Chapter 7

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.