How The Cure Resort Treatment May Be Imitated At Home
( Originally Published 1921 )
What can be done and what is easy to do are two different things. The cure resort treatment of heart disease can be imitated and has often been imitated in the home; but this is quite difficult, because one must revise in a measure the psychology of the whole family and the habits of the patient suffering from heart trouble. At the cure resort everything is carried on as a matter of custom and routine, and in a short time the guest falls into the cure almost unconsciously. In the household the diet must be regulated, the hours of work and recreation arranged, and the whole family must be imbued with the idea that the person is taking a "cure" which is going to have good results.
Between the cure resort and the home treatment we have the treatment away from home at a place that is not essentially a cure resort. This is easier than giving the treatment at home, and can quite closely approach the treatment given at a cure resort. For instance, it is possible for a person who lives outside of New York to come to New York for the cure and have it carried on satisfactorily in every respect. I have at the present time a gentleman from the South and another one from the North, both residing near Central Park and coming to my own nurse for the carbonated baths, and spending the rest of the day very much as if they were in a cure resort, namely, walking out of doors and meeting only people whom they can approach on a purely social basis and not talk of business. Both of them are doing well, and I believe are taking a good cure. They were both desperately ill when they began their course of treatment.
In this country the sanitarium takes the place of the cure resort; that is, the sanitarium in this country approaches more closely the cure re-sort than the so-called cure resorts themselves which are here. Perhaps the most important is at Battle Creek, Michigan. Good heart work is also done at Saratoga Springs, Clifton Springs, and Watkins Glen, N. Y.
To review the health resorts in this country where a systematic "cure" for heart disease is given, let us consider the forms of carbonated brine baths (Nauheim baths) that exist and the relative value of one kind as compared with another. First: The natural bath in which a natural carbonated water is used as well as a natural brine water containing chiefly calcium and sodium chloride. This combination is to be found only at Bad-Nauheim, and this is the finest type of bath for heart troubles. Second: The partially natural bath of which there are two types, (a) the partially natural bath using a natural' charged water, and (b) the partially natural bath using natural brine water. Third: The artificial bath.
The partially natural bath using a natural carbonated water is the best and is second to Nauheim only. The partially natural bath using a natural brine with artificial carbonation is in no wise better, than the artificial bath. The reason the natural carbonated water is better for the baths is because the carbonated brine water is allowed to circulate in the tub about the patient and there are successive crops of carbonic acid gas bubbles that attach themselves to the skin, this feature aiding materially the part that carbonic acid gas plays in the physiology of Nauheim baths.
In Saratoga Springs, New York, we find a natural carbonated water. The possibilities of Saratoga as a cure resort for heart trouble are second to none in this country. A technic including a "cure" for heart troubles is being developed, patterned after the Nauheim method which includes baths, resistive exercises, out door life, diet, and special attention to physical and mental hygiene. The chief trouble with Saratoga today is that it has too many laxative waters; the Conservation Committee permitting their use to the extent of abuse by the laity. Saline waters do no good in heart troubles as they are always overdone, and no resort can become successful that persists in prescribing their use or allows their unprescribed use by one under treatment for heart trouble or high blood pressure.
At Watkins, New York, the Nauheim treatment has been developed for heart disease and the management approaches more closely that used at Nauheim than any resort in this country. A natural brine water is used that is artificially carbonated by using hydrochloric acid and bicarbonate of soda. The success of Watkins lies chiefly in the management of the guests (not patients) who take the cure and not upon the brine water that they use for the bath. An-other feature that has materially contributed to success has been the absence of a saline spring, and if no attempt to discover one is made, the success will remain assured a long time.
The Battle Creek Sanitarium, Battle Creek, Michigan and Clifton Springs Sanitarium, Clifton Springs, New York, have as a part of their general therapeutic plan a department devoted to the treatment of heart diseases by artificial baths and resistive exercises. The work of these two reputable institutions has been of great aid to the heart specialist.
To organize the cure treatment at home, it is necessary that some one should take charge of the cure, and that a definite time should be set aside for it. For instance, engage a nurse for a month or six weeks, and have her instructed by the physician just what the person should do in every part of the day. Then see that the nurse carries out the instructions.
This adherence to a schedule is important. It is so easy for an invalid to become demoralized by lying in bed in the morning, eating when hungry, and becoming absolutely idle, that the discipline of a regular schedule becomes an important matter. Take the question of sleep, for instance. The person who sleeps late in the morning because he has not slept during the night can more easily be cured of his insomnia by getting up early in the morning and laying up the sleepiness for the next night.
The cure resort treatment of heart disease is in a great measure a matter of reeducation and of enabling people to discover exactly what their limitations are. One of the most important discoveries that I made early in the development of my own special work with heart troubles was that people with heart trouble nearly always travel well. No matter how sick they were, if a journey was necessary, they almost always got through it without accident and usually with much less discomfort than they had anticipated. So, in case of necessity, I have not hesitated to allow people who were almost bedridden to take journeys to cure resorts. The cure resort proprietors do not like to have these people sent to them. They say that they are not suitable cases, and that they give a lot of trouble and in case of a poor result do not add to the reputation of the place. But the cure resorts should not be so selfish as to exclude patients if there is a fair chance, of helping them. The public almost demands from cure resorts a claim that everybody is cured who goes there, but even brief consideration shows that this is absurd.
The least difficult part of the cure resort treatment at home is the imitation of the Nauheim baths. The important thing is to use enough sea salt to make a brine of considerable strength. The salt element of the Nauheim bath is important, and at home is often entirely omitted. Carbonic acid is easily introduced into the water by mixing in bicarbonate of soda and then causing it to effervesce by adding a suitable acid; or the water can be charged before is put into the bath, just as the water of a soda-water fountain is charged. See below for explicit directions.
The bath for heart trouble is essentially a cool bath, and an important reason for making it a chemical bath is that this enables the patient to take it at a lower temperature than he could if it were plain water. The stimulation of the skin by the salt and carbonic acid gas produces a warm sensation that keeps the patient from being chilled by the cool bath. As he becomes accustomed to the baths, they are gradually cooled. All these things have to be done according to a precise set of formule, which we give below.