CHAPTER III.

THE BATHS AND MODE OF APPLICATION.

Kinds of Baths--Natural and Hot--Action of Thermal Water upon the

Skin--Natural Baths--Swimming and Plunge for Males and Females--Necessity

of Caution in their Use--Importance of Time and Frequency in Taking the

Baths--Directions During and After Bathing--Most Favourable Time for

Taking Warm or Hot Baths--Directions for the Use of Half, Three-quarters,

and Full Baths--Drowsiness after Bathing--Massage, When and How

Used--When Baths Inadmissible--Hours for Drinking the Medicinal

Waters--Diseases in which the Thermal Water should Not be Drunk.

There are two kinds of baths, viz., the natural and hot. The natural

bath is so called because the water used in its formation is at the

natural temperature, as it issues from the perforations in the floor of

the baths. The stream being continuous and large in volume, an overflow

is provided at the top of each bath, which not only secures constant

change of water for the bathers, with corresponding purity, but much

greater medicinal action upon the system.

The water renders the skin smooth and pliant, probably on account of its

alkaline character and the large amount of free nitrogen suspended in it.

Its alkalinity also saponifies the fatty acids on the surface of the

body, cleanses and opens up the sudorific glands, and thus assists the

free absorption of the nitrogen into the system. Brisk rubbing of the

skin (whilst in the water) with the hands promotes a similar result.

Under the head of natural baths are included large swimming, plunge, or

public baths for males and females, also private ones fitted up with

every modern comfort and convenience, which are situated at the west-end

of the Crescent, adjoining the pump-room or drinking fountain.

As the medicinal thermal water of Buxton is admitted to be very powerful

in its action upon the human system, it is absolutely necessary that it

should be used with the greatest care. I have known many accidents and

even deaths take place from the incautious use of the natural baths by

persons wilfully or negligently taking it in a totally unfit state of

health, or by remaining in the water too long. When used as a bath at

the natural temperature, the water is buoyant and emollient to the skin,

and produces a sense of exhilaration both to the body and mind of the

bather. But if indulged in too frequently or too long at one time, this

beneficial effect is entirely lost, and instead of the glow of heat which

ordinarily takes place directly after immersion, the surface of the body

becomes chilled and covered with what is commonly called "goose" skin, a

sense of oppression and discomfort ensues, erratic pains are developed,

and the mind becomes greatly depressed. The bath, therefore, should not

be taken more than two or at most three days consecutively, nor should

the immersion extend beyond seven or eight minutes. It is well for the

bather to take gentle exercise prior to entering the bath, in order that

the surface of the body may not be chilled, but rather in a glow upon

immersion. If after being in the water a few minutes a feeling of

persistent chilliness ensues, the bather should leave the bath, get

rubbed down with a hot rough towel, dress as quickly as possible, and

then return home, where he should remain until reaction is perfectly

established. When the natural bath is prescribed during the summer

months, viz., from the commencement of June until the end of September or

the first week in October, to those capable of locomotion the best time

for bathing is from 6 to 8 o'clock a.m., but when incapable of walking

from 11 a.m. to 1 p.m. The bather should invariably (when taking a

natural bath) lave the water over the face, neck, and chest, prior to

plunging into it, and should not remain more than seven or eight minutes

immersed, the two last minutes being occupied in applying the douche to

the parts specially indicated in the doctor's prescription. When a

longer time is indulged in, frequently reaction does not take place, but

chilliness and discomfort ensue, and the rheumatic pains are increased in

severity rather than diminished. Energetic friction of the joints and

surface of the body generally, with the hands beneath the water, should

be resorted to, and gentle rubbing through a hot towel immediately upon

leaving the bath, after which the bather should at once go to the

drinking fountain and take the prescribed quantity of the thermal water.

Instead, however, of at once returning home, if possible, a sharp brisk

walk should be taken, so as to secure a full action upon the skin and

kidneys. The bath may be taken between ten and one o'clock, or four and

six, observing the same rules as to meals as given when speaking of the

hot baths. The latter hours would apply to all cases except the very

mildest during the winter months.

The most favourable time for taking the warm or hot baths is between ten

a.m. and one p.m., provided that breakfast is not taken later than nine,

and luncheon before half-past one, it being of paramount importance that

they should not be used either directly after or before a meal. The hot

baths may be taken either as half, three-quarters, or full baths,

according to the nature of the case and the condition of the bather.

In the first of these (viz., a half-bath), which immerses the body no

higher than the waist, it is well to apply a towel wrung out of cold

water to the head, at the same time (especially in the case of females)

wearing an oilskin bathing cap, to prevent the hair from getting wet.

Cold to the head is of signal advantage when there is persistent

headache, or a tendency of blood to that part. In cases of acute

sciatica, congestion of the liver, spleen, and kidneys, accompanied by a

general sluggishness and torpidity of the portal circulation, frequently

very painfully indicated by internal or external hemorrhoids, the hot

sitz bath gives very speedy relief.

In a sitz or three-quarters bath the bather should, immediately upon

entering the water, lave it over the face, neck, and chest. After being

in the bath five minutes, two more should be devoted to the application

of the douche, first to the spine and then to the joints and other parts

particularly affected, with the exception of those inflamed and painful,

which should not be douched but gently rubbed with the hands beneath the

surface of the water, in order to promote free cutaneous circulation and

absorption of the nitrogen gas through the skin.

After leaving a full hot bath the body should at once be enveloped in a

warm sheet and friction applied over the whole surface. Dressing should

be accomplished as rapidly as possible in order that a chill may be

avoided, and then the bather, if able to walk (if not, in a bath chair),

should go to the drinking fountain at the west-end of the Crescent, where

either a large or small tumbler of the thermal water (as prescribed)

should be drunk, and then return home, where rest upon a sofa or bed

should be taken for at least an hour, the body being well covered with

rugs, &c., so as to promote, as much as possible, an action upon the skin

and consequent elimination of the gouty and rheumatic poison through its

pores by free perspiration.

Frequently, after taking one of the hot medicinal baths, a feeling of

drowsiness steals over the bather, and it has been thought by some

medical men that sleep should not be indulged in. During a long

experience in prescribing the medicinal baths of Buxton 1 have never

observed any ill effects ensue from giving way to sleep, and therefore

allow my patients to follow their own inclination in the matter. When

the bather has been covered up for a quarter of an hour, and the skin

acts freely, he or she may begin to throw off some of the wraps, thus

permitting the surface of the body to cool by degrees. When a full hour

has been accomplished, the ordinary occupations and duties of the day may

be resumed. It is not advisable, however, to risk exposure in an open

conveyance for at least three hours after taking a hot bath, as might be

done after using a natural one.

The massage bath may be used with most advantage between ten-thirty and

twelve a.m., and three and five p.m. It is not advisable to take the

massage bath within two hours after a meal, or less than one before.

Massage, or kneading of the whole body, is carried out in this bath after

which a steam douche or a warm spray is turned upon the affected parts,

according to the nature of the case.

Chronic rheumatic arthrites, with painful and contracted muscles,

obstinate lumbago, diaphragmatic, intercostal, periosteal, and synovial

rheumatism, and sprains and injuries to joints, are greatly benefited by

the application of massage, followed by the hot steam douche or warm

spray. Much relief is obtained from the application of the douche (first

hot and then reduced to tepid or cold, according to the nature of the

case) in subacute rheumatic arthritis, long-standing sciatica, facial

neuralgia or tic douloureux, intermittent headache, spinal irritation,

chorea or St. Vitus' dance, wrist drop (from lead poison), writers'

cramp, where there is the rheumatic diathesis, and paralysis agitans, &c.

The Buxton medicinal baths, either at their natural temperature, or when

the water is artificially heated, are, on account of their powerful

action upon the human system, quite inadmissible in all cases where there

is acute inflamation of any organ. In extensive valvular disease of the

heart, especially when accompanied with regurgitation, or advanced

degeneracy of that organ, atheromatous degeneration or aneurism of the

larger arteries, lung disease, in an advanced stage, especially when

connected with the phthisical diathesis, asthma, or amphipneuma,

complicated with fatty degeneration or dilatation of the heart,

giddiness, vertigo, or sudden faintness consequent upon organic disease,

the baths should not be taken, except locally, and even then with the

greatest caution. When so used the affected parts may be sponged with

the thermal water heated to the prescribed degree. An ordinary compress

soaked in the heated water may often be advantageously worn continuously

over an inflamed joint, congested liver, inactive kidneys, or irritable

stomach.

When the thermal water is only prescribed, the most favourable time for

drinking it is from seven to eight and eleven to twelve a.m., and from

four to five p.m., but when ordered to be taken in conjunction with the

chalybeate, the former should be taken in the morning and the latter in

the afternoon. It has been customary for some medical men to prescribe

the two waters mixed together. My own experience leads me to think that

such a mode of using them (in a great measure) destroys the efficacy of

the thermal by reducing its temperature, and driving off one of its most

active and essential constituents, viz., the nitrogen gas.

The water can be drunk with safety in most cases, but there are some in

which it is as inadmissible as the use of the baths.

In acute cystitis, advanced stage of Bright's disease, certain forms of

dyspepsia, irritation in the urinary passages, either in the male or

female, drinking the thermal water should not be resorted to. The mucous

membrane under its influence becomes more irritable, and where the

urinary passages are specially involved, the impulsive efforts to void

urine are extremely painful and distressing, the urine being reduced to

mere driblets, and sometimes even to complete retention. Constant

sickness, either arising from mucous inflammation or ulcer of the

stomach, contra--indicate the use of the thermal water.

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