Rules for bathing

Rules for bathing and the adminstration of the baths

These text about hot bating has been written by prominent physician of XIX and XX cent. J. H. Kellogg. His insights remain extremely useful today. We reprint them unchanged from 1906.

The following general rules should be carefully studied and thoroughly understood by every one who expects to employ the bath. Much injury to health and most of the discredit cast upon the use of water as a remedy have arisen from a disregard of some of them.

1. A full bath should never be taken within two or three hours after a meal. Such local baths as fomentations, compresses, foot baths, and even, sitz baths, may be taken an hour or two after a meal; indeed, compresses and fomentations may be applied immediately after a light meal without injury.
2. Employ the thermometer to determine the temperature of every bath when possible to do so; if not, employ the other methods described.
3. The temperature of the room during a bath should be 70° to 85°. Invalids require a warmer room than persons in health. Thorough ventilation is an important matter; but drafts must be carefully prevented, by screens of netting placed before openings into the room when necessary.
4. Never apply either very cold or excessively hot treatment to aged or feeble patients. Cold is especially dangerous. Hot baths are rarely useful in health. The warm bath answers all the requirements of cleanliness.
5. Never take a cold bath when exhausted or chilly. A German emperor lost his life by taking a cool bath after a fatiguing march. Alexander came near losing his life in the same manner. Many have been rendered cripples for life by so doing. No harm will result from a , cool bath if the body is simply warm, even though it may be in a state of perspiration. Contrary to the common opinion, a considerable degree of heat is the best possible preparation for a cold bath. The Finlanders rush out of their hot ovens—sweat-houses—and roll in the snow, without injury.
6. Cold baths should not be administered during the period of menstruation in females—unless there is fever with an extremely high temperature. At such times, little bathing of any kind is advisable with the exception of warm or tepid sponge baths, or such treatment as may be advised by a physician.
7. Bath attendants should carefully avoid giving “shocks” to nerv¬ ous people or to those inclined to apoplexy or affected with heart disease. Shocks are unpleasant and unnecessary for any one.
8. Never apply to the head such treatment as will cause shock, as the sudden cold douche, shower, or spray bath.
9. In applying a bath to sick persons, it should always be made of a temperature agreeable to the feelings.
10. The temperature of a warm or hot bath should always be decreased just before its termination, as a precaution against taking cold.
11. Very cold and very hot baths are seldom required. The barbarous practices of half a century ago are now obsolete, or should be if they arc not quite discontinued as yet. No good resulted from them which cannot lie attained by milder means, and much harm was occasioned which is avoided by the use of less extreme temperatures.
12. Those not strong and vigorous should avoid drinking freely of cold water just previous to a bath.
13. The head should always be wet before any bath; and the feet should be warmed—if not already warm—by a hot foot bath, if necessary.
14. A light hand bath every morning will be none too frequent to preserve scrupulous bodily cleanliness. More than a week should never be allowed to elapse without a bath with warm water and soap.
15.  One very important element in the success of a bath is the dexterity of the attendant. The patient should be inspired with confidence both in the bath and in the skill of the attendant. The mind has much to do with the effect of a bath.
16. Patients should receive due attention during a bath, so that they may not feel that they are forgotten. Nervous patients often become very apprehensive on this account. It is also important, in most cases, that a reasonable degree of quietude should be maintained.
17. When any unusual or unexpected symptoms appear during a bath, the patient should be removed at once. In case symptoms of faintness appear, as is sometimes the case in feeble patients, during a hot bath, apply cold water to the head and face, give cool water to drink, lower the temperature of the bath by adding cool water, and place the patient as nearly as possible in a horizontal position.
18. In general baths, the patient, unless feeble, will derive benefit by assisting himself as much as possible.
19. The best time for treatment—especially cool treatment—is about three hours after breakfast.
20. In health, a cool or cold bath should be very brief, lasting not more than one or two minutes. A tepid bath should not last more than ten or fifteen minutes. A warm bath may be continued thirty or forty minutes, or even longer, but nothing; could be more absurd than the custom prevailing in some places of prolonging the bath to great length.
    At Pfeffers and Leuk, in Switzerland, many persons spend the whole day in the water, taking their meals on floating tables, and occupying their time in reading, playing chess, and other games. Some remain in the water as many as sixteen hours out of the twenty-four. Of course, certain baths may be advantageously prolonged in cases of disease; but no intelligent physician will now recommend the antiquated practice which we sometimes see represented by a patient seated in a tub, with an open book in hand.
21. It is of extreme importance that the patient should be carefully dried after any bath. A large sheet is much better for this purpose than a towel. An old linen or cotton sheet is preferable to a new one, being softer.
22. A patient should never be left chilly after a bath. Rub until warm. It is equally important that the body should not be left in a state of perspiration, for it will soon become chilly.
23. Patients who are able to do so should exercise a little both before and immediately after a cool bath, to insure thorough reaction.
24. For feeble persons, an hour’s rest soon after a bath will add to its beneficial effects. It is best to go to bed and cover warm.
25. If a bath is followed by headache and fever, there has been something wrong, either in the kind of bath administered, or in the manner of moving it.
26. Always employ for bathing purposes the purest water attainable. Soft water is greatly preferable to hard on many accounts.
27. Patients should not be allowed to become dependent on any special form of bath, as an after-dinner fomentation to aid digestion, the abdominal bandage, or any other appliance. Destroy such a habit if it has been formed.
28. Order, cleanliness, dispatch, and a delicate sense of propriety, are items which every bath attendant should keep constantly in mind, and which will often contribute in no small degree to success in the use of this agent.
29. Never employ a bath without a definite and legitimate purpose in view. It is somewhat customary, in many institutions where water is employed, to apply it in a routine way. Many baths are prescribed for the sake of producing variety or pleasing the patient. A faithful and scientific physician will carefully adapt his remedies to the condition of his patient, and will observe the results.

It seems to be a prevalent error that it makes little difference how water is applied, provided the patient is only wet. Warm, hot, tepid, temperate, cool, and cold baths are used indiscriminately. So, also, the different modes of administering baths of the same temperature are disregarded in many cases. In general, each particular form of bath is especially adapted to the treatment of special conditions, and it is the best test of the proficiency of a physician, in the use of water, to observe whether he recognizes the distinctions between the various kinds of baths, and is able to adapt them to the appropriate conditions.

Giving too much treatment is likely to be the error into which the inexperienced will fall, rather than the opposite extreme. Nature cannot be forced to do more than she is capable of doing; and as nature must do the healing, if a cure is accomplished, remedies should be of a helping rather than a crowding or forcing nature. The vitality of patients may be expended uselessly by treatment; for baths excite vital resistance, as well as drugs, a. fact which many overlook. The dangers of over-treatment are not so great as some imagine, however, who take the opposite extreme, and advocate rest as the great cure-all. We have seen patients who seemed to be quite monomaniacs on the subject of “ rest cure,” who needed a good thorough stirring up with useful exercise more than any other kind of treatment.

M.D. J. H. Kellog HOME HAND-BOOK  OF Domestic Hygiene  AND  RATIONAL MEDICINE.