SANITARY PURPOSES OF THE BATH.
In reference to the sanitary purposes of the bath, I assume that it is Preservative of Health; that it is Preventive of Disease; and that it is also Curative of Disease.
The mode in which its power operates in the fulfilment of these results is by the production and maintenance of a healthy skin. A healthy skin I therefore assume to be the end and aim of the bath; and to support my argument it will be necessary that I should point out the importance of a healthy skin in the animal economy, and those conditions and circumstances of common life that tend to deteriorate its structure and function; to show, in fact, why the skin is worth preserving, and how its preservation in a state of health conduces to the health of the entire organism.
The skin, from its large extent, deserves to be ranked among the great organs of the body, and belongs especially to that group that are commonly called emunctory—in other words, the cleansers or purifiers of the blood. In this sense it ranges side by side with the liver and kidneys; and, all things considered, it would be a difficult problem for any physiologist to solve, to determine which of the three deserves to stand before the others in importance. These three organs are sometimes called the scavengers of the body; and they may with considerable truth be regarded as three great and important systems of purification and drainage.
Now, if to drain the system of its impurities, to cleanse and purify the blood of the animal economy, three grand systems of drainage are required, the inference is plain, that one would not be enough—that two might perform the office, but with a strain upon the machinery. But to be perfect, to perform the office completely and efficiently, to be, in fact, in health, to constitute health, all are needful. Therefore, if in the course of these observations I can show that one of these scavengers is weakened in its powers, and being weakened in itself, throws an additional degree of labour on the remaining two; if, in fact, our present mode of management of the skin tends to deteriorate its powers as a purifier of the body, and consequently produces a strain on the liver and kidneys, which leads to their deterioration and disease, I shall, provided I can also show that the bath preserves the health of the skin, make out a primâ facie case in favour of the bath.
But it is not as an emunctory or purifier only that we must regard the skin; its influence and power have a wider range of action in the maintenance of health. Besides comprehending a vast system of drainage tubes, which open on the surface by seven millions of pores, and which in actual measurement would stretch over nearly thirty miles if laid end to end; besides this, which belongs to its purely emunctory function; besides, also, a wonderful and perpetual labour, by which the skin is drawing from the blood certain organic elements in the fluid state, and converting them into solid organic formations, which are known as cells and scales, these cells and scales being the tesselated mosaic with which the skin is finished upon the surface, so as to render it capable of existence in the atmosphere of the external world; besides this, and much more, unnecessary in this place to detail, the skin is converted into a kind of sponge by the myriads of bloodvessels which enter into its structure—bloodvessels, that many times in an hour bring the whole—ay, every drop—of the blood of the body to the surface; bring it that it may furnish the materials for the microscopic pavement; that it may be purified by the abstraction of its unwholesome principles; that it may breathe the vital air of the atmosphere without;—besides this, also, the skin near its surface is one vast network of nerves—nerves, mysterious organs, that belong in their nature to the unknown sources of the lightning, the electric currents of the universe. And, besides these again, there is every variety of animal tissue and contrivance by which all this apparatus is held together and maintained in the best state and position to ensure its safety and perfection. In truth, the contemplation of the structure and functions of the skin, when viewed with the eyes of the mind, is almost overwhelming; and as we gasp breathless, to gain an instant of reflection, the words of the Poet break upon our memory:—
"In human works, though labour'd on with pain,
A thousand movements scarce one purpose gain;
In God's, one single can its end produce,
Yet serves to second, too, some other use."
One word more as to the importance of the skin in the animal economy, and that word a summary of its functions and principal vital attributes. The skin is a "sanitary commissioner," draining the system of its impurities; it is an energetic labourer, in that perpetual interchange of elements which in its essence constitutes life; it is a regulator of the density and fluidity of the blood; it performs the office of a lung in supplying the blood with oxygen, and abstracting its carbon; it changes the crude organic elements of the blood, so as to render them capable of nutrition; it emulates the heart in giving speed to the circulating blood; it is the minister of the brain and spinal marrow in its properties of sensation; and it feeds and nourishes, and keeps in the highest operative condition, that part of the nervous system which is confided to its care. Viewing the skin in this way, and recognising its just claims to consideration as an important animal organ, we are led to the conclusion that the skin is a part of the digestive system, like the liver and kidneys, by virtue of its emunctory and nutritive powers; it is an appendage of the heart and a part of the system of circulation of the blood; it is a surface lung, a breathing organ; and it partakes of man's intellectual nature by its close connexion with, and dependence on, the brain. In the lower animals, the skin combines in itself alone, the feeling, seeing, smelling, hearing, and judging organ.
The structure of the skin—with its drainage tubes requiring a free exit; its streams of blood seeking for oxygen from the air; its nerves demanding the contact and stimulus of the atmosphere—obviously points to the relation which should subsist between man and the external world—to the fact that his natural and intended state is one of nakedness. Certain portions of the skin, in different parts of the world and among different nations, are commonly exposed to the air as Nature doubtless intended the whole body to be. Our faces and hands; in women, the neck, and often the shoulders; among the Highlanders, the lower limbs; these portions of the body are naked, are unblushingly exposed; and, as we all know, without inconvenience. Who ever feared to take cold because his hands and his face were open to the free air of Heaven? What lady ever complained of inconvenience resulting from her décolleté shoulders at an evening party or the opera, or even from the bitter draughts of night air that frequently close those entertainments? Who ever heard of a Highlander suffering from rheumatism in the knees? That charming friend and companion of our youthful dreams, Miss Jane Porter, who was always taking colds from the slightest exposure of her skin to the air, once said to her brother, who was a physician,—"How I wish that my skin were all face?" "Try and make it all face," was his reply. And she partially succeeded; but for complete success she wanted the knowledge of the Turkish Bath.
The bath has the property of hardening and fortifying the skin, so as to render it almost insusceptible to the influence of cold. The feeling after quitting the Calidarium is one of defiance of cold; the bather has a longing for the cool air of the outer world, and with no other covering than his cotton mantle, a lawn or a terrace would be his chosen resort if the opportunity were within his reach. In the hands of Mr. Urquhart, the bath has presented us with one remarkable instance of the power of endurance of the skin developed by its aid. A fine, athletic child of five years old has been brought up in the bath, and has never worn other clothes than a loose linen garment. He is a sturdy little fellow, with the independence of deportment of an Indian and the symmetry of an Apollo. He was met one wintry day, when the snow was on the ground, walking in the garden, perfectly naked. "Do you feel cold?" inquired his interlocutor. "Cold!" said the boy, touching his skin doubtfully with his finger, "yes, I think I do feel cold." That is, he felt cold to his outward touch, but not to his inward sensations, and it required that he should pass his finger over the surface of his body as he would have done over a marble statue to be sure, not that he was cold, for that he was not, but to be convinced that his surface felt cold.
That the skin of man can support the temperature of a climate such as that of Britain, when trained to it from the cradle, is perfectly clear; our forefathers, the ancient Britons, wore no clothes. The Roman invaders of Britain tell us of the "naked savages of Scotland." The inhabitants of the Tierra del Fuego at Cape Horn, a country colder than Britain, have no other clothing than a hide which they hang on their windward shoulder; and their children may be seen, perfectly naked, gambolling on the sea-shore, and scrambling in the bottoms of the boats that come off to the passing ships. The mother of the little Apollo I have already described called the attention of a friend to the warmth of her infant's feet, and with the remark, "While my old nurse was with me, the child's feet were always cold, because she insisted upon covering them up with socks; but now that I leave them exposed to the air, they are constantly warm."
I need scarcely say more to prove that the bath gives endurance, and that endurance fortifies the individual against a very prevalent cause of disease in this climate—namely, colds and affections of the chest and lungs. A Doctor of Divinity whom I frequently met in Mr. Witt's Bath, told me that during the winter-time he was scarcely ever free from colds, often so severe as to lay him up for several weeks, and that he also suffered from attacks of neuralgia; but that, since he had adopted the use of the bath twice a week, all disposition to colds and neuralgia had ceased; and, for the first time in sixteen years, he had passed the winter without a cold.
It is impossible, therefore, to avoid the conclusion that the close clothing of the body from the moment of birth, and the continuance of the process throughout our lives, must tend to prevent the proper and healthy development of the skin and also to debilitate it; and that the opposite course, of exposing the skin to the air, and promoting its natural functions by means of the bath, must have the contrary effect of hardening and strengthening the skin and rendering its functions more perfect.
In the bath we learn to distinguish by the eye and by the touch, the weak and the strong, the unhealthy and the healthy skin; we find the former pale, soft, flabby, wrinkled, sordid, starved, and morbidly sensitive; while the latter is pink, hard, firm, elastic, smooth, clear, sensible, and well nourished. When the fingers are drawn forcibly over the skin of the practised bather, the white streaks caused by the pressure are instantly restored to their pink hue when the pressure is relaxed; the sanguineous stream seems to follow the pressure like a surge and instantly obliterates its effects; and the skin recoils with a snap like India-rubber when it is pulled away from the body and suddenly released. In the bath there are no wrinkles and no decrepit age; the skin becomes firm and elastic; it recovers its colour and its smoothness; it fits close to the muscular frame beneath, instead of falling away from it in grim festoons; its hues are selected from the palette of youth. But this is not all: as the skin regains its health, the hair returns upon the scalp of the bald; and white hairs which have crept untimely and unbidden among the dark locks of mid-age, shrink away from the sight, and seek a more suitable and more unwholesome roost.
But these visual appearances of the skin, which obviously indicate its unhealthy external characters, also denote a deficient and imperfect circulation of the blood; a deteriorated sensibility; a defective cell-formation and secretion; an exhausted tone and vigour.
In respect of one of these qualities—namely, healthy sensibility of the skin—I met in the bath with a curious and unexpected illustration. When I was invited by Mr. Stewart Rolland to pass from his Calidarium at a temperature of 170°, into his Laconicum, in which the actual temperature was 190°, but the sensible temperature some degrees higher, in consequence of the presence of watery vapour, I was suddenly made aware that the skin of my body had lost its power of appreciating the higher degrees of heat, and that my face and hands were my only reliable monitors of the actual elevation of the temperature.
To the face and hands the temperature was for a moment almost scalding, but my body was sensible of no inconvenience. Had I been asked, before I made this experiment, what part of the body would have suffered most from the extreme heat, I should have said, the skin of the trunk of the body, because this is naturally the most sensitive from being covered and protected by clothing; but I was unprepared to find the real fact in the very reverse of this—to learn that the skin of the trunk of the body had lost its power of sensibility; in other words, had become partially paralysed from disuse of its proper functions.
In a word, the habit of clothing the body, of keeping it shut in from the air and from the light, weakens the nerves of the skin and consequently the natural and healthy sensibility of the organ. Although I could not appreciate the extreme heat of Mr. Rolland's Laconicum, I should have suffered acutely from a scratch, a pinch, or a blow on the bare skin: but the habit of the bath would reverse this unnatural sensitiveness, the skin would learn to appreciate truly instead of mendaciously; and blows, or pinches, or external injury, unless very severe, would cease to be felt as an inconvenience or an annoyance. The little boy bred in the bath complains of no hurt when he is accidentally struck or when he tumbles; and that which would be punishment to another boy is none to him. This, we see, must be the natural state of the skin, otherwise the Indian could no more exist without clothes than the lobster without his shell.
Another phenomenon of the bath shows the power of increased firmness and solidity and strength which the texture of the skin acquires by its use. A person unaccustomed to the bath bruises without any great force, and the discoloration of the bruise, occasioned by the escape of blood from its vessels and the dispersion of the blood in the texture of the skin, lasts for a considerable time. Indeed, we know of some skins that bruise upon the most moderate pressure, even without a blow. But the practised bather does not bruise, excepting from serious injury; and, when he does bruise, the discoloration is rapidly dissipated.
The power of influencing the skin by education is also shown in the degree of facility with which perspiration is induced in the bather. In the practised bather the perspiration comes almost at call; it comes soon, freely, abundantly: but in the neophyte, the perspiratory fluid is slow to emerge from its pores; it comes unwillingly and in insufficient quantity. Each succeeding bath, however, exhibits an improvement; and, in time, the perspiration obeys the word of command in the pupil as well as in the master.
I have assumed for the skin the possession of a power of nutrition, and have in this way brought it into the category of the digestive organs; let me explain:—Nutrition, in its essence, is that interchange of material, by the influence of which the old material is removed and new material is deposited in its place. Now, the emunctory function of the skin obviously results in the removal of the old material from the body, and in proportion to the energy and completeness of its removal, will be the eagerness of the tissues to take up new material from the blood. If the skin be in the torpid and atrophied state I have already described as the consequence of our present habits of life, this source of interchange, of nutrition, will be valueless: but if, by improving the health of the skin through the agency of the bath, or by any other method that can be devised, we render its function more active and energetic, we necessarily make nutrition also more active and complete.
The accomplishment of this object is the basis of that process known by the name of training, by which animals are brought into the highest state of condition and strength. It is for this that the racehorse is galloped, and sweated, and often purged; for this, also, the prize-fighter, the prize-rower, and the prize-cricketer are made to go through a similar ordeal. It requires little argument to show how admirably the bath is suited to this purpose; the sweating, the cleansing, the strengthening of the blood, are obtained in the bath, without effort and without exhaustion; and the system is brought into that state which, above all, is most favourable for the absorption of new and nutritious material. The bath has been already applied to the training of horses, and before long will be used in the training of men. The Romans kept their army in health and strength by means of the bath; and the bath might, on the same principle, be adopted with advantage under all those circumstances in which bodies of men are assembled together, temporarily or permanently, as in barracks, prisons, schools, factories, &c.
In the gas factories and metal-smelting houses, and probably in other trades where men are exposed to great heat, a plan is adopted which has considerable physiological interest, and is specially illustrative of the nutritive capabilities of the bath. In the retort-house, the stokers are kept for many hours in a deluge of perspiration; the drain is consequently very active, and it is necessary to supply the loss occasioned by that drain by means of drink. With this object, each man is allowed a certain quantity of oatmeal daily: the oatmeal is served out by the foreman, and is scalded with hot water and made into thin gruel; this is the drink with which the men supply the place of the perspired fluid. They give forth, in the shape of perspiration, water holding in solution the used and useless materials of the frame, and they receive in return a wholesome nutritive material. Can we wonder that these men are perfect Athletæ in form, that they are in the finest possible condition for labour; and that, although working in buildings open to every draught of cold wind, and bathed in perspiration, they never, indeed they cannot, take cold.
Let us apply this lesson of the retort-house to the ill-nourished, weakly invalid; or, better still, to weakly, ill-conditioned children. Let us suppose that we have the power, by an easy, pleasant process, of extracting the old, the bad, the useless, even the decayed and diseased, stuff from the blood and from the system by means of the bath; how simple the operation by which we could give back in its place wholesome and nutritious material.—Where would be atrophy and scrofula, if we had this power?—and this power is, I believe, fast approaching, fast coming within our reach, by means of the Eastern Bath. We squeeze the sponge as we will; we replenish it as we will.
The faculty of preventing disease, as exercised by the skin, besides being indirect and operating on the general health of the body, is also direct. The skin repels the depressing effects of cold, of alternations of temperature, of extreme dryness or moisture, by virtue of its own healthy structure; by its intrinsic power of generating heat; and it also repels other causes of disease, such as animal and miasmatic poisons, by its emunctory power, which enables it to convey them directly out of the body. In unwholesome states of the atmosphere, in an atmosphere of malaria, which must necessarily pass into the body with the inhaled air, and being in the lungs must be absorbed by the blood, we naturally inquire by what means we escape the morbid effects of such malaria? The answer is:—the malaria is conducted out of the body as rapidly as it is introduced, by the emunctory organs—by the liver, kidneys, and notably by the skin. If the powers of the skin be weak, then the poisons are detained in the blood, and disease is the result; but if the skin be healthy and active, then they can do no evil; and ultimately they become innocuous. Thus the bath, by conducing to the health of the skin, becomes a direct means of preventing disease.
Reasoning, on the same premisses, shows us how the bath may be employed in the cure of disease. We can, at our will, so far excite the emunctory power of the skin as to make it the means of carrying off the elements together with the seeds of disease. If we wish to comprehend the operation better, we have only to watch Nature's own processes. A morbid poison is in the blood, it produces a shock to the whole system, that shock is represented by a chill; next to the chill succeeds a fierce fever, which marks the furious battle waged between the poison and the blood; then follows the perspiration, which hurries the contending poison out of the system; the perspiration, for the time being, is the cure. The observation of this well known series of symptoms suggested to the inventive mind of Mr. Urquhart the notion, that by raising artificially, as by the bath, the temperature of the body above fever-heat, the proper stages of fever might be stepped over; the chill fit would pass at once into the hot fit, and the hot fit be resolved by perspiration. The suggestion is worthy of mature thought.
Let me conclude with a brief summary of the sanitary views which it is my aim to inculcate in this essay.—I have endeavoured to show the importance of the skin as an independent organ endowed with sensation, circulation, powers of nutrition, and powers of elimination. I have viewed it in its relations to the rest of the animal economy—the digestive organs, the heart, the lungs, and the brain—with the purpose of showing its influence on these organs. I have regarded it in its natural state, as full of vigour, and possessing the properties of healthy colour, texture, sensation, and secretion; and in the unnatural state to which it has been brought by the perpetual use of clothing, wherein its colour, texture, sensation, and secretion are unhealthy, and its power of generating heat lost. I have explained the manner of operation of the bath on the skin, both in its healthy and unhealthy state; how, in the former case, it is a direct preservative of the health of the skin, and, through the skin, of the entire organism; and, in the latter, that it possesses the power of restoring the skin to a state of health: further, that the bath may be made the means of preventing disease, and an adjuvant in its removal when already established.