The cold shower, 60° to 70° F., duration from five to thirty seconds, is useful in phlegmatic neurasthenics and dyspeptics; sedentary people in whom the general metabolic activity is diminished; also in obesity and in all cases after a sweating process. By standing in hot water the bather is much more tolerant of cold.
The neutral shower is one of the most effective measures for the relief of insomnia; especial attention should be given to the back and legs. The action is quicker than that of the neutral immersion bath.
As a hygienic measure, the shower bath offers a most agreeable and rapid means of cleansing the whole surface of the body.
Since the effect of the douche depends on the pressure, it will be readily understood that the hose attached to the faucet of the domestic bath-tub is merely a sprinkler, and not a douche, in the proper sense of the word. Such a procedure can only be tolerated by the most robust. In the upper stories of most city houses the pressure is probably not more than from 3 to 10 pounds; the stream of water from the sprinkler is really only a drizzle; the mechanical effects being so slight, there is no reaction produced; the result is that its use is followed by a feeling of chilliness and depression.
The Hot Foot-bath.—The temperature of this bath should be at the beginning from 102° to 104° F., and the duration from three minutes to half an hour. The pail is nearly filled with water, care being taken that it shall not be so full as to overrun when the feet and legs of the bather are put in. A blanket, closely wrapped about the patient and the pail, should come up above the knees. As the water cools off, hot water should be added.
This form of bath is most commonly used to relieve congestion and inflammation. The dilatation produced in the blood-vessels of the feet and legs relieves congestion of the brain and the organs of the upper half of the body, as well as of the pelvic viscera. It should be taken immediately before retiring.
The Sitz Bath.—The sitz or hip bath requires a tub made for that particular purpose. The back of the tub, which is most commonly made of tin, is cut high, while the front must be sufficiently low for the patient to sit comfortably in it, without undue pressure being made on the under side of the knees.
The tub is half filled with water of the prescribed temperature. It is well to begin with water at a temperature of 102° F., and increase the temperature while the patient is in the tub, making it as hot as is comfortable.
Fig. 2.—Sitz-bath tub made of tin (Ashton).