1 '
754
Appendix.
and in a case of disphagia, in which neither food nor drink was taken by the mouth for jconsiderable time, the patient, when put into the tepid bath, felt his thirst alleviated,and received much comfort, without his weight being at all increased. Dr. Curriesupposed, that the abatement of thirst in this case arose from the relaxation #f theexhalants of the surface produced by the bath, and those of the stomach sympathizing ;and that although the exhalants terminate by open mouths, which pierce the epidermis,yet as the mouths of the absorbents terminate under it, and do not come into contactwith the open air; so while the epidermis remains unirritated and entire, no absorptionof fluid can therefore take place from the surface. Many experiments made by Seguiuare also in favour of the opinion that no cutaneous absorption is effected in the bath.Among others, he immersed venereal patients in baths containing oxynniriate of mer-cury in solution, and found that while the cuticle remained entire, no salivation, norother effect of the mercury on the system, was apparent; but the specific effect of theremedy always look pluce when the epidermis was injured or destroyed, as in itch. Itmust, however, be observed, that in tile case of disphagia the urine flowed as if drinkhad been taken by the mouth ; a circumstance which Currie supposes to depend on theabsorption from the atmosphere by the lungs. This, however, is an assumed position ;the free exhalation from the lungs is evident, but it is by no means proved that anyabsorption takes place. It is true that the weight of the body in the above case wasdiminished; but from the sum of this loss we must abstract the cutaneous exhalation ofthe part of the body not immersed, the pulmonary exhalation, and the weight of theegesta ; and were a supposition to be admitted as argument, it might be suggested thatthe relaxant power of the warm water acting on the epidermis as on inert matter, mayopen a way through it to tbe mouths of the absorbents. The question is still unde-cided, and fortunately it is not of much importance in a practical point of view.
Warm and vapour baths ' are efficaciously employed in acute rheumatism, inflamma-tion of the abdominal viscera, of the kidneys, bladder, ar.d uterus j in suppression ofurine, and in spasmodic affections, particularly those to which infants are liable, arisingfrom dentition and other irritations. The general relaxation produced by their use has beentaken advantage of, also, for assisting the reduction of strangulated hernia ; for, althoughthe effect be not topical as it regards the hernial tumour, yet the general relaxation pro-duced gives a disposition to all the parts to regain their proper place. The tepid bathis found to fe very useful in the rigidities which follow some acute diseases, as gout andrheumatism, nodosities of the joints 2 , and, according to some, the rigidities attendanton old age. J Its effects in promoting the natural excretions by the skin render it veryserviceable in promoting the cure of herpetic eruptions ; in slighl cases of lepra the useof it with friction is all that is required ; and in ail cutaneous foulnesses it is a most im-portant auxiliary. It has, also, been found very beneficial in cases of insanity. Ingenera! the period of immersion should not be less than twenty minutes, nor exceedone hour. 4-
The partial application of warm water as a remedy is made by means oft 1. a. The foot bath (pediluvium) ;
b. The hip bath (cox<elitvhim) ; and
c. The baud bath (manuluvium).
■ A very simple and convenient vapour bath for military practice has been recom-mended by my friend Dr. A. Nicoll. It may be formed of a common beer or spiritbarrel, with a false bottom, placed about a foot from the bottom of the cask, that is, theend on which it is standing, and perforated with numerous small holes. A gun barrelconnected with the spout of a tea-kettle placed on a fire, is to be introduced into anopening in the side of the cask between the real and false bottom ; and the patient, beingseated on the false bottom, the steam or vapour from the boiling kettle soon surroundshim by rising through tbe holes. It must be prevented from escaping by means of ablanket, which should cover the open end of the cask, and apply closely round the neckof the patient.
* Haygarth, Clinical History of Diseases, Svo. Loud. 1805.
3 Tepid bathing with friction is said by one author, " vitam saepe per plures menses,interdum etiam per aliquot annos, protraxisse." — Gregory, Conspectus Med. ii. 100.
■» The Arabian physicians used the vapour bath in a singular mode, in scrophulousaffections, which they denominated Bother, " ponatttr sub puero olla plena aqua calida,In principio apparitioni" pustularum, ut attrahat ab interioribus superfluum humorem adcorporis superficiem." Rhaxes de Mortis Infant, cap. 19. by Willan, p. 31.