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WATER-TREATMENT (HYDROTHERAPEUTICS).—The method of treating patients by means of water is as old as mankind. Accounts of cures effected by this means have been handed down from antiquity. The Greek physician Hippocrates (400 B.C.) recommended hydrotherapeutics in cases of paralysis and rheumatism, by means of douches and rubbings. Cold-water treatment was re commended also by the Roman physician Celsus, who died shortly before the birth of Christ. In the middle ages the care of the body was sadly neglected ; but in the seventeenth century hydrotherapeutics was ' revived by Floyer, an English physician ; and in the following century the physicians Hoffmann and Hahn strongly recommended its use in Germany. Preisznitz, a layman, merely \ von the distinction of founding the first hydrothera peutic institute. His mode of treatment was very one-sided, very energetic, and very unscien tific. During the last fifty or sixty years many improved hy drotherapeutic institutes have been founded the world over, following the general plan adop ted by Preisznitz. At one time it was thought that only cold water could be used ; and the essential feature was considered to be—" the colder, the better." Physicians, however, began to notice that not all patients could stand this method of treatment. Bad results were frequent ; and the institutes in charge of edu cated physicians soon began to break away from the one-sided method. Efforts were made to treat each patient according to his particular complaint ; and those for whom cold water proved harmful were treated with lukewarm or warm water. The name " Cold-Water Institute " was gradually dropped. At the present time there are probably no institutes of the old type in existence, their place, having been taken by the so-called " sanatoriums," in which every known remedy is used, in addition to hydrotherapeutic measures (see Fig. 436).

Local applications of water have been recognised as remedial measures since times immemorial. Cold water is invariably used, which, by irritating the nerves of the skin, acts stimulatingly upon the blood-vessels, as well as upon internal organs. Cold affusions are useful in reviving persons who

have fainted, or who have become unconscious owing to alcohol-poisoning or other causes. By dashing cold water in the face of such patients, it is often possible to make them regain consciousness rapidly. In the presence of mucous obstructions in the lung (as in bronchitis), cold affusions over the neck and shoulders are often of service in stimulating respiration.

Their efficiency is increased if the patient is sitting in a warm bath while the cold ter is being poured over him. In tuberculosis of the lungs, ere the disease has advanced too far, cold affusions of 'the entire body may be of service. It is best to begin with lukewarm water, gradually letting it become colder and colder. The patient must go to bed afterwards ; or, if the weather be warm, he may take a walk in the sun.

Affusions of different parts of the body are very frequently used. They are hest given by means of a rubber hose at tached to a faucet, through which the temperature of the water may be regulated. An ewer or other vessel can, of course, be utilised. The pa tient should stand in a shallow basin or bath-tub while the water is being poured over him.

The arm is sprinkled in the direction from the hand up to the shoulder. Only cold water is used. This measure is indicated in obstinate bronchitis, in congestion of blood to the head, and in neuralgic pains in the arms.

Affusion of the legs is given on both sides, beginning on the back side. The legs are sprinkled from the heel up to the buttocks, whereupon the patient turns round and is similarly douched in front (see Fig. 437). Cold water is to be used, and the entire proceeding must be done quickly. The patient is then dried, whereupon he may take a walk, perform gymnastic exercises, or go to bed. according to his condition. This measure tends to divert blood from the upper parts of the body, and is therefore useful in congestion of blood to the head or chest, in cold feet, and in vertigo.

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