370
powerful stimulant, meaning thereby a potent agent in bringing about changes in the
body is, I think, not to be wondered at. Such improvement- as occurs is to be attri-
buted, I think, to the resumption of functions previously more or less deranged as the
result of the diseased state of the patient, but it must be remembered that for the
great part this resumption is only temporary. The old abnormal state is quickly re-
established and with each bath the stimulus become less and less.
With the cold bath we have other things to consider. In nearly all feverish
conditions when we apply a cold bath after a hot bath, the risk of inducing shock is
great, but never in it greater than when we have to deal with a disease such as plague,
in which cardiac enfeeblement is only too common. In addition the visceral conges-
tion induced in the pelvic organs and lower abdominal regions must, in my opinion,
together with the risk of shock, quite condemn the use of the cold bath.
Chart C-2 calls for a little attention. It wag my original intention to gather
from the large collection of statistics I have accumulated, numbers enabling me to shew
graphically the varying successes of the bath and the non-bath treatments at different
ages of life ; also among different castes and among different occupations. Had
these results for the bath and the non-bath treatments been widely divergent, the in-
ference would have boen that the bath at certain ages or among certain castes or
among certain occupations had been markedly potent either for evil or for good.
The result as regards age is shown in Chart C-2 where for the most part there is not
much difference. The most favourable age for the bath is 25—30 while over 40 bath
cases do badly. I do not know that any other inference can be fairly drawn and with
results so scanty I was deterred from pursuing my inquiries into caste ani occupation.
Moreover, there must be many other circumstances which must quite overshadow all
these, for example, as Dr. Dhalgabir has pointed out to me, the question whether the
patient is well fed or nearly starved on admission.
For the last Chart C-3,1 am indebted to the kindness of Mr. Moos, Director of the
Observatory, Colaba. I asked for curves for temperature, barometric pressure and
humidity, and was kindly supplied with the same together with some of the results
gained at Colaba in connection with Pi ague. Apparently Mr. Moos considers ground
temperature a most important factor in this propagation of plague and probably the
connection is very close. I was induced to ask for the curves represented inasmuch
as with the climatic changes noted during the course of February and March, there were
mnrked changes (for the worse) in the results for all treatments. At one time I
fancied the meteorological changes might have in some way modified the conditions
favouring sweating, and so have accounted partially for the increased bath mortality :
but as all methods of treatment showed increased mortality, some other cause must ba
sought for.
[ Addendum, 17-7-99 ].
CHART C.-4.
Added to shew the results obtained at the end of every week from January the
first, 1899.
The most marked feature is the decline in the success of the bath, but it must be
noted that the comparative success only occurred when a small number of cases was
taken.
CONCLUSION.
Part I deals with actual results, Part II deals with certain phenomena occur-
ring during the administration of the hot bath, and Part III, along with miscellaneous
questions deals with the alloviative as opposed to the curative nature of the steam
treatment. Bath and Non-bath methods alike have, at the Maratha Hospital, been