The cold sponge bath is even more simple, and may be considered as one of the hygienic measures in health. The cold sponge bath which must be given in bed to very delicate or sick children has already been described upon page 275. Otherwise, the child is made to stand in a flat vessel (of rubber if it is to be transported) or bath tub, and washed superficially all over the body with a cloth dipped in cold water but not wrung out; or the water is squeezed out of a large sponge and allowed to trickle over the body. This may be followed by pouring water from a pitcher or watering pot. The body is then dried.
The simplest procedure, but one which has a distinct power as a nerve stimulant, is the spinal douche. The child sits erect upon the edge of a. bath tub or wooden tub, and cold water is allowed to fall upon the median line of the back for not more than one minute.
The shower bath is considered in this place only as a spray. The size of the drops must be small, the pressure but slight, and the dura tion short, from less than one minute to ;Wont two minutes. A luke warm shower bath is about equal to a lukewarm bath. If the water is gradually cooled, the action is increased, because the stimulation from the cold and the mechanical stimulation are successfully combined. The Scotch douche of alternately hot and cold water. may he ordered for children only with great care: for instance, alternately 3S° C. (100° F.), :30° C. .S6° F.), 35° C. (94° F.), 2s° C. (;',2° F.); and the follow ing day with a greater difference-36° C. (97° F.), 22° C. (72' F.), 36° C. (97° F.), 22° C. (72° F.), or, in the case of nervous children, only in the sequence of 3S° C. (100° F.), :30° C. Is(i° F.). 3S° C. (100° F.). and 30° C. (S6° F.), proceeding to 3S° C. (100° F.). 26° C. (79° F.), 3S° C. (100° F.), and 2(1° C. t79° F.). The cold showers may often be used with great advantage as the final step of a combined hydriatic treatment.
In the same manner a hot pack or bath may be followed by a tepid or cold bath. At home, by means of the shower, one can quickly cool the surface of the body, in the simplest possible manner thereby restoring tone to the blood vessels. All hyd•iatic measures intended to stimulate the nervous system accomplish this object only when the patient experiences thereafter a pleasant sensation of warmth, increase of energy and of bodily strength. This sensation of warmth must be maintained as long as possible by active though gentle exercise, in the fresh air if possible.
Hydriatic measures should always be looked upon in the same light as medicine, and their application should therefore not be left to the discretion of the uninitiated, and should not be kept up longer than from four to eight weeks, without interruption. The action of the water may be changed by the addition of some chemical introduced artificially, or by the use of natural water in which it already exists. The difference between the medicated baths and the natural mineral waters is not marked, inasmuch as the latter may in many instances be imitated artificially. The action of warm or hot full baths. or hot packs, to which aromatics have been added is particularly beneficial, their sedative action being increased. Infusions of chamomile, sweet flag. and of vari ous aromatic herbs are used for this purpose; or extract of pine needles may be added to the bath. On the other hand, the addition of irritants to the bath is of value in deep-seated inflammations (e.g., pneumonia), by acting as revulsives upon the skin, or by acting as a stimulant to the nervous system in conditions of weakness. Mustard packs and the mustard baths (four to five tablespoonfuls of powdered mustard enclosed in a small linen bag) are the most useful of this type. It is unnecessary to discuss the local application of mustard paste and mustard plaster at this time. It is impossible to make use of mustard when the skin is very delicate or in a state of irritation. Astringent baths are given when moist eruptions of the skin exist, tannin, or, better still, decoction of oak bark, being added to the water. (A cup of pulverized bark is added to one litre of cold water and is boiled for one-half to three quarters of an hour. after which the decoction is strained and added to the bath.) The irritation which water is apt to produce upon recently inflamed skin may be allayed by adding a decoction of white bran or malt to the water.
Sulphur baths are to be used in itching skin eruptions unaccom panied by moisture. 25 to 50 Gm. (1 to 2 ounces) of sulphurated potassa (100 Gm. (V- ounces) for larger children) is dissolved in water and is added to the bath, after which the skin is thoroughly anointed with some neutral salve. Among the natural sulphur baths which are prescribed may be mentioned those of ileustrich, Leuk, Stachelberg, Kreuth, Nenndorf, Schinznach, and Landeck.