Mark Twain tells us about a man who so thoroughly abhorred water, because his brother was drowned in it when a boy, that he never drank anything but whiskey. But people of But people of average intelligence with proper ideas of cleanliness, usually make good use of water applied to the body externally, for hygienic, and cosmetic reasons. As we know, the body is largely composed of water, and it is highly essential to life and health internally and externally. As has been said, water, the universal solvent, is the "blood of the earth," and when we have a long drouth it is a self evident fact that neither animal nor vegetable life would continue without water.

Water, as a therapeutic agent, has a variety of indications and effects, but our attention will be directed only to the use of water as a hygienic and therapeutic agent when utilized in the form of vapor as a bath.

Vapor baths are not a thing of to day, but are of great antiquity, as we have accounts of the use of the vapor bath during the 12th century, so that none of our modern physicians can claim the honor of invention. It is even now and has for ages been employed among semi-civilized and barbarous nations. Whether applied by the savage in his hut by pouring water over heated stones, or dropping hot stones into the water until it boils and throws off the vapors, or applied in an elegant marble tiled saloon, by an experienced masseur, the object aimed at and achieved is essentially the same.

We excrete refuse matter in four ways viz:— by the kidneys, bowels, lungs and the skin, and the proportionate area of excretory surface is the inverse of the order named.

It is estimated that there are seven million pores in the human skin, each one of which has its especial function to perform. Interfere with that function to any great extent, by covering the pores with an imperoious covering and how quickly death ensues.

So we see how essential it is that the skin perform it's whole share of the work.

The skin not only has an excretory function, but it acts as a safe guard against heat or cold. Stop the evaporation of the insensible perspiration and the body temperature rapidly rises; increase it and it rapidly falls.

As ordinarily applied, a soap and water bath does not cleanse the skin, for be it applied ever so frequently and thoroughly, the skin will be seen under a magnifying glass to be dotted all over with thousands of little dark points, showing where the mouths of the pores and ducts are plugged with dirt.

Perspiration keeps the pores open by pushing out these minute plugs and depositing them upon

the surface, thence to be rubbed off, and the vapor bath is the ideal excitant to this process.

By an artificial elevation of external temperature, exosmosis is aided and the moist heat is better than the dry heat, in that it soaks the surface and loosens the dried and dead epithelial scales and plugs, making the vis a tergo required be less than it otherwise would. When a person sweats as one does either as a result of physical exercise, work or hot weather, this process goes on, but in this instance, the excreted effete matter and dirt is allowed to dry on the surface, and the pores are still either covered or plugged up. Therefore something else is required, following the exosmosis; that is, friction, applied to the skin, to entirely remove the matter from the skin, and leave it clean.

There are a variety of baths known by dif ferent names, and differing only in minor details, as the object sought in all is essentially the

same.

The Turkish bath is a sweat produced by immersion in a dry hot air. The Russian bath is produced by means of a moist hot vapor or steam according to the degree of heat. The Turko Russian is a combination of both, as its name signifies.

The aromatic, perfumed, medicated, and sulphur, mercurial, salt, alcohol, and vinegar bath, is either of the before named, with the air or vapor charged with the agents indicated.

The aromatics commonly used are the essentail oils of aromatic herbs or trees, as cedar, turpentine, pine, needle, anise, sassafras and a number of others. The oriental bath is a Turko Russian aromatic bath, so named from the custom of the orientals anointing the body with spices and perfumes after the bath, and is, in my experience, the most pleasant, satisfactory and preferable.

These baths, as given in the larger commercial bath houses, have many objections, a few of which will be discussed. These places consist essentially of four departments, viz the warm room the hot room, the steam room and the cold room. In the hot and the steam rooms the temperature is very high, too high for comfort or health.

A person entering the hot room has a sense of suffocation, which is often highly painful and injurious. In these rooms the atmosphere is superheated and must necessarily be deficient in oxygen and loaded with carbonic acid gas and nitrogen, and when a number have been in the same small room it is charged with the emanations from their sweating bodies, the exhalations from their lungs, bacteria and microbes of consumption and skin diseases of all descriptions, and to the mind of all physicians must certainly be an unsafe place in which to

breathe. Then, after the high temperature room the person is at once subjected to a sudden reversal of temperature, in going suddenly to the cold shower, or the plunge, and it must certainly be a strong constitution, and a well balanced nervous organization to withstand the shock.

Even with the strongest and best, there is a sense of weakness and debility that follows that requires hours of rest to dispel. This is nature's protest against such barbarity. The barbarous nations rush from their hot sweat holes, and jump into a cold s ream or roll in the snow, but that is because they know no better, and with many the remedy is worse than the disease, as it is often fatal. Yet I have heard some of our intelligent physicians praise this form of bath, and generally recommend it.

The therapeutic cabinet bath has been devised, in order to utilize the good points and avoid the evil results of the vapor bath, and as now used, is a safe, pleasant, healthful and beneficial means of combating disease.

It consists of a cabinet, or box, which surrounds the body, leaving the head outside, thus preventing the heating of the head, eyes, nose and lungs, and allowing the patient to breath pure cool air and converse freely. Sulphur and mercurial vapor could not safely be applied to the body any other way.

In this way each patient gets his bath alone, he is gradually heated and gradually cooled, thus doing away with the sudden extreme change of temperature, and subsequent shock to the nervous system, and the great physical depression. The patient sweats more freely at a lower temperature, and there is less danger of taking cold afterward. The electro vapor bath is any or all of these baths, combined with general or local applications of the different forms of electricity. As the bath cabinets are now arranged, the currents can be applied over any part of the body, and the moist skin makes a good conductor, and the cataphoric action of the current aids the absorption of the medicament contained in the vapor, and at the same time exerts its own sedative, stimulating, or anodyne effects.

The after treatment consists of massage, dry ing, rubbing, cooling, spraying with alcohol, etc., and when through, the patient is cooler than when he entered, the skin is soft and velvety, and clean, and the patient says he is rested and refreshed and better able to do work both physical and mental, and can at once go about his business without risk. This form of therapy is applicable to many affections, such as rheumatism, that bug bear of medicine, both articular and muscular, lumbago, sciatica, neuralgia, neurasthenia, colds, bronchitis, many forms of female

diseases, impotence, paralysis, and a host of skin diseases, especially common acne and hives. As a simple hygienic measure, the electro-vapor cabinet bath is invaluable as a cleansing and prophylactic agent.

The writer has had one of these aparatuses in practical daily operation for a year, and can speak from an experience that is entirely satisfactory. Neither the profession nor the laity are alive to the importance and the benefits to be derived from this form of medicine, but both are rapidly awakening to the fact that there is something in it, and are taking to it with goods results. Like any other therapeutic agent, the vapor bath can be abused, and must be given with judgement and sense, and when so given will not be a disappointment. The day will come when it will be recognized and generally approved by all.

HOMER C. BENNETT M.D., No. 5-7 Collins Block, Lima, O.

A Unique Method of Removing the Urine from an Over Distended Bladder.

Editor MEDICAL WORLD:-Some three months ago, a Koord was brought to the hospital, who for a month or more had been suf fering from retention of urine. The only way he had been able to get any relief, was by one standing his full weight upon the bladder. In that way they were able to force out a quantity two or three times a day, but never able to fully empty it. Is this a modern or an ancient method? I have not found it mentioned in the books. He is a large, strong, well built Koord, sixty years of age, had never seen a sick day, nor had any of the venereal diseases; had never done any bard work further than to rob and steal. The retention came on suddenly without any known cause. When he was first brought in the bladder was very greatly distended; he was unable to walk, and with difficulty could ride. I passed a No. 12 steel catheter with ease, drew off about four quarts of water, the color rather high, but with no abnormal odor. He remained in the hospital for a week or so, having his urine drawn off twice a day, in the meantime using treatment to try and tone up the organ so as to have it resume its normal duties. He was taught, in the meantime, to use the catheter himself, as I was about to leave for a time. It is now three months since I first saw him, and a faithful use of sanmetto and many other cure alls (!) highly recommended for such troubles, have failed to accomplish anything; he still has to use the catheter. Now, what is the trouble? A paralyzed organ from so long neglect which does not recover its contracility? I had some faith in sanmetto, but it failed here.

The man has another peculiarity, a double testicle on the left side; he takes a good deal of pride in it. D. M. B. THOм, M.D.,

Mardin, Turkey.in-Asia.

the sex. prodite.

I therefore pronounced it a hermaph

orrhea.-Plea for Acetanilid.

Editor MEDICAL WORLD:-I send you two photographs of two views of a child, delivered one year ago, which confinement I attended. The woman was in the best of health during her pregnancy excepting an abscess upon either labium majorum, each of which I lanced at different times and both of which discharged a large quantity of offensive pus.

The mother was a primipara aet. 20; the father 60. There was a very large amount of liquor amnii. The case was a breech-presentation. I believe this child can lay claim to more deformities than any other of which I have ever heard. If any reader of THE WORLD has had a case of any worse deformities I would be glad to hear from him.

You will observe, first, that it has a meningocele-protrusion of the meninges of the brain, caused by an accumulation of fluid within the cranium. I found the brain substance protruding (encephocele) with the meninges from the occipital region of the skull. The occipital bones had expanded and were much thinner, as

is usually the case, I believe. The saggital suture was intact to the frontal bone, but from the frontal bone to the inferior maxillary there was no union of the parts.

There was only the slightest sign of a nose upon either side of the division. There were no eye balls. The jaws were unnaturally large, resembling those of a hog. There was no evidence of a left arm but the right was perfectly developed. The major part of the small intestines were protruding, most of the stomach, part of the liver could be seen, all covered by a thin membrane. I was unable to distinguish as to

mother made a good recovery.

The

If Dr. Brooks, of Sunbury N. C, will dilate the cervix two or three times, a week or two

Permanganate of Potassium for Hornet's Sting. Editor MEDICAL WORLD:-I sent a man, with others, into a field to assist in cutting a certain piece of grass. This man came in contact with a nest of hornets, one of which stung him over the right eye. In about fifteen minutes the man came to the stable with a fellowhelper to grind their scythes, when he said he had been thus stung, and that his eye pained him badly. My attention being called to it, I saw that the parts were quite badly swollen. immediately dissolved three grains of permanganate of potassium in half an ounce of water and applied it to the part swollen, and in five minutes the pain ceased and in six hours the swelling was gone. A. W. HOBBS, M.D., Freedom, N. H.

I

New subscribers who send $1 now for 1895, will receive WORLD for the remainder of this year free.

A Case of Obstetrics. Editor MEDICAL WORLD:-In March last I was hurriedly called from my home, at a distance of twelve miles, to see a girl about sixteen years of age, stated by the messenger who came after me to be dying in child birth, and suffering with the most fearful puerperal convulsions. He stated that she had been taken in labor on Thursday, and this was now Sunday. Hastily mounting my horse, I was soon at the patient's bedside. I found her utterly unconscious, and suffering from fearful puerperal convulsions, her tongue protruding from her mouth and fearfully cut, swollen and bleeding profusely, the patient apparently in the very agonies of death, throwing herself from side to side of the bed with maniacal fury, utterly unable to swallow, and her parents and neighbors standing around, looking on in speechless terror. What scenes a doctor is sometimes called upon to witness, that to his dying day are indelibly photographed on his memory!

On examination I found the os rigid and undilatable. She had made no progress, and from the very nature of the uterine action she could not. The waters had made their escape two days before. Something had to be done, and that quickly. I administered a hypodermic of morphine and atropine. This seemed for the time being to have a quieting effect. During the interval I administered a full tablespoonful of tincture of lobelia, my purpose being to relax the system and relieve the rigidity of the os. Waiting about an hour, I gave her another full tablespoonful of the tincture, causing her in a short time to vomit freely. I then again made an examination, and found the os not quite so rigid and slightly dilatable; no bearing-down pains amounting to anything. I then gave tincture of ergot in full doses, but without any apparent effect, the convulsions setting in again with redoubled vigor. Again, by the use of hypodermics I gained for the patient a slight season of quietude, and, after waiting awhile, I again examined, and found a footling presenta tion, with the arm above the child's head. I succeeded in bringing down the arm, but found another complication -the umbilical cord being fast tied around the neck. At this critical period the patient again went off into the most fearful convulsions, through which I greatly feared she would never survive. I then stated to the parents and friends that I must and should deliver her at all hazards. I then had her placed on her father's knees, he holding her firmly around the waist, while two other assistants held her arms above her head, and two more held her feet apart. I then knelt between her knees, and after thoroughly anointing the

parts, as also my hands, with vaseline, I gently but firmly grasped the feet of the child, using gentle traction, delivering her in about fifteen minutes, having in the meantime to unfasten the umbilical cord from around the child's neck before I could possibly deliver the child, a male, weighing about eleven pounds, dead, of course, and had been so some days.

After the delivery of the placenta, hemorrhage set in, the blood coming in great gushes. I had to act quickly to save my patient's life. Inserting my hand into the uterus, I grasped the fundus externally. After giving two spoonfuls of ergot contraction took place, and the hemorrhage ceased. hemorrhage ceased. I have no doubt that had the flooding continued a few seconds longer I should have lost my patient. She, however, made a rapid recovery. Of course, I have not given this case with all its details and minutiæ, but enough for a slight conception of the case. Florence, Tex. W. K. GRAYSON, M.D.,

Vomiting of Pregnancy.

Editor MEDICAL WORLD:-A great deal has been written on this subject, but unfortunately the mystery of its causation is far from being solved. The old theory of a sympathetic relation between the stomach and uterus seems very plausible in some cases in which the effect is manifest by nausea and vomiting during the period of evolution or when there is a displacement of the body or irritation of the os. Though we may give this theory a prominent recognition, yet it is very inadequate when it comes to the question of why the nausea and vomiting are manifest only in the morning or in the evening, as some cases may be, and then only during certain periods of gestation.

Let us reason a little. The appetite is largely under the influence of the sympathetic nervous system, if not entirely so; and anything which interferes with the nutrition or functions of that system causes a marked change in the desire one has for food. Fright, disgust, chagrin, or bad news will have an almost instantaneous effect on the appetite. It is even so in some cases of nausea and vomiting. Now when a woman conceives she has evidently to furnish all the material for the growth and develop. ment of her fetus, even the oxygen needed in the process. The brain of the fetus is very much larger in proportion to its weight than is that of an adult; so is its osseous system; and now, since we know that the phosphate of lime is largely used in forming both neve and bone, we can readily see what the mother has been furnishing. If the mother eats the same kind of food after conception as she did before and

furnishes her fetus with phosphate of lime in abundance, we are forced to believe that the mother will suffer with the troubles caused by a deficiency of the lime. Now what are those troubles? First, I might say, is starvation of the bony system, as is manifest in decay of the teeth, which is so common with all pregnant women. Second, starvation of the nervous system, as is manifest by neuralgia, headache, psychic changes, anorexia, boulimia, etc. The trophic or sympathetic nerves, being deficient in their supply of the phosphate of lime, would naturally take on weakness and irritability, such as bring about the above disorders.

In my hands the above is not altogether theoretical. Last August my wife gave birth to a child which soon died of spina bifida. The case was reported in THE MEDICAL WORLD of September or October, 1893. At this writing she is about four months advanced in her second pregnancy. When I first learned her condition, two or three months ago, I began giving her syr. calcii lactophos. to secure against another deformity, if possible. The acid lactophosphate soon caused irritability of the bladder, and it therefore was abandoned. Soon following that the irritability ceased, but nausea and vomiting returned in its stead. I again tried the lime, but used the phosphate in lieu of the lactophosphate, so as to avoid the acid; again the vomiting ceased. When the vomiting first ceased under the lactophosphate I did not recognize the cure, but when it returned without the lime my wife knew it and called my attention to it. I don't know whether this remedy will prove successful in all cases or not, but I do know that it is satisfactory "at our house." I would like for the profession to try the lime and see if it is "any good."

If this theory is true it may be that sickness in the morning is caused by twelve hours without food and hungry nerves. The phosphate of lime ingested at supper may be exhausted before morning. Sometimes eating something before attempting to rise so strengthens the nerves that nausea does not appear.

How about the evening sickness? Perhaps the twelve hours of labor so exhausted the nerves that they become deranged, though food be taken at regular intervals. Why does vomiting o cur only during the first three or four months? Because this is the period of formation and development of the fetus, and at the four or fifth month the relation between the brain and skeleton and the rest of the child is having a better symmetry than before, and then the child has nothing to do but grow and kick around as it pleases. Why is it that in some cases nausea and vomiting come on during the

last month of pregnancy? Simply because nature is making the last and finishing effort to prepare the child for an independent life, so it makes an extra demand for phosphate of lime on the mother's economy.

The above reasons are highly theoretical and may be subject to criticism. One thing, however, I do know, and that is this: I gave phosphate of lime, and nausea and vomiting ceased. You must believe that much anyhow, and then if you don't like my theory you can build one of your own. J. J. WALLER, M.D.,

Oliver Springs, Tenn.

Editor MEDICAL WORLD:-In July WORLD, page 243, Dr. Clouse says: "There is no circulation between the mother and placenta after the child is removed."

Is there any circulation between the mother and placenta before the child is removed? Certainly not.

I know a physician of thirty years' practice, who says he does not tie the cord until the placenta is separatel, the indication of which, he says, is cessation of pulsation in the cord-having the erroneous and very common idea that the pulsation is from the mother's heart instead of that of the child. D. ROSE, M.D., 1064 Millard ave., Chicago, Ill.

Clinical Memoranda.

Editor MEDICAL WORLD:- For itching piles I have long used the following:

R. Powd. camphor....................
4 opium...
Calomel......
Carbolic acid.
Simple cerate

...........1 scruple ................................5 grains .5 grains

......qe.......to make 1⁄2 ounce

Mix and apply night and morning.

For pruritus ani, caused by eczema, also for scrotal eczema, I have used a 1 to 1000 solution of corrosive sub., applied by means of the positive pole of the galvanic battery. The current intensity may be from five to ten milliamperes. This method of treatment is the most effective of anything I have ever used for tinea circinatus, ringworm, and all forms of parasitic infection. It will kill the acarus scabiei also, but for this trouble I prefer a bath with the following lotion: Take four ounces each of sulphur and quicklime; slake the lime, place the two in a gallon of water and boil for a half hour, or until you get about a pint of solution. Let it settle, pour off, and use freely over the whole surface of the body for half an hour. Wash off with a neutral soap, and, with a complete change of clothing, the patient is well. Tincture of benzoin comp., painted directly on the parts, is also most excellent for pruritus vulvæ and ani.