HYGIENE OF THE SKIN, CONTINUED.
685. Bathing, its necessity and expediency, is obvious from the
structure and the functions of the skin. The cuticle is cast off in
minute, powdery scales, many of which are retained upon the surface by
the pressure of clothing. These mingle with the oily and saline
products of the skin, and form a thin crust. This crust, on account of
its adhesiveness, collects particles of dust and soot from the
atmosphere, and particles of foreign matter from our dress; so that in
the course of the day the whole body becomes coated with impurities.
If this coating remains, becomes thick and established upon the skin,
it will produce the following effects:--
686. 1st. _The pores will be obstructed, consequently transpiration
impeded, and the influence of the skin as an excretory entirely
prevented._ When the pores are obstructed, and transpiration is
checked, the elements of the transpired fluids will necessarily be
retained in the system; and, as they are injurious and poisonous if
retained, they must be removed by those organs whose functions in the
animal economy are similar, as the lungs, kidneys, liver, intestines,
&c.
687. When these organs are called upon to perform their offices, and
in addition that of another, the healthy equilibrium is destroyed, and
the oppressed organ will suffer from exhaustion, and become the prey
of disease. Thus, obviously, habits of uncleanliness are a cause of
consumption and other serious diseases of the vital organs. Again,
obstruction of the pores will prevent respiration through the skin,
thus depriving the blood of one source of its oxygen, and one outlet
of its carbonic acid, which will diminish the temperature of the
system, and the same results follow as when the clothing is
inadequate.
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685. Show the necessity for bathing. 686. What effect upon the body if
the pores of the skin are obstructed? 687. What is the effect when an
organ not only performs its own specific function, but that of
another?
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688. 2d. _The retained perspirable matter will irritate the skin, both
mechanically and chemically_; and this membrane will be kept damp and
cold, from attraction and detention of moisture; and foreign material,
as before adverted to, once removed from the system, may be reconveyed
into it by absorption. As a consequence, cutaneous eruptions and
diseases will be produced, and the re-absorption of matter once
separated from the system, will be the exciting cause of other
injurious disorders.
689. 3d. _A film of foreign substance on the skin will inevitably
become the seat of detention of miasmata and infectious vapors._ These
will remain until absorbed, and engender the diseases of which they
are the peculiar cause. This is one reason why filthy persons contract
infectious diseases more frequently than individuals of cleanly
habits.
690. _Bathing is useful to promote cleanliness._ In this capacity, it
enables us to remove the coating of impurities from the exterior of
our persons. It effects this purpose by dissolving saline matters, and
holding in temporary suspension those substances which are insoluble.
691. The cuticle is composed of a substance resembling the dried white
of egg, or, in a word, _albumen_. This is soluble in alkalies, and
these are the agents which are commonly employed for purifying the
skin. Soap is a compound of the alkali soda with oil, the former being
in excess. When used for washing, the excess of alkali combining with
the oily fluid, with which the skin is naturally bedewed, removes it,
in the form of an emulsion, and with it a portion of any adhering
matter. Another portion of the alkali softens and dissolves the
superficial layer of the cuticle; and when this is removed the cuticle
is free from impurities.
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688. How are cutaneous eruptions frequently produced? 689. How are
infectious vapors transmitted to the system? 690. How does bathing
promote cleanliness? 691. Why is it necessary to use soap in bathing?
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692. Every washing of the skin with soap removes the old face of the
cuticle, and leaves a new one; and were the process repeated to
excess, the latter would become so thin as to render the body sensible
to impressions too slight to be felt through its ordinary thickness.
On the other hand, when the cuticle and its accumulated impurities are
rarely disturbed, the sensitiveness of the skin is impaired. The
proper inference to be drawn from the preceding remarks, is in favor
of the _moderate_ use of soap to cleanse the skin.
_Observation._ If any unpleasant sensations are felt after the use of
soap, they may be immediately removed by washing the surface with
water slightly acidulated with lemon juice or vinegar, which
neutralizes the alkali that may remain on the skin. This is effective
treatment for "chapped hands."
693. _Bathing may be partial or general, and the water used may be
cold, temperate, tepid, warm, or hot._ A person may apply it to his
system with a sponge, it may be poured upon him, or he may immerse
himself in it. The simplest mode of bathing is to apply water to a
small extent of surface, by means of a wet sponge, and after being
wiped dry, again cover with the dress. In this way the whole body may
be speedily subjected to the influence of water, and to no less useful
friction. The water used may be warm or cold. This species of bathing
may be practised by any invalid, and always with benefit, if the
bathing is succeeded by a glow of warmth over the surface; and this is
the test by which the benefit of all forms of bathing is to be
estimated.
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692. Why should only a moderate amount of soap be used in bathing? If
unpleasant sensations are felt from too free use of soap, how can they
be counteracted? 693. Give the different forms of bathing. What is the
simplest mode of bathing? Can this mode be adopted by invalids with
safety?
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694. When the heat of the system is adequate, the bather may stand or
sit in a shallow tub, while he receives the water from a sponge
squeezed over the shoulders or against the body. In this form of
bathing, the person is more exposed to the cold air, and on this
account it is less suitable for very feeble individuals than the
first-mentioned method. In the early use of this form of the
sponge-bath, the bather should content himself with a single affusion
from the sponge; the body should be quickly wiped with a soft towel,
and friction applied with a crash towel or a brush.
695. The third kind of bathing is that of the shower-bath, which
provides a greater amount of affusion than the former, combined with a
greater shock to the nervous system. The concussion of the skin by the
fall of water, particularly distinguishes this from the previous modes
of bathing. The degree of concussion is modified by the size of the
openings through which the water issues, and the height of the
reservoir. The shower-bath admits of modification, adapting it to the
most delicate as well as the robust. The extent of fall, the size of
the apertures, the quantity and temperature of the water, may be
regulated at pleasure.
_Observation._ In using the shower-bath, it would be judicious to
commence with warm or tepid water, for which, by a gradual process,
cold water may be substituted. In this way the system may be inured to
cold water. After bathing, the skin should be wiped dry and rubbed
briskly.
696. The fourth form of bathing is that in which the body, or a
portion of it, is immersed in water. The temperature of water in this
form of bathing may be modified according to the sensations and
purposes of the bather. This form of bathing is designated according
to the heat of the water. When the temperature is below 75 deg., it is
termed a cold bath; when from 75 deg. to 85 deg., a temperate bath; from
85 deg. to 95 deg., a tepid bath; from 95 deg. to 98 deg., a warm bath;
from 98 deg. to 105 deg., a hot bath. In using this form of bathing, the
skin should be wiped perfectly dry, and briskly rubbed.
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What is the test by which to estimate, the benefit of all modes of
bathing? 694. Give another method of sponge-bathing. 695. What is said
of the shower-bath? What caution is given? 696. Give the fourth form
of bathing.
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_Observation._ The length of time a person may remain in a cold bath
with benefit varies from two to ten minutes; while a person may remain
in a temperate, tepid, or warm bath, from ten to thirty minutes, or
until special indications are exhibited.
697. In the vapor-bath, the vapor is not only applied to the exterior
of the system, but it is inhaled and brought in contact with every
part of the interior of the lungs. The bather is seated upon a chair,
and the vapor gradually turned on around him, until the proper
temperature (90 deg. to 110 deg.) is attained. The bath may be continued
from ten to thirty minutes. After leaving the bath, attention should be
given to the skin, as in other forms of bathing.
698. In order to increase and promote reaction of the skin, various
measures and processes are used, some of which are practised in, and
others after, quitting the bath. Of the former, the rubbing and
brushing the skin are the most common and important. The brisk and
efficient friction of the skin with a coarse towel and flesh-brush,
after quitting the bath, should never be omitted. This short catalogue
embraces all the appliances requisite for the purpose.
699. _Bathing promotes health by its immediate and remote physiological
effects on the system._ When the body is moistened with a sponge wet
with cold water, or when an affusion by the sponge or shower-bath is
used, the skin instantly shrinks, and the whole of its tissue
contracts. This contraction diminishes the capacity of the cutaneous
system of blood-vessels, and a portion of the blood circulating through
them is suddenly thrown upon the more internal parts of the body.
The nervous system, among others, participates in it, and is stimulated
by the afflux, and communicates its stimulus to the whole system.
This causes a more energetic action of the heart and blood-vessels, and
a consequent rush of blood back to the skin. This is the state
termed _reaction_, the first object and purpose of every form of
bathing.
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What degree of temperature of water is termed a cold bath? A
temperate? A tepid? A warm? A hot bath? State the length of time that
a person should remain in the different baths. 697. What is said of
the vapor bath? 698. Mention the different methods for promoting
reaction of the skin.
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700. This condition of the skin is known by the redness of the
surface, the glow, comfort, and warmth which follow the bath. The
bather should direct all his care to insure this effect. By it the
internal organs are relieved, respiration is lightened, the heart is
made to beat calm and free, the mind is clear and strong, the tone of
the muscular system is increased, the appetite is sharpened, and the
whole system feels invigorated. This is the end and aim of the bather,
and to this all his training tends. The error is, to expect the result
without the preparation.
701. In order to promote reaction, and to be efficient in preserving
health, bathing should be regular, should be commenced by degrees, and
increased by a process of training, and should not be permitted to
intrude upon hours devoted to some important function, as digestion.
It must not precede or follow too closely a meal, or severe mental or
muscular exercise, as reaction is less certain and vigorous when
important internal organs are employed, than when they are at rest.
When the vital powers are greatest, and the system most free from
exhaustion, bathing is most beneficial; hence the morning is
preferable to the evening, and the middle of the forenoon to the
middle of the afternoon, for this healthful and agreeable duty; as the
vital action of the system is most energetic in the early part of the
day.
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699. What is the effect upon the skin when cold water is applied? What
is the first object and purpose of every form of bathing? 700. How is
this condition of the skin known? Mention the salutary effects that
this condition has on the body. 701. How should bathing be performed,
in order to be efficient in preserving health?
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702. In regard to the frequency of bathing, the face and neck, from
their necessary exposure to the atmosphere, and the impurities which
the latter contains, should receive at least two washings in
twenty-four hours, one of which should be with soap; the feet, from
the confined nature of the coverings which are worn over them, require
at least one; the armpits, from the detention, as well as from the
peculiar properties of the secretions, at least one; and the hands and
arms, as many as seem proper. The whole person should be bathed at
least every second day, but the most perfect health of every part of
the body would be maintained, if the excretions from the skin were
removed daily.
703. In diseases of the skin and internal organs, bathing is a
remedial measure of great power. It should never be neglected or
omitted. It is not only pleasant and safe, but is really more
effective than any medicine administered internally. This, like other
curative means, should be applied by the direction and under the eye
of the medical adviser, that it may be adapted to the condition of the
patient.
704. "From the first hour of man's existence to his latest breath, in
health and in sickness, rich or poor, water is always requisite. Baths
were dedicated by the ancients to the divinities of medicine,
strength, and wisdom, namely, AEsculapius, Hercules, and Minerva, to
whom might properly be added the goddess of health, Hygeia. The use of
water has been enforced as a religious observance, and water has been
adopted as one of the symbols of Christianity."
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When should bathing be performed? 702. How often should we bathe? 703.
What is said of bathing in disease? Who should direct the kind of bath
proper in different diseases? 704. Were baths dedicated by the
ancients?
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705. The AIR is an agent of importance in the functions of the skin.
It imparts to this membrane oxygen, and receives from it carbonic
acid. It likewise removes from it a large portion of the perspiration
and the more fluid portions of the oily secretion. In order that the
air may accomplish these ends, it is necessary that it come in contact
with the body. This is one of the many reasons why we should wear
loose and porous clothing.
706. Again, the air should be pure, and free from redundant moisture.
In the warm mornings of July and August, the air is loaded with
moisture and impurities, and the perspirable matter is not removed
from the system as it is when the air is pure and dry. This is the
cause of the general lassitude that is experienced during such
mornings. As soon as the fog is dispelled, these unpleasant sensations
are removed. To sustain the functions of the skin in a healthy state,
the parlor, kitchen, sleeping-room, school-house, and work-shop,
should be well ventilated. The blood of the system will be purer, and
its color of a brighter scarlet, if the skin is surrounded by fresh
and pure air, than when it is foul or moist.
707. The LIGHT permeating the skin, not only exercises a salutary
influence upon this membrane, but upon the blood, and, through this
fluid, upon the whole system. For this reason, the kitchen and the
sitting-room, which are the apartments most used by ladies, should be
selected from the most pleasant and well-lighted rooms in the house.
On the other hand, dark rooms and damp cellar-kitchens should be
avoided, as exercising an injurious influence upon both body and
mind.
708. The dark, damp rooms, so much used in cities and large
villages, by indigent families and domestics, are fruitful causes
of disease, as well as of vice, poverty, and suffering. Common
observation shows that solar light also exercises much influence
upon the vigor and color of vegetables. Plants that are kept in
well-lighted rooms, have darker and more brilliant colors than
those that grow in darkened apartments.
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705. Give the reasons why pure air should be supplied to the skin.
706. What is the cause of the general lassitude in a damp, warm
morning? 707. Show the salutary effects of light on the skin. 708.
What is one cause of disease and suffering in large villages?
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709. BURNS and SCALDS are terms applied to those conditions of the
skin which are produced by the application of an undue amount of heat,
which changes the action of its vessels.
710. A small degree of heat will irritate the nerves, and cause an
increased action of the blood-vessels. This is attended with severe
smarting pain, and will be followed by the deposition of serum under
the cuticle, unless applications are made immediately, to prevent
vesication, or blistering. To prevent or suppress this state of
arterial action, wet some folds of cotton or woollen cloth with cold
water, and apply them to the parts scalded; continue to apply cold
water, so as to steadily maintain the low temperature of the
applications, as long as the _smarting pain_ is experienced. The
steady application of cold dressing also tends to prevent an increased
action of the blood-vessels, and will suppress it, if it already
exist.
711. When blisters are formed, the cuticle is separated from the other
tissues of the skin by the effusion of serum. In all cases, if this
layer of the skin is not removed, a small opening should be made in
the raised cuticle, by which the serum deposited may be removed. Under
such circumstances, never remove the cuticle, as it makes the best
possible covering for the blood-vessels and nerves of the true skin.
The cold water dressing, recommended in the preceding paragraph, may
then be applied as long as the smarting sensation continues. After the
pain has subsided, the blistered part may be covered by a patch of
cotton or linen cloth, upon which an ointment, made of lard and
bees-wax, has been spread.
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709. To what condition of the skin are the terms burns and scalds
applied? 710. What is the effect when only a small degree of heat is
applied to the skin? How can vesication be prevented? 711. What should
be the treatment when blisters are formed?
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712. If the cuticle has been removed, there will be much suffering,
because the nerves are unduly stimulated by the air. The cuticle is
the sheath or covering of the vessels and nerves of the skin, and when
it is removed, a substitute should be applied. This substitute should
be soothing, and cover the denuded surface. Linseed-meal or ground
slippery-elm bark poultice, fresh cream, or lard and bees-wax, spread
upon linen or cotton cloth, would make a good dressing. When dressings
are applied, they should not be removed until they become dry and
irritating.
713. If there is much suffering, administer to an adult from
twenty-five to sixty drops of laudanum, according to the severity of
the pain. If the patient is a child, from fifteen drops to a
tea-spoonful of paregoric may be administered. When there is much
prostration, some hot peppermint tea or other stimulant may be found
necessary to bring on reaction.
714. The hands, feet, ears, &c., are subject, in cold latitudes, to be
_frozen_, or _frost-bitten_. This may occur when the patient, at the
moment, is not aware of it. The part affected at first assumes a dull
red color, which gradually gives place to a pale, waxy appearance, and
becomes quite insensible. The first thing to be done in such cases, is
to reestablish circulation. This should be effected very gradually. If
a large quantity of blood is thrown suddenly into the chilled and
debilitated vessels of the frozen part, inflammation may be produced
that will destroy the vitality of the limb.
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712. That should be the treatment if the cuticle has been removed? How
often should the dressing of burns be removed? 713. What may be
necessary when there is much suffering? 714. What is the appearance of
limbs while freezing? How should the circulation be at first
reestablished? What should be avoided?
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715. The circulation and sensibility may be restored by rubbing the
frozen limb, with snow, or, when this is not to be obtained, cold
water; but snow is always to be preferred. The fire should be avoided;
and it would be better for the patient to be kept in a cold room, for
a time, where there is no fire, or where the temperature is moderate.
716. When a person is found benumbed with cold, and almost or quite
insensible, he should be taken into a cold room, the clothing removed,
and friction commenced and continued for some time, with _snow_. When
warmth begins to be restored, the individual should be rubbed with dry
flannel, and the friction continued until reaction takes place.
_Observation._ When the toes and heels have been repeatedly chilled,
there may be produced a disease called _chilblains_. This affection is
attended with tenderness of the parts, accompanied with a peculiar and
troublesome itching. The prevention of this disease is in wearing warm
hose and thick shoes of ample size. Bathing the feet morning and
evening is also a prevention of this disagreeable affection. When
chilblains exist, apply cold water, warm camphorated spirits, or
turpentine linament.
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715. How may the circulation and sensibility be restored? 716. What
treatment should be adopted when a person is benumbed with cold? What
treatment should be adopted when warmth begins to be restored? What is
said of chilblains?
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