CHAPTER XXXIV.
HYGIENE OF THE SKIN, CONTINUED.
685. Bathing, its necessity and expediency, is obvious from the structure and the functions of the skin. The cuticle is cast off in minute, powdery scales, many of which are retained upon the surface by the pressure of clothing. These mingle with the oily and saline products of the skin, and form a thin crust. This crust, on account of its adhesiveness, collects particles of dust and soot from the atmosphere, and particles of foreign matter from our dress; so that in the course of the day the whole body becomes coated with impurities. If this coating remains, becomes thick and established upon the skin, it will produce the following effects:—
686. 1st. The pores will be obstructed, consequently transpiration impeded, and the influence of the skin as an excretory entirely prevented. When the pores are obstructed, and transpiration is checked, the elements of the transpired fluids will necessarily be retained in the system; and, as they are injurious and poisonous if retained, they must be removed by those organs whose functions in the animal economy are similar, as the lungs, kidneys, liver, intestines, &c.
687. When these organs are called upon to perform their offices, and in addition that of another, the healthy equilibrium is destroyed, and the oppressed organ will suffer from exhaustion, and become the prey of disease. Thus, obviously, habits of uncleanliness are a cause of consumption and other serious 312 diseases of the vital organs. Again, obstruction of the pores will prevent respiration through the skin, thus depriving the blood of one source of its oxygen, and one outlet of its carbonic acid, which will diminish the temperature of the system, and the same results follow as when the clothing is inadequate.
685. Show the necessity for bathing. 686. What effect upon the body if the pores of the skin are obstructed? 687. What is the effect when an organ not only performs its own specific function, but that of another?
688. 2d. The retained perspirable matter will irritate the skin, both mechanically and chemically; and this membrane will be kept damp and cold, from attraction and detention of moisture; and foreign material, as before adverted to, once removed from the system, may be reconveyed into it by absorption. As a consequence, cutaneous eruptions and diseases will be produced, and the re-absorption of matter once separated from the system, will be the exciting cause of other injurious disorders.
689. 3d. A film of foreign substance on the skin will inevitably become the seat of detention of miasmata and infectious vapors. These will remain until absorbed, and engender the diseases of which they are the peculiar cause. This is one reason why filthy persons contract infectious diseases more frequently than individuals of cleanly habits.
690. Bathing is useful to promote cleanliness. In this capacity, it enables us to remove the coating of impurities from the exterior of our persons. It effects this purpose by dissolving saline matters, and holding in temporary suspension those substances which are insoluble.
691. The cuticle is composed of a substance resembling the dried white of egg, or, in a word, albumen. This is soluble in alkalies, and these are the agents which are commonly employed for purifying the skin. Soap is a compound of the alkali soda with oil, the former being in excess. When used 313 for washing, the excess of alkali combining with the oily fluid, with which the skin is naturally bedewed, removes it, in the form of an emulsion, and with it a portion of any adhering matter. Another portion of the alkali softens and dissolves the superficial layer of the cuticle; and when this is removed the cuticle is free from impurities.
688. How are cutaneous eruptions frequently produced? 689. How are infectious vapors transmitted to the system? 690. How does bathing promote cleanliness? 691. Why is it necessary to use soap in bathing?
692. Every washing of the skin with soap removes the old face of the cuticle, and leaves a new one; and were the process repeated to excess, the latter would become so thin as to render the body sensible to impressions too slight to be felt through its ordinary thickness. On the other hand, when the cuticle and its accumulated impurities are rarely disturbed, the sensitiveness of the skin is impaired. The proper inference to be drawn from the preceding remarks, is in favor of the moderate use of soap to cleanse the skin.
Observation. If any unpleasant sensations are felt after the use of soap, they may be immediately removed by washing the surface with water slightly acidulated with lemon juice or vinegar, which neutralizes the alkali that may remain on the skin. This is effective treatment for “chapped hands.”
693. Bathing may be partial or general, and the water used may be cold, temperate, tepid, warm, or hot. A person may apply it to his system with a sponge, it may be poured upon him, or he may immerse himself in it. The simplest mode of bathing is to apply water to a small extent of surface, by means of a wet sponge, and after being wiped dry, again cover with the dress. In this way the whole body may be speedily subjected to the influence of water, and to no less useful friction. The water used may be warm or cold. This species of bathing may be practised by any invalid, and 314 always with benefit, if the bathing is succeeded by a glow of warmth over the surface; and this is the test by which the benefit of all forms of bathing is to be estimated.
692. Why should only a moderate amount of soap be used in bathing? If unpleasant sensations are felt from too free use of soap, how can they be counteracted? 693. Give the different forms of bathing. What is the simplest mode of bathing? Can this mode be adopted by invalids with safety?
694. When the heat of the system is adequate, the bather may stand or sit in a shallow tub, while he receives the water from a sponge squeezed over the shoulders or against the body. In this form of bathing, the person is more exposed to the cold air, and on this account it is less suitable for very feeble individuals than the first-mentioned method. In the early use of this form of the sponge-bath, the bather should content himself with a single affusion from the sponge; the body should be quickly wiped with a soft towel, and friction applied with a crash towel or a brush.
695. The third kind of bathing is that of the shower-bath, which provides a greater amount of affusion than the former, combined with a greater shock to the nervous system. The concussion of the skin by the fall of water, particularly distinguishes this from the previous modes of bathing. The degree of concussion is modified by the size of the openings through which the water issues, and the height of the reservoir. The shower-bath admits of modification, adapting it to the most delicate as well as the robust. The extent of fall, the size of the apertures, the quantity and temperature of the water, may be regulated at pleasure.
Observation. In using the shower-bath, it would be judicious to commence with warm or tepid water, for which, by a gradual process, cold water may be substituted. In this way the system may be inured to cold water. After bathing, the skin should be wiped dry and rubbed briskly.
696. The fourth form of bathing is that in which the body, or a portion of it, is immersed in water. The temperature 315 of water in this form of bathing may be modified according to the sensations and purposes of the bather. This form of bathing is designated according to the heat of the water. When the temperature is below 75°, it is termed a cold bath; when from 75° to 85°, a temperate bath; from 85° to 95°, a tepid bath; from 95° to 98°, a warm bath; from 98° to 105°, a hot bath. In using this form of bathing, the skin should be wiped perfectly dry, and briskly rubbed.
What is the test by which to estimate, the benefit of all modes of bathing? 694. Give another method of sponge-bathing. 695. What is said of the shower-bath? What caution is given? 696. Give the fourth form of bathing.
Observation. The length of time a person may remain in a cold bath with benefit varies from two to ten minutes; while a person may remain in a temperate, tepid, or warm bath, from ten to thirty minutes, or until special indications are exhibited.
697. In the vapor-bath, the vapor is not only applied to the exterior of the system, but it is inhaled and brought in contact with every part of the interior of the lungs. The bather is seated upon a chair, and the vapor gradually turned on around him, until the proper temperature (90° to 110°) is attained. The bath may be continued from ten to thirty minutes. After leaving the bath, attention should be given to the skin, as in other forms of bathing.
698. In order to increase and promote reaction of the skin, various measures and processes are used, some of which are practised in, and others after, quitting the bath. Of the former, the rubbing and brushing the skin are the most common and important. The brisk and efficient friction of the skin with a coarse towel and flesh-brush, after quitting the bath, should never be omitted. This short catalogue embraces all the appliances requisite for the purpose.
699. Bathing promotes health by its immediate and remote 316 physiological effects on the system. When the body is moistened with a sponge wet with cold water, or when an affusion by the sponge or shower-bath is used, the skin instantly shrinks, and the whole of its tissue contracts. This contraction diminishes the capacity of the cutaneous system of blood-vessels, and a portion of the blood circulating through them is suddenly thrown upon the more internal parts of the body. The nervous system, among others, participates in it, and is stimulated by the afflux, and communicates its stimulus to the whole system. This causes a more energetic action of the heart and blood-vessels, and a consequent rush of blood back to the skin. This is the state termed reaction, the first object and purpose of every form of bathing.
What degree of temperature of water is termed a cold bath? A temperate? A tepid? A warm? A hot bath? State the length of time that a person should remain in the different baths. 697. What is said of the vapor bath? 698. Mention the different methods for promoting reaction of the skin.
700. This condition of the skin is known by the redness of the surface, the glow, comfort, and warmth which follow the bath. The bather should direct all his care to insure this effect. By it the internal organs are relieved, respiration is lightened, the heart is made to beat calm and free, the mind is clear and strong, the tone of the muscular system is increased, the appetite is sharpened, and the whole system feels invigorated. This is the end and aim of the bather, and to this all his training tends. The error is, to expect the result without the preparation.
701. In order to promote reaction, and to be efficient in preserving health, bathing should be regular, should be commenced by degrees, and increased by a process of training, and should not be permitted to intrude upon hours devoted to some important function, as digestion. It must not precede or follow too closely a meal, or severe mental or muscular exercise, as reaction is less certain and vigorous when important 317 internal organs are employed, than when they are at rest. When the vital powers are greatest, and the system most free from exhaustion, bathing is most beneficial; hence the morning is preferable to the evening, and the middle of the forenoon to the middle of the afternoon, for this healthful and agreeable duty; as the vital action of the system is most energetic in the early part of the day.
699. What is the effect upon the skin when cold water is applied? What is the first object and purpose of every form of bathing? 700. How is this condition of the skin known? Mention the salutary effects that this condition has on the body. 701. How should bathing be performed, in order to be efficient in preserving health?
702. In regard to the frequency of bathing, the face and neck, from their necessary exposure to the atmosphere, and the impurities which the latter contains, should receive at least two washings in twenty-four hours, one of which should be with soap; the feet, from the confined nature of the coverings which are worn over them, require at least one; the armpits, from the detention, as well as from the peculiar properties of the secretions, at least one; and the hands and arms, as many as seem proper. The whole person should be bathed at least every second day, but the most perfect health of every part of the body would be maintained, if the excretions from the skin were removed daily.
703. In diseases of the skin and internal organs, bathing is a remedial measure of great power. It should never be neglected or omitted. It is not only pleasant and safe, but is really more effective than any medicine administered internally. This, like other curative means, should be applied by the direction and under the eye of the medical adviser, that it may be adapted to the condition of the patient.
704. “From the first hour of man’s existence to his latest breath, in health and in sickness, rich or poor, water is always requisite. Baths were dedicated by the ancients to the divinities of medicine, strength, and wisdom, namely, Æsculapius, Hercules, and Minerva, to whom might properly be added the goddess of health, Hygeia. The use of water has been 318 enforced as a religious observance, and water has been adopted as one of the symbols of Christianity.”
When should bathing be performed? 702. How often should we bathe? 703. What is said of bathing in disease? Who should direct the kind of bath proper in different diseases? 704. Were baths dedicated by the ancients?
705. The AIR is an agent of importance in the functions of the skin. It imparts to this membrane oxygen, and receives from it carbonic acid. It likewise removes from it a large portion of the perspiration and the more fluid portions of the oily secretion. In order that the air may accomplish these ends, it is necessary that it come in contact with the body. This is one of the many reasons why we should wear loose and porous clothing.
706. Again, the air should be pure, and free from redundant moisture. In the warm mornings of July and August, the air is loaded with moisture and impurities, and the perspirable matter is not removed from the system as it is when the air is pure and dry. This is the cause of the general lassitude that is experienced during such mornings. As soon as the fog is dispelled, these unpleasant sensations are removed. To sustain the functions of the skin in a healthy state, the parlor, kitchen, sleeping-room, school-house, and work-shop, should be well ventilated. The blood of the system will be purer, and its color of a brighter scarlet, if the skin is surrounded by fresh and pure air, than when it is foul or moist.
707. The LIGHT permeating the skin, not only exercises a salutary influence upon this membrane, but upon the blood, and, through this fluid, upon the whole system. For this reason, the kitchen and the sitting-room, which are the apartments most used by ladies, should be selected from the most pleasant and well-lighted rooms in the house. On the other hand, dark rooms and damp cellar-kitchens should be avoided, as exercising an injurious influence upon both body and mind.
708. The dark, damp rooms, so much used in cities and 319 large villages, by indigent families and domestics, are fruitful causes of disease, as well as of vice, poverty, and suffering. Common observation shows that solar light also exercises much influence upon the vigor and color of vegetables. Plants that are kept in well-lighted rooms, have darker and more brilliant colors than those that grow in darkened apartments.
705. Give the reasons why pure air should be supplied to the skin. 706. What is the cause of the general lassitude in a damp, warm morning? 707. Show the salutary effects of light on the skin. 708. What is one cause of disease and suffering in large villages?
709. Burns and SCALDS are terms applied to those conditions of the skin which are produced by the application of an undue amount of heat, which changes the action of its vessels.
710. A small degree of heat will irritate the nerves, and cause an increased action of the blood-vessels. This is attended with severe smarting pain, and will be followed by the deposition of serum under the cuticle, unless applications are made immediately, to prevent vesication, or blistering. To prevent or suppress this state of arterial action, wet some folds of cotton or woollen cloth with cold water, and apply them to the parts scalded; continue to apply cold water, so as to steadily maintain the low temperature of the applications, as long as the smarting pain is experienced. The steady application of cold dressing also tends to prevent an increased action of the blood-vessels, and will suppress it, if it already exist.
711. When blisters are formed, the cuticle is separated from the other tissues of the skin by the effusion of serum. In all cases, if this layer of the skin is not removed, a small opening should be made in the raised cuticle, by which the serum deposited may be removed. Under such circumstances, never remove the cuticle, as it makes the best possible covering for the blood-vessels and nerves of the true skin. The cold water dressing, recommended in the preceding 320 paragraph, may then be applied as long as the smarting sensation continues. After the pain has subsided, the blistered part may be covered by a patch of cotton or linen cloth, upon which an ointment, made of lard and bees-wax, has been spread.
709. To what condition of the skin are the terms burns and scalds applied? 710. What is the effect when only a small degree of heat is applied to the skin? How can vesication be prevented? 711. What should be the treatment when blisters are formed?
712. If the cuticle has been removed, there will be much suffering, because the nerves are unduly stimulated by the air. The cuticle is the sheath or covering of the vessels and nerves of the skin, and when it is removed, a substitute should be applied. This substitute should be soothing, and cover the denuded surface. Linseed-meal or ground slippery-elm bark poultice, fresh cream, or lard and bees-wax, spread upon linen or cotton cloth, would make a good dressing. When dressings are applied, they should not be removed until they become dry and irritating.
713. If there is much suffering, administer to an adult from twenty-five to sixty drops of laudanum, according to the severity of the pain. If the patient is a child, from fifteen drops to a tea-spoonful of paregoric may be administered. When there is much prostration, some hot peppermint tea or other stimulant may be found necessary to bring on reaction.
714. The hands, feet, ears, &c., are subject, in cold latitudes, to be frozen, or frost-bitten. This may occur when the patient, at the moment, is not aware of it. The part affected at first assumes a dull red color, which gradually gives place to a pale, waxy appearance, and becomes quite insensible. The first thing to be done in such cases, is to reëstablish circulation. This should be effected very gradually. If a large quantity of blood is thrown suddenly into the chilled and debilitated vessels of the frozen part, inflammation may be produced that will destroy the vitality of the limb.
712. That should be the treatment if the cuticle has been removed? How often should the dressing of burns be removed? 713. What may be necessary when there is much suffering? 714. What is the appearance of limbs while freezing? How should the circulation be at first reëstablished? What should be avoided?
715. The circulation and sensibility may be restored by rubbing the frozen limb, with snow, or, when this is not to be obtained, cold water; but snow is always to be preferred. The fire should be avoided; and it would be better for the patient to be kept in a cold room, for a time, where there is no fire, or where the temperature is moderate.
716. When a person is found benumbed with cold, and almost or quite insensible, he should be taken into a cold room, the clothing removed, and friction commenced and continued for some time, with snow. When warmth begins to be restored, the individual should be rubbed with dry flannel, and the friction continued until reaction takes place.
Observation. When the toes and heels have been repeatedly chilled, there may be produced a disease called chilblains. This affection is attended with tenderness of the parts, accompanied with a peculiar and troublesome itching. The prevention of this disease is in wearing warm hose and thick shoes of ample size. Bathing the feet morning and evening is also a prevention of this disagreeable affection. When chilblains exist, apply cold water, warm camphorated spirits, or turpentine linament.
715. How may the circulation and sensibility be restored? 716. What treatment should be adopted when a person is benumbed with cold? What treatment should be adopted when warmth begins to be restored? What is said of chilblains?