STUDIES ON THE EFFECTS OF BATHS ON MAN

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Abstract
Subjects were immersed in hot baths for varying periods until tetany developed. Observations were made of body temperature; rate, depth, and minute volume of respiration; quantity, titratable acidity, ammonia and Ph of the urine, as well as the pH and total CO2 of the blood. Analyses of expired air provided data for computing O2 consumption, respiratory quotient and alveolar CO2 tension. After immersion for a control period in a neutral bath (36.0-36.5[degree]C.) the temperature of the water was elevated to maxima of 40.2-43.0[degree]C. and there maintained for 30-65 minutes depending upon the symptoms. The higher temperature in every instance caused a hyperpnea the severity of which depended on rate of rise of body temperature and also on the temperature level at which this rise takes place. The hyperpnea involves a change in both rate and depth,[long dash]there is never a shallow respiration except in the first few moments, when there is strong skin stimulation, and during the recovery period. Slight rhythmic variations of depth and frequency of breathing were observed but never a true Cheyne-Stokes respiration. Alveolar CO2 was much reduced, to 20 mm. or less, as computed independently from analyses of expired air, and from blood pH and total CO2. The increase in blood pH was always marked, varying from 0.12 to 0.33, and is apparently determined by the hyperpnea but is not proportional to it. Titratable acidity and ammonia of the urine fell uniformly and the pH is shifted to the alkaline side. There may take place an excretion of urine which is more alkaline than blood, apparently with varying efficiency in different individuals. On 2 occasions a change in the pH of the blood towards the acid side was demonstrable within a few minutes of the onset of definite tetany, and the pH change was accompanied by a fall in the total blood CO2. This might readily be explained if lactic acid was produced during tetany. No evidence was obtained of any definite ph level at which tetany occurs, nor even of any critical degree of change in the pH level. O2 did not relieve the tetany, but CO2 gave definite improvement.

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