The principles and practice of hydrotherapy : a guide to the application of water in disease for students and practitioners of medicine / by Simon Baruch ... ; with numerous illustrations.

  • Baruch, Simon, 1840-1921.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: The principles and practice of hydrotherapy : a guide to the application of water in disease for students and practitioners of medicine / by Simon Baruch ... ; with numerous illustrations. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    is, nevertheless, of great importance in the maintenance of a healthy condition. Through its extensive glandular structure, an enormous discharge of water is produced from the cutaneous surfaces. Carbonic acid also is exhaled through the skin, as well as urea. According to Schierbach,* C02 is eliminated in moderate quantities from the skin when the temperature ranges from 29° to 33° C. A rise over 33° pro- duces a sudden increase of CO., which may be doubled when 34° is reached. Watery excretion is not abundant under 33°; it increases simultaneously with the C02 excretion, both being probably produced by the activity of the gland cells. The quantity of water excreted through the naked skin, according to Schierbach, in a temperature of 36°, is about equal to that secreted by the covered skin in a temper- ature of 32°. In various diseases of the lungs and heart also, in which other physiological functions of these organs are diminished, the exhalation of C02 by cutaneous excretion is usually enhanced. Witness the profuse perspiration attendant upon severe asthma; the walls of the cutaneous vessels are dilated; more water, aqueous vapor, and carbonic acid are excreted; and the dyspnoea is somewhat relieved. So, when the heart's action is embarrassed, the lumina of the cutaneous vessels become distended, affording some compensatory action to tide the patient over immediate danger. The clammy sweat, characteristic of cardiac in- adequacy, is a commonly observed clinical phenomenon. The similarity in the anatomical structure of the skin and the glo- meruli of the kidneys, and the chemical resemblance of perspiration and urine, have often been pointed out. Many clinical observations go to show that the skin is one of the most important aids to the kidneys. That the perspiration and urine are secretions, to a certain extent vicarious, is proved by the fact that their relation in this respect is generally enhanced in disease. Thus is produced an increase in the perspiration of those constituents which the kidneys are incapable of eliminating. Urea has been found by Favre, Picard, and Funke, in the normal perspiration to the extent of 0.1 to 0.2 per cent. The eli- mination of the most dangerous chemical elements by the skin is gen- erally enhanced in those diseased conditions in which the kidneys be- come inadequate. Schottein, who failed to discover urea in the normal perspiration, observed it when the kidneys became inadequate, as in the uraemia of cholera. In these cases he saw the whole body covered with a thin white crystalline layer of urea. Unna confirms this state- ment by observations made in cases of uraemia due to suppuration of the kidneys and in cholera typhoid, in which these deposits could be scraped off daily in large quantities. * Archiv fur Anatomie und Physiologie, 1893.