The mineral and thermal springs of the United States and Canada

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Contents

CHAPTEE I.

Chemical division of mineral waters — Their efficacy as remedial agents inquired into — Hygienic precautions for visitors to mineral springs — Clothing, diet, sleep, amusements, exercise . . . . .13

CHAPTEE II.

Chapter I

Chemical division of mineral waters — Their efficacy as remedial agents inquired into — Hygienic precautions for visitors to mineral springs — Clothing, diet, sleep, amusements, exercise.

Mineral Springs will be spoken of in these pages under the heads of — 1. Acidulous or Carbonated. 2. Saline. 3. Sulphureous. 4. Chalybeate. To these some add two other classes, the Ioduretted and Bromuretted, and the Acid. The name of the first of these two designates their predominant traits. The second or acid includes those waters, comparatively few in number, in which there is an excess of sulphuric acid, usually with alumina and iron, as sulphates. In Yirginia, they are called Alum Springs.

1. Acidulous waters are sometimes called gaseous, on account of their containing 2 and evolving gas — which is chiefly carbonic acid. Owing to this ingredient they are sparkling, stimulant, and agreeably pungent to the taste. They hold in solution various saline substances, in which, for the most part, the carbonates, first and mainly of lime, and then of magnesia and soda, predominate, with the addition often of the carbonate of iron and chloride of sodium, or common salt. These waters are occasionally spoken of as alkaline.

2. Saline waters, as their name implies, abound in salts, of which the sulphate of magnesia or Epsom salts, and the sulphate of soda or Glauber's salts are, medicinally, the most active, while chloride of sodium, a common constituent, adds to their virtues in this respect. Sulphate of lime, which is of little therapeutical value, is quite common in this, and still more in the acidulous and sulphureous classes. Carbonic acid abounds in some of the saline waters, entitling them to be called acidulo-saline. A remarkable example of this union is met with in the Saratoga springs.

3. Sulphureous waters are characterized by

CHEMICAL DIVISION. 15

their odor, which is due to the escape of sulphuretted hydrogen gas (hydrosulphuric or sulphohydric acid) or to the presence of an alkaline sulphuret. They strike a black color on the addition of acetate of lead, and impart a dark hue to silver and other white metals. They have been divided into 1st. Hydrosulphureous waters, which contain free sulphuretted hydrogen gas. 2d. Sulphuretted or hydrosulphuretted waters, in which the sulphur is combined with metals, most generally with sodium, in the state of a sulphuret. 3. Acidulo -sulphureous, which hold carbonic acid in addition to the gas just named. 4. Sulphuretted acidulous waters, which contain at the same time a sulphuret, carbonic acid, and sulphuretted hydrogen gas. 5. Chalybeate sulphureous, which hold iron in solution.

4th. Chalyheate or Ferruginous waters are readily recognizable by their taste, compared usually to that of ink, which, as most readers know, depeuds on the iron which enters into its composition in union with a vegetable astringent. Chalybeate waters are discolored by tincture of galls, and eventually give, by this addition, a black precipitate; with ferrocyanate of potassa the precipitate is blue. By contact with the air, they deposit gradually reddish flocculi of the oxide of iron. Most of them are cold, and the iron is in the state of a carbonate of protoxide dissolved in carbonic acid. This salt is precipitated to a certain extent by exposure of the chalybeate water to the air, and still more readily when it is subjected to heat. In a few instances the iron is combined in the form of a sulphate, and in others, as Berzelius has shown, it unites with organic acid, in the state of a crenate or a procrenate.

Another division of mineral springs is into cold and thermal, one which is applicable to all of the four great classes, for we have cold and thermal acidulous, cold and thermal saline, &c.

In imitation of Bischof, I shall use, in these pages, the term thermal, to designate any spring, the temperature of which throughout the year is steadily above that of the common springs, or above the mean temperature of the soil, of the district in which it is found.

OPINIONS KESPECTING THEM. 17

He who- desires to speak of Mineral Waters as remedial agents, in an impartial manner, finds himself somewhat embarrassed between two extremes of opinion ; one of which inclines to a belief in their surprising and almost miraculously healing powers; the other, bordering on skepticism, can see nothing in even the admitted beneficial results of visits to watering places but the working of imagination, and the changes brought about by travelling, new and pleasant scenes, regular hours, and relaxation from the toils of labor, and the cares of business. The first extreme can only be treated as a modified empiricism, which would convert good remedies, under properly defined circumstances, into panaceas of universal application, and never failing efficacy. The skeptics, on the other hand, require to be reasoned with, although, in truth, their arguments are hardly more logical than those of the empirics.

The question, after all, is one to be determined by observation and experience. Now it is an undoubted fact that many mineral waters hold in solution ingredients similar to those of admitted activity, which we find in the apothecary's shop, and which are compounded and directed according to formulas, laid down in the pharmacopoeia and the dispensatory. And again, it is equally certain that these ingredients are often in such quantities, in the waters, as to produce marked sensible effects, as purgatives, diuretics, diaphoretics, and antacids; means universally admitted by observing physicians, in all ages, to be those by which a large circle of diseases is combated and overcome. But mineral waters, when drank in certain prescribed quantities, and when, under defined circumstances, used as a bath, not only produce the therapeutical effects of medicines obtained from the shops, but they do it with more ease, and with less perturbation, and even in a painless manner. Shall we then deny to these natural compounds, with the admitted adjuvants of better air, exercise, new scenes, and pleasant company, a power and efficacy which is so readily conceded to them in a sick chamber at home, with its too often unavoidably depressing influences and associations?

THEIR EFFICACY EEAL. 19

Nor do we find the cure of many diseases at watering places, by drinking the waters, confined to those who have left the crowded city and its unwholesome air. The inhabitants of the country are often equally benefitted by the same course of treatment, although they cannot be said to enjoy the additional advantages of change of air and of rural scenes obtained by the other class. In regard to the state of the mind, and particularly an active imagination, by its influence on the body, explaining the good effects of visits to mineral springs, we do not find, by any means, that the most imaginative are they who report the most favorably, or who exhibit by cures in their own persons, the sanitary powers of the waters. On the other hand, the dull, unlettered clown, or the exacting logician and mathematician will often come away cured of their dyspepsia, torpid liver, rheumatism, or long-endured cutaneous disease, by drinking these waters, without any exercise of the imaginative faculty, either to have relieved or persuaded them that they had found relief; and to whom society would be more irksome than agreeable.

Animals, moreover, such as horses and cattle, and dogs, and even the literal swine have been evidently cured of obstinate maladies by this means, without our being able to divide the credit of the cure with country air, change of food, and pleasant company. "Wild animals, prompted by conservative instinct, resort in large numbers *to salt-sulphur springs or "licks," and take freely the unpalatable sulphureous ingredients for the sake of the saline.

In chronic maladies, the physician has recourse, with avowedly good effect, and on what is regarded a philosophic basis, to the administration of medicines in minute, but still appreciable quantities, constituting what is called the alterative practice. In these cases, beneficial results, by the great abatement or entire removal of disease, are brought about in a slow and scarcely sensible manner, without purging, increased diuresis or sweating. So, in like manner, do mineral waters, if their ingredients be few and of no great activity, or, more especially, if small quantities of the stronger ones be given, act as alterative medicaments. Time

SENSIBLE EFFECTS OF. 21

is an important element for the amelioration or cure, whether the artificial remedies from the shop, or the natural remedies from the great subterranean laboratory be the means employed. Not unfrequently weeks, sometimes months will elapse after the invalid has left the spring, before he realizes the salutary operation of its waters, in obviously amended health, and greater strength and spirits; and yet these results are often obtained, in despite of the counteracting influences of return to the old habits of business, with its cares, confinement once more to the city, and want of exercise in a pure air.

The sensible changes produced in the blood and the secreted fluids by the ingestion of certain mineral waters, and even by bathing in them, afford strong evidence of their physiological action ; and would, a priori, lead us to infer beneficial therapeutical effects and renovation of the system, which had been suffering from disease, by the use of the same means. A single bath in the hot waters of Yichy, which abound in carbonate of soda and carbonic acid, renders the fluids even of gouty persons alkaline, which had been previously acid. It certainly requires very little faith to make us believe that the regular use of these waters, internally and externally, for a month or two, must powerfully modify the morbid state of the assimilating functions, as in gout and renal diseases ; and if we falter in our anticipations of good in this way, experience comes in to remove all doubts, and establish our favorable convictions.

Skepticism has made large use of and converted into ridicule, the alleged medicinal powers, and the cures brought about by means of certain waters, in which chemistry has failed to detect active ingredients, or, if any, these were in such small quantities as to be, it is thought, necessarily without effect. To this it may be replied, that chemistry is sometimes at fault, for a considerable period ; but, ultimately, with improved science and more delicate processes, therapeutical agents of great energy have been found in waters which previously had been believed to be pure or slightly impregnated with foreign substances. Among these agents may be mentioned iodine and bromine, and, of late

MEDICINAL PROPERTIES. 23

years, arsenic. An announcement of the presence of this last in mineral waters, may startle many persons, until they learn that this metal is in such minute, but still appreciable proportions, as to place it safely on the prescribing list. Small as are the closes of arsenical preparations, in our existing materia medica, they are still beyond those in mineral waters drank in the ordinary quantity. The reference is made at this time, however, to show that neither the sensible properties of certain waters, as measured by taste and smell, nor their chemical analysis, when furnishing negative results, are proofs of the absence of medicinal properties and curative powers in these waters. Accident at first, sometimes the experience of the aborigines on the spot, suggested by a resort of the wild animals of the forest to the springs ; sometimes the traditional, but abiding reputation of their virtues among the country people around, who had used them in certain complaints with obvious benefit, preceded the more methodical trials of educated and scientific inquirers, and furnished a large body of experimental proof, which ought to have more weight in guiding us to a right decision, than all the reasonings and deductions from data of another kind.

The most practical men, as many of our non-reading, and we fear we must add unread physicians, love to be called, are in the habit of prescribing preparations of iron as a toDic, which of all the metals, and indeed of all the medicines of this class, is most congenial with the organism, and which exerts in many disorders of the anemic kind such benign and renovating effects. Now many mineral waters hold in solution this tonic, and in the state, too, of a carbonate, which is generally admitted to be its most active form, and one which is not easily retained in our customary medicinal preparations.

HYGIENIC PRECAUTIONS IN VISITS TO WA- TERING PLACES.

These come under the heads of clothing, diet, sleep, and amusements. In our climate, or we may say series of climates, within the limits of our vast confederacy, no person of common prudence ought to leave home, for even twenty-four hours, in the summer

ATTENTION TO CLOTHING. 2D

months, without having at hand a change of warm clothing, including inner garments, and those for external use and show. Owing to the situation of most mineral springs in valleys, or at the foot of a lofty range or mountain, the air of the place is cool and damp at nights, and in the early morn and evening, even although the heat may have been considerable during the day. It becomes necessary, therefore, for invalids and persons of delicate frames to guard against these changes, which are still more trying during a period of rain with keen easterly winds. No matter what may be the malady or the organ affected, the probability of cure will be lessened by. checked perspiration, or interference with the functions of the skin, so that it is chilled or thrown into an atonic state through cold and moisture. If the happy medium of temperature cannot be preserved, it will be safer for the invalid to keep the skin moderately excited by flannel, merino, or silk worn next to it, than to allow it to be, at any time, cold, and wanting in activity of capillary circulation. I shall not enlarge on this point here, as in another work (Baths and the Watery 3

Regimen) I have spoken in detail of the sensibility of the skin, and of its sympathies with other organs, and the conditions for preserving its functions, as offered in clothing, exercise, and bathing. The exposure encountered by persons of the other sex in putting on light attire, and leaving the arms and, at least, the neck bare, dancing in crowded and hot rooms, with an occasional escape into the piazza and its cold air and drafts, brings with it new ailments and the aggravation of old ones — a result foretold, in tones of warning and often of earnest entreaty, but which are too often disregarded or laughed at. Laugh and ridicule and disregard the laws of nature as we may, we cannot escape the penalty for their infraction. They are part of the ordinances of Nature's God, and can neither be evaded nor abrogated by his creatures.

Although it is not often necessary in chronic diseases, as met with in invalids at watering places, to enforce very rigid dietetic rules, it will always be desirable for them to avoid extremes and excesses in the quantity and quality of the food, and to take it at hours, as nearly as may be, the same as

PROPER DRINKS. 27

those to which they had been accustomed at home. The selection of dishes must be made with due regard to their own personal experience, not of what they like as palatable, but of what they know to be easy of digestion. As a general rule, the drink at meals and in the intervals between them ought to be water of such a temperature as best agrees with the stomach. They who wish to give mineral waters a fair trial, and to derive the fullest effects from their excursion to the Spas, will abstain from alcoholic drinks of all kinds, not excepting the sparkling champagne with its bubbling imposition and falsehoods, persuading the credulous drinker that it came from the vine-clad hills of France, when, in fact, the greater part of it first saw light in some obscure manufactory of factitious liquors at home. The ladies, on their part, will have to practise abstinence from another beverage, the decoction of the Arabian berry, as it is phrased by poets and fine writers, and, in the vernacular, coffee. In inflammatory and irritable habits, and in those who suffer from abdominal congestions and irregular action of the heart in either sex, coffee is very injurious. The nervous and hysterical, they who cannot sleep, and who are on springs, jerky and fidgety, now in the seventh heaven of sublimated sentiment, and again in the depths of despondency, complaining, and begging for sympathy, without offering any in return, will have to abandon the use of tea. If either it or coffee be taken at all, they ought to receive so large an addition of good milk or cream as just to allow of their flavor being retained. In this way the drinker may escape the disturbing effects of these beverages on the nervous and digestive systems.

Sleep, like other true friends, is most welcome when it comes uninvited, without coaxin or wooing, as it generally does in the evening, after due exercise and rational amusements during the preceding day. But sleep can hardly be expected to approach those who have shut it out at the customary hour of its visit, and who only seek it after midnight, with their hearts beating wild yet weakly, their temples throbbing, their whole system heated, excited, and jaded by the close air of a crowded room, and perhaps the

SLEEP — EXERCISE. 29

rapid whirl of the waltz and the, at least, not graceful movements of the exotic polka, which, we must hope, will soon die for want of cultivation by those who make any pretensions to refined taste.

They who would visit, as they ought to do, the mineral spring before breakfast, must rise early, which implies that they have gone to bed in proper time, so as to allow themselves eight hours' sleep. Some will be content with six hours. This will be the minimum, as the first mentioned period will be the maximum, compatible with health and the due exercise of both body and mind.

Exercise, both as regards kind and amount, will be regulated by the constitution and practice of individuals themselves, provided they had been in the habit of taking daily exercise at home. After every allowance made for individual peculiarities and particular infirmities, it may be laid down, as a general rule, that all the visitors at the springs ought to take daily exercise on foot or on horseback; the time and distance being such, as to prevent a feeling of much fatigue, or exhaustion. In fact, exercise and recreation ought to be combined ; and amusements, to a certain extent, should come under the same head. Could the dance be enjoyed at proper hours, adequate space and ventilation being obtained at the same time, and the dancers attired in a suitable, easy-fitting dress, it might come under both the heads just designated. Yarious gymnastic exercises for the men, and calisthenic for the other sex, so arranged that they could be taken in the same enclosure, would increase the beneficial action of the waters, and contribute not a little, in many instances, to the restoration of invalids to health.

No active exercise should be taken for, at least, an hour after the chief meal, nor should a bath of any description be taken until a much longer period has elapsed after eating heartily. The better time for both is in the early part of the day.

DRINKING THE WATERS. 31

Chapter II

Rules for drinking mineral waters — Time of the day — Best in the morning early — Repetition — Same rule for bathing — Quantity drank — Different temperatures of the water drank — Cold — Tepid — Hot — Condition of the invalid modifies the effects of the waters — Bathing while drinking mineral waters, and rules for the use of the bath at different temperatures — Division of baths.

RULES FOR DRINKING MINERAL WATERS.

As travelling is always productive of more or less febrile excitement and fatigue, the visitor at the springs ought to rest a day or two after his arrival, before he begins to drink the water. A warm or tepid bath may be taken in the meanwhile.

The proper time for drinking a mineral water is early in the morning, an hour at least before breakfast, when the stomach is empty, most impressible, and most readily transmits the effects which it experiences to the other organs. The water ought not to be drunk when the stomach is engaged in the

32 MINEEAL AND THERMAL SPRINGS.

process of digestion, and, of course, not for several hours after a meal, especially dinner. A neglect of this precaution in drinking mineralized water, not only prevents its salutary operation, but disturbs digestion, and interferes with those changes which the food ought to undergo in the stomach to prepare it for being assimilated to the fluids of the body, and especially to chyle, or first blood. If the water is to be taken a second time in the day, this should be two hours before dinner; and if its use be admissible at all in the evening, it can only be on condition that the dinner had been eaten at an early hour, we will suppose one o'clock, and that no repast had been subsequently taken, except perhaps a sandwich or a slice or two of bread and butter. As remarked in my first work on the subject,* " An invalid may drink a moderate quantity of the water before breakfast with comfort and advantage, but not be able to do the same before dinner with equally good effects. He may be able to take the water both before breakfast and before dinner, and yet if he drink in

* On Baths and Mineral Waters.— 1831.

THE PEOPER HOURS. 83

the evening he will, perhaps, have a restless night, and be worse next morning than he had been twenty-four hours before."

If modifications of the rule now laid down be admissible, it will be in the case of the milder mineral waters, such as the acidulous, in which carbonic acid often abounds, and which also hold in solution common salt. But the strongly saline, the sulphureous, and the chalybeate cannot be drunk with impunity, either on a full stomach, or during the time of stomachic digestion, and before the food has been converted into the somewhat homogeneous mass of chyme, and has, in great part, passed out of the stomach.

The same rule, precisely, will govern in the use of the bath, except in the case of a cold one, which should not be taken at all in the evening.

Imperfect sleep on the preceding night, or fatigue and languor from late sitting up and dancing, will impede not a little the expected effect of the morning draughts of mineral water, and if it be of the purgative class, ought to prevent its use altogether for that day.

The quantity of water drunk at one time must depend on various circumstances — its nature, strength of mineral impregnation, condition of the patient, and the immediatelysensible effects expected. When taken with a view to its purgative operation, the quantity will be much more than when an alterative or even a diuretic, or diaphoretic effect is desired— supposing always that the same water is used to meet these different indications. But where others of less activity can be drunk in quantity without oppressing the stomach, they will be more likely to act on the kidneys and skin, and promote free secretions from these organs.

Modifications of effect may be expected from the different temperatures at which mineral waters are used. Common water, when cold, is rapidly absorbed, saline or mineral but slowly, and if the dose be considerable, both are eliminated through the kidneys. If the temperature be somewhat raised, so as to approach the degrees of tepidity, the stomach no longer receives either common or mineral water with the same complacency; and if they do not cause nausea, they excite

EFFECTS VARY WITH TEMPERATURE. 35

this organ to expel them, and acting in the same way on the intestinal tube, they give rise to a purgative operation. At a more decidedly elevated temperature, or that which brings simple water to the standard of hot, it is again better borne by the stomach, is absorbed freely, and excites both pulmonary transpiration, and copious sweating. When the water is saline or mineral and at a high temperature, it also will act in the same way on these organs — lungs and skin — provided the impregnation be not very strong. The temperate degree, approaching the tepid, is the most favorable condition for mineral water, particularly of the saline class, producing a purgative effect, as it is also that for creating nausea and vomiting. In both instances, it stimulates the muciparous glands to increased secretion.

Certain modifications in the therapeutical action of mineral waters, and of other medicinal substances, will depend on the condition of the invalid at the time, so that their powers shall be exerted on one organ in preference to another. Thus certain saline and vegetable substances will either cause vomiting or sweating, will act as diuretics, diaphoretics, or expectorants, according to the state of the skin, its feverish heat, or its coldness, its warmth by clothing, or its exposure, at the time, to dampness and cold.

If the water be too cold for the stomach, it may be kept in corked or otherwise wellclosed vessels, in the room of the invalid, until it acquires the temperature of the air, or, if need be, immersed in warm water, so as to render it slightly tepid.

BATHING IN CONNECTION WITH THE DRINK- ING OP MINERAL WATERS.

I alluded, in a preceding page, to the prominent part which bathing was made to perform in the medical treatment of invalids at the watering places of France, and still more of Germany. In similar places in the United States, the bath is either entirely neglected or is regarded as a thing of secondary or small moment ; and hence the defective arrangements in this particular, at most of our mineral springs. The bath houses, when constructed, are too often small, damp, and gloomy, and placed out of the way, instead

KULES FOR BATHING-. 37

of being near to, if not directly connected with the springs, or the main building in which the visitors take up their abode. There is seldom adequate provision made for that most important variety of the bath, the douche, which, at different temperatures, cold, warm, or hot, is so powerful an agent in the cure of many diseases.

The temperature and duration of the bath will, of course, vary with the degree of vascular excitement and heat of the skin of the invalid, as well as with the indications which are proposed to be fulfilled by drinking the waters. When the saline aperient waters are employed with a view to diminish plethora, and the remains of febrile excitement, the temperate or even the tepid bath will be found the best adjuvant ; the stay in it short. So, also, when acidulous waters are given with reference to an alterative action, and especially where it is intended to promote the secretion from the kidneys, baths of this kind will be found serviceable. The action both of purgatives and diuretics is favored by cool skin, so, on the other hand, their operation would be retarded and rendered 4 incomplete, by stimulating this organ, as in the case where baths of a high temperature are had recourse to.

When it is desired to keep up a full capillary circulation in the skin, and to favor insensible perspiration, so as to allay irritation and prevent any vascular strain on internal tissues and organs, the warm bath will be found the most appropriate means for the purpose. It will be used auxiliary to alterative doses of sulphureous waters, and to the tonic treatment by chalybeates, in those cases in which the latter are used for the relief of languor, debility, a pale and dry skin, and a soft and rather feeble pulse. In other cases of feebleness of function, with a hot skin and febricula, the cool or temperate bath does good service.

When, again, we wish to excite the skin to free secretion, by converting sensible into insensible perspiration, and to stimulate, also, a languid circulation and organism generally, as in chronic rheumatism and atonic gout, anemia and chlorosis, not complicated with inflammation of an organ, scaly diseases of the skin, of long standing, atonic dropsy,

DIVISION OF BATHS. 39

simple paralysis without evident cerebral lesion, and indolent glandular and other swellings, the hot bath, from 100° to 120° F.,and the hot douche will be found to aid powerfully the stimulating and alterative effects of sulphureous waters.

Differences in the temperature and duration of the bath will grow out of the properties of the mineral waters employed for the purpose. Sulphureous waters, for instance, excite the skin and system generally more than others.

Division of Baths. — As there is still a too general ignorance of the actual temperatures of the received divisions of baths — cold, warm and hot, in which not a few medical men participate, it cannot be deemed amiss to introduce here the table which will be found, also, in my work already referred to •

The cold bath

from 33° to 60° I

The cool bath

The temperate bath