In scarlatina Dr. Currie has lately shown the advantages of cold ablutions, and the necessity of continuing them steadily to obviate the violent heat which attends the paroxysms of this complaint; and he has been successfully followed with equal spirit and perseverance by Dr. Gregory. -As the object is to abate heat, it is only used in this complaint when the heat is very violent, and continued until it is mitigated. In small pox, accident has also shewn its utility; and in the whimsical compilation of Dr. Baynard there are numerous instances of this kind. It has in this complaint also been continued till the extreme heat is repressed, and, on returning to bed, a gentle perspiration has come on; some of the pustules have filled, and the greater number in the skin have disappeared. Since the general progress of vaccination we shall probably have little occasion for this remedy, either communicated by air or water.
In hemorrhages, cold-bathing, or, more frequently, cold applications, have been employed with the same views; nor, excepting in haemorrhoids and haemoptyses, has it been neglected: in the former, as a supposed critical discharge; and in the latter, from apprehension of accumulating the blood in the lungs. Cold drinks have, however, in haemoptyses supplied their place; and it is doubtful whether the American practice of giving a solution of common salt may not derive part of its advantages from the cold of the water, which common salt however will not increase. The utility of nitre in all haemorrhages, is certainly increased by the cold it imparts to water during its solution. Hippocrates remarks, that the cold should be applied ' non supra ipsas partes, sed circa ipsas, unde profluit.' The haemorrhage most certainly relieved by cold is maenorrhagia, and particularly that of pregnant or puerperal women. It may be safely and advantageously carried to a very considerable extent.
In more general fevers, cold in every form is useful. In those of our own climate, cool air and cool drinks are perhaps sufficient. In those of warmer regions, however, the cold must be more actively exhibited. It is chiefly confined to such fevers as have considerable internal heat without topical affections; and whether, with Hippocrates, we give water with
Lommius and Avicenna, apply cold water or snow to the extremities; with-celsus, apply vine leaves dipped in water to the pit of the stomach; the principle is the same. Paulus AEgineta recommends bathing; and in later periods it has been employed by Dr. Stevenson. But the most striking and satisfactory case is that of Sir J. Chardin in the Gombron fever of the remittent kind, related by himself, in which the coldest drinks and the application of cold water externally were of the greatest service. The Neapolitan physicians, following the ancients, according to the plans detailed by Lommius, give the coldest drinks; and if faint sweats come on, the water is if possible rendered still colder with snow and ice; for Cyrillus adds, that 'a person who sweats while under this course, is in danger of losing his life by faintness.' If cold drinks do not produce this effect, ' the patient is uncovered, exposed to cold air, and continually fanned; and some have gone so far as to sprinkle snow powdered on the skin.' The plague is attended with great internal heat, and cold applications have been found useful. Dr. Baynard has detailed many rambling stories of this kind, and we apprehend that they have been of service in our late experience of this disease in Egypt. Dr. Rush used cold applications with advantage in the yellow fever.
In mania, cold bathing seems to have attracted the attention of Van Helmont, in consequence of an accident which happened to a carpenter at Antwerp, and he afterwards employed it designedly. The patient was immersed so long as was necessary to repeat, distinctly, the psalm 'miserere;' and, though he would be often taken up apparently lifeless, Van Helmont adds that he might be recovered; since people do not die from being under water so soon as is imagined.' It is however more to the purpose to remark, that this remedy is spoken of with respect by Boerhaave, and countenanced by Van Swieten.
The repeated action of cold bathing affords numerous opportunities of relieving some of the most troublesome and obstinate diseases to which the human frame is subject. Every complaint arising from debility in its varied forms and numerous consequences often yields to this remedy, when every other has proved ineffectual. Palsy, so often benefited by the stimulus of the warm bath, is greatly relieved by the tonic power of the cold; nor is the danger of its being improperly applied so great. It must not be used early in the complaint if the case is hemiplegia, nor until every symptom of congestion is removed. The partial palsies will not require even this precaution; but the cold is more useful if the water is poured from a height, or thrown from a pump, on the part affected.
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Chronic rheumatism, we have said, is a paralytic affection of over distended vessels, and cold bathing is a singularly useful remedy. Sir John Floyer thinks it more beneficial if the patient is afterwards put between blankets to sweat. In the intervals of gout, if the patient is perfectly free from the disease, it is of service in restoring flexibility to the stiffened limbs, giving strength, and perhaps protracting, with safety, the return of the paroxysm. In stiffness of the joints from old strains, or any cause, it is useful; and the sea bathing has been supposed particularly so in white swellings of the knee. In other forms of scrofula, bathing and drinking salt water alternately are very serviceable.
In the haemorrhages "without fever, called by pathologists passive, and in the mucous discharges from relaxation, the tonic power of the cold bath is useful. In those little fevers, connected with debility or owing to excess, it relieves; though it is doubtful whether it be from its tonic power, or, in the language of Petron, from its exciting new motions. In chlorosis, though it does not produce any very rapid benefit, it is often of the greatest service to the general health, and ultimately brings on the expected evacuation.