We shall treat first of the cold-bath, as applied to the whole surface of the body. A healthy person upon entering a cold-bath experiences a sensation of cold, followed by slight shuddering, and if the immersion has been sudden, a peculiar impression on the nervous system, called a shock. The skin becomes cooler and paler, the respiration hurried and irregular, the action of the kidneys increases and the bladder contracts. In a few moments the colour and warmth return to the skin, and a glow is felt, especially if assisted by rubbing the surface. If the person remains more than five or ten minutes in the bath, the glow disappears, and paleness returns, which again gives place, though less quickly and perfectly, to a renewed glow. During the existence of the primary action of the cold, the bulk of the whole body, but especially of the more contractile parts, diminishes. Should the stay in the water be greatly prolonged, no reaction ensues, but a general feeling of chilliness prevails, with quick feeble pulse, convulsive breathing, cramps of the limbs, or fainting. If the person quit the bath after the few first minutes, as in prudence he should, the blood returns to the surface, accompanied with a sensation of pricking, itching, and sometimes throbbing of the arteries: the elasticity of the muscles being increased, more animal power is felt, accompanied with a general feeling of enjoyment. Very young or feeble individuals are either incapable of bearing the shock, or the re-action is so slight that they cannot endure to stay in the bath beyond a very short time. If they unwisely stay or are held in the bath longer than one or two minutes, the heat never regains its proper height, the extremities remain contracted, and they, as well as the lips, nose, &c., are of a livid hue. In such cases, either artificial means must be used to bring about reaction, or the bath must be relinquished, as improper for such persons, as we shall show at a future part of our observations.

The phenomena just described generally accompany cold bathing; and it is clear that we can recognise in them a series of three or even four distinct actions: namely, 1st, the shock; 2nd, the cooling effect; 3rd, the contraction or astringent effect; and 4th, the re-action. Coldbathing may be employed therefore in such a way as to insure the predominance of one action over any of the rest, according to circumstances, where all are not desired. They vary with the degree of cold and the suddenness of the application, as well as from the body being plunged into the water, or the water dashed against the body. Where the shock, as a stimulus to the nervous system, is desired, the water should be very cold, and where practicable should be dashed against the body, or, if the contrary, the stay in the bath should be momentary. This mode of using it may be either general or local. It has been employed generally that is, the whole body exposed to the action of the waterin mania, with occasional success, and in the early stage of the common continued fever (under certain regulations, for which see Currie's 'Medical Reports'), sometimes with great success, cutting short the train of morbid actions which constitute the fever. It has been employed also in nervous affections, accompanied with a convulsive action, or deficient action of the muscular system, as in hysteria, in lock jaw (see Paper by Dr. Wright, London Medical Observations and Inquiries,' vol. vi. p. 143): in some cases of obstinate constipation, dashing cold water on the person, or the cold bath frequently repeated, has been of great service.

Its stimulating effect is sometimes best procured by a local application, in the form of a stream of water falling on the head, from a considerable height. The simplest example of this is the common practice of sprinkling the face with cold water in case of a tendency to faint; and in many diseases of the most dangerous character it is a remedy superior to any other. It is called the cold dash, or douche, or douse, and is beneficially employed in fever, particularly when the brain continues the seat of inordinate action of the blood-vessels, after depletion has been carried as far as prudence will allow. (See the instructive case of Dr. Dill in Dr. Southwood Smith's Treatise on Fever,' p. 398). It requires to be used with the greatest caution. Also in the state of stupor or coma which occurs in the last stage of hydrocephalus acutus, or water in the brain, it often succeeds in rescuing the patient from imminent danger. (See Abercrombie, 'On Diseases of the Brain,' first edit. 1828, p. 157.) Its utility is well known in the East in rousing drunken soldiers from their stupor so effectually as to enable them to rise up and appear immediately on parade. In the melancholy and mania which overtake habitual drunkards it is of great efficacy, and also in cases of loss of nervous power from excessive mental exertion. In apoplectic stupor it has also been very advantageously employed. In the sinking stage of croup, when all other remedies have failed, cold affusion has sometimes restored the functions of life to new action.

The cooling or refrigerating effect of cold bathing is most desired in diseases where the animal heat rises above the proper standard, as in fevers, both continued and eruptive, especially scarlet fever; also in

some local inflammations, particularly of the brain. For the principles which should regulate our practice in this application we must refer to Dr. Currie and other writers, only remarking that, in the hot and rest less stage of scarlet fever, when the heat is steadily above the natural standard, the skin hot and dry, and neither sleep nor perspiration can be procured, a plunge into cold water will be followed by both, to the relief and often recovery of the patient. (See Bateman On Cutaneou Diseases,' edit. 1829, p. 120.) In applying cold locally, as in infan mation of the brain, one rule is of the utmost importance to be observed, namely, that the application of the cold shall be continuous; therefore a second set of cold cloths or bags of ice should be applied before the former has become warm. This plan, especially pursued during the night, along with judicious internal treatment, will save many children from perishing under the most insidious and fata disease of childhood-water in the brain.

The cases already mentioned are mostly acute diseases, where the cold affusion is employed to avert an imminent but temporary dange, It is generally in chronic diseases that the cold bath is employed for a length of time, and in these it is chiefly the secondary effect, the glow or reaction, which is desired. The rules to be observed in order to obtain this effect are founded upon the strength, which is generally inferred from the age, of the individual. The degree of reaction is, for the most part, dependent upon the coldness of the water and the length of time the person remains in the bath. Very cold water, in which the person remains but a short time, will in general produce a greater degree of re-action than a more moderate temperature n which he remains longer. But here everything depends upon the general power of the individual, the state of the system, especially the skin at the moment of immersion, and the nature of the bath according as it is fresh or salt water, and also the season of the year. As the immersion of infants and young children in tubs of water mast be considered as bathing, we deem it necessary here to explain the principles upon which the temperature of the bath for them should be regulated, especially during winter. The experiments of Dr. Edwarda (see Edwards 'On the Influence of Physical Agents on Life,' Londen, 1832) have proved that "the power of producing heat in warm-blooded animals is at its minimum at birth, and increases successively to adult ex." It is clear therefore that water of a higher temperature than what fees cool to the hand of the nurse should be used, particularly in winter, when the power of regaining a proper degree of heat is necessarily less The attempt to harden children by exposure to too great a degree of cold is of the most injurious nature; it either produces acute disease of the lungs, which are then very sensible to external impressions, er disease of the digestive organs, leading to disease of the mesenterie glands, scrofula, water in the brain, or, if they survive a few years, to early consumption. (See an illustrative instance in a young sister of Southey the poet, in vol. i., p. 28, of his Life,' 1st edit., 1849.) Delicate and feeble persons of all ages require a higher temperature of the bath, and a shorter stay in it than others. If the re-action does not speedily take place, means must be employed to ensure its so doing, or the use of the cold bath must be abandoned. A tepid or temperate bath may be used in the early treatment of feeble persons, and the cold bath gradually substituted for it, or a glass of wine, or, what is far preferable, strong coffee or chocolate may be taken before entering the bath. Where the arrangements are such as to admit of it, a brief stay in a warm bath before going into the cold has a good effect. Nor, in general, is danger to be apprehended from such a proceeding. Though in most cases moderate exercise is advantageous before bathing, unless the person has an opportunity of springing out of bed into the bath, still he should never think of undressing and going into the water when fatigued, or when the skin is covered with perspiration. It is a good rule to wet the head before taking the plunge. For a person in good health, early in the morning is the best time to Lathe; for one more delicate, from two to three hours after breakfast is preferable; but no one should bathe immediately after a full meal, particularly if there be a tendency of blood to the head, and a disposition to apoplexy. Epileptics should rarely bathe, least of all in the sea.

Exercise while in the bath, such as friction of the limbs and chest, or swimming, is advisable, but not even this can prevent evil conse quences if the bather remain too long in the water. To say nothing of the risk of cramps and convulsive action of the respiratory muscles, from the blood being pent up in the large internal vessels, which may occur while the person is in the water, the foundation may be laid for future internal disease if the blood do not soon revisit the surface, either from the natural powers of re-action, or from friction with coarse dry cloths. Friction should follow the use of the bath in most instances, except where the bath has been in the sea, in which case the salt particles if allowed to remain in contact with the skin, stimulate it more.

The cases of disease for which cold bathing is a valuable remedy are, morbidly increased irritability and sensibility, accompanied with general debility. If the sensibility be extremely high, it is best to begin with the tepid or cool bath, and pass gradually to the cold. Where there is a tendency to colds and rheumatism, the cold bath is an excellent preventive; for this purpose it should be used continually throughout the year, and the chest should be sponged with cold water, or vinegar and water may be substituted in winter, when there are not facilities for using the complete bath. Before beginning this practice, careful

investigation of the state of the mucous membranes of the chest and intestinal canal should be made, as it will certainly prove hurtful where chronic inflammation of these organs exists. If tubercles are suspected to exist in the lungs, cold bathing should be dispensed with. Though cold bathing is very useful in a tendency to scrofulous diseases, it is very hurtful when these are really developed, though tepid and warm bathing are allowable.

Where the increased irritability shows itself in the mental functions or in the muscular system, as in hypochondriasis or hysteria, cold bathing is very useful; and especially in the hypochondriasis of literary persons, accompanied with a disposition to indigestion, and a dry harsh skin. In actual indigestion, especially if complicated with sub-acute inflammation of the mucous membrane of the stomach or intestines, cold bathing is very injurious.

In cases of torpor and loss of power, cold bathing is of much service; in a relaxed state of the skin, subject to debilitating perspirations, it is often the most effectual remedy; in weakness of the limbs, or of any member, and after sprains or paralysis, the local cold bath is very useful. The astringent as well as tonic effect of the cold bath is employed to prevent the prolapsus or descent of different parts: hence, in a tendency to hernia (or even when it has occurred, ice laid upon the tumour, and frequently renewed, has restored the bowel to its place, or at least warded off the inflammation till other means could be tried); in loss of power of the sphincter muscles, or of the contractile power of the bladder, pumping cold water on the back is very useful; but it should be used only for a minute at a time. In chronic hæmorrhages, cold applied locally or generally has a good effect.

The cold bath, like every other powerful agent, when improperly used, is capable of producing much mischief; in some states of the system it must be carefully avoided. In infancy and very advanced age it is less admissible than at other times, and even quite improper if the debility be great. It is inadmissible during, or immediately before, certain conditions of the female system; also when there is congestion of blood in the veins or internal organs: hence it is not suited to chlorosis. In any organic affection of the heart, or aneurism, it is altogether improper.

Of the cold shower-bath and douche we shall only observe here, that their effects are more speedy, and extend more to the internal organs: consequently they are only to be used for a very short time, whenever recourse is had to them. A glow of the surface is sooner felt after the shower than the common bath; and as soon as this is perceived the person should withdraw himself from the stream. If the douche falls upon the head, it produces almost instantaneous and most powerful effects. If its use be prolonged, it quickly lowers, then destroys the sensibility, induces faintings, and places the patient in the most imminent danger. Medical superintendence is therefore required through every stage of its employment.

When the body is surrounded by media of a temperature in some cases lower, and in some higher than its own, it receives caloric, instead of parting with it. The difference of density and humidity is the cause of its receiving it from some media which are of a lower temperature than its own, as well as from most which are higher. This depends upon the capacity for caloric, and the conducting power of the surrounding medium. Thus, dry air at 70° Fahr. will impart heat to the body, while water at 92° will abstract it, though water at 96° may impart heat. The tepid bath, therefore, being so close upon the limit of abstracting or imparting heat, cannot exercise a very powerful effect upon the function of the development of animal heat; neither does it much affect the circulation, which it rather retards than quickens; but its influence is mostly confined to the skin, which it cleanses, softens, and renders more fit to execute its duties. The cases in which the tepid bath is to be preferred to that of a different temperature, are those of a febrile character joined to an irritability of the skin, which is generally dry and harsh; some cutaneous diseases, where, by friction, the scales are removed and a new surface presented; and, lastly, as preparatory to the cold bath in delicate persons, or for those whose peculiarities of system render them unable to bear a warm bath of a high temperature. It is of much use in the form of tepid sponging of the surface in the advanced stage of fevers, and in convalescence from acute diseases. In this case vinegar is often added to the water with increased good effect. The natural tepid waters of Buxton furnish a most valuable bath for persons suffering from gout or rheumatism.

fuller and slower, and the greatest quantity of the blood lodges in the veins, particularly in the great venous centres, such as the vena porta and the liver, which it stimulates to increased secretion of bile. Corresponding changes occur in all the other organs; and if the application of the warmth be continued for a longer time, the increased energy and elasticity of the muscles disappear, and a sense of fatigue, with atony, and a tendency to sleep, succeeds. The final result of the action and re-action is an augmented secretion from the skin, and a corresponding diminution of urine, and of the secretion from the mucous surfaces.

The primary effect of the application to the surface of the body of water of a temperature varying from 93° to 98°, is, in consequence of the communication of warmth, the same as that of dry heat, namely, a stimulating, enlivening, and expanding effect. Hence there is a quickening of the circulation and respiration, as well as the direction of a greater quantity of fluid to the surface, manifested by the swelling and redness of the part. There results also a freer and more lively action of the muscular system, and increased sensibility and activity of the nervous system. Diminished exhalation from the skin takes place, while a greatly increased absorption occurs: the exhalation from the lungs, however, is increased. An increased quantity of heat is thus introduced into the system, felt first in the superficial, but afterwards in the most internal parts of the body.

The warm bath may be employed to effect two opposite ends, to stimulate or calm and soothe. It accomplishes the first when its temperature is high (98°), and its use is confined to five or ten minutes; the second when it is about 93°, and continued for three-quarters of an hour, or an hour. Employed in this last way, Marcard found that it always diminished the velocity of the circulation, and that the longer the bath was continued the slower the pulse became; also, that the more the pulse deviated from a state of health, the more it is diminished by the warm bath. The bath may even be prolonged till it induce fainting and other consequences of a depressed circulation. Short of actual fainting it may be beneficially employed to produce great relaxation of the muscular system, so as to enable dislocations or hernias to be more easily reduced. The state of relaxation bordering upon fainting is very favourable to the process of absorption; it may," therefore, be advantageously employed in dropsy arising from weakness of the absorbents. As the warm bath has generally the effect of equalising the circulation, and relieving internal congestion, it is much resorted to as a remedy in spasmodic and convulsive diseases; but here the utmost caution and discrimination are necessary. If the spasmodic actions result from an inflammatory state of any of the nervous centres, more harm than good will be done by a bath. The inflammatory condition must first be removed or greatly lessened by bleeding, purgatives, and other appropriate means, before the bath can be safely used. These cautions do not so strictly apply to the convulsive excitement which often precedes the eruption of small-pox, or even measles, which is often greatly relieved by the warm bath, which may also be repeated during the early stages of the eruption. (See Marcard, 'Uber die Bäder,' Hanover, 1793; or Duncan's Med. Comm.' 2nd Decade, part x. p. 153.) The convulsions of infants during teething are almost invariably attempted to be removed by the warm bath, but in many instances more harm than good is done. The condition of the brain must be carefully inquired into by the medical attendant, and the state of the gums investigated, before this measure should be had recourse to. If there be congestion of blood in the brain, this must be removed before any good can result from a bath, and after its removal the convulsive actions will generally subside. The same good effect will follow free scarification of the gums, if a tooth be preparing to protrude. [ANTISPASMODICS.] Even when the bath is properly applied, the good which might be derived from it is often frustrated by inattention or ignorance. The bath is prepared at random, and the temperature is never sufficiently regarded. If above 96°, it cannot fail to be injurious.

During the existence of all active inflammation, at whatever age, the warm bath may be pronounced an unfit measure; and even after the acuteness may have been reduced by active antiphlogistic means, the warm bath is a doubtful remedy, if we except a very few cases. Of these, inflammation of the peritoneum is the best marked exception; but even here the bath is a very secondary means towards lowering the action of the system, though it may assist the flow of blood from leechbites, and may be continued till a tendency to faint show itself.

In acute rheumatism, after venesection, the warm bath may perhaps be employed, if we can ensure its being followed by copious perspiration. For this purpose the patient should have the bath close to his bed, remain in it for half or three-quarters of an hour, be well rubbed with warm flannel cloths, replaced in bed between warm blankets, take diaphoretic medicines, and drink bland warm fluids, such as gruel or weak tea, and maintain the perspiration for twenty-four or forty-eight hours.

In a disposition to gout or rheumatism the warm bath is more proper than when a paroxysm of these diseases occurs. In such cases the natural warm baths are preferable: those of the Queen's Bath, or Cross Bath, at Bath, the temperature of which is from 94° to 96°, are well calculated for such cases.

In few chronic inflammatory diseases are warm baths allowable, if we except some of those of the digestive organs, especially sub-acute inflammation of the mucous membrane of the stomach and intestines. Indigestion is often the most common symptom accompanying this state, and it is almost always benefited by a course of warm or tepid bathing.

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cannot be found. In cases of nervous exhaustion from intense literary employment, or official or parliamentary duties, the warm bath is of great service, more particularly when, in addition to the warm bath, the cold douche is employed, directed upon the head for a few seconds, while the patient is in the bath. In the milder cases of mania it has been found of great use.

In cases of contractions of the joints from rheumatic or gouty inflammation, the warm bath, or, what is better, the local vapour bath, is of service in restoring the flexibility of the limb.

But

It may be briefly stated that the warm bath is much more serviceable when there is a tendency to disease, constitutional or accidental, or in convalescence, than in any other circumstances. It is therefore rather to be considered as a preventive than remedial measure. its value in this point of view is very great; and it is to be regretted that it is not sufficiently appreciated and used. It is exceedingly beneficial as a means of allaying the irritation of the vascular system, which occurs in young persons disposed to consumption, when the disease is beginning slowly to impair the integrity and healthfulness of the lungs or other important organs. To prevent the development of the morbid deposit in the lungs is of infinite importance; and this will be best accomplished by keeping up a more vigorous action of the skin. The bath must be persevered in for a length of time. Proper bathingrooms should exist in every well-constructed house; but as this is rarely the case in this country, a good substitute may be obtained by using some of the recently-invented bathing-machines, which combine facilities for using the different kinds of bath in the same apparatus. The best which we have seen is that made by Read, Regent Circus, which possesses an apparatus for applying the douche while in the warm bath, and may be used as a cold, a shower, a warm, a douche, or a vapourbath. Baths should be attached to all large manufactories, as a refreshment for the workmen, to ensure cleanliness, and as a means of warding off many diseases: in lead-works, painters' and plumbers' establishments, they would protect the men from painters' colic; and in other establishments, they would preserve the workmen from many cutaneous diseases. "A multitude of chronic inflammations of the skin are produced by uncleanliness, or other agents, which directly irritate the skin; and it is to the want of cleanliness in the inferior classes that Willan attributes the frequency of cutaneous diseases in London. In France, advantages are placed within the reach of the poor, to which the rich alone aspire in other countries. The number of gratuitous baths which are given at the hospitals of St. Louis and La Charité is truly prodigious: in 1822 it amounted to 127,752 for the out-patients only of the hospital of St. Louis." (Rayer, 'On Diseases of the Skin.') Why some portion of the funds of hospitals and dispensaries in London and other large towns should not be applied in a similar way, we can see no good objection: there is as much philanthropy and benevolence in preventing disease as in curing it. The establishment of public baths in London and other large towns has proved of incalculable benefit. Where washhouses are attached to them, the advantage has been still greater.

neous diseases, in which great thickening or torpor of the skin exists, are benefited by the hot-bath.

Vapour-baths are either natural or artificial. Several natural vapourbaths exist in the Neapolitan States, in Switzerland (Pfeffers in the country of the Grisons), and in Ischia. The artificial vapour-baths are much in use in the East and in Russia, where they are public, or intended for several persons to use at the same time; and occasionally in Britain, where they are always solitary or for a single individual. The Russian baths are described in Lyall's Character of the Russians,' pp. 112-115. The bathing-room contains tiers of benches, like an amphitheatre, the seats nearest the bottom being the coolest, those higher up hotter. The temperature varies from 112° to 224°. Persons commencing the use of such baths occupy the lower seats, and ascend as they become accustomed to them. While exposed to the vapour, the body is washed or rubbed with soap or bran, and beaten with fresh birch-twigs. The head is surrounded with a cold cloth, or cold water is dashed over the head. When the person does not wish to breathe the heated vapour, a sponge which has been dipped in cold water is held to the mouth and nose. On first employing the vapourbath, the person usually remains about fifteen minutes, but afterwards three-quarters of an hour, and at Pfeffers, the temperature of which is only 100°, sometimes four, eight, ten, or sixteen hours. After coming out of the bath, the bather goes into a room heated with dry air, where he is rubbed, puts on a flannel dress, and then reposes upon a couch for some time, where he may drink warm drinks to promote the perspiration.

"As soon," says Dr. E. D. Clarke, "as the inhabitants of these northern nations have endured the high temperature of their vapourbaths, which is so great that Englishmen would not conceive it possible to exist an instant in them, they stand naked, covered with profuse perspiration, cooling themselves in the open air. In summer they plunge into cold water, and in winter they roll about in the snow, without sustaining injury, or even catching cold. When the Russians leave a bath of this kind, they moreover drink copious draughts of mead, as cold as it can be procured." (Travels in Russia,' part. i. p. 143). The absence of all risk in exposing the person to such extremes of temperature is explained by the experiments of Dr. Edwards, who found that "after an exposure to cold, sufficient to diminish the power of producing heat, continuance in a high temperature tends to the recovery of this power; for in exposing animals to successive applications of cold, their temperature will fall the more slowly the longer they shall have been subjected to the influence of warmth. It follows, therefore, that the effect of the application of a certain degree of heat is continued after the cessation of the cause. Hence, we see that those who are liable to frequent exposure to severe cold are rendered more capable of supporting it, by subjecting themselves in the intervals to a high temperature, a practice adopted by northern nations, and justified by facts." (Edwards on the Influence of Physical Agents on Life,' p. 125.)

The vapour-bath is distinguished from all other means of intro

Water of a temperature from 99° to the highest which can be endured, is termed the hot-bath. When a person in health enters such a bath, it greatly excites the nervous system, and, through that, the heart and arteries; causes heat and constriction of the skin, with disturbance of the internal organs generally, but especially those of secretion. This state of uneasiness is lessened by the breaking out of perspiration, which is succeeded by great languor, torpor, and disposition to sleep. In such a bath little absorption takes place through the skin, and the body is found to have lost weight. The hot-bath is a powerful stimulant, and can never be used by persons in a state of health. The same cautions which were stated under the head of the warm-bath apply to it in a greater degree. The few cases to which it is suited are chronic affections of the nervous system, such as paralysis, when all vascular fulness of the brain or spinal cord has been removed. The waters of the King's Bath at Bath, and some of the hot-baths on the continent, are very beneficially employed in such cases; but careful discrimination must be made to suit the temperature to the degree of sensibility remaining in the paralysed part. Where the power of motion is lost, the sensation is sometimes increased: here the hotbath would be very hurtful. On the other hand, the sensation may be lost, while the power of motion remains: here equal care must be observed not to use too high a temperature. Erythema, erysipelas, mortification, or death may follow the use of too high a temperature or a stay too prolonged even in a proper temperature.

Sudden retrocession or repulsion of some cutaneous or eruptive diseases is relieved by the use of a hot-bath for a few minutes, the cruption often coming out favourably after it. Some chronic cuta

a portion of the vapour is converted into water, by coming in contact with the surface of the body, it communicates a quantity of sensible caloric to it. It is without doubt the most powerful means of supplying a great heat to the greatest portion of the surface of the body, internal as well as external; for when breathed, the extensive surface forming the interior of the lungs is influenced by it in the same way as the skin. On the skin it exerts a peculiar influence. It does not cause that constriction of the skin, which follows the application of dry air, nor does it exert that pressure upon the surface, which, in the case of warm water, retards the breaking out of the perspiration. On the contrary, moisture of the skin, followed by profuse perspiration, occurs immediately upon entering the vapour-bath.

In Russia, where such baths are used on a large scale, their employment is not found to be productive of weakness. The subsequent exposure to cold restores the tone of the skin which had been lost, and the process leaves the person with a general sense of good health, strength and power, both of the internal organs and of the skin. "These practices," says Dr. Clarke, seem to delight them, and to add strength to their constitution."

The vapour-bath, by attracting the blood more speedily to the surface, and by being followed by more profuse perspiration, is more powerful than the warm water-bath. It is employed as a remedy in gout and rheumatism, and in the numerous consequences of these when they have assumed the chronic form. Many cases of rheumatic and gouty contraction of the joints have been removed by persevering in the use of vapour-baths, as employed by the continental nations. In scrofulous diseases, especially when they affect the skin and the glands, benefit is derived from the vapour-bath, unless there be a manifest tendency to active inflammation, and great irritability of the nervous system. In some chronic affections of the nervous system, especially when connected with the repulsion or imperfect development of cutaneous diseases, the vapour-bath is of great use; and also in some affections of the respiratory organs, such as dry catarrh, asthma, spasms of the muscles of respiration, if these are not complicated with inflammation or organic disease of the lungs or heart.

The use of the vapour-bath would be found to ward off many acute diseases resulting from exposure to coid, if had recourse to immediately

after exposure to the exciting cause; as after travelling, or falling into the water in winter.

The local application of warm vapour is very serviceable in many recent diseases. Catarrhs, sore throats of an inflammatory kind, inflammations of the eyes and ears, are greatly alleviated by such means. But when the lungs are inflamed, though Mudge's or other inhaler is much recommended, yet the effort required to draw in the vapour is injurious. The head, from which a flannel cloth may fall down in such a way as to hinder the vapour from escaping, should be held over a bason full of warm water, and the vapour inhaled in the ordinary mode of respiration. The vapour-bath is very improper for plethoric persons, those predisposed to congestion, or to apoplexy, and also for individuals in a state of great debility.

The employment of heated air, as an application to the body, causes the primary action of heat to manifest itself more than the secondary. The hot-air bath is therefore powerfully stimulant to the skin and nervous system, and is of great service in all cases where the production of animal heat is less than natural, as in the cold stage of fevers, and exhaustion of the nervous power. It has been employed beneficially in congestive fever, and after great and continual mental exertion. It proved less useful in the Asiatic cholera than was anticipated. A convenient apparatus for applying it was invented by the late Dr. Gower, called a Sudatorium.

Medicated baths rarely possess greater power than that possessed by the water alone; but there are a few exceptions. The admixture of common salt makes the water more stimulating and tonic. Sulphurous vapour-baths fall under the head of medicated baths, and a few remarks may be here made respecting them. Nightmen, and other individuals who live much in an atmosphere charged with sulphurous exhalations, are rarely affected with chronic diseases of the skin, while other trades seem to predispose to their development, such as the baker's itch and grocer's itch. It is chiefly for the cure of

cutaneous diseases that the sulphurous vapour-baths are employed. In many of these they are very useful, especially those belonging to the genus scabies and genus impetigo of Bateman. A caution is requisite for their safe employment, that the vapour should not be applied to more than a fourth part of the body at one time, lest the disease should be suddenly cured, and the internal organs suffer by the repulsion. The person who uses the sulphurous vapour-bath must be careful not to breathe any of the vapour. This kind of bath has been used in rheumatic affections, some diseases of the stomach, and in chronic paralysis. It may sometimes be a useful addition to internal treatment, but alone can be of little avail, till the state of the internal organs be improved, especially the liver, the action of which is almost always faulty in gout and rheumatism.

The nitro-muriatic bath of Scott is of use in chronic inflammation of the liver, such as occurs in warm climates. The iron-baths in Nassau and the Hartz are more tonic than the simple cold-bath, but none of the iron can be absorbed at the low temperature of these baths; it is only, therefore, by their direct action upon the skin, and the sympathies of this with the internal organs, that they are more beneficial. We have no knowledge of the effects of the mineralised mud baths, called by the Italians Lutatura. (See Gairdner On Mineral Springs,' p. 404.)

Though unacquainted with the results of employing hot sand or ashes, as done by the Turks, we can conceive them useful in allaying cramps and neuralgic pains, as heat generally does in whatever way applied. A collection of the opinions of ancient writers on the subject was published in the sixteenth century. (De balneis omnia quæ extant apud Græcos, Latinos, et Arabes,' fol. Venet. apud Junt. 1553.) The best modern treatise is that of Marcard, in German, an abstract of which may be found in Dr. Beddoes's Treatise on Consumption.' A French translation of it was published in 1802. The natural baths will be treated of under the article WATERS, MINERAL.