the natural tendency of cold• to cause a congestion of bleed is the vessels of those parts, in consequence of the contraction of the superficial vessels. The sudorific effect of the warm bath, fol lowed. by the refrigerant quality of the tepid, and powers of the cold,. exhibit a succession of vaiseilia nearly analogous to the mode of treatment which, is usually found to be most successful in fevers ef various kindle.; in most of which we begin with sudorific medicines, and proceed to astringents and accts. Hippoontes, in his book on the use of li qeide,obaervea that gout is one of the diseases in which botb•hot and cold applications afford effectual Wig; WitiltheregASIII is equally just with respect to seine cases of rheumatism ; but, move commonly, the best mode of using baths in rheumatism is to begin with a bath raised, during the immersion, to as high a temperature as the patient can bear, so as to act as a powerful sudorific, and to continue the course, when the pain has been relieved, at lower and lower temperatures, ending it with cold bathing in the open sea.

Notwithstanding the acknowledged utility of warm bathing in a variety of circumstances, there may pos. sibly have been some exaggeration in the marvellous opinions which have been sometimes entertained of its utility for the prolongation of life. Galen has indeed mentioned a number of persons who had at tained a great age, and who were in the habit of making daily use of the bath, which is enough prove that such a habit cannot be extremely perni cious ; and if we supposed a constitution to retain all its energies, but to have them concealed and ob scured for want of proper stimuli, the warm bath might tend to remove the evil; but it is mere natu ral to believe, that the approach of old age has a tendency to weaken the radical powers of the con. *Auden, which cannot afford to be roused into dis proportionate exertion ; and to apprehend, that the temporary vivacity and activity, superinduced by any foreign agent, whether by warm bathing, or by a removal to a warmer climate, would only tend still more to exhauta. the already diminished store of vitality.

The

narcotic and os speaiscally antispas modic effects of bathing are most effectually exhi bited, in ordinary 011101, by the warm or tepid bath, which is often employed for the relief of pain, and for the removal of any irregular or convulsive ace. tion. Possibly also the effect of the warm bath in retarding the pulse may be partly derived from its sedative power as affecting the heart ; and if we take this connexion for granted, we may infer from it, that the antispasmodic effect will be most advents.. geously obtained from a bath at 90°, which has been found to retard the pulse the most effectually. But where there is internal inflammation, it may be de sirable to dilate the superficial vessels by a bath somewhat hotter than this, so as to relieve the inter nal parts fron•a part of the fluid which distends them, but without increasing the velocity of the circulation by too high a temperature. Tho cold affueion is also a powerful remedy in many cases of tetatio disease. Hippocrates (4.4. v. 21) has remarked, that it often creates a glow which overpowers the convulsive contraction, especially where the subject is young and. athletic, the weather hot, and the die ease independent of local injury ; and the modern ex perience of Dr Wright and Dr Currie has confirmed and extended. the observation. In another passage he tell us (Aph. v. 25), that the abundant effusion of cold water [faunally relieves and removes swell,. ings and pains in the limbs as well aspro. during moderate degree of torpor, which the pain ; but, in fact, the relief of inflammatory afflictions by cold is rather to be referred to its astringent than to its sedative powers. This is, in deed, a point which has been much discussed by mo dern theorists; but it must be confessed, that all our theories are of little importance in physic, any fur ' ther than as they assist us in clearly comprehending and distinctly remembering the facts, which we de rive from immediate experience in the treatment of diseases. (v. N.)