As a prophylactic, this form of bath is especially valuable for all persons leading a sedentary life; it is the best substitute for exercise in the open air, and, where there are no contraindications to its use, should be taken once a week.
In cases of obesity, sweating may be used to reduce the weight; but, in order to obtain the best effects, it must be combined with exercise, and it must be borne in mind, that in obesity there is great danger of overheating the blood, in consequence of the obstacles to heat elimination presented by the thick layers of non-conducting fat. Therefore, these hot applications for the reduction of fat should never be too much prolonged, and the bath should always be finished by vigorous applications of cold. These cold applications have also a tonic effect upon the nervous system, and increase the muscular disposition for exercise, and this is the most rational treatment for obesity.
Loss of Weight.—There are many cases in which metabolism has been so sluggish, allowing an accumulation of imperfectly oxidized matters in the body, that the first active stimulation of the nutritive processes is in disproportion to the increased destructive metabolism. Under these circumstances there is necessarily a decrease in weight. The rubbish must first be removed and old defective structures before new and highly organized tissues can be deposited. A slight loss of weight need, therefore, give rise to no apprehension, but if the loss is considerable, or continues for some time, especially if accompanied by loss of strength or appetite, it is a matter for investigation.
Palpitation of the heart and fulness of the head are an indication that the applications have been too hot or too long continued. Vertigo and fainting are apt to occur when hot applications have been continued too long, but they are quickly relieved by cold applications, especially by cold affusions to the chest and shoulders. Headache may result, either from excessively hot or cold procedures. Deficient reaction is generally the result of a too prolonged application of cold.
On entering the electric-light cabinet, a wet towel wrung out of ice-water is placed around the neck and another around the forehead; or an ice-bag may be placed on the top of the head.
The Douche.—A douche consists of a single or multiple columns of water directed against some portion of the body. The apparatus is complicated, and it is essential that an accurate pressure-gauge and thermometer should be introduced into the circuit of the douche. It can only be properly administered in a hydriatic establishment. In the employment of the douche three factors must be considered—the temperature, pressure, and the mass.
The range of temperature employed varies from 45° to 125° F. The pressure ordinarily employed varies from 10 to 60 pounds. The mass varies according to the effect desired, and may be regulated by means of the finger, placed in the water column near the nozzle.
The douche is applied by means of the rubber hose, which is connected at its proximal end with the water-supply, and at its distal end is attached a nozzle, the average diameter of which varies from 2 inches to ⅜ inch. From these a fine or coarse jet or a fan douche may be produced. The latter is formed by placing the index-finger of the hand holding the nozzle upon the lower border of the outlet, producing an expansion of the otherwise solid jet into a fan-shaped stream.
The mechanical effects of the douche are derived from atmospheric pressure, and this is of more importance in the effects produced than the temperature.
The Scotch douche consists of alternate streams of hot and cold water. The general cold douche is the most powerful of all the tonics; the warm or neutral douche is sedative; the very hot douche is frequently followed by atonic reactions.