CHAPTER XIX.

HOT WATER IN THE TREATMENT OF EXTERNAL SYMPTOMS.

After proctitis has continued for many years it will give rise to painful inflammatory and ulcerative processes at the external anal vent and in the adjoining tissues. The anal mucous membrane and the integument about the anus become brittle, loosened, and detached from the areolar connective tissue by the retention of inflammatory serum. The engorged, indurated, and swollen mucous membrane and integument serve as reservoirs, especially when the chronic inflammation is excited to an acute stage, which stage is often accompanied by a fissure, abscess, or anal ulcer. Soreness and pain in the parts may then be so severe that the sufferer is compelled to stay indoors or in bed. Whatever the symptoms may be--piles, fissure, pruritus, abscess, or fistula--the sufferer desires to reduce the local fever and the acute inflammation, as well as to find relief from the pain. The customary treatment is to use poultices, which are troublesome and ineffective.

In the following illustration I give a good idea of a perfect device for relieving quickly the soreness, pain, acute inflammation, and induration, all of which are so very prostrating; and, situated as they are physiologically, they are exceedingly inconvenient to treat properly by the ordinary methods in use:

The Sitz-bath pan, though small, is yet of sufficient depth and diameter for all practical purposes, and can be placed wherever is most convenient--on a low chair or a box. The bather should sit on the instrument with the limbs on either side of the funnel through which the hot water enters the pan. Just below the funnel is an overflow tube, under which a vessel should be placed to catch the water as it flows out. While sitting on the pan the elbows may rest on any convenient support, so as not to tire the invalid too much during the bath, which should consume from half an hour to an hour, or longer if agreeable. Hot water may be added every few minutes as the bather finds that the tissues will tolerate it. Depurant powder may also be added to the water in the Sitz-bath pan.

What has been said in a previous chapter on the therapeutic effects of hot water in the treatment of proctitis need not be repeated here.

The three indispensable appliances for combating and effectually overcoming the pathological conditions to which this book and my two previous books--_Intestinal Ills_ and _How to Become Strong_--are devoted, are _The Internal Fountain Bath_, _The Intestinal Recurrent Douche_, and _The Shallow Sitz-bath Pan_. These appliances are well-nigh perfect for the uses to which they are adapted.