The Neutral Bath for Sleeplessness
THIS is simply a full bath at the temperature of ninety-two to ninety-seven degrees, administered in the usual manner. Friction should not be administered, unless it be very gentle rubbing when the patient first enters the bath, if he feels a slight inclination to chill. Chill will not occur, however, if the temperature of the bath is properly adjusted to the patient’s condition. The average temperature of the bath should be ninety-four or ninety-five degrees. When the patient is feverish, and the skin hot and flushed, even though there be no rise of temperature, the temperature of the bath may be ninety-two or ninety-three degrees. If the patient is thin and bloodless, with small heat-making capacity, the temperature of the bath should be ninety-six or ninety-seven degrees. All mechanical efforts should be avoided after as well as during this bath, as its purpose is to secure calmative or sedative effects. The duration of the bath when applied for relief of insomnia, should be from fifteen minutes to one hour. When used for the reduction of temperature, however, it may be continued for a much longer time, as three to four hours; and in certain cases of acute mania, obstinate insomnia, or fever, it may be continued for several hours consecutively, at a temperature of ninety-two or ninety-three degrees. The neutral bath diminishes the pulse rate, but does not modify the respiration. Exhalation by the skin is suspended, so that water accumulates in the tissues. It is in this way the cutaneous nerves become supersaturated with water, rather than by absorption of water from the bath. At the neutral point, there is then practically no movement of fluids either inward or outward. The urine is greatly increased in quantity, while its acidity is decreased; it may even become alkaline. The temperature and mode of administration of the neutral bath are such that neither thermic or circulatory reaction is produced. The bath may consequently be prolonged for an almost indefinite period, without producing exhaustion or any other untoward effects. When the bath is prolonged for a considerable period, the patient should be suspended in a sort of hammock, consisting of a sheet let down into the tub and secured to the edges, and should be made comfortable by means of an air pillow. The temperature of the neutral bath may be maintained uniform by placing covers over the tub, and adding jugs or bottles filled with hot water as often as may be necessary; or a portion of the water may be removed from time to time, and replaced with water at a higher temperature. When the temperature of the surrounding atmosphere is such as to prevent cooling, so that the bath is warmed by the heat of the body, it may be necessary to add cooler water occasionally to prevent elevation of temperature, whereby the bath would cease to be neutral in its effects. This bath depends for its good effects entirely upon the careful adjustment of the temperature within the limits named, ninety-two to ninety-seven degrees Farenheit. In insomnia there is practically no single measure of treatment so valuable as the neutral bath. For this class of patients the bath should be administered at bedtime. The patient often becomes drowsy in the bath, and may fall asleep. He may be allowed to sleep in the bath for several hours if it is found that removal counteracts its hypnotic effect, which is not infrequently the case. The sleeping patient must be carefully watched, however, to see that the head is not submerged. On removal from the bath, in cases of insomnia, great care should be taken to avoid chilling of the surface by evaporation. The patient should be instantly wrapped in a Turkish sheet and woolen blankets, and should be dried by gentle patting of the sheet or blanket, and without rubbing either with the sheet or with the dry hand, being afterward placed in bed as quickly as possible, and his surroundings made in every way conducive to sleep, so that the good effects of the bath may not be lost by excitation of the nervous system by unfavorable conditions. It will be interesting to recall the fact that Hippocrates well appreciated the neutral bath as a means of inducing sleep. — Good Health.