Paper Presented to The National Association of Bath Superintendents Twenty-First Annual Conference 12^th June 1951 By PROFESSOR WILLIAM OLIVER, B.Sc., A.M.I.C,E., F.R.S.E.

INTRODUCTION

The “Aeratone” Therapeutic Bath developed out of research work carried out in a field which had no relation whatever to the subject of Baths and their applications in the field of Medical Hydrology, and it was quite an accidental circumstance which directed my attention to the possibility of connecting this research work with Balneotherapy. In the year 1938, I was deeply interested in the dyeing of textile materials by a new air bubbling process which involved the passing of a current of air bubbles through dye liquor in which was suspended the material to be dyed. The con­struction and operation of the dyeing machine were such that the upward flow of air bubbles was resisted by the downward flow of the dye liquor. It was then clearly ascertained that the textile material, exposed to the vibrating hydraulic hammer action caused by the resisted passage of the air bubbles through the dye liquor, was more thoroughly and more rapidly penetrated with dye than with the older method of propellor actuated liquor flows. By chance a friend told me that he had been treated for heart trouble at a French Spa in a bath of spring water containing carbon dioxide gas in solution giving rise to a formation of a sheath of carbon dioxide bubbles on the surface of the patient’s warm skin from which bubbles, when reaching a supercharged condition, gradually detached themselves, allowing the water taking their place to apply a gentle form of hydraulic massage. That this treatment was effective was evident from the improvement in my friend’s health, and it inspired an association of ideas between the vibrating hydraulic hammer action, so successful on the textile material, and the possibility of applying a similar vibrating hydraulic massage to the human body with equally advantageous results.

An experimental bath, modelled on the general lines of the bubble dyeing machine, but adapted to accommodate a human being, was prepared with a view to testing the idea. The tests then carried out and the striking results obtained from this relatively crude and ill-adapted experimental equip­ment gave me confidence to go on and develop an equip­ment specially designed for the comfort of the bather and to give fuller effect to the principles briefly outlined above than was possible in the experimental equipment. And so the “Aeratone” Therapeutic Bath was born. Despite the inter­vention of the War period and the subsequent difficult years, the “Aeratone” Bath has more than fulfilled the expectations aroused by the early experiments made in the original make­shift apparatus.

DESCRIPTION

The “Aeratone” Bath comprises three main pieces of equipment:

(A) The Bath which is available in two general types: ­(1) Vertical. (See Fig. No.1).

(2) Horizontal. (See Fig. No.2). (B) The Control Desk or Panel. (C) The Air Compressor Unit.

(A) (1) The Vertical Bath consists of an outer vertical water-tight cylinder, open at the top, and an inner concentric open-ended cylinder, the latter forming the treatment cham­ber, entered by means of a removable teak treaded ladder suspended from the outer bath cylinder. If the Bath is to be used for the treatment of patients who could not negotiate the ladder, an overhead runway can be provided with a slung chair, so that the patient can be lowered into the treatment chamber in comfort. The treatment chamber is provided with a perforated floor-plate carrying a perforated adjustable stool upon which the patient sits at ease with the shoulders level with the top edge of this chamber. The central air-diffuser, in the form of an inverted cone, is mounted below the per­forated floor plate, and provides the upward flow of air bubbles in the treatment chamber. The surround air-diffuser, in the form of a perforated circular pipe, is disposed round the bottom of the annular space between the wall of the treatment chamber and the outer Bath cylinder. This air-­diffuser provides for the upward flow of water in the annulus, and causes the water in the annulus to rise and cascade over the top edge of the treatment chamber, where it forms a downward flow of water meeting the rising current of bubbles from the central air-diffuser, thus giving rise to the vibrating hydraulic massage, one of the outstanding features of the “Aeratone” Bath. An emptying valve is provided for rapidly emptying the bath, while an overflow orifice is also provided. The necessary connections are provided for the compressed air supplies to the air-diffusers and for the hot and cold water supplies. The bath cylinder, inner cylinder, floor plate and air-diffusers are of welded and polished stainless steel con­struction throughout, presenting a smooth and easily cleaned surface with no corners and in line with modern hygienic ideas. If, therefore, any chemical additions to the water, solid, liquid or gaseous, are prescribed for particular treatments, these can be made without any danger of injury to the bath or its fittings. The main bath vessel is mounted on adjustable supports which allow of easy erection and levelling, and is provided with a surround pipe on its top edge which forms a wash-down spray or cold spray if desired.

There are three different arrangements for the erection of the Vertical Bath, depending on the site conditions:­

(a) If a basement is available below the bathroom floor, the Bath vessel may be entirely lowered through a hole in the floor, leaving a small portion or the Bath projecting through the bathroom floor as shown on Fig.1.

(b) The Bath may be partially lowered through a hole in the bathroom floor, but leaving about 2 ft. 6 in. of the bath’ vessel projecting into the bathroom, entrance into the bath being effected by means of a short stair.

(c) If no basement is available below the bathroom floor, the Bath is erected at its full height on the bathroom floor, entrance being gained by a full stairway with hand rails.

(A) (2) The Horizontal Bath, developed for those who prefer to undergo treatment in a horizontal position, operates under exactly the same principles as those governing the operation of the Vertical “Aeratone” Bath, and is just as effective. This type of Bath consists of an outer rectangular polished stainless-steel water-tight vessel open at the top and provided with two weir plates of the same material and finish which form the sides of the treatment chamber and take the place of the circular treatment chamber of the Vertical Bath. The bottom of the treatment chamber is formed by a perfor­ated polished stainless-steel plate on which the patient reclines, an adjustable canvas strap suspended from the top edges of the weir plates being provided to support the patient’s head. The Bath vessel is sunk into the bathroom floor, leaving about 2 ft. projecting into the bathroom, access to the treatment chamber being gained by a movable step and platform with handrails, while an overhead runway and sling can be pro­vided for handling helpless patients into the treatment cham­ber. The central air-diffuser, modified in shape to suit tile rectangular form of Bath, is mounted on tile bottom of the main Bath vessel directly below the perforated floor-plate of the treatment chamber, and provides tile upward flow of air bubbles in this chamber. The side air-diffusers, comprising perforated stainless-steel pipes disposed between the weir plates and the sides of the main Bath vessel, provide the upward flow of water behind the weir plates, over which the water cascades into tile treatment chamber where it forms a downward flow of water meeting tile rising current of air bubbles from the central air-diffuser thus giving rise to the vibrating hydraulic massage on the reclining patient’s body. The general construction follows tile same lines as the Vertical “Aeratone” Bath described above. The Control Panel, in polished stainless steel, is placed at the end of tile Bath, usually behind tile patient’s head, and is provided with the same control gear as the Vertical “Aeratone” Bath. The general arrangement of the Horizontal “Aeratone” Bath is shown in Fig. 2.

I am glad to say, that due to the courtesy of our Hosts, the Blackpool Corporation, and the kindly co-operation of Mr. J. H. Hollingworth it has been possible to provide a demonstration of an actual Horizontal Type “Aeratone” Bath in running order at the Derby Baths, and I trust that those interested in this newcomer in the field of balneotherapy will take this opportunity of not only seeing the “Aeratone” Bath, but of trying it out. Indeed, a practical personal test is probably the best way of judging the effectiveness of the “Aeratone” Bath, which is so difficult to describe adequately in words.

(B) The Control Desk of polished finish carries on its upper surface Bakelite panels, on which are mounted tile following gauges and valves with which to control the con­ditions in the Bath

1. A Dial “Thermometer with connecting capillary tube to the Thermometer Pocket in tile main Bath vessel.
2. An Air Pressure Gauge.
3. A Hot Water Valve.
4. A Cold Water Valve.
5. A Wash-down or Cold Spray Valve.
6. A Valve controlling the Central Air-Diffuser.
7. A Valve controlling tile Surround Air-Diffuser.

An alternative form of control panel is provided where it is desired that the bather should be able to control the condi­tions in the Bath. This control panel takes the form of a polished stainless steel box carrying the same equipment as described above, and is placed adjacent to the Bath so that the controls are within easy reach of the bather undergoing treatment. This type of control panel has been widely adopted in Colliery Pithead “Aeratone” Bath installations, and dis­penses with the services of a bath attendant. The control panel for the horizontal type Bath is on similar lines and is provided with tile same equipment.

(C) The Air Compressor which has been specially chosen for service with the “Aeratone” Bath Equipment is of the sliding vane blower type driven by an electric motor and provides for a very high-frequency air impulse into the Bath. The compressed air passes through a non-return valve into a small balancing air receiver and thence to the Bath. The equipment includes an air inlet silencer, an air outlet silencer, a safety valve and an air filter. The electric motor is started and stopped by means of an automatic self-acting starter actuated by a pressure regulator connected to the air receiver. After the main supply switch to tile motor is closed, complete control of the motor is obtained by the operation of the air valves at the control desk. There are, therefore, no electrical connections near the ^–Bath, with the consequent entire absence of danger from electric shock either to the patient or to the attendant.

There are no mechanical moving parts in the Bath – only air and water – and every care has been taken to provide a Smooth, rounded design throughout, so that bathers can be encouraged to move about freely in the treatment chamber without danger to themselves, thus exercising stiff joints, limbs and muscles with small expenditure of energy due to the supporting effect of the water.

The construction of tile Vertical Type Bath is clearly shown on Fig. 3, where the various parts are lettered and a key to the letters is provided on below.

“Aeratone “Bath Diagram

Key to reference letters on Fig. 3:­

1. Control Panel mounting the following equipment:

• Hot Water Valve
• Cold Water Valve
• Surround Air-Diffuser Valve
• Central Air-Diffuser Valve
• Wash-down or Cold Spray Valve

On this Control Panel are also mounted the­ Dial Thermometer.
Air Pressure Gauge.

1. Connection to Cold Water Wash-down Spray.
   C. Main Bath Vessel.
   D. Inner Cylinder or Treatment Chamber.
   E. Arm Rest.
   F. Access Ladder to Treatment Chamber.
   G. Adjustable Stool.
   H. Perforated Foot Plate.
   J. Outlet to Drain.
   K. Overflow.
   L. Drain Valve with Supporting Column and Hand­ Wheel.
   M. Surround Air-Diffuser Pipe.
   N. Water Inlet.
   O. Thermometer Pocket.
   P. Adjustable Supports.
   Q. Supply Pipes.
   R. Still Water Level.
   S. Central Air-Diffuser Cone.
   The leading dimensions of the Bath are shown on the drawing.

OPERATION
The bath, being simple to operate, requires no special tech­nical knowledge or skill, and the bath attendant soon acquires the necessary experience to apply the prescribed form of treatment for the different types of patient. Complete control of the conditions in the bath is effected from the control desk and the temperature and the weight of vibrating hydraulic massage can be varied to suit the patient.

The sequence of operations is then as follows:-­

1. Close the main switch controlling the electric motor. The motor will immediately start up and the air pressure will rise in the air receiver until it reaches about 6 to 7 lb. per sq. in., at which point the motor will automatically stop.
2. The Bath is now filled with water at the desired temperature, probably between 95° F. and 98° F., to a level of about five inches below the top edge of the treatment chamber. The air valves may then be opened for a few moments to ensure that the mixture of hot and cold water is uniform in temperature. Bath water temperature being a matter of personal habit, it is desirable to ascertain what temperature the patient is accustomed to. As, however, the patient is sitting or lying in hot water up to the neck level, the water will generally feel some­what warmer than water at a corresponding temperature in the ordinary plunge bath, and allowance should be made for this fact. Water temperature is not in general an inherent feature of the “Aeratone” treatment, and it is merely a matter of providing a comfortable medium in which the patient can sit or lie at case throughout the period of immersion. It will be found that the water temperature will fall about 2° F., during a 20-minute immersion, and this slightly falling temperature charac­teristic is found to be rather beneficial than otherwise. Indeed, physically strong patients experience an invigorat­ing effect if the water temperature is rapidly lowered at the end of the treatment period to say 80° F. or thereby for a few moments.
3. The patient is introduced and seated comfortably on the adjustable stool in the treatment chamber, as shown on Fig. 1. The patient’s shoulders should be about level with the top edge of the treatment chamber, and the water level will have risen about three inches, due to displacement by the patient’s body, leaving the top edge of the treatment chamber about 2 inches above still water level.
4. The surround or side air valve is now gradually opened, and air bubbles enter the water contained in the annular space between the walls of the treatment chamber and the main bath vessel. The effect of this air is to reduce the density of the water in the annulus relative to the water in the treatment chamber, and as these two liquids are in direct contact under the bottom edge of the inner cylinder or weir plates, the heavier liquid in the treatment chamber presses down under the inner cylinder or weir plates, and pushes the lighter liquid in the annular space upwards until it pours over the top edge or sides of the treatment chamber in a cascade forming a con­tinuous downward flow in the treatment chamber during the whole period of treatment.
5. The central air valve is now gradually opened, and air bubbles enter the treatment chamber from the air-­diffuser situated below the perforated floor plate. These bubbles form an ascending stream struggling vigorously upwards against the retarding downward flow of water entering the treatment chamber from the annulus or sides. This struggle causes the air bubbles to vibrate as they pass upwards, continually striking and rebounding from the surface of the patient’s body. As each bubble comes in contact with the skin, a quantity of water is pushed away from the skin, and on the rebound the water rusk back to fill the space left by the rebounding bubble, causing a slight depression of the skin at the point of contact. When it is realised that each bubble, during its ascent through the treatment chamber, comes into contact with the patient’s body many times, and that there is a vast number of bubbles steadily ascending throughout the treatment, some idea is gained of the extent and character of the vibrating hydraulic massage being applied to all parts of the patient’s body simultaneously under relatively constant temperature conditions. Since the patient is sitting upright in the Vertical Type Bath, the application of this massage is in general at right angles to the axis of the body or to the horizontal axis in the Horizontal Type Bath, and the patient is therefore exerting no fatiguing muscular reaction, but is, in effect, in a condition of complete and pleasant relaxation. The relaxed muscles, tissues and joints are in a condition to benefit to the maximum extent from the vibrating hydraulic massage. The upward flow of bubbles and the downward flow of water gives the patient a sense of lightness which encourages freedom of movement, a very desirable charac­teristic, especially in the treatment of arthritis. During the period of treatment the muscles of the body are in a state of gentle vibration, while the blood circulation is stimulated to a high degree. At the termination of a treatment, which may last from 15 to 25 minutes, depend­ing on the patient, it will be found that the skin condition appears to be unchanged, and there is no redness similar to that resulting from immersion in a still hot bath at the same temperature. In fact, the patient comes out of the bath feeling stimulated and energised, while he experiences .a pleasant internal glow which may persist for hours after the treatment. It should be understood that the weight of the massage is controlled by the central air valve, and that the more this air valve is opened, the heavier will be the massage and the lower will be the reading on the pressure gauge on the control panel.
6. Since the Bath is constructed of polished stainless steel, the surface remains bright, clean and hygienic. It is, however, a wise precaution to fill up the Bath every three or four days with water at about 150° F. to 160° F., and after putting three to four pounds of washing soda and about a quart of sodium hypochlorite in the Bath, to turn on both air valves and allow the circulation to run for 30 minutes. This process will thoroughly cleanse every part of the Bath, and will supplement the usual wash-down after each patient. Some waters may cause a slight scale to form on the inner surface of the Bath vessel which resists the treatment suggested above. If so, about 2 pints of hydrochloric acid should be used occa­sionally in the cleaning process, and this will generally be found effective in removing the scale.

TREATMENT
Based on the results of many hundred test immersions carried out on behalf of members of the Medical Pro­fession, it has been found that immersion in the “Aera­tone” Bath has produced beneficial results and, in order to assist Bath attendants it has been found possible to indicate suggested treatments in a variety of ailments which respond to treatment in the “Aeratone” Bath. A Schedule of Suggested Treatments is set out as Fig. 5, and although this Schedule is based on specific cases, the Schedule will form a basis on which to proceed.

Bath attendants soon gain experience, and as wide latitude is permissible there is no danger in varying the figures given on the Schedule to obtain the best results. If a patient complains of fatigue in the Bath, attendants should not hesitate to cut short the period of immersion. It will generally be found that delicate patients can be worked up gradually to normal immersion period after a few baths have been taken. In order to take full advantage of the stimulated blood flow arising from treatment in the Bath, patients should be encouraged to rest after treatment for 15 to 20 minutes. As with most other bodily activities, a gentle start is advisable, and the desire to get striking immediate results should be rigidly held in check. Patients should be warned that the first one or two treat­ments are in the nature of acclimatising treatments. The results begin to appear after the acclimatising process is completed. Similarly, patients may feel a little muscular stiffness after the first treatment. This arises from the fact that the patient’s muscles have been given unaccus­tomed exercise. This stiffness rapidly wears off, and is not usually experienced after further treatments.

A diagrammatic representation of a patient undergoing treatment in the “Aeratone” Bath is given in Fig. 4, and this will perhaps serve to clarify some of the rather compli­cated text. The diagram shows the respective flows of water and air bubbles relative to the patient as he sits in the bath and probably illustrates the process more clearly than mere words can do.

CONCLUSION

The field of application for this new type of Bath is very wide, and although a considerable amount of research work has been done under the supervision of leading members of the Medical Profession, this research work has been mainly confined to rheumatism and allied complaints such as fibrositis, lumbago, sciatica and others. During the course of these researches, however, it was found that many com­plaints outside the rheumatic field yielded to the “Aeratone” Treatment, and much work remains to be done in order to exploit to the full the possibilities of the “Aeratone” Bath. It should also be realised that “Aeratone” Treatment is beneficial to the healthy bather, and especially to those elderly people leading sedentary lives, since muscular exer­cise can be undergone in the “Aeratone” Bath so easily, pleasantly and under conditions which impose no strain on the heart. At the other end of the scale, the sportsman finds in the “Aeratone” Bath a means of obtaining muscular relaxation and also treatment for sprains, strains and other injuries arising from athletic activities. In fact, from its versatility and from all points of view, the “Aeratone” Bath forms an attractive addition to the equipment of Municipal Public Baths where facilities are offered for remedial treatment to the public. A short Appendix has been added to this Paper on the question of running costs for the “Aeratone” Bath which may prove interesting to those responsible for the financial side of Municipal Public Baths.

APPENDIX

It may interest members of this Conference to have before them some technical data regarding direct costs of operation for the “Aeratone” Bath and, while it is difficult to give exact figures since the bases of these costs will vary from place to place, the average figures given will no doubt be of interest:-­

Quantity of water in the Bath at treatment level: 233 gals.

Corresponding volume of water in Bath: 37.5 cu. ft.

Corresponding weight of water in Bath: 2,330 tbs.

Normal temperature of water during treatment: 95/98 degs. F.

Tap water temperature, say: 48 degs. F.

B.Th. Units required to raise the temperature of the above quantity of water from 48 degs. F. to 98 degs. F.: 116,500 B.Th. units

Amount of coal (assuming a Calorific value of 12,000 B.Th. Units per Ibs) required to raise the temperature of the above quantity of water from 48 degs. F to 98 degs. F., and assuming an over-all boiler efficiency of 25 per cent. would be:­

2,330 x 50 x 100 = 39Ibs.
12,000 x 25

Assuming coal at £3 10s. per ton, the cost of 39 tbs. of coal would be approximately: 8¹/₂ d.

Volume of compressed air required during maximum weight of treatment: 75/80 cu. Ft. free air per min

Air pressure required under above conditions: 7/9 Ib. per sq. in.

Electrical power used in producing the above quantity of air at the desired pressure during a treatment period of 20 minutes: 1 B.O.T. unit

Cost of electrical power for air compressor (assuming electricity at the power rate of Id. per B.O.T. Unit: 1d.

Cost of water required per Bath (assuming a price of 8d. per 1,000 gallons): 1³/₄d.

Direct cost of one Bath treatment: 11d.

(NOTE.-Overhead costs have been omitted from the above figures since these vary so much. The “Aeratone” Bath is usually associated with the Turkish Baths in a Municipal Public Baths Establishment, and it is found that the Turkish Bath Attendant can easily look after the running of the “Aeratone” Bath along with his Turkish Bath duties without difficulty. No allowance has therefore been made to cover the cost of a special “Aeratone” Bath Attendant, nor has any allowance been made to cover rent of space occupied, since space is usually found in most Bath Establishments for the “Aeratone” Installation. Capital cost allowances also vary with the site conditions and have been omitted.)

QUESTIONS

The PRESIDENT: I am sure that all delegates would wish me to thank Professor Oliver for the very fine paper he has given us this morning. I will now ask Professor Oliver to answer questions which have been handed to him.

Mr. B. ISHERWOOD (Shipley):
(a) Having experienced an “Aeratone” Bath 10 or 12 years ago I can vouch for its efficiency as a tonic effect on the robust bathers but am sceptical with regard to the chronic arthritis patients both from a psychological and operative result, other than general tone. Will the writer say which type of Arthritis responds best to this type of treatment?

(b) How many installations are there in Great Britain, i.e., Hospitals, Collieries, Baths Service, etc., and can the writer give information with regard to the procedure for obtaining an “Aeratone” Bath at these premises’?

(c) The author does not question the Medical profession until his concluding chapter. Personally I think the Baths Service should be clear on this issue. Although this is a balneological installation, and, therefore, perhaps not in competition with Health Centre Service, does he advocate treatments (Rheumatism and allied complaints) without a medical prescription?

(d) Does the author think that this is the appropriate time to go forward with extensions in view of the legal and financial difficulties or has he proof that the Ministry concerned will grant the necessary permission for this additional apparatus’?

(e) What would be the cost of the installation?

PROFESSOR OLIVER:
(a) It is undoubtedly an excellent thing even for elderly people. There is not the slightest danger or difficulty in treating delicate people since the weight of massage can be controlled from zero to maximum and can therefore be adjusted to suit the patient. The types of Arthritis which respond best to Aeratone treatment are Monarticular and Multiple Arthritis.

(b) The answer is 11 at Colliery Pithead Baths; Industrial Welfare 6; Public Baths 6; Private Clinics and Hospital and Public Clinics 5; Football Clubs 1; making 29 in all.

(c) The attention given by the Medical profession to the Aeratone Bath has not been stressed in the paper which is intended for the information of Municipal Bath Superintendents. The Medical profession are very interested in the Aeratone Bath where they have had experience of it and send patients to public baths with every confidence and with, in most cases, excellent results. At the same time patients present themselves at Public Baths having an Aeratone Bath installation without any Doctor’s certificate and again with usually excellent results. There have been no accidents and the Aeratone Bath has been in use since 1938.

(d) An Aeratone installation should prove not only an asset but should help to cut down industrial absenteeism. There should be no difficulty in getting a bath provided the case is properly presented to the Authorities.

(e) The answer is it all depends on the site. It would by approximately £850, plus carriage and installation charges.

ALDN. DR. GLASS (Birmingham): What is the difference in principle and structure of the “Aeratone” Therapeutic Bath and the Norheim Therapeutic Bath used in continental spas and at Buxton Remedial Baths for at least 25 years?

PROFESSOR OLIVER: I am not familiar with the Norheim Therapeutic Bath referred to in this question. All I would say is that the Patent Office had no difficulty in granting Letters Patent over the Aeratone Therapeutic Bath and the Patent Office are careful to see that the principle of prior inventions are not infringed by any new Patent applied for. One of the patients successfully treated in the Aeratone Bath had had no permanent benefit from treatment at Buxton and I presume at least some of his treatment would include this Norheim Bath.

COUN. J. H. BEDFORD (Richmond, Surrey): Can the author give an estimated capital expenditure for a horizontal type bath’?

PROFESSOR OLIVER: Approximately £850 plus carriage and installation charges.

Mr. F. LATCHFORD (Finsbury): Would the appropriate Ministry approve a loan sanction for the installation of, say, several of these baths also a building to house same’? What would be the cost of installation?

PROFESSOR OLIVER: I would refer to the answers already given.

Mr. G. H. HUTCHINSON (Salford):
(1) Could the speaker give the initial cost of installation of the “Aeratone” Bath at Edinburgh and at certain pit-head Baths (pre-war)?

(2) Has the Professor installed an “Aeratone” Bath in an establishment Municipal Bath or Hospital-since the last World War. If so, would he please give the total cost of installation?

(3) Will the speaker please state the installation cost of the Horizontal and Vertical Bath?

PROFESSOR OLIVER: The answers are as follows:­

(1) £425 per Bath.

 (2) Yes, at the Thistle Foundation Clinic, Craigmillar, Edinburgh in 1950 Horizontal Type approx. £775.

(3) Horizontal type – £850. Vertical type – £850.

ALDN. W. J. M. CLARK (Liverpool): Have any I.P. cases been treated with the bath, and, if so, with what results?

PROFESSOR OLIVER: I take it reference is made to paralysis.

I am afraid I cannot say with regard to these. This is a field where much valuable research work could be done.

COUN. D. SHOPLAND (Fulham): What is the approximate capital cost’?

What sort of charge is usually made for a treatment’?

What is the normal life of an air-compressor?

What is the cost of compressor replacement?

PROFESSOR OLIVER: Capital cost-see answers above.

The charges made for treatment vary. In Edinburgh it is 3/- per treatment, some are 5/- and some 10/-.

Re Air Compressor. A good deal depends on the care and maintenance, but under average conditions I should say at least 20 years. Complete replacement of Air Compressor Unit is approximately £160/£175.

Mr. L. W. PARK (Worcester):
(1) Has the “Aeratone” Bath been favourably recognised by the Medical profession and is the bath in regular use at Hospitals and Spas generally?

(2) Would it not be possible to reduce the volume of water in the case of the reclining or if not the vertical bath without reducing its efficiency and efficacy?

(3) In assessing heating costs should not the figure be nearer twice that given-approximately 1/3d. and not 8¹/₂d.’?

PROFESSOR OLIVER:
(1) The Bath has been well received by the medical profession. The only Hospital in London where it is installed is the Manor House Hospital (Golders Green), (Male Section) where it is in regular use. It has also been installed at Strathpeffer Spa, The Edinburgh Orthopaedic Clinic, Miss Walker’s Nursing Home, Strathearn Nursing Home, Edinburgh, The Thistle Foundation Clinic, Edinburgh.

(2) The efficiency and power of the massage depends on the depth at which the air diffusers are installed. The deeper the better. The depth chosen for the Aeratone Bath is the result of careful experimental tests and is a. compromise between the practical and the desirable.

(3) Heating costs are variable, depending on local condi­tions. The figure given is admittedly approximate and is based on actual results.

Mr. J. ANSTEY (Haslingden): Has any research taken place in the field of treating polio, and, if so, what are the results?

PROFESSOR OLIVER: See answer to Aldn. W. J. M. Clark (Liverpool) above.

Mr. F. M. BROWNLEE (Islington): Has the treatment any adverse effect on persons suffering from blood pressure’?

PROFESSOR OLIVER: No. In fact it results in a lowering of high blood pressure and a raising of low blood pressure. It is thus a normalising agent of considerable value.

COUN. W. PRESCOTT (Preston):
(a) What is the total cost of an “Aeratone” Bath and installation’?
(b) Will the author please give a rough estimate of both’?
(c) What is the cost of running same and;
(d) the average charges made’?

PROFESSOR OLIVER:
(a) Cost-see answers above.
(b) Installation variable, say approximately £150-£200.
(c) See Appendix of Paper-approximately 11d.
(d) Varies between 3/- and 10/- per treatment (20 minutes).

COUN. B. BURCHILL (Salford) In view of the apparent remedial effects of the “Aeratone” Bath Would tile N.A.B.S. consider approaching the Minister of Local Government with a request to have these Baths embodied in the National Health Service Scheme?

PROFESSOR OLIVER stated that this was an outside question and therefore gave no reply. Such an approach if decided on would have his whole-hearted support.

COUN. J. MORAN (Haslingden): Would circulatory troubles benefit bearing in mind varicose conditions which may have had a past history of Phlebitis or Thrombosis possibly un­known to the operator’?

PROFESSOR OLIVER: One of the main purposes of the Aeratone Bath is to deal safely and satisfactorily with cir­culatory troubles. Certain troubles arising from Varicose Veins have responded successfully to Aeratone Treatment.

Patients who have suffered from Phlebitis have taken no harm from Aeratone Treatment.

Mr. J. W. WRIGHT (Bingley): I would like to ask if the relief of rheumatic conditions treated by this method give a very long period of relief`?

PROFESSOR OLIVER: Yes, and further, the improvement in condition has continued after the treatment was stopped.

Mr. N. J. WALKER (Darwen); Would the Professor give his candid view on the comparison between the “Aeratone.” Therapeutic Bath and the Foam Bath, largely allied to the treatment under discussion?

PROFESSOR OLIVER: The answer is that the Foam Bath is entirely different in action. The Aeratone Bath is depend­ent on a definite and fairly powerful physical massage of the percussion hydraulic type, so much so that the muscles of the body can be seen to be vibrating during the treatment.

Mr. E. A. BARNFIELD (Cardiff): Is the “Aeratone” Bath safe treatment for patients suffering from the different kinds of heart disease’?

PROFFESSOR OLIVER: Treatment in the Aeratone Bath with its vibrating hydraulic massage leads to a softening of the blood vessels and a consequent reduction of the load on the heart. There is therefore no danger to “heart” patients in the bath. Indeed the effect is beneficial and there have been no accidents during the 13-14 years the Aeratone Bath has been in use.

Mr. J. M. BUCKLEY (Hove): Can sea water be used`?

PROFESSOR OLIVER: It is quite all right to use sea water, but as stainless steel valves are costly and difficult to obtain just now, bronze valves are used, but should be connected up by brazing not screwing. Dundee Corporation use sea water ozonised in their Aeratone Bath.

Mr. F. D. BOONE (Hastings):
(a) Can the author give any information concerning the continued use of sea-water upon the metallic surface and the perforations`?

(b) At what stage in the sequence of operations is it recommended that any prescribed solid or liquid addition to the basal water be made to ensure diffusion’?

PROFESSOR OLIVER:
(a) Dundee Corporation 1939 – No difficulty – See answer above to Mr. J. M. Buckley of Hove, re valves, otherwise Dundee Bath is quite standard and is as good to-day as when installed.

(b) Any time. Complete circulation is going on all the time.

COUN. T. E. EVANS, J.P. (Southwark): The learned Pro­fessor states that the treatment is good for every muscle. On page 33 of the paper the following words appear “patients may feel a little muscular stiffness after the first treatment.” Coming from a Cockney Borough the people would want a lot of convincing that the treatment is a cure for rheumatism. After having one of the baths and getting still they would hesitate to take another.

PROFESSOR OLIVER: The preliminary stiffness after the first bath is the stiffness experienced by anyone taking exer­cise of a vigorous nature. It can hardly be termed other than slight and I think “Cockney” shrewdness would not allow such a slight and natural stiffness to deter them from giving the Aeratone Bath a fair trial especially when the “bait” is relief from rheumatism.

COUN. W. J. COX (Nottingham): What system have you got in teaching the ordinary Baths Attendant to fit him to be responsible to give the “Aeratone” Bath treatment’?

PROFESSOR OLIVER: Put the attendant in the bath and let him feel the various conditions which can be produced and in half an hour he will have grasped the principles.

THE PRESIDENT: Ladies and Gentlemen, I think we are deeply indebted to Professor Oliver for the very tine paper given us this morning. He has also done his best to answer the numerous questions put to him by delegates. He has informed us that it is not possible to describe thoroughly on paper the working of the “Aeratone” Bath but I think he has made a good show.