CHAPTER XXIV BATHING
1, The Hygiene of Bathing. — The principal hygienic purpose of bathing may be stated in one word, namely, cleanliness. A bath is often stimulating and refreshing, and special kinds of baths may be used upon occasions for good and useful ends; their value in the treatment of many diseases is coming to be widely recognized, and even in health they may be useful as aids to the best work- ing power. But experience shows that it is not necessary, even if it be refreshing, for a healthy person leading a healthy life to use bathing for any other purpose than cleanliness.
The sweat glands and the sebaceous glands pour out upon the skin secretions which primarily serve the useful purposes of regulating the temperature of the body and keeping pliable the horny layer of the epidermis. Each of these secretions contains solid material, which, as the water of perspiration evaporates, is left on the surface of the skin or in the ducts of the sweat glands ; some of the solids, too, are either themselves odorous or else are putrescible, giving rise to offensive decomposition products; conse- quently it is a duty which every one owes to his fellow-man to bathe so as to be clean and to render that bathing effective by wearing clean clothes. A clean person, clean clothing, ‘a clean house, clean premises, clean streets, a clean town are so many forms of that habit of cleanliness which is one of the characteristics of high civilization, one of the funda-
mental elements of self-respect and proper living. 413
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Besides this, filth and dirt are effective carriers of dis- ease; consequently bathing and the use of clean clothing diminish the chance of infection. Finally, personal clean- liness also keeps the skin in a healthy condition, and this alone is a sufficient reason for making it a rule in the hygienic conduct of life.
The Indifferent Bath. — A bath which is neither dis- tinctly cold nor hot may be said, in general, to answer all purposes of cleanliness. The temperature of such a bath varies between 80° and 90° F. with different individuals. When soap is used, water of this temperature removes the waste products from the skin sufficiently for all practi- cal purposes, especially when such a bath is taken daily. Indifferent baths are, however, without any stimulating (or depressing) physiological effect, provided they are not taken in a cold room; and for some people they are the most advisable form of bathing.
The Hot Bath used alone is not as a rule advisable. It has a well-recognized enervating effect, and experience shows that after it great caution is required as to exposure to cold. These effects, however, are generally obviated by following the hot bath with a cold needle bath, a cold shower, or a cold plunge, and possibly this procedure may be recommended as the most useful and beneficial form of bathing for the great majority of people. The hot bath serves the purposes of cleanliness more effectively than the indifferent bath, and the shock of the cold bath is not so trying to many people when taken immediately after the skin has thus been thoroughly warmed. Too frequent and especially too prolonged hot bathing, however, is apt to remove too much oil from the skin.
Hot baths, either of the body as a whole or at times a hot footbath, are often useful in bringing the blood to the skin and thus checking a threatened cold or other inflam- matory process. Special care is needed, however, in this
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case to avoid subsequent exposure to cold. It should also be remembered that a very hot bath is a strong stimulus to the nervous system as a whole.
- The Cold Bath is a powerful stimulus to the nervous system. When the irritability of the latter is low, as when we awake from slumber, it “wakes us up,” and immedi- ately after it we feel distinct exhilarating effects. In addition to this it probably serves as a training to the heat-regulating mechanism of the body, “hardening ” the body to the effects of cold. Undoubtedly its influence with a large proportion of healthy people is beneficial, though, as we shall see, this is not the case with all. Before dealing with this side of the question we may give some rules which are always applicable in the use of such baths.
First, they should not be prolonged. To stay in a cold bath longer than one minute is undesirable save in a very few exceptional cases; thirty seconds is the usual time, while with some people ten seconds is the maximum.
Second, a cold bath should be taken when the skin is warm. Immediately on rising in the morning, immediately after muscular exercise, or immediately after a hot bath it is most beneficial and least likely to produce bad after effects.
Cold bathing should always be followed, excey-t in warm weather, by a good rub-down with a rough towel. This promotes a good flow of blood through the skin and adds to the tonic effects.
A cold bath should not be taken in a cold room. Many profit by its use in summer, but experience undesirable effects in winter.
Third, cold bathing should not be used unless it is fol- lowed by what is called the “reaction”; that is, unless it produces a distinct glow in the skin. The persistence of pallor in the skin after the rub-down is proof that the
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system does not react properly, and is a warning that this form of bathing should be given up or at least modified. This does not mean that the bath necessarily agrees with us if it does produce the “glow,” for this is only one of its after effects, and we must judge of its usefulness not by one but by the sum total of the effects produced.
Fourth, no bath, unless it be possibly the indifferent bath, should be taken within an hour or more after a meal. The evidence of experience on this point is so unmistakable that nothing more need be said about it.
It would be a mistake to discourage all bathing except that which is used for purposes of cleanliness; and when we insist that both hot and cold baths are an artificial ele- ment introduced into the environment, it is only to enforce the need of carefully observing the effects of their use. No one is justified in saying that these baths are neces-
sarily good for all healthy people; no one is justified in
recommending them as essential elements in the hygienic conduct of life. They must be judged by their effects, and when submitted to this standard it would appear that while they are beneficial to some people they are harmful to others.
We must furthermore distinguish between the immediate results, those noticed later in the day, and the remote results. The immediate effects may be exhilarating; we may “feel splendid” afterward, and yet this feeling may be succeeded by one of depression. At times cold bathing on rising in the morning results in constipation, although the bath itself may be enjoyable. This may be exceptional, but it shows that every one must determine for himself
the value of the bath by the sum total of its after effects,
and not alone by those which accompany or immediately follow it.
- Swimming and Salt-Water Bathing. — When one is swimming, the heat produced within the body by muscular
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activity counteracts to some extent the effect of the cool or cold water applied to the skin. Hence it is possible to remain in the water a longer timé with safety and even with profit than in the ordinary cold bath. It is quite impossible, however, to give definite rules as to the length of time one should remain in the water, since this depends on the amount of muscular activity, on the tem- perature of the water, and on the condition of the bather. But the hygienic value of swimming and sea bathing must be determined by the same tests as have been urged in the case of cold bathing in general.
It is also important to remember the danger of going into cold water when one is fatigued from muscular activ- ity. The fatigued muscles seem especially liable to go into cramps under these conditions, and persons have been drowned in this way before help could reach them.
When one takes vigorous daily exercise the best time for the bath is immediately after the exercise. One is then in a perspiration and it is best to change the clothing. The skin is most readily cleaned in this condition, and most persons find a hot bath, with or without the use of soap, followed by a short, cold needle bath, shower, or plunge, preferable to other forms of bathing. The time for bathing, however, like the time for eating, must depend on one’s work in life. We do not live to bathe, any more than we live to eat.