In addition to the historical, economical, and physical details respecting the practice of Bathing, which have been inserted in the body of the Encyclopedia, we find many investigations in the works of some of the latest authors, relating to its medical and physiological effects, which require to be attentively considered.

A methodical arrangement of these effects, referred to the respective divisions of therapeutic agencies, would be of great use in enabling us to attain a distinct idea of their nature; but such an arrangement is, in fact, a matter of extreme difficulty, for two reasons; first, Because the temperature, the continuance, and the impregnation of the bath, are capable of being so varied, as materially to vary the nature of the remedy, without any distinct limit between its different forms; and, secondly, Because the classes of medical agents, to which several of these effects belong, are by no means distinctly defined; to say nothing of the additional complexity arising from the division of the effects into immediate and remote, which is often extremely important. The remote effects, however, being of a more general nature, and relating chiefly to the improvement or deterioration of the actions of the whole system, it is only the immediate effects that require to be accurately analyzed and distinguished; and these we must endeavour to reduce to some methodical classification of therapeutic powers.

Baths, as depending on water, have been naturally referred to the class of diluent remedies, in which water is comprehended; and they have sometimes even been recommended as nutrients; they may also act as excitants of cutaneous sensation; as stimulants, or rather calefacients, increasing the velocity of the circulation of the blood; as sudorifics; as diuretics; as "sorbentia" or sorbefacients; as refrigerants or astringents; as tonics; and as retardants of the pulse, a capacity in which some would call them relaxants; while they seem in many cases to be useful as antispasmodics, or to relieve certain nervous affections, by something like a narcotic or sedative power. We might also refer the mechanical effect of ablation, in removing the natural secretions of the skin, to the dietetic habits conducive to the preservation of health; but this process, though highly necessary for our comfort, is perhaps less essentially important to health, than has often been imagined; and, in some particular cases, the practice of the very frequent removal of the unctuous and volatile secretions of the skin has even appeared to be injuri- Bathing.

ous, and to occasion indolent tumours of the absorbent glands belonging to the parts concerned.

If we admit that baths are ever, strictly speaking, either diluent or nutrient, we must suppose the cutaneous absorbents to be the channels of these actions; and the majority of authors, both ancient and modern, have certainly considered the skin as imbibing, with great facility, not only water, but also any kind of substance capable of being dissolved in it; nor is there any doubt that, under some circumstances, the cutaneous absorbents have been found to possess such a power in a certain degree; but Mr Séguin and Dr Currie have shown that, in common cases, very little or no effect is to be expected from this absorption;* that the strongest medical agents, when dissolved in the water of a bath, exhibited no operation on the system while the skin was entire; and that no perceptible advantage was obtained from a continued immersion in a bath of nutritive fluids, notwithstanding the extreme exhaustion of the system, in a case of completely obstructed deglutition; and they suppose that where weight has been gained during immersion in a bath, the absorption occasioning its increase has been principally performed by the lungs, retaining the moisture, which they receive in abundance with the air inhaled.

The other immediate effects of bathing must depend on the contact of the fluid with the skin, either as simply moistening and softening the cuticle, or as exciting a peculiar sensation in the cutaneous nerves, whether of touch only, or of heat or cold, or, in some cases, of slight pain, where the skin has been previously in a state of irritation, especially if the water contains a saline impregnation; or, lastly, as altering the state of the circulation by any of these means, especially by the change of temperature; this effect being also often modified by the change of the position of the body, and by the distribution of the pressure or resistance which supports its weight throughout almost the whole surface, instead of its being confined, as usual, to the parts on which we sit or stand. The excitement of the nerves of the skin appears to be salutary in many cutaneous diseases, which are benefited by warm bathing, whether in fresh or in salt water, or in sulphureous or other mineral waters, as at Harrogate, and at Baden, and Pfeffer and Leuck in Switzerland; the bathers sometimes remaining whole days in the water for weeks together, until a peculiar efflorescence has appeared on the skin, and has again disappeared.+ The nud baths in the north of Italy are of a nature somewhat similar, and are said to be of considerable advantage in some paralytic cases. But if we allow the truth of the opinion of Séguin and Currie, we must infer that there are few instances in which the effects of bathing on the system in general can depend much on the impregnation of the water; and we ought perhaps to attribute the acknowledged advantage of sea bathing in a variety of diseases, in great measure, to the mildness and equability of the temperature of the sea. It is true, that persons accidentally wetted with salt water are but little liable to take cold; and this fact has been supposed to indicate some stimulant property in the contents of the fluid; but it may be explained, with greater simplicity, from the slower evaporation of salt water, which causes it to carry off heat much less rapidly than fresh, the cooling process being also retarded by the greater moisture of the sea air.

In order to determine how far any kind of bathing may properly be called a stimulant or calefacient, we must consider what are the tests by which we judge of the increased rapidity of the circulation of the blood. The term calefacient is, indeed, somewhat objectionable, as implying, that animal heat depends solely or principally on the motion of the blood, which is not, in the present state of our knowledge, the most probable opinion; and besides this etymological inaccuracy, the definition of the term, as implying an accelerated circulation, involves a considerable difficulty, since we have no means of ascertaining whether increased frequency of pulsation compensates, or not, in any particular instance, for diminished fulness and strength. On the other hand, the operation of almost all medical agents is such as to relieve us from this ambiguity in the application of the definition; for we can scarcely mention any remedy which materially accelerates the pulse, without, at the same time, increasing its strength. There are, indeed, many medicines which are often designated by the vague denomination of stimulants, and which have no effect whatever on the circulation, but either simply awaken the nervous energies in general, or excite local sensations of heat or pain, and this multiplicity of significations is a sufficient reason for rejecting the term from a correct classification. It happens, however, not unfrequently, that astringent and febrifuge medicines will reduce the frequency of the pulse, and increase its fulness; and it becomes necessary, for an accurate analysis of the operation of remedies which affect the circulation, to distinguish the accelerants of the pulse from the augmentatives and the intensives, all of which may possibly be independent of the production of an increase of temperature; and this increase may also in some cases be produced, at least in the extremities and the superficial parts, and apparently also in the whole system, without any change in the circulation, by the operation of certain remedies, which might be called thalpatics, if it were necessary to distinguish them as independent agents: and to these four classes we might add four others of an exactly opposite nature, which might be called retardants, diminutives, and remissives of the pulse, and psycitics, or direct refrigerants; and the last four classes would belong to a general division of remedies comprehending those which lessen the force of animal actions; a division which it has not commonly been found necessary to establish, for any practical classification of the materia medica.

Now, it appears that a hot bath, of a temperature exceeding 98°, the usual heat of the human body,

* Currie's Medical Reports on the Effects of Water, 8vo. Liverpool, 1798, p. 244. † Marcard über die bädern, 8. Hanov. 1793. Traduit par Parant, 8. Par. 1801, p. 40, 41. will commonly act both as an accelerant and an augmentative of the pulse, but probably not as an intensitive; it may, however, very properly be classed as a calefacient, if such a description of remedies be admitted. Dr Parr* says, that a bath of 100° rendered the pulse fuller and more frequent; but that, after the bath, it was slower than usual; at higher temperatures, the effects were still more marked; and in Marcard's experiments (p. 71) the results were nearly similar. Dr Haygarth observed (Marcard, p. 67), that in a bath of 114° the pulse was rendered more frequent, and the arteries were evidently dilated. In Finland, according to Martin (Marcard, p. 223), the vapour baths are usually heated to about 120°, and they often increase the frequency of the pulse from 70 in a minute to 110 or 120. Fourcroy mentions a bath of 66° degrees, which must have been of the centigrade scale, making 151° of Fahrenheit, and not 181°, as Marcard supposes (p. 216), which was followed, an hour afterwards, by a fatal apoplecty. Whatever exaggeration there may be in this report, it may still serve to explain to us the excesses which were frequently committed in the use of baths by the Greeks and Romans, and the pernicious effects attributed to them by the ancient physicians. Hippocrates observes (Aph. v. 16), that the too frequent employment of hot bathing causes a softness and debility of the muscles, a want of firmness of the nerves, and a dulness of the faculties, with occasional hemorrhages and faintings, sometimes even terminating in death; and in the Clouds of Aristophanes, we have a mock defence of warm bathing deduced from the usual dedication of hot springs to Hercules, which implies a perfect confidence in the opinion of the pernicious tendency of the practice, accompanied, or followed, as it frequently was, by other indulgences, to which it has too often given occasion. This traditional condemnation of hot bathing has been erroneously transferred by some of the moderns to warm or tepid bathing; and since it has been asserted by authors of high celebrity, that air above 60° will generally occasion a sensation of warmth, it seems to have been inferred that water above 60° must constitute a warm bath, and consequently produce enervating and debilitating effects. The fact is, however, that a bath below 100° is scarcely ever heating in any material degree; and even at 100°, the pulse, though somewhat accelerated, is often not at all augmented in fulness, nor are the subsequent effects materially different from those which usually result from an equal acceleration produced by any kind of moderate exercise. It is observed by Galen in his Treatise on the Pulse (Opp. Vol. III. p. 3. Ed. Bas.), that "baths, when moderately warm, cause the pulse to be full, and strong, and frequent; when excessively hot, small and obscure, but frequent and hard, sometimes, however, after a time, becoming slow, though still feeble." Of this retardation of the pulse in a very hot bath we have no experience in modern times; it is obvious, that what Galen calls moderately warm, we should at present term a hot bath; and probably his excessively hot baths somewhat resembled that which is mentioned by Fourcroy. "Cold baths," he says, "at first make the pulse slow and weak; afterwards, if they disagree, and produce torpor, the pulse remains weak; but if the bath is likely to strengthen the system, producing a salutary glow, then the pulse becomes full and strong, and natural in point of frequency."

It is, however, remarkable, that the cold bath not uncommonly renders the pulse very considerably more frequent at the first immersion; a circumstance which was particularly observed by Athill,+ and which, notwithstanding Marcard's doubts, has been since fully confirmed by Dr Stock.‡ This increase of frequency seems principally to depend on the painful sensation of cold occasioned by the first immersion, especially while it is incomplete; it is commonly very transitory, and is succeeded by a retardation, while the fulness of the pulsations is diminished from the first.

The sudorific effect of the hot bath seems to be, in great measure, the natural consequence of the acceleration of the circulation, and to be nearly proportional to this acceleration, being also favoured by the softening of the cuticle, and perhaps by the dilatation of the cutaneous exhalants. It is principally recommended in rheumatism, and it is also considered as conducive to the cure of some cutaneous affections; and when this effect is thought particularly desirable, it is usual to take the bath late in the evening, and to promote its operation by going into a warm bed immediately after it.

In considering these and other changes produced in the system by bathing, we must be careful to avoid the very common error of applying inaccurately and indiscriminately the laws of mechanical and physical agents to the effects produced in the animal economy. Some of the latest and best authors on therapeutics have talked of the expansion of the fluids contained in the vessels, in consequence of the elevation of temperature occasioned by the warm bath, and of the contraction of the vessels themselves by the cold bath, as if they were phenomena of the same kind, and simply opposed to each other. The truth is, that the mean temperature of all the fluids in the body is seldom elevated more than a degree or two by the effect of a bath of any kind; and even if the elevation were ten degrees, the expansion of all the circulating fluids would not exceed the bulk of a single additional ounce of blood or of water. The mechanical effect of cold, on the other hand, would immediately tend to lessen the tension of the vessels, by contracting the fluid contained within them more than the vessels themselves; but this effect would be scarcely more sensible than the former, even if we allowed that the general temperature might be depressed 10° or 12°, as it seemed to be in some of Dr Currie's experiments; and the actual contraction,

* De Balneo, Med. Comm. Ed. i. 297, or Marcard by Parant, p. 66. + On Cold Bathing, Marcard, p. 239; Med. Comm. Edinb. vi. 62. ‡ Medical Collections on the Effects of Cold, 8vo, Lond, 1805, App. Bathing, which is really observable in the superficial parts during immersion in the cold bath, can only be referable to the action of living powers, which fall decidedly under the description of involuntary muscularity. Dr Parry's late experiments have very clearly shown the existence of such powers, and exhibited their temporary and local action.* He found that, when the carotid of a ewe was laid bare, its circumference was .525 thousandths of an inch; "but it almost immediately shrunk, through the whole space which was exposed, so as to become in circumference only .470; at the same time, a portion of the artery, before the contracted part, and which had been more recently exposed, was .635; the pulse in the dilated part was very strong and full, that in the contracted part very weak and soft." Dr Parry has chosen to distinguish these effects from those which are observed in other muscular parts by a peculiar denomination; but the distinction appears to be perfectly arbitrary, and Dr Young, whom he quotes as denying the muscular powers of the arteries, on account of the chemical nature of their coats, has expressly asserted their muscularity, in contradiction to the conclusions of Bichat and Berzelius. (Medical Literature, 8vo, Lond. 1813, p. 502.) But by whatever term we choose to denote the effect, there is little doubt that an unusual degree of cold has a tendency to produce such a general contraction of the coats of all the superficial capillary arteries; and the diminution of their diameter must necessarily increase that part of the resistance to the blood's motion, which is derived from its friction against the sides of the vessels, and must, therefore, tend materially to lessen its velocity. Again, if the contractions of the heart are at all proportional in magnitude or in frequency to the quantity of blood entering it, and acting as a stimulus to its motions, it is not unnatural to suppose that its pulsations will be rendered feebler by the diminution of that quantity, occasioned by the increase of the resistance, and that the primitive retardation will be redoubled by the operation of this cause. At the same time, however, that the cutaneous vessels are contracted, those of the internal parts must necessarily be enlarged. Hence arises the sensation of oppression on the chest, with the sobbing or panting for breath, which generally occurs at the first immersion in cold water, from the fulness of the vessels of the lungs, and which is increased, in some measure, when the immersion becomes total, by the pressure of the water on the abdomen, and consequently of the contents of the abdomen on the diaphragm. From the same cause arises also the pulsation in the descending aorta, which has been observed to be much more distinguishable after swimming than at other times (Medical Transactions, Vol. V.); the internal vessels being distended so as to exhibit the effects of the heart's action more violently, and the heart itself beating with more than usual force in consequence of the exertion, while the contents of the abdomen are compressed, and are enabled, by the presence of the surrounding fluid, to transmit the pulsation very completely to the superficial parts, to which the hand is applied. The diuretic effect of a cold bath may be partly explained from a similar distension of the renal vessels, which must be favourable to the secretion of the kidneys; and if the same effect is sometimes produced in a hot bath, when the superficial vessels are rather dilated than contracted, it is in this case much less considerable than in the cold bath, and probably only takes place in consequence of the increased rapidity of the circulation, which affects the whole sanguineous system.

The glow, which succeeds to the first sensation of cold, may be attributed in great measure to the increased sensibility of the nerves after a partial torpor, rendering them more susceptible of the sensation of heat, which is always relative to the actual temperature of the skin; but it appears, from Dr Currie's experiments, that there is also sometimes a real increase of heat as measured by the thermometer; and it is probable, that the causes concerned in the production of animal heat are called up into a more vigorous exertion, in a strong constitution, whenever they are required for the purposes of life; so that they first supply the superficial parts of the body during the immersion, with as much heat as is necessary to overcome the painful sensation of cold, and afterwards, by a continuation of the same action, occasion an actual elevation of temperature above the natural standard. Dr Currie found, that, during the affusion of a bucket of cold salt water on the heads and whole bodies of two healthy persons, no depression of temperature was observable; but in a minute or two afterwards, although they remained without motion, the mercury rose 2°; in a third person of a feebler constitution, although the temperature remained equally unchanged during the affusion, it sunk, in a minute after, half a degree. These effects seem to be almost entirely independent of any change in the state of the circulation, which must be rather retarded than accelerated, while the generation of heat is increased. It is true, that the heart might be called into more powerful action at the same time that the pulsation at the wrist became feeble, from the permanent contraction of the radial artery; but the action of the heart would still be exhibited by the carotids, undisguised by this modification; and the carotids have not been observed to beat more strongly in the cold bath than at other times, although Dr Currie has remarked, that when "the pulse could hardly be felt at the wrist," "the heart pulsated with great steadiness and due force:" a fact precisely analogous to Dr Parry's interesting experiment on the carotid of the ewe.

Warm baths may be classed with propriety among the most useful sorbefacient remedies; but it is not easy to decide, whether they are much more active in promoting absorption than other sudorifics, or than evacuants in general. When the weather deprives a valetudinarian of his accustomed walk, the bath often affords him a valuable substitute, increasing the appetite, and promoting the digestion; but too great an appetite, without muscular exercise, is

* Experimental Inquiry on the Arterial Pulse, 8vo, Bath, 1816, p. 41. sometimes an evil, and this may have been one of the causes of the inconveniences occasioned by an abuse of bathing. A warm bath has often been of advantage in promoting the absorption of dropical fluids, especially when they are of limited extent, as in cases of partial anasarcaous swellings; but the most important sorbafacient effect of bathing is exhibited in the cure of glandular diseases, for which sea water, whether in the form of a warm or a cold bath, has long been considered as a specific remedy; and there is no doubt that a residence by the sea side, with a judicious employment of bathing, and the occasional internal use of sea water, or of some equivalent remedy, has been of the most essential service to many constitutions, which have exhibited these symptoms of general debility and languid absorption; the tonic and sorbafacient powers of the remedy being happily combined, for invigorating and calling into activity the diminished energies of the constitution.

The refrigerant or astringent powers, both of warm and of cold bathing, have been abundantly elucidated by the late Dr Currie, who has introduced the remedy into general practice, as a febrifuge, especially in the form of cold or tepid affusion, with the most salutary effects. It is not easy to determine how far the contraction of the superficial vessels by the astringent powers of cold, and how far the retardation of the pulse, which may possibly be dependent on that contraction, are concerned in the advantage derived from bathing in fevers; but it is at least obvious that the remedy does not operate simply by the abstraction of heat, since the tepid affusion is often more rapidly successful in abating fever than the cold. We may also collect from the experiments of Marcard, that a bath at about 90° is more efficacious in abating the frequency of the pulse, than at any lower or higher temperature; and these facts appear to afford a very strong argument against the hypothesis, that the principal utility of the cold affusion depends on the sudden shock which is given to the nervous system. Dr Currie has frequently found the pulse reduced by a single cold affusion from 120 or 130 to 80 or 90, and the heat from 104° or 106° to the natural standard. But he very properly limits the employment of the remedy to those cases in which the temperature is considerably elevated, and the arterial system is in strong action, without local inflammation; and where there is less vigour in the system, he often employs the tepid instead of the cold affusion, or even contents himself with moistening the face and the extremities; for instance, in hectic fever, the hands and feet only, which he finds actually hotter than the rest of the body. A late writer on consumption has very justly remarked how much of Dr Currie's reasoning on the effects of cold bathing had been anticipated by Galen, although, for want of a thermometer, he had not been able to employ the remedy in fever with safety. "Bathing," says Dr Young (On Consumptive Diseases, 8vo, Lond. 1815, p. 135), "is very strongly recommended in the Method of Healing, and the process is very minutely described: first warm air is employed, next warm water, and then cold water, and lastly, the sweat is wiped off. When we are fatigued or dried up by exercise, the bath restores us to comfort, and defends us from fevers. A strong young man in the country will plunge into cold water at once when heated, and be much refreshed by it. Animals also wash themselves when they are hot, by a natural instinct, as they eat when they are hungry, and seek warmth when they are cold. In fevers, if we had sufficient powers of discrimination, we might probably sometimes derive material advantage from the use of the cold bath, without premising the hot; and some persons have been actually benefited by this remedy. But without a more intimate knowledge of diseases than we possess, we cannot generally venture on the practice; and least of all in hectic fever, where there is not strength enough to bear the shock. A stout young man, having a fever, in warm weather, without visceral inflammation, would bring on a salutary perspiration by bathing in cold water; and if he were in the habit of cold bathing, he might have recourse to it with the more confidence; but, for the hectic, it is unsafe, especially when there is much emaciation: thus, in a hot and dry summer, those who have travelled far, and are become thin and weak, have no need of being cooled, nor would it be safe for them to use the cold bath without first going into the warm. For we seem to be hardened by the cold bath like iron, when heated first; and if we previously warm ourselves by exercise, the effect is the same." Dr Currie's relation of an adventure of his own might almost be supposed to have been intended as a commentary on these remarks of Galen. (Reports, p. 120.) "On the 1st of September 1778, two students of medicine at Edinburgh set out on foot on a journey, a considerable part of which lay along one of the rivers of Scotland. They started by sun-rise, and proceeded with alacrity in the cool of the morning. At the end of eight miles, they breakfasted, rested for an hour, and then resumed their journey. The day grew warm as it advanced, and after a march of eight miles more, they arrived heated, but not fatigued, on the banks of the river above mentioned, about eleven in the forenoon. Urged by the fervor of the day, and tempted by the beauty of the stream, they stripped instantly, and threw themselves into the river. The utmost refreshment followed, and when they retired to the neighbouring inn, this was succeeded by a disposition to sleep, which they indulged. In the afternoon they proceeded, and travelling sixteen miles further at a single stretch, arrived at the inn where they were to sleep, a little after sunset. The afternoon had been warm, and they perspired profusely: but the evening was temperate, and rather cool. They had travelled for some miles slowly, and arrived at the end of their journey stiffened and wearied with their exercise. The refreshment which they had experienced in the morning from bathing induced, however, one of them to repeat the experiment, and he went perfectly cool into the same river, expecting to relax his limbs in the water, and afterwards to enjoy profound sleep. The consequences were very different. The Tweed, which was so refreshing in the morning, now felt extremely cold; and he left the water hastily. No genial glow succeeded, but a feverish chill remained for some time, with a small frequent pulse, and flying pains over the body. Warm liquids and frictions brought on at length considerable heat, and towards morning perspiration and sleep followed. Next day about noon they proceeded on foot, but the traveller who had bathed was extremely feeble; and though they had to perform a journey of a single stage only, as some part of it was difficult and mountainous, he was obliged to take the assistance of a carriage which overtook them on the road. "It was several days before he recovered his usual vigour."

The experiments of the same judicious author, published in the Philosophical Transactions for 1792, afford some striking illustrations of the effects of severe cold: he employed baths at the temperature of 44° and 40°; the natural pulse of the person subjected to the experiment was about 70 in a minute, and it was generally raised to 85 or more by the preparation for immersion; but in the water it invariably sunk to about 65, becoming firm, regular, and small. The change of temperature, as measured under the tongue, was still more remarkable, and greater than could have been expected either from reasoning or from former observations; for the mercury fell, within a minute or two after immersion, from 98° or 100° to 87° or 88°; it then rose gradually, but not regularly, in a quarter of an hour, to about 96°. Upon a second exposure to the wind, it fell to about 90°, and was in one instance lowered 2° more at the first immersion in a bath of 97½°, in which the natural temperature was by degrees recovered, although not much more rapidly than it had risen during the former immersion in the very cold water; but what raised it by far the most speedily was the application of very hot water to the region of the stomach. When, however, Dr Currie himself went slowly into a bath of 36°, in a light flannel dress, and remained in it for two minutes, no observable alteration was produced in the heat of his body; and this circumstance might almost induce us to suspect that the other subjects of his experiments had incautiously allowed their mouths to be cooled by the inhalation of the cold air. Dr Marcard's experiments (p. 71) not only confirm the fact of the general retardation and diminution of the pulse by the cold bath; but they show that the retardation commonly extends to all temperatures below that of the human body, becoming, indeed, much more remarkable in the tepid bath than in a bath of the ordinary temperature of the atmosphere, which does not appear to produce the effect with equal uniformity. Thus, in a bath at 60° and at 63°, the pulse was rather accelerated than retarded: in six experiments from 70° to 80° inclusive, taking the mean of all the quantities, in order to obtain a result less liable to accidental errors, and representing all the experiments in a compendious form, the temperature was 75°, and in 20 minutes the pulse was reduced from 78 to 70: in four from 80° to 90°, the mean temperature was 87°, and the pulsations were reduced in 54 minutes from 91 to 75: in three at 90°, the mean reduction in 36 minutes was from 97 to 75: and three experiments above 90° give for a mean temperature 92°, and a reduction from 82 to 70, effected in 35 minutes. Marteau had found a slight reduction of frequency at 93°: but at 96°, according to Dr Parr, there is commonly no observable change. (Marcard, p. 63, 66.)

From these experiments Dr Marcard very justly infers, that in a great variety of cases, the warm bath affords the only direct and certain mode of lowering the pulse without inconvenience (p. 88); and we must be contented with the empirical knowledge of this fact, without attempting to explain why a temperature of 90° is more favourable for the retardation of the pulse, than a much lower temperature, at which the thermometrical heat would certainly be more rapidly reduced. Dr Stock has also made several observations on the effect of cold bathing on the pulse; but, in his experiments, the retardation was much less constantly observable than the diminution; a variation which frequently occurs when the temperature is very low.

The salutary effects of cold applications, in some cases of gout, were well known to Hippocrates, and have been more lately extolled by Honberg, Floyer, and Pietschen: Marcard (p. 256) very properly states the objections to their employment, and, notwithstanding all that Dr Kinglake has done to recommend them, they have not been adopted by prudent practitioners, except in very recent cases, and in young and unbroken constitutions. Arateus prescribes the affusion of cold water for giddiness and headache, and it has certainly been successful in some obstinate cases of this kind (Marcard, p. 255); and has even appeared to be a powerful palliative in some descriptions of mania. In fevers, Dr Currie found its effects more permanent than those of the tepid affusion, although not always so speedy.

We have ample experience of the tonic powers of bathing in more than one of its forms; although no more than thirty or forty years ago, the great majority of practitioners in Great Britain were disposed to confine these powers within the limits of the cold, or at most of the tepid bath. But travellers in warmer countries had often informed us of the invigorating effect of a warm bath taken after fatigue; and Bruce, in particular, extolled its comforts and its salubrity, from having used it in Egypt. The opinions of Marcard on the same subject were partly made known through Beddoes: Count Rumford, in his thirteenth Essay, has exhibited, in a popular point of view, the benefits which he himself derived from taking the warm bath habitually in the middle of the day rather than at night; and Dr Alexander Buchan, in his work on sea bathing, has assisted in dissipating the remaining prejudices against its employment as a mild tonic. For feeble or enervated constitutions, and for persons who have suffered from great fatigue, it is decidedly preferable to the cold bath; but as the strength is gradually recovered, it may often increase its efficacy to lower the temperature by degrees. We may begin, for instance, with a warm bath at 96° or 98°, and lower it by degrees to 90° or a little less; and hence the transition to the open sea in the middle of a summer's day will not be too abrupt, the water being often heated to 70° or more on a coast well suited for bathing; and if the constitution appears to acquire strength under the experiment, the hour of bathing may be made earlier and earlier, until the temperature is no higher than about 60°. The time of remaining in the water may also be modified according to the powers of the constitution; a single immersion being the most easily supported, and a longer continuance in the water, till the sensation of cold has subsided, calling forth the faculty of generating heat into fuller action; observing always not only how the health appears to be affected, but which mode is the most conducive to the pleasure or comfort of the individual, which will often throw some light on the operation of the remedy. In most cases it will be found, that where either warm or cold bathing agrees with the constitution, it is followed by a sense of youth, and vigour, and self complacency, which is equally agreeable and salubrious. We must also make allowances for peculiarities of constitution, which may require a deviation from the temperature usually recommended. Thus, there are some persons who have so singular a sensibility, as to feel a bath of 110° not too warm, and to be absolutely chilled by a bath of 100°: and, in such cases, it is probable that at 105° the pulse would not be materially accelerated. In other instances, the cold bath produces headache and dejection of spirits. This inconvenience is sometimes obviated by proper evacuations, which should also always be premised to bathing, where there is any appearance of visceral disease, or of congestion of any kind. The sea water will answer this purpose sufficiently well, either alone or mixed with warm milk, or with some chamomile flowers infused in it; but it has no material advantage over any other cathartic which may be preferred by the patient. It is also recommended by all authors on cold bathing to plunge in head foremost, and this precaution is highly proper where there is any apprehension of headache, but in other cases it is of little moment. If, after all, the cold bath continues to disagree, it will be generally advisable to exchange it for the warm; and after a time it may be proper to give the cold a second trial.

It is unnecessary to enter into a minute detail of the diseases in which bathing is useful as a tonic. It is, however, particularly indicated in a variety of complaints which are peculiar to females; and to weakly children, especially such as are ricketty and scrofulous, sea bathing is most essentially necessary. On the other hand, cold bathing is almost universally to be avoided where there is any consumptive disease, or any inflammatory affection of any of the internal parts; an exception which is easily understood, from the natural tendency of cold to cause a congestion of blood in the vessels of those parts, in consequence of the contraction of the superficial vessels. The sudorific effect of the warm bath, followed by the refrigerant quality of the tepid, and the tonic powers of the cold, exhibit a succession of remedies nearly analogous to the mode of treatment which is usually found to be most successful in fevers of various kinds; in most of which we begin with sudorific medicines, and proceed to astringents and tonics. Hippocrates, in his book on the use of liquids, observes that gout is one of the diseases in which both hot and cold applications afford effectual relief; and the remark is equally just with respect to some cases of rheumatism; but, more commonly, the best mode of using baths in rheumatism is to begin with a bath raised, during the immersion, to as high a temperature as the patient can bear, so as to act as a powerful sudorific, and to continue the course, when the pain has been relieved, at lower and lower temperatures, ending it with cold bathing in the open sea.

Notwithstanding the acknowledged utility of warm bathing in a variety of circumstances, there may possibly have been some exaggeration in the marvellous opinions which have been sometimes entertained of its utility for the prolongation of life. Galen has indeed mentioned a number of persons who had attained a great age, and who were in the habit of making daily use of the bath, which is enough to prove that such a habit cannot be extremely pernicious; and if we supposed a constitution to retain all its energies, but to have them concealed and obscured for want of proper stimuli, the warm bath might tend to remove the evil; but it is more natural to believe, that the approach of old age has a tendency to weaken the radical powers of the constitution, which cannot afford to be roused into disproportionate exertion; and to apprehend, that the temporary vivacity and activity, superinduced by any foreign agent, whether by warm bathing, or by a removal to a warmer climate, would only tend still more to exhaust the already diminished store of vitality.

The narcotic and sedative, or specifically antispasmodic effects of bathing are most effectually exhibited, in ordinary cases, by the warm or tepid bath, which is often employed for the relief of pain, and for the removal of any irregular or convulsive affection. Possibly also the effect of the warm bath in retarding the pulse may be partly derived from its sedative power as affecting the heart; and if we take this connexion for granted, we may infer from it, that the antispasmodic effect will be most advantageously obtained from a bath at 90°, which has been found to retard the pulse the most effectually. But where there is internal inflammation, it may be desirable to dilate the superficial vessels by a bath somewhat hotter than this, so as to relieve the internal parts from a part of the fluid which distends them, but without increasing the velocity of the circulation by too high a temperature. The cold affusion is also a powerful remedy in many cases of tetanic disease. Hippocrates (Aph. v. 21) has remarked, that it often creates a glow which overpowers the convulsive contraction, especially where the subject is young and athletic, the weather hot, and the disease independent of local injury; and the modern experience of Dr Wright and Dr Currie has confirmed and extended the observation. In another passage he tell us (Aph. v. 25), that the abundant affusion of cold water generally relieves and removes swellings and pains in the limbs as well as spasms, producing a moderate degree of torpor, which supersedes the pain; but, in fact, the relief of inflammatory affections by cold is rather to be referred to its astringent than to its sedative powers. This is, indeed, a point which has been much discussed by modern theorists; but it must be confessed, that all our theories are of little importance in physic, any further than as they assist us in clearly comprehending and distinctly remembering the facts, which we derive from immediate experience in the treatment of diseases.

(v. n.)