General Hydro-therapy
That hydro-therapy constitutes one of the most effective, if not the most effective, methods of treating gout, is almost a truism, if judged by that most “acid test”—Experience. The particular applications we are about to discuss entail exposure of the whole body. In other words, those measures directed more especially to treatment of the underlying causal state—the correction of that warp of metabolism or auto-toxic state of which the arthritic, muscular, or other lesions are but local manifestations.
It goes without saying that, with this for our objective, there is much need for discrimination in the selection of measures suitable for individual cases, and, naturally, the basis of such differential treatment is thorough physical examination prior to embarking on the course. Yet how frequently on their own initiative do these subjects enter lightly upon a series of baths, mingling stimulant and sedative procedures in haphazard fashion, unwitting that hydriatric measures are capable of infinite harm when misapplied.
For in hydro-therapy the personal equation is of prime importance, varying with individual reactive peculiarities. In short, the character of the response differs widely in different subjects, efficiency or not of the nervous and circulatory functions being the chief controlling factors. Hence accurate appraisement of the reactive powers of the constitution to hot and cold applications is the basis of rational hydro-therapy.
Thus nervous irritability is the outstanding characteristic of some gouty constitutions. They are therefore intolerant of extremes of temperature, and for them sedative or sub-thermal baths are the most suitable.
Others suffer from torpid circulation and sluggish vascular response, and in their instance, stimulant measures, hot or cold, in sequence or in alternation, are indicated. Again, some are obese, and others lean, and while of the twain the former react more feebly, on the other hand, they stand prolonged courses of hydro-therapy more satisfactorily. In contrast, the thin, though they react well, are more readily exhausted, and so apt to suffer from “secondary chill” or other untoward consequences.
Prophylactic Measures.—As we have noted, the “gouty,” more than others, are intolerant of atmospheric vicissitudes. Accordingly, if we would strengthen their defensive mechanisms in this respect, we must endeavour to train them to react more adequately to cold or sub-thermal impressions.
Of the value of thermal applications in chronic gout I am convinced, but, on the other hand, we must not blind ourselves to the value—prophylactically speaking—of their judicious conjunction with sub-thermal or cold procedures. For these latter stimulate oxidation processes, and in chronic gout, according to many, there is deficient oxidation of protein waste, while, apart from this, in the gouty obese there is imperfect oxidation of adipose tissue.
Prophylactic measures to be of any real avail must be continuous, and spas or hydropathic establishments should indeed be more alive to their educational responsibilities in this matter, for the benefits of hydro-therapy as regards prophylaxis are within the reach of all possessed of the convenience of a modern bath-room.
They should be taught to inure themselves by taking daily a tepid bath followed by a cold shower or rain spray. If this be too drastic, let them, while standing in warm or tepid water, briskly rub the rest of the body with a coarse towel wrung out of cold water, into which, if liked, salt has been added to the point of saturation. In this way the tonic effects upon the skin of hypo-thermal or cold applications may be invoked, and thereby its undue sensitiveness is reduced and therewith the liability to subsequent attacks.