Updated 15 Jul 2006

WIRKSWORTH Parish Records 1600-1900

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Smedley's Bath Book

Front cover of booklet, 9 cms x 13 cms.

This is an OCR transcription of a Bath Book issued in 1934 by Smedley's Hydropathic Establishment, Matlock.

Around 1855 Smedley's Hydro was founded by John Smedley of Matlock. Over the next 60 years, a great industry was developed, which led to some 24 Hydro Establishments in the town, and changed the wealth and size of Matlock out of all recognition. The Census entries bear witness that patients came to stay in Matlock from all over the world, the popularity of the idea was astonishing.

Today, Hydropathy is classified as "Alternative Medicine" and viewed with amused suspicion by the mainstream of the modern medical establishment. Perhaps Medicine was so frightful in 1855 that Hydropathy offered welcome relief to many people and became very fashionable.

Information about John Smedley, elsewhere on this website:
Smedley empire 1784-1893 | Smedleys autobiography 1868
Rare cabinet card of:John and Caroline SMEDLEY
Pedigree of John Smedley by Thomas INCE updated 1858.
Wirksworth Parish Register: Baptisms, Marriages and Burials | Baptisms only
Census for Hydro: 1901 | 1891 | 1881 | 1871 | 1861.
Mentioned: FLINT pedigree
White's directory 1857: Indexed | Baths | Extract
Photos: Hydro (I) | Hydro (II) | Hydro grounds | Hydro 1868 | Interior | Interior | Interior | Advert 1905
Photos: Smedley's engravings | Smedley's winter gardens | Riber Castle.

INDEX to Bath Book

Abdomen pack
Arm baths,packs &c
Ascending douche
Ascending spray
Back pour
Back sponging
Back spouting
Back spray
Blanket pack
Bowel kneading
Bowel pack
Chest bandage
Chest pack
Cold cloth
Cooling bath
Cooling pack
Cooling towel
Cooling waist pack
Dripping sheet
Dry dressing
Ear douche
Enema (ordinary warm)
Eye spray
Flesh gloves
Mud pack
Foot bath
Foot or hand pack
Wet sheet
Half pack
Head bandage
Head bath
Head bathing
Head pack
Hot-air bath
Hot and cold pads
Hot water bath
Hot water bottle
Ice bag
Inhalation of steam
Leg bandages
Leg bath
Leg pack
Liver pack
Medicated bath
Nauheim baths
Mustard cloth
Nose bath
Oil rubbing
Plunge bath
Rain bath
Russian bath
Shallow bath
Sitz bath
Spinal bandage
Spinal pack
Spinal sitz bath
Spinal slapping
Sponging, general
Sponging, local
Sponging sitz bath
Spray bath
Steam bath
Steaming, local
Stomach bandage
Stomach packs
Swimming bath
Throat bandage
Throat pack
Trunk pack
Turkish Bath
Vaseline dressing
Waist bandage
Waist pack
Water bag
Water dressing
Wave bath
Morning Bath for Home
Weir Mitchell Treatment
Soapless Foam Bath
Plombieres Douche
DIETING-General Caution
General faradisation
Intestinal faradisation
Local faradisation
Rectal faradisation
Central galvanisation
Galvanism to the head
Local galvanisation
Galvanic bath
Faradic bath
Galvano-faradic bath
General franklinisation
Franklinic dry bath
Electric wind
Electric sparks
Electric shocks
Ionization with
Iodide,Salicyclate &c

Radiant heat bath
Ultra-violet radiation
Infra-red radiation
Ultra-short wave therapy
Avoid climbing
Avoid standing
Be out in the open air
Rest completely
To the Abdomen
To the Trunk
General (modified)
Aix Douche Massage
Vichy Douche Massage
Vibration Apparatus

Chest expansion
Liver and abdominal Compression
Limb exercise
On the sixth day
With pain
Current terms for
Common Temperatures

Diet List, No 1
Diet List, No 2
Diet List, No 3
Diet List, No 4
Diet List, No 5
Diet List, No 6


    GENERAL BATH-HOUSES -The bathmen and bathwomen are on duty in their respective bath-houses as follows: Morning - from 7-0 a.m. till 8-15 a.m. Forenoon - " 9-30 a.m. " 12-30 p.m. Afternoon- " 3-0 p.m. " 5-0 p.m. Evening - " 8-0 p.m. " 9-30 p.m. FOR THO NIGHT -From 11 p.m. till 6-30 a.m. the night watchmen are available, and through them, a special bath-attendant if necessary. TURKISH AND RUSSIAN BATHS. From 10 a.m. till 1 p.m., and " 3 p.m. " 5 p.m. The GENTLEMEN's Turkish and Russian baths are open from 7 a.m. till 8 a.m. as well. THE ELECTRICIANS AND RUBBERS (male and female) are arranged with through the head bath-attendants as to hours of treatment. ON SUNDAYS, a morning bath can be had from 7-0 a.m. up till 8-15 a.m., preceded, if prescribed, by the Turkish or Russian Bath (for gentlemen only). A special bath-attendant is at call on Sundays, but, special cases apart, there is no treatment on Sundays, nor on Saturday afternoons. IN EVERY DIFFICULTY the head bathman or head-nurse should at once be applied to. If not at hand, a message will secure speedy attention, if left at Hall Porter's Office.

    Instructions addressed to the Patient in DIET and REGIMEN. (For letter refer to Appendix at end of Book) Diet No. | | | | [This page left empty] | | | | | | | | | | | |




    Bathing is to be deferred for one hour, at least, after a meal. A cold bath is to be followed at once by exercise : a hot one by rest. A cold bath should not be taken the patient being chilly, nor a hot one should he have become overheated. Exercise should vary in amount with the energy at command at the time. Frequent short walks should be the rule, long ones the exception: actual fatigue avoided. Walk most on cold or damp days, and in warm weather drive more. Clothing demands close consideration on the part of the delicate, who should be prompt to meet variations in the atmosphere with commensurate changes in the clothing. The morning being dull, cold, or windy, the underclothing should be made thicker for the day. The outer clothing should be heavier for the forepart of the day, as a rule, when the circulation is feeblest. The clothing should be lightest while active exercise is being taken, and when at rest the feet and legs should be well covered. Feeding demands more than anything the exercise of self-restraint and constant discretion at the hands of the patient. With a good appetite three fair meals a day are ample, and may not be exceeded with impunity. The last meal of the three should leave four to five hours clear before bedtime, and no sort of supper should be deemed light. Avoid drinking during mastication: never eat to satiety, nor come fatigued to meals, and rest quietly for some time afterwards. Abstinence from all kinds of alcoholic liquors and from tobacco is required of patients. This tacit understanding holds for every case not explicitly excepted, and the patient who violates it stultifies himself, and may be seriously misleading his advisers to his own injury. Discussing maladies one with another is a mis chievous and foolish practice. It never did any good and has been an injury to many.


    REVISION OF 1934.


    1. Abdomen pack. -[A] With a hot Pad. Across the bed spread a macintosh cloth and small blanket, each two feet broad and two yards long. On these the patient, partly undressed, lies down, and has a fomentation pad * laid, as hot as can be borne, over the stomach and bowels -i.e., from the tip of the breastbone downwards, and from flank to flank. This, without loss of time, is well covered with the blanket, which is brought over, tucked well under the flanks, a hot stomach-tin laid on top, and the macintosh cloth over all. Near the feet a hot water jar is placed, and round the head a cold wet cloth (thin). Duration 20 mins. On removal, sponge the parts with cold (or tepid) water and pass the sponge twice or thrice down the spine. ^ -[B], With a Cold Cloth. A pad of towelling or soft calico, eight-fold, is wrung lightly out of cold water, and applied in the manner described above, but omitting both waterproof and stomach-tin. Duration 20 mins., with cold sponging as above. -[BB], Domestic. A towel folded twice and wrung well out of cold water, with a piece of dry flannel, two-fold, to cover it fully, are laid close by on going to bed. On awaking for good, slip them in over the abdomen, the damp towel next the skin. Place a pillow on top of the bed clothes to secure warmth. Lie thus for 20 mins. at least, and on rising sponge the parts with cold water, or take a general bath. -[C], With a Hot Pad and Cold Cloth. Apply the hot pad as above [A], and in 5 mins. replace it with the cold. cloth [B], for 15 mins. more, changing quickly from one to the other. Cold sponging to follow as above. -[D], Hot and Cold Cloths, alternate. Hot first as [A] 5 mins., then cold as [B] 5 mins. more, and repeat both once over, making 20 mins. in all. Conclude with sponging as above. -[E], With Mustard Cloth, as [A]. (For mode of prepara tion, see note to Mustard Cloth, p. 21.) Retain 20 mins., or less if too acute, and conclude with sponging as above. -[F], With Hot Fomentation and Mustard Cloth, the former as [A], 5 mins., the latter as [E], 15 mins. more, Conclude with sponging as above. 2. Affusion.-[A]. Cold, to loins. A large canful of cold water is dashed on the back. -[B]. Hot and Cold alternate -hot (105') first, cold next, two of each. - Arm baths, packs, &c., see their equivalents in Foot Bath, Leg Packs, &c. ------------------------------------------------------------ * For mode of preparation, see note to Fomentation, p.13. ^ "Cloth" appended, in writing, requires the substitution of towelling or soft calico eight-fold, for the flannel pad.

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    8 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ 3. Ascending douche.-[A], Cold, for 1/2 min. to fundament, N.B.-Not so strong as to enter the bowel unless so prescribed. -[B]. The same. Tepid (80') for 1 min. -[C] as Hot and strong as can be borne. 1/2 min.; to enter the rectum. -[D], The same. Hot and Cold alternate. Hot (105') and cold, min. each, for 3 mins. in all, ending with cold. -[E], The same. Hot and Cold alternate, to enter the rectum. Hot (105' to 110') 1/2 min., strong enough to enter the rectum. After voiding, cold next to enter rectum for 1/2 min. Void, and repeat twice : in all 3 mins. 4. Ascending spray -[A], Cold, for 1/2 min. to fundament. -[B], The same. Tepid (80') for 1 min.. -[C], Hot as can be borne for 2 mins. -[D],The same. Hot and Cold alternate. Hot (105') and cold, 1/2 min. each, for 3 mins. in all, ending with cold. 5. Back pour. -[A], Cold. 2 galls. of cold water are poured slowly down the back, the patient partly undressed, seated on a board across a sitz bath. -[B], Hot and Cold alternate, of each 1 gall.; hot (105') first, cold next, two of each. 6. Back sponging. -[A], Cold. The patient, partly undressed, sits on a board across a sitz bath half full of cold water, and, with a sponge (or towel) dipped afresh each time, the entire spine is laved for 5 min. -[B], The same. Tepid to Cold. At 8O' 4 mins., and cold 1 min. -[C], The same. Hot and Cold alternate. Run the water gradually from warm (90') down to cold, then up as high as can be borne, and down once more to cold. Keep laving the back from the bath for 5 mins. in all. -[D], The same. Hot and Cold alternate, changing abruptly from hot (105') to cold, each for 1/2 min. This from a couple of cans, side by side, with Sponge apiece, for 5 mins. in all. -[E], The same, with Mustard. A decoction (of the bran, a breakfast cupful, or of table mustard, a large spoonful, to the quart of boiling water) is employed as hot as the back will bear -the patient seated. over the sitz bath. Duration, 4 mins. (less, if felt too acutely), and conclude with cold water, plain, for 1/4 min. more.* 7. Back spouting. -[A], Cold. A jet of water is played down and up the whole length of the back, the patient partly undressed and seated on a board placed over a sitz bath for 1 min., or less if found too severe. -[B], Warm to Cold. Begin at 90' and run down qradually in the course of a minute to cold, at which continue for 2 mins. more. -[C], Hot and Cold alternate. Hot (105') first, 1/2 min. ------------------------------------------------------------ * See Note to Mustard Cloth (52) page 21.

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    MATLOCK.] BATH BOOK. 9 ------------------------------------------------------------ then cold, 1/2 min. Keep changing from one to the other for 3 mins., and conclude with cold. 8. Back spray. -[A], Cold. With the rose a foot off, play down and up the length of the spine for 2 mins., the patient partially undressed, and seated on a stool, or board, across a sitz bath. -[B], Warm to Cold. Begin at 90', and run down to cold over a period of 3 mins., at which continue for 1 min. more. -[C], -Hot and Cold, alternate. Hot (105') first, for 1/2 min.; cold next, the same ; and so on for 3 mins. in all, ending with cold. 9. Blanket pack (dry sweating). The patient, divested of all clothing, is promptly wrapped up in a large thick blanket, hot from before the fire (or from out of the oven). A pair of blankets spread on the bed beforehand are thereupon drawn round the trunk and limbs, and pushed well under, one side after the other, as tightly as possible, the neck and feet with special care, while on the top lay three or four blankets. Hot water jars place one on each side of the trunk and legs, a fifth at the feet, and a cold wet cloth (thin) round the head. Duration 40 to 60 mins., or longer if comfortable. Give cold water to drink as may be desired, and keep the window open, if not too cold. 10. Bowel kneading. See Appendix E1. 11. Bowel pack (see Abdomen Pack.) 12. Chest bandage. -[A], Day: Made up of swansdown calico, oiled silk, and flannel, the former worn damp on the front of the chest from rising until going to bed. -[B], Night: The same, but without the flannel, and worn from bedtime until rising. -[C], Cooling. Swansdown calico or towelling, two-fold, wrung lightly out of cold (or tepid) water, and covered at all points with a single fold of dry flannel. Worn continuously, and studiously kept wet.* 13. Chest pack. -[A], with a Hot Pad (^). Apply a large fomen tation, as hot as bearable, to the chest in front, put a waterproof cloth above, and loosely over all a half blanket -laid beforehand across the bed. A cold wet cloth (thin) wound round the head, and a hot water jar place near to the feet. Duration 20 mins., with cold damp sponge of the part afterwards, and of the spine. ------------------------------------------------------------ * A poultice, when prescribed along with the chest bandage, is attached to its upper margin with a safety-pin. ^ When ordered to right lung or left, the application is made to one or other side of the chest separately, to the back as well as front, and under the armpit. Three separate pads are used, one for the back, laid in advance on the blanket (with waterproof material beneath), the next to the axilla, or armpit, as far forward as the breast bone, and the third over the apex of the lung, and overlapping the others.

page 10

    10 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ -[B], with Hot Pad and Cold Cloth, the former for 5 mins., and the latter for 15 mins. Secure as above, and be expeditious in changing. Cold damp sponging of the part to follow, and of the spine. * -[C], with Hot Pad and Mustard Cloth, the former for 5 mins., and the latter for 15 mins., or less if felt too acutely. Tepid sponging of the part after, and of the spine. ^ 14. Cold cloth. - [A], A pad of towelling or soft calico, eight folds thick, and one foot square, is wrung tightly out of cold water (iced, if so ordered), and applied to the part specifled for 20 mins. Cover with dry flannel, to avoid wetting the bed. clothes. -[B], The same renewed - Change the cloth every minute, using two pads, one lying ready in cold water (iced, if so ordered), while the other is on. # -[C], With Sponges - A sponge fresh out of iced cold water is kept on the part specified for 1/2 min., and then replaced by another - two in use, one lying in the water while the other is on. Continue for 10 inins. # 15. Cooling bath. - Into a large bath, about 2 1/2 ft. deep, 6 ft. long, and holding 18 ins. of water at 90', carefully lift the patient by means of a sheet, one person at each corner, while a fifth supports the head. Let the head rest half immersed, on a strap across the bath. In two or three minutes add a gallon of cold water, pouring it gently against the foot, and making it circulate towards the head of the bath. Repeat this every two minutes, taking out as much each time, until the temperature of the patient (in the mouth) is reduced to 100' (that of the bath to about 70'). Replace the patient in bed, on a couple of hot blankets and a waterproof sheet, which withdraw presently, carrying the wet sheet and blankets along with it. Put a hot water jar to the feet, cover up warmly and administer a hot drink. The bath should be adjacent to the bed. # 16. Cooling pack - Two towels - thick and large - are tightly wrung out of tepid water, and one of them spread length- wise on a dry blanket laid across the bed. The patient lies down on this, and has the other towel placed on the front of the body, extending from neck to knees. The blanket is brought loosely round the trunk, and the bed clothing over all, less the coverlet, which double down over the feet and legs. A cold wet cloth (thin) is put on the forehead, and another, eight-fold, upon the pillow, which is protected with waterproof. Every 20 mins. ------------------------------------------------------------ * For mode of preparadon, see note to Fomentation, p. 13. ^ For mode of preparation, see note to Fomentation, p. 13, and for Mustard Applications, page 21. # See note on over-cooling, on next page.

page 11

    MATLOCK] BATH BOOK. 11 ------------------------------------------------------------ renew the towel in front out of cold water (iced, if so directed): while that behind need only be changed every hour. The head cloth keep moist meanwhile by dropping warm water on to it from a sponge. Continue the pack until the temperature falls to 100'.* 17. Cooling towel - A piece of soft towelling or calico, about 2 ft. by 1 ft., four-fold, and well charged with tepid water, is laid along the chest and abdomen, the nightdress being drawn up, or slit down the front and folded back. Cover with a single fold of dry flannel, and replace but one of the bed blankets. Every 20 minutes exchange the towel for a fresh one out of cold water (iced, if so directed). Continue as long as the temperature is over 100'.* 18. Cooling waist pack - Across the bed is laid a small blanket 2 ft. wide and long enough to go well round the trunk. A linen (or cotton) sheet a little less in breadth than the blanket, and long enough to overlap a foot or so in front, is lightly wrung out of tepid water and spread on the blanket. On this the patient (with nightdress lifted to the shoulders as he sits up in bed) lies back and has the sheet brought over, one end after the other, and folded tightly about the waist. The blanket comes next, lying loose, and the ends lightly pushed behind the back. Continue as long as the temperature keeps above 100', changing the sheet out of cold water as it becomes dry. * 19. Dipping. - [A], In cold water (iced, if so directed), keep plunging the part indicated until thoroughly chilled, at the rate of 10 to 20 times a minute for 3 or 4 minutes. [B], Hot as can be borne (110' to 125'), instead: until the skin is sore and red. -[C], Hot and Cold alternate; hot (110' to 125') first and cold next, ten times each, ending with cold. 20. Douche - [A], Descending - From a pipe 1 1/2in. diam., discharging 10 to 15ft. above the floor level. Let the stream fall first on the upper part of the spine, then on shoulders, hips, arms and legs, and finally on the head, the stream broken then by the hands held archwise above the head. Sponge the head and chest beforehand with cold water. Duration from 20 to 60 secs., as directed. ------------------------------------------------------------ * N.B. - Should the cooling process chance to be overdone, and a chill be threatened, heap on two or three blankets, and tuck well in behind. The pack is thereby converted from a cooling into a heating one, and mischief averted. Thus forearmed against a chill the cooling progess may be carried on for hours, and even for days, with nothing but advantage. In the absence of a thermometer, the sense of touch is a fair guide as to the need for further cooling. All interference should be suspended during sleep, of course, and deferred for 15 minutes after feeding.

page 12

    12 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ -[B], Horizontal - From a pipe 1 1/2 in. diameter, dis- charging 4 ft. above the floor level. Play on the back, chest, arms, and legs in quick succession, the patient rubbing himself vigorously all the while. Wet the head first with cold water, and again at the end by the douche itself, the impact being broken on the uplifted hands. 21. Dripping sheet.-[A], Cold. Wetting the head first with cold water, the patient stands in a sitz or other bath, half- inch deep with hot water, and is enveloped from head to foot in a large thick sheet, taken from a pail of water close by. Rubbing outside the sheet is carried on briskly all the time, from behind by the bath attendant and in front by the patient, the sheet carried along with the hand. In 3 mins. replace the sheet by a dry one, and resume the rubbing until reaction is assured. -[B], Hot and Cold Sheets, the latter as above, but preceded by one out of hot water (105') for 1/2 min. 22. Dry dressing - Dust well the part indicated with oxide of zinc, finely powdered boracic acid, or other simple pow der, such as wheaten flour, starch, oatmeal, fuller's earth, or violet powder. 23. Ear douche - Gently wash the ear out with a pint of warm water at 90' to 98'.* 24. Enema (ordinary warm). - [A], Inject from half a pint to one pint of plain water at 90'. Fill the tube with water before insertion into the bowel, and oil the nozzle. The reservoir hangs about 6 ft. from the floor, the patient lies on the left side or back, with the knees drawn up. Remain recumbent for a minute or two, then rise and pass slowly and without straining. With a sense of fullness or spasm, more than momentary, rest a little and resume. ^ -[B], The same periodically - Every second day in the absence of a natural action of the bowels, every third day with motions scanty and hard. If ineffectual, repeat the enema in a few hours. -[C], Large Hot Enema - Charge the reservoir to the full with plain water at 105'. Take in as much as the bowel will tolerate, checking the flow for any slight uneasiness. Replenish the reservoir if necessary to fill the bowels to their utmost capacity. Remain five or ten minutes, then rise and pass slowly and without straining. ------------------------------------------------------------ * See note, page 26, for explanation of "Boracic," &c., when added to the prescription. ^ Taken with the ball Enema, self- administration is easiest crouching on the floor over a basin charged with water in which the receiver tube of the enema lies. The left hand holds the nozzle in position while the right works the ball.

page 13

    MATLOCK] BATH BOOK. 13 ------------------------------------------------------------ -[D], Oil Enema - With a small syringe inject two ounces of warm olive oil (98') into the rectum. Retain the oil as long as convenient-all night if taken at bedtime. -[E], Small Cold Enema - From a small syringe inject about two ounces of plain cold water before the daily motion, permitting no action of the bowels without this preliminary. Pass at once and rise the moment after, all straining avoided. -[F], Glycerine Enema - With a small syringe inject a tablespoonful of glycerine mixed with three of water. Pass at once. Auxilliaries to Enemata. -[G], Oil Suppository - A conical mass of cacao- butter and olive oil is passed into the rectum at bed- time. The small end is placed against the anus, the finger presses steadily on the broad end, and the suppository slips in. Retain all night. -[H], Glycerine Suppository - Use as above, but on rising from bed, and pass after breakfast. 25. Eye spray - One pint of warm water (90') sprayed gently on the closed eyes. Make cooler from day to day, as experience may warrant. 26. Flesh gloves - See 60C, page 23. 27. Fomentations - A flannel pad, eight-fold in thickness and 11 in. by 22 in., is [A] applied as can be borne (110' to 120') to the part indicated. Cover at all points with two folds of dry flannel and waterproof cloth. Keep close in contact by a flannel binder or small blanket. Duration 20 mins.* -[B], Renewed - A change of pad every 5 mins., with as little exposure as possible, one being in readiness against the other coming off. Duration 20 mins. ------------------------------------------------------------ * The Fomentation Pad is prepared for use (if not steamed and passed through a roller, as in a well-appointed bath-house) by rolling it up the long way, and pouring boiling water in it at one end until it runs out at the other. This is repeated in the reverse direction. It is then rolled up in a towel by twisting the loose ends of which with a stick it can be wrung out and made as dry as possible. It shoW be kept tightly wrapped up until the moment of application, gauging the heat with the back of the hand before putting on. The ordinary bath-house fomentation pad is cut and quilted, half an inch thick, and 11 in. by 22 in. The large one is 22 in. square, and the small 11 in. by 14 in. "Cloth " appended in writing, requires the substitution of a piece of towelling or calico, eight-fold, for the flannel. With "Turpentine" added, sprinkle a dessert spoonful on the face of the pad as it is cooling.

page 14

    14 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ -[C], With Sponges (small and soft) out of scalding hot water (110' to 120') applied to part indicated, changing every minute, the hand protected by a towel (in grasping the sponge) and keeping up close and steady contact. Duration 20 mins. 28. Mud pack -To be applied as directed from 30 to 45 mins. Temp. from 105' to 125' Fahr. Thickness, 1-1 1/2 inches. Tepid spray after. Rest, lying down, for one hour after. 29. Foot bath. -[A] Hot (105'), 3 in. deep, the patient sitting with a sheet and blanket enclosing the bath and limbs as high as the waist. For 10 mins., concluding with cold sponging of the feet and ankles, and a brisk rubbing. -[B], Hot, prolonged for 20 mins., the patient sitting as above, while boiling water is poured slowly against the side of the bath, a cupful every few minutes, removing as much in advance. Sponge lightly with cold water to conclude. * -[C], Mustard - A breakfast cupful of mustard bran (or a large spoonful of table mustard) to the quart of boiling water. Use as hot as bearable, and continue for 20 mins., or less if too severe.* ^ -[D], Cold, 2 ins. deep, for 30 mins., the feet kept on the move all the time, and rubbed one on the other. Dry well, and walk afterwards till warm. -[E], Treading in Cold water, 1 in. deep, 2 to 3 mins. Dry well, and walk till warm. -[F], Cold Sponging of the feet and legs, over a bath, one limb at a time, for 2 to 3 mins. Rub well after until warm, and walk, if not going to bed at the time. -[G], Hot and Cold Alternate - in two vessels, side by side, 2 ins. deep with water. one at 103', the other cold. Shift the feet from one to the other every half minute, and conclude in 5 mins. with the cold. 30. Foot or hand pack. - [A], Hot. Wrap the foot in soft calico or cotton wool, soaked with hot water, and cover with a waterproof bag, tied round the ankle. Keep the foot as high as convenient, and free of pressure from the bedclothes. Re-wet the wrappings every four or six hours. -[B], Cooling. The wrappings, as above, are kept moist with warm water (dropped on them occasionally from a sponge), and left uncovered to favour free evaporation, the waterproof bag used flat on the pillow below, to keep it dry. ------------------------------------------------------------ * If administered as the patient lies in bed, the legs are drawn up, and the bath is covered in with a towel pinned round the ankles. ^ See note to Mustard Cloth (52), page 21.

page 15

    MATLOCK] BATH BOOK. 15 ------------------------------------------------------------ -[C], Wet Socks (cotton or merino), extra large, wrung well out of cold water, are worn for the night covered with dry woollen socks, large and thick. * 31. Wet sheet. -[A], Cold. On a bed or packing couch spread three blankets (large and thick) lengthwise, and, lay on these a thin linen sheet, wrung well out of cold water, its upper margin coming short of that of the blankets by 4 in. The patient, unclad, lies down on this, the arms kept close to the sides, the head just beyond the upper margin of the sheet, the feet well within the lower, and is promptly wrapped up in the sheet, one side after the other, the neck and feet with special care. The blankets are next each in turn, and side after side, tucked round underneath the body, smoothly and tightly, the spare end of the blanket beyond the feet being doubled back beneath. Over all place the bedclothes, pushed lightly under on each side, and the pillows over these, one lengthwise on the trunk, and another across the legs, leaving the bolster alone beneath the head. Put a cold wet cloth (light) on the forehead, a hot water bottle to the feet, and give cold water to drink as desired. The window should now be opened wide - there being nothing in the case to the contrary - and sleep favoured. Let the patient remain thus for one hour. ^ -[B],Hot. The sheet wrung out of boiling water instead, and left in coil till all is ready. ^ 32. Gargle -[A], With Cold Water (iced if ordered) two tumblerfuls at a time : night and morning. -[B], Hot as can be borne instead. 33. Half pack - On a couple of blankets, with a waterproof sheet beneath, lay a linen (or cotton) sheet, broad enough to envelop the body from waist to feet, the sheet first wrung well out of cold water. The patient, bare from the waist down, is wrapped in the sheet, one side after the other being tightly drawn round and pushed underneath, the blankets the same, the waterproof next, and then the bedclothes. A cold wet cloth (thin) is wrapped round the head, and a hot water bottle put to the feet, if cold. Duration, one hour, or, if given at bedtime and sleep ensues, the pack is left on for the entire night. -For Hand baths and packs, see Foot ditto. ------------------------------------------------------------ * The feet or hands must first be warmed, and briskly rubbed beforehand, if need be. When the feet are tender or swollen, the inner sock should not be damped until after it has been drawn on. ^ Due forethought will make up largely for the lack of experience in attaining expedition without hurry. Two persons are required to wring the sheet out thoroughly.

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    16 BATH BOOK. [SMEDLEY'S ------------------------------------------------------------ 34. Head bandage. -[A], A closely fitting cap, charged with cold water, worn continuously. The hair is well moistened at first, and the cold water applied to the cap as it dries. # -[B], Wet Cap, with Pad. The former as above: the latter of towelling or calico, eight-fold, laid on the pillow. The whole is kept moist by dripping warm water over the forehead at brief intervals from a sponge, the pillow protected by a piece of waterproof. 35. Head bath - The head resting comfortably in a suitable vessel charged to within an inch of the brim with water at 80', pour continuously over the forehead from the bath by means of a breakfast cup. After 30 mins. of this, slip the vessel away - the head being held up by the hand - replace it with a pillow having a dry towel upon it, lay another towel loosely over the hair, and leave thus for 30 mins., or more if agreeable. ^ 36. Head bathing. -[A], Cold Immersion in the bedroom basin (or bath) one side after the other, for 6 times: dry well. "Face" affixed to the prescription signifies that no more be immersed, and the hair kept dry. -[B], Warm Immersion, the same but at 100', and the hair left somewhat damp. # - [C], Hot Soaping (100'), the hair left somewhat damp. # -[D] -Damp the hair by passing the hand through it from front to back a dozen times, the hand dipped each time in cold water and the hair left damp for evaporation. 37. Head pack. -[A], Hot. A two-fold strip of flannel, 4 ft. long and 3 in. broad, wrung lightly out of hot water, is wound round the head, the wet part next the head, the dry part outside. Tie a silk handkerchief over all. --[B], A Cold Wet Cap of swans down calico (or a towel, small and thin) - the hair previously damped - and an oiled silk cap over it. Re-wet from time to time, as directed. 38. Hot-air bath. -[A], In a Box, with, gas, or spirit lamps. Before entering heat up to 100'. Cover the seat with a ------------------------------------------------------------ ^ The patient lies on his back, the shoulders raised by pillows to the level of the edge of the bath-from the sharpness of which guard the neck by a pad. The feet and legs are well covered up, with the addition, if necessary, of a hot water bottle. Should a regular head bath not be available, an ordinary washstand basin, with an inverted soap-dish in the middle, and capped by a sponge, will suffice. Long hair should be plaited and kept clear of the water. Comfort of position is essential, and care should be observed to avoid haste in lying down and rising up again. # Ladies, on the score of long hair, should dip no more than the face; or, if wetting the whole head, shculd keep still until it dries, or wrap it up meanwhile in a silk handkerchief.

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    MATLOCK] BATH BOOK. 17 ------------------------------------------------------------ large, hot fomentation pad (half hanging down in front) and place a foot bath at 105' below. After entering and closing the lid, the neck is packed about with a damp towel, and after wetting the hair, a cold wet cloth is wrapped about the head. Keep up the heat just short of discomfort (from 110' to 120'): give cold water to drink as desired, and re-wet the head towel out of cold water if fullness is felt. Duration, 20 mins., or less, with bath to follow as prescribed. --[B], On a Chair (of wood or cane-bottomed). The patient seated, with fomentation pad and foot bath as above, two or three spirit lamps, lighted in advance, are placed beneath the chair, and a blanket cape with macintosh cape above it, are hung from the neck to the floor. In the absence of these, two blankets (large and thick) hung, one in front from neck to floor, the other behind in like manner, and enclosing patient, chair and foot.bath at every point, will serve. Proceed thereafter as above [A].* 39. Hot and cold pads. -[A], a fomentation,^ as hot as can be borne, to the part indicated, kept in close contact by means of a flannel binder. Duration, 5 mins. Replace then by a piece of towelling or soft calico, eight-fold, out of cold water, for 15 mins. more. -[B], Alternate. The hot fomentation first for 5 mins the cold pad next for the same, and so on alternately for 20 mins. in all. 40. Hot water bath in ordinary house or shallow bath at 98' the patient immersed to the chin, and a cold cloth wrapped about the head - the hair first damped. Dura tion, 20 mins., and conclude as may be directed. 41. Hot water bottle (bag or tin), [A], to the feet, a rug or blanket interposed * -[B], In Bed (at the foot) for 20 mins. or so before bedtime, and remove on lying down. -[C], To the Stomach, over the clothing, as the patient rests semi-recumbent after a meal, and removed when the heat becomes oppressive. 42. Ice bag (India-rubber), applied, with dry flannel between, to the part indicated. Re-fill once an hour if continued so long.# ------------------------------------------------------------ *Two, or if need be, three large spirit lamps (Lang's " Rechaud by preference) are necessary as a rule ; or a scroll of perforated gas piping connected with the gas supply of the room by india-rubber tubing. ^ For mode of preparation, see note to Fomentation, p. 13. # The stock of ice keeps best in half a yard of flannel disposed half in and half out of a jar, a tape tied round the neck of the jar so as to leave the upper half available for covering up the ice from the atmosphere.

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    18 BATH BOOK [SMEDLEY's ------------------------------------------------------------ 43. Inhalation of Steam -[A], from a jug, half full of boiling water, held in the lap, both head and basin covered in with a large towel. Inhale the steam through the open mouth slowly and without effort, for 5 mins. -[B], From an Inhaler, drawing the vapour through the mouth and into the chest, to expel it again by the nostrils. For 5 mins. or more, avoiding all effort. -[C], A Kettle is kept on the boil night and day in the sick room, discharging its moisture into the room through a tube 3 ft. long. * -[D], Medicated vapour as directed, inhaled from a "nebulizer" for 2 mins. -[E], From INHALATION STANDARD, plain or medi cated, as prescribed. 44. Injection -[A], Of Cold Water, 2 quarts. If self-adminis tered, crouch over a basin upon the floor: if by an attendant, to be given recumbent on a bed or couch with a bed bath beneath the patient, and from a reservoir douche. Special care should be taken that the nozzle is well oiled before administration. -[B], Hot. One quart, at 105', as above. -[C], Hot and Cold alternate, one pint each at a time hot (105') first, cold next, hot again, and cold last. Given recumbent. 45. Irrigation - From a jug, or tin vessel, kept constantly charged with cold water and suspended within a few inches of the part concerned, is maintained a perpetual dropping on the same by means of a wisp of thread. The wisp is long enough to furnish a coil at the bottom of the vessel and, crossing the brim, to deliver within an inch of the part. A thin soft cloth, two-fold, covers the part, and a waterproof sheet is spread beneath to carry the waste water into a pail by the bedside. Continue for such length of time as may be directed. 46. Leg bandages. -[A], Of Swansdown Calico, waterproof, and flannel, in long narrow slips 8 ft. by 2 1/2 in., a set for each leg. The calico is wrung well out of cold (or hot) water, and wound from the ankles up to the knees, the waterproof above it and the flannel over that, all in smooth spirals, overlapping about 1 in. at the edge, and neither too slack nor the reverse. The legs must be warm at the moment of application: the water-proof must cover the damp calico at every point, and the limbs must be kept warm thereafter, or the result will be contrary to what is intended. To be worn for the night or the day, as directed, ------------------------------------------------------------ *The bedroom fire may be utilised, and the steam must then be got clear of the chimney. A spirit lamp should be used where a fire is not permissible.

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    MATLOCK] BATH BOOK. 19 ------------------------------------------------------------ -[B], Of extra Stocking Legs worn over and above the stockings proper, and of thick worsted. -[C], An India-rubber Bandage perforated is wound round the foot and as much of the leg as may be indicated. Begin at the roots of the toes, and before rising in the morning. Remove only on going to bed. Sponge and dry the limb carefully at bedtime, and wash the bandage in cold water at night, drying it well before re-application. Let it hang unrolled when not in use. 47. Leg bath. -[A], Cold, as high as the knees, the whole enclosed in a blanket: duration 20 mins. -[B], Hot. (100') for 10 mins., with tepid (80') sponging after. -[C], With Mustard, a breakfast cupful of mustard bran (or large spoonful of table mustard) to the quart of boiling Water, and this brought down with cold water to 103'. For 20 mins. (or less if too acute) and cold sponging to follow. * -[D], Meal (or bran or flour), a breakfast cupful to the quart of boiling water, and this reduced with cold water to 100'. Duration 20 mins. Then pat the skin gently in drying, and do not rub. -[E], Sweatting. A deep pall filled to within 3 ins. of the brim with hot water (100') is setin front of a kitchen chair, and the seat covered with a hot flannel pad. The Patient, undressed, and seated with his legs in the hot water, has a dry hot blanket hung about him from neck to floor in front, and another behind, overlapping the first, and pinned. close round the neck. Raise the heat then by pouring a pint of boiling water every 2 to 3 mins. against the side of the bath (taking out as much in advance), and all with as little exposure as possible. Keep the tempera ture as high as can be borne (110' to 120') for 20 mins., and the patient will perspire freely. Dry then lightly beneath the blankets with a hot towel, and put the patient to bed, next the blankets, there to sweat as long as possible with the aid of extra bed-clothing and hot drinks (gruel or toast and water). Give by the bed-side, with the room about 65'. 48. Leg pack. -[A], With Hot Flannel Pads, 4 in number, each 22 in. square, and eight folds thick, laid lengthwise, one below and the other on the top of each limb separ ately, from the knee downwards, and folded over each other at the sides. A small blanket lying across the lower half of the bed, with a waterproof sheet outside, are then folded round and tucked well underneath. Duration 20 mins., and tepid sponging of the parts after ^ ------------------------------------------------------------ *See note to Mustard Cloth (52), page 21. ^For mode of preparing the pads, see note to Fomentation, page 13.

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    20 BATH BOOK. [SMEDLEY's, ------------------------------------------------------------ -[B], With a Hot Sheet, four-fold, instead of flannel pads. -[C], With a Mustard Cloth. The sheet as above [E3], but out of hot mustard and water. Retain for 20 mins., or less if felt too acutely. Tepid sponging to f0llow.* -[D], With a Cold Cloth of towelling or soft calico, four fold, wrung lightly out of cold water, wrapped round the leg and foot. A single fold of dry flannel is brought, loosely over from behind, and the bed is kept dry by a piece of waterproof cloth. Re-wet the cloths ere they become dry (hourly perhaps), and keep the bedclothes from weighing on the limb. Continue as directed. 49. Liver pack. -[A], A Hot Pad,* is applied to the region of the lower ribs on the rightside - from the nipple to the navel, and from the breastbone round to the backbone. A small blanket, two-fold, is laid across the bed beforehand, with waterproof beneath, and the patient, lying down on this, has one end of the pad (wrung out of water as hot as can be borne) pushed under the back, and the other brought round in front, the blanket over and all tightly secured by the macintosh. A hot stomach-tin lay on the right side. Put a cold wet cloth (thin) on the forehead, and a hot water bottle near the feet. Retain for 20 mins., with damp sponging of the part to follow. -[B], With a Mustard Cloth - a plece of towelling or soft calico, eight-fold (instead of the flannel), wrung well out of hot mustard and water.* Retain for 20 mins. (less if felt too acutely) and sponge the part with tepid water. -[C], With a Hot Fomentalion and Mustard Cloth---the former as above [A] for 5 mins., replace them by, the mustard cloth as [B] for 15 mins. more, making. 20 mins. in all. ^ --[ D], With Hot and Cold Pads in close succession, the former for 5 and the latter for 15 mins., the details as above. 50. Medicated bath - The patient lies at full length, im mersed. to the chin in water at 98' duly prepared with meal, bran, soda, sulphur, or the like as directed. After 20 mins. lave all over, the head excepted, with water (80'), and dry gently with soft towels, avoiding friction. 51. Nauheim baths. - Usual course is 20 baths, taken as follows ; A bath once daily for three days, then omit one day, and so on for the course. Remain in first bath for 10 mins., then gradually increase the duration to 12, 15, 20, or 25 mins. Commence with a temp. of 98' and decrease a degree each bath to 96', or in hot weather 94'. ------------------------------------------------------------ *For mode of preparing the pads, see note to Fomentation, page 13.

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    MATLOCK] BATH BOOK 21 ------------------------------------------------------------ After the bath the patient must go to his room and rest on the bed, warmly covered, for one hour. Along with the above, if so ordered, soft pressure massage is given. to feet and legs, upwards to abdomen. back and loins, shoulders and arms. After the first week the Schott exercises are begun and continued daily. It is essential to the efficacy of this course that patients studiously avoid all worry, mental excitement, or physical strain, and adhere precisely to the directions given as to diet and exercise, rest being the order of the day. 52. Mustard cloth. - [A] A piece of calico or towelling, four fold, wrung lightly out of hot mustard and water, is applied as hot as can be borne to the part indicated. Keep in close contact for 20 mins. at the most, removing earlier if felt too acutely, and sponge the part with tepid water. * -[B], Hot Fomentation and Mustard, The flannel pad (hot) for 5 mins.: the mustard for 15 mins., or less, if too acute. ^ 53. Nose bath. -[A], Bending over an empty basin, draw up through the nose from a tumbler of water, at 90' and slightly salted, as much as possible at one breath. Let it pass quite to the back of the throat, and return then by the way it came to fall into the basin beneath. Empty the tumbler twice over, inspiring deeply whilst the nose is immersed and the mouth shut. --[B], With the reservoir douche, hung above the level of the head. and charged with a quart of warm water (90') ------------------------------------------------------------ * Mustard Applications are positively injurious when, on the part concerned, an eruption has meanwhile come out under a wet bandage or poultice. A plain hot application should then be substi tuted for the mustard one. For the mustard decoction allow a large spoonful of table mustard to the pint of boiling water, or a breakfast cupful of mustard bran to the same. The cloth is wrung out of this after a minute's stirring up and another minute allowed for settling. For less sensitive skins a paste is made of the mustard (and for this the bran is quite strong enough as a rule) and spread on the face of the hot cloth, with a thin fold of muslin laid over it, and this so expeditiously as to ensure a hot application. Table mustard and linseed (or oatmeal) in equal proportions are equivalent in strength to a like bulk of mustard bran. The individual susceptibility to mustard varies so much that no definite duration can be laid down. The 20 mins. specified are only approximate, and give the maximum. To push endurance to the point of distress is a mistake, and converts benefit into injury. It lies with the patient to acquaint the bath attendant when once the limit of reasonable endurance is reached - Packs, Sitzes, Foot Baths, Spinal Sponging, &c., in which mustard is used, are to be found under their respective headings of "Waist pack", "Leg pack," &c. ^ See note to Fomentation, page 13, for mode of preparing the pad.

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    22 BATH BOOK. [SMEDLEY's, ------------------------------------------------------------ in which is disolved a teaspoonful of common salt. The nozzle is applied to one nostril after the other, each for half a niinute at a time, the water passing up one side of the cavity of the nose and returning down the other, to fall into the basin below. 54. Oil rubbing. -[A], with olive oil rubbed well into the part indicated. Let the part, the hand, and the oil be warm and use no more oil than will disappear in the course of 2 or 3 minutes' rubbing. -[B], with Chillie paste as above [A], rubbing as briskly as the skin will bear. and leaving it red and warm. For young children camphorated oil is strong enough. 55. Pad - Four folds of soft calico or swansdown 6 ins. by 8 ins. square are wrung well out of cold water (hot; if the patient be chilly) and applied to the part specified. Cover at all points with oiled silk or waterproof cloth, and keep in close contact with the part indicated. N.B. - When prescribed along with a chest bandage, pin the pad to the upper edge of the same. If to be worn day and night separate pads are used, one washed and aired while the other is on. 56. Plunge bath -Cold. Immerse the body once or twice, wetting the head beforehand, and dipping it under at the last. One minute, or less if chilly. 57. Poultice. -[A],, Of bread, boiled, steamed, or scalded 6 in. by 8 in., and 1 in. thick, enclosed in a thin calico or muslin bag. Apply warm and moist (neither more nor less) to the part specified, and cover at all points with oiled silk or waterproof cloth. When conjoined with a wet banadge no further covering is required. -[B], The same mixed with Chillie Powder (in the making) a teaspoonful or less, according to the sensi bility of the skin in each case. No more than a sense of warmth being in view, if found to be too hot the poultice should be taken off once, or turned face outward.* -[C], Of Linseed Meal, applied as hot as can be borne. -[D], Of Linseed Meal and Mustard Bran, 1 part of the latter to 3 of the former, or, if table mustard be used, a heaped up tablespoonful to the breakfast cupful of linseed meal. -[E], Of Boracic Acid. A piece of fresh lint of the required size, two-fold. is wrung out, of very hot boracic solution (1 teaspoonful to the pint of boiling water), and applied under oiled silk to the part indicated. Duration as dlirected. ------------------------------------------------------------ If an eruption comes out on the part poulticed, the Chillie Powder should at once be discontinued, and the bread poultice applied plain.

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    MATLOCK] BATH B00K. 23 ------------------------------------------------------------ 58. Pouring - [A], With Cold Water, one quart poured slowly over the part specified, from a height of 3 or 4 ins. -[B], Hot as can be borne (105' to 120'), in the same manner. -[C], Hot and Cold. Alternate : hot (105') first, and cold next, a quart of each, three times over. 59. Rain bath. -[A], Hot (100') to begin with, and straight way reduced by degrees to cold. Wet the head from time to time by stooping, and keep rubbing the trunk all the time : for 1 min. in all. Rub well afterwards (saye when it follows on the Turkish Bath). -[B], Warm (90') to begin with, and reduced to tepid (70') only. 60. Rubbing - [A], With the dry hand rub briskly all over the trunk and limbs (or part indicated), until the skin is in a glow : 1 to 2 mins. -[B], With a Flannel cloth, hot and dry, to part specified. -[C], With Flesh gloves and strap. A dry rough towel will serve at a pinch, or the dry hands if used rapidly and vigorously. 61. Russian bath. - [A], at 110': for 15 to 20 mins. -[B], The same for 10 mins. only. -[C], The same for 2 mins. or less - until warm simply. 62. Shallow bath. -[A], Hot (100') first, and straightway reduced to cold over 2 or 3 mins. Lave the head, and legs, all the while from the bath with a little bowl, and rub briskly, the patient himself in front, and the attendant behind. [B], Warm (90') reduced gradually to tepid (70') only. 63. Sitz bath* -[A], Of Cold Water, sufficient to cover the groins and no more. Sitting wrapped in a blanket the patient remains for 10 mins., rubbing the back and abdomen if at all chilly. Undress no further than is necessary to keep the clothing clear of the water. Dry well afterwards, and exercise till warm. ^ -[B], Tepid (80') for 10 mins., with a little cold water run in at the finish. ------------------------------------------------------------ * The male sitz bath measures 20 in. by 15 in. in breadth, and 8in. in depth, and has the back nearly straight. The female sitz is narrower across the brim in order to keep the clothing up and dispense, when desirable, with undressing. " Deep," when appended to the prescription, requires the water to be within an inch or so of the brim when the bath is occupied. " Special," when appended to the prescription, implies a hot water bottle to the feet, and a cold wet cloth (thin) on the head throughout the course of the bath. ^ See note to Mustard Applications (52) page 21, for general caution.

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    24 BATH BOOK. [SMEDLEY's --------------------------------------------------------- -[C], Flowing. Cold water is kept running through the sitz-bath all the time. Duration, 2 mins., or less if the cold be felt too keenly. -[D], Dipping. In a sitz bath, 3 in. deep with cold water, the patient keeps moving up and down all the time. Grasping the sides of the bath, he rises clear of the water, to sit down again at once, and this every second or two, for 2 minutes. -[E], Hot as can be borne. The sitz half full of water at, 100', a foot bath of the same in front, and hot, flannel pads,* one laid on the back of the bath, the othert floating in the water, the patient, fully undressed, sits clown, and is enveloped from neck to foot in warm blankets, and has a cold wet cloth (thin) wrapped about the head. A minute after. pour gently a pint of boiling water agalnst the side of the bath, disturbing the wrappings as little as possible. Add boiling water thus every minute until the bath is as hot as can be borne (110'to 120'), removing (in the absence of an overflow pipe) as much in advance each time. In 20 mins. wipe dry with hot towels as the patient sits wrapped in a dry sheet, and put to bed next the blanket. Give by the bedside, with the room at 65' or 70'. -[F], Hot and Cold Alternate by gradual transitions. Begin hot (100'),, and raise in a minute as high as can be borne (110' to 115'). Reduce then slowly until quite cold, raise the temperature again and reduce as before, taking about 2 minutes for each change, and 10 minutes in all. Undress entirely. --[G], Hot and Cold Alternate - by sudden changes. Every 2 mins. move from out of one into the other of two sitz baths, side by side, holding each a gallon of water, one hot (105') and the other cold. Begin hot and end cold, taking 8 mins. in all. --[H], Warm, with Cold Affusion to Bowels - The patient, seated in a bath at 100' full up to the overflow pipe, has a pint of cold water poured over the lower part of the abdomen every 2 mins., with a fall of 12 in. Rub the bowels all the time, and continue thus for 10 mins. Conclude with cold sponging of the parts. -[K], With Mustard - A breakfast cupful of the bran (or a tablespoonful of mustard flour) to a gallon of hot water (105'). Duration, 20 mins., or less if felt too acutely. Conclude with cold sponging of the parts. -[L], Hot - At a temperature of 103' to 105', adding fresh hot water as needed to maintain it at this. Conclude with cold sponging. Duration, 10 mins. --------------------------------------------------------- * See note to Fomentation, page 13, for mode of preparation. ^ See foot-note to Mustard Application (52), page 21, for general caution.

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    MATLOCK] BATH BOOK. 25 -------------------------------------------------------- 64. Soaping -[A], Standing up in a bath with hot water to the feet (or a hot pad), wash all over with hot soap lather (105'), and conclude with plain tepid water (70'). N.B. The head may or may not be soaped - at the convenience of the patient,. -[B], In Bed the same, part by part, concluding with plain tepid water (70'), each soaped, sponged, and dried before going on to the next. Keep well covered, save the part in hand. -[C], In a Sitz Bath, half filled with. hot water (100'), soap the head first, kneeling in front ; the trunk and arms next, seated in the bath ; and lastly, the feet and legs, standing up in the bath. All as quickly as possible, and dry well afterwards. -[D], In a Sitz Bath. with Hot Pads. The bath half full of hot soap and water (100') : a foot bath, hot (105'), in front: a hot flannel pad (see note to "Fomentation") on the back of the bath : and another floating on the water. The patient, warmly wrapped about with a couple of blankets, remains for 10 mins., then, standing up in the bath is well sponged from the same, and thereafter with plain, tepid water (80'). -[E], In a large House Bath. half full of water, at 100'. Soap the whole body, the head included, and conclude with cold or tepid sponging. 65. Spinal bandage of Swansdown Calico, with oiled silk over, 6in. by 17in., applied to the upper half of the spine, the calico damped, and the bandage secured by long tapes carried over the shoulder, crossed on the chest, and taken back under the arm-pits, to be tied over the lower end of the bandage. With a wet pad or poultice superadded, attach to the upper edge by a safety pin. For day or night, as directed. 66. Spinal pack. -[A], Hot, of towelling of soft calico, eight fold, 4in. by 15in. Wring lightly out of hot water, and apply closely to the upper half of the spine, a waterproof cloth, and a pillow laid lengthwise, outside. Duration, 20 mins. : then sponge the part with cold water. -[B], Out of Cold water instead. -[C], Mustard - with the cloth wrung well out of hot mustard and water. For 20 mins. (less if felt too acutely) and tepid sponging to follow. * 67. Spinal sitz bath. -[A], Cold. Lave the spine from above downwards, the patient partly unclad, and seated in the bath with 3in. of cold water. Duration, 3 mins., then dry and rub the skin till warm and red. --[B], Flowing. The same, with a stream of cold water passing through the bath all the while. Duration, 1 min. --------------------------------------------------------- * See note, Mustard Applications (52), page 21.

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    26 BATH BOOK. [SMEDLEY's, ------------------------------------------------------------ 68. Spinal slapping. - Sitting on a board across a sitz bath, half full of cold water, the attendant, dipping his hands frequently in the bath, plays up and down the spine. slapping it with the palms of the hands in rapid succes sion, one after another. Duration, 1 to 2 mins., until the skin is in a glow. 69. Sponging, general. - [A], Standing on a dry towel, or flannel pad, a towel (or sponge), lightly charged with cold water, is passed rapidly over the trunk and limbs. Dry them with a thick sheet, rubbing vigorously. * -[B], Sitting up in Bed. The upper half of the body is uncovered and sponged, the arms as well. After drying and clothing these, the lower half of the body and the legs are sponged, as the patient sits on the edge of the bed. Dip the head (the face at least) on rising. * -[C], Lyingin Bed. The attendant sponges with tepid water (80') the patient's face and neck, the chest next, then the bowels, each part, drying and covering it before passing to another. The limbs are next dealt with in turn, and finally the back, the patient kept carefully covered throughout. ^ 71. Sponging, local. -[A], A towel (or sponge) dipped from time to time in cold water is passed repeatedly over the part indicated for 1 min. Dry well, and rub till warm again. * -[B], the same, as hot as can be borne (105' to 110'), the sponge (or towel) very soft. For 2 mins., and dry gently. * -[C], the same with hot water and cold alternate. Hot (105') first for 1 min., then cold the same. Repeat thrice (6 mins. in all), and dry well, rubbing till warm. 72. Sponging sitz bath. -[A], Cold. Kneeling in front of the bath, half full of cold water, immerse the head several times - ladies should immerse the face only - then, sitting down in the bath, lave the shoulders, chest, and back with a large sponge. Thereafter stand up in the bath and sponge the legs. # ------------------------------------------------------------ * "Vinegar" appended to the prescription means the addition to the water of one part in four of common vinegar. "Salt," a breakfast cupful to the quart of water. "Meal", a breakfast cupful of oatmeal bran, or wheaten flour, to the pint of water. " Boracic," a teaspoonful of boracic acid crystals to the half-pint of hot water. When either of the two latter is prescribed, abstain from friction patting gently with a soft cloth instead. ^ See note, Mustard Applications (52), page 91. # When the Sponging Sitz is taken as a morning bath, let the nightdress down about the waist whilst bathing the head, and soap there and then the hands, face, &c. A folded towel in front of the bath serves first for kneeling, and later for standing on while drying. The quicker the bathing the better. In winter bring the temperature up to summer heat - about 70'.

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    MATLOCK] BATH BOOK. 27 ------------------------------------------------------------ -[B], Modified. Omit all sponging, immersing simply the head and hips, each three or four times in succession, and tread thereafter in the water whilst drying the head. Or, dipping the head first, tread the water whilst drying. and then, stepping out on to a towel, dip the hips three or four times. The singlet may be donned while treading, and rolled up as required. 73. Spouting -[A], Cold, to the part indicated, for 1 min., rubbing briskly both at the time and afterwards until warm and red. -[B], As hot as can be borne (105' to 115') for 1 min., the rubbing omitted. -[C1. Hot and cold alternate -hot first (105') for 1 min., then cold the same, and repeat four times over -for 4 mins. in all. Rub afterwards till warm. 74. Spray bath. -[A], Warm (90'), for a second or two only, and reduce straightway to cold, over a space of from 1 to 2 mins., the patient rubbing, turning himself about, and bringing the head occasionally under the spray. Dry well, and rub afterwards till warm (except when it follows on a Turkish bath). -[B], Warm (90') down to tepid (70'), merely: from 1 to 2 mins. 75. Steam bath. -[A]. The box being warmed up in advance, the seat covered with a hot flannel pad, and a hot foot bath (105') below, the patient enters, the neck is packed about with a damp towel, and the head (sponged first with cold water) is wrapped up in a cold wet cloth. The steam jet is turned on by slow degrees until oppression is felt, and thereafter moderated to the point of comfort. Keep thus for 20 mins. or less, cold water being given to drink as desired, and the head-cloth renewed as it gets hot. * -[B], A Brief Warming only in the steam-box, for 2 or 3 mins. 76. Steaming, local -The foot (or hand) held in a steam-box (or in a waterproof tent kept charged from a steam kettle) for 10 mins., the aperture made air-tight with a damp towel. 77. Stomach bandage -Of swansdown calico, with water proof over, 9 in. by 15 in., the former damped with cold water (or warm, if preferred). Worn by day, or for the ------------------------------------------------------------ * A simple domestic equivalent for the Steam (or "Vapour bath is obtained in the Hot-air Bath (38 B) by the addition of a tin vessel, with metal legs, charged with an inch of boiling water, and set over the spirit lamp.

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    28 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ night, as prescribed, and secured round the waist by dry flannel attachments. * 78. Stomach packs, see Abdomen packs [1A, &c.]. 79. Swimming bath (60' to 70'). Wet the head in advance (if not diving), and remain in from 2 to 3 mins - less, if feeling chilly. 80. Throat bandage - A strip of swansdown calico, 18 in. long by 4 in. broad, wrung well out of cold water and doubled on its breadth, is wrapped round the throat, the ends made to overlap in front. A piece of dry flannel of the same length, but 1 in. broader, is employed to cover it at all points, and secured with safety-pins. To be worn for the day or night, as prescribed. 81. Throat pack-Hot. A piece of flannel, thin and soft, 3 ft. long and 9 in. broad, is folded thrice upon its breadth, and, for one-balf its length, is well wrung out of hot water. The moist half is wound round the throat, over lapping in front, and the dry half covers it all outside. Retain for 20 mins., and sponge then the parts with cold water. If prescribed for bedtime, leave on all night with a large silk handkerchief above. 82. Trunk pack. -[A]. Cold. A blanket is spread on the bed or packing couch : a second, folded to the breadth of the trunk, from armpits to thighs only, is laid across, and upon that a sheet of the same width wrung well first out of cold water. The patient, unclad, lies down on and is wrapped up in these, one after another folded over and pushed under, smoothly and tightly, the arms excluded save from the outermost blanket. Pack well about the neck and feet, then lay the bed-clothing over, with the pillows on top of all, one lengthwise on the body, the other across the legs, and leaving the bolster alone beneath the head. Duration 40 mins., or as much longer as the patient may be comfortable in it. -[B], Hot. The sheet wrung well out of boiling water instead, and kept in coil till all is ready. ------------------------------------------------------------ * The region of the stomach extends from the breastbone to the navel, and from one nipple to the other. When a pad is superadded to the stomach bandage (77, 55) it is attached by means of a safety-pin to the upper margin of the bandage. The stomach bandage may be made available for the liver, the bowels, the bladder, the kidneys, or the uterus, according to the area of the application.

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    MATLOCK] BATH BOOK 29 ------------------------------------------------------------ 83. Turkish Bath, of three chambers, viz. 1.--- "Warm Room" at a temperature of 115' to 120'. 2.--- "Hot Room" at a temperature of 130' to 135' * 3.--- "Flue Room at a temperature of 1.60' to 170 -[A], Ordinary Bath. Go straight into the Flue Room (No. 3), remaining 6 mins. : the Hot Room (No. 2) next for 15 mins. : and then the Warm Room (No. 1) for 10 mins., more or less. -[B], Full Bath. The Flue Room (No. 3) first, till oppression is felt : the Hot Room (No. 2) next, by the same rule. Remain thereafter in the Warm Room (No. 1) until called, the whole process taking 40 to 60 mins. . -[C], Brief Bath. The Hot Room (No. 2) first. for 10 mins., and the Warm Room (No. 1) for 10 mins. more or less. -[D], Mild Bath. The Warm Room (No. 1) for 20 mins. -[E], A Warming merely - 5 mins. spent in the Warm Room (No. 1) as a preliminary to a general bath. 84. Vaseline dressing. -[A], A thin coating lightly applied to the part indicated, night and morning, or oftener if required for comfort. Unsalted lard olive oil, lanoline, vinolia, or other plain lubricant, will serve on occasion. -[B], The same spread thick on soft calico. or other soft material for application to the part indicated. Renew night and morning, or oftener if the part be dry and uncomfortable. 85. Waist bandage. -[A], Heating. A piece of swansdown calico, 3 ft. long by 8 in. broad, covered by waterproof cloth, 3 ft. long by 10 in. broad. The former wrung well out of cold water (warm, if preferred), is made to encircle the waist (between the breasts and the navel) and worn for the day or night, as prescribed. ^ -[B], Cooling. The same, without the waterproof and the calico two-fold. Wring lightly out of cold water, and re-wet from time to time, before it can become dry --every 4 to 6 hours, according to the degree of fever. # ------------------------------------------------------------ * The thermometer should be fixed not higher than 3 ft. from the floor level, as there alone will it show the temperature to which the bather, as he lies, is actually exposed. The difference may be as much as 5' for every foot above that, and a thermometer 5 or 6 ft. high is altogether misleading. ^ The Waist Bandage must be adjusted with care -not made too tight, nor the reverse -and, on removal, it should be aired, the same bandage being never worn for 24. hours together. Should the heating bandage fail of becoming warm, add the dry belt (85 D) and increase the clothing if need be. Should the bandage still remain cold remove it altogether, and rub the parts till warm again. If the subject be chilly at the time, the bandage may be applied hot. # See note on Cooling Bandage, page 30.

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    30 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ -[C], The Towel Bandage. A large, soft towel, wrung out of cold water for two-thirds of its breadth, is folded thrice lengthwise, and worn with the damp side next the skin. Re-wet as it becomes dry.* -[D], A Dry Belt of flannel worn over the wet bandage. When prescribed for the day, and without other bandage, let it be worn over the underclothing, not next the skin. ^ 86. Waist pack. -[A], Hot. A small blanket, no broader than will span from armpit to hip, is spread across the bed, with a waterproof sheet of like size beneath. Upon these is laid a cotton or linen sheet, 6 or 8 folds thick, of nearly the same breadth, and long enough to embrace the trunk (the arms excluded), and overlap well in front. On this, wring out, of very hot water, the patient lies down, undressed in part, and the sheet is brought round and tucked tightly underneath the flanks, each side in turn, the blanket in like manner, and the waterproof over all A hot water jar is put to the feet, a cold water cloth (thin) on the head, and the lower limbs are warmly covered up. Duration, 20 mins.: then sponge the parts with tepid water. -[B], Cold. The same, the sheet wrung out of cold water. -[C], Mustard. The same, the sheet wrung out of hot mustard and water. Keep on for the full 20 mins. only if not felt too keenly meanwhile. ^ 87. Water bag (india-rubber), 8 in. by 12 in. -[A], Hot (105') laid over, under, or close to the part specified and covered up well with a rug or blanket. Half fill the bag only, and re-charge as soon as it cools and as often. -[B], Cold (iced, if so ordered). N.B.-When used as a pillow, interpose a soft thin towel or pocket handkerchief. Re-charge as the bag becomes warm. 88. Water Dressing -Of lint (or soft linen) two-fold, cut to size for the part concerned, allowing half an inch extra on every side. Moisten with cold (or tepid water), apply to part indicated, and cover with a single fold of oiled silk (or guttapercha tissue) large enough to overlap the lint at every point. Secure with a surgical roller (or other bandage) and renew night and morning. ------------------------------------------------------------ * The cooling or towel variety of waist bandage being used mainly in feverish conditions with prostration, it is of importance that the patient be disturbed as little as possible over the process of application. Slip, therefore, the bandage under the loins as the patient lies, or, if he is able to sit up in bed, lay it across the bed that he may lie back upon it. The two ends, overlapped in front, secure with safety-pins. ^ See note on Waist Bandage, page 29. # See note to Mustard Applications (52), page 21.

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    MATLOCK] BATH BOOK. 31 ------------------------------------------------------------ 89. Wave bath -Wetting the head first, present the chest to the rush of water, the back next, and finally the head, the latter shielded by the clasped hands held between it and the wave. Duration 1 min. or less. 90. Morning Bath for Home -On rising step into a house bath or foot bath containing sufficient hot water to cover the feet. Then sponge the body all over with the hot water, and immediately after with pure cold, and dry with a rough towel. In weak cases the lower half of the body can be done first, then partly dress and do the other half, using a tepid instead of a cold sponge. 91. Weir Mitchell Treatment -The course for this varies from 4 to 6 weeks. The treatment consists in isolation, liberal feeding and rest, the place of exercise being taken by massage and electricity, the amount and kind of which will vary with the exigencies of the case. 92. Soapless Foam Bath -Duration 10 to 30 mins. Rest well wrapped up for half an hour after. 93. Plombieres Douche. - High irrigation of the colon, first with warm water, followed by normal saline solution.

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    32 BATH BOOK. [SMEDLEY's, ------------------------------------------------------------


    DIETING. -General Caution -All foods are nourishing if duly digested. Dieting belongs to disease, and is properly a compromise merely with a disordered digestion -an en deavour at giving the organs rest, as much as may be possible, while in a state of disablement more or less temporary. Quantity is therefore a point of even greater importance than kind. To be correct as to kind but wrong in point of quantity is small gain, and excess in the amount of food tqken is an error of the worst sort, an insuperable obstacle to cure, in truth. It is equally important, however, that the patient should take food up to the limits of his digestive capacity, as that he should refrain from over stepping these limits. To overdo dietetic restriction, as some over-anxious patients will, is even more mischievous in the long run than practically to ignore them. Restrictions in diet are a concession simply to the state of the digestion for the time being, and are less and less incumbent, therefore, as recovery advances and the digestive power returns. A. -1. General -Avoid coming in fatigued to meals. Rest for some time after. Masticate well, stop short of actual satiety, decline second helpings. Take nothing cold at meals, unless, like meat or bread, it entails delay in mastication. Drink nothing at any meal until done with eating, and nothing cold then until the lapse of an hour or so. B. -WATER DRINKING. 1. Cold -Drink a glass of cold water (plain water, if preferred) shortly before each meal. If more than three glasses a day are prescribed, distribute them as con venient, avoiding always the hour after meals. 2. Hot -Drink a glass of hot water at 7 a.m. daily, and shortly after each meal, taking it as hot as convenient. If more than four glasses a day are prescribed, let an hour elapse between each. Drink nothing at meal time. 3. Drink a glass of hot water at 7 a.m. daily, and one hour before lunch and dinner. C. -ELECTRIC TREATMENT. General Directions. A large electrode (5 in. by 3 in) covered with flannel, and a small one fitted with a sponge, are in use. These are well moistened with a warm solution of common salt. The large one is then inserted between the clothing and the skin at the, nape of the neck, if the patient is not un dressed at the time, or placed over the loins if in bed. The part indicated is then moistened with warm water, and the smaller electrode applied to it. The current (merely nominal at first) is slowly increased, as the

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    MATLOCK.] BATH BOOK. 33 ------------------------------------------------------------ patient can bear it, until the full amount is reached, and then the administration proper begun - to be carried out thereafter for the period prescribed. N.B. The Elec trician should always test the strength of the current upon himself before commencing to apply it to the patient. 1. General faradisation - The patient sits with both feet on a large metal electrode covered with moist flannel, and kept warm by a hot water bottle. The other electrode is moved slowly over the body as follows :- To the neck and cervical spine ... 3 minutes. " back ... ... ... ... ... ...4 " " abdomen ... ... ... ... ... 4 " " arms ... ... ... ... ... ...2 " " legs ... ... ... ... ... ...2 " NOTE -When the word "Transmitted" is added to the prescription, the hand of the Electrician is substituted for the smaller electrode : the current being modified thus by passing through the operator on its way to the patient. 2. Intestinal faradisation. - The large electrode is applied to the loins and the smaller one passed slowly and steadily over the surface of the abdomen from right to left (of patient) above the navel and in the reverse direction below it. Primary current only. Duration 10 minutes. 3. Local faradisation. -[A], The large electrode is applied to the cervical, dorsal, lumbar, or sacral region as may be specified, and the other electrode passed slowly over the muscles indicated. Duration 10 minutes. -[B], Apply the poles to separate muscles, or groups of muscles, selecting the "motor points" on each limb, or part indicated. Duration 15 minutes. 4. Rectal faradisation -The large electrode is applied to the abdomen, and the small held firmly to anus. (When "Internal" is added, a small zinc rod in place of the sponge is used, and introduced inside the rectum.) Primary current only. For 5 minutes, beginning very gently. 5. Central galvanisation. -Place the negative pole at the pit of the stomach: the positive pole is then carried slowly down the length of the spine, from cervix to sacrum, for 10 mins. in all. The position of the negative pole is changed occasionally, should irritation be felt at the point of contact.

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    34 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ 6. Galvanism to the head -Use large electrodes and begin with current of 1 milliampere, gradually increasing up to (but not exceeding) 5 milliamperes. From forehead to back of head. ... ... ... ... ...1 minute From one side of forehead to the other ... ... ...1 " From side to side of the head from behind the ears... 1 " From one side of forehead to the nape of neck ... 1 " From the other side of forehead ... ... ... ... ..1 " 7. Local galvanisation -Apply the large electrode (positive) to the spine at the point specified, and the small one (negative) move slowly over the part indicated, for 10 mins. ELECTRIC BATH -General directions-Let one hour elapse after a meal before taking the bath, and rest 15 or 20 minutes after it. The water should be kept at a temperature of 90' F. An ordinary bathing dress or waist towel is worn. The current is turned on after the lapse of a minute or so, and increased gradually, and reduced as slowly at the end. Duration 20 mins. If the head feels full and throbs, a cold wet towel is wrapped. about it: if faintness is felt the current is reduced. 8. Galvanic bath -The direction of the current is from feet to head, the negative pole being at the upper end of the bath and the positive at the foot. A slight pricking sensation at the ankles and knees is all that should be felt by the patient, and a galvanic taste should not be more than perceived. The current does not exceed 100 milliamperes at the first bath, and is gradually increased at subsequent baths until a strength of 200 milliamperes is reached, say by the third bath. Duration 20 mins. 9. Faradic bath -Administered as above, but with the primary current from an induction coil switched in circuit. Duration 20 mins. 10. Galvano-faradic bath -With both currents simul taneously passed along the wires. Duration 20 mins. FRANKLINISATION -General directions -An insulated chair or couch is always necessary, and the machine should be kept at as uniform a speed as possible all the time. 11 - General franklinisation -The patient sits upon a chair and has the current passed through the body, the positive pole attached to the leg of the chair, and the negative to the head electrode under which the patient sits. Duration 10 mins. 12. Franklinic dry bath -The patient sitting (or reclining, as preferred) holds the electrode (positive or negative, as pre- scribed), and is charged for 15 minutes, the machine being worked for 3 minutes and left at rest for 2 minutes alternately.

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    MATLOCK.] BATH BOOK. 35 ------------------------------------------------------------ 13. Electric wind -A pointed electrode is attached to the conductor of the machine, brought near to the part directed, and held there for 5 mins., moving it about in a small circle all the while, sparking being avoided. 14. Electric sparks -The patient holding one pole of the machine, the electrode attached to the other pole is brought near enough for sparking to occur. The skin is bare, or a single fold of linen may be interposed. Duration 5 minutes. 15. Electric shocks -From a small Leyden jar direct a slight electric shock to the part indicated. To be repeated five times at a sitting. 16. HIGH FREQUENCY- (1) On couch, 10 mins., 150 to 250 M.A. (2) Local (from couch connection). (3) Local (from top of Resonator)-(a) Effluve, 3 to 5 mins. for neuritis, sciatica, skin and visceral troubles. (b) From glass electrodes (using very mild current), applied locally or internally. 17. Diathermy. --(a.) Condenser Couch, 20 to 30 minutes. (b) Local to the parts indicated for 20 to 30 minutes. 18. Ionization with Iodide, Salicylate, &c., as directed for 25 minutes. 19. Radiant heat bath -(1) Local. The patient is clothed in a dressing-gown of Turkish towelling and reclines on a couch. The hot-air chamber is in two sections, and these are placed one on each side of the part to be treated, the intervening spaces being covered in with asbestos cloth. The limb is protected from the direct heat rays by a thin layer of lint. Within a few moments of switching on the electric current the temperature in the air-chamber rises to some 350' F -a heat which is borne comfortably, and is usually sufficient. A glass of hot water is given at the commencement of the bath and again after twenty minutes. The duration of each bath is forty minutes (more or less as prescribed), and towards the end of the application a profuse general perspiration occurs. At the conclusion of the bath. the patient is sponged all over, carefully dried, and should lie down, preferably in bed, for at least an hour. (2) Full complete bath to whole body. 20. Ultra-violet radiation. -(a) General, for 5 to 30 minutes. (b) Local, 5 to 30 minutes. 21. Infra-red radiation. -(a) Long Wave Element for 15 to 20 minutes at 18 inches distance. (b) Mixed Wave Element for 15 to 20 minutes at 3 feet distance. 22. Ultra-short wave therapy -Ultratherm machine with pad electrodes or Schliephake's glass electrodes : 10 to 30 minutes as directed.

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    36 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ D. EXERCISE AND REST. Caution -Note well the para graphs "Exercise" and "Bathing" at the beginning of the Bath Book before entering on the prescribed exercises. 1 . Walk for 20 minutes (more or less) three or four times a day. 2. Avoid climbing as much as possible, keeping always to the level in taking exercise. Guard against hurry and sudden effort. Avoid stooping, straining, lifting heavy things, or rising quickly from a recumbent posture. 3. Avoid, standing long erect, descending stairs and slopes, straining, stooping, or lifting. Walk little, stand less, and lie much. 4. Be out in the open air as often and as long as the weather will allow, and well covered up. 5. Rest completely, keeping to bed with the head low, and avoiding all exertion of mind or body. Sleep as much as possible and at all hours. E MASSAGE -The various movements employed are (a) Stroking (effleurage). -Long smooth sweeps made firmly and steadily with the palm of the hand (over large flat surfaces), or with the edge of the spread out forefinger and thumb followed by the palm (for groups of muscles, as in the limbs). (b) Kneading (petrissage). -Effected by a series of firm compressions made with the tips of the fingers, the knuckles, the pulp of the thumb, or between the thumb and fingers according to the part to be kneaded. (c) Tapping (tapotement) -Performed with the knuckles or the pulps of the fingers (as over the chest). chopping also with the ulnar edge of the open hand (to muscles of limbs), and slapping with the flat of the open palms, one hand following the other in rapid succession (to large flat surfaces). 1. To the Abdomen -The patient lies recumbent with the knees half drawn up, and the abdomen relaxed. Stroking is given for 1 min., then kneading (deep and firm) for 3 mins., and then tapping, with the open hand, for 1 min. more. Work slowly, and with a circular movement, passing across the abdomen from right to left (of the patient) above the navel, then from above downwards on the left side, to pass from left to right below the navel, and then upwards on the right side, to the starting-point again, this being the direction of the peristaltic move ments.

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    MATLOCK.] BATH BOOK. 37 ------------------------------------------------------------ -Domestic. -Self-administered at home, the patient may carry out as much of the above as he can, always careful not to exhaust himself in the effort. By means of the shot-bag much of the muscular effort can be dispensed with. It is placed on the centre, and let sink into the bowels. Give the bag a circular motion, carrying the skin along with it, and not sliding over the surface. Press well with both hands on the bag meanwhile, so as to enhance its weight as much as comfort will allow. After twenty turns over the navel, shift the bag to the pit of the stomach, repeating the circular movements there, then slide it for half an inch to the left and repeat the move ments there. Make the circuit of the abdomen thus, as described above. 2. Local -The limb being bared, and every muscle quite relaxed, the Rubber begins at the extremity, and puts each joint slowly and steadily through its natural range of movements, each half a dozen times. Then stroking, kneading, tapping, and stroking once more are gone through from below upwards, each group of muscles taken separately and in succession. 3. To the Trunk -Undressed, and lying face downwards on a couch, the patient has the great muscles of the back, loins, and hips massaged as described above (No. 2), slapping the spine for its whole length with a large movement special to that region. The patient is next placed on his back, and has the muscles of the chest manipulated, but more gently than those of the back. 4. General -The patient, fully undressed and wrapped in blankets, is placed on a couch: the room is kept at 65' F and every part save that in hand is kept well covered throughout the process, the general warmth being care fully maintained both now and afterwards. The whole body is massaged as before described under (a), (b) and (c), the lower limbs first, the upper next, the trunk next, and the abdomen last. The Rubber soaks his hands well in hot water immediately beforehand. At the conclusion the patient is wrapped in a hot blanket, put to bed, some hot soup or beef tea administered, and sleep favoured. 5. General (Modified) -Given as above, but with the tapping movements omitted. N.B.-The Rubbers are under strict injunctions not to talk to the patient during the process, perfect rest of mind as well as body being essential to the best results. 6. Aix Douche Massage -The patient sits or reclines upon a stool or couch while a stream of water is directed to the parts indicated, these being subjected. at the same time

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    38 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ to thorough kneading, rubbing, shampooing, and passive movement. The temperature of the water should be carefully regulated: beginning at about 80' it is gradually raised to 105' to 115' on the parts under local treatment. Duration 10 mins. Conclude with a spray to the general surface, reducing the temperature gradually from 100' to 70'. Dry carefully with Turkish towel and light surface friction. The patient should rest after the bath, lying for an hour at least. 7. Vichy Douche Massage -Used in similar manner to Aix Douche. Duration 10 mins. 8. Vibration Apparatus -An oscillating surface actuated by an electric motor. To be applied to the part indicated for one minute or longer as prescribed. F -MOVEMENTS WITH ELASTIC STRAND APPARATUS- 1. Chest expansion. -Standing upright with back to appara tus, grasp the rings, extend the arms at right angles to the body, and bring them slowly forward [at the level of the shoulder] until the hands meet in front. Take a deep inspiration at this point, and then let the recoil of the elastic pull the arms back with a jerk, rising on the toes at the same time. Repeat for ten minutes slowly and steadily, with what pauses may be necessary for fatigue. 2. Liver and abdominal Compression -Sitting upon the floor (or a couch) with the knees drawn up, grasp the handles and gradually fall backwards, putting the elastic on the stretch. When the india-rubber is at full length let the recoil bring the trunk back suddenly to the sitting posture once more, and as far forward as it possibly can go, so as to jerk the lower part of the chest against the knees. Repeat for five minutes, slowly and steadily, with pauses for fatigue. 3. Limb Exercise -Put the elastic upon the stretch by pulling towards the trunk with the arm in question. Let the recoil then restore the limb to the extended position, slowly and steadily. Repeat for ten minutes, twice daily, pausing at times for fatigue. For exercising the leg the Patient lies on the floor or on a couch, with his back to the wall. G -PERIODIC. 1. On the sixth day (if not over by then) take a sitz bath [63 B], tepid (80') for 3 mins., at rising, on going to bed, and twice in the course of the day, midway between meals. The next day repeat, but cool (60'): and the day after take the sitzes quite cold. Continue this as long as occasion lasts, and for a clear day beyond.

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    MATLOCK.] BATH BOOK 39 ------------------------------------------------------------ 2. With pain coming on take at once the hot sitz bath, mustard [63 K], apply a poultice of bread with chillies [57 B] to the lower spine, and a hot water bag over that. Later, if still in pain, take a hot foot bath, with mustard [29 C], and apply the leg bandages [46 A], and the foot pack of wet socks [30 C], keeping on with these and the poultices as long as the occasion continues. 3. Daily -a brief sponging sitz bath of temperature 70' to 90' to be taken night and morning. ------------------------------------------------------------ CURRENT TERMS FOR COMMON TEMPERATURES COLD ... ... ... ... ... ... ... ... ... ... 40` to 50' COOL ... ... ... ... ... ... ... ... ... ... ... ...60' TEPID ... ... ... ... ... ... ... ... ... ...70' to 80' WARM ... ... ... ... ... ... ... ... ... ... ... ...90. HOT ... ... ... ... ... ... ... ... ... ...100' to 103' HOT as can be borne ... ... ... ... ... ..115' to 120'

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    40 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ Diet List, No. 1. May take beef tea, mutton, chicken broth, solutions of beef, meat juice, raw-meat pulp, Valentine's meat juice one teaspoonful every 3 hours. Eggs beaten up with milk. FOODS -Barley or oatmeal, gruel, milk, lime water. peptonised milk, Benger's food, Mellin's food, gruel, bread and milk. DRINKS -Iced barley, toast, rice or soda water, whey. Vichy, weak tea or coffee, fresh lemonades. Must avoid -Solid foods of all kinds. Average quantity -3-4 pints in 24 hours. 5 oz. every 2 hours.

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    MATLOCK.] BATH BOOK. 41 ------------------------------------------------------------ Diet List, No. 2. BREAKFAST -Tea, coffee, cocoa (from the nibs), bread, butter, eggs (lightly boiled*), whiting, sole, fat bacon, grapes, oranges, bananas. LUNCH -Whiting, sole, brill, turbot, cod, tripe, sweet breads, sheep's head, undercut sirloin, roast mutton, game, chicken, turkey, potatoes, vegetable marrow, roast or stewed apple, milk puddings, ripe fruit, cabbage, spinach, lettuce. DINNER -As Lunch, without meat. Also custards, oranges, milk, broth thickened, jelly, juice of beef, oysters, pounded raw meat. Avoid -Salmon, mackerel, veal, pork, beans, potatoes, carrots, pastry, pickles. * The lightest way of preparing eggs is to half fill a small pan with water, bring it to the boil, remove to side of fire, and place the egg in the water for ten minutes. It will be cooked, and yet the white remains fluid.

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    42 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ Diet List, No. 3. May take soups-Clear vegetable, mutton, veal and chicken. Fish -Sole, haddock, whiting, plaice, flounder, cod, turbot, oysters. MEAT (Only once a day in moderate quantity)-Under done beef or mutton. Bacon, ham, chicken, pheasant, grouse, partridge, pigeon. Sweetbread, rabbit, tripe, calf's head. Eggs (one a day), butter, stale bread, oatmeal, rice. Vegetables (freely), except below. Fresh fruit, except below. BEVERAGES -Hot water, soda water, weak tea, cocoa, lime juice. Must avoid -Sugar, fat, except bacon, rich soups, mackerel, salmon, eels, lobster, crabs, veal, pork, entrees, currie, hashes, salt meat, duck, goose, beans, peas, asparagus, tomatoes, carrots, parsnips, jams, new bread, omelettes, cheese, gooseberries, rhubarb, currants, bananas, strong tea and coffee, strong beer, porter, sweet wines.

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    MATLOCK.] BATH BOOK. 43 ------------------------------------------------------------ Diet List, No. 4. BIREAKFAST-Tea, coffee, cocoa (from the nibs), fish of all kinds (fresh or cured), eggs, ham, bacon, water cress, lettuce, butter, gluten, bran or almond bread. LUNCH -As Dinner. DINNER -Chicken, mutton, veal and meat soups, fish, all kinds of meat, fowl and game, green vegetables and fruits, nuts, cream jellies, custard, cheese, cream cheese. SUPPER -As Breakfast. BEVERAGEs-Aerated waters or fresh lemonade. No sugar; use saccharin instead. Must avoid -Sugar in any form, wheat bread and biscuits, farinaceous foods of all kinds, potatoes, rice, peas, beans, sweet fruits and wines, parsnips, pastry and puddings of all kinds.

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    44 BATH BOOK. [SMEDLEY'S, ------------------------------------------------------------ Diet List, No. 5. BREAKFAST -Coffee, cocoa, butter sparingly, no bacon, fish, chops, poached egg, brown bread, whole meal bread, bran bread, ginger bread, groats, coarse oatmeal porridge, lettuce and radishes, fresh ripe fruits, marmalade, jam. LUNCH AND DINNER -Clear soups, fish of all kinds, chicken or turkey; chicken, mutton, or Scotch broth; beef, mutton, game, poultry, green vegetables, onions, cauliflower, prunes, figs, dried fruits, stewed fruits, roasted or stewed apples, tomatoes. No salted or rich foods. TEA -Breakfast, with fish only. SUPPER-Cocoa and biscuit, or shredded wheat biscuit broken, broken into 1/2 cup of hot milk. BEVERAGES -Aerated waters, milk sparingly.

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    MATLOCK.] BATH BOOK. 45 ------------------------------------------------------------ Diet List, No. 6. BREAKFAST -Whiting, sole, plaice, turbot, haddock, weak tea, cocoa, oat flour, toast, stale bread, eggs (lightly boiled). LUNCH AND DINNER-No soups. Fish, as breakfast. Roast mutton, roast beef (underdone) sparingly, chicken, rabbit, pigeons, tripe, calf's head, sweet bread, oysters, mealy potatoes (roasted or boiled), rice, vegetable marrow, spinach, roasted or stewed apples, grapes, stewed prunes and figs. TEA - SUPPER -Cocoa and biscuit, Benger's food, hot milk, peptonised milk, hot water. Shredded wheat biscuit as No. 5. Must avoid -Oily fish, lobster, crab, made dishes, salted meat, pork, ham, veal, sausages, goose, duck, Sauces, pickles, raw fruits, new bread, muffins, hot toast, pastry, ices, much sugar, cheese, all greasy foods.


    Friday March 17th Massage 8.30 Breakfast 9.15 Poultice 11.0 Saturday March 18th Massage 8.30 Inducts 12.30 Tuesday March 21st Inducts 12.30 Hairwave 5.15 Friday March 31st Electric 2.0 [crossed out] Poultice 11.15


    ------------------------------------------------------------ DATE HOUR WEIGHT In Clothes Without Clothes ------------------------------------------------------------ 15/3/39 2.0 pm 9st 22/3/39 2.0 pm 8-12-12 28/3/39 2.30 pm 8-10-4 Apr 3 12.0 8-7 1/2 Apr 4 2.0 8-13 1/4 Apr 10 12.0 8-8 Apr 11 2.30 8-12 ------------------------------------------------------------ N.B. - Weigh always at the same hour of the day and in the same clothing, if not in the Turkish Bath. The latter is to be preferred, as less open to error. This record should never be omitted


    The head bath-attendant or head nurse ex- plains how to read the prescription, and arranges for its being carried out. The patient retains this book for reference at every stage of the treatment, and will oblige by presenting it at consultations on entering the room. While noting carefully the instructions ad- dressed to himself, the patient should, by means of this book, check the bathing operations at every point. Any departure from the strict letter of its terms should be reported to the head bath-attendant without delay. ----------- Bath Attendant Wm Allsop

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