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attacks of bronchial catarrh and acute and chronic rheumatism ; in some forms of retarded convalescence from acute disease ; in scrofulous and other inflammatory enlargement of joints; and the stronger kinds locally in chronic glandular enlargements of scrofulous origin, in the chronic hypertrophies of certain organs. In some parts of the Continent these baths take the place of hot and cold sea baths, with which they have much in common.
Internally the milder kinds of common salt springs, when charged also abundantly with carbonic acid (Homburg and Kissingen), are especially beneficial in cases of atonic dyspepsia and chronic gastric catarrh, conditions frequently associated with hæmorrhoids and 'torpid liver,' and what is termed in Germany abdominal plethora. They are valuable also in those cachexias,' or low states of health, contracted often by prolonged residence in tropical climates.
In certain forms of anæmia, where regulation of the bowels is a primary consideration, they often do more good than pure, nonaperient iron waters, for many of these springs contain an appreciable amount of iron which gives to them a tonic property (Harrogate).
As examples of this class, the stronger ones are represented abroad by Kreuznach, Nauheim, Reichenhall, Ischl, and Rehme; the milder ones by Homburg, Kissingen, and Wiesbaden; in this country Droitwich has very strong salt springs, and can furnish brine baths as strong as any of those to be obtained on the Continent, and they are applicable to the same cases. The water of the Droitwich springs is conveyed in tanks by rail to Great Malvern, where brine baths can also be obtained.
Woodhall Spa, near Horncastle in Lincolnshire, possesses a spring which may be regarded as a moderately strong common salt water, containing also an unusually large proportion of bromides and iodides, and is suitable to the treatment of the same class of cases as are sent to Kreuznach. Harrogate possesses not only sulphur springs, which contain a large proportion of common salt, but also chalybeate waters containing common salt in proportions which liken them in some respects to the springs of Homburg and Kissingen. They are, however, more unpleasant to drink, owing in part to the absence of carbonic acid, which renders them more difficult of digestion to some persons.
3. The next is also an important class of waters—the alkaline waters—of which we have no representative in this country. The chief constituent of these waters is carbonate of soda; they also contain free carbonic acid in varying amount.
The water of the various springs at Vichy may be taken as a type of this class.
Some of these alkaline springs also contain an appreciable quantity of chloride of sodium, and this circumstance has led to the subdivision of this class into
a. Simple alkaline waters, and b. Muriated alkaline waters (i.e. alkaline waters containing common salt).
Of the simple alkaline division some are hot springs, as those of Vichy and Neuenahr; and some are cold, as those of Vals, Apollinaris, and Bilin; the same is the case with the muriated alkaline division, the springs of Ems and Royat being hot and those of Selters and Rossbach cold. Most of the common so-called “table waters' are examples of cold, weak, muriated alkaline springs, the most gaseous being the most popular.
Many of the springs of this class are found to be most valuable curative agents. They are all taken internally. They are also used as baths, but not very largely, although, in some spas, they are greatly employed in the form of local douches (Royat, La Bourboule).
They are applicable to the treatment of a great number of chronic maladies. In moderate doses they exercise an important solvent and purifying influence, correct acidity, promote tissue change, and possess active diuretic properties. If taken in too large quantity they depress the heart's action, and cause emaciation through excessive solvent action. They are given in cases of acid dyspepsia, especially in the gouty and rheumatic; in constitutions showing a tendency to the formation of uric acid (gouty); in cases of renal calculous disorders and gravel, in which they often prove of very great service; in diabetes; in cases of torpid liver, with tendency to gall-stones, in constitutions which would not bear the stronger alkaline aperient waters like those of Carlsbad.
These waters are also found of very great service in the treatment of chronic catarrh of the bronchial and other mucous membranes.
Those containing common salt are more tonic and stimulating than the simple alkaline ones. As we have no waters of this class in this country we are obliged to have recourse to foreign spas for the treatment of the very large number of chronic ailments in which they prove beneficia).
4. Scarcely less important are the waters of the fourth class, the sulphated waters. This group includes all the best known aperient waters, which owe their aperient qualities to the presence of the sulphate of soda and magnesia, singly or combined. Some of these springs contain also considerable quantities of carbonate of soda and chloride of sodium, which add greatly to their remedial value, and this fact has led to the subdivision of the class into two groups :-
a. Simple sulphated waters—the so-called “bitter waters,' such as Friedrichshall, Pullna, and Hunyadi. These are rarely drunk at their source, but are largely imported for home consumption.
And b. alkaline sulphated waters--a group comprising such world-renowned spas as Carlsbad, Marienbad, Franzensbad, and Tarasp. I have dwelt fully elsewhere on the important services rendered to suffering humanity by this last group of waters. The cases to which they are appropriate are often of so serious a character that it would serve no good purpose to attempt to indicate them in a summary like this.
Strictly speaking we have no spa in this country representative of this latter group. The Cheltenham waters contain sulphates of magnesia and soda as well as common salt, and resemble, therefore, the waters of the simple sulphated group; but they are cold, and have no claim to be classed with the important second group of this class. The same remark applies to the Leamington springs, which contain sulphate of soda and chlorides of sodium, calcium, and magnesium, a valuable combination it may be, but not applicable to the same cases as the Carlsbad group.
5. We next come to the large and interesting group of iron or chalybeate waters. These are tonic waters par excellence. They are valuable in proportion to their purity—that is, in proportion to the absence of other solid ingredients—and in proportion, usually, to the amount of carbonic acid, in a free state, they contain. The presence of free carbonic acid promotes the digestion and assimilation of the iron, and renders the water more palatable. The carbonic acid is also a very important agent in the baths that are given in connection with most chalybeate courses. These iron and carbonic acid baths are found in great perfection at Schwalbach. I have entered very fully into the action of iron water and carbonic acid baths in the chapter on St. Moritz in the work already referred to.
The purest iron waters are those of Spa, Schwalbach, Alexisbad, and Tunbridge Wells, but the absence of any appreciable quantity of free carbonic acid in the Tunbridge spring really puts it out of competition with such celebrated iron waters as those of Spa, Schwalbach, and St. Moritz.
In many iron springs salts of lime are found in rather large pro portions, as in the St. Moritz spring, and the spring at Santa Caterina. The same is the case with the Orezza (Corsica) spring, perhaps the strongest iron spring in Europe.
The iron water at Pyrmont is stronger than that at St. Moritz or Spa, but it is not so agreeable to drink, as it contains a small quantity of the bitter sulphate of magnesia. There is a valuable iron spring at Bocklet, near Kissingen, but that also is not a pure iron spring, as it contains aperient sulphates and chlorides of soda and magnesia; and the chalybeate waters of Rippoldsau contain sulphate of soda. Harrogate possesses useful composite chalybeate springs, but no pure gaseous iron springs like those of Spa or Schwalbach, so that, in this class again, when we require a comparatively pure, natural, gaseous, iron spring, we are compelled to seek for it on the Continent.
6. The sixth class comprises the numerous and well-known sulphur springs. Some of these are hot springs, some of them are cold.
Of the hot sulphur waters, perhaps the best known to our countrymen are those of Aix-les-Bains and Aix-la-Chapelle. The celebrated Pyrenean spas also are nearly all of them hot sulphur springs—as Luchon, Les Eaux Bonnes, Cauterets, &c. Besides these Baden in Switzerland, Baden near Vienna, Allevard, Uriage, Schinznach, and Heluan, near Cairo, are all hot sulphur waters. Examples of cold sulphur springs are found at Enghein, Challes, Gurnigel, Eilsen, Neundorf, Weilbach, and in our own country at Harrogate, Dinsdale, and Strathpeffer.
Some of these sulphur springs contain a considerable amount of common salt; this is the case at Uriage, Aix-la-Chapelle, and Harrogate.
Here again it will be seen that while hot sulphur springs abound on the Continent, we have not a single natural hot sulphur water in this country.
Luchon is perhaps the most remarkable of European sulphur spas. Apart from the natural beauty of its situation, which is very great, it is pre-eminent for the abundance and variety of its springs, the vast quantity of water they afford, their composition, and range of temperature. The hottest have a temperature of 154° F., and most of them have to be cooled or mixed with springs of lower temperature before they can be used as baths. In consequence of the possession of this immense quantity of hot sulphur water, the most extensive and elaborate arrangements have been established at Luchon for their administration in all possible forms, including large and small swimming baths, vapour baths, douches of all kinds, inhalations, pulvérisations, &c.
Aix-les-Bains has also the command of a very abundant supply of water, the temperature of which ranges from 113° to 115° F., and very elaborate and complete arrangements prevail there for the utilisation in all possible ways of their natural resources.
Harrogate is the chief sulphur spa in this country. Dinsdale-onTees, with much more limited resources, has acquired a considerable local reputation. At Harrogate the waters have of course to be heated before they can be employed as baths; the arrangements for their application are fairly good, and where the tonic effect of a bracing upland country, 430 feet above the sea, is required, no doubt a course of sulphur waters can be obtained at Harrogate which is likely to be as efficacious in many cases requiring this form of treatment as that at more distant spas. The great variety of ailments —rheumatic, gouty, cutaneous, catarrhal, and constitutional—remediable by treatment at the various sulphur spas I have fully considered elsewhere.
1 Climate and Health Resorts.
7. Finally, there is the class of earthy and calcareous waters, so named on account of the preponderance in their composition of the earthy salts of lime and magnesia. As examples of this class, Leuk, Wildungen, Lippspringe, and Contrexéville may be mentioned.
When employed as baths their mode of action is much the same as that of the first class of springs, the simple thermal waters ; in some places, as at Leuk in Switzerland, they are applied as very prolonged baths in certain inveterate forms of skin disease, where longcontinued soaking the skin is thought advantageous.
At Contrexéville, where the waters are largely employed internally, a great deal is claimed for them, and great benefit is undoubtedly derived from them in many cases; especially in cases of irritative, acid, or gouty dyspepsia, and in particular in calculous and vesical complaints. It must, however, be admitted that the precise mode of action of these earthy waters is not well understood; probably much of their efficacy is due to the large quantity of an active solvent, such as hot water, which the patient is induced to consume. In this country the Bath waters offer the nearest approach to an example of this group of spas, and they would possibly prove as efficacious, when judiciously administered, as those of Contrexéville, in some of the cases that are sent thither.
This brief summary and review of the several classes of natural mineral springs will, as I have already said, show clearly how limited are our own resources, and that, in availing ourselves of the help of a great number of foreign spas, we are only doing what we are compelled to do from the absence of any examples of the waters we require in England. Sometimes, indeed, there are other reasons besides the mere composition of the mineral spring for selecting a foreign rather than an English spa. It is often advantageous and desirable to associate change of climate, of entourage, and of mode of life with a course of mineral waters. It may be altogether preferable to follow a course of baths in a drier and more bracing climate than our own. The influence of forest or mountain air is certainly a not unimportant adjunct to some cures.
Some of the most successful applications of the simple thermal springs are found to occur at such a sub-Alpine spa as Gastein, or in the forest air of Wildbad. And this leads me to remark how impossible it is to determine all the appropriate uses of a mineral spring from too exclusive a consideration of its mineral ingredients. Chemical analysis certainly fails to reveal, in all cases, even the physical peculiarities of a mineral spring; and to maintain the opinion that all mineral waters of analogous composition must have the same curative action can only be the outcome of haste and inexperience. One of the springs at Vichy (l'Hôpital) is found practically to be more suitable to the treatment of irritative dyspepsia than the