On the whole it that the stimulant effects of the warm bath are very inconsiderable ; and that it is useful chiefly in allaying irritation, 'diminishing morbid frequency of the pulse, and'relaxing and pu rifying the skin.
Hence the warm bath is likely to be attended with advantage in those cases of fever where the heat is preternaturally great, but where, from some affection of the lungs, or other unfavourable symptom, cold bathing is inadmissible ; in the paroxysms of hectic fever • in several eruptive diseases, attended with in creased heat and dryness of the skin ; in most chro nic eruptions of the skin, where it acts chiefly as a detergent and sudorific ; in atonic gout and rheuma tism, accompanied with stiffness and swelling of the i joints ; in ehlorosis ; in slight cases of palsy ; in scro phulous swellings ; in some spasmodic and convulsive affections, where the cold bath might prove too vio lent, especially in hydrophobia ; in all those affections of the bowels that seem to depend on an irregular or diminished action of any part of the alimentary ca nal ; and in cases of debility, attended with nervous irritation.
When this remedy is intended to produce increased perspiration, it is best employed in the evening, when the immersion should not be long continued, and the patient should be removed from the bath to a warm bed. Where, however, it is not -intended to excite sweating, the most proper time is about two hours after breakfast. In these cases, the bathing may be protracted to twenty minutes or longer, according to the feelings of the patient ; and after bathing, gentle exercise in the open air should be employed.
Those cases to which the warm bath is less appli. cable, are principally affections of the lungs, accom panied with great difficulty of breathing, and some organic affections of the internal parts.
The effects of the hot bath differ in several parti culars from those of the warm bath. The sensation of heat experienced on entering a bath above 98° is, in general, very striking and permanent. The pulse is increased in frequency and force ; the superficial veins become turgid ; the face is flushed ; the respi ration quicker than natural, and sometimes hurried and laborious ; and the perspiration is increased.
If the heat of the bath much exceed 98°, or if the Immersion be continued beyond a few minutes, the determination of blood to the head is greatly increa sed ; the arteries of the neck and temples throb vio lently ; a sensation of anxiety at the breast, threat ening suffocation, comes on ; the person grows giddy, and feels a fluttering at the heart. If these warnings '.of approaching danger be not attended to, the bather •soon becomes insensible, and expires of apoplexy. ' Water of this high temperature is scarcely ever employed in the way of allusion; nor is such an ap plication likely to be attended with advantage, ex .cept in some paralytic affections of .the limbs. In these cases it is not unusual, at Bath and other hot springs, to pump the hot water on the affected limb. By this dry as it is commonly called, the hot water is applied to the affected parts under a higher temperature than when it is drawn off into the reservoirs commonly employed for bathing.
From the above account of the effects produced by the hot bath, it appears, that this remedy is a power ful stimulus, to be employed only in'a few cases where the ordinary stimuli are ineffectual. Accordingly it is very seldom resorted to in medical practice, and almost the only cases in which, the general hot bath is employed are those of confirmed and obstinate palsy.
In the use of the hot bath, considerable caution is required. The patient should begin with the lowest temperature of such a bath, or about 99°, and gra dually increase the heat each successive bathing, ac cording to its effects. The time of immersion should be short ; and, on coming out of the bath, great care should be taken to avoid sudden exposure to cold. In some cases, attended with fulness of habit, it may be necessary to bleed or purge before attempting the hot bath.
Though the vapour or steam bath may be regard ir cd as a modification of the hot bath, its effects are much less violent ; and it has been employed with considerable success in cases where the hot bath would be attended with danger. It therefore requires our particular consideration.