Part 7

_Sitting shallow_ differs from the half bath in employing less water, and being much more vigorous. Its effects and uses are about the same. The bather should rub his limbs and the front portion of his body while the attendant pours water over his chest and shoulders, and rubs vigorously his back and sides. A person can take the bath very well alone by using a rather long coarse towel which can be drawn back and forth across the back by grasping one end with each hand. It is a very valuable means of applying water, and is in constant requisition in the hydropathic establishments. From 85° to 90° is the proper temperature for this bath. It may be used at a lower temperature in fever cases. At Bellevue Hospital it is applied at about 70° in such cases, and is administered whenever the temperature exceeds 103°. To avoid the shock of a cool bath, it may be commenced at a temperature little below blood-heat and then gradually cooled by the addition of cool water until the desired temperature is reached. The reduction of the temperature obtained by this means fully equals that obtained by the sudden application of cold, and the shock and subsequent reaction are prevented. This applies equally to all cool baths as well as the cool shallow bath.

The duration of the bath may be from one to thirty minutes. Ten or fifteen minutes will be the usual extent.

The _Standing Shallow_ is in some cases preferred by some to the preceding. The patient stands erect in a varying depth of water—from six inches to one or two feet being employed—while his body is vigorously rubbed by one or two assistants, water being poured upon the chest and shoulders at brief intervals. It is a very enlivening bath.

The shallow bath should be completed by a pail douche at a temperature three or four degrees lower than that of the bath.

AFFUSION.

This consists simply in pouring water over the body of the patient, who may be sitting or standing in a bath-tub. It is a very efficient bath for reducing unnatural heat. This mode of treatment was used by Hippocrates, Galen, and other ancient physicians. In the last century, Currie, Jackson, and many others used it with great success in scarlatina. It is a sovereign remedy for delirium tremens, sun-stroke, hysteria, and sometimes of acute mania, when applied of the proper temperature.

PAIL DOUCHE.

This bath scarcely differs from the preceding. It consists in the dashing of one or more pailfuls of water upon the body of the bather by an assistant. By means of a proper arrangement, the bather can administer the bath himself. For this purpose, a pail or other vessel filled with water may be suspended or supported above the head of the bather in such a way that it can be quickly upset by drawing upon a string attached to the side. The stream should fall upon the shoulders, chest, back, or hips, but not upon the head or over the region of the stomach. This bath may be applied after any warm bath, and should be a little cooler than the bath which precedes it. Whether taken alone or after another bath, it should always be followed by vigorous rubbing.

CATARACT DOUCHE.

This is a modification of the douche bath in which a broad sheet of water is allowed to fall upon the body of the bather. The force of the bath depends upon the height from which the water falls, and should be regulated according to the strength of the patient. Almost any one will bear a fall of three or four feet. When the height of the bath cannot be easily modified, it should be of such an altitude as to be well borne by the feeblest patients; the more vigorous can increase its effects by subjecting themselves to it for a longer time.

The observations made relating to the application of the pail douche, apply equally well to this bath.

HOSE DOUCHE.

In this bath, water under pressure is thrown upon the patient from a hose, through a small nozzle. The bather turns his body while the attendant directs the stream upon different parts. It is a less pleasant bath than the spray or other forms of douche. Its general effects are the same as those of the baths mentioned.

SHOWER BATH.

This bath is simply an imitation of rain. Water is allowed to fall upon the body after being divided into a number of small streams by passing through a vessel with a perforated bottom. Its effects depend upon the size of the streams and the height from which they fall, together with the temperature of the bath and its duration. Although formerly much employed in water cure establishments, this bath is now little used, because its place is supplied by other more convenient ones which produce the same results, as the spray and douche. The best manner of administering it is to commence the application with tepid water, and gradually cool it. The temperature may range from 70° to 92°. The water should not usually be allowed to fall upon the head, but should be received first upon the hands and arms, then upon the feet and limbs, and afterward upon the back and shoulders, the body being well rubbed during the application.

The cold shower bath, formerly so common almost everywhere, has been productive of much injury by its indiscriminate use, and has brought much reproach upon the use of water as a curative agent. None but the most vigorous can enjoy the bath at a lower temperature than 70°, and no advantage is gained by its employment at a lower temperature than that, while considerable harm may be done in many cases.

SPRAY BATH.

This bath consists in a number of fine streams of water thrown upon the bather, with considerable force. It may be produced by connecting a hose with spray attachment to a force-pump or reservoir from which to obtain water under a sufficient pressure. The best form of attachment consists of a hollow double-convex brass or copper piece, one side of which is perforated with fine holes, the other side carrying a rim for attachment to the hose. It is preferable to have an arrangement by which the temperature may be readily and gradually changed from warm or tepid to cool without interrupting the bath. In the absence of a proper spray attachment, the apparatus elsewhere described for the hose douche may be made to answer a very good purpose, the stream being broken by placing the thumb or finger over the nozzle in such a way as to partially obstruct the flow.

This is an excellent bath to follow the pack, vapor bath, hot-air bath, sitz bath, or any other general bath which induces perspiration. It is very agreeable to most persons, and can be applied to feeble patients who would be unable to take any more severe form of treatment. The alternate hot and cold spray is very successful as a means of reducing local inflammations. The warm bath is very grateful and soothing to swollen and rheumatic joints; in gout, also, and illy defined, wandering pains, it is an admirable remedy. It is very successful, also, in the treatment of tumors, abscesses, and chronic ulcers, when thoroughly applied.

LOCAL BATHS.

The use of water as a local application is not less important, and is much more varied, than its general application. There is no other topical remedy which will produce such a variety of effects and such prompt results. In removing local congestions, subduing local inflammations, allaying circumscribed pain, and restoring activity to inactive parts, the appropriate applications of water give results which afford both physician and patient a degree of satisfaction which no other single remedy can rival, even electricity, an agent of acknowledged power, not being excepted.

SITZ BATH.

The sitz bath, also known as the hip bath, is one of the most useful baths employed in hydropathic treatment. Its utility was fully recognized by the earlier practitioners, who sometimes kept their patients so long in the bath that they became almost literally water-soaked, and were so numb from the long-continued application of cold water as to possess almost no external sensibility. It is said that in some cases the skin could be rubbed off in the attempts to obtain reaction, without the patient’s knowledge.

For this bath a common tub may be used, by placing a support under one edge to elevate it two or three inches; but it is better to use a tub made for the purpose, which should have the back raised eight or ten inches higher than the front, to support the back, the sides sloping gradually so as to support the arms of the bather. The bottom should be elevated two or three inches. The depth in front should be about the same as that of a common wash-tub.

Enough water is required to cover the hips and extend a little way up the abdomen; four to six gallons will suffice. Any temperature may be employed, being suited to the condition of the patient. The duration of the bath will also vary according to circumstances. A short cool bath is tonic in its effects, like all short cool applications; a more prolonged one is a powerful sedative. The hot sitz is very exciting in its effects if long continued. The warm bath is relaxing. The hips and trunk should be well rubbed during the bath by the patient or an attendant. The bather should be covered with a sheet or blanket during the bath. If it is desirable to produce sweating, several blankets may be used.

The sitz bath should seldom be taken either very hot or extremely cold. A very good plan for administering it, and one which will be applicable to most cases, is this: Begin the bath at 92° or 93°. If a thermometer is not at hand, pour into the bath-tub three gallons of fresh well or spring water, and then add one gallon of _boiling_ water. This will give the desired temperature. After the patient has been in the bath ten minutes, cool it down to 85°, which may be done by adding a gallon of well water. Continue the bath five minutes longer, then administer a pail douche or spray, at about 85°, and wipe dry, as directed after a rubbing wet-sheet.

The sitz bath is useful for chronic congestions of the abdominal and pelvic viscera, diarrhea, piles, dysentery, constipation, uterine diseases, and genital and urinary disorders. In treating female diseases it is an indispensable remedy. It is very valuable in various nervous affections, especially those which immediately involve the brain.

There is no better remedy for a cold than a very warm sitz bath taken while fasting, and just before retiring. It should be continued until gentle perspiration is induced.

The sitz may be converted into a general bath by rubbing the whole body with the wet hand while in the bath, and may thus be made to answer the purposes of the half and shallow baths.

LEG BATH.

For this bath a vessel deep enough to receive the limbs to the middle of the thighs is required. The bath may be taken at any desired temperature; but it is usually employed somewhat cooler than baths which involve the trunk of the body. It is a powerfully derivative bath, and is found very useful to prevent wakefulness in nervous persons, and to relieve cerebral congestion in epileptic patients. It is especially applicable to chronic ulcers of the leg, swollen knees and ankles, and limbs which have suffered by exposure to severe cold. It gives much relief in gout; there is no danger of causing a metastasis of the disease by the application of this bath.

FOOT BATH.

Any vessel sufficiently large to receive the feet, and enough water to cover them to the ankles, is suitable for this bath. The feet should be rubbed during the bath. If the temperature is cool, only an inch or two of water should be employed.

The _walking foot bath_ is an excellent remedy for cold feet. It consists in walking in shallow water five or ten minutes.

The alternate hot and cold _foot bath_ is another valuable remedy for cold feet, and is a certain remedy for chilblains. It is given thus: Place the feet in hot water—100° to 110°—three or four minutes. Then withdraw them and plunge them quickly into a bath of cold water—60° or less. After two or three minutes, restore them to the hot bath. Thus alternate three or four times, and conclude by dipping the feet quickly into cold water and wiping dry. This bath produces most powerful reaction.

The foot bath is applicable in the treatment of headache, neuralgia, toothache, catarrh, congestion of abdominal and pelvic organs, colds, and cold feet. It is very useful as a preparatory for other baths, and as an accompaniment of other local applications.

HALF PACK.

This bath is given in the same manner as the wet-sheet pack, except that the wet sheet extends only from the armpits to the hips. The blankets are wrapped about the patient in the manner described for the full pack. All the precautions given in connection with the description of that bath are applicable to this.

This bath is frequently employed in cases of patients who are too feeble to bear the full pack, or as a preparatory treatment for that bath. It is much milder than the full pack, and is usually more agreeable to the patient, as it does not confine him so closely. It is a very useful remedy in all inflammations of the abdominal organs, gastralgia, pleurisy, acute bronchitis, croup, and pneumonia. When a hot application is required, it is well to use a woolen sheet instead of a cotton one. It requires the same after-treatment as the full pack.

CHEST PACK.

This application is made in the same manner as the half pack, allowing the wet sheet to extend only from the armpits to the navel. It is especially applicable to diseases of the chest. The general directions for the full and the half pack apply to it. It is a very mild application.

LEG PACK.

The pack may be applied to the legs with great advantage in cases of habitual coldness of the feet and limbs or knees. The same principles mentioned in relation to other packs apply to this. The application should be made either cool or cold, and should extend from the hips downward. It should continue from half an hour to an hour and a half.

CHEST WRAPPER.

This consists of a jacket made something like a vest, reaching from the neck to a little below the navel. It should be made of double thicknesses of soft toweling. To protect the garments or bedding from moisture, it should be covered with another jacket made like it but a little larger. In applying it, the wrapper should be wet in tepid water, and should then be applied as snugly as consistent with the comfort of the wearer. It should be re-applied every two or three hours, as it becomes dry.

If properly managed, the chest wrapper is a valuable remedy; but it has been greatly abused. It should not be worn more than a week without intermission. The practice of some in continuing it until it produces an eruption of the skin, and even longer—to promote a discharge—under the idea that a vicarious elimination is thus performed, is highly reprehensible, and has no sound physiological principle to support it. Such treatment is damaging to the skin, and does the patient no good in any way. The better plan is to allow the wrapper to be worn during the night, but omitted during the daytime. If worn during the day, it should be changed often, and should be removed so soon as the patient becomes chilly. Whenever removed, the surface of the skin should be washed or sponged with cool or tepid water. Feeble patients with defective circulation should wear the wrapper only while walking or riding on horseback.

This appliance may be profitably employed in a large number of chronic diseases. In chronic bronchitis, pleurisy, pleurodynia, asthma, and the early stages of consumption, it gives relief.

WET GIRDLE.

This was a favorite remedy with the early German hydropathists, and it is a very useful appliance when properly employed, though it has been much abused by excessive use, as in the case of the chest wrapper. To apply it well, a coarse towel about three yards long is the most convenient for use. Wet one-half of this, in tepid water, wring it until it will not drip, and apply it to the abdomen, placing one end at the side, and bringing it across the front first, so that two thicknesses of the wet portion will cover the abdomen. After winding the whole tightly around the body, fasten the end securely. The remarks made in reference to the wearing of the chest wrapper apply with equal force to the wet girdle. For feeble patients it is better to wet only that portion of the towel which covers the abdomen.

This a very efficient remedy for constipation, chronic diarrhea, and most other intestinal disorders. It is equally valuable in dyspepsia, torpid liver, enlarged spleen, and uterine derangements.

ASCENDING DOUCHE.

This modification of the douche is simply an ascending instead of a descending stream. It can be readily managed by constructing a reservoir in such position as to give the water ten or twelve feet fall, when the requisite force cannot be more easily secured. The water is conducted through a hose, and is allowed to issue through a nozzle near the floor. The patient sits or lies just over the nozzle, and a few inches above it.

This is a valuable remedy in treating piles, prolapsus of the bowels or uterus, and constipation.

DROP BATH.

In applying this bath, a vessel with a small opening in the bottom is elevated to a considerable height, water placed in it being allowed to drop upon the part to be treated. The aperture in the vessel should be only sufficiently large to give egress to a single drop at a time. The bath may also be given by placing in an elevated vessel one end of a skein of cotton yarn, the other being allowed to fall over the edge of the vessel and hang below it. By capillary attraction the water will be drawn up into the yarn and will drop off at the lower end very slowly.

This is a very convenient way of applying water where its cooling effects are required for a considerable length of time, as in wounds, bruises, sprains, and similar cases. It will “keep down inflammation” in a wonderful manner. It is not commonly necessary that the water should be very cold, as evaporation will keep the part sufficiently cool in most cases.

ARM BATH.

This is simply holding the arm in water of proper temperature. It is extremely useful in such painful affections as felons, sprains, and nearly all injuries of the hand and arm. Ulcers and acute and chronic skin diseases of the hands and arm are usually benefited by this bath. If cold water is painful, its application should be preceded by that of hot water, or alternated with it. Cold hands should be frequently rubbed in cool water, and alternately immersed for a few minutes each in hot and cold water. In case of painful felons, the arm must be immersed to the elbow to relieve the pain, although the disease is only in the finger.

HEAD BATH.

The patient should lie upon his back, resting his head in a shallow basin of cool water. The attendant should bathe the forehead, face, and temples during the bath. The bath may be continued until the heat is removed or lessened.

The pouring head bath is often preferable to the preceding. The patient should lie upon a bed or sofa, face downward, allowing his head to extend outward over a tub or other wide vessel, while the water is poured upon the head from a little height, by an assistant. The water may be either hot or cold, according to existing conditions. Very cold water is not usually advisable, as its application soon becomes painful, and produces powerful reaction. It should be tepid or temperate. Some cases require very hot water for a few minutes, followed by a slight affusion of tepid water.

In hysteria, epilepsy, apoplexy, sun-stroke, acute mania, delirium tremens, and cerebral congestion from any cause, the head bath is a promptly efficacious remedy.

EYE BATH.

Water may be applied to the eye in various ways. A convenient method when only a brief application is necessary, is to lave the eye with water dipped by the hand. A gentle spray may be applied, or the eyes may be opened and closed in water, thus bringing them freely in contact with the element. Small glass cups made for the purpose may be filled with water and placed over the eye, the water being frequently changed; or wet cloths may be laid upon them.

In applying water to the eye, it is important to be able to first distinguish the exact nature of the difficulty, as much damage may otherwise be done by a wrong application. As a general rule, inflammations of the conjunctiva and _external_ structures of the eye require _cool_ or _cold_ applications, while inflammations of the cornea, iris, and other _internal_ structures, require _hot_ applications. This rule is often violated in hydropathic establishments through ignorance of the structure and diseases of the eye.

Cool applications are best made by laying upon the eyes thin folds of linen cloth wet in cold water. Not more than two or three thicknesses should be used, as a thick compress soon becomes warm, while a thin one is kept cool for a longer time by evaporation. The compress should be changed every five minutes, at least, when there is much inflammation. The fomentation is as good as any method of applying hot water to the eyes. The application, when hot, should be as hot as the patient can well bear. If it affords relief, continue half an hour or more; if it increases the pain, desist at once. The same may be said of cold applications also.

Alternate hot and cold applications will give most relief in some cases. After a hot application, a slightly cooler one should always be applied for a few minutes.

A little milk, quince-seed mucilage, or other bland substance, added to the water, makes it more agreeable to the eye in bathing it.

The eye bath is applicable in all inflammations and injuries of the eye, and is infinitely superior to all other eye washes.

Daily bathing the eyes in tepid water is a good practice for those who use them much in reading, writing, or other work requiring close attention. Many eyes are ruined by neglect and maltreatment.

EAR BATH.