PRACTICAL DATA ON THE 
APPLICATION OF WATER IN SOME 
INTRACTABLE DISEASES. 
BY / 
SIMON BARUCH, M.D., 
Attending Physician to the Manhattan General Hospital and New York Juvenile Asylum ; Consulting 
Physician to the Moutefiore Home for Chronic Invalids. 
[Read before the New York County Medical Society.] 
COMPLIMENTS OF THE AUTHOR. 
NEW YORK: 
Press of Stf.ttiner, Lambert 6c Co., 
22, 24 & 26 Reade Street. 
1893. PRACTICAL DATA ON THE APPLICATION OF WATER IN 
SOME INTRACTABLE DISEASES. 
The recent revival of hydrotherapy 
is an interesting phase of thera- 
peutics in this country. Three years 
ago the first paper, giving a general 
review of the uses of water, external 
and internal, by lavage, irrigation, 
baths, etc., was read before this soci- 
ety. Therefore the history of this 
subject is closely bound up with the 
history of this society. Articles on 
this same subject have now become 
numerous. A new journal has ap- 
peared on balneology, and a depart- 
ment in that magnificent specimen of 
American journalism, the Annual of 
the Universal Medical Sciences, chron- 
icles the advances in this therapeutic 
specialty. Indeed, a recent letter 
from Dr. Winternitz, professor of hy- 
drotherapy in the University of Vi- 
enna, refers to the fact that more is 
now done in this country for hydro- 
therapy than in Germany, its birth- 
place. For this reason I venture to 
offer you some practical remarks on 
this subject. 
The chief, though not the only, aim 
of hydrotherapy is to stimulate or 
give tone to the nerve centres. Since 
all vital energy emanates from the 
latter, since the proper performance 
of all the organic functions depends 
upon their activity, it is fair to de- 
duce important therapeutic results 
from an agency which influences it 
so potently. The main question is, 
does the application of water to the 
cutaneous surface stimulate the nerve 
centres ? That this is a trite physio- 
logical fact is daily observed in the 
effect of a dash of cold water in re- 
viving a person under syncope. Here 
we have a brief shock to the sensory 
peripheral nerves, followed by reac- 
tion whose effect is transmitted to the 
central nervous system, and thence 
to the respiration, deepening it and 
the circulation, restoring the failing 
pulse; thus the temporarily dormant 
vital powers receive a stimulus whose 
appreciation must convince the most 
sceptical by its very simplicity. 
At this time I do not propose to 
dwell upon the various modifications 
which change in temperature of the 
water applied to the cutaneous sur- 
face may produce, nor the remark- 
able difference of effect resulting 
from the increase of the pressure un- 
der which it strikes the skin, nor 
the valuable results of changes in the 
duration of the procedure.1 Suffice 
it to say that we have in the external 
use of water a therapeutic agent so 
flexible that it may be adapted to the 
most varying types and forms of dis- 
ease. The following brief outlines 
of cases are presented in order to en- 
able you to obtain a view of the prac- 
tical application of hydrotherapy in 
some intractable chronic diseases, to 
demonstrate its flexibility, and to 
point out the methods of adapting it 
to varying conditions. 
Miss H., age 20, ill two years, under 
constant treatment by gynaecologists 
Case I.—Intense Chlorosis. 
1 See “The Uses of Water in Modern Medicine.” 
By Simon Baruch, M.D. Detroit: Geo. S. Davis. 2 
in Harrisburg, Baltimore, and Phila- 
delphia, was brought as a last resort 
to Dr. T. G. Thomas, to be placed in 
his sanitarium. Dr. Thomas discov- 
ered no uterine trouble and referred 
her on June 8th, 1892, for hydriatic 
treatment, with a diagnosis of chloro- 
sis of aggravated type. Local and 
medicinal and institution treatment, 
iron, arsenic, diet, and massage and 
change of air, had been tried in vain. 
Although the patient was plump, a 
more pallid creature could not be 
imagined. Appetite was poor, bow- 
els irregular, her sleep was disturbed, 
and she was subject to frequent (hys- 
terical) fainting spells. The slightest 
exertion produced difficult breathing 
and rapid heart action. Menstrual 
flow was regular, but scant and very 
pale. Blood examined by Fleischl’s 
haemometer registered thirty-one per 
cent. 
June 10th : Preparatory treatment 
by hot-air baths and spray douche, to 
educate the patient’s reactive capa- 
city, was ordered. Fainting in the 
hot-air bath, she was removed. A 
spray douche of two seconds at 64°, 
with twenty pounds pressure, was 
rapidly passed over her in a sitting 
posture. She again fainted. Fric- 
tion produced no reaction. 
On the following day, a milder 
course was pursued. She was gently 
wrapped in a long-haired woollen 
blanket for forty-five minutes. Parts 
of the body were then successively 
uncovered and splashed with water 
at 6o°, thrown with some force from 
the hollow hand of the attendant. 
This was followed by friction, and 
continued until the whole body had 
received the ablution and friction. 
The same treatment was continued 
on the nth and 12th, when she faint- 
ed twice. This was repeated with- 
out fainting until the 16th of June. 
She was again placed in a hot-air 
bath (167°), with a cold compress 
around the head, and given frequent 
sips of ice water. The head not 
being subjected to the heat, the pa- 
tient was enabled to breathe the 
cool air which permeated the room. 
When the cutaneous vessels became 
tinged she was seated in a tub con- 
taining eighteen inches of water at 
ioo°, thoroughly rubbed for three 
minutes. This was followed by an 
ablution at 6o°, good friction-drying, 
and general massage for fifteen min- 
utes. She fainted twice during these 
procedures. 
July 8th : The last treatment had 
been continued, reducing tempera- 
ture of the spray douche daily one 
degree ; to-day she had an air bath 
(i6o° F.), followed by spray douche 
under thirty pounds pressure for five 
seconds, beginning at 8o° and rapidly 
reduced to 50°, followed by fifteen 
minutes’ general massage. She re- 
acted well and felt comfortable. 
July 14th : Same treatment has 
been continued. To-day she had a 
hot-air bath (175°), followed by rain 
bath, thirty seconds, at 940 reduced 
to 69°, then spray douche, ten seconds, 
790 to 540, and general massage. Re- 
action good. 
July 30th : This treatment has 
been continued, until to-day she took 
a jet douche at 450 without flinching. 
Being absent in Long Branch, I wired 
to Dr. F. Armstrong to examine her 
for me. Dr. A. reports: Miss H. 
looks quite well, eats and sleeps well, 
and is certainly improved since I 
last saw her. The comparison test 
indicates about one hundred per cent 
haemoglobin. 
August 1st: Miss H. left for her 
home in Pennsylvania. This case 
certainly illustrates, first, the effect 
of the douche in improving the 
nutrition; second, that haematosis 
may be enhanced by the stimulus 
conveyed from the periphery to the 
nerve centres, and thus reflected 
upon the blood-making functions, as 
has been well shown by Winternitz, 
Thermes, and others; third, that the 
most feebly reacting patient may, by 3 
perseverance and proper adaptation 
of the hydriatic procedures, become 
accustomed to this treatment. The 
danger of shock from cold water 
is proven to be chimerical by this 
case. 
If this fragile and sensitive young 
woman could be accustomed to the 
douche by beginning with mild pro- 
cedures, no chronic case that is not 
in extremis could fail to respond to it* 
placed upon daily hydriatic measures, 
as follows: 
May 6th : Hot-air bath at. 169° for 
six minutes filled the cutaneous ves- 
sels of her pallid skin and produced 
free perspiration. This was followed 
by a tub bath of water at 98° for five 
minutes, and a rain bath of 950 re- 
duced to 90°, for half a minute, at 
twenty pounds pressure, for the pur- 
pose of increasing cutaneous action. 
A tonic procedure by the spray 
doiiche at 8o° for five seconds, with 
friction, closed the first treatment and 
resulted in good reaction. 
On the following day she remained 
in a hot-air bath at 164° only long 
enough to render the cutaneous ves- 
sels turgid, to promote reaction from 
the rain bath for thirty seconds at 
900 reduced to 8o°, and a spray douche 
at 70°. Reaction very fair. 
May nth: Temperature of rain 
bath was reduced to 750, and a jet 
douche at 65° was added. Reaction 
good. 
May 23d: Same treatment, with jet 
douche to back at 6o°. 
May 25th: Complained of sciatic 
pains on right side. The Scotch 
douche was applied to the gluteal 
region for thirty seconds, followed by 
jet douche of one second at 590. 
May 31st: On account of menstru- 
ation, treatment has been omitted for 
six days. Sciatic pain is relieved. 
Treatment of May nth resumed. 
June 2d: Temperature of rain bath 
reduced to 70°, and of jet douche to 
57°- 
June 12th: Same treatment, except 
jet douche lowered daily one degree, 
reaching to 48°. Patient has been 
steadily improving in flesh and spi- 
rits, being free from pain until to- 
day. The addition of cauliflower to 
her diet reproduced pains. Stomach 
was now washed out and some mucus 
found in it. 
Temperature of jet douche was 
raised to 6o°, as patient was excited 
by it. 
Case II.—Nervous Dyspepsia; 
Anaemia. 
Mrs. O., age 28, resident of Flo- 
rida, consulted me, May 5th, 1892, 
for “ catarrh of the stomach,” be- 
cause of agonizing pains after meals. 
She has been living on mush and 
milk, and has had medical treatment 
for several years, with diminution 
but not disappearance of the pains. 
She is emaciated; her voice is fee- 
ble; she is depressed and hopeless. 
Her wan face and prematurely old 
appearance bear evidence of a life of 
constant physical suffering. There 
is not a particle of the hysteric ele- 
ment in this case. Ordered at 12:30 
p.m. a full test meal at Delmonico’s, 
which she reluctantly accepted be- 
cause of dreaded increase of pain. 
Returning to my office at 5:30, the 
stomach was washed out without dif- 
ficulty, Mrs. O. displaying marked 
patience. To her great surprise, my 
prediction that her dinner would be 
digested was verified, a little tomato 
peeling being the only remnant visi- 
ble. 
The diagnosis of a gastric neurosis 
being thus confirmed, she was or- 
dered a mixed diet, chiefly consisting 
of hot milk and stale bread and ho- 
miny for breakfast, adding eggs (soft- 
boiled later), same with fish or oys- 
ters for luncheon, and steamed rice 
and roast beef for dinner. Desserts 
and salads forbidden. 
The general invigoration of the 
entire system being the chief ele- 
ment in this case, she was at once 4 
June 18th: Jet douche suspended; 
hot-air bath, 180°, followed for forty 
seconds by rain bath of 750 reduced 
to 65°; stomach washed out again. 
June 20th: Pain returning, the 
constant current, 12 milamperes, was 
applied by a large flat sponge elec- 
trode over epigastric and a small one 
over lumbar region. 
June 27th: Temperature of baths, 
having been higher, was now re- 
duced, patient being again depressed; 
the jet douche was given at 5,0° for 
three seconds. Reaction good. 
July 9th: Electricity having been 
unavailing and fermenting material 
being found in the stomach, the 
Scotch douche has been applied to 
epigastric region for thirty seconds 
after the rain bath, 70° to 45°, daily, 
and followed by jet douche at 50° for 
three seconds. Patient now feels 
sufficiently restored to go to Buffalo 
to her parents. 
Under date of November 26th, 1892, 
she writes that she has gained fifteen 
pounds in weight and is much strong- 
er ; has continued the diet prescribed, 
because, like most of these neurotics, 
she “ feared her stomach was not 
equal to much of a change.” Most 
of the time she is entirely free from 
pain ; she has slight distress every 
now and then, but expresses the 
warmest gratitude for the help given. 
This case is similar in many re- 
spects to the case of Dr. H. reported 
in “ The Uses of Water,” page 85, vol- 
ume I., and demonstrates the value of 
hydrotherapy in improving the nutri- 
tion and thus furnishing better blood 
to the stomach nerves, which are 
calling for it through pain. 
cular rheumatism by wet packs and 
massage a year ago. 
Examination revealed six per cent 
sugar by fermentation test. Specific 
gravity 1.040 ; quantity passed in 
twenty-four hours, eighty-one ounces. 
She was languid and indisposed to 
exercise, weighing without clothing 
two hundred and fifty-three and a 
quarter pounds on the 21st of March. 
An antidiabetic diet was ordered 
and systematic walking exercise. 
The former was rigidly adhered to 
for four weeks without effect; the 
latter could not be accomplished be- 
cause walking two blocks “ put her 
out of breath ” and exhausted her. 
Acting upon the well-known physio- 
logical fact that next to the liver the 
skeletal muscles hold most glycogen, 
and that sugar is by exercise of these 
muscles best utilized for the benefi 
of the organism, I regard systematic 
exercise of quite as much import- 
ance as diet. I have the record 
of six cases in which these two 
combined entirely and permanently 
removed the sugar from the urine. 
A strict diet having failed in this 
case, it was important that some 
therapeutic method be adopted to 
enhance the patient’s capacity for 
muscular exercise. It was deter- 
mined to reduce her weight and in- 
vigorate the nervous system by a 
carefully regulated hot-air bath un- 
til free perspiration ensued, once a 
week, followed by the spray douche 
at 90° for a half-minute, and at 8o° 
for ten seconds. This was succeeded 
by active massage. Five times a 
week she received a tonic hydriatic 
procedure, beginning on the 28th of 
March with the dry pack for a half- 
hour to fill the cutaneous vessels, 
followed by a general ablution at 70° 
and good friction. Patient attended 
daily, coming from her home in 
West 15 2d street in a carriage, as she 
was unable to walk. On April 15 th 
she had lost six pounds and felt able 
to walk six blocks twice a day. 
Case III.—Diabetes and Obesity. 
On March 2d, 1892,1 was consulted 
by Mrs. S., wife of a prominent police 
official, age 63. She had been suffer- 
ing from lassitude, loss of appetite, 
depression of spirits for several 
months ; had been relieved of mus- 5 
April 2 2d : Urine showed specific 
gravity 1.035 I sugar five and a quar- 
ter per cent. Wet packs forty-five 
minutes, sheet wrung out of water 
at 50°, were ordered, followed by half- 
bath ten minutes at 85°; sponge ablu- 
tion on back at 70° with active friction 
in tub ; massage fifteen minutes. The 
object of this treatment was to in- 
crease tissue change and improve the 
circulation in the muscular tissues. 
This was continued until June 6th, 
the jet douche at 750 being added as 
a tonic and for contracting the mus- 
cles. The result of these procedures 
was ability to walk more every day 
until she was not fatigued by four 
miles per diem. The diet being rig- 
idly adhered to, a rapid decrease of 
sugar was evident every week from 
the date of the first half-mile walks. 
Since July 1st she has been entirely 
free from sugar until the present 
time, frequent analysis having been 
made until December 1st, 1892. 
In this case the diet alone, pursued 
for four weeks, made no impression ; 
but as soon as the patient was able to 
oxidize her sugar by means of mus- 
cular exercise improvement became 
pronounced. No medicinal agent 
could have accomplished this change 
in the nervous, muscular, and vascu- 
lar structures in so brief a time, if at 
all. Of this I am convinced by other 
cases similarly treated. 
and began to improve. On the fol- 
lowing evening she was seen in con- 
sultation by Dr. A. L. Loomis. She 
continued under treatment, chiefly 
dietetic, and codeia and constant cur- 
rent for severe neuralgic pain at for- 
mer seat of herpes. Sugar has been 
almost constantly present in small 
quantities—one-half to one per cent. 
During the winter of 1892-93 she de- 
cided to undertake a thorough course 
of hydrotherapy, encouraged by the 
patient whose history is given above 
and who lives near her. The same 
treatment had not the slightest effect 
on the urinary sugar. But she re- 
garded herself as so much invigorated 
and capacitated for more work and 
exercise that she voluntarily takes 
the treatment twice a week as a tonic 
agent. 
Case V.—Sexual Hypochondriasis. 
Mr. M., age 47, was referred on 
June 5th, 1892, to the Institute by 
Dr. S. Weir Mitchell, of Philadelphia, 
with the following history (here ab- 
breviated) : Patient complains of im- 
potence and a sensation of water 
trickling down front of thighs. Hab- 
its good. Had three children, all 
dead ; two died at birth. Three 
years ago, when his wife was absent, 
he first discovered the trickling sen- 
sation. On her return he found sex- 
ual desire present, but was incapable; 
emission occurred, and still occurs, 
in sleep. Had two strictures cut 
without relief. After being in the 
mountains a year ago he had two 
successful connections, and again in 
November, 1891 ; none since; fre- 
quent emissions and firmer erections 
during sleep. These are rare now. 
Present state : Stout man, abdominal 
paunch; urogenitals normal; cremas- 
ter reflex absent; parsesthesia along 
anterior crural nerve. Electrical ex- 
amination negative. Sleeps well. 
Appetite good. No sperm in urine. 
Dr. De Schweinitz pronounced eyes 
normal. Dr. Mitchell regarded pa- 
Case IV.—Diabetes Influenced by 
Diet and Hydrotherapy. 
Mrs. Du B., age 65, applied for 
treatment for a severe herpes zoster 
on the left part of the back, below 
the scapula. On the evening of 
April 4th, 1890, I was hastily sum- 
moned, after I had treated her herpes 
on the preceding afternoon. She was 
absolutely comatose, without any re- 
flexes, etc. Drawing some urine by 
catheter, I found no albumin, but 
decided evidence of sugar, this being 
its first discovery. Toward morning 
she became conscious spontaneously, 6 
. tient as suffering from some slight 
but distinct trouble of the lumbar or 
dorso-lumbar cord ; dread of sexual 
failure is probably emotional; full 
recovery of power is probably not to 
be looked for ; advises electricity 
(detailed), also douches—alternating 
warm and cold—to spinal column. 
. Treatment at Institute, June 5th. 
The patient’s peripheral circulation 
being feeble, skin flabby and inelas- 
tic, pulse compressible, and a gene- 
ral aspect of mental and physical 
depression being present, it was 
thought advisable to give him tonic 
treatment as follows : A hot-air bath 
(170°) for twelve minutes having 
warmed him up, a rain bath of ioo°, 
reduced to 8o° during forty-five sec- 
onds, was given under thirty pounds 
pressure, and followed by the jet 
douche at 70° for two seconds 
under fifteen pounds pressure. 
General massage was given for fif- 
teen minutes. Reaction was poor. 
June 6th : Hot-air bath (178°) ten 
minutes. Rain bath, 95 °, reduced to 
70° during one minute, was followed 
by Scotch douche (alternating hot 
and cold stream) to spine. Reaction 
poor. 
June nth: Same treatment was 
continued, reducing temperature of 
douche daily one or two degrees and 
increasing pressure. Reaction is 
now good and patient looks brighter. 
The perineal douche (jet) of 6o°, for 
one minute, is now added for psychic 
effect. 
June nth: Patient dissatisfied; 
does not think he “ can improve by 
having a little cold water sprinkled 
on him,” and insists upon more ac- 
tive measures. 
June 16th : The psychrophore of 
Winternitz (a small rubber or skin 
bladder secured to a double-current 
straight rectal tube attached to an 
irrigator) is applied for five minutes, 
with water flowing at 45 °. 
June 19th : Patient looks brighter, 
but insists that, without having any 
test, his sexual power has not im- 
proved. He leaves for Chicago to- 
morrow, and tells me that without 
my knowledge he had been under 
local treatment by Dr. E. L. Keyes 
while he was under my care. 
Two other cases of sexual hypo- 
chondriasis, of a milder form and in 
younger men, were successfully over- 
come by the treatment here outlined. 
Case VI.—Sexual Neurasthenia in 
a Man of 25. 
In this case the tonic treatment by 
hot-air baths, followed by rain baths 
and jet douche to spine, gradually 
lowered to 45 °, was positively efficient 
in establishing a satisfactory condi- 
tion. This gentleman applied for 
treatment for general debility. He 
was not a sexual hypochondriac, be- 
cause he incidentally mentioned that 
he had been married six weeks and 
did not experience the feelings that 
he had anticipated from sexual con- 
gress, to which he had been an entire 
stranger before marriage. 
After two months’ treatment he 
volunteered the statement that he 
was entirely satisfied with the re- 
sult. 
Case VII.—Angina Pectoris. 
Mr. D., merchant, age 40, of robust 
appearance, gives a history (Septem- 
ber 24th, 1892) of having suffered for 
several months from agonizing pains 
in the praecordial region whenever 
he attempted to exercise much. He 
was disabled from business and much 
depressed. Dr. Janeway, in consul- 
tation with Dr. Keune, his attendant, 
diagnosed angina pectoris. Another 
consultant diagnosed aneurism of 
aorta. Rest was advised and the 
usual treatment. 
Mr. D. presenting a decidedly 
gouty diathesis, with high arterial 
tension, urine loaded with lithates, 
he was put upon a non-meat diet, 
glonoin and strychnine, etc. A wet 
pack for an hour was given every 7 
morning, water at 6o°, followed by 
rapid ablution at 50° and friction. A 
wet compress was worn all day 
around left half of chest, renewed 
hourly in water at 6o°. He almost 
invariably slept in the pack. After 
three months’ treatment, during 
which the frequency and intensity 
of attacks diminished rapidly, never 
at any time reaching their previous 
character, he was allowed to take a 
trip to Chicago. On his return he 
was put on chopped beef, preceded 
by hot water, for breakfast and din- 
ner, oysters and hot milk for lunch- 
eon. Compresses were discontinued ; 
wet packs continued daily, followed 
by an affusion with water at 70°. 
January 21st, 1893, he reports himself 
as quite free from all pain ; losing 
some flesh, but feeling well, although 
he has done more work than ever 
before in his life. He has passed 
satisfactorily through the ordeal of 
seeing his large factory burned down 
and through the excitement and la- 
bor of reconstructing it in another 
locality. The soothing effect of the 
wet pack and its effect in promoting 
tissue change are well exemplified 
in this case. 
ceived a hot-air bath until warm, to 
enhance his reactive powers. This 
was followed by a rain bath of 95 ° 
F., reduced gradually to 8o°, for forty 
seconds under ten pounds pressure, 
gradually increased; then spray 
douche at fifteen pounds pressure, 
gradually increased to thirty pounds 
for four seconds at 70°. 
This was repeated daily. He re- 
ported again at Long Branch ten 
days later looking better, appetite 
improved, and with a gain of one and 
one-half pounds. He says a friend 
having advised him to have his spu- 
tum examined, the latter was found 
to contain bacilli. He was urged to 
see Dr. E. G. Janeway, who, after 
prolonged examination, pronounced 
him phthisical, advised him to leave 
the city at once, and ordered him to 
take creosote. As he was improving 
under hydrotherapy, I regarded his 
departure with disfavor and advised 
continuance. 
September 8th : The hot-air bath, 
followed by rain bath 8o° to 70°, and 
spray douche 70° to 40°, has been 
continued, until to-day patient weighs 
one hundred and fourteen pounds, a 
gain of seven and one-half pounds in 
five weeks. Appetite is excellent: 
cough still troublesome ; is very 
hoarse. Temperature, 101°. Ben- 
zoin inhalation and one-fourth grain 
codeia every four hours improved 
cough in two days, during which 
time hydriatic treatment had been 
discontinued. It was now resumed. 
September 12th : Temperature is 
990 ; cough reduced to a minimum ; 
appetite excellent. Weight, one hun- 
dred and thirteen and one-half 
pounds. Has been taking six drops 
creosote t. i. d., which sickens him 
and is discontinued. Ordered malt- 
ine with peptones, t. i. d., in milk. 
September 19th : Hot-air bath 
(170°) three minutes. Rain bath, 8o° 
reduced to 64°, one minute, from 
which he reacted well. Cough trou- 
blesome. A spirometer test shows 
Case VIII.—Incipient Phthisis. 
Mr. S., from Kentucky, age 26, mer- 
chant, consulted me at Long Branch 
on July 29th, 1892. Looks pale, 
emaciated ; states that he has been 
losing flesh and coughing seven 
months ; is constipated, has no appe- 
tite. Caught cold during a fire. No 
hereditary element. Temperature, 
1010 ; pulse, 1200. Physical signs : 
Percussion over left supraclavicular 
space dull, respiratory murmur in left 
apex harsh, expiration prolonged. 
Ordered calomel, six grains, and ab- 
solute rest. 
July 31st: Feels better. Tempe- 
rature, 990 F. Ordered to go to Insti- 
tute for treatment. Here he was 
weighed (nude)—one hundred and 
six and one-half pounds—and re- 8 
190° before and 260* after treatment, 
which is 200 above the average for 
his height. 
September 20th : Dr. J. S. Ely re- 
ports tubercle bacilli in small num- 
bers. 
December 30th: With occasional 
interruptions and loss of weight, pa- 
tient has progressed well, and to-day 
weighs one hundred and twenty-one 
and a half pounds, looks well, coughs 
but little, no temperature, and is 
anxious to go home. Dr. Freuden- 
thal, who treats his throat, writes 
under date of January 12th, 1893, 
after detailing from his case records 
the physical signs he found on July 
27th and again on November nth, 
1892 : “ Patient looks and feels much 
better, and has gained ten pounds in 
weight. Ulcerations of the ligamen- 
tum glossepiglotticum and of the 
vocal cords have healed under lactic 
acid and menthol oil (twenty per 
cent). Although I am not as op- 
timistic as you are regarding water 
treatment, I must acknowledge that 
the improvement in the case is re- 
markable.” 
January 21st: Patient is now al- 
most free from cough and has good 
appetite. Weighs one hundred and 
twenty-two and a half pounds (a 
gain of sixteen pounds, and five 
pounds more than he ever weighed in 
health). Dr. Van Gieson reports 
that no tubercle bacilli could be found 
after examining several slides. 
Remarks.—There having been no 
change made in the patient’s diet, 
mode of life, and treatment, this 
case is a clear illustration of the 
utility of a judicious hydrotherapy 
in improving nutrition in cases that 
usually thwart us. Clinical evidence 
of its value in phthisis is accumulat- 
ing so rapidly that I need only refer 
here to a few of the cases I reported 
to the State Medical Society last 
February. One of these, age 33, of 
one and a half years’ duration, be- 
ginning with pulmonary haemor- 
rhage, gained twenty-six pounds in 
three months, and coughed so little 
that no specimen of sputum could be 
furnished. Another, 36 years old, ill 
two and a half years, beginning with 
haemorrhages, gained twenty-one 
pounds and lost all bacilli from spu- 
tum, and returned to work. An- 
other, age 31, ill one year, with re- 
peated haemorrhage, night sweats, 
etc., was discharged, after one year’s 
treatment, with twenty pounds gain 
of weight, without bacilli, slight 
physical signs, and able to go to 
work (Transactions New York State 
Medical Society, 1892, page 382). 
Such stubborn facts should make us 
pause ere we condemn these suf- 
ferers to exile from home. A more 
methodical management, as indi- 
cated in the above quoted essay, 
offers a reasonable prospect of suc- 
cess for home treatment. Witness 
the case of H. B. (page 383), who, 
after emigrating to Minnesota and 
improving there for six years, came 
to this city with a cavity and in the 
most desperate general condition, 
and was sent home so much im- 
proved that he was able to attend to 
business. 
Clinical proof abounds that phthi- 
sis offers, next to nervous diseases, 
the most fruitful field for hydro- 
therapy. 
Case IX.—Advanced Bright’s Dis- 
ease ; Remarkable Results 
from the Hot-Blanket Pack. 
Mr. A., age 60, a foreman in a lead 
trap factory, came under my care, by 
request of his benevolent employer, 
on the 4th of May, 1891. I had at- 
tended him several years ago for lead 
colic and severe headaches, from 
which he recovered. I now found 
pronounced swelling of feet and 
ankles, breathlessness on exertion, 
morning nausea, headache, double 
vision, and vertigo. Urine showed a 
large proportion of albumin, abund- 9 
ance of hyaline casts ; specific gra- 
vity, 1.020. 
Patient received ten grains of cal- 
omel, was put on bitartrate of potas- 
sium lemonade, and was ordered one 
minim of one-per-cent solution glo- 
noin every three hours until flushed. 
He also received hot-blanket packs 
of one hour morning and evening. 
The quantity of urine having been 
reduced to twenty-two ounces, the 
treatment continued active until 
May 28th. Dr. Edward S. Peck ex- 
amined his vision to-day, and diag- 
nosed homonymous diplopia, ambly- 
opia, and albuminuric retinitis. Dr. 
Peck examined urine on the 29th, 
and found it to “ contain albumin in 
large reduction.” There being some 
improvement in the symptoms, the 
same medicinal and dietetic treat- 
ment was continued. 
The hot-blanket packs were now 
given once a day. They were, like 
the first, always given by means of a 
blanket, thoroughly wrung out of hot 
water, laid upon another blanket. 
Patient was snugly tucked into the 
hot blanket and afterward covered by 
the other blanket. He remained in 
this one hour or more until he per- 
spired very freely. Successive parts 
of the body were now gradually 
uncovered and thoroughly dried. 
General friction closed the pro- 
cedure. 
June 30th : Examination of urine, 
made from time to time, revealed 
gradual improvement in quantity and 
constituents. He went to the coun- 
try on the 1st of July, 1891. On 
vSeptember 9th he called at my of- 
fice. His urine presented but a trace 
of albumin. He was free from all 
unpleasant symptoms, was strong, 
and had resumed his duties at the 
factory for the past week. 
October 4th : I could find no trace 
of albumin or casts in his urine. 
He worked without interruption 
during the entire winter, until Au- 
gust, 1892, when he was obliged to 
discontinue by a severe diarrhoea, for 
which I was not called. He went to 
Hackensack, N. J., and was there at- 
tacked on the 16th of August by apo- 
plexy and hemiplegia, from which he 
died after remaining unconscious six 
days. 
Dr. St. John, his attendant, states 
that prior to this illness he had ex- 
amined the urine, finding no casts 
and but a small percentage of albu- 
min. There was no oedema. 
This case illustrates the value of 
the hot pack in restoring the failing 
function of the kidney. It is to be 
regretted that the patient did not 
remain under observation. These 
points, however, cannot be disputed : 
That he was utterly disabled by pro- 
nounced uraemia and albuminuric 
retinitis ; that he recovered from 
these so as to work steadily for a 
whole year. His work demanded 
precision and good sight, both of 
which he possessed during this pe- 
riod. 
Dr. Wm. McLaury, who attended 
other members of the family, saw 
him during and after the illness. 
Cases like this should give us con- 
fidence in the value of hydrotherapy 
in milder cases of Bright’s disease. 
In the Montefiore Home such cases 
are not infrequent. In the report for 
1891 Drs. Ettinger and Rosenthal 
say : “ Two cases of chronic Bright’s 
disease owe marked improvement to 
the systematic application of hydro- 
therapy. Both had been treated for 
several months elsewhere without 
benefit. Both suffered from exten- 
sive dropsy of abdomen and legs. 
Eight quarts of fluid were removed 
from one of these on the day of ad- 
mission, and the other had been re- 
peatedly tapped. The dropsy has 
progressively disappeared, until now 
it is entirely gone in both cases.” 
Case X.—Subacute Nephritis ; In- 
tense Catarrhal Jaundice. 
Mrs. S. consulted me on June 29th, 10 
1892, being pregnant eight months. 
Symptoms, and albumin and granular 
casts in urine, indicated nephritis 
of pregnancy. Two days later she 
was attacked by convulsions, during 
which she was delivered by forceps 
of a living child, which has continued 
to thrive. She remained comatose 
twenty-four hours, the urine being 
reduced to six ounces. Calomel, hot- 
blanket packs, and nitroglycerin “ un- 
locked ” the kidneys. The urine re- 
mained albuminous and scant for 
several weeks. Her recovery has been 
slow but steady under a non-meat 
diet, digitalis, nitroglycerin, etc. 
Urine was still albuminous when I 
was compelled to leave her on the 
5 th of September. She was now 
kindly cared for by Dr. A. H. Smith 
who sent her to me on the 26th of 
September with the following (here 
abbreviated) history : 
“For some time after you left Mrs. 
S. did very well. The urine was 
abundant and the amount of albu- 
min very small. I allowed her meat 
once a day. Appetite improved and 
kidneys remained satisfactory until 
her menstrual period, when there 
was an abrupt fall in the amount of 
the secretion to thirty ounces or less, 
with increase of albumin to five or 
six per cent. I then put her back on 
digitalis and added potassium acetate. 
This failed to increase the urine, and 
the hands and feet became a little 
swollen. I then ordered nitrogly- 
cerin, and in twenty-four hours the 
amount was doubled. The specific 
gravity kept about 1.015 to 1.020. 
Diet mostly milk. About a week ago, 
when the quantity of urine was 
smallest, she developed an intense 
itching of the surface without any 
eruption. Increase of urine was not 
followed by improvement in this re- 
spect. 
“ It appears to me to be a case well 
adapted for hydrotherapy, and I am 
glad she is under your observation 
for this reason especially. The itch- 
ing is very distressing. Bicarbonate 
of soda has little effect. Hyoscy- 
amine gave her sleep. I sincerely 
hope you will be able to do some- 
thing for her relief,” etc. 
Having returned to the city on the 
27 th of September I found Mrs. S. in 
a most distressing condition from 
constant itching of the entire surface. 
Her eyes and skin had a yellowish 
tinge, bowels constipated, stools clay- 
colored, no appetite ; urine thirty to 
thirty-six ounces daily by careful 
measurement, and decidedly albu- 
minous. All sorts of local applica- 
tions failed except a warm bran 
bath, whose success was temporary. 
She was now ordered a daily wet 
pack for three-fourths of an hour, 
sheet wrung out of water at 70° re- 
duced daily 20, followed by rapid 
ablution with water at 6o° reduced 
daily i° ; also an enema of one and 
one-half quarts of water every day 
at 8o° reduced daily 50 until 6o° was 
reached ; Carlsbad salts twice a week 
and a non-meat diet. She passed 
twelve ounces of urine during the 
first four hours after the first pack. 
It continued to increase daily until 
the quantity reached far beyond the 
normal. This treatment was contin- 
ued until November 1st. The last 
albuminous urine (a trace) is re- 
corded for October nth, at which 
time a few granular casts were still 
present. 
December 27th : Since that time 
eight specimens have been examined, 
all of which are entirely free from 
abnormal elements. Patient has 
gradually improved, with the excep- 
tion of three days of intense colic, 
which I attributed to gall stones. 
These were carefully searched for 
and found on November 26th, since 
which time the pain ceased, the skin 
cleared up entirely. 
For two weeks she had hot-air 
baths, followed by the rain bath 
at 950 reduced to 8o° for twenty 
seconds, and the jet douche at 70° 11 
for two seconds, with massage. This 
tonic procedure improved her ap- 
petite. She is now taking two ounces 
olive oil twice a day in sarsaparilla 
syrup, and is allowed white meat 
three times a week and beef once 
a week. 
In this case the action of the wet 
pack as a stimulant to cutaneous 
action, which relieves the kidneys of 
work, was potent. Kussmaul, Fried- 
rich Hoffman, and others have point- 
ed out the superiority of the cold 
pack over the hot in subacute cases 
of nephritis. Krull’s injections have 
so frequently proven themselves the 
most efficient remedial agents in ca- 
tarrhal jaundice that the value of this 
hydriatic procedure need not here 
be dwelt upon. Dr. Smith's predic- 
tion that this case required hydro- 
therapy proved correct. 
January 15th: Patient has been dis- 
charged for several weeks, with an 
allowance of meat every other day. 
She is perfectly well. Urine, exam- 
ined to-day, is found normal. 
him from doing himself bodily harm. 
Dr. Jacoby was again called in con- 
sultation and made an unfavorable 
prognosis—several neighboring phy- 
sicians who had been called during the 
attacks gave him hypodermics of mor- 
phine. Patient also has received 
electrical treatment from Dr. Cahen. 
Statusprcesens.—Face pale, covered 
with acne, eyes restless, hand tre- 
mulous, gait unsteady, appetite fair 
but capricious, gastric oppression 
after meals, bowels constipated. Pa- 
tient appeared to be brominized. 
Treatment.—Resorcin three grains 
in half a pint hot water, an hour be- 
fore lunch and dinner. He was 
ordered to be at once well scrubbed 
with soap and water. This was fol- 
lowed by a wet pack, sheet wrung 
out of water at 70° reduced daily 20, 
this to be followed by a rain bath 
at 90°, twenty-five pounds pressure, 
gradually reduced during thirty sec- 
onds to 750. 
August 20th: This treatment had 
been used daily, the temperature of 
the bath being reduced 20 every 
day. He had a slight attack five 
days after treatment was begun, 
none since. He was ordered to 
Long Branch to take surf baths. 
September 29th: Patient has called 
on me several times, reporting steady 
improvement. He is discharged 
cured. 
January 1st, 1893: Up to this writ- 
ing no further attacks have appeared. 
Besides these there were a number 
of cases of chronic rheumatism, 
neurasthenia, bronchitis, asthma, 
sciatica sent to the Institute for treat- 
ment by Drs. Starr, Dana, George W. 
Jacoby, Sachs, Leszynsky, Walton, 
Teschner, Pritchard, Willy Meyer, 
Allen, Schoney, Lincoln, Offenbach, 
Sayre, and others, the results of 
which will doubtless be reported by 
some of these gentlemen. 
If the few clinical histories here 
offered will induce practitioners to 
utilize water more frequently as one 
Case XI.—Epilepsy. 
A. F., age 15, was brought to the 
Hydriatic Institute July 19th, 1892, 
by his father, who says on the 31st 
of March, 1892, on the day of his 
daughter’s burial, the boy fainted. 
Ten days later he fainted in school, 
and again two days later. Dr. S. P. 
Cahen was called and investigated 
the case at school, coming to the 
conclusion that it was a form of 
epilepsy. The boy was kept from 
school and put on bromide po- 
tassium. The attacks becoming more 
frequent, Dr. George W. Jacoby was 
called in consultation; the same treat- 
ment was continued. He continued 
to have attacks every day and very 
often twice a day, lasting from five 
to ten minutes. At first he lay un- 
conscious, without any movement 
whatever; then the attacks became 
violent, frequently requiring several 
men to hold him down and prevent 12 
■of their remedies, the writer will be 
content. In his propaganda of hy- 
drotherapy he has, in some quar- 
ters, been charged with unwarranted 
enthusiasm. If a conscientious prov- 
ing of all remedial agents in vogue 
and proposed during an active gene- 
ral practice of thirty years entitles a 
man to an opinion on therapeutics, I 
would reiterate with emphasis the 
conclusions given in Hare’s “Sys- 
tem of Practical Therapeutics.” To 
sum up the aims, capabilities, and re- 
sults of hydrotherapy, it may be 
said : 
We possess in this method a valu- 
able auxiliary to methodical treat- 
ment of many, though not all, acute 
and chronic maladies. 
In many chronic diseases it has 
proved so successful after failure of 
medicinal remedies that no case 
should be yielded up as hopeless 
until hydrotherapy in some form has 
been tried. My observations at the 
Montefiore Home, which receives 
only incurable cases, demonstrate 
this fact. 
Domestic treatment will suffice in 
most cases, but if these fail a meth- 
odical treatment, under an expert 
hydrotherapeutist, may be of advan- 
tage to the patient. 
The best consultants in Germany, 
Italy, and France, men like Leyden, 
Charcot, Nothnagel, and Erb, send 
their patients to these institutions 
with their diagnosis and general 
suggestions, rather than with speci- 
fic directions. Finally, so much de- 
pends upon the reactive capacity of 
each individual that only systematic 
observation can determine the most 
useful procedure in each case. Journal of Balneology. 
xvii 
PREMIUM. 
IT is gratifying to us to be able by special arrangement to continue 
to offer as a Premium so important a work as 
“The Uses of Water in Jflodern JVIedieine” 
by Dr. Simon Baruch. 
This is the only treatise on Scientific Hydrotherapy In the English 
language, and embodies the results of the author’s vast experience, as 
well as the most recent investigations of European authorities. 
A few extracts from reviews of leading Journals will show its 
value to every progressive practitioner. 
After reading this admirable monograph, we are unable to comprehend why the remark should be per- 
sistently made, that “ there is no modern treatise on hydrotherapy.”—It is impossible, within the limits pre- 
scribed, for us to do justice to its many good points, so that we can only advise the profession to read and 
judge for themselves.—Vol. II., including ten chapters, is literally a small cyclopaedia of usual information.— 
Pass ng over the descriptions of the douche and sitz bath, we come to the most elaborate chapter in the book, 
on *• Hydrotherapy in Fevers,” which should be read by every physician who wishes to keep abreast of 
modern therapeutics.—We cannot dwell upon the many excellent suggestions which meet the eye on every 
page.—We have reviewed only in the most superficial manner a work which possesses many inherent claims 
to the recognition of the profession, aside from the author’s well known thorough acquaintance with the 
matters of which it treats. Unlike many medical works of greater pretension, it attracts by its literary style, 
which is at once forcible and elegant.—M°dical Record, New York, February 18th, 1893. 
Dr. Baruch has laid the medical profession in America under obligation, not alone for his persistent and 
well-directed advocacy of hydriatic measures in suitable cases of acute and chronic disease, but for gather- 
ing into a small compass, and presenting in a clear, accurate, and readable manner, the principal facts 
necessary for the understanding of hydrotherapy, and for its proper application in the art of medicine —The 
object of the work, as stated in the preface, “ to sever hydrotherapy from any connection with * hydropathy’ 
or * water cure,’” is well carried out.—Water is not a panacea in the author’s hands—it is one among many 
agents to be employed intelligently in suitable cases. —While we differ from the author on some minor points, 
we can cordially commend the book to the careful study of every practitioner.—The American Journal of 
the Medical Sciences, Philadelphia, November 1802. 
The praise we gave to the first volume of this first American original work on Hydrotherapy, must be 
bestowed in fuller measure to the second volume.—With the simple, yet clear powers of observation and pre- 
sentation which characterize the author, he offers in a few chapters a complete description of the methods of 
using water.—Endowed with wide experience and an extensive knowledge of all German, English, and French 
publications, he is an excellent guide to the beginning hydrotherapist.—But even the more experienced will 
find an abundance of valuable hints, instructive observations and procedures deserving imitation. It would 
be a creditable undertaking to render into German this work, so brief and yet so rich in information.—Blaetter 
fuer klinische Hydrotherapie, Vienna, January, 189*1 
In diseases of the nervous system we believe hydrotherapy has its most important field of usefulness, on 
account of the physiological action exercised by the water, and the author's indications for its employment 
seem to be well considered.—This work will be suggestive and useful to all who read it carefully and apply its 
teachings, and its incorporation of the latest facts on the subject of hydrotherapy will make it the standard 
work on that subject.—New York Medical Journal. 
Subscribers to the JOURNAL. OF BALNEOLOGY, which treats of 
the same subject, will receive the complete work, together with the 
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