Chapter XI: Preface (11)

It is to this same property perhaps that its influence in chronic painful affections of single nerves is to be attributed. The point whether salt is actually absorbed from a bath is not, I believe, absolutely decided; but certainly, if the fact be true, as is my firm belief, it is worthy of remark to those patients who look for the tonic effect of the absorption of iron into the blood, that it is in the mud-baths only that this metal is contained in a soluble state. In the baths of _Schwalbach_, so famous for chlorosis, there is plenty of iron; but it is in the form of an insoluble carbonate: yet it is stated to be absorbed by the skin, and to produce its well-known effect on the coloring matter of the blood; it has always appeared to me that, provided chlorotic patients could bear the stimulation applied to the surface, the mud-baths of Franzensbad would be pre-eminently serviceable. This remark applies equally to some forms of hysteria; and to those irregular muscular contractions of the limbs termed chorea. Indeed it is to the absorption of this iron, I deem that the exhilarating effect universally experienced after their use is to be attributed. Dr. Kœstler quoted to me two cases of diabetes, in which these baths were extremely useful; he could not however say were actually effectual. In conclusion, cutaneous affections of a chronic character, unattended by fever, will be most effectually benefitted; and I believe that these very obstinate complaints, which baffle in so determined a manner the skill of the medical man, will derive more benefit from the mud-baths of Franzensbad than from any other mineral baths, with one exception—those of Kreuznach. I have entered more fully than I had originally purposed into this subject; but I trust that its very great interest, both in a scientific and medical point of view, will be deemed a sufficient apology for trespassing so long on your patience.

I am, dear Sir,

Your’s very sincerely,

ROBERT J. SPITTA.

MARIENBAD.

At the distance of sixteen or eighteen English miles from Eger, lies the now celebrated spa of Marienbad, though a place of yesterday, comparatively speaking. It is situated in a gorge or small valley between cheerful and pine-clad hills; and the houses being all modern, look extremely well. Numerous shady walks are constructed in every direction; and two murmuring and crystal streams run rapidly down the valley. Three of the springs are within a few hundred yards of each other—viz. The Kreuzbrunn, the Carolinenbrunn, and the Ambrosiusbrunn. The Ferdinandsbrunn, lies about a mile out of the village. There is another spring still farther in the woods, which contains only 7/10ths of a grain of solid matter in the pint of water. It is called the Marienbrunnen.

I. THE KREUZBRUNN.

This is the lion of the place. It is the strongest of them all—its predominant qualities being _solvent_, with an ulterior stimulant and tonic property. It boils up under a beautiful building resembling a small Grecian temple, from the entrance of which a fine shaded promenade, with a bazaar on one side, and a dell on the other, extends to the Carolinenbrunnen. In a pint of this spa there are 28½ grains of sulphate of soda—10 grains of muriate of soda—7½ ditto of carbonate of soda—3 grains of carbonate of lime—2 of carbonate of magnesia—⅒th of a grain of iron—some vegetable extract, &c. making 52 grains in the whole. The cubic inch of water contains about a cubic inch of carb. acid gas.

_Physiological Effects._—This water sits easy on the stomach. Five or six glasses are generally taken in the morning, without inconvenience, and even with pleasure. When impurities, however, exist in the stomach or bowels, the Kreuzbrunnen often causes sickness or disagreeable eructations, and then some opening medicine should be taken. If this water causes a sense of distention, weight, or oppression at the stomach—or diarrhœa, or loss of appetite, it is a sign that the water is taken in too large quantity—or taken too fast—or taken too long—or, in fine, that it is not agreeing with the individual. Very often, however, it is more owing to errors of diet than to the nature of the waters that these phenomena occur.

In general the appetite is increased by the Kreuzbrunn, after the third or fourth day. It augments considerably the action of the kidneys, the water becoming more pale and copious—and this effect generally continues during the period of the cure. It acts on the bowels also—five or six glasses usually operating two or three times. The exported water is more aperient than that taken at the source. The evacuations are often of a green, black, or brown colour—or glairy, and gelatinous. Sometimes dark coagulated blood is passed. When the motions become watery, the Kreuzbrunn is not answering the purpose. The discharges above-mentioned afford indescribable relief to the sufferer.

Things do not always, however, proceed so quietly. Occasionally the abdomen becomes distended—the pulse accelerated—the bowels get confined—and the fears of the hypochondriac are then greatly augmented. According to Dr. Heidler, Dr. Herzig, and others, these symptoms are _critical_, and soon disappear, when Nature has accomplished her object by a discharge of vitiated excretions. It is quite a mistaken notion that the dark or green colour of the motions is owing to the minute proportion of steel contained in the water.

The _circulation_ is sometimes disturbed. The head becomes giddy, the chest oppressed, the pulse hard and frequent—with a sense of prostration, or, on the contrary, of excitement. These are considered by the authorities above-mentioned, as precursors of the critical discharges, and return of health. In many cases such stormy crises do not take place, and the cure is effected gradually and imperceptibly. In people of plethoric habits and irritable temperaments, when any of the foregoing symptoms occur, it is safest to mix the water with some warm milk, or allow the carbonic acid gas to escape before it is taken. The Kreuzbrunnen, however, is one of those solvent, and, at the same time, tonic waters (according to Dr. Heidler) that may be taken by almost every one, whatever the age, sex, or constitution, with little or no danger, even where there are complications of organic diseases of the heart, lungs, or great vessels. In such cases, the dilution with warm milk and the extrication of the gas, will be proper. Dr. Heidler cites the case of a young lady who came to Marienbad labouring under sympathetic hectic fever, and who had had hæmoptysis. The stomach would retain no food—especially the dinner. Constipation was obstinate, and nocturnal perspirations were profuse. The Kreuzbrunn waters were taken, and, after eight days, the fever ceased. In four weeks more the stomach became retentive. Next Summer, however, she returned to Marienbad, with the evening vomitings as before. Eight days’ course of the waters dispelled the sickness, and she recovered her health. The physicians of Marienbad exhibit the Kreuzbrunn to people who have had apoplectic attacks, provided all symptoms of congestion be removed before the waters are begun. In hæmorrhoidal and other sanguineous fluxes, the same source may be used; but in moderate quantities.

The effects of the Kreuzbrunn on the nervous system are much dwelt on by Dr. Heidler and the other practitioners. They are considered to be antispasmodic, and are highly praised in the numerous and Proteian forms of hysteria, hypochondriasis, weakness of stomach, &c. Many patients of this kind recover at the Kreuzbrunn, after vainly trying more tonic and chalybeate springs elsewhere.

In cases of pure debility, both of body and mind, the more tonic waters of the Carolinenbrunn (to be presently noticed) are prescribed, together with baths of the same. This water is much used in tremors of the limbs, paralysis from mere weakness, or from losses of blood, excesses, severe illnesses, distresses of mind, &c. It is to be remembered, however, that mere debility is but seldom the cause of these nervous sufferings; and that the feelings of lassitude and exhaustion, the small pulse, cold extremities, cramps and spasms, so frequent among hypochondriacs, are generally symptoms or effects of congestion in the vessels of the liver and abdominal organs, giving rise to irritation in the nervous system, constipation, and morbid secretions. The classes of people who become hypochondriacal are those who have lived well, both in food and drink, and who have led an idle life, mental and bodily. In such, the pathological condition above-mentioned is likely to occur. The action of the Kreuzbrunn is eminently calculated to clear away viscid and unhealthy secretions, and rouse the circulation of the liver and glandular organs of the abdomen. The Marienbad physicians employ the Kreuzbrunn in gravelly complaints, but in small quantities, and with good effects apparently.

The physiological action of this water on the lymphatic or absorbent system, is very striking, as might be expected. Tumours of the glands, especially if not of long-standing, disappear or greatly diminish during a course of the Kreuzbrunn. Cutaneous complaints are generally cured or ameliorated by the same waters assisted by baths.

But it is chiefly in chronic complaints of the abdominal, and especially of the digestive organs, that the Kreuzbrunn is famous. The symptoms which indicate the use of these waters, according to Dr. Heidler and the other physicians of Marienbad, are the following:—yellow, pale, or cachectic complexion—loss of appetite—distaste of food—sickness—furred tongue with bitter taste in the morning—acid or rancid eructations—oppression or cramps about the stomach—distention and tenderness of the abdomen, local or general—colics—kidney-affections—constipation—diarrhœa—dysury—deposits in the water—irregularities of females—sterility—leucorrhœa—hypochondriasis—hysteria—epilepsy—various and anomalous nervous affections—headaches of all kinds—giddinesses and vertigo—noise in the ears—sleeplessness—asthma—anxiety about the chest—palpitation of the heart—languor of the muscles—cold extremities—feeble circulation—atrophy, &c.

II. FERDINANDSBRUNN.

This spring lies about a mile out of the town, and has a greater affinity to the Kreuzbrunn than any of the other wells of Marienbad. Its constituents are as follow:—In the pint there are 17 grains of sulphate of soda—7 grains of muriate of soda—6½ carbonate of soda—3 of carbonate of lime—2 of carb. magnesia—⅓rd of a grain of carbonate of iron—traces of carbonates of strontia, manganese, and lithian—in all 36½ grains—with 146 inches of carbonic acid gas to 100 cubic inches of the water.

From the above analysis it will be seen that the Ferdinandsbrunn contains nearly three times as much steel as the Kreuzbrunn, with considerably more of carbonic acid gas; but it contains much less of the sulphates and muriates of soda. Hence it is more tonic, and less aperient than the master-spring, the KREUZBRUNN. The water is clear and transparent in the glass—sparkles like champagne—and has a most agreeable refreshing taste. It leaves a slight smack of ink on the palate. It may be administered in the same class of maladies as the Kreuzbrunn is applied to—and that either simultaneously, alternately, or successively. Thus, where the solvent powers of the former spring are still wanted, but the debility of the patient requiring a more tonic source, the Ferdinandsbrunn may be advantageously conjoined with the Kreuzbrunn, or substituted for it during a period. It may be as well to cite a case or two here from my friend Dr. Heidler.

“A gentleman, 60 years of age, who had led a sedentary life, and experienced much trouble of mind, became extremely hypochondriac. When he arrived at Marienbad, his complexion was cachectic—eyes dull and sunk—tongue furred—appetite gone—abdomen distended, but not tender—hæmorrhoids—bowels inactive—discharge of bloody mucus occasionally with the motions—some eruption on the skin—slight wandering gouty pains—skin dry—pulse small and slow. The Kreuzbrunn was first tried, but produced watery evacuations, and distention of the stomach. The Ferdinandsbrunn was therefore substituted at the end of ten days. This water, in conjunction with mud-baths, produced, in the course of five weeks, the most salutary effects, clearing the patient of his hypochondriasis, and nearly the whole of the other symptoms.”

_Case the second._—“A gentleman, 50 years of age, who had lived well, became weak and cachectic after some considerable hæmorrhoidal discharges—one of them amounting to several pints of blood in one day. He had derived considerable advantage from the waters of Carlsbad the preceding year, but it increased the intestinal hæmorrhage. On his arrival at Marienbad, he presented the following symptoms:—complexion pale, and inclining to a yellow tint—lips bloodless, as was the tongue, and even the palate—swelling of the eye-lids—small appetite—sleeplessness—rose from bed more fatigued than when he lay down—great difficulty of breathing, but without any symptoms of water in the chest, on ascending stairs—abdomen distended, but soft, and without tenderness—constipation and diarrhœa alternately—the pulse feeble and 85 to 95—skin rough and dry.

“The Kreuzbrunn was tried, but caused oppression at the stomach—diminution of appetite, and watery evacuations. The Ferdinandsbrunn was then employed, and agreed better, and produced more consistent motions, but very unhealthy—some blood was passed each time from the hæmorrhoidal vessels. The appetite soon increased—the digestion improved—and sleep became more refreshing. Towards the end of the course, which lasted five weeks, he was able to go up stairs without difficulty. He returned two years afterwards to Marienbad, with the same symptoms, and was again relieved.”

The Kreuzbrunn is preferable to the Ferdinandsbrunn, where the invalid is of sanguine temperament, robust, inclined to apoplexy, or hæmorrhages. Also for females who are subject to miscarriages—and, in general, for all those who shew a tendency to fulness or congestion in any of the vital organs—diseases of the chest—derangements of the circulation—inflammatory complaints—and diseases of children.

III. CAROLINENBRUNN AND AMBROSIUSBRUNN.

These two springs are near each other, and only a few hundred yards distant from the Kreuzbrunn. They come under the head of “acidulous chalybeates,” and only differ from each other in strength—the Carolinenbrunn being rather more potent than the Ambrosiusbrunn, as the following analysis will show. The CAROLINENBRUNN contains in the pint of water, 2½ grains of sulphate of soda-½ grain muriate of soda—⅔rds of a grain of carbonate of soda—nearly a grain of carbonate of lime—3 grains of magnesia—⅓rd of a grain of carbonate of iron—in all amounting to about 9 grains—and 123 cubic inches of carbonic acid gas in 100 cubic inches of the water.

The AMBROSIUSBRUNN contains only six grains of solid matters in the pint—the iron being only ¼ of a grain. The other ingredients are the same in kind as in the Carolinenbrunn, but one-third smaller in quantity. The carbonic acid gas is also rather smaller in quantity.

Dr. Heidler considers the Ambrosiusbrunn as bearing considerable analogy to Bruckenau, Bocklet, and the Stahlbrunn at Swalbach; but as far as the chemical composition is concerned, there is much difference, as may be perceived by reference to those springs. Dr. H. prefers the Ambrosiusbrunn for children, and also for adults of very weak and delicate constitutions, as preparatory to the water of the Carolinenbrunn. It is easy of digestion, and may be taken for a long time, without inconvenience. It is very useful in gravelly complaints.

The Carolinenbrunn is of more extensive application than the Ambrosiusbrunn; but much less so than the Kreuzbrunn, or even the Ferdinandsbrunn. Experience has shewn that the “_acidulous chalybeates_,” whose properties are exciting and tonic, are much less useful in chronic diseases than those which are solvent, and which produce crises in the course of their operation—especially through the medium of the bowels and the kidneys.

The first impression of the Carolinenbrunn on the stomach is excitant and refreshing, like all other acidulous springs. It has been generally used by the inhabitants as common drink; and yet it does not digest so easy, among the invalids, as the other springs of Marienbad—many of them experiencing weight and oppression at the epigastrium, particularly if they are weak and irritable constitutions, or labouring under any congestion or engorgement of the abdominal organs. It is much less aperient than the Kreuzbrunn and the Ferdinandsbrunn—indeed it often confines the bowels, and then the patient must take some of the other waters with the Carolinenbrunn or aperient medicine. This spring is the strongest in iron of all the others. It bears the greatest affinity to Schwalbach and Spa; but is a stronger chalybeate, and contains more carbonic acid gas than they do. It leaves an _après-gout_ of steel on the palate, as also of sulphur.[63]

The Carolinenbrunn may be classed amongst the exciting and tonic waters. It moderately excites the circulation and the nervous system, by a transient stimulation, which does not leave a debility behind. Although it is not aperient, it rarely produces astringent effects, like bark, steel and other tonics. It augments the action of the kidneys—and may be said to gently increase the activity of the whole organism, without checking any of the secretions. It is therefore prescribed, with much advantage, in all cases of pure debility, and unattended with any fever or local inflammation. Care ought always to be taken that the bowels are cleared of all impurities before this water is used, and that constipation is guarded against during the course. It is used in baths. The rules for using the waters are not materially different from those enforced at other spas. The season lasts from the beginning of May till the end of September.

THE BATHS.

The baths of Marienbad are on a splendid scale—including the mineral water—the gas—and the mud baths. The grand source of the waters for bathing is the MARIENBRUNN, which furnishes 5280 cubic feet of water in 24 hours. The basin is large and capacious—entirely covered over—and the carbonic acid gas boils up in all directions, and in globes and globules of all sizes, with astonishing vehemence and agitation. The disengagement of gas here is, in my opinion, much more striking and wonderful than at the Cold Sprudel and its neighbour at Franzensbad. There is always a thick stratum of this deadly gas incumbent on the surface of the water. There is an admixture of sulphuretted hydrogen gas with the carbonic. All the experiments that are made on animals at the famous Grotto del Cane, near Naples, may be repeated here with perfect success. The Marienbrunn is more elevated than the bathing-establishments, so that the water is conveyed fresh from the source, through pipes that prevent all decomposition.

PHYSICAL AND PHYSIOLOGICAL EFFECTS OF THE BATHS.

1. Soon after entering the bath—say at blood heat—innumerable globules of carbonic acid gas are seen on the surface of the body. 2. Many people perceive a redness of the skin, soon after immersion, accompanied by a sense of heat, even when the bath is not above 88° or 90° of Fahrenheit. 3. Some people of irritable and sensitive constitutions, on the contrary, experience a slight shiver, even when the temperature of the water is above that of the blood. This phenomenon is, however, rare. 4. The bath occasions a prompt and copious secretion from the kidneys. 5. Many people who have had old wounds, fractures, or ulcers, feel pains in the parts, while immersed in the water. 6. The same may be said of gout and rheumatism; and this renewal of pains is considered a favourable omen. 7. Old and ill-conditioned ulcers soon assume a more healthy appearance under the use of the baths, and take on a more active, or even inflammatory condition. Ulcers ought to be covered with oil-silk or other defence while the patient is in the bath. 8. In the course of the bathing—generally after ten or fourteen days, any eruptions that previously existed become more developed—and very often new cutaneous eruptions come out. These are considered to be more or less salutary.

The Marienbrunn water is much weaker than the Kreuzbrunn and other drinking springs, and is soon decomposed by exposure to the atmosphere. These baths are contra-indicated, or even prejudicial in cases of dropsy, phthisis, aneurysms, irritations or inflammations of any important organ, especially if accompanied by fever or suppuration—disposition to hæmorrhages, or vomitings of blood—disposition to miscarriage—paralyses the result of apoplexy. With these exceptions there are few chronic diseases which may not be benefitted by the Marienbad baths in conjunction with the internal use of the waters.

It is chiefly, however, in gout, rheumatism, tic-douloureux, paralytic debility without preceding apoplexy or affection of the head, scrofula, cutaneous eruptions, stiffness and contractions of joints, and old sores, that the baths of Marienbad are recommended as essential auxiliaries to the waters internally. The baths are generally used at a temperature of 94° to 98°, and at any time of the day except when digestion is going on after dinner.

MUD-BATHS.

These are in great requisition at Marienbad. The peat bog is found near the spa. It is of a very dark brown colour—friable when dried, and unctuous to the feel when wetted. It is here, as elsewhere, the product of vegetable matters decomposed by water, and highly impregnated with carbonic acid gas and sulphuretted hydrogen, which gases are disengaged in prodigious quantities. Much sulphur is found in this earth, together with various mineral salts, as hydro-chlorate of soda, sulphate of soda—sulphates of lime and magnesia—carbonate of iron—silex—alum—bitumen, &c.

Besides the general effects of hot, warm, and tepid baths of mineral water, the mud-baths exhibit effects peculiar to themselves. They may be taken at a higher temperature than water-baths, without inconvenience. They are never employed cold. They excite the skin much more than the liquid baths,—cause a greater degree of redness—bring out more eruptions—and stimulate the nerves of the surface, as well as the vessels. They are employed by the Marienbad physicians in all those cases where the mineral-water baths are used. They are preferred, however, to the latter, in all those maladies where the natural and salutary crisis takes place chiefly through the excretories of the surface, and by determination to the joints, as in gout; and in those cases where the disease is attributed to checked perspiration. The mud-baths are much employed by Dr. Heidler, Dr. Herzig, and others, as local applications in various local maladies, as, for example, in swellings and stiffness of the joints—old wounds—ulcers—neuralgic affections, &c.

As the stratum of mud in contact with the body soon loses some of its caloric, it is proper and even necessary, to keep moving about in the bath, and using friction with the hands as well as motion with the limbs. The fluid bath, which is placed at the side of the mud-bath, loses temperature also, while the bather is in the latter, and as it is often a moveable tub, warm water cannot be always added to it—therefore it should be two or three degrees higher than usual when operations are commencing. No time should be spent in the washing-bath longer than is necessary for cleaning the surface of the body.

Having used the mud-baths both at Franzensbad and Marienbad, and accurately watched their effects on my own person, I can aver that I perceived no difference, either in sensible properties or physiological results, between the mud-baths of the two places. I always felt more exhilarated through the day, when I used the mud, than when I took the common mineral-water bath.

GAS-BATHS.

At Marienbad, as at Franzensbad, the carbonic acid gas rises from the earth in such abundance, that it is only necessary to inclose a piece of ground and form a reservoir, when the deadly mephitic gas collects in such quantities as would destroy the whole population of those spas in a few minutes! But as the most potent poisons have been converted into the most efficient remedies, so has this deleterious emanation from the bowels of the earth, been made an instrument for restoring various lost powers in the human frame. The application of this gas is only of modern date. The first notice I have seen is in the Dict. des Sciences Medicales, 1812. Since then Dr. Heidler, Dr. De Carro, and others have published on this subject. The gas-bath was first used at Marienbad about twenty years ago, on the following occasion. Dr. Struve, of Dresden, had been using the waters and baths of Marienbad for a painful affection of the left thigh and leg, which prevented him from walking without crutches, and, on any little exertion, caused the most excruciating pain. A number of lymphatic glands were swelled in the course of the vessels of that limb, and the vessels themselves were enlarged and inflamed, though the limb was emaciated. He had a gorged liver and hæmorrhoids. He exposed the afflicted member daily to the action of the carbonic acid gas, which always floats on the surface of the Marienbrunn; and the following were his words:—“I soon felt an agreeable warmth creep up the limb exposed to the gas, which went on increasing, accompanied by a sense of formication (creeping of ants) over the skin. After half an hour’s application, on the first trial, I removed from the Marienbrunn, by the aid of my servant and crutches; but my astonishment was great, when I found that I could put my foot to the ground with increased power, and that the painful titillation soon subsided. In the course of a few days the power of the limb was so far augmented that I was able to walk without crutches or even a stick. I continued, however, the Kreuzbrunn water internally—the mud-poultices to the limb—and the gas-bath for three weeks, when the cure was complete and permanent.”[64]

This almost miraculous cure attracted Dr. Heidler’s attention to the subject, and, from that period, he has made numerous experiments on other patients, with this new remedy, as well as on himself personally, and published the results in the year 1819, at Vienna. The succeeding year six gas-bathing chambers were constructed, and now, (August 1840) this gas-bathing establishment is on the completest scale of perfection. The Count St. Leu, and Marshal Schwarzenberg, were among the first patients who used the gas-baths after their establishment in 1819. The physicians of Marienbad have, ever since the last-mentioned period, employed this remedy in a great number of cases and diseases, and, they informed me, with great advantage.

The sensible effects are chiefly as follows:

1. A sensation of heat (sometimes preceded by a slight coldness) very soon is felt after entering the gas-bath, beginning at the feet and mounting upwards over the whole body, in the majority of cases, but, in others, it is most sensibly experienced in those parts of the body or limbs which are or were the seats of diseases. In the abdomen, and especially in the lower parts of the pelvis, this pleasant sensation of heat is more felt than in the chest—a fact which led to the application of gas to certain complaints in both sexes attended with torpor and debility of particular functions.

2. A sensation of twitching, formication, and even pain, is often the result of the gas-bath, especially in parts which have formerly been the seat of fractures, sprains, wounds, or severe gout or rheumatism. These pains are so acute as sometimes to force the patient to quit the bath before the usual time has expired. On the other hand, most excruciating pains of rheumatism, tic, &c. unaccompanied by inflammation, have been instantaneously relieved by the application of the gas. 3. Perspiration is generally produced or augmented by the bath, either at the time of immersion, a few hours afterwards, or in the following night. 4. The gas-bath sometimes brings on, at others regulates, periodical discharges, hæmorrhoidal or otherwise. 5. The gas-bath is exciting or even irritating to the organs of respiration, and should not be used where there is any inflammatory action or congestion in the chest. 6. If a certain proportion of the gas gets mixed with the common air, and is thus breathed, it produces giddiness, vertigo, anguish at the pit of the stomach, and oppression about the lungs. If the _pure gas_ is breathed, instant death is the result. A few years ago the life of a female peasant was lost by the stupidity of her husband, who put the cover of the bath over her head, instead of being round her throat. No one is now allowed to take a gas-bath without the medical or some experienced attendant.[65]

The carbonic acid gas is generally employed here in commixture with a small proportion of sulphuretted hydrogen gas.

The mode of action of the gas-bath being decidedly stimulant, it should never be employed where stimulants are improper. The disorders in which it is most employed by Dr. Heidler, Dr. Herzig, and other physicians at Marienbad, are the following:—1. Suppressed or scanty menstruation—especially after the waters and common baths have been used without effect. 2. Suppressed hæmorrhoidal discharges, in which the mineral waters may also be employed. 3. In scrofulous ulcers and swellings, aided by the mud-baths and mineral water. 4. Various derangements of digestion, where there is no plethora of any of the abdominal organs. 5. In gouty affections of a painful kind, without actual inflammation, and where the other baths and waters have proved ineffectual. In such cases, the gas-baths often bring out an acid and fætid perspiration on the pained part. 6. In some chronic affections of the sight, as amaurosis, not accompanied by inflammatory symptoms, the local application of the gas has been found useful: also in deafness dependent on torpor of the nerves and membranes of the ear, or where the natural secretion is defective or nul. Great caution, however, is necessary in the local application of streams of this gas to the eyes or ears, where there is any tendency to vertigo, or fulness about the head.

The gas-baths are taken locally or generally. In the general bath the patient should be lightly cloathed, as the gas generally induces perspiration. When it is used locally, by way of douche, it may often be applied to the naked part, or with a gauze covering over the surface, especially if to the eyes. Care should always be taken to prevent the introduction of gas into the lungs—or even into the mouth or nose, lest disagreeable consequences should ensue.

This new remedy has attracted individuals of both sexes to Franzensbad and Marienbad, from the wilds of Russia, and from various parts of the South and centre of Europe. Those who come with the greatest anxiety, and with the most ardent hopes, or at least expectations, to the gas-baths, are such as have long sighed, but sighed in vain, to become—

“The tenth transmitters of some foolish face,”

placing, apparently, more faith in the physical operation of the waters, baths, and gases of the spas, than in the intercession of saints or even the prayers which they had offered up at the shrine of the Madonna herself! How far and how often the gas-baths have wrought the happy revolution, I cannot say. The doctors have firmly asserted, and the patients have willingly believed the “flattering tale.” As the gas-baths are seldom trusted to alone, it is impossible to say with accuracy, what share they have in the general restoration of health, and the consequent invigoration of the constitution. Upon the whole, I left Marienbad with the strong conviction on my mind, that its waters and baths were among the most efficient in the list of the German spas.

The valley of Marienbad is well sheltered, and surrounded by pines in the immediate neighbourhood of the spa; but we have only to mount a couple of miles on the Carlsbad road, when we get into a high open country, with a bracing air and a boundless prospect. Some parts of this route are extremely picturesque—I would almost say romantic, especially a few miles from Marienbad, where the road winds down a precipice in numerous tourniquets, into a valley surrounded on all sides by steep acclivities, some bare and rugged, others crowned with woods. A rivulet roars through the valley, and a village, a convent, and some factories, give cheerfulness and animation to the scene.

P.S.—Before quitting the subject of the Marienbad waters, I must dedicate a few lines to a small brochure on these waters, published by my friend Dr. Herzig, in the Summer of 1840.

Die Heilung der Krankheiten, mit hulfe des Kreuzbrunnen zu
Marienbad. Von Dr. L. Herzig.—The Cure of Diseases by the help
of the Marienbad Waters.

The water of the Marienbad springs has a soothing effect on the nervous system, and checks vomiting and pain in the stomach and bowels, in consequence partly of the carbonic acid contained in the water, and partly of its property of increasing all the secretions.

In plethoric persons it often proves stimulating, and causes headache, redness of face, and feelings of cerebral congestion—owing probably to the carbonic acid and the iron contained in it.

Its most marked effect is to increase all the secretions, especially those of the bowels, liver, kidneys and skin—large quantities of mucus are discharged with the stools. The mucous secretions of the bladder, and also of the vagina, are usually much increased at first, but subsequently greatly diminished, when these organs are in a state of weakness. Various forms of cutaneous eruption often make their appearance, and rheumatic and gouty pains are usually increased at first, but subsequently disappear during the use of the waters.

The digestive and nutritive functions are quickened and invigorated, and the patients acquire strength and liveliness, in consequence of the improved state of the intestinal secretions. The Kreuzbrunn waters at Marienbad produce similar effects to those of the Carlsbad and the Kissengen waters; but the former are more purging and evacuant, and act less upon the vascular system, and more upon the digestive functions than they do.

The diseases in which the Marienbad waters are most useful, are—

1. All congested states of the _portal_ system of veins, indicated by torpid bowels, loss of appetite, hæmorrhoids, and gouty complaints; and the various diseases connected with inactivity of the abdominal circulation, such as hypochondriasis, dyspepsia, morbid sensibility, headaches, &c. Numerous cases of chronic rheumatism and gout, which are so frequently associated with congestion of the vena portæ, are relieved by the use of the Marienbad waters.

2. Diseased state of the mucous membranes, such as some obstinate catarrhs, affections of the mucous coat of the bladder, uterus, &c.

3. Plethora, sanguineous congestions, crampy pains of the limbs, absent or difficult menstruation, and the numerous morbid symptoms dependent upon this state.

4. Torpor of the bowels, and its host of attendant evils.

“By means of its property of increasing all the secretions and excretions of the body, and of bringing out cutaneous eruptions and gouty affections to the limbs, the Kreuzbrunn waters at Marienbad are an excellent remedy in numerous diseases which depend either upon a plethoric state of the abdominal circulation, or upon the accumulation of impurities in the bowels, or upon an unhealthy condition of the mucous membranes. At the same time, they subdue the morbid irritability of the whole system, or of individual parts; they remove congestions, plethora, and various evils dependent upon these. They are especially useful in all cases where Nature herself seems to be striving to induce either an increase of the secretions, or a flow of blood from certain parts, as the nose, anus, &c.”

When the Marienbad waters do not prove sufficiently aperient, a small portion of Glauber or Epsom salts may be added to it. In some cases, the waters will agree better, if previously heated; and in others, they are usefully combined with a little warm milk, or with a small portion of wine.

Dr. Herzig is an attentive physician, who speaks English, and may be usefully consulted by my countrymen. I have also to express my grateful thanks to Dr. Heidler, the spa physician of Marienbad, for his kindness and attention.

CARLSBAD.

——fælix per secula mana,
Fons sacer, humano generique salutifer esto,
Redde seni validas vires. Pavidæque Puellæ,
Formosam confer faciem, morbisque medere
Omnibus, et patrias accedat lætior oras,
Quisquis in hæc lympha fragiles immerserit artes.[66]

Sacred Font! flow on for ever,
Health on mankind still bestow—
If a virgin woo thee—give her
Rosy cheeks and beauty’s glow:—
If an old man—make him stronger—
Suffering mortals soothe and save—
Happier, send them home, and younger,
All who quaff thy fervid wave!

This is denominated the KING of the Spas, whilst Baden-Baden is the QUEEN. I wish his majesty of the “WARM WASSERS” had condescended to hold his noisy court a little nearer to that of his royal consort. Two hundred and thirty miles from Frankfort, through a country that is not always very smooth, or very interesting—with dust in some places half a foot deep on the roads—the thermometer at 80°—and the rate of progression five miles an hour, is a tolerable sacrifice to the hygeian goddess of the Sprudel! It is not improbable that many of those who travel to Bohemia, in search of health, might find it in various other directions, and much nearer their own doors. The journey itself requires some good stamina, as well as resolution, and, if borne well, gives promise of success at the Sprudel.[67]

I suppose Carlsbad claims the prerogative of curing by the “_Royal touch_,” all those maladies that resist the powers of his subject spas—and even of the Queen’s own at Baden.

I think I have discovered one cause of the great efficacy of the Carlsbad waters, which has escaped the notice of the spa doctors, including my friend Dr. Granville. In travelling to Bohemia, the invalid must, on a moderate calculation, swallow full a pound of sand and dust on the road. This being mixed with an indefinite quantity of grease, oil, and vinegar, at the hotels, forms a kind of amalgam, resembling “_fuller’s earth_,” the clearing away of which, by the hot and alkaline waters of Carlsbad, must leave the stomach, liver, kidneys, and other internal organs, as bright and shining as a newly-scoured copper kettle.

It is ascertained that Carlsbad is built on a thin crust of limestone, forming a dome over several immense cauldrons of boiling mineral water. At present the chief crater of this aqueous volcano offers a safety-valve for all the superfluous soda-water unconsumed by the subterranean spa-goers; but it has often been feared that the whole dome may one day fall in, when the bibbers and bathers, the ramblers and gamblers, the sick and the sound, will all have a dip in the Sprudel at its natural temperature, and without the expense of 48 kreutzers for the bath!

On some occasions the usual vent of the Sprudel has become obstructed, and then the ground in the neighbourhood has trembled and vibrated, as if from an earthquake. At one time the pent up water burst out in the bed of the river: and here they have formed a large shield of wood and stones, clasped with iron, with a plug or safety-valve in the centre, along the sides of which the steam and water now oozes out, and the aperture can be enlarged at any moment by removing the plug, when another Sprudel rises in the middle of the Teple.

Be this as it may, Carlsbad may now be considered as the grand “MAISON DE SANTÉ” of Europe, where the patients support themselves, on the principle of the Sanataria in general, and where Mr. Owen might find his social system almost perfect. Thus we have at Carlsbad (and indeed at most of the great German spas,) our food in common—our physic in common—and even our physician in common. The air we breathe, the water we drink, and gardens and walks where we exercise, are all in common. The socialists might even find little reason to complain of that “accursed thing,” MATRIMONY, for although _matches_ are occasionally projected at Carlsbad, I believe that _marriage_ is seldom perpetrated there.[68]

This great valetudinarium then presents four or five wards or hygeian fountains, of which the SPRUDEL stands most conspicuous. I was completely disappointed at the first sight of this lion of the Spas. The descriptions and drawings of the spring are most outrageously exaggerated. One would expect to see a fountain of boiling fluid rising to a height of six or eight feet, and falling down in fervid and foaming showers. No such thing. During half the time, it does not rise above the level of the kettle in which it boils; and is often below that mark. Then it mounts a foot or so, and every now and then spirts a small irregular and ragged pillar or column of foaming water to a height of two, three, or perhaps four feet above the reservoir. More frequently, however, it squirts a jet of water to one or the other side of the kettle, which splashes into the conduits that carry it off. The whole of the kettle, reservoir, and exits are coated with calcareous deposits, and, in many parts covered with green matter, the bodies or receptacles of animalculæ. Still the Sprudel is a stupendous ebullition of hot medicinal water from some infernal laboratory, amply sufficient for the expurgation of a whole nation! The temperature of the water is 168° of Fahrenheit, each pint containing about 44 grains of solid matters, of which the sulphates, carbonates, and muriates of soda form 37 grains. A trace, and merely a trace, of iron is found in the water. Some very recent analyses have also detected traces of iodine, and of an animal substance, together with some sulphuretted hydrogen gas. Its taste is certainly not very agreeable and rather mawkish—and though clear at the fountain, it is turbid when cold. It very much resembles the Cockbrunnen in savour.

The second spring is the MUHLBRUNN, whose temperature is nearly 30° below that of the SPRUDEL; but whose constituent salts are the same. Nevertheless this difference of temperature is supposed to produce a difference in the taste of the water, and renders it more acceptable to the stomachs, or at least to the palates, of many of the drinkers at Carlsbad.[69]

The NEUBRUNN is separated from the former source only by a covered walk, and marks 144° of heat. It did not appear to me to be so much in vogue at this fashionable watering-place, as the Muhlbrunnen.

Behind the Neubrunn there is a hill, cut into terraces and gravelled walks, where rises the THERESIENBRUNN—a spring much frequented by the ladies, and indeed by both sexes. The temperature is only 134° of Fahrenheit, and the water is almost tasteless. These three (with the Hygienequelle, close to the Sprudel) are the chief springs, which are much frequented by the great mass of bibbers at Carlsbad.[70]

The waters of all the springs deposit abundance of calcareous matters, which crystallize in stalactites of all shapes and hues, called _Sprudelstein_, and give employment to numerous hands in the formation of snuff-boxes and various kinds of bijoux.[71] As incrustations form on the surfaces of any woody, mineral, or vegetable substance immersed in these waters, a fear is sometimes engendered in timid minds that similar incrustations might form in the stomach, bowels, or kidneys of those who drink them! It has been proved by Dr. De Carro and others, that the stalactitious deposits will not take place on any _animal_ substance, with the exception of the teeth. Even here, the quantity of stony matter is so small in a dozen beakers of the Sprudel, that nothing is to be apprehended to the teeth on this score. It would, perhaps, be a happy circumstance for Germany, if the Sprudel had the faculty of encrusting the teeth with a calcareous enamel! If such were the case, the whole of the five springs at Carlsbad would be insufficient to supply dentrifice varnish enough!

A serio-comic anecdote is related of a hypochondriac, who had drunk of these waters for some weeks before the _petrifying_ thought flashed across his mind, (in consequence of some uneasy sensations in his stomach) that incrustations were forming in his interior. From that moment he became firmly convinced that snuff-boxes, heads of canes, Madonnas, and even crucifixes, were torturing his entrails! He drenched himself daily with drastic purgatives—but, unfortunately, no stalactites came forth: on the contrary, his inward pains and miseries were increased by the very means that were employed to expel the enemy! Whether he ever recovered from his imaginary sufferings is not known.

Another source of terror to the timid and nervous drinkers at Carlsbad has lately arisen. A learned German philosopher has discovered living fossil animalculæ in the waters of Carlsbad. Now if these little salamanders can “live and move, and have their being,” in the Sprudel at a temperature of 167°—or rather in the bowels of the earth, where the water is at the boiling point, or even in the form of steam, it may well be supposed that they would thrive luxuriously in the temperate climate of the human stomach, where the heat does not exceed 98° of Fahrenheit. However, the drinkers of the Thames water need have no fears respecting the INFUSORIA of Carlsbad, which would soon be devoured by the proteiform monsters which are daily ingurgitated by the citizens of London.

I have already stated that some of the philosophic spa doctors have broached the doctrine, that mineral waters are merely _secretions_ from one great watery being residing deep in the bowels of the earth! As the secretions from the human body are very various, so the secretions from the mother Spa are almost innumerable, and thus the infinite variety of mineral waters is readily explained and accounted for. Q. E. D.[72]

The situation of Carlsbad is very picturesque—I might say romantic. It might be pretty well characterised by a single line, descriptive of a very different locality—the valley of the UPAS TREE:

“Rocks rise on rocks and fountains gush between.”

The town is built partly in the valley, partly on the ledges of granite rocks that rise abruptly behind it, to a height of 1500 feet, while the lazy TEPLE—

“Slow as Lethe’s stream,”

creeps at a snail’s space through the vale, contrasting remarkably with the boisterous, foaming, upheaving, and boiling SPRUDEL, that gushes from unknown and unfathomable depths in the bowels of the earth, carrying health and life to its unnumbered votaries.

Carlsbad cures, as a matter of course, nine-tenths of human maladies; but as King of the Spas, it has a royal prerogative of a curious and important nature—namely, the power of curing those diseases which resist the virtues of all other spas and all other remedies! In answer to a question, “why Carlsbad sustained its reputation undiminished?” HUFELAND replied—“C’est qu’il guérit des maux rebelles a tout autre moyen curatif.” It is true that, if we take the testimonies of the other spas, none of which admit their fallibility in any case, this prerogative of Carlsbad would be little more than a sinecure; but the promises of spa doctors, like the waters which they prescribe, must be taken _cum grano salis_; and we may safely conclude that some maladies present themselves at the Sprudel which have resisted the Cockbrunnen, as well as many other brunnens between the Rhine and the Danube.[73]

The attestations to the power of the Carlsbad prerogative would fill a volume. One just before me, as recorded by Dr. Granville, on the authority of a British nobleman, well known in the world of wit, is worthy of notice. Lord A——, it appears, through the efficacy of the Carlsbad waters, “had lost a _pleuritic adhesion_ under the sternum (or breast bone) the consequence of neglected inflammation in the chest, which had annoyed him for a long time, and resisted all curative means. The complaint made him short-breathed in ascending hills, and gave him a dragging sensation whenever he sneezed—all which symptoms have since disappeared.”

Whether his lordship’s breathing, and consequently his years, have been lengthened by the dissolution of substernal _adhesions_, or by certain _corporate reforms_ effected by the Sprudel, may admit of some doubt; but the narrative shews on what sort of evidence the miracles of the spas sometimes rest! Not that this evidence is worse than we have often at home—witness the attestation on oath by a nobleman, that he saw St. John Long extract quicksilver from the brain of a man who had taken mercury—and the solemn assertions of grave and learned doctors, that an Irish girl could see through her navel, and hear with the points of her fingers!!

If we estimate the number of cures by the number of candidates, this spa must be “a sovereign remedy” for many of our ills. But this criterion is not always correct. It is not always the physician who sees most patients that cures most diseases. But Carlsbad, like other bads, has a very convenient postern to retreat through, when hard pressed for testimonials. Thus, if the first season fails, the most confident hopes are held out that the second will succeed. If the second turn out a miscarriage, then the third will prove infallible! It requires no ghost to prophesy that, if the pilgrim of the spas goes two successive years to Bohemia, without relief, the third pilgrimage will, in all human probability, be to that “undiscovered country,” whence no invalids return to tell their tale of disappointment! If a patient die at home, it is because he did not visit Carlsbad—if at Carlsbad, because he came too late.

The waters of Carlsbad were formerly used almost entirely as baths—but now it is just the reverse—they are chiefly taken internally. In former times the bathers passed eight or ten hours in the baths, as they now do at Leuk, Baden, and Pfeffers. My friend De Carro thinks that, formerly, cutaneous complaints were more rife—and now, that liver and stomach affections are the prevailing maladies—hence the change from bathing to drinking at this celebrated spa. There may be some truth in this. The taste of these waters very much resembles that of weak chicken-broth, with a flat and alkaline savour. It has been seen that SODA, combined with sulphuric, muriatic, and carbonic acids, is the chief agent in the Carlsbad waters. Soda uncombined with acids, either out of or in the body, has rather a deleterious effect on the organs of circulation and digestion. “But the Carlsbad water (says Chev. De Carro) though used for a long time, reanimates, vivifies, excites the appetite, and promotes digestion—thus with proper regimen, restoring the patient to health.” Doubtless the efficacy of the waters is augmented by the admixture, however small in quantity, of other elements, as the oxide of iron, the carbonic acid, the iodine, and materials yet unknown, diffused in extreme solution, through a fluid of a very high temperature, which enables the component parts of the spring to permeate the minutest vessels of the body. The Carlsbad salts are found in the renal secretion, as well as in the cutaneous transpiration, after being taken internally. These waters act by exciting the stomach, bowels, kidneys, liver, and abdominal organs generally, augmenting the secretions and excretions—especially those of the intestines, sometimes it is said even to purgation, when they are taken in considerable quantity. This effect, however, must be rather unfrequent, for I found no one, including myself, who experienced it. “They excite the circulation, so as frequently to produce palpitation of the heart, and determination of blood to the head. This water augments the activity of the absorbents; but it is not till after its other operations, that it acts as a direct TONIC.” Purgation is not considered by the Carlsbad doctors as essential to its beneficial agency, which is often produced without any action on the bowels, but only on the various secretions already mentioned. In all cases, however, it is necessary to guard against constipation, by adding some Carlsbad salts to the water, or exhibiting some other aperient. Although these waters contain no sulphuretted hydrogen gas, or extremely little, they produce fætid eructations from the stomach when drunk—but they have not a corresponding effect on the alvine evacuations. “The operation of the Carlsbad waters, in fact, is what is called ‘_alterative_,’ or ‘_deobstruent_;’ and as such they are applicable to a long list of maladies arising from congestion or obstruction in the abdominal organs, particularly the liver, spleen, mesentery and other glandular viscera, attended by debility of the stomach, heart-burn, acidity, distention, eructations, constipation, jaundice, biliary concretions, hypochondriasis, hæmorrhoids, head-aches, giddiness, gouty feelings, cutaneous eruptions, scrofula, and urinary obstructions.”[74]

This is an encouraging picture, but I have no reason to consider it as overcharged. Dr. De Carro observes, that it is impossible to explain the _modus operandi_ of such simple and minute ingredients on the human organism. “Whoever, he remarks, has experienced a crisis (called also the spa fever—the bad-sturm, &c.) in his own person, will never doubt the power of the Carlsbad waters.”

Dr. De C. compares the action of the Carlsbad waters on the human frame to a good filter that separates all impurities from the constitution.

“Hypochondriacal affections appear nowhere under more various forms than at Carlsbad; and the misanthropic and pusillanimous feelings of those unfortunate beings, passing, without known motives, from hope to despondency, from moroseness to exaltation, deserve the greatest indulgence and sympathy. When we see so many hepatic and splenetic patients whose temper depends entirely on the state of their abdominal functions, we feel disposed to forgive the materialism of the ancients, who placed the seat of so many passions in the liver; we remember unwillingly the _Fervens difficili bile tumet jecur_, the _jecur ulcerosum_ of Horace, as synonymous of _jealousy_ and _violent love_, and we understand how they could say that men _splene rident, felle irascunt, jecore amant, pulmone jactantur, corde sapiunt_.”