Cold and sea.
By the cold bath is meant that application of cold water which produces a sense of coldness called a shock, and which is followed by the increased action of the extreme vessels styled a glow. One extreme of the scale we well know, that of the freezing point; the other is undetermined. The Buxton water of 82° occasions a slight but sensible shock, so that the limits are not below this degree; and as temperate heat is placed at 62°, we shall not be greatly in error if we fix the other extreme at 72°.
The first effects of the. cold bath are well known. The whole body is contracted; the bulbs of the hair are conspicuous; and the skin, resembling that of a newly plucked goose, has been styled cutis anserina. The debility and tremor are considerable; a sense of weight is felt in the head; the respiration is quick and laborious. These appearances are followed by a very different series. A glow soon returns to the surface; the weight in the head is almost instantaneously relieved, and every function appears to be carried on with increased activity. If a person stays for a longer period in the cold bath, the glow will be slighter and soon disappear, while every previous symptom of debility will return and continue.
Few experiments have been made on the efecct of the pulse after cold bathing. Dr. Stock has, in the trials he made, found in general the pulse quicker and weaker after immersion; in a few instances only slower. The writer of this article has found similar results; but the pulse, felt at a more distant period than that mentioned by Dr. Stock, has been usually more slow and full. In a slight feverish complaint, the quickness of the pulse was greatly mitigated. Other authors have found the pulse much slower, but this was the consequence of partial cold only.
If the immersions arc at due intervals repeated, and the stay in the bath be not improperly continued, the general health and spirits are greatly improved; the different necessary evacuations properly carried on and supported; and the body and mind appear to act with increased vigour.
The explanation of these phenomena is not difficult. The cold, by its sedative power, represses the circulation in the extreme vessels, and the fluids are accumulated in the larger arteries and veins. Whether the distention excites the action of the former; whether in consequence of repressed irritability it is afterwards restored with greater vigour; or whether the vires medicatrices re-act to conquer debility; we must not now enquire: but in every such circumstance, from one of these causes, the circulation is again restored with additional activity. The repetition of cold bathing produces tonic effects, which, we own, that we are inclined to attribute to the frequent exertion of this reacting power. We have often remarked in this work that the constitution gains energy by the exertion of those powers whichpreserve life and correct deviations, and we think the benefit, thus obtained, is a proof of that position.
According to the management of this remedy, we-may therefore secure very different and opposite effects. A sudden change in the determination of the blood and nervous power, assisting its re-action, will produce a very different effect from the continued, and this again from the repeated, application: a distinction necessary to be attended to, in considering the different diseases in which the application of cold water has been considered as a remedy.
From the sudden changes in the determination of the blood it has been employed in many diseases, and particularly to prevent or remove the paroxysms of an intermittent. In the attack of this disease, there is a similar change of determination to that which has been described from the effects of the cold bath; and it is relieved by a similar exertion of the constitution. The cold bath, therefore, may be supposed to excite that exertion, and to render the subsequent relief more permanent and effectual; or, if the determination to the skin from the bathing has come on, the fit may be wholly prevented. The plan certainly has succeeded, and it is mentioned by Senac to have been useful even after the cold fit has appeared, (De Recondita Febrium Natura, p. 218).
If continued fevers are only intermittents, whose paroxysms run into each other, so that the earlier stages are less observable, we may see some foundation for its use in these also. Remittents are confessedly of the same nature as intermittents; and in the Breslaw fever (the trytaeophya Wratislaviensis of Sauvages), De
Hahn used the application of cold water with success. It brought on a glow of warmth; and, in the language of an ancient physician, inde novi motus initium. In some other cases of typhus it has been employed, seemingly with success; but in some late trials, at a period of the disease when the powers of nature were unable to excite these new motions, it was unsuccessful and even dangerous. Dr. Currie's practice of cold ablutions we shall soon consider.
In ileus, the practice of dashing cold water against the legs and thighs of a patient standing on a cold floor has certainly succeeded. It is mentioned by Brassavolus, as the practice of Savanarola, and is recommended by Hoffman (iv. 349). The latest author who seems to have employed it successfully is Dr. Stevenson (Edinburgh Medical Essays, vi. 895). We remember having tried it with little advantage. If sudden immersion in cold water has prevented threatening paroxysms of hysteria and epilepsy, it must be referred to altered determination.
The debility occasioned by continuing long in the cold bath has occasioned its employment in many instances, where the excitement of both the nervous and sanguiferous systems was morbidly increased. (See Cold.) In cases of phrenzy it has, been employed with success; but the most striking instance of this kind is in Dr. Willis's work, De Anima Brutorum, p. 201. The most frequent cases in which its advantages have been conspicuous, occurred from phrenitic patients escaping their confinement, and running spontaneously to a river or pond. Applications of cold water to the head are frequently employed; but the more general influence of cold must produce a more powerful effect. There may appear to be some danger from rupture of the over distended vessels of the brain, but no such accident seems ever to hare occurred.