Water may render great service in constipation, through the general improvement in health which may be secured by its sytematic use. Cold water is of the greatest service. The short spinal douche is one of the most effective means which can be employed for improving the tone of the nervous system.
The inactive skin, due to the general saturation of the body with toxins, is an indication for sweating baths. In constipation these should be made short, however, barely long enough to stimulate the skin to vigorous perspiration, and should be immediately followed by a short general cold application, including a cold douche to the spine, abdomen and legs. Short, cold applications applied to the surface cause reflex contraction of the internal involuntary muscles. It is for this reason that placing the feet, sometimes even the hands, in cold water will often produce a desire to empty the bladder, through stimulation of the urinary centre.
The defecating centre and intestinal muscles may be stimulated in the same way. Various local applications are of great service in improving the tone of the bowels, though local cold applications must be used with great discretion and with careful knowledge of the exact nature of the case; for the tendency of cold to produce contraction of the involuntary muscles leads to an aggravation of the condition in colitis with spastic constipation.
Of the many different modes of applying cold water, which may be of service, the following are especially recommended:
Swimming is undoubtedly the best form of bath, as well as the best form of exercise for general hygiene effects. Unfortunately, facilities for this natural exercise bath are not available for the majority of persons, especially during the winter season. Some time ago, it occurred to the writer that most of the advantages of the swimming bath might be secured by combining exercise with the cold bath in an ordinary bath tub. The following is a description of the rowing or surf bath as it is in use at the Battle Creek Sanitarium:
The patient sits in a bath tub partly filled with water, and dips water over himself while at the same time executing the movements of rowing. The temperature of the water may be 100° F. at the start, but should be rapidly lowered by opening the cold water faucet and, if necessary, letting out part of the water while the cold water is running in. The rowing and dipping apparatus consists of a parr of handles to which is attached a dipper and a rubber cord.
The Bath Exerciser and Surf Bath.
The Pouring Douche.
The bather fills the bowl as he reaches forward, then dashes the water over his body as he pulls the bowl towards his chest and bends his body back. Strokes are made at the rate of about thirty per minute. From one hundred to one hundred and fifty strokes are made. The temperature of the water grows continually colder to the close of the bath or until pipe temperature is reached. A temperature of 70° F. to 65° F. is easily borne, and one finishes the bath with the same delightful sensation of warmth and glow which one feels after a swim in the surf. The temperature of the water is, of course, under perfect control, an advantage over sea bathing; and the work done may be made as vigorous as one desires.
This exercise bath is most excellent for persons suffering from constipation. The impact of the cold water upon the surface of the abdomen re-flexly stimulates intestinal activity.
A short cold douche to the lower part of the back, buttocks, abdomen and feet. The temperature should be 70° to 50° F., and the duration ten to thirty seconds. With patients who are not accustomed to applications of cold water, the temperature of the douches should at first not be lower than 70°. This should be gradually lowered at each application until the temperature of 60° to 50° is reached. In general, the douche should be preceded by a short hot bath to prepare the patient for the cold application, and to secure prompt reaction, which is still further encouraged by exercise after the bath.
A very excellent form of bath especially adapted to cases of constipation, is the simultaneous warm shower bath (100° F.), with short cold douche to the abdomen. The warm shower bath should be applied for half-a-minute so that the skin will be thoroughly warm first, and the cold spray or broken jet should be applied to the abdomen without interrupting the warm shower. The temperature of the spray should be 70° to 50°. The duration of the cold application should be not more than a minute. At the end of the bath a short general cold application lasting no more than ten to fifteen seconds should be made to secure reaction, and thus fix the blood in the skin.