Cold and hot applications have unquestionable value in inflammatory affections of the abdominal organs. The author has seen excellent results from the application of an ice-bag over the swelling in cases of typhlitis and perityphlitis. Peritonitis is similarly treated with advantage. When the inflammation is recent, the abdomen may be covered with an ice-bag of sufficient size. It has been shown that not only may the local symptoms of inflammation be abated in this way, but the general temperature of the body be thus reduced. It is proper, in making these cold applications, to interpose a napkin or towel between them and the skin.

Pounded ice is an excellent application to strangulated hernia to favor reduction, and this has often been sufficient when the taxis failed. Haemorrhoids that are much swollen and painful, or that bleed, are much improved by applications of ice. Bubo and swelled testicle are greatly benefited, and the pain attendant on them relieved, by ice.

Cold to the abdomen in the form of ice or cold water, and ice-water thrown into the uterus, or ice introduced into the cavity of the womb, are measures of great utility in uterine haemorrhage, whether from threatened abortion or post partum.

Hot-water injections, or the hot douche, is one of the most effective measures to be used in chronic metritis. A large quantity of water and frequent applications are needed to procure the best results. Not less than a quart of water as hot as can be borne, and three applications each day, are necessary. A Davidson's syringe, a vessel containing hot water, and a suitable vessel to receive the water as it flows away, are the materials needed for the vaginal douche. The first effect of this is to increase the blood-supply, but a marked degree of pallor of the mucous membrane follows, the opposite effect to that caused by cold water. When there is great relaxation of the vaginal passage and the uterus is large and spongy, the cold douche is more serviceable. Excellent results are sometimes obtained by the alternate use of the hot and cold douche. The free use of filtered rain-water has proved very efficacious in albuminuria, and to effect the solution of renal calculi. It must be drunk in large quantity. The good effects of Behesda and of other weak alkaline waters must be referred to the same action; for these waters can be drunk in larger quantity without distressing the stomach, than the hard waters. They must be used freely and for many months, to accomplish curative results.

The applications of water in surgical practice are numerous and important. As a dressing for wounds, contusions, and inflamed parts, it is in universal use. The author is convinced that the cold-water treatment of wounds is often overdone, the circulation in the wounded part being too much depressed, whence repair is slow, or sloughing is induced. The hot-water dressing, or the immersion of the affected part in hot water (95° to 100° Fahr.), as proposed and practiced by Prof. F. H. Hamilton, of New York, is a method which promises most successful results:

"The phenomena usually observed in cases of recent lacerated or incised wounds, when submerged, are a sense of comfort, yet not absolute relief from pain; on the second or third day the parts adjacent are swollen but not much reddened; the integument generally assumes a white and sodden appearance, and with only slight tenderness. On the fifth, sixth, or seventh day the swelling is greater than usually accompanies other plans of treatment, and, with the inexperienced, is likely to excite alarm; but it is found not to be attended with increased tenderness, and it pits under pressure, showing that it is a condition of oedema chiefly. At this time the granulations are generally covered with lymph, or some exudate of a whitish color, and which might easily be mistaken for a diphtheritic deposit. At the end of fourteen days or thereabouts (the period at which, in most cases, we substitute fomentation for submersion) the limb is still aedematous, the granulations are abundant, sometimes presenting a fresh red appearance, and at others covered with the white exudate."

Prof. Hamilton further remarks:

"No treatment hitherto adopted, under our observation, has been attended with equally favorable results. Under this plan the area of acute inflammation is exceedingly limited; erysipelatous inflammation has been uniformly arrested or restrained when it has actually commenced, and it has never originated after submersion; gangrene has in no instance extended beyond the parts originally injured, and, when progressing, it has in most cases been speedily arrested (in gangrene, hot water, or water at a temperature of from 100° to 110° Fahr., is to be preferred). Septicaemia and pyaemia have not ensued in any case in which submersion has been practiced from the first day of the accident. Purulent infiltrations and consecutive abscesses have been infrequent, and always limited to the neighborhood of the parts injured, and of small extent. Traumatic fever, usually present after grave accidents, when other plans of treatment have been pursued, as early as the third or fourth day, has seldom been present when this plan has been adopted, and in no case has the fever been intense or alarming."

For the immersion of hand, foot, arm, and leg, Hamilton has constructed bath-tubs of peculiar shape. He advises this method of treatment in contused or lacerated wounds of the extremities. Simple incised wounds and amputations are unsuited to this plan of treatment.

I subjoin the titles of some of the most recent and important contributions to our knowledge of the actions and uses of water. It is proper to add that I have also consulted the works of the followers of Priessnitz, but they are singularly deficient in accurate and scientific knowledge:

Brand, Dr. Ernst. Die Heilung des Typhus, mit einem Anhang: Anweisung fur die Krankenwarter bei Behandlung des Typhus mil Büdern, Berlin, 1868, A. Hirschwald.

Braun, Dr. Julius. Systematisches Lehrbuch der Balneotherapie, dritte umgearbeitete Auflage, Berlin, 1873, pp. 714.

Fox, Dr. Wilson. Observations on the Treatment of Hyperpyrexia, London Lancet, vol. ii, 1871, p. 231, el seq.

Hamilton, Dr. Frank H. The Medical Record, New York, vol. ix, May 15, 1874.

Jurgensen, Dr. Theodor. Die Körperwärme des gesunden Menschen (Studien), Leipzig, 1873, p. 28, el seq.

Liebermeister, Prof. Dr. Carl. Beobachiungen und Versuche über die Anwendung des kalien Wassers bei fieberhaften Krankheiten, Leipzig, 1868, pp. 480.

Ibid. Ziemssen's Cycloapedia, American edition, vol. i, p. 206, et seq.

Ibid. Handbuch der Pathologie und Therapie des Fiebers, Leipzig, 1875, p. 598, et seq.

Valentiner, Dr. Th. Handbuch der allgemeinen und speciellen Balneotherapie, George Reimer, 1873, pp. 850.