at 5 A.M. Douche for three minutes at 12. Two Abreibungs and a Sitz-bath
for half an hour at 5 P.M. If I remain the summer, should I continue or
diminish this cure?
A. Continue it certainly for a month, and then begin to diminish it,
leaving off the Douche for instance.
10.--Q. If continued, might I take the Douche after my walk in the
morning before breakfast, and the Abreibungs at mid-day, so as to have
my afternoons free?
A. Some cure must be taken after dinner as a rule; but in case of
necessity the cure may be shirked.
11.--Q. Ought I to continue any part of the treatment on leaving
Gräfenberg, and what?
A. Washing morning and evening, either bath or Abreibung.
12.--Q. After leaving must I attend to the same diet, and abstain
entirely from Wine, Coffee, and Tea? or may I indulge in them
continuously in small quantities, or only occasionally?
A. Wine, Coffee and Tea may be taken now and then, but by no means
regularly.
13.--Q. On any return of my old complaints, blistered mouth,
indigestion, restlessness, uneasy sensations in the back and side, what
portion of the cure should I have recourse to?
A. The old complaints ought not to return, and will not if the cure is
carried through the summer; on the appearance of any of them, they must
be treated the same as they were here.
14.--Q. The sensations mentioned before now return sometimes; but vanish
after a few days' severe treatment. It is only since the last month that
my limbs and muscles have appeared to recover their tone and firmness,
and enlarge.
A. Both of these observations speak volumes for the continuance of the
cure, as one cannot do too much: but one may easily do too little; and
it would be highly advisable to keep on cleansing and strengthening
every possible way.
15.--Q. Should I continue any of the treatment for the child?
A. Bathe the child every morning and evening, that is, cold washing, by
means of bath or Abreibungs.
16.--Q. Might I myself treat her in the cases of measles and scarlatina,
and how?
A. In case of slight fever, a rubbing-sheet and Umschlag; but it is
impossible to prescribe beforehand how these diseases are to be treated,
as one cannot know how the child may be affected. If the fever is
severe, more wet sheets or rubbing-sheets must be used than if it is
slight. The criterion of treatment is the degree of fever.
TREATMENT AND CASES.
XXXIV.--GOUT.
Great difference of opinion exists as to the cause of gout. Ancient
physicians called it the daughter of Bacchus and Venus; and truly
persons, or their progeny, devoted to these two divinities, offer the
greatest number of examples.
To cure this complaint, the ingenuity of thousands of scientific men has
been taxed, and the whole pharmacopœia applied to in vain. Perspiration
is mostly resorted to; but as this is effected by warm baths, vapour
baths, or drugs, the consequences are so debilitating that few
constitutions can bear them. The result of all medical treatment in this
disease is, the degradation of robust constitutions, and the promotion
of diseases worse than the gout itself.
Volumes might be written on the various remedial measures which have
been resorted to in this complaint, and of which time has shewn the
fallacy. We now ask the invalid, if he ever knew the gout radically
cured by any pharmaceutical means? Were Hydropathists asked whether they
ever knew cases of gout cured by water, they would unhesitatingly answer
in the affirmative. Incipient gout is always curable. The same may be
said of chronic gout, except in isolated cases: then Hydropathy
invariably gives relief; and by regulating the functions of the body,
improves the general health.
The following treatment and cases will shew how the manipulation is
varied, to combat this disease in its manifold forms:--
Gout cannot be cured by local applications; the whole system must be
purified by a general treatment, or no permanent cure can be effected.
For occasional attacks of gout in the extremities, the constitution
being otherwise robust:--
In the morning, put a bandage on the part affected, pack the patient in
blankets (sweating process) until perspiration appears in the face.
Then put him into the half-bath--water 62° to 65° Fahr.; let him be well
rubbed in this from 5 to 25 minutes, or until friction can be applied to
all parts alike. Cold water should be occasionally poured over head and
shoulders during the operation. This ended, put bandages round the waist
and on the afflicted part.
For the second treatment:--About mid-day, rubbed in a packing-sheet;
take a sitz-bath for fifteen minutes--first time tepid 64°, afterwards
cold; then put the offending member into cold water for ten or fifteen
minutes, and renew bandages.
In the afternoon, at 5 o'clock, repeat mid-day treatment. During the
day, drink ten to fourteen tumblers of water.
The above treatment will generally put an end to a slight attack of
gout; but to eradicate it from the system, the cure must be followed up.
To effect this, for the sweating process on the second day, substitute
the packing-sheet until warm, which generally requires the patient to
lie in it from thirty minutes to an hour.
Where a bath cannot be obtained, the rubbing sheet is used instead; this
should be very little wrung out, and if one does not cool the body, a
second or a third should be applied.
The douche is often applied in gout; but as that cannot be the case in
ordinary practice, the practitioner must use his discretion in
prescribing it.
It is good treatment to use the sweating process in the morning, and the
packing-sheet in the afternoon.
The bandages must be worn day and night, and changed often.
_Cases._--A patient, fifty years of age, with rheumatic gout, bad
digestion, nervousness, fingers blue and swollen, slight pain in the
knee, much debilitated, was ordered:--In the morning, five rubbing
sheets, two or three minutes each, allowing a short interim between
each. At noon, the same. At five o'clock, the same. Ten tumblers of
water daily. Bandages to parts affected, and round the loins always. On
the patient experiencing great pain under the knees, the morning
treatment was changed to lying in packing-sheets until well warmed,
followed by the tepid bath. Patient soon improved in health.
A----, forty-six years of age, suffered fifteen years from periodical
attacks of gout, and had his last severe attack in his feet, hands, and
elbows, accompanied by paralysis, which affected his voice.
_Treatment._--Laid in packing-sheet until perspiration ensued (two or
three hours); then tepid bath renewed by cold water being thrown over
head and shoulders; noon, rubbing-sheet, followed by sitz-bath 62° for
fifteen minutes; cold foot-bath fifteen minutes, and head-bath ten
minutes; afternoon, morning treatment repeated.
Alternate days, sweating in blankets instead of the sheets; all other
treatment the same as before.
This continued treatment was persevered in for ten weeks, when patient
was prescribed sweating in the morning, and packing-sheet in the
afternoon, followed by cold bath. Sitz and foot-baths as before;
head-bath discontinued. Shortly after, sweating twice a day, with
foot-baths, fifteen minutes in the middle of the day. Sitz-baths
dispensed with. This treatment at the end of six weeks was again changed
for perspiring only once a day, for three hours. Patient was at length
ordered to discontinue the treatment altogether, and proceed to the
sea-side for a month. Soon after his return again to Gräfenberg, he was
able to walk fifteen miles at a time, as is seen by his own letter.
B----, fifty-six years of age, suffering from Gout upwards of seventeen
years, generally incapacitated from following his occupation seven or
eight months in a year. Feet and hands distorted.
_Treatment._--Packing sheet and tepid-bath in morning and afternoon, and
sitz and foot-bath, each fifteen minutes; at noon, bandages round the
waist. After a week's treatment, a fit of gout came on in foot and
ankle, which was combated by packing-sheet and tepid bath before
breakfast; tepid sitz-bath at noon, and the morning treatment repeated
in the afternoon. After three days, a boil began to form under the left
jaw; treatment continued, with the exception of patient's going (_after
the packing-sheet_), into tepid bath for two minutes, then into the cold
bath for two minutes, and back to the tepid, from ten to fifteen
minutes.
In eight days, gout returned with greater violence, when recourse was
had to the packing-sheet, as before; with tepid baths from twenty
minutes to an hour, besides following up other parts of the treatment.
In seven or eight days the fit quite subsided. Some time after this he
had a relapse, which patient stated to me, under the allopathic
treatment, would have confined him to his room at least six months; this
was treated as follows:--
Packing-sheet until warm, followed by tepid bath, ten minutes; then
walked about the room for a quarter of an hour; then the bath again for
a quarter of an hour, a respite of a few minutes, and the bath a third
time.
Two hours after the above operation, a tepid sitting-bath 62°, for
twenty minutes.
In the afternoon the packing-sheet and bath as before. This treatment
was repeated, every day for six days, when patient was out of doors
again.
From this time patient felt himself so changed a man, that the author
saw him cry with joy. He could use his limbs as he had not done for many
years, and to prove it, ran up a hill with astonishing alacrity. Three
days treatment were sufficient to reduce the swelling of his knuckles,
toes, and hands.
This patient, on his first arrival, Mr. Priessnitz ordered, without any
previous preparation, into a tepid bath, where he was rubbed upwards of
an hour.
C----, aged forty. Gout generally returned in summer.
_Treatment._--Morning, and afternoon, packing-sheet, tepid bath; noon,
douche, three minutes.
After six weeks treatment, strong redness and much pain to the
conjunctiva; douche omitted.
Sitz-baths of from an hour to an hour and a half; foot-baths; cold wet
bandages to the eye, which became effected.
Then sweating processes, with wet bandages to the head, which afforded
relief.
Alternate tepid, cold and tepid baths for a quarter of an hour;
immediately after the packing-sheet, foot-bath and water poured over the
ancle. Eyes still red; foot-bath resorted to three times a day, followed
by rubbing sheet, instead of the bath and bandage to the eye. Eyes could
bear the light. Patient's appetite good and sleep sound. At night his
arms, head, and most of his body were covered with bandages.
In three weeks, patient's whole body covered with an eruption; recourse
again had to the packing-sheet and tepid bath twice a day. From this
time health improved daily.
D----, a gouty subject, forty-five years of age. Priessnitz, called up
in the middle of the night, found the Baron labouring under an attack of
gout in his chest and stomach, which almost prevented his breathing. He
was immediately put into a packing-sheet for from five to ten minutes,
and out of that into a tepid bath, where two men rubbed him for a
quarter of an hour; cold water being continually thrown over his head
and shoulders; this effectually put an end to the attack, and the
patient afterwards slept soundly until the time for his usual treatment
next morning. This case shows that the fear of this treatment driving
gout to the stomach, is groundless and it combats a dangerous attack,
and quicker than it can be done by any other means.
_Hereditary Gout._--E----, a Polish nobleman, fifty-four years of age,
suffered two winters from hereditary gout, which had existed in his
family for upwards of forty years.
He was attacked in his feet and arms, which confined him to his bed
several months.
_Treatment:_--In the mornings, packing-sheet and tepid bath; noon,
rubbing-sheet followed by sitz-bath, fifteen minutes; afternoon,
rubbing-sheet.
In eighteen days he had boils on his feet and arms, from which matter
continued to exude for three or four weeks; at the expiration of which
Priessnitz said, "Now we will increase the treatment, to see if any more
bad matter remains in the system."
The sweating process and cold bath were now resorted to three or four
times a week; the packing-sheet and cold bath other days; and the douche
every day for three minutes. This treatment was continued for several
weeks, during which no change of any kind was produced, a confirmation
of the cure being effected.
On leaving Gräfenberg, Priessnitz advised him to return the next year,
to see if the cure was a radical one.
In 1845, the Count returned, when he was subjected to a most vigorous
treatment, such as sweating, douche, etc., for a month, without any
return of gout.
On leaving Gräfenberg he assured me, that he was not only cured of gout;
but that his digestive powers, which for years had been deranged, were
in perfect order, and that his general health was completely restored.
Sixteen years previous to the Count's going to Gräfenberg, he had his
elbow wounded by a ball in a duel, which occasionally caused him great
pain. For the cure of this, he, at the time, rubbed in a yellow
ointment. Singular to say, after a lapse of sixteen years, during a
crisis, this ointment re-appeared on the elbow and arm, so thick as to
be taken off with the finger. The exuding of this ointment lasted about
eight days. Since the cure of his gout was effected, the arm has been
pliant, and the elbow has been free from pain.
_Gout in Head and Feet._--F----, a German professor, aged sixty; a small
delicate man, with gout in both hands and both feet: all were
contracted, he had been a martyr to gout for years and upwards, when a
paroxysm of gout came on the following morning.
The following treatment was resorted to. Morning, packing-sheet until
thoroughly warm; then tepid bath 64° for two hours, during which time
200 cans of cold water were thrown over his head and shoulders.
Twenty-five cans were first thrown; then great friction for some time;
then twenty-five cans more, followed by friction; and so repeated until
two hundred cans had been thrown over him.
Heating bandages were applied to all parts afflicted, and kept there day
and night.
The above treatment was resorted to again in the afternoon.
One paroxysm that I witnessed, lasted three weeks. It was astonishing to
see the courage displayed by this patient.
Each operation afforded relief for the time; but the enemy had strong
hold upon the system, and was ejected with difficulty.
During all the time the patient had a good appetite and slept soundly at
night.
He was still under the cure when I left Gräfenberg. Priessnitz said, to
effect this cure, it would require at least four years' treatment, which
the patient said he would prefer to a renewal of the suffering he had
already undergone, previously to coming to Gräfenberg.
_Calcareous Deposit in the Knees, and high state of Inflammation._--The
last case shews how the human body may be exposed to the action of
water, with friction, for any length of time. The present case is that
of an English Gentleman, well known to all visitors at Gräfenberg.
G----, aged between 50 and 60, gouty for the last twenty years, with
contraction of the limbs, chalk stones having formed in the joints. This
patient travelled from Italy to Gräfenberg during the heat of summer,
and, on arriving, had a most painful attack of gout in his lower
extremities.
Priessnitz, without the least preparation, put him into a tepid bath,
and he was rubbed by three men for nearly three hours, occasionally
throwing pails of cold water over his head and shoulders. This so
reduced the inflammation, that, towards the end of that period, the
afflicted part might also be rubbed with the wet hand.
Heating bandages were then applied to those parts and the waist.
Water was drunk plentifully during and after the operation.
Patient was able afterwards to get out of doors with the use of sticks,
and slept well at night.
Next morning he began the regular treatment, which was as follows:--
Packing-sheet until warm; then the bath as before for about two hours;
noon, rubbing-sheet and sitz-bath, fifteen minutes; afternoon, morning
process renewed.
Mr. Priessnitz told this patient that, by the following means, he might
always ward off a violent attack of gout:--
On feeling the slightest sensation of gout, he should instantly be put
into a tepid bath, 62 deg., replenished with cold water, and be therein
rubbed for a couple of hours.
This gentleman's general health is perfect: he very seldom has any
attacks, and they are slight; but the calcareous deposit in his knees,
up to the present, resists all attempts at removal.
_Acute attack of Gout._--A patient being attacked with gout was put into
a tepid bath, 68 deg., up to the neck, and rubbed by himself and two
men. By particular injunctions, the process was not to be discontinued
until all pain subsided. The original temperature of the bath was
maintained by fresh supplies of cold water. In seven hours the patient
was completely relieved. His after-treatment was:--
Morning, packing-sheet and plunge-bath, bandage round the waist and on
part afflicted; at noon, douche, and afterwards a rubbing-sheet;
afternoon, rubbing-sheet; the simplest food. On a return of the acute
attack, patient was ordered to perform the bath operation again; but,
not persevering in remaining seven hours in the bath, the attack was not
overcome: the patient was then ordered cold bath every morning before
breakfast (temperature kept always as cold as possible), from fifteen to
twenty minutes, which effected the cure. This patient was allowed a
little weak chocolate, and was ordered to drink abundantly of water.
A---- had a most violent attack at Gräfenberg, for which he was put up
to his neck into a tepid bath, 64 deg., and there rubbed by two men for
_seven_ hours. Priessnitz gave particular orders that the patient should
not leave the bath until all pain had completely subsided. Cold water
was frequently added, to keep that in the bath at the original
temperature. By these means the attack was completely subdued. Daily
treatment:--
Morning, packing-sheet and cold plunge-bath; bandage to be applied to
parts affected; noon, douche, and sitz-bath, fifteen minutes; afternoon,
as in the morning.
Instructions:--Eat plain food; and in case of a return of gout,
faithfully perform the first operation.
_Gout in the Foot and Ankle._--A lady awoke in the morning with pain in
her foot and ankle, which were both swollen.
_Treatment._--Packing-sheet for an hour, followed by a rubbing-sheet;
after which a foot-bath, up to the instep, for a quarter of an hour; and
the foot and leg, up to the knee, well rubbed all the time.
Bandages were then applied from the toes to the knee.
At noon, and in the afternoon, the foot-bath was again applied, and the
bandages were changed.
This simple treatment put an end to the attack in two days. If it had
not done so, it ought to have been repeated.
XXXV.--RHEUMATISM, ETC.
Gout, rheumatism, sciatica, lumbago, tic doloureux, and neuralgia, all
being attended with inflammation, are so nearly allied, that the same
treatment as for gout, with slight variation, might be applied to any or
all of them.
_Rheumatism._--On a slight attack of rheumatism, rub the part affected
with wet hands three times a day, from a quarter of an hour to an hour
each time; then apply a bandage, which change when dry, and wear it
until the pain ceases.
Rub the body all over with a wet towel, then a dry one; wait five
minutes, then repeat the same operation four times in succession: this
will animate the circulation. Then apply a bandage as in the case of
gout. This treatment should be applied several times a day. Rheumatic
subjects ought never to be overclothed, wear flannel, or fail drinking
water.
When the attack is more severe, three rubbing-sheets in succession,
allowing an interim of from three to five minutes between each. The body
must be dried after each rubbing-sheet; this increases the effect of the
next rubbing-sheet. Rub the parts affected often with wet hands, and
apply bandages. This treatment may be repeated three or four times a
day. If there is a great want of circulation, the patient may lie in bed
until warm, between the application of each rubbing-sheet.
_Neuralgic Pains._--Whatever the nature of these pains may be (supposing
the patient not too debilitated), perspiration will generally be found
to relieve them. To effect this:--
When in bed in the morning, add a number of blankets, and on them a
feather-bed: there remain until in a profuse perspiration; then cool the
body, either by rubbing-sheets, a cold bath,--or get a washing-tub,
stand up in it, and have some jugs of water poured over the head and
shoulders. This very often settles the affair at once.
A patient was afflicted in every joint so that he could not be moved in
bed without great pain.
Packing-sheets until warm, which required about half an hour, ten times
a day, allowing an interval between them. Each packing sheet was
followed by a rubbing with wet hands.
This treatment in one day enabled patient to stand; then the packing
sheets were used four times a day, followed by rubbing sheets. Parts
affected and loins always enclosed in bandages. Patient drank sixteen to
twenty glasses of water a day. He was out of doors the third day, and
afterwards pursued a more vigorous treatment, such as sweating, douche,
&c.
A----, had a severe rheumatic attack in both knees; he thought swinging
his legs backwards and forwards would relieve him; instead of which, it
brought on enlargement of the joints and inflammation: whilst at
Gräfenberg I inquired of Priessnitz what he ought to have done.--
_Answer_--He ought in, the first instance, to have rubbed the knees well
and often with wet hands and worn a bandage. If this was not sufficient,
then to have put the feet and legs, over the knees into cold water for
half an hour at least, rubbing them all the time, and apply a bandage
from the calf of the leg to the middle of the thigh.
_Chronic Rheumatism._--A----, contracted rheumatism in 1837, which
commenced as sciatica. Constitution greatly debilitated. Medical advice,
sea baths, hot baths, and other remedies, useless.
Patient went to Gräfenberg, August 1843, and left in May following.
_Treatment._--Packing-sheet, followed by cold bath twice a-day; noon,
sitz-bath and foot-bath, fifteen minutes each; legs rubbed all the time
up to the knee. Douche three minutes daily.
In November, one of his usual attacks came on, when sixteen rubbing
sheets a-day were resorted to. Four of these were given in succession
four times a-day; between each rubbing sheet, the patient being weak lay
down in bed, until warm bandages were applied as usual.
This attack subsided after the second day, when patient renewed his
former treatment.
B----, travelling in North America, and exposed to severe rains without
the means of changing his clothes, suffered the consequences such
circumstances frequently entail. Rheumatism almost beyond endurance
induced him to go to Gräfenberg.
At the first interview, Priessnitz put him first into a tepid bath 64
deg., out of which he plunged into a cold bath, where he staid about a
minute, and from that he returned again to the tepid, when bandages were
applied to his waist and parts affected.
_Treatment._--Morning, packing-sheet until warm, then cold bath; noon,
rubbing-sheet; afternoon, packing-sheet, twenty minutes, and then
rubbing-sheet again.
Left Gräfenberg in a month, during which time patient used the
rubbing-sheet mornings and evenings; exposed his body (after that in the
morning) quite naked in his room, from a quarter to half an hour.
On returning to Gräfenberg, the douche was substituted for the
rubbing-sheet at noon. After continuing the treatment for some time,
rheumatism returned, when he was ordered three rubbing-sheets five
minutes each, twice a-day; between each an air bath of five minutes.