Chapter II: Part 2

1. The increased quantity of blood circulating through the part brings to it an increased amount of heat;

2. Increased vital and chemical action increases the production of heat;

3. The body absorbs heat from the surrounding medium as any other colder object would do.

In the general application of hot water or vapor, effects similar to its local effects are produced upon the whole surface of the body, involving, also, to a considerable extent, the deeper structures. The pulse is accelerated because the small arteries are distended and more active, creating a demand for a greater quantity of blood, requiring an increase in the heart’s action. It is also quite probable that the action of the heart is somewhat quickened as the result of the influence of heat upon the pneumogastric nerve which controls it.

The cerebral symptoms, faintness, etc., which occur when heat is applied in excess, are the result of the diversion of so large a proportion of the blood into the superficial vessels. A prolonged hot foot bath or leg bath will often produce faintness.

There are few agents which will so rapidly produce such powerfully excitant and stimulant effects as the hot bath. The painful and undesirable results occasioned by its incautious use are evidences of its power.

_The Warm Bath._—In this connection we apply the term warm to baths of a temperature between 85° and 98° F., though baths of a temperature between 85° and 92° would be more accurately termed tepid, which term is applied to baths of that temperature elsewhere than in this immediate connection.

The warm bath never exceeds the temperature of the body, and is usually below it. Its effect is uniformly to diminish the frequency of the pulse and of respiration, and to decrease animal heat. Its effects are the same as those of the cool or cold bath, in this respect, but they differ in several other particulars. Unlike the cold bath, the warm bath is not accompanied by an unpleasant shock, or chill, and, hence, is not followed by reaction. It promotes the action of the skin in a very marked degree, increasing both perspiration and absorption. When continued for an hour or two, the weight is appreciably increased by the absorption of water. Its general effects are very mild and soothing, often inclining the patient to sleep.

This bath seems to produce its effects not so much by exciting the vital energies to abnormal action or resistance, as by supplying the most favorable conditions for the performance of the natural and usual functions. This is doubtless on account of its close approximation to the temperature of the body. In this respect, if this supposition be true, it differs from baths of a temperature either much above or greatly below the normal temperature of the body.

The warm vapor bath produces effects quite analogous to those of the warm water bath. Its effect upon the processes of perspiration and absorption is a little more marked, even with the same degree of temperature. The results differ somewhat, according as the whole body is enveloped, so that the warm vapor is taken into the lungs, or the head excluded. A more equable effect is produced by including the whole body in the bath, and no harm can result if the temperature is not raised above that of the body, as it should not be, in the _warm_ bath.

=Sympathetic Effects.=—There is scarcely room for doubt that many of the effects of the various kinds of water applications are wholly of a sympathetic character. All portions of the body are intimately associated together by a system of nerves called the sympathetic system, from their peculiar function. Certain portions, as the skin and mucous membrane, are particularly related. The large number of sensitive nerves which connect the skin with the brain, bring it in peculiarly close relations to that organ, and give additional potency to any agent applied to so extensive a surface. The well-known fact that burns of the skin are often the occasion of fatal ulceration of the mucous membrane of the intestines sufficiently attests the intimate relation between these two tissues; while the effects upon the skin of mental emotions, as of shame and of fear, are conclusive evidence of the peculiar closeness of relation between the cerebral and cutaneous organs. The condition of the mind has much to do with the effect of a bath.

=Modes of Administration.=—There are numerous modes of administering baths of all temperatures, each of which produces some modification of the general effect of the given temperature. For example, such baths as the douche, the spray, and the shower bath, are much more cooling in their effects than a full bath at the same temperature; since, in the latter case, nearly the whole body would be submerged in a medium of equable temperature, while in the case of the spray, etc., the body would be additionally cooled by the rapid evaporation taking place upon its surface. Many other peculiar effects are obtained by particular modes of administration, which will be described in their proper place.

HISTORY OF WATER CURE.

The utility of water as an agent in the treatment of disease is not a modern discovery, as the pretensions of some aspirants for notoriety have led many to believe. A very cursory glance at the history of various ancient nations furnishes sufficient evidence that the use of the bath as a curative agent was of very remote origin. The works of the oldest medical authors contain numerous references to the bath, recommendations of its use in cases of disease, and testimonials of its good effects when properly employed. As this is a matter of some interest to many of those who employ and advocate the use of water as a remedial agent, as well as to those who are investigating its merits, we shall devote a little space to a sketch of the use and estimation of the bath by various nations and tribes—civilized and barbarous—and regular and irregular physicians, from the remote ages of antiquity down to modern times. For several of the facts presented we are indebted to a valuable work by Dr. Bell, long out of print and now somewhat rare.

=The Bath in Egypt.=—That bathing was practiced to a considerable extent by the Egyptians at a very early period, is evinced by both sacred and profane history. It was through obedience to this custom that Moses was discovered among the rushes by Pharaoh’s daughter as she went down to the river side to bathe. Pictures discovered in ancient Egyptian tombs represent persons preparing for the bath. We have no expression of the estimate which was placed upon the bath as a remedial agent; but it is hardly possible to believe that an agent held in such high esteem as a preventive of disease should not be valued as a useful remedy.

=Bathing among the Jews.=—The code of laws prepared by Moses, under divine instruction, for the government of the Hebrew nation after its departure from Egypt, made bathing a prominent feature. The connection of the bath with the treatment of leprosy would naturally lead to the conclusion that it was employed for its curative effects.

=Persian Baths.=—The ancient Persians held the bath in such high esteem that they erected magnificent public structures devoted to bathing. The baths of Darius are spoken of as especially remarkable.

=The Bath among the Greeks.=—The cold bath was employed among the Greeks. Lycurgus, the famous Spartan legislator, prescribed its daily use for all his subjects, not excepting the tendered infants. In later times, the warm bath was introduced, and stately buildings were erected for the accommodation of bathers.

The learned Greek, Hippocrates, the father of medical literature, and a very acute observer of disease and the effects of various agents upon the body, highly recommended the use of water in many diseases, describing with great care the proper mode of administering a simple bath. He laid great stress upon the careful and skillful use of the bath, asserting that, when improperly applied, it, “instead of doing good, may rather prove injurious.” His directions for the employment of the bath were very discreet. He very wisely remarks that those patients whose symptoms are such as would be benefited by bathing should be bathed, even though some of the requisite conveniences may be wanting; while those whose symptoms do not indicate the need of this remedy, should not employ it, though all the necessary appliances are at hand. He made great use of water as a beverage in treating disease.

=Roman Baths.=—The Romans excelled all other nations in the sumptuousness of their bathing arrangements. Their public baths were among their greatest works of architecture, and were supplied with every convenience for increasing the utility and luxury of the bath. Kings and emperors vied with each other in perfecting and enlarging these sanitary institutions. Accommodations were provided, in some cases, for nearly 20,000 bathers employing the baths simultaneously; and at one time the number of public baths in Rome was nearly one thousand. Even Nero, whose name has come down to us covered with infamy, has the credit of doing at least one good act in erecting a magnificent public bath, though even the detergent effects of such an act can hardly cleanse his character of the many foul blots by which it is rendered odious.

Celsus and Galen, two noted Latin physicians, extolled the bath as an invaluable remedy, almost two thousand years ago. The latter pronounced the bath to be one of the essential features of a system of perfect cure which he termed _apotheraphia_, exercise and friction being the other essentials. If the regular physicians of half a century ago had followed the practice of Galen, as described in his works, they would have refreshed their languishing fever patients with cold water as a beverage instead of leaving them to be consumed by the pent-up fires which parched their lips, disorganized their blood, and finally ended their sufferings with their lives. Celsus was proud to boast of employing the bath more frequently and systematically than others had done before his time.

The Emperor Augustus was cured, by the bath, of a disease which had baffled all other remedies.

=Testimony of Arabian Physicians.= — Although the Arabians are at the present day looked upon, and justly, as a horde of wandering wild-men, a thousand years ago their physicians were among the most learned of the age; and they were as sensible as learned, we judge, for they were most enthusiastic advocates of the efficiency of the bath. Rhazes, one of the most eminent of them, describes a plan of treating small-pox and measles which would scarcely be modified by the most zealous advocate of water treatment at the present day. Avicenna and Meshnes, with others, may be mentioned as holding similar views.

The bath was much used in pestilences by this nation, and was largely employed in Constantinople in the fifteenth century.

=Modern Bathing Customs.=—Three centuries ago, public vapor baths were very numerous in Paris, being connected with barber shops, as are many baths in this country at the present time. According to Dr. Bell, Paris can still boast of a great number of bathing establishments. He states that in the baths connected with the city hospitals nearly 130,000 thousand baths were administered in a single year to out-door patients. Doubtless those treated in the hospitals were duly washed and steamed as well. This is certainly a very marked contrast with what we see in the hospitals in this country at the present day. Notwithstanding the advances in many other particulars of hospital management, the cuticles of patients are sadly neglected. In some of our largest hospitals, the filthiness of many patients is so great that close proximity to them is absolutely intolerable. Half a dozen of them, placed in a warm room, speedily impart to the air a fetor unequaled by anything but the effluvia arising from a neglected pig-sty. Such neglect is inexcusable.

The Germans of olden time were very fond of bathing, according to their historical records, and during the Middle Ages, when plagued by the leprosy, the national faith in the virtues of the bath was manifested by making it a religious duty. It is related of Charlemagne that he used to hold his court in a huge warm bath. Modern Teutons seem less partial to the bath, having transferred their fondness from _aqua pura_ to lager beer.

Although the bath was very freely used in England while the island was occupied by the Romans, who erected commodious baths like those in Rome, the wholesome practice is now sadly neglected by the English people, if we may credit their own writers.

It is a curious fact that the bath seems to be quite generally neglected by the most civilized races, while it is almost universally employed by those less advanced nations, the Russians, Turks, Finlanders, and the inhabitants of Persia, Egypt, Barbary, and Hindostan. The Finlanders make great use of the sweating bath. To nearly every house is attached a small sweat-house, where they subject themselves to a temperature of more than 160° F., often emerging at once into an atmosphere much below freezing, with apparent impunity. The Turkish and Russian baths, similar to which are those in use in Egypt and India, are elsewhere described.

The North American Indians employ the bath for many diseases. They have original and peculiar ways of administering both water and vapor baths. The most common bath among them is the vapor, followed by a plunge into a neighboring stream. They generate the steam by pouring water upon hot stones while they are inclosed in a small, close hut made of mud or skins. The native Mexicans secure a hot-air bath by confining themselves in a brick sweat-house which is heated by a furnace outside. These savages seem to have the most implicit confidence in the efficacy of the bath, always employing it when ill, and with excellent success.

=Modern Medical Use of Water.=—In the early part of the eighteenth century, a Sicilian named Fra Bernado acquired the title of “coldwater doctor” from his exclusive use of cold water in treating the sick.

At the very beginning of the eighteenth century, Floyer published a history of bathing which contains accounts of many remarkable cures effected by means of the bath, which he recommended as a most efficient cure for numerous diseases.

A Mr. Hancock, a clergyman, published, in 1722, a tract entitled, “Common Water the Best Cure of Fevers.” Another writer, in a work entitled, “The Curiosities of Common Water,” published in 1723, speaks of water as an “excellent remedy which will perform cures with very little trouble, and without any charge,” and “may be truly styled, an universal remedy.” Both French and German writers were zealously advocating the use of water as a remedy for many diseases at this same period. Many of the French surgeons had also discovered the immense utility of water in surgery, receiving their first lessons of instruction from an ignorant and superstitious miller, who used water in conjunction with charms.

In the latter part of the last century, Drs. Jackson and Currie each published reports of cases of fever in which they had found the use of the bath a remedy of remarkable efficacy. Dr. Currie obtained many followers for a time, but no very deep impression was made upon the public mind, though his cases were authentic, and were very ably reported.

About the end of the first quarter of the present century, a native of Græfenberg, Prussia, by the name of Priessnitz, met with an accident by which three of his ribs were broken. He treated himself by applications of cold water, and then tried the same remedy upon others in similar cases. His success encouraged him to make further experiments, and though an ignorant peasant, his natural acuteness enabled him to devise various means for applying water to the body, and to suit the application to different diseases. His increasing success attracted numerous patients, and his fame became, in a few years, worldwide. Many of his methods were very rude, and his ignorance of medical science often led him into errors; but he succeeded in restoring to health hundreds of patients whose maladies had been pronounced incurable.

The interest in the new method became so great that numerous other individuals, equally ignorant and possessing less shrewdness, undertook to imitate the German innovator. Some of them were successful, many of them were not; all were alike in committing numerous blunders through ignorance of scientific medicine. But the public attention was called to the utility of water as a remedial agent so forcibly that a powerful impression was produced in its favor. From that time until the present, the use of water has been largely in the hands of unscientific empirics who have advocated it as a specific, and employed it to the exclusion of other remedies in a great degree. This course, together with many other gross errors connected with the practice, has deterred scientific physicians from employing it sufficiently to test its merits, only in a few exceptional instances.

The friends of Priessnitz claimed for him a great discovery; but as we have seen, he discovered nothing which was not known a century before, if not, indeed, some thousands of years previous. It is doing Priessnitz no injustice to say that he did little or nothing toward establishing principles, but followed, chiefly, a routine method of practice.

Some scientific members of the medical profession have investigated the subject in some degree, however, at various times, and the result has been that at the present day the utility of water is a well-recognized fact, and it is now often prescribed in the standard text-books as an excellent remedy for many diseased conditions. Yet, that there is still a want of appreciation of the remedy is fully attested by the infrequency of its use by the regular profession. This neglect may be due in part to a prejudice which the members of the regular profession have acquired, on account of the quackery which has too often been connected with the use of this remedy. Nevertheless, there is no good reason why an efficient remedial agent should be suffered to receive the stigma which properly attaches only to those who are responsible for its abuse.

REMEDIAL PROPERTIES.

The value of a drug is judged by its medicinal properties. The more properties it has, and the more powerful its “action,” the more valuable it is considered to be. We need not here enter into a discussion of the nature of medicinal properties, since there is no question among scientific physicians, that the medicinal properties—so-called—of drugs, or their effects upon the human system in diseases, are, in general, the result of vital resistance on the part of the system, an attempt to expel or remove the poison, or defend itself against it. Water also possesses remedial properties, some of which are due to vital resistance, while others grow out of the aid which it affords the vital organs by its physical properties. As its value as a curative agent depends upon these properties, it is important to know what they are.

_Refrigerant._—Refrigerant or antiphlogistic medicines are used for the purpose of diminishing the heat of the body. The most they can do is to so depress and paralyze the vital forces as to diminish the _production_ of animal heat. Water, when applied at a proper temperature—any temperature less than 98°—not only diminishes the production of heat, but removes the superfluous heat by conduction. There is not a drug in the whole materia medica that will diminish the temperature of the body so readily and so efficiently as water. How this is effected, has been previously explained in considering the physiological effects of water.

_Sedative._—Drugs, the administration of which is followed by a diminished action of the heart, are termed sedatives. They comprise the most powerful poisons known. Their sedative effects are the result of their poisonous influence upon the heart or the nerve centers controlling it. Water is a much more efficient sedative, and its use is never followed by poisonous effects, as is the use of sedative drugs, the “action” of which is often very uncertain. By the cool or cold bath, the pulse may often be reduced twenty to forty beats in a few minutes.

_Tonic._—Water may be used in such a way as to increase the rapidity of the circulation and the temperature very quickly and powerfully. The hot bath is a most efficient stimulant, in the true sense of the word. It will so excite the circulation as to increase the pulse from seventy to one hundred and fifty in fifteen minutes. The tonic effects of a cool bath are well appreciated by all who have ever enjoyed it.

_Anodyne._—Certain drugs are called anodyne because they diminish nervous sensibility, thus relieving pain. Water applied in the form of a hot fomentation will not infrequently give relief when every drug has failed. Applied in various other ways, it is very effectual in allaying nervous irritability.

_Antispasmodic._—No remedy is so certainly successful in hysterical convulsions as water. In infantile convulsions, its success is also unrivaled. In cramp, and even in puerperal convulsions, its utility has been well demonstrated.

_Astringent._—The value of cold water in arresting hemorrhage is well attested by all physicians.

_Laxative._—Used in various ways, water is very effectual in producing movement of the bowels, but never occasions those violent and unpleasant symptoms which accompany and succeed the use of purgatives.

_Emetic._—In the great majority of cases, no other emetic is needed, and no better can be found.

_Eliminative._—Water is a most perfect eliminative. It dissolves the excrementitious and other foreign elements of the blood, and thus materially aids in their elimination. Hence, it is a very useful _diaphoretic_, increasing the action of the skin, and is equally valuable as a _diuretic_, having the same effect upon the kidneys.

_Alterative._—For a long period, mercury has been considered as the champion alterative of the materia medica. It must yield the place to water, however; for the most it can do is to destroy the elements of the blood, while water not only accelerates waste, but increases construction in the same proportion, according to the experiments of Prof. Liebig.

_Derivative._—One of the most important properties of water applications is their powerful derivative effect. No other application, internal or external, can equal them in efficiency and certainty of action.

There are very few agents which possess so many remedial properties as water. There are none which effect so much with so little expense to the vital powers of the patient. Many drugs will produce results similar to those obtained by the use of water, and thus accomplish good, no doubt; but at the same time, they often work so much mischief in the system that the evil done is frequently much greater than the good accomplished. The aim of the faithful physician should be to accomplish for his patient the greatest amount of good at the least expense of vitality; and it is an indisputable fact that in a large number of cases water is just the agent with which this desirable end can be obtained.

=Testimony of Eminent Physicians.=—The testimonies of Currie, Jackson, and numerous other physicians of the last century have already been quoted in favor of water. There are numerous practitioners of the present day who are equally favorable to this remedial agent. Perhaps we cannot do better than to quote from the _Health Reformer_ the following paragraphs of an abstract report of a paper read before the New York Academy of medicine, by Prof. Austin Flint, M. D., president of the society, the title of the paper being, “The Researches of Currie, and Recent Views Concerning the Use of Cold Water”:—

“Currie employed scientific methods in observing the phenomena of disease. He was one of the first to employ the thermometer in studying disease, and his observations can be received as reliable.

“The use of water externally as a means of reducing the temperature of the body in disease has recently been coming quite prominently into notice. According to Liebermeister, a noted German medical author, Currie was the first to systematize the use of water. His work was published in 1797. Liebermeister, in his recent article on typhoid fever, accords to cold water the first place in importance as an article for reducing the temperature. The use of water for this purpose is at present attracting much attention; and it is safe to predict that _it will soon occupy an important place as a remedial agent_.

“Much harm has been done by the ‘rude empiricism’ of Priessnitz, and the various water cures in the country; though much good has also been accomplished by the latter institutions, and they have in a measure prepared the public mind for the general introduction of water as a remedial agent.

“After the publication of the views of Currie in 1797, his method of practice, which was chiefly hydropathic, became quite general, but it was soon nearly forgotten. Trousseau recommended water treatment in scarlatina, and the use of the remedy has continued to be recommended in the text-books; but as a measure of treatment in practice, it has become nearly obsolete. It is, however, obvious that unless we accept the absurd proposition that diseases have changed since Currie’s time, the remedy which he recommended so highly must be just as efficient now as then.

“Dr. Currie made use of the cold douche in fevers, applying it vigorously to the patient while in the height of the fever, and continuing it until the temperature became decreased, as indicated by the thermometer and the pulse. He treated seven cases of continued fever by this method at the Liverpool Infirmary. All recovered. In an epidemic of typhoid fever among a regiment of troops, he treated fifty-eight cases, using the cool tepid douche in all but two cases. The latter died. The remaining fifty-six recovered, the disease being greatly shortened in more than half the cases.

“Dr. Currie asserted that, in small-pox, the use of the bath afforded instant relief to the patient, and caused the disease to assume a benignant form.

“He found the cold bath always effectual in tetanus and convulsions, as also in hysteria.

“In temporary insanity from the use of liquor, this acute observer found that the cold plunge was the most efficient remedy for the worst cases.

“But Dr. Currie’s practice was not confined to _cold_ water. He observed that affusion with tepid water was not only a more pleasant application, but that it was even more effectual in reducing unnatural heat than cold water, as it produced no reaction, not being at all stimulating in character.

“With regard to the efficacy of this agent, Dr. Currie stated that by its use in fevers the pulse would be reduced thirty or forty beats, with a corresponding decrease of temperature and almost immediately relief of headache.

“In his second volume, published some six years after his first volume, Dr. Currie declared that although his experience in the use of water, especially in fevers, had been very extensive, he had had only four fatal cases in which water was employed, and had never met with a single evidence of its being in the least degree objectionable or injurious. Neither had he found that it had been thought to be objectionable by those whom he had treated. He details a very interesting account of his treatment of scarlatina in the cases of his two sons, aged, respectively, three and five years. He gave the older, in thirty-two hours, fourteen affusions, varying from cold to tepid. Twelve were found to be sufficient for the younger one. Both became convalescent in three days.

“It was established by Currie that by the use of water the course of typhoid fever may be abbreviated. This is not even claimed for the modern remedies in common use.

“In referring to his own experience in the use of water, Dr. F. remarked, ‘The relation of my own experience will of necessity be stated in a few words, as my employment of the remedy has heretofore been much more limited than it will be in the future if my life is spared.’ He then related some very interesting cases in which he had employed water as the chief remedy with the most excellent success. He also took occasion to recommend, as one of the best means of applying water in fevers, the wet-sheet pack as employed in the various hydropathic institutions of the country. He had used the continued cold pack in a number of the worst cases of sun-stroke in Bellevue Hospital with marked success. This remedy is still employed there in this class of cases.

“In a case of obstinate remittent fever, which was not in the least benefited by the thorough use of quinia, he employed the cool pack thirty-five times in a week, continuing each application from ten to thirty minutes, and always with great relief to the patient, although he finally died [perhaps from the huge doses of quinine previously given]. He expressed the opinion that if he had employed the pack more thoroughly, making the applications longer and more frequent, the patient might have recovered.

“Currie announced a true theory when he said that _the voice of nature should not be superseded by theories_. He advocated the free use of water as a beverage in febrile diseases [fever] as an important remedial agent. Dr. F. unhesitatingly advanced the belief that the chief benefit derived from the numerous mineral waters so largely used was only that which was due to the properties of pure water. He stated as proof that it was not long since demonstrated by chemical analysis that the only thing peculiar about the water of a certain spring, famous for medicinal virtues, was its remarkable purity. He also suggested the introduction of distilled water for cooking and drinking purposes as a necessary sanitary measure.

“Dr. F. then related a remarkable case of acute inflammation of the kidneys in which the patient exhibited the characteristic symptoms of poisoning from the retention of urea. After other remedies were tried in vain, the patient’s life was saved by the simple administration of water as a beverage at short intervals. The diuretic effects of the water soon washed away the poison and gave immediate relief.”

“After the conclusion of the paper, by Dr. Flint, the venerable Dr. Richards arose and gave his experience in the use of water. His ideas of hydropathy were obtained when he has a young man, from Dr. Currie’s works. He adopted the practice of Dr. C. at that time in an epidemic of typhoid fever, and with such remarkable success as to astonish old practitioners. He stated that he had cured more than one hundred cases of obstinate constipation by simply directing the patient to drink a glass of cold water half an hour before breakfast, each morning. In one of these cases the patient had not had a natural passage from the bowels for a number of years; but he was effectually cured, by the simple remedy mentioned, in the course of a few months.

“Dr. Loyle gave an interesting resumé of ten years’ experience in the use of water, with uniform success, especially in convulsions and scarlatina. He had employed water alone in about one hundred cases of acute inflammation of the kidneys and dropsy after scarlatina, and with wonderful success in every case. He had found it equally successful in coma, restoring consciousness when life was apparently extinct. During the late war, he on one occasion renovated twenty ambulance loads of exhausted soldiers who had fallen on the march, by the judicious use of water. He recommended water most highly as an excellent diuretic and a capital regulator of the bowels, far superior to ‘after-dinner pills.’ He commended it also as an efficient remedy for sun-stroke and frozen feet.

“The sentiment of the audience—which was wholly composed of medical gentlemen—was shown by the hearty applause with which the remarks of each speaker were received.”

We might add much other medical testimony; but as we could give no higher authority than the distinguished Dr. Flint, who stands at the head of medical practice in America, being author of the standard American text-book on practical medicine, we will not weary the reader with further quotations. The German physicians, as well as German medical works, abound with tributes to the value of water. American medical journals are full of accounts of the beneficial results following its use in fevers and numerous other diseased conditions.

In surgery, the employment of water is rapidly gaining entire precedence. It has replaced nearly all other kinds of dressing for wounds, and its use has saved a valuable limb to many a poor sufferer who must otherwise have submitted to amputation.

In short, wherever it is faithfully and intelligently applied, water is working wonders. Yet it is still little used in comparison with its importance. Especially is its use neglected in chronic diseases. The only reason we have been able to discover for this neglect of a remedy, the merits of which are so well demonstrated and generally acknowledged, is that its use is more troublesome and laborious than the use of drugs. A half-dozen purgative pills are administered much more easily than an enema. The administration of a diaphoretic powder is far more convenient than a pack. A blister is easier to manage than a fomentation. But the true physician, who has at heart the real good of his patient, will not sacrifice the safety or comfort of the latter to his own personal convenience.

ERRORS IN WATER CURE.

Much of the prejudice against the use of water in treating disease has grown out of abuses of the remedy, and the putting forward of absurd claims by ignorant persons professing to understand its use. In order to vindicate the character of this powerful curative agent, it is necessary to expose the errors and ignorance of those who have abused it.

=“Cold Water Doctors.”=—In the early days of the modern water cure practice, which was very largely introduced by Priessnitz, cold water was the universal remedy. No matter what the nature of the disease, or the condition or temperament of the patient, the remedy was the same. At the establishment of the Græfenberg doctor, ice-cold douches, precipitated from a height of sixteen to eighteen feet, the plunge, directly supplied by the cold mountain springs, and the shower bath of the same temperature, were all administered to patients with little discrimination of modifying circumstances, in rooms unwarmed by artificial heat, even in the depths of the coldest mountain winters. As Græfenberg was the source whence most water doctors of that time drew their knowledge, the same practice was pursued elsewhere. The unreasonableness of such a course was perceived by the more judicious, and thus its influence was prejudicial.

=Heroic Treatment.=—Such treatment as that described in the preceding paragraph could not result otherwise than disastrously in numerous cases. The evil effects were sometimes seen at once, but more frequently they appeared after periods more or less remote. In some cases, patients were led to drink twenty or thirty glasses of cold water before breakfast, under the absurd doctrine that the evils of a small excess would be cured by greater indulgence. Hundreds of persons adopted the practice of daily bathing in cold water in a cold room, even in the coldest weather. A few even went so far as to spring from their warm beds on the coldest mornings, run to a neighboring brook in a state of nudity, and plunge into its frigid waters through a hole in the ice. So infatuated were these enthusiasts, they really thought they enjoyed this refrigerating process; but, generally, a few years’ continuance of it was sufficient to produce such a “sedative” effect upon their systems that some became the victims of consumption and other constitutional diseases, while others were compelled to discontinue the practice from absolute inability to continue it. A few of the more vigorous were enabled to survive this violent treatment without apparent injury for a long time; but those of weaker vital powers soon showed the results of its evil effects.

By such processes, together with the cold sitz bath, the dry pack, and other harsh measures, the patient was sometimes brought to the very verge of the grave.

Strange as it may appear, those who have been the strongest opponents of the use of water, themselves afford the best instances of its excessive use. For instance, in a case of low typhus fever, a “regular” physician ordered the patient, a young woman, to be immersed in cold water for half an hour. The attendants attempted to carry out the prescription, but in a few moments her symptoms became so alarming that the patient was removed from the bath. It will not be considered remarkable that she died. A prominent New York physician, a professor of practice in one of the largest medical colleges in America, in a report of a case of remittent fever which he had treated with water, said that he administered thirty-five cold packs in a week. The patient died; but the doctor thought that if he had been more thorough in his treatment, giving more packs and longer ones, he would have lived. Another professor, of a rival college in the same city, cited, in a public lecture, a case of pneumonia which was treated hydropathically by a regular physician of note. The patient, while very feeble, was placed in a cold bath. He was taken out shivering, and died an hour afterward. His conclusion was that water was a very hazardous remedy. We would certainly agree with the professor’s conclusion if the case cited were an example of the _proper_ use of water. In the preceding case, we will not say that the packs were not beneficial; but if they had been thus used by a professed hydropathist, the treatment would have been pronounced decidedly heroic by “regulars.”

=Crisis.=—By the violent processes which have been mentioned, the patient was frequently brought into a condition similar to that produced by the old process of depletion by bleeding, antimony, mercury, and purgatives. Painful skin eruptions, boils, and carbuncles, often covered the whole body. Acute pains racked the body of the patient from head to foot. If he survived this “crisis,” he usually got well, which was regarded as an evidence of the salutary effect of the crisis, and so it became an important object to be attained; and the worse a patient felt, the more certain and speedy, he was encouraged to believe, would be his recovery. No account was taken of the immense waste of vital energy during these painful morbid processes.

The use of the abdominal bandage, continued for a long time until an eruption is produced, is another means by which some have sought to effect a cure of their patients. This course is pursued under the belief that the discharge occurring from the surface which thus becomes diseased is a vicarious means of removing impurities from the system—an absurd notion which no one acquainted with the first principles of physiology and surgical pathology could entertain for a moment.

=Hydropathic Quacks.=—Unfortunately for the reputation of water as a remedy, its use has been largely in the hands of empirics who have used it in a routine manner, and have supposed it to be a cure-all, and the only remedy of any value. At least, such have been the claims made for it. This has served to bring it into disrepute, the disgrace which ought to attach to individuals being applied by an undiscriminating public to the innocent victim of abuse.

=Ignorance.=—The greatest bane of all has been the ignorance of those who have professed to be qualified to administer water as a remedy understandingly. Priessnitz himself was an ignorant peasant. He was innocent of either anatomical or surgical knowledge. His slight acquaintance with physiology was gathered by cursory observations of patients. Of the effects of water he knew more, studying them with a good degree of acuteness. His lamentable want of knowledge allowed him to fall into many errors. It is related of him that he treated hopeless cases of solid anchylosis of joints just as though they were mere cases of stiffness from rheumatism. Cases of hopeless organic disease, he pronounced curable and submitted to long but unavailing treatment, not knowing the real nature of the disease. A young lady died of what he supposed an internal abscess. No abscess was found, upon which he remarked that “she had too short a neck for long life.”

It could be no wonder, then, that the disciples of such a master should be sadly lacking in many of those qualifications essential for a successful physician, no matter what the remedies employed. The most lamentable feature of the matter is that the same ignorance has continued to be, with few exceptions, characteristic of those who have employed water as a remedy; this has been especially disastrous because a man with the native shrewdness and acuteness of perception of Priessnitz has rarely appeared in the ranks of hydropathists.

=A Popular Error.=—It is a grievous popular error that any one can apply water as skillfully as the most experienced physician, and that its successful use requires no knowledge of the structure and functions of the human body. No doubt this has grown out of another error, perhaps quite as common; viz., that water is so simple a remedy that it will do no harm if it does no good. Such notions have frequently led to most disastrous results. Water, as already shown, is one of the most powerful remedies. And while it is, undoubtedly, far safer in the hands of the uneducated than blisters, purgatives, diuretics, and such agents as opium, chloral, alcohol, and most other drugs, yet it certainly requires careful usage, and the more scientific knowledge the user possesses, the more skillfully will he be able to apply it. It is, furthermore, true that a great majority of ordinary diseases are commonly so void of danger under careful nursing and hygienic management that the application of water is a simple matter which any intelligent mother can perform successfully. A case is related by good authority of a person who fell in apoplexy an hour after taking an excessively hot bath. Another patient became a paralytic from the same cause. Water is a remedy which cannot be safely used by one who has not informed himself of its effects, and of the proper modes of application.

=Absurd Claims.=—Sensible people have been rightfully disgusted with the claims which have been made by certain pretentious ones for the use of water. One declares that the bath will dissolve out of the body mineral substances which have been taken into it. Another claims to have been able, by the application of fomentations to a rheumatic knee, to extract in regular order the ointments which had previously been successively applied. Numerous other claims equally preposterous might be related, if it were necessary. They have all tended to excite a feeling of contempt for a means of treating disease which is really worthy of the highest estimation.

=Neglect of Other Remedies.=—As has been previously remarked, many seem to have forgotten that water is not the only remedy for disease, and not only attempt to cure every disease by its application, but use it to the exclusion of all other remedies. In nearly all cases, sunlight, pure air, rest, exercise, proper food, and other hygienic agencies are quite as important as water. Electricity, too, is a remedy which should not be ignored; and skillful surgery is absolutely indispensable in not a small number of cases. Even drugs are sometimes useful auxiliaries, though, doubtless, infinitely more harm has resulted from the employment of drugs in conjunction with water treatment than from their omission.

_Rational Hydropathy_ leaves room for every other remedy of value. It does not regard water as a specific nor as a panacea, but only as one of the most valuable of numerous excellent remedies. It discards the erroneous and harmful practices of empirics and ignorant charlatans, whether they concern water or other agents, and gives to the aqueous element only its due share of importance.

APPLICATIONS OF WATER.

The indications which are to be met in the treatment of disease are chiefly those enumerated below; and how admirably they are met by applications of water may be easily demonstrated by following the directions given.

=1. Equalization of Circulation.=—Disease cannot exist without some disturbance of the circulation. In perfect health each part receives its due share of blood. One of the first indications in disease, then, is to balance the circulation. If an organ contains too much blood, the application of cold water to the part will occasion contraction of the minute vessels of the part, and thus the amount of blood is lessened, as explained more at length in considering the physiological effects of water.

Or, the part may be relieved by the application of warm water in some form to adjacent or remote parts of the body, by which means the surplus blood will be drawn to other parts, thus relieving the suffering organ. Again, if an organ contains too little blood, the opposite course must be pursued. Warm or hot applications are made to the part, while cold applications may be made to other parts if necessary. Very often the two remedies may be advantageously combined, since one part cannot contain too much blood without some other part or parts being deprived of the due proportion, and _vice versa_; so that while a cold application is needed at one part, the opposite is required at another.

=2. Regulation of Temperature.=—As the condition of the bodily temperature is closely associated with that of the circulation, the two are usually controlled by the same remedies applied in the same manner. A part which contains too much blood has usually, also, too high a degree of heat. The cold application relieves both. If the entire surface of the body is involved, the application must be as extensive as necessary to affect the whole. In general fevers, the admirable adaptation of water to this end is well exhibited. When the temperature of the body rises above 100°, or even above 98°, a cooling bath should be resorted to. It may consist of a simple sponging with water, scarcely below the bodily temperature, an affusion with tepid water, a full bath of a tepid, temperate, or cold temperature, or some other form of cooling application according to the degree of cooling effect desired. Any temperature below 98° will be cooling. In general, it is better to employ a bath only a few degrees below the bodily temperature, as its application will not be followed by an increase of heat, called reaction, which follows a brief application of a cool bath. To obtain the proper cooling effects of a cool or cold bath, it must be continued for some time, from ten minutes to half an hour, at least. The same remark applies also to the application of cool baths for the purpose of equalizing the circulation.

=3. Removal of Pain.=—Pain is usually dependent upon disturbance of the circulation, being caused by the pressure of overfilled vessels upon the nerves in a confined space. Pain may be relieved by either hot or cold applications. The first object should be to remove the surplus blood, by local cold applications, and remote hot ones. If this plan is not successful, relief will be obtained by a hot local application, which operates by relaxing the surrounding tissues, so that the nerve fibers are relieved from pressure, as well as by quickening the local circulation, and so relieving congestion. The latter method is usually most quickly successful; but it is not so radically curative as the former. Pain dependent on passive congestion will be best relieved by the method next described.

=4. To Excite Activity.=—Many organs often become torpid or inactive, as the skin and liver, especially. Sometimes the blood-vessels of an organ become relaxed and inactive, passive congestion resulting. No remedy will so readily induce a return of activity to the affected parts as alternate hot and cold applications, continued for some minutes, fifteen to thirty or more. This is one of the best applications for the relief of old pains.

=5. Removal of Obstructions.=—A very large class of diseases are attributable to obstruction in various organs, caused by the reception of foreign matters into the system, and the accumulation of the natural waste of the tissues. The warm bath, to remove, external obstructions, and the internal use of water as a solvent for internal sources of obstruction, are the remedies which will achieve success in nearly all cases. Offending substances in the stomach are readily removed by the water emetic; and hardened accumulations in the large intestine are removed with equal facility by means of the enema.

=6. Dilution of the Blood.=—In fevers, cholera, and other diseases, the blood often becomes abnormally thickened, dark, and viscid, circulating with difficulty, and not imparting due nourishment to the tissues. Nothing but water can remedy this difficulty. It may be got into the blood by absorption from the skin, if the mucous membrane of the stomach will not absorb it.

=7. Influence on the Nervous System.=—Finally, it is often important to affect certain organs through their nervous centers. Water, properly applied, will accomplish this also. A fomentation applied to the abdomen will often remove headache, and is an excellent remedy for general nervousness, seeming to affect the whole system, just as does galvanic electricity when applied to the same locality, doubtless through the large nervous ganglia located in that region.

Some physicians claim to have obtained peculiar results by the application of heat or cold to the spine. It is said, for example, that cold applied to any portion of the spine will produce an increased circulation in the portion of the body supplied with organic nerves from the part. Hot applications to the spine are said to produce a contrary effect upon corresponding organs. Perhaps there should be still further observations upon this subject before any attempt is made to establish a definite law. It is well known that applications of ice to the spine is an excellent remedy for chorea, and several other nervous diseases.

For general nervous irritability, or nervousness, the _warm_ full bath may be applied with uniform success. Neither hot nor cold applications are generally useful in such cases.

=Temperature of Baths.=—The thermometer is the only accurate measure of temperature; hence the importance of its use in the administration of baths. Yet the thermometer may be abused. A given temperature may seem warm to one individual and tepid or cool to another. The same difference of sensation will occur in the same individual on different occasions. What seems cool to-day will be thought warm to-morrow. The susceptibility of the body to sensations of heat and cold largely depends upon its condition and the temperature of surrounding objects. In consequence of this physiological fact, it is improper to attempt, as some have done, to fix certain exact temperatures at which baths must be given to all persons under all conditions.

For convenience and perspicuity, the temperatures of baths have been divided into six grades, as given in the following table by Forbes; all who attempt to use the bath according to the directions should carefully learn and preserve the distinctions here made:—

1. Cold Bath, 33° to 60° F.
2. Cool, 60° „ 75°
3. Temperate, 75° „ 85°
4. Tepid, 85° „ 92°
5. Warm, 92° „ 98°
6. Hot, 98° „ 112°

The vapor bath ranges from 98° to 120°; the hot-air or Turkish bath from 100° to 160°, or even higher, though not usefully so.

A bath of any temperature above the natural heat of the body, 98°, is a hot bath. At 32°, water becomes ice; a bath is very rarely given at this temperature, and then the application should be made to only a small surface. Water at 32°, and even ice and snow, may be usefully employed as topical remedies in local diseases. It will rarely be necessary to employ a full bath at a lower temperature than 65°, which will usually seem very cold to the patient. A temperature from 85° to 95° is the most generally useful for baths which involve a considerable portion of the body, though of course higher temperatures are employed in local applications.

=How to Determine the Temperature of a Bath without a Thermometer.=—It is often necessary to administer a bath when a thermometer cannot be obtained. In such cases it is customary to test the temperature by placing the hand in the water. This is an unreliable method, however; for the hand becomes, by usage, so obtuse to heat that water which would seem only warm to it would be painfully hot to the body of the patient. To avoid this source of error, it is only necessary to plunge the arm to the elbow into the water, by which means its real temperature will be determined. Water which causes redness of the skin is hot; when it feels simply comfortable, with no special sensation of either heat or cold, it is warm. Slightly cooler than this, it is tepid. When it causes the appearance of goose-flesh, it may be for practical purposes called cool, a still lower degree being cold.