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VOL. 5.

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From the North American Medical and Surgical Journal, Philadelphia. ON THE EFFECTS OF THE VAPOR

BATH.

VAPOR BATHING, it is well known, has been employed, in some shape or other, almost from time immemorial. We have good reason to believe, that Hippocrates, Galen, and others of the olden time, were not unacquainted with its effects; and we find it used, either as a luxury or remedy, in civilized and in savage life, in polar regions and beneath a tropical sun. In Russia and the adjacent countries, it is so commonly employed, that to be excluded from its use is regarded as a punishment of some severity. The aborigines of our country place great reliance on its powers in fevers, &c.; and for evidence of its being a luxury, if personal experience be wanting, we need only appeal to the turbaned followers of Mahomet. It is not my object, however, in the present paper, to enter into its history, or even detail the improvements made in its mode of administration. For these and other points, we must refer to the various Works on vapor bathing, and particularly to those of Rapou and Gibney, and to a review of the

NO. 12.

latter, in the April number of the Medical Recorder for 1826. The principal object of this paper being to give an account of some cases which were treated by the vapor bath in this city, and which fell under my immediate observation, I enter at once on the task, intending to offer, as I proceed, such remarks and reflections as may seem to arise out of the nature of the subject.

On the establishment of the vapor bath in this city some time since, a brief record of most of the principal cases was kept by the physicians connected with the institution, with a view to a subsequent report; but this having been mislaid, nothing but a very general statement has yet been made public. Having been so fortunate lately as to recover a small portion of these cases, and thinking, imperfect as they are, they might not be wholly destitute of interest to some of the readers of this journal, I have concluded to present them at this time to their notice.

I would merely premise, for the information of those who may not have seen the apparatus employed, that the vapor, generated in a boiler, escapes through a bent tube, furnished with a stop cock, into a small basin or receiver in the lower part of a box. The top of this receiver, into which herbs, or other articles

were placed, as well as the upper covering of the box, was perforated, and allowed the free ascent of the medicated vapor into the upper or curtained portion of the contrivance, where the bather sat, and either inhaled the vapor, or had it merely applied to the surface of the skin, according to the situation of his head, whether within or exterior to the enclosure.

Among the first cases that presented for trial, was that of a Mr. S-, from Kentucky, who had been under the care of several physicians for many years, had traveled much in search of health, and undergone a variety of treatment. His complaint was a chronic hepatic derangement, with great torpor of the bowels. The skin was constantly dry and harsh, as well as very sallow, and digestion much impaired. He had been thus affected for six years, occasionally relieved by the prescription of some of his physicians, but never permanently better. He

began the use of the bath on the twenty first of October, and took it sometimes daily, and sometimes every second day, till the beginning of December, when he left the city to all appearance perfectly well. He took the bath at a pretty high temperature, inhaling the vapor, and sweating very profusely. He also used frictions with a flesh brush over the region of the liver. In consequence of these measures, his skin became soft, his complexion clear, and his digestion good; the torpor of the bowels was removed, and notwithstanding the depletory operation of the bath, he had actually gained flesh. Perhaps in no case were the benefits from the bath so signal and striking as in the

present one, though in most of the cases where the skin was much affected, it showed decided powers.

About the same time, a Mr. H-, of this city, resolved to try the efficacy of the bath. He had been long subject to rheumatism, and was in the frequent habit of taking the Lisbon diet drink. For three weeks he had suffered severely from an attack, having been obliged to take laudanum every night to procure sleep. From the pain and stiffness in his shoulders, he was unable to shave, or put on his coat or cravat, without assistance. His muscles generally, but particularly those of his arm and back, were contracted, the former being bent at the elbow. The first bath he took, inhaling the vapor and sweating freely for upwards of half an hour, afforded such relief that he tied on his cravat himself, and slept that night without laudanum. A second bath was followed by similar results, and the disease seemed to be so nearly removed, that he omitted coming again for some time. A slight return of his complaint, however, brought him again to the bath, after which he declared himself free from pain, and with but a slight stiffness of the shoulder and elbow remaining. Not very long after, we were surprised to hear that this gentleman was confined to his bed, much emaciated, suffering under an increase of pain and stiffness, and that all this was attributed to the bath. How this supposition could be well founded, after at first deriving so much benefit from it, and without some particular and imprudent exposure, we were at a loss to conceive; and the more especially as some of us were in the habit of

frequently taking the bath at different temperatures, and sallying immediately forth on our usual business, sometimes indeed before we were completely dry, in all weathers, cold, warm, wet and dry, without subsequently experiencing any ill effects. It is possible, however, that the altered condition of a rheumatic system, where more or less fever attends, may induce a liability to take cold after bathing, which we did not experience.

With regard to exposure, and liability to take cold after using the bath, a few words in this place may not be improper; and we here wish to be considered as speaking of persons in health, for disease may, and doubtless does, greatly modify the human constitution and susceptibilities. The Russian, who delights in a vapor bath of high temperature, goes reeking from it to roll in the snow, or plunge into cold water. This he does not only with impunity, but advantage; and though this may be owing now to habit, that "second nature," there must have been a beginning, when this could not be brought into the account. Strangers, too, unaccustomed to the manners and custom's of the country, have borne it well. Beaupre, in his treatise on cold, says he frequently had buckets of cold water thrown on him while in, or immediately on issuing from the bath; that the first time it created but a lively coolness; but that the second time, after a bath of higher temperature, his feelings were decidedly agreeable. The stronger the heat, the less sensible is the cold impression. When the skin is highly excited and reddened by a bath of from 120 to 160 degrees, cold has

scarcely any effect; but in the ordinary state of the cutaneous functions, a suaden change of 20 or 30 degrees in the temperature is sensibly felt. Blagden, who entered ovens heated to 250 degrees, says, "we passed out after every experiment, immediately into the cold air, without any precaution; after exposing our naked bodies to the heat, and sweating most violently, we instantly went into a cold room, and staid there even some minutes before we began to dress, yet no one received the least injury." The experience of Dr. Dobson at Liverpool, is to the same effect, as also that of Dr. Clendinning, and many others. Captain Parry, in his account of some of his polar expeditions, mentions that his crew suffered comparatively little from the cold, after the adoption of the plan of thoroughly heating all parts of the vessel, and that they were in the constant habit of passing from a temperature of 50 or 60 degrees Fahr., to one of 15 or 20 degrees below zero. They also could work better and longer in the cold, in proportion to the accumulation of caloric which they acquired on board the vessel.

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But to return from this digression,-other cases of rheumatism were treated by the bath with complete and permanent success. These differed essentially from each other in the degree of violence, length of duration, and the system and habits of the individual, and yet the favorable effect on all was the same. A valet of a foreign minister, who had been afflicted with rheumatism of the upper extremities for a long time, had undergone a variety of treatment, and who at this time.found great difficulty in moving his left

arm, applied to us on the first of November. The first bath afforded him great relief, and the second cured him completely.

A gentleman from Woodbury, N. J., of a robust constitution, was attacked, in July, 1825, during the very hot weather, with a violent pain in his heel, which subsequently extended up the leg to the hip, causing eventually great stiffness and difficulty in walking. He had used various remedial measures with but little benefit, and resolved to take advantage of his visit to the city, to make trial of the vapor bath. He took five baths in as many days, and was then obliged to leave town; and though not quite cured, his improvement was manifest. He could walk without difficulty, and very little stiffness or pain remained.

In a severe case of lumbago, the patient being unable to dress himself, one bath, at a high temperature, aided by the flesh brush over the loins, effected a complete cure.

A few cases of a different character will now be related. Mr. H. aged 22, had an ulcerated tonsil on the right side, another ulcer on the back of the fauces, and a third on the velum pendulum palati.

There was also considerable tumefaction, so as to render deglutition very difficult, and the glands on the exterior were tumefied and painful. On the 25th of October, leeches were applied, and the use of the bath was commenced the next day. By evening the swelling was diminished, and deglutition easier. The bath was repeated on the 27th, with continued amendment. On the 29th, the ulcer on the velum pendulum palati, and that on the

posterior fauces, were well; the tonsil nearly healed; the external tumors removed; and an eruption of pimples on the face, which had existed for some time, fast disappearing. In a few days, probably from some imprudence, the external swelling again increased, but another bath, followed by a blister, soon removed it. The effects of the bath in removing pimples, and otherwise improving the complexion, in many who were taking it with other views, were so striking, that several females were induced to use it solely for this purpose, and were generally benefited.

About the same time, Mr. C., a student of medicine, aged 22, was induced to make trial of the bath. He had an enlarged spleen, with a tumid, soft abdomen, denoting the commencement of effusion. His complexion was sallow and leucophlegmatic, his tongue furred, his bowels irregular, and skin dry. The first bath caused him to sweat freely, and he slept better than usual the succeeding night. The next morning his urine was thick, and he was free from an unpleasant taste in the mouth, which had been a constant attendant on his complaint. He repeated the bath from time to time, with such advantage, that his skin became gradually clear and moist, his bowels regular, his abdomen reduced, and his general feelings much improved. In short, the bath, aided by the flesh brush, and attention to his bowels, entirely cured him in the course of a few weeks.

A Mr. V. had for a considerable time suffered from a cutaneous eruption, accompanied by a torpid condition of the liver. attended with white and hard fecal