THE VARIETIES OF BATHS.
The _tepid_ bath has a temperature of from 85° to 92° Fahr., the _warm_
bath a temperature between 92° and 98° Fahr., and the _hot_ bath a
temperature of from 98° to 112° Fahr.
The _cool_ bath has a temperature from 60° to 75° Fahr., and the _cold_
bath is of a temperature below 60° Fahr., downwards to the freezing
point of water.
Hot or cold water may be used locally. We are familiar with the
hip-bath and foot-bath, and occasionally we meet with baths of a
special shape, made for the reception of the arms or hands, in cases
where their local treatment has been deemed necessary.
Various plans have been devised for increasing the stimulating effect
of water. One method of attaining this object is by keeping the water
constantly in motion, as is done in the so-called _wave bath_, common
in some parts of the Continent. Another way is by so increasing the
size of the bath that the patient is able to move freely in it. In a
big bath, not only is the good effect of exercise able to be added to
that of bathing, but the concussion of the water on the surface of the
body, and the constant change of the stratum of water in contact with
the body vastly increases the power of the bath in influencing the
temperature and stimulating the skin.
The best of all baths is the _swimming bath_, for in it the bather can
indulge in a free exercise of his limbs, such as is hardly attainable
under any other circumstances. Swimming is a very valuable exercise,
because it employs the arms equally with the legs, and leads to a
healthy development of the muscles of the chest. Nearly all good
swimmers are big chested.
The _douche_ is a name given to a stream of water, either hot or cold,
which is made to fall heavily or with force upon a part. It acts partly
by the force of mechanical impact, and partly by its temperature. It
is a very exhausting method of treatment, and must on no account be
used too long. A column of water 12 feet high, allowed to fall upon the
head, is so painful that Esquirol, who submitted to it, described it
as resembling the continued breaking of a column of ice on the head,
followed by a feeling of stupefaction, which lasted an hour afterwards.
The douche was formerly much used in lunatic asylums, and was regarded
as a specific against delusions, the unhappy creature possessed by
delusive ideas being held beneath the douche until he recanted; and
such was the agony thus caused, that the mere threat of the douche was
often sufficient to control the wildest of maniacs. Those who have
undergone the process of “shampooing the head,” as practised by the
hair-dressers of our time, will remember the effect of a stream of cold
water allowed to flow upon the head for too long a time.
The most powerfully stimulating action is obtained by the use of the
_Scottish Douche_, which consists in the alternate use of streams of
cold and hot water. By the hot stream the “reaction” after the cold
stream is greatly encouraged. In most of the swimming baths to be found
on the Continent, a pump is provided, in order that a patient may
himself apply the douche to any joint requiring it, and at the same
time encourage his reactive glow, by the exercise of pumping.
In most great bathing establishments two douches at least are provided,
one called the _descending douche_, which may be applied to the head,
shoulders, trunk, or limbs; and the other called the _ascending
douche_, which is designed for throwing a stream of water into the
bowel, a method of treatment which is advocated for conditions which it
is unnecessary to discuss in this place.
_Hot and cold affusion_ are merely mild forms of the douche.
The _shower bath_ differs from the douche only in the division of the
stream of water by causing it to flow through a suitable colander. This
method of treatment is severe and exhausting, and must be used with
caution, especially with weakly people.
The _needle bath_ is merely a general shower bath. The bather stands
within a coil of pipes which are finely perforated, and the water
impinges in finely divided streams simultaneously upon every part of
the body. It is a powerful general stimulant.
The _rain bath_ consists in the letting fall of large drops of water
from a great height upon the part which it is wished to affect.
_Packing with the wet sheet_ is a mode of applying water to the body
which is the very reverse of some of the methods which we have been
considering, since the stimulating action of the water is reduced to
a minimum, and we get the refrigerating action only. It makes very
little difference whether the sheet used be moistened with hot or cold
water, since the temperature of the skin and the sheet very rapidly
approximate in any case, and the more rapid evaporation of the hot
water speedily induces a degree of cold quite equal to that of the
cold sheet. The patient should be stripped naked and should lie upon a
single blanket, the bed being protected by a mackintosh sheet placed
between the blanket and the mattress. He is then enveloped in the wet
sheet. If a maximum amount of refrigeration is desired he is left
uncovered so that evaporation may be encouraged. If, on the other hand,
we wish to encourage the action of the skin, several blankets are
placed over the sheet.
Having discussed the various methods of using water as such for the
purposes of bathing, we may next turn our attention to the _vapour
bath_, which is a favourite method of making use of warmth and
moisture. Here and there throughout the world there are to be found
natural vapour baths; but, as generally employed, the vapour bath is
a very simple contrivance indeed, merely consisting of an apparatus
for conducting the steam of a kettle into a confined space in which
the patient sits. The head of the patient may be either placed in the
bath or not, and the effects of the bath may be expected to differ
according as the steam is inhaled into the lungs or not. The domestic
vapour bath may consist of a flannel steam-proof cloak, which is worn
by the patient, while beneath the chair on which he sits is placed a
small portable kettle heated by spirits of wine for the formation of
the steam. If the bather is unable to sit up, the steam may, with very
great ease, be conducted beneath the blankets of a bed. The vapour bath
can be borne much hotter than the water bath, the temperature varying
between 120° Fahr. and 150° Fahr. The loading of the atmosphere with
vapour, checks, or rather prevents, the natural evaporation of the
perspiration, so that while the body is very strongly heated by the
steam, the natural methods of cooling the body are arrested. From this
it will be gathered that the power of the vapour bath to raise the body
heat is very considerable, and indeed the temperature of the blood has
been known to rise as much as 5° Fahr. during a bath. This power of
raising the temperature of the body causes a very profuse perspiration,
so that the vapour bath is recognised as one of the quickest and most
effectual means of producing a copious action of the skin. The vapour
bath can be locally applied in a very manageable way, and there is
no difficulty in contriving an apparatus, by means of which the legs
alone, or one arm, or one leg, may be subjected to the action of the
vapour. If a quick reaction is desired a cold douche may be added to
the steam, and the so-called _Russian vapour bath_ consists of a vapour
bath of high temperature followed by a cold douche.
_Air baths_ are baths from which we never escape except when we are
taking a water bath, our bodies naturally being always surrounded by
a layer of the atmosphere. _Cold-air baths_ are not much employed,
although they have been recommended; and we have heard of persons who
have sought to stimulate their skins and circulation by running naked
in the open air. The _hot-air bath_ has always, at least since the
days of ancient Rome, been a favourite luxury and means of treating
disease; these baths, which are also called Russian or Turkish baths,
consist really in a succession of processes, which, in the best
establishments, are as follows: The bather is received at a barrier,
where he is relieved of his boots and provided with check napkins in
which to swathe himself while bathing. Passing the barrier he arrives
at the tepidarium, a room of Eastern design, which attracts him by
its coolness, quietness, and cleanliness. A marble basin, filled
with water, into which a jet of water from a fountain falls with a
soothing splash, occupies the centre, while all round are divans
for reclining and conveniences for dressing and undressing. Through
a Moorish arch at the end a glimpse is caught of the sudatorium,
separated by a plate-glass partition from the tepidarium. Stripping
himself naked and donning his checks, the bather passes into the
sudatorium, an apartment with a domed roof, and having a marble floor
and red-brick walls. The temperature of this room is about 120° or
150°, and here the bather sits, reading or otherwise amusing himself
until perspiration is fully advanced. If perspiration is not free it
may be encouraged by a draught of cool water, which will be tendered
him by an attendant. If perspiration is slow in its advance, the heat
of the room causes discomfort. Some burning of the skin, quickness of
the heart’s action, and occasionally a throbbing tensive headache. A
drink of water generally has the effect of causing the whole surface to
bead with moisture, and then a sense of comfort succeeds to discomfort.
Perspiration being fairly started it may be still further encouraged
by removing into a still hotter apartment (of which there are three)
varying in temperature from about 150° Fahr. to 210° Fahr. In these hot
rooms (where it is necessary to wear thick list slippers to prevent
the feet being scorched by the hot marble) the perspiration, in some
persons, streams off the body, and when sufficient perspiratory action
has been allowed, the bather returns to the body of the sudatorium,
and, reclining on a marble slab, he is shampooed by an attendant. Next
the whole surface is thoroughly washed with hot soap and water and the
skin rubbed with a horse-hair glove; lastly, the process is finished
by the application of cold water, which is done in one of two ways,
either by the application of the cold douche, or by diving beneath the
glass screen which separates the sudatorium from the tepidarium into
the marble basin which fills the centre of the latter apartment. This
done the bather is rubbed dry, and then indulges for half an hour in
the _dolce far niente_, while he reclines on a divan, reads the paper,
sips a cup of coffee and smokes a cigarette. As to the value of the
Turkish bath we will speak hereafter, and we will content ourselves
in this place by warning the bather not to “overdo” it. He should be
guided by his sensations, and should not be tempted to go into this
room or that room, or submit to this or that process merely because a
friend does so with benefit, or without harm. He must remember that
constitutions differ, and if the bath is followed by headache, or a
feeling of faintness or lassitude or a want of appetite, he should take
this as a warning that the treatment has been too heroic. The strongest
Turkish bath is that in which the bather spends his time in the hottest
room and finishes with the douche (a process which few can stand);
the milder bath is that in which the highest temperature submitted to
is about 140°, and the dive into the basin is taken in lieu of the
douche. Those who take a Turkish bath for the first time should limit
themselves to its milder form.
_Mineral Baths_ are baths composed of water in which a considerable
quantity of mineral matter has been dissolved, either by natural or
artificial processes. It must be remembered that ordinary water is very
far from pure, and that even rain-water, the purest of all natural
waters, contains a considerable number of saline ingredients dissolved
in it. Spring-water or river-water is very largely impregnated with
matter which it has dissolved. The water of London contains from
18 to 20 grains of chalk in solution in each gallon, besides other
ingredients. The chief of all “mineral waters” is sea-water, and it
is necessary that we should examine its composition somewhat closely.
The specific gravity of sea-water is 1027, and the quantity of salt
dissolved in it ranges from 3·5 to 4 per cent., being least in the
Black Sea and the Baltic, and most in the Mediterranean. The following
is the composition of the water of the English Channel:--
Water 963·8
Chloride of sodium (common salt) 28·0
Chloride of potassium 0·8
Chloride of magnesium 4·0
Sulphate of magnesia (Epsom salt) 2·0
Sulphate of lime 1·4
Bromide of magnesia }
Carbonate of lime }
Iodines } Traces.
Ammonia }
Oxide of iron }
-------
1,000·0
-------
Sea-bathing is a very popular form of the natural bath, and it is
preferable to bathing in river-water or spring-water, because the
sea is seldom so cold as are the latter. A sea-bath has also another
great advantage over all other forms of bath, and that is that it is
taken in the purest air possible; and in considering the effects of
sea-bathing it is impossible to separate the effects of sea-air from
that of the sea-water. The sea-bather is also constantly inhaling the
spray of the sea-water, and thus obtains whatever benefit is to be got
in this way. If he can swim he enjoys all the benefit of exercise. The
motion of the water and the buffeting he gets from the waves act as a
powerful excitant to the skin, and lastly, the salt in the water adds
considerably to the stimulating action. Reaction more readily occurs
after a sea-bath than after a river-bath, and thus the liability to
“catch cold” is less, although the popular belief that it is impossible
to take cold from a wetting with salt water is far from being true.
Besides the water of the sea, there are many other _natural salt
waters_ which have a great reputation both for bathing and drinking.
These salt waters, which may be got of all strengths, from a strong
natural brine to a water in which the salt is scarcely recognisable,
all owe their stimulating power, as does sea-water, to the chloride of
sodium (common salt) and other chlorides which they contain. Salt-water
baths, or sool baths as they have been called, act as powerful
stimulants to the skin, and have a very great reputation in Germany and
other places, where the only seaboard is the ungenial northern coast.
There are many _natural mineral waters_ which contain ingredients other
than common salt, and all of these are much used for bathing. We shall
give some details of these when we come to speak of bathing resorts,
and at present we shall content ourselves by giving merely a rough
classification of them.
1. Many waters issue from the ground at a temperature sufficiently
hot, or even too hot (e.g. the geysers in Iceland) for bathing. Some
of these natural hot waters contain very small quantities indeed of
mineral matters, and these are known as _indifferent thermal springs._
2. Mineral waters containing common salt have been already alluded to.
They are known as _salt springs._
3. The so-called _alkaline springs_ contain as their chief ingredient
carbonate of soda. These waters are more used for drinking than for
bathing. The alkali which they contain helps undoubtedly to soften
the skin of the bather, and acts probably also as a stimulant to the
surface.
4. The waters containing bitter _purgative salts_, such as Epsom salt
or Glauber’s salt, owe their reputation almost entirely to their power
when taken internally. When used for bathing it is probable that these
natural solutions of purgative salts are more stimulating to the skin
than ordinary water.
5. The natural _chalybeate waters_, or waters containing iron, are but
little used for bathing, and it is exceedingly unlikely that the iron
contained in the water has any effect upon the bather.
Although we have classified the waters, and have used that
classification which is generally adopted, it must be remembered that
the ingredients of waters are always multiple, and we usually find
that they contain alkaline salts, purging salts, iron salts, and brine
salts mixed together, so that it is difficult sometimes to determine
which is the predominating ingredient, and therefore to which class a
mineral water properly belongs. All water contains gas of some kind
dissolved in it, and it is well known that a glass of ordinary spring
water may be seen to contain bubbles of gas which adhere to the sides
of the glass, or come “winking at the brim.” The gases which waters
principally contain are atmospheric air, nitrogen, carbonic acid, and
sulphuretted hydrogen, and great stress has been laid upon the presence
in bathing waters of the three last-named gases.
The action of bubbles of gas contained in water is, in part at least,
easy to understand. These bubbles give great mobility to the water, and
thus the particles of water in contact with the skin are incessantly
changing. Gas is soon driven out of water by the application of heat,
and it is only the cooler of the thermal springs which remain charged
with any considerable quantity of gas after the natural pressure, to
which they have been subjected in the earth, has been removed.
The bubbles of gas, contained in the various gaseous waters, resting
upon the surface of the body, produce an agreeable sensation of mild
stimulation not unlike that which we feel when the surface of the
body is gently tickled. The gaseous baths belong necessarily to the
category of cool baths, and it is important to remember that waters
which have been boiled no longer retain any gas, which is all expelled
during the process of ebullition. When a gaseous water issues from
the earth at a temperature too low for bathing purposes, it is very
important that the water should be heated only to the temperature
required for bathing, which is generally between 60° Fahr. and 98°
Fahr. This is effected usually by means of a coil of hot water or
steam-pipes beneath the bottom of the bath, and, by turning a tap, the
bath attendant can produce any temperature which may be desired in a
very short time. Water which has been previously _boiled_ or _heated to
a high temperature_, and has been allowed to cool to fit it for bathing
purposes, contains very little or no gas, and cannot be regarded as
constituting a gaseous bath. Intending bathers should inquire very
carefully into the manner of heating baths at these establishments. If
the natural gaseous water be collected in reservoirs, and be allowed to
lie in these reservoirs for any length of time before being used for
the baths, the greater part of the contained gas will escape, and there
will be a great discrepancy between the actual condition of the water
used and the published analysis of such water.
It is exceedingly unlikely that either carbonic acid or nitrogen
contained in water is absorbed by the skin. The effect of these gaseous
baths is due to their physical condition only (at least we have no
satisfactory evidence to the contrary), and in no way to the absorption
of the contained gases. Carbonic acid is only absorbed by the skin
under the influence of great pressure, and when thus absorbed it
produces a poisonous effect.
At some bathing establishments, so-called baths of pure carbonic acid
are administered, the patient being made to sit in a reservoir of
the pure gas, but, of course, with his head out. We have also seen
arrangements for directing a jet of carbonic acid gas upon different
regions of the body, but we should be sorry to hazard any opinion as to
the _modus operandi_, or the results of such a practice.
In an ordinary water-bath, strongly impregnated with carbonic acid,
there is occasionally some danger of too much gas escaping, and being
consequently inhaled in undue quantities by the occupant of the bath.
_Sulphur baths_, or baths impregnated with sulphuretted hydrogen gas,
and having the well-known and offensive odour of rotten eggs, have
been used as remedies in disease from time immemorial. It must be
remembered that the so-called “sulphur waters” are of a very complex
nature, and contain many saline ingredients, in addition to the
sulphides of lime or soda, to the decomposition of which the presence
of the characteristic gas is due. Most of these waters have also a
high temperature, so that they must be considered as hot salt waters,
with the addition of sulphuretted hydrogen, and it becomes a difficult
matter to determine to which of their ingredients any good effect
which they may produce is due. It must be borne in mind, also, that
the amount of sulphuretted hydrogen contained even in the strongest of
these waters, notwithstanding that it is amply sufficient to offend the
sense of smell, is in reality very small, and there is no evidence that
this gas is ever absorbed through the skin from the bath. People who
visit sulphur baths generally drink the water, and while bathing they
certainly inhale an atmosphere more or less charged with sulphuretted
hydrogen. The general opinion at present is, that the effect of sulphur
waters, when used for baths, is the same as that of other hot and
saline springs, and that the sulphuretted hydrogen in the water is
inoperative. At some of the sulphur baths the attendants point to a
peculiar eruption on the skin, called La Poussée, as evidence of the
peculiar effect of sulphur, but this eruption does not differ from that
which so often results after a prolonged use of baths of any kind.
There is no end to the varieties of baths which have been used at one
time and another for the relief of sickness, and we shall content
ourselves by a short allusion to some of the best known.
_Mud baths, or moor baths_, are much used in some parts of Germany.
They consist of water mixed with moor earth, or the mud deposited
by some of the mineral springs. The resulting compound is thick
and stodgy, and, like loosely-made farinaceous puddings. They cool
unequally, and retain their heat for very long periods in the middle.
Chemically they are composed of the various matters, soluble and
insoluble, animal, vegetable, and mineral, of which mud or moor earth
is formed. Much of their virtue has been ascribed to _formic acid_,
a volatile body formed by ants, having a very pungent odour and
considerable stimulating power. These baths are generally supposed to
exert a very powerful action upon the skin.
_Pine baths_ are in great repute in regions where pine-trees are
plentiful, as in the Black Forest, the Harz Mountains, and elsewhere. A
decoction is made of the fragrant tops of the pine-trees, and this is
added to the baths in varying quantities. It is also largely exported
in a concentrated form from the regions in which it is made. The smell
of the pine extract is most delicious, and the resin which it contains
has an undoubted stimulating action upon the skin.
Blood, milk and whey, as well as various broths and decoctions of meat,
have been used in the belief that they imparted strength to the bather.
It is indeed a practice in some northern countries, even in the present
day, to envelop a weak or dying patient in the skin of a freshly killed
animal, the invalid thereby being supposed to imbibe some of the vital
power of the recently slaughtered beast.
On the banks of the Nile, _slime_ has been used as a bath, and in some
places _sea-mud_ has been used for the same purpose. _Sand baths_, or
arenation, belong to the remedies which are hallowed by antiquity. The
patient is buried in the sand, and exposed to the full rays of the
sun, and the combined effect of the heat and the surface irritation
produces a copious perspiration. At some sea-bathing establishments
_baths of sea-weed_ are given, under the name of ozone baths, from the
belief, right or wrong, that sea-weed is impregnated with ozone. In
some old works we find baths of _dung_ strongly recommended; and even
at the present day it is the practice, among some of the half-civilised
Eastern nations, to smear the body with dung for the cure of all
varieties of ailments. Various refuse matters have been used as baths,
among which we may mention the _husk of the grape_, in countries where
the vine is largely cultivated, and the _refuse of the olive_ in
oil-making countries.
Medicated baths may be artificially prepared, and many such are in
common use in medicine. Among these we may mention--
1. The group of so-called _emollient_ baths, which have the following
composition: To thirty gallons of water, there may be added from two
to six pounds of _bran_; or a pound of _potato flour_; or a couple of
pounds of _gelatine_; or a pound of _linseed meal_; or four pounds of
_marsh mallow_, or other herbs.
2. _Alkaline baths_ are made by adding to thirty gallons of water, from
four to six ounces of carbonate of soda or potash, and occasionally an
equal quantity of borax.
3. _Acid baths_ contain an ounce or more of muriatic, nitric or
nitro-muriatic acid, to each thirty gallons of water.
4. Iodine or Bromine may be added to baths.
The medicated vapour baths are of two kinds, _mercurial_ and _sulphur_,
both being contrived by evaporating flour of sulphur or calomel in
an iron pan. The sulphur bath thus administered emits the pungent
and suffocating vapour of sulphurous acid, the effects of which must
be exerted solely upon the body of the patient, since the inhalation
of any quantity, if not fatal, would prove a very serious annoyance.
We must not forget to mention the old domestic remedy of a bath of
_mustard and water_, which is among the most powerful stimulants to the
skin which we possess.
The _Galvanic Bath_ has been much talked about of late years, and it
becomes necessary that we should discuss its merits. It consists merely
of a bath of water, through which a galvanic current is passed. It
can be easily administered in the following way:--Place an ordinary
bath upon a sheet of mackintosh, which, being a non-conductor of
electricity, has the effect of insulating the bath, as it is termed.
Then fill the bath with warm water to a convenient height, and to the
water add a handful of salt or a wine-glassful of vinegar in order
to increase its conducting power. Next get a galvanic battery, one
having 30 or 40 Leclanché Elements is sufficient, and place it on a
chair or on the floor beside the bath. To each of the poles of this
battery, positive and negative, affix a suitable length (3 or 4 yards)
of insulated telegraph wire, having its extremities freed from the
gutta-percha or other insulating material. Place a length of stout
broom-handle across the bath, resting on its two edges, and round the
middle of this twine the bright metal end of the wire in connection
with the positive pole of the battery, covering it with a piece of
flannel, or wrapping it round with a sponge. The bather then gets into
the bath, and takes hold of the centre of the broom-handle, previously
moistened, so that his hands are out of the bath. The end of the
negative wire is then placed in the bath itself, and as this is done
the bather will feel the shock of the electric current. The current in
this case travels from the positive pole of the battery through the
wire to the broom-handle, down the patient’s arms, through his body to
the water of the bath, and so to the negative pole. This form of bath
is a very powerful stimulant to the skin, but beyond its action on the
skin we know nothing. It is said that by its aid it is possible to
extract metallic bodies, such as mercury or lead, which may be lurking
in the body and causing harm. Of such a power there is no evidence
whatever. We have heard it said that at some galvanic baths visitors
have been shown discolorations on the side of the bath as evidence of
deposits of mercury, &c., but this is merely a quackish imposition, and
it is well that persons should be on their guard against it.
The _electro-magnetic_ bath is given in the same way as the galvanic
bath, an electro-magnetic battery being substituted for the galvanic
battery.
It will be well to close the chapter by offering a few hints to
bathers, and by laying down a few rules for their guidance. Bathing, in
all its forms, increases the internal work of the body; it increases
the action of the heart, the rate of respiration, the rapidity of
circulation, the rate of tissue change, and, in the case of hot baths,
the rate of perspiration through the skin. This necessarily makes a
call upon the vital forces, and causes a certain amount of exhaustion.
From this it follows that baths are best not taken at a time when
the body is much exhausted, and that exhausting exercise should not
be indulged in after a bath until a considerable period of time has
elapsed.
Again, since bathing invariably affects the distribution of the
blood, causing, as the case may be, either a degree of bloodlessness
in internal organs, or, if the bath be cold, an undue congestion of
them, it is important not to overtax those organs during the period of
bathing. It is, therefore, never advisable to bathe directly before or
directly after a meal, since in both cases a want of digestion of the
material in the stomach is likely to result.
Ancient writers are most explicit in their directions for bathers.
Thus Hippocrates, the Father of Medicine, writing some four centuries
before the Christian era, says: “The person who takes the bath should
be orderly and reserved in his manner, should do nothing for himself,
but others should pour the water upon him and rub him; and plenty
of water, of various temperatures, should be in readiness for the
_douche_, and the affusions quickly made; and sponges should be used
instead of the strigil, and the body should be anointed when not
quite dry.... And a man should not be washed immediately after he has
taken a draught of Ptisan, or a drink; neither should he take Ptisan
as a drink immediately after the bath.” These directions are for the
use of invalids, such as are acutely ill, and the writer seems fully
to recognise that bathing in itself is an exhausting process. This
allusion to Ptisan is interesting, as showing how some of our commonest
domestic remedies come to us from a remote antiquity. The Greek word
πτισάνη signifies peeled (or “pearl”) barley, and the drink
made from it, the barley-water of to-day.
As we have before mentioned incidentally, the proper ventilation of the
bathroom is a matter of prime importance; for since the respiration is
quickened by the act of bathing, it is evident that a foul atmosphere
in the bathroom is very liable to produce an ill-effect upon the
bather. Many of the swimming baths in London are very defective in this
respect, and we have been forcibly struck, in more than one of them, by
the ammoniacal odour proceeding from those sanitary offices which are a
necessary adjunct to every bathing establishment. It is a very common
custom in private houses to place the bath and the water-closet in the
same apartment. That this is an undesirable arrangement is evident, for
the water-closet is, of all places in a house, that in which a foul
atmosphere is most likely to be encountered. Although a bathroom should
be well ventilated, it should certainly not be draughty, for currents
of cold air blowing upon the moist skin of the bather are likely to
give “cold,” and produce internal congestions of various kinds. In
summer there is no difficulty in providing a sufficiency of fresh air,
but in winter it is not so easy. The best way, perhaps, to provide for
a constant renewal of air is to admit air by means of vertical tubes,
and to have in the room an open fireplace, in which a brisk fire should
be burning while the bath is being administered.
In order to ensure a proper reaction after a cold bath, and to prevent
chill after a hot one, it is customary to provide the bather with a
supply of hot linen. This is a great comfort and a luxury, and may even
be looked upon as an absolute necessity for delicate persons. It is a
very general custom on the Continent for the bather, after removing
the greater part of the moisture from his body, to don a hot calico
Peignoir, or bathing-gown, which protects from chill, and at the same
time allows of the limbs being rubbed with towels. It is not necessary
to say much about towels. They are to be got of all qualities, from
those as soft as a cambric handkerchief to those which, in roughness,
approach the qualities of a curricomb. The bather may please himself
in this matter, and will choose a soft absorbent towel to remove the
moisture, and a hard one to rub the surface and produce the necessary
reaction. Horsehair gloves and various rubbers made of indiarubber,
&c., are in use, and require only to be mentioned.
Friction and shampooing are valuable accessories to bathing, and serve,
as it were, to take the place of exercise in those diseases in which
the patient is unable to exercise his body thoroughly for himself.
Friction is applied to the skin merely to rub off the surface layers of
epithelium, to encourage the dilatation of the superficial vessels, and
the transudation of the sweat. Shampooing is a deeper and more forcible
kind of friction, in which the rubber kneads the muscles and allows
his fingers to press steadily upon and between them. This acts as a
stimulant to the muscles themselves, much in the same way, but in a far
milder degree, as an electric battery acts upon them. It must be borne
in mind, however, that friction and shampooing are both exhausting,
and must not be used to excess. While a patient is being shampooed, he
involuntarily resists the pressure of the shampooer, and we have seen
a patient reduced to a state of considerable exhaustion, after having
been for twenty minutes in the hands of a professional rubber.
It is not necessary to make any remarks on the subject of soaps. Their
name is Legion, and the bather, guided by the light of common sense,
may make his choice. The ancients were accustomed to anoint their
bodies with a variety of smegmata, unguents and oils, both during and
after bathing.
As to the temperature of the bath and its duration, although these
are both very important questions, it is impossible to lay down any
exact rules, for they must be settled according to the condition of
the bather. A physician, in ordering a course of baths for an invalid,
should state, in writing (in the form of a prescription) the frequency,
variety, temperature, and duration, as well as the time of day at which
they are to be taken.
After a hot bath it is sometimes necessary to arrange that a weakly
patient shall go to bed for a couple of hours or more. To slake the
thirst, both during and after a bath, there is nothing better than pure
water.