Water, as a preservative of health, and a remedy in disease : a treatise on baths ; including cold, sea, warm, hot, vapour, gas, and mud baths ; also, on hydropathy, and pulmonary inhalation ; with a description of bathing in ancient and modern times

Front matter

CUSHING/WHITNEY MEDICAL LIBRARY

HISTORICAL LIBRARY

LUCIA FULTON FUND

Contents

Chap. I. — Bathing too much neglected in England and the United States— The Skin— Its Structure— The Hair 13

Chap. II. — Functions of the Skin — It regulates Animal Heat — Sympathies of the Skin with other organs 25

Chap. III. — Conditions for Preserving the Functions of the Skin — Clothing — Exercise — Baths 45

Chapter I. Bathing An Instinctive Want Is Too Much Neglected

IN ENGLAND AND THE UNITED STATES. THE SKIN ITS

STRUCTURE.

It is the design of the author, in this volume, while he gives the greatest prominence and largest space to the subject of Bathing in all its varieties, to dwell, also, with due emphasis, on the internal use of water, both in its hygienic and therapeutical applications, as one of the chief means of preserving health and of alleviating and curing many diseases. The watery regimen, in its most comprehensive meaning, as adapted to cleansing, purifying, and invigorating the human frame, will thus receive greater developments than it has hitherto obtained in any connected system of instruction. While friendly to the body, it will be shown to be, at the same time, a soother and comforter to the mind, and, nest to fresh and pure air, the best dispeller of the vapours and spasms of fitful hysteria and of gloomy hypochondriasis — the best cosmetic for beauty, the best cordial for care.

Bathing, after some fashion or another, may be considered as the gratification of an instinct common to all living nature ; for, it is no fanciful idea to regard the aspersion of the vegetable kingdom, including all its tribes and varieties, from the cedar and the oak down to the humble and parasitical moss, by rain, atmospheric vapours and dew, as a modification of the bath ; by which dust is removed, insects are destroyed, and fluid is furnished for the nutrition of the plant. Large classes are so distinctly aquatic as to be habitually immersed in water, leaving only their flowers and some of their leaves to float on the surface.

The practice of bathing, either by immersion and swimming in rivers, lakes and the sea, or, in a more restricted manner, in water collected for the purpose in domestic and public baths, would be, one might naturally suppose, of universal adoption, unless in some region of sandy

14 GENERAL NEGLECT

deserts or otherwise arid soil in which water is not procurable. It has been declared to be a law imposed by, nature upon all perspirable creatures. ^ e have, in tact, ample historic precedent and contemporaneous usage in its favour; but yet, it is far from being so general as is necessary for the requirements of health, not to say of personal cleanliness and comfort. In this respect, modern civilization is behind the ancient, and the people among whom science and the arts most flourish, and among whom the theory and practice of medicine and its collateral branches have made the greatest progress, will poorly compare with those whom we are too ready to call semi-barbarous. The singular discrepancy between admitted theoretical knowledge and its practical application for the wants of the many is met with, to a painful extent, in the Anglo-Saxon branch of the great human family, the people comprising which turn water to wonderfully diversified uses, for ocean and river navigation, and manufactories, canals, and steam-engines. They employ it in its solid state, as ice, in its aeriform state as vapour, they use it for bleaching linen, for cleansing wool, and for every assignable purpose except those to which the cravings of instinct sanctioned by sound physiology and hygiene more directly point, viz. ; for drinking and for bathing. It is here that a hydrophobic tendency is manifested by nearly all classes. They are more just to their domestic animals. Their horses, in a more especial manner, receive from their hands the advantages of ablution, often even to excess, with the aid of a thorough currying, brushing and rubbing — healthy observances of which the gentlemen who own, and the coachmen, ploughmen and wagoners who drive, these animals voluntarily and in a spirit of uncalled-for penance deprive themselves.

We read in a small work,* not remarkable for its literary execution, of an assertion, which, bold as it may seem, is not wide of the mark. The writer says : " There is no people in the world who evince so great a disregard of personal cleanliness as the English, and at the same time, no nation that piques itself so much upon the possession of that quality." He asserts it, as a fact that will hardly admit of contradiction, " that a large proportion of the

* The Bath, &c., by Horatio Mahomed

OF BATHING. 15

population of this country [England] never submitted themselves to an entire personal ablution in their lives, and many an octogenarian has sunk into his grave with the accumulated dirt of eighty years upon his skin ; and yet were he charged with uncleanliness would indignantly repel the assertion, and would endeavour to prove the purity of his person, by instancing the cleansing of his face and hands several times daily." The daughter follows the example of the mother, and Columbia is as far from seeking the aids to health and beauty furnished by frequent ablution and bathing, as Britannia was ever wont to be. Of late years, however, the English who have travelled on the continent, and in Turkey and Egypt, have returned home with higher notions of the utility of bathing ; and some of them have adopted, in consequence, a tone of rebuke of the neglect of ablutionary proprieties in the United States, which is notoriously common at home. But, what we are bound to regard is the pertinency of the advice or the rebuke, rather than the qualifications of the adviser. Mr. Stuart, whom we cannot accuse of a censorious disposition, remarks on this topic in his "Three Years in America" : " In fact I have found it more difficult in travelling in the United States, to procure a liberal supply of water at all times of the day and night, in my bed-chamber, than to obtain any other necessary. A supply for wasbing the face and hands once a-day, is all that is thought requisite." Mr. Stuart was not aware of the severe strictures of an English writer, who, in his advocacy of cleanliness, thus speaks of the prevalent practice of his own countrymen : " Some disgusting economists of both time and water, reduced ablution to a habit of washing the face and hands, leaving the clothing to hide whatever dirt might accumulate in the rest of the body, and, as though enamoured of its ingenuity, their descendants have never abandoned the same filthy and unwholesome practice." This writer's observations on the frequenters of the sea-shore during the heats of summer are so entirely applicable to the same class on this side of the Atlantic, that, at the risk of offending some of them, I shall repeat his language on the occasion : " The yearly custom of visiting the watering-places has very little to do with the use of the bath ; this custom, confined as it is to a circle

16 A BETTER PROSPECT.

of society which does not compose a hundredth part of the population, is not for a moment to be placed on a footing with that constant and habitual exercise of bathing which distinguishes other countries. The hydromaniac fever, which comes on about the month of August, arises from a love of change — change of scene and amusement — an ennui of town ; it is a fit of fashion, it is any thing but a parallel to the habit ii feebly caricatures." These annual visits to the sea-shore are not meant to be disparaged. The argument to be conveyed is, that bathing ought to be a daily, instead of a yearly practice, and that simple water of a tepid or a warm temperature may well replace the sea water, the virtues of which are erroneously supposed to depend upon the saline substances which it holds in solution. In this, however, as in other matters of public hygiene, there is an evident improvement, — which has reached the masses, and of which the poor, and even the tenants of the prisons, are now beginning to enjoy the benefits. Baths and washing houses for the poor have been tried with entire success in some of the chief towns of Great Britain; and in Philadelphia, in the new house of Industry in Moyamensing, similar arrangements have been made for this class of persons. Wherever steam is used in manufactories, warm water for bathing can be readily procured, with slight additional cost to the owners, and with so much increase of comfort and better health and alacrity of movement and feeling on the.part of the operatives, and other persons employed in them, that there would be a real gain, in consequence, to all parties even in a pecuniary point of view. Where a building is warmed by steam, all its inmates might easily enjoy the comforts of the warm bath. Taking into account the increased supply of water in our chief cities and towns, and the facilities of the kind just now alluded to, the remark of Dr. Combe, in reference to the state of things in ( ireal Britain, that "bathsare now to be found in fiftyplaces for one in which they could be obtained twenty years a"-o"* ought soon to be equally applicable to this country. °The comparison which immediately follows, must, also, we are afraid, be received to our disadvantage, as well as that of the English. "Even yet, however," continues Dr. C.

* The Principles of Physiology, Sic.

EXTENSIVE USE OF VAPOUR BATHS. 17

"we are far behind our continental neighbours in this respect. They juslly consider the bath as a necessary of life, while we still regard it as a luxury. I believe that I am within the truth when I say that in one hospital in Paris, a greater number of baths have been administered to the poor during the last year, than to the whole working population of Great Britain, during the last ten years." Since this was written, measures have been taken in Liverpool, London and other cities, which will neutralise in a great degree the force of the stricture implied in the last sentence.

Why, it may well be asked, should the people of the United States deprive themselves of the admirable appliances, on the score both of health and enjojTnent, to which all classes in many other countries and opposite climates have ready recourse. In Russia, the use of the vapour bath, in the manner to be hereafter described, is general, from the Emperor to the poorest serf; and, as Dr. Clarke, in his northern travels, truly remarks, through all Finland, Lapland, Sweden, Norway and the vast northern empire there is no hut so destitute as not to possess its family vapour bath, whither all the members of the household resort every Saturday at least, and every day in case of illness. Equally general is the use of the bath in Turkey, Egypt, and Persia among all classes, from the Pasha down to the poor camel driver and porter, or the Arab boatman ; in short every one who can raise a few paras. Even the red men of our forests, the aborigines of this continent, have more fully appreciated the advantages of the bath than their civilized successors and supplanters of the white race.

Details of the various modes of bathing by the people now enumerated, will be found in a subsequent chapter, — following a description of the public and private baths of the Greeks and Romans. The question of the utility of bathing, as a matter of hygiene, might be supposed to be placed beyond all controversy by the example of so many people in all ages of the world, and in the greatest variety and contrast of climates. But science, in the shape of physiology, gives, also, its confirmation of the practice of bathing; and to it I shall appeal, by introducing a brief sketch of the structure and functions of the skin, and of its intimate relations with the chief organs of the human

18 THE SKIX — ITS DIVISIONS.

frame. It will then be seen, how necessary ablution and the various auxiliary processes of the bath are, for maintaining a healthy state of this tegument and of the internal organs with which it is in close functional connection, as well as for preventing a host of diseases to which mankind is liable by a neglect in this particular.

Offices performed l>y the Skin. — The skin, the external tegument or envelope of the animal frame, serves to establish our relations with the external world, by receiving impressions, through its sense of touch, of the physical properties of substances with which we are brought in contact. Through its other modifications of sensibility it apprizes us of the temperature of these substances, and of that of the atmospheric or watery medium in which we may happen to be placed. In this way, the brain is actively and continually impressed through the skin by connecting nerves, and the frame of mind is, of course, not a little dependent on the force and extent of these impressions.

There is yet another series of functions performed by the skin, by which it aids in the nutrition of the body. It absorbs fluids and gases, and exhales the like ; and it is auxiliary to respiration and to the regulation of animal heat.

Anatomical Divisions of the Skin. — The apparatus by which all these various functions are performed will now be briefly described. It consists of two main layers: the external, called epidermis, cuticle or scarf skin ; and the internal, called cutis vera, dermis, coriitm, or true skin, with the perspiratory and the sebaceous or oil-secreting glands.

The True Skin. — The dermis or true skin consists of a dense elastic tissue, with numerous areola? or openings, for the transmission of bloodvessels and nerves from its under surface, and of an intricate web-work of minute bloodvessels, sensory nerves, and lymphatic or absorbent vessels distributed over its upper surface. This web-work is sometimes called the papillary layer. The dermis also contains in its substance the sebaceous follicles, and transmits the ducts of the sudoriparous or sweat glands that lie beneath it. The papillary layer of the dermis consists of conical minute prominences, very irregular in their distribution. The papillae are sometimes collected into masses

EPIDERMIS OR CUTICLE. 19

and are arranged in parallel rows, giving rise to the ridges and furrows seen upon the palm of the hand and sole of the foot. The dermis or true skin varies in thickness in different parts of the cutaneous surface, being most dense on the back, outer sides of the limbs, palms of the hands and soles of the feet; and contrasting, in this particular, with the inner side of the limbs, the breast and the back of the hands and the eyelids. The thickness in these cases is sometimes of the dense sub-stratum or corium proper of the true skin, and sometimes, as where great delicacy of touch and sensation is required, it is by increase of the substance of the papilla? themselves. Of the profuse supply of blood to the true skin, by the interweaving of innumerable fine bloodvessels or capillaries, and of nervous tissue on which last sensitive impressions are made, we may form an idea from the fact, that, in no part of the surface can the point of the finest needle penetrate without blood being drawn and pain felt.

The Epidermis or Cuticle. — The external layer of the skin, called epidermis or cuticle, is formed by an exudation of cells from the papillary layer, which is at first soft, but afterwards becomes hard and horny in its texture, and of a scaly or imbricated arrangement. It consists of several laminae, the outer of which exhibit the commonly described characteristic features of the epidermis, in their being hard and unorganized, while the inner, or those in contact with the papillary layer, are soft and cellular. The latter was for a long time described as a separate layer, and was called the mucous or rete mitcosum, in which the seat of the colour of the skin was believed to reside. It is now ascertained, however, that the pigment cells are scattered through the ordinary epidermic cells in the under lamina? of the epidermis, and contiguous to the papillary layer of the dermis. On the presence of this pigment, in the cells of the epidermis, depend the different tints of colour of the skin, observable in different races and nations. Owing to the laminated texture of the epidermis, its superficial lamina? are continually removed by attrition, and new ones are as continually formed on its internal surface. This outer layer of the skin is accurately modelled on the papillary layer, and each papilla has its appropriate sheath in the newly formed epidermis.

20 SWEAT GLANDS — PERSPIRATION.

The epidermis is pierced by the excretory ducts of the sweat glands, and of the sebaceous follicles, which, as already remarked, lie in the true skin and immediately beneath it, and also by the shafts of the hair. Its lamina? become more numerous, or in other words it becomes thicker, in proportion as the surface is rubbed and exposed to pressure, by which the true skin is excited fo increased secretion, in order to protect the parts most subjected to attrition and pressure, as the soles of the feet and palms of the hands. It is thinnest on the tips of the fingers, and on the lips, parts in which sensibility is required for important purposes. The obvious use of the epidermis is to obtund what would otherwise be acutely painful sensations, from the impression of foreign bodies or extremes of temperature on the denuded dermis, as wc all know in cases where the epidermis has been accidentally peeled off, or removed by disease or by a blister. Under the present arrangement, it allows of a more extended contact with the substances to be examined, by a greater pressure and (inner grasp and diversified handling, so that a more definite and at the same time pleasurable perception of their properties is obtained.

The Sudoriparous or Sweat Glands. — The sudoriparous, or perspiratory, or sweat glands are small, oblong, rounded bodies, in some cases sacs situated on the tissue beneath the skin. Under the microscope these bodies present the appearance of a solitary tube intricately ravelled, one end of which is closed, and usually buried within the gland, the other emerges from the gland, and opens on the skin. The external end passes through the dermis and opens obliquely by a pore upon the surface of the epidermis or scarf skin, so that the orifice is covered by a minute valve of this outer layer of the skin. The convoluted tube, making a kind of knot of which the gland consists, is copiously supplied with bloodvessels, and lined by a prolongation of the epidermis. The pores are visible to the naked eye upon the palm of the hand, the sole of the foot, and the extremities of the fingers: they arc ranged along the little ridges of sensory papilla?, and give to the latter the appearance of being crossed by transverse lines.

Perspiration, and Extent of the Perspiratory Tribes.

From these glands there is constantly secreted the watery and saline fluid of perspiration. The following minute esti-

SEBACEOUS GLANDS. 21

mates by Mr. Wilson, in his Practical Treatise on Healthy Skin, are curious and interesting.

" Taken separately, the little perspiratory tube, with its appended gland, is calculated to awaken in the mind very little idea of the importance of the system to which it belongs : but when the vast numbers of similar organs composing this system are considered, we are led to form some notion, however imperfect, of their probable influence on the health and comfort of the individual. I use the words ' imperfect notion' advisedly ; for the reality surpasses imagination, and almost belief. To arrive at something like an estimate of the value of the perspiratory system, in relation to the rest of the organism, I counted the perspiratory pores on the palm of the hand, and found 3528 in a square inch. Now, each of these pores being the aperture of a little tube of about a quarter of an inch long, it follows that in a square inch of skin on the palm of the hand, there exists a length of tube equal to 883 inches, or 73j feet. Surely such an amount of drainage as 73 feet in every square inch of skin, assuming this to be the average for the whole body, is something wonderful; and the thought naturally intrudes itself, What if this drainage were obstructed ? Could we need a stronger argument for enforcing the necessity of attention to the skin ? On the pulps of the fingers, where the ridges of the sensitive layer of the true skin are somewhat finer than in the palm of the hand, the number of pores on a square inch a little exceeded that of the palm ; and on the heel, where the ridges are coarser, the number of pores on the square inch was 2268, and the length of tube 567 inches, or 47 feet. To obtain an estimate of the length of tube of the perspiratory system of the whole surface of the body, I think that 2800 might be taken as a fair average of the number of pores in the square inch ; and 700, consequently, of the number of inches in length. Now, the number of square inches of surface in a man of ordinary height and bulk is 2500 ,• the number of pores, therefore, 7,000,000, and the number of inches of perspiratory tube 1,750,000, that is, 145,833 feet, or 48,000 yards, or nearly 28 miles."

Sebaceous or Oil-Forming Glands. — The sebaceous or oil-forming glands which are included in the above calculation of Mr. Wilson, are small, oblong bodies closely

'22 ANIMALCULES IN THE S. GLANDS.

resembling the perspiratory glands, and sometimes they are short straight follicles "or pooches, sealed in the substance of the dermis. Their excretory or terminal ducts open, in the largest numbers, in a hair follicle. In the hairy parts of the skin, we usually find a pair of sebaceous follicles opening into the passage through which every hair ascends. In general, the sebaceous tubes are straighter and wider than the perspiratory ones. They are absent in the palm and sole, but abound in the face and nose, the head, the ears, the borders of the eyelids, arm-pits, and the natural outlets of the body, &c. The purpose of the sebaceous secretion is to keep the skin soft and pliable, and to prevent its being dried and cracked by the influence of the sun and air, and, also, to protect parts much exposed to friction. This oily fluid is much more abundantly formed in the races of mankind which live in warm climates than in those that inhabit cold countries. Its presence on the skin of a person in a bath causes the water to form itself into separate drops or globules on this surface ; and it imparts, also, a certain degree of greasiness to a garment that has been worn for a length of time next the skin.

The sebaceous tubes are frequently the seat of a curious parasite, or animalcule [Demodex follitulorum), which Mr. Wilson represents to be present in great numbers on the inhabitants of cities and large towns, whose skin is more or less torpid in its functions. He has found it in all ages, from youth to old age ; more numerously, it is true, in the latter than in the former period, and in great and remarkable numbers during sickness. He is disposed to regard it as answering a salutary purpose, by helping to keep open the over-distended cells and tubes, which, in the persons referred to, become impacted with hardened sebaceous matter, and which are in this way irritated and sometimes inflamed.*

* The British ami Foreign Medical Review, after demurring to this hypothesis of Mr. Wilson, makes the following pertinent remarks: "Doubtless it will be highly gratifying and instructive to the public mind, to be made acquainted with the fact, that the habits of ' refined society1 tend just as strongly to the production of this tribe of parasites, as the habits of the ' great unwashed' favour the development of certain others, which are not in themselves one whit more disgusting. Here, as else-

THE HAIR. 23

The Hair. — The hair is an important appendage to the skin : it derives its origin from follicles situated under this membrane, still more deepl}"- than the sweat-glands. The hair-follicle is formed by the inversion of the skin. From the bottom of the follicle, a kind of papilla of a cellular structure rises; the exterior and densest part of which is called bulb, the inner and softer is known by the name of pulp. The shaft or body of the hair begins at the external surface of the skin : it is of a darker colour, harder, and flatter than the bulb, and is somewhat curved, particularly at its termination. It consists of two elementary parts : a cortical or investing substance of a fibrous or horny texture ; and a medullary or pith-like substance occupying the interior. The latter is, sometimes, almost entirely wanting. A section of hair is represented by Mr. Wilson to consist of three different textures, a loose cellular texture in the centre, a strong texture of parallel fibres becoming more and more dense towards the circumference externally to this ; and a thin, varnished layer of flattened cells, constituting the polished surface of the hair. By Krause the hair is regarded as a tissue analogous to the epidermis ; the cortical portion resembling the outer layer, and theme-

where, we see how nature manages to compensate one class for the exemption they may enjoy from the evils incident to another. The delicate town-bred lady of fashion, in descending from her carriage, shrinks instinctively from the mass of rags, filth, and vermin, which is brought into contiguity with her precious person by some pertinacious beggar; ignorant all the while that her sebaceous follicles give board and lodging to a host of parasites, whose number may equal that of the various kinds of ' small deer' that nestle in the matted hair and tattered garments of the fellow-being whom she regards with such loathing. ' Where ignorance is bliss, 'tis folly to be wise ;' and some, perhaps, of Mr. Wilson's fair readers may not thank him for enlightening them on the subject. But we consider that such knowledge ought not to be withheld from deference to fastidious delicacy ; and that, besides the immediate inducement it affords to the adoption of such habits as may free the sebaceous system of those unwelcome inhabitants, it may also have the beneficial moral use, of aiding in the demolition of those barriers between the classes of society on which we are thankful that every day is now making some fresh inroads."— Vol. 21, pp. 201-2.

24 THE HAIR AND NAILS.

dullary portion the inner layers of the epidermis. But, whatever differences of opinion may prevail respecting the intimate structure and composition of the hair, its scaly character externally is generally conceded. The scales resemble those of the epidermis, but they are much smaller; they are arranged in rows like tiles upon a roof, and their edges form delicate lines upon the surface of the hair, which are sometimes transverse, sometimes oblique, sometimes apparently spiral. This imbricated arrangement of the cells, composing the outside of the hair, gives rise to the sensation of smoothness, which we feel on drawing a hair between a finger and thumb in one direction, and of roughness when this process is performed in another direc tion.

The hair grows, by the addition of new matter at the base of its shaft. That it is organized, and that in its changes — in growth, colour, abundance, sparseness, and falling off— it is influenced by the causes which act on the nutrition of other parts is evident under various circumstances. Among these may be mentioned its coming away in febrile and other violent diseases ; its change of colour in old age, or in states of the economy which bring on premature senility, and also of strong mental emotion, as of anxiety and fright. The changes in certain diseases of the hair itself, are demonstrative of the same fact, as in the Plica Polonica, in which the hair is matted together by a glutinous secretion, and bleeds when cut off close to the stumps. Mr. Paget relates the history of a case of a lady, who was subject to very violent attacks of nervous headache, which generally came on towards evening. She was able to predict that on the following morning there would be a total loss of colour of a tuft of hair, which was, however, generally restored after a few days. In appearance and in texture, the hair differs, as is generally known, in the different races of mankind, and, also, in different individuals.

The Nails. — The nails are another appendage to the skin, and so closely do they resemble the epidermis that the}' are little else than an altered form of this latter. They consist of cells which gradually dry into scales and become coherent, one to another.

FUNCTIONS OF THE SKIN. 25

Chapter II

FUNCTIONS OF THE SKIN ITS CONNECTION WITH THE INTER- NAL ORGANS OR THOSE OF NUTRITION THE SKIN IS THE