A treatise on mineral waters, with particular reference to those prepared at the Royal German spa, at Brighton

Front matter

".mm in memory of VERA SCHWEITZER

From a fund

for literature in the field of

Preface

It is a favorite prepossession, and a just one, in the British Islands, that an occasional residence by the seaside, has, generally speaking, a very beneficial influence on the health ; in fact, he must be a bold man, who would venture to contravene an opinion, so deeply-rooted in every grade of society. What the seaside is to an Englishman, the numerous Spas, with which its surface is dotted, are to the inhabitant of the Continent. There, — more especially in countries possessing a considerable number of potent springs, as Germany for instance, — the people entertain a kind of

IV. PREFACE.

reverential regard for mineral waters, and have a faith in their great salutary powers, which is fully borne out by many irrefragable proofs.

This opinion concerning the efficacy of mineral waters, holds good on the continent, not only in respect to the community at large, but obtains equally with the medical faculty. Indeed I am convinced, there is no continental practitioner, who would hesitate to bear public evidence, as to the innate sanative poioer of these remedies, and the great, nay, sometimes marvellous effects they produce, in the treatment of chronic diseases ; and ivho would not be able to substantiate his statements, by numerous cases from his own experience, as well as that of his professional brethren.

I myself have had the good fortune, to be personally acquainted with several continental physicians of great experience and high standing in the profession, with whom I had frequent conversations on the subject, all confirmatory of the above view, — / may mention the late Dr. Kreysig, who, in this

PREFACE. V.

department of practice, was considered the first authority of his day. Further, having observed the effects of this class of remedies, under various circumstances and conditions, both in Dr. Struve's establishments, at Dresden, (where I saw the parent institution of this kind, spring up under Struve's personal direction) Leipsic, and Berlin, and likewise at the natural Spas most in vogue in Germany, — / feel bound to offer my humble, yet earnest testimony, to the high and surpassing worth, both of the natural springs, and of Struve's imitations. The results produced in the treatment of diseases, by both descriptions of waters, have been found by myself, as well as by others, to be perfectly identical in a medical point of view ; which, with the confirmation comparative analysis has afforded, undoubtedly justifiesus in deducing the conclusion, that the artificial waters are correct and faithful representatives of their prototypes, — the natural mineral springs.

The object with which this little volume has been written, renders it more incumbent on me, to make the public distinctly aware of the facts just mentioned; because, when travelling through Great Britain and Ireland, several years ago, and during my subsequent residence in this country, I have had frequent opportunities of becoming acquainted with the ideas, nearly universal, amongst non-professional persons, on this subject ; and which, I may venture to say, are quite different from, and, in some points, directly opposite, to those prevailing on the continent. In regard to this, I have no doubt, that medical men, who know the opinions entertained in this country and abroad, about the natural and artificial waters, will fully agree with me.

This is certainly not the place, to argue upon the difference of these opinions ; I may be allowed, however, to notice briefly, one which is very prevalent. It is common enough, to ascribe the benefit that may have been derived, from visiting, either a continental Spa, or one of this country, almost entirely to the journey, change of air, mode of living, early rising, amusements and agreeable society of the place, 8fC. Now, no one would deny, that these circumstances, exert a favorable influence upon the constitution ; and there is even little doubt, that health might be restored to many invalids, by such means, without having recourse to the waters at all ; yet, in this respect, I perfectly agree with Dr. Granville, that, in the greater number of cases, these incidental matters, are entirely subordinate, and the use of the mineral water, the chief means of recovery. That this is the case, is proved by many patients being cured by mineral waters, without going to a Spa at all; and sometimes even, without being able,- in the commencement, to leave their beds.

I trust this avant-propos will be excused by those, who are already aware of, and know hoiv to appreciate, the virtue of mineral waters; it is addressed only to the many who say, " We have no faith in such remedies.'' At the same time, it will convey the reasons that have induced me, to comply with requests made to me, from time to time, to write a small work like the present ; which I have rather reluctantly complied with, as, of late years, several publications, on the same subject, have been given to the world.

In composing the following pages, my chief object has been, — to furnish an outline of the history ; and of the physical, chemical, and medicinal nature of mineral waters ; and likeioise to give some vieiv of the relation in which they stand, to the healthy and to the disordered animal economy ; to point out the maladies in which they are applicable, and the method, according to which, they ought to be employed internally ; and finally, to lay down some rules, for the conduct necessary to be observed, by patients who use them. I have given, however, a more particular account of the operation, effects, and internal employment of those waters, which are prepared at the Royal German Spa, at Brighton.

PREFACE. IX.

The work is principally intended for general readers ; but it may, perhaps, also convey a few useful hints, to those of the younger class of the medical profession, who are beginning to study the internal use of mineral waters. On this account, I have forborne to enter into arguments and hypotheses of any kind ; and, in the plainest language I could choose, have merely endeavoured to exhibit the results I arrived at, by comparing the fruits of my own experience with the observations of others, as communicated to me either orally, or through their several works.

It is manifest, that, to compress a subject so ample as the one in hand, into a confined compass, must necessarily leave many deficiences, of which, therefore, I am well aware, the present volume is not devoid ; but if it serves, in however small a degree, to direct public attention and enquiry, towards the subject treated of; or to modify the distrust that generally prevails in this country, concerning the virtue of mineral waters; my

PREFACE.

THE AUTHOR.

6, King's Road, Brighton, July, 28th, 1842.

CHAPTER I. Page

Historical Introduction 1

Dr. Struve's labours relative to the factitious mineral waters 6

Advantages derived from Struve's discovery 13

Chapter II

On the nature of mineral waters, in a physical, chemical, and medical point of view 17

Considered physically —

Origin of springs 17

Source of thermal heat 18

Difference between mineral and common springs . . 20 Refutation of some prevailing hypotheses, concerning the natural mineral waters 21

Considered chemically —

General constituents of mineral waters; their properties, and relative action upon each other 23

Xll. CONTENTS.

Page.

Conditions on which the different nature of the

various mineral waters depends 20

Particular agency of a mineral water, in what it

consists 27

Considered medically —

General constituents of mineral waters ; their relation to, and action upon the animal economy :

a.— Water 29

b. — Temperature 30

c. — Carbonic-acid gas 31

d. — Saline substances 32

General character of the medicinal efficacy of mineral waters 36

The general action of mineral waters, taken as a

criterion for dividing them into two classes 38

The author's opinion of mineral waters 39

Chapter III

On the internal use of the mineral wateks, pret-ared at the royal german sra, at Brighton; and the diseases in -which their employment is indicated 41

CONTENTS. XU1.

Page.

First Section.

I. — Physiological observations on organic life 42

II. — General doctrine of disturbance of organic life . . 45

A. — Modifications of power .... 47

B. — Modifications of the blood 48

C. — Modifications of the functions of the vascular system 50

Second Section.

I. — The relations in which the individual mineral waters, under consideration, stand to organic life; the effects produced by them, in anomalous conditions of that life ; and particular indications for their use, in the treatment of diseases 56

Applicability of mineral waters, —

In a state of comparative health 57

In acute diseases 58

In chronic maladies 59

First class. — Springs, possessing a resolvent virtue .. 61 /. — Springs acting especially on the venous system

of the abdomen, and the primae viae. A. — Waters in which the property of sulphate of soda is predominant, in their collective agency.

1. The thermal springs of Karlsbad 63

2. Kreuzbrunnen of Marienbad 69

XIV. CONTENTS.

Page. 3 and 4. Seidschiitz and Pullna 71

II — Springs acting especially on the lymphatic

system, and on the mucous membranes.

B. — Waters in which the property of chloride of

sodium is prevalent, in their collective agency.

5. — Ragozi of Kissingen 73

C. — Waters in which the properties of iodide and

bromide of sodium, together with the chloride of

sodium, are predominant, in their collective agency.

6. — Adelheidsquelle of Heilbrunnen ^

7. — Elisenbrunnen of Kreuznach y 75

8. — Congress spring of Saratoga J

D. — Waters in which the property of carbonates,

especially of soda, is prevalent, in their collective

agency.

9.— Grande Grille of Vichy ,

f 79 10. — Kesselbrunncn of Ems . '

11. — Obersalzbruunen of Silesia ■

12.— Seltzer f

t 84 13. — Fachinsjen

*

14. — Geiluau

Second class. — Springs possessing a tonic virtue .... 87 ///. — Springs acting especially on the arterial system, and on the irritable fibre and structure.

CONTENTS. XV.

Page.

E. — Chalybeates, or waters in which the properties of steel or iron are predominant, in their collective agency.

15.— Pyrmont 89

16.— PouhonofSpa 93

17. — Ferdinandsbrunnen of Auschowitz 91

18. — Franzensbrunuen of Eger 91

II. — A few general remarks on the proper method of selecting and administering mineral waters, in a

given case 95

Conditions for selecting the water 96

Circumstances to be attended to, while the water is

in the course of being taken 98

Season of year best adapted for a course 103

Bathing during the internal use of mineral waters.. 106

Mineral waters employed as lavements 110

Mineral waters employed as eye-douches Ill

Some advice for Ladies Ill

CHAPTER IV. General instructions tor patients using mineral waters internally 119

I. — Rules to be observed previous to the course 122

XVI. CONTENTS.

Page.

II. — Rules to be observed during the course 125

Time of day for taking the waters 126

Mode of drinking the waters 128

Attention to the teeth 131

Diet and regimen 132

Breakfast 133

Dinner 134

Evening meal or tea * 136

Exercise 136

Rest 137

Sleep 138

Mental regulation 139

Attention to the cutaneous functions 139

Use of other medicines during a course of the water 140

Rules with regard to bathing j 141

III. — Some injunctions respecting the termination of the course; and the conduct of the patient, after it

has been discontinued 142

Conduct of the patient after the course 146

Table of analyses of the mineral waters, as prepared at

the Royal German Spa, at Brighton 150

Criticisms of the Reviewers 154

Chapter I. Historical Introduction

WE may reasonably infer that the religious rites of ablution and bathing, which have been observed by various nations, since the earliest periods of the world, were intended to be not merely typical of moral purity, but had also a distinct hygienic object. Although Hippocrates appears to have been the first who, in conformity with the doctrines laid down by Pythagoras, discovered the medicinal action of water in relation to its physical properties ; and who, guided by the principles of the Asklepiades, of which sect he was an initiate, advised its external and internal use in various diseases ; still, centuries before him, certain wells were already renowned amongst the people of Greece, for their heneficial and sanative powers. The Greeks considered these springs as holy, and built temples in their vicinity, to which they performed pilgrimage. Such, for instance, was the well at Pergamus, dedicated to Esculapius.

The Romans had also their favourite miraculous springs, which were held in high esteem amongst them, and to which they resorted for the purpose of drinking and bathing. But with them the employment of water, as a remedial agent, was already more under the guidance of medical men. The great success with which Antonius Musa treated the Emperor Augustus, by advising him to drink copiously of aqueous fluids and to use the cold bath, is well known. Indeed the practice of bathing, became, amongst the Romans, a general object of fashion and luxury to such an extent, that wherever they carried their victorious arms, the most splendid baths were erected, of which numerous traces are still to be found in Britain, France, and Germany.

After the fall of the Roman empire, bathing was greatly neglected, and almost abandoned by the inhabitants of Europe for many centuries, only the very highest classes continuing the practice, and that to a much smaller extent. The Emperor

Charlemagne, for example, visited the baths of Aix-la-Chapelle once a year.

Bathing, however, gradually crept into vogue amongst the lower orders, especially the country people, who got into the habit of using some particular spring that had become popular in the vicinity of their habitations. The practice at length became again universally established, and was considered every where to be, not only necessary for the preservation of health, but a specific remedy against numerous diseases.

Some of these springs became famous for possessing miraculous powers, because they had proved more beneficial, and had more frequently effected a perfect cure of complaints, in which the baths, generally visited by the higher classes, had failed. This may, perhaps, have been owing to the circumstance of these springs being frequently situated in wild countries, and amongst woods — where only the bare necessaries of life were attainable ; and where, consequently, all those irregularities of diet and living were out of the question ; for which, the comfortable and luxurious baths of the wealthy, afforded ample inducement and opportunity. The miraculous efficacy which the people of that period, in their blind supersitition, assigned to certain wells, may, no doubt, in some measure, have given rise to those mystifications and puerilities indulged in, by professional men, during the subsequent centuries, in explanation of the innate properties of mineral waters ; and which, in an altered and more scientific form, are still adhered to, even by some of the present day.

The external use of mineral waters, appears to have been, for a long time, the almost exclusive mode of employing them in the cure of diseases. At the commencement of the sixteenth century, however, the internal use of some springs again began to be recommended ; yet the old practice of bathing continued to prevail, until the advantage and benefit to be derived from drinking the waters became more manifest by repeated instances of its success.

Since that time, neither mode of employing mineral waters has ever been neglected at the expense of the other. Both have gained largely in public estimation, and in the approval of the medical profession, in spite of various changes and revolutions in the systems of medicine. Physicians, however, of that and of the succeeding century, made use of mineral waters merely in an experimental or empiric manner. The science of Chemistry was then in its infancv, and, moreover, evidently labouring under a wrong tendency, viz.

towards a synthetic rather than analytic manner of investigation. The chemical examinations of such mineral waters were consequently, at that early period, insufficient to account for the extraordinary effects frequently produced by them. Physicians, therefore, judged of the cause, which was hid from their vision, by the effect they plainly saw, and, influenced by the prevailing popular notion, assigned, without scruple, miraculous power and properties to them, and endowed those properties with mysterious names, as " Mineral, and Wild Spirits," *' The Spirit of the Spring," &c.

In the eighteenth century, mineral waters became more particularly an object of attention and enquiry, amongst medical men ; who, assisted by the favourable progress that had been made in the sciences of physics and medicine, were now better able to throw some light on their chemical nature, and medicinal efficacy. Although the old notions about mysterious and miraculous powers were still adhered to, in a theoretical point of view ; yet, in practice, the use of mineral springs was gradually delivered from rude empiricism, and more firmly based upon scientific principles.

At the end of the last, and at the beginning of the present century, many important discoveries, in physical science, materially contributed to unveil a 1 the hitherto mysterious nature of these waters. The advances made in chemistry, furnished proper means of analysing their complicated chemical constitution, and the progress in geological knowledge, led on to a more correct insight into the physical circumstances and conditions, under which they are prepared by the cunning hand of nature. At this stage of the question it followed, almost as a matter of course, that the idea of imitating the natural mineral waters, which had originated with that eminent natural philosopher and physician, Frederic Hoffmann, nearly one hundred years previously, — and which had subsequently been the subject of many but unsuccessful trials and experiments, — was revived in the minds of several able chemists, of whom, however, but one succeeded in carrying it into execution with entire success. Of this gentleman's labours I may here be allowed to give a short description.

Frederic Adolphus Struve, m.d. &c. — born 1781, died 1840 — was engaged in the year 1808 in making experiments on the preparation of hydrocyanic" acid. Unfortunately the glass apparatus he was using burst suddenly with such violence, that he was thrown on the floor in a state of insensibility. In consequence of this accident, a serious and obstinate disease was brought on ; for the cure of which, he employed, with great benefit, the waters of Carlsbad and Marienbad. During his stay at Marienbad, he made some experiments with the view of imitating the waters of these places for his own use, when he should return home. While further pursuing these experiments in his own house, he was led to the idea of imitating, not only those I have mentioned, but all the other mineral waters of Germany, which were then held in the highest repute for the cure of diseases. He commenced this great work, by numerous trials to ascertain the exact mode, by which the water was impregnated with gaseous and saline substances, in the great laboratory of the earth. He also examined the existing analyses of the various springs ; and finding most of them inaccurate, personally visited the different Spas, in order to analyse the waters himself, immediately after they had been taken from the Well. When these preparatory researches were completed, he proceeded, in his chemical laboratory, to the second (and not less difficult) task of synthesis, or composition.

After having at length succeeded in preparing what he thought a perfect imitation of the original, he analysed his factitious waters, in order to compare them with the natural ones. The test was successful, as, upon examination, they proved exactly similar. Having thus satisfied himself, that the factitious waters in his possession were, in a physical and chemical point of view, perfect fac-similes of the natural ones, he now thought it time to subject the result of his labours to the last and conclusive test, viz. to try what effect, their internal use would produce on the constitution. For this purpose his numerous professional friends were, in the year 1818, invited to his summer residence, where, in a large and pleasant garden, with his usual liberality, he dispensed, not only to his friends, but also to a great number of patients recommended by them, such of his factitious waters as their diseases seemed to require. His medical friends, who were, from experience, well acquainted with the action of the natural waters, took the greatest interest in this first trial, and watched most attentively and carefully, the immediate and the more remote effects of the manufactured ones, both upon themselves and upon their patients. The result proved most satisfactory. Both in their mode of acting on the constitution, and in their power of curing diseases, Struve's factitious mineral waters, were thus found to be identical with the natural product of the earth. After having been thus engaged in innumerable experiments, of the most difficult and expensive kind, for nearly ten years, without intermission ; Struve turned his attention to the construction of a mechanical apparatus, which would enable him to prepare and dispense the waters on an extensive scale. In the year 1820, he opened to the public, at Dresden, the first establishment of his manufactured mineral waters. The success, this met with, was so great, that, soon after, he founded another at Leipsic ; in 1823, one at Berlin; one at Brighton* in 1 825 ; and others since then at Konigsberg, Warsaw, Moscow, St. Petersburg, and Kiew.

Each of these establishments comprises two distinct departments. The first is the laboratory, in which the various salts and minerals are got ready and purified, the carbonic acid gas prepared, the common spring water distilled and freed from atmospheric air ; and where, finally, these various component parts are combined in the relative proportions of the different mineral springs, which it is intended to imitate.

The second or dispensing department, includes an apparatus of a very complicated construction ;

•In this establishment are prepared sixteen of the most efficacious mineral waters of Germany, one of France, and one of America.

A 2 by means of which the factitious waters are kept beneath a constant and undeviating pressure of carbonic acid gas, and are maintained at the precise degree of temperature of their respective originals, until the moment when the fluid bubbles from the spout, in the pump-room, into the beaker of the invalid.

In the year 1824, Dr. Struve published the first, and, in 1826, the second volume of a Treatise on his factitious mineral waters, with numerous accounts of cases, in which they had been used, drawn up by some of the first physicians in Dresden, Leipsic, and Berlin ; and all tending to establish the fact, that the medicinal efficacy of these waters, is precisely the same as that of the natural springs. About the same time, Dr. Kreysig of Dresden, — a veteran practitioner in medicine, who, during his long career, had directed his attention particularly to chronic diseases, and to their treatment by mineral waters, on the subject of which he was deemed the first authority of his day, — published his Treatise on the use of the natural and factitious mineral waters. In the preface to this work, he expresses himself thus :* " I have

* From tbe translation by Dr. Thomson and Mr. Bekenn. London, 1824.

observed, during three years, the most beneficial effects from these (Struve's) factitious mineral waters, on a vast number of patients, and twice experienced the greatest relief from the artificial Carlsbad waters myself. Nor do their effects differ in any way from those produced by the natural springs." The extraordinary degree of chemical exactness and accuracy, which Struve obtained in his compounds, has been firmly proved by analyses instituted by many able continental chemists, as well as by one of the first in this country, Professor Farraday, to whom Struve submitted a quantity of the waters for examination.

After this testimony, I need not quote any other authority, or record direct facts or cases, in illustration, and as additional proofs of the identity (both in a chemical and in a remedial sense) of Struve's artificial waters with the original springs. Nor shall I enquire here into the animated dispute which, the moment Struve's discovery became known, was commenced and carried on, for a long time, by the chemists and medical men in Germany. The difference is now generally adjusted, except on one or two points, which will be touched upon in the next chapter, when I come to speak of the nature of mineral waters. I cannot omit to mention, however, that the adverse party — which comprised several physicians practising at the various Spas, and whose opinions could, on this account, hardly be expected to be unbiassed — could only combat the discovery of Struve, by reverting to ancient prejudice and hypothesis. This very controversy served to remove, from every impartial mind, any doubt, that might linger, concerning the uniform character of the two kinds of mineral waters ; to confirm and strengthen the evidence already given in favor of their identity ; and to extend the knowledge, together with the employment, both of the natural and of the artificial waters.

Yet, notwithstanding all this, there are persons, even at the present day, who ought to know better than to assert, that the natural mineral waters possess what they call " a mysterious thermality, a certain caloricity," not to be measured by Reaumur or Fahrenheit ; or that there is present in these waters, "a subtle tether, a living property ;" in fact, " a something, the nature of which we certainly do not know, nor can deduce from any known principle, and which is entirely wanting in the factitious waters." Again, it is asserted, that, in point of efficacy, artificial mineral waters resemble water in a kettle, wherein some common cathartic salt has been dissolved. It is argued that an imitation of wine is never so good as the real juice of the grape ; and that, as an artificial leg is infinitely worse than one of flesh and bone, even so must the factitious mineral waters be inferior to the natural. The absurdity of such modes of reasoning is too palpable, to require any remark, or any attempt at refutation on our part.

I cannot conclude this part of my subject, without pointing out some of the advantages which medical science, the physician, and the patient, have derived from Dr. Struve's important discovery.

1st. Although, at the time of Struve's invention, much had been done to rescue the employment of mineral waters from the empiricism of earlier times, they were still, in most instances, used at random, and frequently considered merely as the ultimum rem.ed.ium in hopeless cases. But, by the study of their nature and properties, to which, as above-stated, Struve's discovery gave a great impulse, the indications, under which they ought to be used, became well-defined ; their mode of operation better understood and explained on acknowledged physiological principles ; and, lastly, mineral waters were introduced into the Materia Medica, where they now rank as sovereign remedies against a large number of diseases, and, moreover, as pre-eminently qualified to cure them, according to Asklepiade's injunction : " tuto, celeriter, et jucunde."

2nd. The distance of the various Spas from each other, formerly rendered it almost impossible for a physician to obtain a practical knowledge of more than one or two of them ; but now, a few weeks' stay at one of Struve's establishments, will make him an eye-witness of the medicinal effects of most of the principal springs of Europe, and, at Brighton, of an American one besides.

3rd. In natural mineral waters, the proportion of the constituent parts, and consequently their power of action, varies in some degree as the season is wet or dry. This can never be the case with those of Struve, as, in his establishments, the waters are of course fac-similes of the natural Springs, at the season when the latter are in full perfection.

4th. At watering places, it sometimes happens that a patient discovers he has been originally directed to a Spa, which the resident physician finds not appropriate for his disease ; and that he is put to great inconvenience and expense in leaving it for another Spa better suited to his case. This difficulty can never occur at Struve's establishments ; for, where so many waters of varied character are collected on one spot, the patient may be sure to find one that will suit his complaint, if at all fit for treatment by these means. Moreover, under proper medical advice, he may here change one water for another of a different degree, or different kind of action, just as his constitution or complaint may require it. He may also, by mixing one mineral water with another, modify their operation, or create an entirely new remedial tendency — an object of no small importance ; yet not to be attained where no such establishment exists.

5th. Patients of this country, who are prevented by the nature of their complaints, by age, family affairs, business, insufficiency of means, &c. from undertaking a long journey abroad to the natural springs, have an opportunity of using, in their native land, the most efficacious mineral waters of other countries, in a state of full and perfect vigor.*

• It is true that the cold waters may be had in bottles from the natural springs, but they always lose more or less of their virtue ; and it is evident that the hot waters cannot be transported by any means. This partial loss of virtue is caused by the atmospheric air, with which the water comes in contact, during the bottling process; the oxygen of the air changes the protoxide of iron into peroxide of iron, which is insoluble in water. This partial decomposition is perfectly avoided by Struve's method of bottling. At some few of the springs in in Germany, Struve's plan of filling the bottles with carbonic-acid gas previously to their being filled with the mineral water, is adopted, and is certainly a great improvement.