Before proceeding further on the cold bath, let us glance at the peculiar manner in which it is employed by the hydro-therapeutic doctors of Germany, who have now establishments in many of the principal towns.
About four or five o’clock in the morning, the patient is wrapped up to the chin (while in bed) in a thick woollen shirt. Outside of this is placed another covering of down, fur, or any warm and impermeable material. In a short time the disengagement of animal heat from the body thus enveloped, forms a fervid atmosphere around him, which soon induces a copious perspiration, in the greater number of individuals. It has been observed that, in diseased parts, as for instance, in the joints of gouty people, the perspiration was longest in breaking out. When the skin is obstinate, friction and other means are used to accelerate the cutaneous discharge. When the physician judges that the perspiration has been sufficient, the patient is quickly disrobed and plunged into a cold bath, which is kept ready at the side of his bed. The first shock is very unpleasant; but that over, the invalid feels very comfortable, and when the process is likely to prove favourable, there is frequently observed on the surface of the water a kind of viscid scum, the supposed morbid matter thrown off from the body. The period of immersion in the cold bath is carefully watched, for if protracted too long it proves hurtful, or even dangerous. Some people will not bear the cold immersion above a minute—others are allowed to remain till the approach of a second shiver. Where the patient is very delicate or weak, the temperature of the bath is raised a little. In other cases, the bath is artificially depressed below the natural temperature of the water.
On emerging from the bath, the patient is quickly dressed, and immediately commences exercise, and drinks abundantly of cold water. The limit to this ingurgitation is sense of pain or weight in the stomach. The patient, although rather averse to the cold drink at first, soon becomes fond of it, and will swallow fifteen or twenty goblets with a keen relish. After the promenade and cold drink is over, a nourishing breakfast is taken. All stimulating or exciting beverages are entirely prohibited. The appetite generally becomes keen, and the digestion, even of dyspeptics, strong and effective during this course. Between breakfast and dinner is variously employed, according to the strength of the patients or the nature of the disease. Some take riding or pedestrian exercise—others gymnastics—and a few have more cold water, as a plunging or shower bath.
The dinner is to be light, and soon after mid-day. It is generally taken with a keen appetite. During the three or four hours after dinner, all exercise of mind or body is forbidden, but sleep is not to be indulged in. Towards evening, some of the stronger patients repeat the same process which they underwent in the morning; but those who are weak, or in whom the crisis is approaching, only take cold water to drink in moderation. After a slight supper the patient retires to sleep, in order that he may early resume the routine of the water-cure.
The professors of this system vary the mode of application almost infinitely—especially the external application of the cold water, according to the general or local seat of the complaint. They act very much on the doctrine of revulsion or derivation. Thus when there are symptoms of fulness or congestion about the head or the chest, a half-bath or hip-bath of cold water is employed, disregarding the first impression of cold on the lower parts of the body, but looking to the reaction which is to take place there, and to the consequent derivation of blood from the head and chest. Foot-baths, cold lotions, fomentations, and poultices are variously used, according to the nature or seat of the malady.
Like the spa waters, this hydrotherapeia produces, in a great many instances, a crisis. For some days the patients feel themselves much more energetic and comfortable than before the course was begun; but after a time “a veritable state of fever is produced, the result of this general effervescence.”[46] Then the symptoms of the complaint, whatever it may be, are all exasperated and acquire an increase of intensity—even old diseases, that were forgotten, will sometimes re-appear—but all this commotion is the precursor of a salutary crisis and a return to health. A kind of prickly heat, with itching of the skin, is a common occurrence in the course of the cure. “The effects produced even on organic diseases by this hydro-therapeutic treatment would convince the most sceptical of its wonderful efficacy.”—Engel.
The diseases to which this remedy is now applied in Germany are numerous and very different. Fevers, even of the most inflammatory kind, are said to yield to it. Pure inflammations of vital organs are fearlessly submitted to it. The first case related by Dr. Engel, is one of pneumonia, well marked, in a young girl who had been exposed to a current of cold air after violent exercise in the heat of the day. Dr. Weiss ordered her to be enveloped in a blanket, wet with cold water, and then other blankets over the wet one, with plenty of cold water to drink. Some amelioration of the symptoms followed; but in two hours they were again intense. Two foreign physicians accompanied Dr. E. to the bed-side of the patient, and prognosticated a fatal termination unless she were bled, and the cold water treatment declined. Dr. E. with the greatest confidence, ordered the blanket to be again wetted with cold water. This second application was followed by increase of the burning heat, and also by delirium. Notwithstanding the remonstrances of the foreigners, Dr. E. was still firm in his purpose—and ordered the wet blankets to be applied every half-hour. No change took place till after the sixth application, when the kidneys acted copiously. The seventh application was followed by diminution of the thirst and heat—the patient became more tranquil—began to perspire—and fell into a short sleep. The perspiration continued copious for twenty-two hours, and was kept up by the drinking of large quantities of cold water. The perspiration having ceased, the patient was put into a cold half-bath (slipper) where the respiration became more free. On being taken out and covered over she perspired copiously. The wet blankets were now applied only twice a day, with an occasional half-bath. On the fifth day she was well. (Weiss.)
Before proceeding farther, it will be proper to explain that the transition from a hot bath to a cold one, even in a state of perspiration, is not half so dangerous as most people imagine. It is well known that if we jump out of hot water into cold, we resist the shock, and bear the effects of the latter better than if we took the plunge without any preparation. But then there is a strong prejudice that perspiration is an insuperable bar to the application of cold water to the surface. If the individual has come into a state of perspiration from bodily exercise, and especially if he be fatigued or exhausted—then the cold water would be dangerous. But this is not the case, to any extent, when he is warmed either by the hot bath, or by the accumulation of heat generated in his own body. This is proved by authentic facts which have come under my own observation. Forty years ago, when the Russian troops were encamped in the islands of Guernsey and Jersey, the soldiers constructed rude stone huts or ovens along the beech, for vapour baths. Into these they put stones, and heated them by fire, when they poured water over them, and thus filled the hut with a dense vapour. When the men had continued in this rude vapour-bath till they were in a state of perspiration, they leaped into the sea, and swam about till they were tired. All this was done, partly for health, partly for pleasure. It is well-known to all northern travellers that the Russians are in the habit of steaming themselves in the vapour-baths, and then directly rolling themselves in the snow. Every one, too, must have observed postillions dashing their foaming and perspiring horses into any convenient water at the end of their journey, without the least fear of their animals being injured by the dip.
Here then is a complete counter-part, or rather prototype of the hydro-sudo-pathy, as already described. But there is one process which will appear incredible to most people—that of procuring perspiration by means of blankets wetted with cold water. Let us see whether an illustration of this may not be found. Every one who has read the Waverly Novels must have been struck with the singular practice pursued by some Highlanders (outlaws I think) who were obliged to pass many winter nights unsheltered on the freezing mountains. When they were desirous of sleeping, they dipped their plaids in the freezing water of the nearest pool or stream, and, wrapping themselves in this dripping and gelid mantle, went quietly to sleep! So long as the plaid kept wet, the Highlander kept warm, and slept soundly; but the moment it got dry, the man was awoke by the cold, and proceeded to the brook or stream to saturate his bed-clothes again with cold water. Here we have the prototype of the German process described in the case of the girl with inflamed lungs. By what process of reasoning the Silesian peasant and the Celtic mountaineer, arrived at the knowledge of these curious facts, would be difficult to imagine. There was probably no reasoning in either case, but chance, observation, and experience.
It is sometimes more easy to explain a phenomenon when discovered, than to arrive at it by any process of reasoning previously. The wet plaid by confining the animal heat of the Highlander, soon occasioned a warm atmosphere around his body, which kept him comfortable. But as soon as the plaid got dry and its texture pervious, then the animal heat rapidly escaped, and the feeling of cold dispelled sleep. In the case of pneumonia related by Dr. Weiss, the wet blanket was surmounted by several other blankets, which effectually prevented the escape of animal heat, which would soon accumulate and eventuate in perspiration. In such cases there would be a chill at first, succeeded by reaction, heat, and transpiration. We see this exemplified every day, where cold lotions are applied to an inflamed part. If the clothes are defended from the external air, they soon become warm, and form a fomentation—whereas, if exposed to a current of air, they will almost freeze the part by evaporation. Dr. Weiss’s patient would never have perspired, if the wet blanket had not been covered by dry ones.