used either directly after or before a meal.  The hot baths may be taken either as half, three-quarters, or full baths, according to the nature of the case and the condition of the bather.

In the first of these (viz., a half-bath), which immerses the body no higher than the waist, it is well to apply a towel wrung out of cold

water to the head, at the same time (especially in the case of females) wearing an oilskin bathing cap, to prevent the hair from getting wet.  Cold to the head is of signal advantage when there is persistent headache, or a tendency of blood to that part.  In cases of acute sciatica, congestion of the liver, spleen, and kidneys, accompanied by a general sluggishness and torpidity of the portal circulation, frequently very painfully indicated by internal or external hemorrhoids, the hot sitz bath gives very speedy relief.

In a sitz or three-quarters bath the bather should, immediately upon entering the water, lave it over the face, neck, and chest.  After being in the bath five minutes, two more should be devoted to the application of the douche, first to the spine and then to the joints and other parts particularly affected, with the exception of those inflamed and painful, which should not be douched but gently rubbed with the hands beneath the surface of the water, in order to promote free cutaneous circulation and absorption of the nitrogen gas through the skin.

After leaving a full hot bath the body should

at once be enveloped in a warm sheet and friction applied over the whole surface.  Dressing should be accomplished as rapidly as possible in order that a chill may be avoided, and then the bather, if able to walk (if not, in a bath chair), should go to the drinking fountain at the west-end of the Crescent, where either a large or small tumbler of the thermal water (as prescribed) should be drunk, and then return home, where rest upon a sofa or bed should be taken for at least an hour, the body being well covered with rugs, &c., so as to promote, as much as possible, an action upon the skin and consequent elimination of the gouty and rheumatic poison through its pores by free perspiration.

Frequently, after taking one of the hot medicinal baths, a feeling of drowsiness steals over the bather, and it has been thought by some medical men that sleep should not be indulged in.  During a long experience in prescribing the medicinal baths of Buxton 1 have never observed any ill effects ensue from giving way to sleep, and therefore allow my patients to

follow their own inclination in the matter.  When the bather has been covered up for a quarter of an hour, and the skin acts freely, he or she may begin to throw off some of the wraps, thus permitting the surface of the body to cool by degrees.  When a full hour has been accomplished, the ordinary occupations and duties of the day may be resumed.  It is not advisable, however, to risk exposure in an open conveyance for at least three hours after taking a hot bath, as might be done after using a natural one.

The massage bath may be used with most advantage between ten-thirty and twelve a.m., and three and five p.m.  It is not advisable to take the massage bath within two hours after a meal, or less than one before.  Massage, or kneading of the whole body, is carried out in this bath after which a steam douche or a warm spray is turned upon the affected parts, according to the nature of the case.

Chronic rheumatic arthrites, with painful and contracted muscles, obstinate lumbago, diaphragmatic, intercostal, periosteal, and synovial

rheumatism, and sprains and injuries to joints, are greatly benefited by the application of massage, followed by the hot steam douche or warm spray.  Much relief is obtained from the application of the douche (first hot and then reduced to tepid or cold, according to the nature of the case) in subacute rheumatic arthritis, long-standing sciatica, facial neuralgia or tic douloureux, intermittent headache, spinal irritation, chorea or St. Vitus’ dance, wrist drop (from lead poison), writers’ cramp, where there is the rheumatic diathesis, and paralysis agitans, &c.

The Buxton medicinal baths, either at their natural temperature, or when the water is artificially heated, are, on account of their powerful action upon the human system, quite inadmissible in all cases where there is acute inflamation of any organ.  In extensive valvular disease of the heart, especially when accompanied with regurgitation, or advanced degeneracy of that organ, atheromatous degeneration or aneurism of the larger arteries, lung disease, in an advanced stage, especially when

connected with the phthisical diathesis, asthma, or amphipneuma, complicated with fatty degeneration or dilatation of the heart, giddiness, vertigo, or sudden faintness consequent upon organic disease, the baths should not be taken, except locally, and even then with the greatest caution.  When so used the affected parts may be sponged with the thermal water heated to the prescribed degree.  An ordinary compress soaked in the heated water may often be advantageously worn continuously over an inflamed joint, congested liver, inactive kidneys, or irritable stomach.

When the thermal water is only prescribed, the most favourable time for drinking it is from seven to eight and eleven to twelve a.m., and from four to five p.m., but when ordered to be taken in conjunction with the chalybeate, the former should be taken in the morning and the latter in the afternoon.  It has been customary for some medical men to prescribe the two waters mixed together.  My own experience leads me to think that such a mode of using them (in a great measure) destroys the efficacy

of the thermal by reducing its temperature, and driving off one of its most active and essential constituents, viz., the nitrogen gas.

The water can be drunk with safety in most cases, but there are some in which it is as inadmissible as the use of the baths.

In acute cystitis, advanced stage of Bright’s disease, certain forms of dyspepsia, irritation in the urinary passages, either in the male or female, drinking the thermal water should not be resorted to.  The mucous membrane under its influence becomes more irritable, and where the urinary passages are specially involved, the impulsive efforts to void urine are extremely painful and distressing, the urine being reduced to mere driblets, and sometimes even to complete retention.  Constant sickness, either arising from mucous inflammation or ulcer of the stomach, contra—indicate the use of the thermal water.

CHAPTER IV.
diseases in which the waters are useful.

Acute Gout and Rheumatism—Chronic Gout and Rheumatism—Chorea—Paralysis Agitans—Many Forms of Paralysis—Muscular Atrophy consequent upon the Gouty Diathesis—Loco Motor Ataxia—Syphilis—Local Injuries—Neuralgia—Sciatica, Lumbago, &c.—Number of Baths Constituting a Course—Length of Residence Required—Action of Water upon Acute and Chronic Disease—Extract from Devonshire Hospital Report—Inference.

The following are amongst the principal diseases for the relief of which the Buxton medicinal thermal water is deservedly celebrated: Acute gout and rheumatism (in neither of which can the baths be taken with advantage until the acute or inflammatory stage has subsided),