Baths which are both astringent and disinfectant are prepared with permanganate of potash; disinfectant baths, with bichloride of mercury. (1-20,000). But when the skin is not intact, the mercury must be administered internally and the baths be omitted. These baths are used in abscesses of the skin, and the bichloride baths are employed also in syphilis with localization upon the surface of the skin.
Instead of medicated baths, one may use other methods of skin medication, such as rubbing in tar preparations or medicated soaps, and following this with an ordinary bath, by which the skin is finally cleansed.
When the nervous system, the circulatory organs, or the general state of health is to be influenced the natural water baths are to be given in preference to those artificially prepared, because these baths when given at the watering places. according to tried rules, are more easily and satisfactorily administered, which assists in a marked degree in obtaining the desired result. In making a choice of baths, or of health resorts, it is not only necessary to determine the action of the waters, but also to take into consideration the entire condition of the watering place: indeed, one must bear in mind the many points which are of importance especially for children. The writer is personally acquainted with most of these resorts, but it is impossible here to go into the sub ject in detail.
Despite the fact that the so-called indifferent hot springs appar ently depend for the reaction upon the degree and constancy of their temperature, the latter being obtained by means of a continual ebb and flow of the water, they should he classed here with the natural baths. The invigorating and strengthening action of the warm springs makes them particularly valuable for all weakly children, awl especially for those suffering from neurasthenic disorders, while the hot springs are especially highly esteemed in rheumatic disorders. Of the warm springs may be mentioned those of Vaslau near Vienna, Johannisbad, Baden-Baden, Baden \\Tiler, and Schlangenlmd; and of the hot springs, Teplitz and Warmbrunn.
The physical action of the different baths is aided by the presence of carbonic acid and minerals. The nature of the mineral present can hardly be considered of much importance, however, and if steel baths, for instance, are especially renowned for their effect in aim win and chlorosis, it must not he forgotten that in these places water containing iron is internally administered at the same time. As a matter of fact those baths should be considered as a whole, whose action, like that of the cold water treatment, stimulates the nervous system, through which the vascular system is powerfully affected, differing only in this, that there is almost an entire absence of shock, and that the action is more prolonged.
The heavy salt solutions, such as those which manifest themselves by depositing innumerable bubbles of carbonic acid gas upon the sur face of the skin, may produce such an unfavorable influence not only upon the tonicity of the peripheral vessels, but also upon the heart action, that the immediate reaction may continue for hours, and the indirect effect perhaps for days, while it may be even longer before the normal physiological balance is restored. For this reason it is necessary to find out in every case the temperature and duration of the bath which each individual can tolerate. This is to be judged by the subjective sensations, and objectively by the tension and frequency of the pulse. After the bath, the patient should be made to rest in bed for one or more hours, and another bath be given only when the reaction from the previous one has disappeared. An interval of one or two days must usually be allowed, during which the course of treatment demands bodily rest and a more liberal hut simple diet. After the course of baths has terminated, these precautions in regard to rest and diet are continued as an aftercure.
Owing to the great fluctuation occurring in the distribution of the blood (after temporary contraction, dilatation of the peripheral vessels), and the accompanying fluctuations which appear in the innervation of the heart and blood vessels, constitutional diseases, such as rickets, scrofulo-tubereulosis, and andemia, are distinctly influenced, and old inflammatory processes of the internal organs are cured. The vicarious action of the skin as a derivative also acts favorably upon inflamma tions of the kidneys. The baths when they are properly used present an exceedingly effective exercise cure for the circulatory system, and particularly for the function of the heart, which it may improve, if this has not already been too seriously affected. Whether the action upon the skin, which in turn reflexly influences the innervation of the blood vessels, is due more to the solution of salts or to the contained carbonic acid, is not definitely known; the action of the salt baths, the carbonic acid salt and mineral baths, and the simple carbonic acid baths differ probably only in degree.