RE-ACTION AFTER THE COLD BATH.

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feverish chill remained for some time, with small, fre quent pulse, and flying pains over the body. Warm liquids and friction 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. This relation will not, I hope, be deemed of the less authority because it is given by the person who suffered by his imprudence."

4th. The effect of immersion in cold water varies according to the heat of the skin, and the vigour of the cutaneous circulation, at the time of bathing. The hotter the skin, and the greater the vigour of its circulation, the more safe is the use of the cold bath. This, however, supposes the heat and active condition of the vessels of the skin to be caused, not merely by the sun's rays, or any similar external irritant or excitant, but to be produced by an energetic action of the heart and arteries; and the hotter the surface of the body under such circumstances, the more prompt and efficient the re-action. It is, therefore, not well to stand any long time after undressing, before plunging into the water. Such a practice chills the body very much more; and in many cases, renders the use of the cold bath absolutely unsafe, when it would be otherwise profitable and advantageous.

It was on this principle, that the use of cold water to the surface of the body generally, either by immersion, affusion, or sponging, was so strongly recommended by Dr. Currie, in fevers and many other diseases, chiefly characterised by general excitement of the vascular system, and an undue heat of the skin. And the reason of this great agent having been used so comparatively seldom, or in so much modified a degree, in the treatment of such cases, is to be found in the generally complicated character which they present, being mixed up with undue determination of blood to, if not a congestive or inflammatory condition of some of the great internal and vital organs; when the risk of increasing such determination of blood, or aggravating such congestion or inflammation, by the action of cold water on the surface of the body, may well be feared to be greater, than the probable advantage derivable from lowering the febrile temperature, moderating the vascular excitement, and promoting the eventual efflux of the cutaneous secretions. Yet, when not contra-indicated by any considerable degree of organic congestion, or more marked vascular determination to some of the great organs, the external application of cold water, generally or locally, is one of the most energetic and trustworthy of remedial resources in the early stages of fever, and febrile complaints in general, and one that is apt to be too little attended to.

5th. The effect of immersion in cold water varies according to the fulness or emptiness of the stomach; according to the period at which the digestion of the

aliment may have arrived; and according to the healthiness and power of the digestive organs. It has been said before, that the stomach during digestion, and particularly during the first stages of digestion, is supplied with a very large quantity of blood. So large a quantity of blood being directed to the stomach at such times, the whole energies of the heart and arteries are not at immediate command, to meet the effect of the cold bath; diverted by the demands of the stomach, and those of the skin and system. generally, re-action is less prompt, and less perfect in its degree; and a risk is incurred of more or less serious disease.

6th. The effect of immersion in cold water varies according to the state of the mind. Mental exhaustion and bodily languor are generally concomitants; mental irritability and undue physical sensitiveness generally obtain at the same time; mental torpidity and vascular sluggishness are generally attendants on one another; and they would equally contra-indicate the use of the cold bath, without a very careful consideration, and an anxious watchfulness. In general, under such circumstances, the use of the tepid or warm bath, is to be preferred; and often proves to be a very influential remedial measure.

Too much can hardly be said of the value of muscular exercise, and friction of the skin, while the person is in the bath. Swimming calls into action almost every muscle of the body, and hence it is valuable as a kind of exercise; and in the same proportion does it assist the action of the heart and

arteries, diminish the risk of congestion, and determine the blood to the vessels of the surface; and by thus equalising the distribution of the blood, it promotes and maintains re-action, and lessens the chance of an undue depression of the nervous energies. When swimming cannot be practised, or from circumstances would not be justifiable, its place should be supplied, as far as possible, by constant exercise of the muscles of the trunk and extremities, as long as the individual remains in the water. In some cases, general frictions of the surface, and kneading the muscles well with the fingers, may be useful as auxiliaries, or even as substitutes, for the more active exercises, while the person is in the bath.

The action of the warm bath is essentially very different from that of the cold bath; and their effects may be conveniently considered together, for the sake of comparison. The immediate effect of the warm bath (temperature 95° to 100°), is to promote the secretion from the skin, and probably from the lungs ; to determine the blood to the cutaneous and mucous tissues; and according to the greater or less heat of the water, and the length of time during which the person remains in the bath, to diminish or excite the power and quickness of the circulation. The tepid bath, if the individual remains only a few minutes in the water, will be usually found to act as a stimulus to the nervous and vascular systems for some hours afterwards. The warm bath, on the other hand, if the individual remain half an hour or longer in the water, has decidedly a lowering and depressing effect

on the system generally,-relaxing the tissues, lessening the force and frequency of the heart's action, and exhausting considerably the nervous energies. The immediate effect of the cold bath, if adjusted as to its temperature to the power and condition of the system, and attended with immediate and full re-action, and not remained in too long, is decidedly that of a stimulant to the nervous and vascular systems; and therefore to all the mental faculties and bodily functions. The stimulating effect lasts for many hours afterwards. The effect of the undue use of baths of any temperature, either remaining in the bath too long at a time, or bathing too often, so frequently as to be disproportioned to the strength of the system, or to the season, climate, &c.,-is always what might be expected from an agent which promotes the action of the emulgent organs generally, and stimulates only for a time, but in general to a considerable degree, the economy of the system : the undue use of the bath is always followed by much debility; and accordingly this great means of health, and great agent in the relief or cure of disease, should be had recourse to with discretion, and never practised without due care. Debilitating results are necessarily more likely to follow the undue use of the warm than of the cold bath; and perhaps more likely, the higher the temperature of the bath, supposing that a perfect degree of re-action attends the use of the bath at the lower degrees of temperature.

The climate, and the season of the year, have much to do with the degree to which baths of any temperature may be used advantageously. In the