THE BATH IN DISEASES OF THE SKIN. CHAPTER I. VALUE OF BATHS IN DISEASES OF THE SKIN. Extensive Prevalence of these Affections.-Necessity for the Vapour Bath in such Cases.—Value of it generally in Skin Disorders.— In certain individual Diseases.-Lepra.-Relief from the Itching and Stiffness.-Cases.-Reaction under the Bath.-Ichthyosis. -Eczema.-Vapour Baths for Children.—Mere Perspiration not the sole Agent of Relief.—Different kinds of Perspiration.— Value of the Vapour Bath in Prurigo.-Nettle Rash.-Skin Diseases as Safety-valves.—Gout, Rheumatism, and Neuralgia as Complications of Skin Diseases.-The modified Turkish Bath as a Remedy for these, and for a Cold.-Wrapping up.— Cultivation of Tendency to Gout, Bronchitis, etc. A BOUT a year and a half ago I calculated, from the figures in the last census and numerous returns procured from hospitals, dispensaries, and workmen's clubs, that the number of persons, attacked every year in Great Britain by diseases of the skin severe enough to call for immediate relief, and for which the advice of medical men is sought, could not be less than a hundred and twenty-seven thousand five hundred. I advisedly stated then, in a lecture on the subject, that I believed this computation to be far below the reality, and have since been informed that I might very well have doubled it. I therefore assume that it would be quite safe to put down the number at a hundred and fifty thousand. To this must be added at least a third more for chronic cases given up in despair, and those of a large proportion of persons debarred by one reason or other from seeking medical assistance. Lastly, there are many thousands of both sexes suffering from a tender irritable state of the skin, sometimes misunderstood nascent disease, who do not feel justified in incurring the cost of a long course of treatment, and, indeed, are often ashamed to solicit the surgeon's aid for the removal of complaints which, though a source of great discomfort and even misery, do not appear of sufficient gravity to warrant such a step; an error for which they now and then pay dearly enough in the end. To these may be tacked on a host of persons labouring under three well-known affections often supposed to be connected with skin diseases-namely, gout, rheumatism, and neuralgia. For at least seven-tenths of the first class of sufferers— that is to say, those with actual skin disease—for the whole of the second and for a large proportion of the third, the vapour-bath might be spoken of as a boon, assuaging, and very often rapidly, distressing symptoms which medicines reach but slowly and inadequately, or even fail to relieve, however long their use may be persisted in. It would only weary and confuse the reader were I to give here the reasons for this conclusion; it must seem rather startling to affirm, that one simple and uniform remedy exerts so potent a sway over a group of evidently dissimilar affections, but the justification will appear set out at length in the body of the work. Suffice it to say, merely for example's sake, that every case of eczema in the dry stage is more or less benefited by the bath; that every case of lepra requires it; and that these two forms of disease, alone, take up about forty per cent. of all skin affections, a proportion which rises in some parts of America to nearly sixty in the hundred. Indeed, whatever discrepancy of opinion may prevail with respect to the value of vapour-baths in other maladies, I have seen every reason to believe that, as regards their action in the diseases for which they are now recommended, experience will be almost unanimous among those who give them an impartial trial. At one time I dreaded their effects in the very affections for which I now recommend them, but that was before the objections to the baths, at that time alone in use, had been overcome. The same objections still hold good with respect to the majority of them, and therefore I must ask the reader to understand that those now advised are essentially and almost exclusively such as have vapour for their basis. And first of all, as concerns the efficacy of these in lepra, sometimes known, improperly to my thinking, as psoriasis, more frequently as the white leprosy of Scripture, though this really included two other quite independent |