SOUTH NORWALK, CONN.
The modern pathology and clinical history of mental and nervous diseases has demonstrated the fact that many of the affections of this important branch of the human economy are due to, or aggravated by, intoxication – the introduction of poisons into the system, or the absorption of the toxic products of incomplete metabolism.
Alcohol develops alcoholic neuritis; excessive use of tobacco produces the well known type of amblyopia; wood-alcohol affects the optic nerve also; morphine and cocaine exercise a destructive effect on the mental process and a decided loss of moral tone. These are examples of poisons introduced into the system from without.
The nervous phenomena attending the clinical syndrome known as uremia are a classical example of the effects of auto-intoxication, the poisoning of the system by products of incomplete metabolism.
It is widely understood, nowadays, that many cases of neurasthenia, especially in women, are caused or contributed to by chronic constipation and a greater or lesser degree by fecal impaction. In such cases there is a sort of vicious circle; the absorption of toxic products from the bowels poisons the nervous system and the neuro-muscular working of the intestine is interfered with. Digestion and metabolism are impaired, constipation is still further increased and the auto-intoxication augmented and thus an endless chain set up.
Nature has provided four channels of elimination from the system; bowels, kidneys, respiratory apparatus and the skin.
The medical profession attaches due weight to correct functionating of the intestinal tract and urinary organs and the necessary measures to be taken when these physiological actions are impaired. The part played by the lungs in the elimination of poisons is quite limited, though very vital, and so long as respiration continues, elimination goes on.
With regard to the fourth channel provided by nature for the expulsion of deleterious substances from the body – while in a general way we recognize the importance of the physiological action of the skin and even its vicarious power when one of the other natural eliminants of poison, especially the kidneys, fail to act properly. It is, perhaps, true to say that in the treatment of mental and nervous conditions the importance of the sweat glands as a means of elimination of toxic products has not been properly developed.
Heat is, of course, the chief physical agent for the stimulation of the sudorific glands and the use of the hot pack is widely known in the practice of medicine. Of late years apparatus has been devised for the application of dry hot-air to a part or whole of the body. By means of this apparatus the surface of the body can be subjected to a temperature as high as 315° F.
This extreme degree of heat is well borne by the patient when provision is made for the removal of perspiration as fast as it is poured out on the skin. This is accomplished by wrapping the patient in a sheet of toweling which absorbs the moisture as fast as it exudes from the pores. Were the perspiration allowed to accumulate on the skin even for a short time the patient would be badly scalded. During the entire bath the pulse and respiration should be carefully watched by a trained attendant, or, better, a physician, if the patient has a weak heart or is not accustomed to the bath. The patient is allowed to drink a large amount of water, usually given by means of the feeding cup. Towels should frequently be wrung out of cold water and applied to the head.
The time necessary for this bath depends much on the condition of the patient. Usually a good perspiration can be produced in 15 to 30 minutes. After removing the patient from the heat-cabinet he is rubbed down and at the same time massaged, unless there are symptoms which make this not advisable. Rest in bed should then follow.
I will mention an extreme case that was greatly benefited by the dry hot-air bath.
Mrs. “T” – aged 45. Diagnosis: Acute Melancholia. For the past six months had not been sleeping more than two or three hours during the night, and many nights was restless and awake all night. First night after admission to sanitarium, no sleep for either patient or nurse. Second night, no sleep; and walked the floor most of the night. Third night, one hour’s sleep. Fourth day, patient was given a dry hot-air bath at 4 P. M., and it took nearly three-quarters of an hour for her to perspire freely. Patient went to sleep two hours after bath and slept until twelve o’clock, took nourishment and went to sleep again, sleeping until 4 A. M. Patient made an uninterrupted recovery, gaining mentally and physically. All cases do not respond as promptly as did this one. Few or no cases are made worse, and most are greatly benefited.
In Germany, for some years past, considerable use has been made by eminent clinicians of electric-light baths. The American part of the profession has had but limited experience with this therapeutic agent. The effects of the bath varies somewhat on the source of illumination.
The arc-light is richer in ultra-violet and actinic rays than the incandescent lamp so that the former has more effect on bacteria than the latter; but the permeative power of the electric light is but slight, and probably only bacteria inhabiting superficial tissue are affected by it.
In the incandescent light bath the great factor is probably the heat generated by the large number of lamps within the cabinet, although we must not entirely eliminate the influence of the light, per se, as it has been demonstrated that electric light as well as sunlight, has a direct effect on the blood and blood-vessels, increasing the circulation and the amount of haemoglobin in the blood. That CO2 in the expired air is increased, has also been demonstrated.
In the vegetable kingdom we recognize the influence of photo-activity. Plants languish and droop in a dark cellar while similar specimens flourish and bloom when they receive a due share of sunlight, and it has also been shown that the growth of plants can be hastened if they are exposed to the action of light, while the sun is below the horizon.
Chlorophyl pigment can only be found in light; plants and plant parts grown in the dark have no chlorophyl, but are pale-yellow in color. Electric light has the yellow rays needed for chlorophyl. The quantity of light need not be large. Sprouting plants will grow dark green in a light which barely suffices for the reading of large script.
The electric light bath-cabinet should be so constructed that the patient’s head can be outside the cabinet, which is lined with reflectors, so arranged that the light from 50 to 60 sixteen-candle-power incandescent lights is reflected on the patient, who is seated in the cabinet. The bath should last in all, 25 to 30 minutes. It depends on the special case, whether the cabinet should be heated, before bath, or not.
The temperature of this bath should be between 110 and 122, not higher, unless the patient is accustomed to the bath and you are familiar with his condition. Massage and rest in bed should follow this bath as in the dry hot air.
With the electric light bath the giving off of CO2 is more abundant than in the vapor baths and what is especially interesting, is that perspiration appears very quickly and at a low temperature, is very profuse, the time required for the first appearance of perspiration is one-half that required for other vapor baths.
In the anemic, poorly nourished patients, the light bath should be preferred. When there is pain and we desire a decided action on the superficial nerves, then the extreme high temperature of the dry hot-air bath.
Of course, the use of the dry hot-air bath or the electric-light bath does not constitute the whole treatment of mental or nervous affections depending on the absorption of toxic material, but it is one of the most valuable of the therapeutic measures to be employed in these cases. The resources of materia medica, hydro-therapeutics kinesotherapy, all have their place in the scientific treatment of neurotic affections, especially as carried out in up-to-date institutions.