9. Rather cut short, than prolong, the bathe. Swimmers possess the power of remaining in the water for a considerable time, in consequence of their active movements. But even in their case injury is often wrought by unduly extending the exercise. The slightest feeling of chilliness should be taken as a sign to leave the water at once.
It is a recognised fact that a sudden head douche of cold water is apt to cause giddiness in many persons from its effect on the brain-circulation, which forms in itself a peculiar part of the blood-system. Cases of persistent headache, often accompanied by giddiness and faintness, have followed sea and river bathing; these effects having disappeared when the practice of plunging the head below water was discontinued. Persons thus affected cannot do better than omit the head from the bath, and, in shower baths, stoop forward or lean backward and sidewise, so that the water shall fall on back, chest, and shoulders, but not on the head.
Hot Baths.—Concerning the bathroom, Edis remarks that whenever a bath is provided, it is generally left open, and forms a receptacle for dirt and dust, which is not always cleaned out when the bath is filled. He suggests that the bath be slightly lowered into the floor, and fitted with a hinged top, about seat-high from the floor, so as to keep the bath clear of dirt, and when not in use make it answer as a table or seat. A bathroom is often fitted up with cupboards for linen, and if the hot-water cistern be placed in the room on the floor level, or sufficiently high for use, or a coil of hot-water pipes be carried through, the linen cupboard with lattice shelves might easily be fitted over it, with closed doors of course, by which the linen would always be kept properly aired; and if the room be lined with tiles, there would be no fear of damp or moisture from steam condensing on the walls. The bath should be formed in a recess, with tile lining all round and overhead, and the recess might then be fitted with cupboards over, and drawers and useful shelves at one end, so as to provide storage-room for a large amount of spare clothing and linen, which it is often so difficult to find room for. A curtain drawn across the bath keeps it clean, and hides it from view when not immediately required.
Hot-air and Vapour Baths, Turkish Baths, &c.—The Lancet expresses a strong objection to that form of bath which involves the patient being in an erect or sitting posture, where the bath is used to produce perspiration; it is always possible that some amount of faintness or giddiness may be experienced by the bather even when the blanket or tent-shaped envelope is so effectively applied as to prevent the fumes rising to the mouth and being inspired. It is always far better, and ought to be a rule, that the patient should be in the recumbent position. With a properly constructed cradle-head, the bed-clothes can be raised and the lamp placed safely in the bed itself, the clothes being well tucked in round the neck and under the chin, so that nothing may reach the mouth. In this way the patient may enjoy the full benefit of a fairly high temperature without the least fear of faintness. There are, nevertheless, certain precautions which ought to be observed, and which are too commonly overlooked. (a) A thermometer with a long stem ought to be so placed that the bulb may be inside the clothes and the indicator-column visible outside. Such a thermometer might with advantage be supplied with the bath. It is always desirable to know the temperature of the atmosphere to which the patient is subjected. (b) The moment perspiration is induced there arises the question—How far ought it to be carried? If the purpose of the bath be to eliminate fluid or any product of tissue-waste from the body, there may be a need for the maintenance of the cutaneous perspiration for some time: but otherwise it is not, generally speaking, well to let the patient remain in the heat for more than 10 minutes; otherwise, the result can only be to saturate the bed-clothes with moisture, which will begin to cool as soon as the lamp is removed, and after the lapse of 20-30 minutes must place the patient in the perilous position of lying, perhaps sleeping, in a damp bed. A hot-air bath for ordinary purposes is better given in the morning than at night; or, if that be impossible, the patient should be removed to a dry bed with hot blankets. The body-heat can never be safely trusted to keep the clothes, which have been saturated with moisture by a bath, warm after the lamp is withdrawn. It is quite a different matter when the perspiration has been raised by the heat of the body itself. As a rule, the patient should be removed and wiped dry in about 20 minutes after the withdrawal of the lamp—that is, in ½ hour from the commencement of the bath. If the perspiration be acid, it is desirable to sponge the surface with hot water, in which about 1 dessertspoonful soda carbonate has been dissolved—say, in 1 qt. water. (c) If the case be one of rheumatism or gout, it must be recognised that by determining to the skin we are likely to get increased stiffness and surface irritation after each bath until the excrementitious material has been thoroughly eliminated. Overlooking this fact, patients, and sometimes practitioners, fail to persevere long enough with the baths, because, as it seems, each bath makes matters worse.
A simple form of hot-air or steam-bath for home use may be made as follows:—To the back of an ordinary wooden or cane-bottom chair fix an upright piece of wood, and to this at the height at which the neck of the sitter on the chair will be fix a hoop of cane or other material sufficiently wide to keep the cloth to hang from the hoop free from the shoulders of the sitter. Place beneath the chair a gas or oil lamp or two, if one does not give sufficient heat. If, now, a cloth be fixed round the ring sufficiently ample to reach the ground and close all round the sitter, a tent will be formed from the top of which the head of the sitter will project. Let the cloth overlap the ring freely, so as to permit of being pulled close to the sitter’s neck. Whilst taking this hot-air bath, the feet must be kept in a basin of warm water. If there is danger of a headache, a cold wet cloth on the head will prevent it. If a vapour bath is preferred, place a pan of water over the lamp, so that the water may boil.
127. Ellis’s Bath.
Ellis & Co., of 47 Farringdon Road, London, have introduced a Cabinet Turkish Bath, which dispenses with chair, lamp, sheets, and covers. It is exceedingly simple, and consists of a neat cabinet (Fig. 127) made of well-seasoned wood, taking up a floor space of only 2 ft. 5 in. by 2 ft. 8 in., and large enough to admit the person comfortably. It is mounted upon castors, so that it may easily be moved from place to place on the same floor; and it is light enough to be carried if required. It is fitted with a foot-warmer, and with an adjustable seat, so that it can be used by children and by adults of different sizes. A book-rest is arranged conveniently, so that the time may be pleasantly occupied, and small doors are provided through which the hands may be passed in order to turn over the leaves of a book, or to wipe the face, or to remove a cigar from the mouth, &c. The bath is heated by gas, or by a special lamp in which spirit is burned. It may be managed with the greatest ease without the aid of an attendant, being, in fact, quite as simple as an ordinary sponge or sitz bath. It is only necessary to fill the foot-warmer with hot water, covering it with a piece of flannel, to light the lamp, and step into the bath with a towel round the neck to prevent the heat escaping too readily. Ample ventilation is allowed, so that the body is not exposed to the action of vitiated air, since this is constantly being renewed from outside. The bath constitutes, in fact, a small ventilated hot chamber, the time spent in which may vary from 10 minutes to ½ hour, according to pleasure. The prices of this bath range from 5l. 10s., as made in best pine, to 9l., in black walnut.
Management of Hot-water System.
Before entering into the details of the management of a hot-water system destined to supply baths, &c., it will be desirable to acquaint the reader with the general plan and principle of an apparatus, and to explain the cause of circulation, &c., as this will convey some idea of the subject to be treated, for although many possess an apparatus fitted in their residences, yet much practical information cannot be gained from it, as a major portion of the work is hidden from view.