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Mineral Spring Waters




 THEIR CHEMICAL COMPOSITION, PITYS.OLOOICAL

     ACTION AND THERAPEUTICAL USE;



      WITH A SHORT REVIEW OF THE HISTORY


             OF


   MINERAL WATERS.



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GAEL SCHULTZ.
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Mineral  Spring Waters,
THEIR CHEMICAL COMPOSITION, PHYSIOLOGICAL
    ACTION AND THERAPEUTICAL USE:
WITH A SHORT REVIEW OF THE HISTORY
MINERAL  WATERS
CARL  SCHULTZ
%
       NEW YORK:
BAKER & GODWIN, PRINTERS,
  PRINTING-HOUSE SQUARE, OPP. CITY HALL.
         1865. 
            Entered, according to Act of Congress, in the year 1865, by
                           SCIIULTZ &  WARKER,
In the Clerk's Office of the District Court of the United States for the Southern District
                                of New York. 
    Mineral Watees are the only  medicines offered to us by
nature, in a state fit for immediate use.   They are admirably
suited for  various diseases  and constitutions, and the expe-
rience of three thousand years has proved them, in many
cases, far superior to the artificial compounds of our pharma-
cies.  The scant knowledge of natural laws, in former times,
ascribed to them the remarkable power of curing all diseases,
and the superstition and mystery in which everything was
shrouded that  could not readily be explained, was increased
by the intentional   perversions  and  exaggerations of local
physicians, who desired to attract crowds of patients.  The
numerous  semi-scientific  publications which annually went
forth from European watering places deserve, indeed, little
credit, and it is only lately that strict and reliable researches
have been made into the chemical  composition  of mineral
springs, and their physiological effects upon the healthy and
diseased body.
    It is the purpose  of this pamphlet to collect those  investi-
gations, as far as they more immediately concern our prepara-
tions, and to put them before our patrons in a readable form.
In  enumerating the therapeutical uses of mineral waters,  I
have, of course, followed the best medical authors, and have
omitted all applications which seemed to have no good founda-
tion in the nature of the spring, or for which Spas of another
class are more suitable. 
               HISTORICAL  KEVIEW.

   The principal difference between a mineral and an ordinary
spring is to be found in the larger volume of gases, especially
carbonic acid gas, dissolved in the water, and in the mineral
ingredients which are held in solution by both; also in the
temperature of the  water, which varies  from 33° to 212  .
They often present  remarkable  appearances  when relieved
from  subterranean pressure, by losing their gases with more
or less rapidity, according to the tension to which  they had
been subjected,  and by parting with a portion of their mineral
ingredients.  Some of them issue from the earth with rum-
bling, gurgling or hissing noises;  others do so only at regular
intervals, and rise to a height of from twenty to forty feet;
some ascend from the bottom  of the sea,  of lakes and rivers  ;
others appear many thousand feet above  the level of the
ocean;  some break at a boiling  heat  through a crust of ice
and  snow;   others issue with icy coldness  near  shrubs and
flowers; some destroy vegetation in their immediate neigh-
borhood, while others  penetrate and cover organic structures
with calcareous incrustations,  and preserve them for the study
of future generations.
   Such phenomena were replete with wonder to the unedu-
cated, and  attracted the attention of philosophers from  an
early period.  Supernatural  properties were ascribed  to the
springs.  Strange theories were  propounded regarding their
origin, and  wonderful tales and fables were current of their
curative powers.
   Strabo  relates that the springs of  Hierapolis imparted a
red color to the roots of trees  and shrubs, and that the  juices
of the latter, when mixed with the water, produced a purple
liquor which was used for dyeing wool.   Philostratus, when
speaking of the sanguinary  battle which the Greek army
fought with Telephus,  on the banks of the river Caicus, states
that the wounded Greek  soldiers who resorted to Agamem- 
s
non's spring, near Smyrna, were all restored.  According to
Herodotus, a spring in the country of the Ichthyophagi or
fish-eaters prolonged life to beyond 120 years;  it made the
skin shine as if polished, and had the perfume of violets.  A
spring in Chios caused insanity;  another  in Magnesia im-
proved the voice of singers ; and the spring of Alysson was a
specific for hydrophobia.   The springs of Lethe and Mnemo-
syne are  often mentioned in classical literature;  the former
gave oblivion and the latter memory.
    Little is mentioned of  mineral  springs in the Old Testa-
ment.  According to the Genesis, Anah, the father of Esau's
wife, discovered  some thermal  springs in the desert, and in
the second book of Kings, we find mention made of a spring
at Jericho which made the ground barren, and was made
wholesome by the Prophet Elisha throwing salt into it.   But
from the New Testament we learn that the Jews, before
Christ, used thermal waters extensively.   " There lay a great
multitude  of impotent folk, of blind, halt, and withered, in
the porches of the lake of Bethesda, by the sheep-market at
Jerusalem, waiting for the moving of the water / and whoso-
ever first after the troubling of the water stepped in, was made
whole of whatsoever disease he had."   This water had a red-
dish brown color, from a sediment of ochre, probably deposited
by the escape of carbonic acid gas;  sulphur was also found in
the mud, and the more rapid disengagement of carbonic acid
and sulphuretted hydrogen, when the water was  stirred up,
may account for its increased curative power at such time.
    The most important of the sulphurous thermals of  Pales-
tine are those of Tiberias, near the lake of Genesareth.  Their
temperature varies from 86° to 130°. They were used by the
Komans, and are visited by patients from  all  parts of Asia
Minor even at the present time.   There was another thermal
spring near the Dead Sea, in the country  of the Edomites,
called Calirrhoe, or beautiful spring, which was used by the
King Herod, in the hope of being cured of his sickness.  Ac-
cording to Josephus, he caused himself to  be carried across the
Jordan to use the thermals of Callirhoe,  which flow intot he
Lake Asphaltites.  He,  however, found it a hard road  to
travel, and failed to recover his health. 
6
    Mineral springs play also an important part in the religion
of the ancients.  AYhen temples were erected to the god of
medicine, the priests of ^Esculapius took good care to locate
them in the vicinity of mineral springs, and such places were
destined both for worship and the cure of the sick. They
were not only provided with theatres and places of amusement
which perfectly outstrip the modern contrivances of our fash-
ionable resorts, but also with hospitals and medical schools for
the  instruction of students.   The most  important of these
were the springs of ]S"auplia, in the sacred grove of iEscula-
pius.  They have been described by Pausanias, and from the
remains  of their  structures wc can, even at the present day,
judge of their former greatness.  The water  of Kauplia has
been recently analyzed by M. Landerer, and found to contain
chiefly chloride of sodium, carbonate of lime, and  carbonic
acid.
   "We should also mention the Castalian spring, which had
a temperature of only 33°, and in which  Pythia had to bathe
before ascending the tripod in the steaming cave  in Apollo's
oracle at Delphi.   There are copious exhalations of  carbonic
acid gas in that cave, and from the short and  incoherent sen-
tences which  the priestess uttered in her  excitement  and
paroxysms the most important prophecies were drawn by a
cunning  priesthood.    Such were  also  the  gas  springs of
Dodona,  the most ancient oracle of the Greeks, and the places
where Odysseus and  ^Eneas communicated with Hades to
meet the spirits of the departed.
   Roman literature tells us of the magnificence and splendor
of the bathing places of Italy in the time of the emperors, the
most fashionable of which was Bajae.  They were embellished
with the  costliest statuary and paintings.  Laocoon, from the
baths of Titus, the Farnesian Hercules, from those of Caracalla,
and the horse-tamer, from those  of Constantino, are  master-
pieces which have never been equaled.   To judge  from the
ruins of Caracalla's baths, they must have resembled a small
village.   There were over two hundred marble columns found
in them, some in a good state  of preservation, and over 1600
seats cut  out of solid marble.
   The fashion of bathing  in  hot springs gradually became 
7
almost a necessity with the Romans, and in the course of their
warlike expeditions they discovered many of the most import-
ant thermals of Europe, and used  them as stations for  their
armies.  We will only mention Baden-Baden (Thermae Aure-
lise), "Wiessbaden (Aquae Mattiacse), Bath (Aquae calidae), Aix-
la-Chapelle (Aquae Granenses), and Spa, in  Belgium  (Aquae
ad civitatem Tungriam).
   The philosophy of springs—the theories held by natural
philosophers of different  ages  on their origin, composition,
specific properties and therapeutical use—would form one of
the most pleasing  and instructive chapters of literature, but
it is clearly beyond the compass of  these pages  to  do the
matter justice.  These  theories were based upon the state of
natural science at the time.   According to the  great thinker
Aristotle, there were in  the interior of the earth a multitude of
large caverns containing air. The air at the roofs of these cav-
erns was, by the cold, condensed to water, and the water broke
forth at the surface, wherever it  could find an outlet; and his
theory throughout antiquity and the middle ages was believed
in implicitly.  Even good old  Origenes, who ascribed the
origin of springs to the  tears wept by fallen angels, could not
materially  shake the  belief in Aristotle.  His  supposition
certainly bears  some  improbable features.  If we consider
that the springs of Yichy alone  discharge three millions, and
those of Carlsbad another three  millions of cubic feet of water
annually, the fallen angels must either weep very abundantly,
or their number must be legion.  Hippocrates was very skep-
tical on the use of mineral waters.  He accused those persons
of ignorance who asserted that saline waters excited the action
of the bowels, and readily passed off with the faeces, because
they had just the contrary effect. Waters that issued from rocks
were considered as  indigestible, and  thermal springs heated
the system, and dried up the juices, as, amongst other unwhole-
some  ingredients,  they contained  copper,  silver and  gold.
Galenus held the same  views as Hippocrates, but his disciple,
Caelius Aurelianus, who lived at the  end of the second cen-
tury, already prescribed the  alkaline saline waters of Ischia
for stone in the bladder.  Paracelsus  called the gases ascend-
ing from springs wild spirits, and remarked in his work, de 
8
aquis mineralilms, 1562, that their heat was caused by the
burning of certain minerals; and Hufeland and others, who
called it volcanic heat, believed it to be entirely distinct from
ordinary caloric, and possessed of specific curative effects not
shared by ordinary water of the same temperature.   Great
stress was also laid upon  the electricity of thermals, though a
delicate multiplier was necessary to prove its presence; and
the nature  of the water itself  was doubted, on account of
the variations which were  observed to  exist in the boiling
point of different springs, which, however, can  be  readily
explained by the varying quantity of salines kept in solution,
and by the difference of elevation. Thus Gastein water, which
boils at 2o7£° at an elevation of 3000 feet above the level of
the sea, was actually taken down by Yon Graefe to the plains
of Albano, in Lombardy, in order to prove that it would boil
there at 2123. Baumgartner and Ilessler even went so far as
to claim for Gastein water a chemical composition entirely
different from ordinary water.   According to  those savans, it
contains one part of oxygen to three parts of hydrogen ; and
a law was enacted in the Duchy  of Salzburg, in 1797 (not yet
repealed), threatening with the penalty of one  guilder all per-
sons who should have the temerity of calling the Spa water.
   Real progress in  the knowledge of  the  composition of
mineral springs was only made by the discovery of the alkalies
and fixed  air by  Yan Ilelmont, in 1648.  The demons of  the
ancients,  and the wild spirits of  Paracelsus, were then found
to be our familiar carbonic acid  gas.  The  great philosopher
Arago proved the temperature  of the springs to correspond
with the depth from which they ascend ; and Bergmann, Ber-
zelius, Bischof, and Struve showed  their  composition  to  de-
pend upon the amount of carbonic acid and other gases which
are dissolved in them, and upon the nature of the rocks and
strata  which they permeate.  Struve proved this by direct
experiment.  By powdering  the clinkstone of  Bilin, and sub-
jecting  it to the action of carbonic acid water, under a small
hydrostatic  pressure, he  succeeded in producing an artificial
water which was identical  in  composition with the natural
spring of Bilin.   Having himself been cured by the use of
a gas spring, or rather by the escaping gases, he devoted his 
9
life to the investigation and reproduction of mineral waters,
and  must be called the father of artificial spring waters.
His  artificial  Carlsbad water which he sent to Faraday, and
his artificial Friedrichshall  bitter water which he sent to
Liebig for  examination,  were pronounced by those distin-
guished philosophers to be identical in chemical composition
and  physiological action with the natural springs they repre-
sented.
        ON  THE USE OF MINERAL SPRING WATERS.

    According to Althaus,* " Spas are only suitable for pa-
 tients suffering from chronic diseases, and in these only, if
 the composition of the blood has noi become too much altered,
 and in the absence of considerable structural changes of im-
 portant organs."   Their  use is not limited to any season, as
 the  patient is not now required to undertake a long journey
 to  a watering place; the spring comes to his bedside,—the
 mountain comes to Mahommed.
    Their physiological action depends upon the water itself,
 and upon the carbonic acid gas  and saline substances dis-
 solved  in  it.  It  was formerly believed that the beneficial
 action of a  Spa corresponded to the amount of water taken,
 and that crises and critical excretions were necessary to a suc-
 cessful treatment; but that idea has been happily abandoned
 by all enlightened physicans.  There are cases  on  record,
 where from 20 to 40 pounds  of  water have been taken daily,
 and a consumption of 6 to 10 pounds constitutes the rule even
 now.  The stomach becomes overloaded, digestion is impaired,
 and  the constitution of the  blood is  much altered.  A large
 portion of the water, especially if free from salines, is directly
 absorbed by the intestines, and excites the skin and kidneys
 to morbid action, and dropsy and general prostration are often
 the result.
   Another widely spread error is the belief that a glass of

  * The Spas of Europe, London, 1862.  A work of great excellence and pro-
found research.
• 
10
any mineral water must produce a strong laxative action, and
the value of artificial preparations is often, but very wrongly,
estimated by their purging power.   Nothing could be further
from the truth.  It would be indeed a very simple  matter  to
impregnate  a solution of some purging salts with carbonic
acid, and name it after  some celebrated Spa; but it is after
all a fact that most Spas, even Kissingen, only purge if over-
doses be taken, and that violent evacuations are usually fol-
lowed by obstinate constipations.  Their object is  mainly to
regulate  the functions  of the  different organs, to reduce the
constitution of the blood  to its normal condition,  to promote
the assimilation of food, and  to stimulate the excretion of
metamorphosed matter.
   It will therefore, in  most cases, be found advisable to use
the Spas in moderate quantity, in place of common water be-
tween meals, after liberal exercise has been taken, and when
the feeling of thirst will make them quite acceptable.  If an
action upon the bowels be contemplated, or for persons who
indulge in the luxuries  of the table,  and suffer rather from an
excess of health than the opposite,  a glass of their favorite
Spa  will be just the thing  before breakfast; but persons of
regular habits, who take a light and early supper, have usually
an aversion to cold water in the morning, and their stomachs
require indeed food more than anything else. It may prop-
erly be  stated in  this  place, that the best time for d/inking
mineral  waters  is in  the evening, a practice which was first
recommended,  and on  excellent grounds, by Dr. Heidler, of
Marienbad,  and approved of by most of the German physi-
cians of note,  who are conversant with mineral water treat-
ment.  Effects  of this practice  are to promote sleep, and to
cause a considerable appetite, almost hunger, in the morning.
In delicate constitutions,  with pulmonary affections or where
cold water does  not agree with the stomach, the Spa should
be mixed with its own bulk of hot milk.  There are of course
waters which have a specific action, where it must be left to the
care of the attending physician, to prescribe them  according
to the condition of the patient; but, as a general thing, the
above rules will be found sufficient in most cases.  They will
be instrumental in restoring health gradually, but surely, and
t 
11
without those much-praised violent and barbarous perturba-
tions of the whole system.
   As carbonic acid is the most important constituent of all
Spas, we  will  treat of it separately, before entering into a
detailed description of the various mineral springs.
    CARBONIC ACID GAS AND CARBONIC ACID WATER.

    Carbonic acid consists  of one equivalent of carbon and
 two equivalents of oxygen.  At the ordinary temperature
 and pressure it is a colorless gas, and about one and a half
 times heavier than atmospheric air.  By pressure and cold it
 can be condensed to the liquid state.   If liquid carbonic acid
 is exposed to the air, it evaporates with an enormous reduc-
 tion of temperature, the remaining portion freezing into a
 snowy white solid.
    Water absorbs about its own volume of carbonic acid gas
 at 60°, but its coefficient of absorption increases in an inverse
 ratio to  the temperature of the water.*   By an increase of
 pressure, water  absorbs more gas, but not quite one volume
 for each  additional atmosphere.  At seven atmospheres it
 absorbs five volumes.   Water  charged with  an excess of
 carbonic  acid, under great pressure, is called carbonic acid
 water, and frequently misnamed  soda water, because bicar-
 bonate of soda is sometimes used  for the generation of the gas.
 The water contains no soda, and has nothing to do with soda.
 Priestley  first produced it, by pouring dilute sulphuric acid
 over carbonate of lime, and impregnating the water with the
 gas, a method which is now generally followed, and the name
 of lime water would therefore  be much more  appropriate
 than that of soda water.   We call it, what it really is, carbonic
 acid water.
   Carbonic acid converts the carbonates of the alkaline earths
 into bicarbonates, and  dissolves also iron, copper, zinc  and
lead, and attacks the best Banca  tin, which  is never free from
* Bunsen.  Gasometrische Methoden.  Braunschweig, 1857. 
12
those impurities.  The custom of keeping carbonic acid water
in metallic fountains  for any length of time must  be highly
prejudicial.   The action of carbonic acid goes continually on,
and we finally get a water highly impregnated with poisonous
metallic salts, the  carbonates  of copper and lead  rendering
carbonic acid water not only worthless, but absolutely inju-
rious.*  In France, the use of metallic fountains is prohibited
by law.
   Yarious contrivances have been used to remedy the inju-
rious effects of metals, but without success.  The only effective
way, viz., using glass fountains, seemed to be precluded by the
deficient resisting power of glass, if vessels of large capacity
are required.  We have succeeded in constructing glass foun-
tains containing ten to fifteen gallons, which will resist as great
a pressure as any metallic fountain.  It is done by surrounding
the-glass fountain with a strong and air-tight metallic casing,
and  providing a  gas communication between the  inner and
                  outer surfaces of the glass fountain.  The
                  pressure is  thus equalized, and the foun-
                  tain is only  affected by the weight of water
                  it holds.  The water itself is only in con-
                  tact with glass.  They have the great prac-
                  tical advantage  of having their gas reser-
                  voir outside.   While only two-thirds of the
                  common fountains can be made useful,
                  these can be filled up  to the neck.   We
                  hope that this notice will be sufficient to
                  recommend  them  for general  use.   Ar-
                  rangements have been made with a manu-
                   facturer f who will be able to fill all orders.
   But it should not be inferred that a good glass fountain is
sufficient for the manufacture of good carbonic acid water, as
the  gas evolved from sulphuric acid and  limestone is quite
impure.  Oil of vitriol contains sulphurous and arsenious acids,
and a considerable amount of sulphate of lead ; and the lime-
 stones are contaminated with iron pyrites and bitumen ;\ and

  ' E Parrish's Pharmacy, 1864, p. 349.   f JOHN MATTHEWS, of New York
          \ James D. Dana.  A System of Mineralogy, p. 438.
 
13
if  chalk be used, with nitrogenous organic matter.   Besides
that, the process takes place in a leaden vessel (or lined with
lead), and by the violent effervescence which ensues, a con-
siderable amount of sulphuric, sulphurous, and arsenious acids,
and of lime and lead salts are carried along with the spray,
and are only very imperfectly arrested by a common dip-pipe.
The  organic matter of the limestone adds its portion to the
flavor,  and  the whole  mass is then  incorporated  with the
water, and makes up what is called a refreshment.   Gas com-
panies might, with the same right, deliver to their consumers
illuminating gas in the condition in which it comes from their
hydraulic main and condensers ; but they have to go to con-
siderable expense  and labor to deprive it previously  of its im-
purities ; because they  can be  readily detected  by the nose,
and spoil pictures, books, and furniture; but with soda water
the matter is quite different.  Our free-and-easy  people  have
made up their minds that plain soda water is a vile drink, which
must be mixed with syrups and brandies, and, if the matter
be left to the routine of the  trade, their opinion  promises
to be of long continuance.
   The purification of carbonic acid gas has seemed to us from
the beginning a subject of the greatest importapce, and we
have labored conscientiously to invent and construct proper
apparatus, and to find suitable reagents for the perfect remo-
val of its contaminations ; and we hope that our  methods will
be generally adopted  at some  future time.  Our waters are
kept in  glass fountains, from which they  flow  bright and
sparkling, preserving their purity  and effervescence to the last
drop.   They are constantly found at the bedside of the sick,
and are generally preferred in their plain  state. We  have
been often asked the question, " What do you put into them to
give them their pleasing taste f "  They are found on the table
of the rich,  and have to a great measure displaced wines and
brandies,  and  have thus become an importaut  auxiliary in
the establishment of general health and temperate habits.
   Carbonic acid is  exhaled in great quantities in volcanic
regions  where fissures of the earth provide it with an outlet,
and  when such fissures become  accidentally obstructed, it
sometimes breaks forth with great violence.  Near the lake of 
14
Laach, there are over a thousand gas  springs in  a circular
valley which is  probably the crater  of an extinct volcano,
and some of them produce gurgling and hissing noises which
can be heard at a great distance.  Carbonic acid accumulates
also in grottoes and caves, where the diffusion of gases is im-
peded.—When pure, or when mixed with an equal volume of
air, it cannot be inhaled, because the glottis is spasmodically
closed by it.   But if mixed with a large proportion of atmos-
pheric air, it can be inhaled in considerable quantities without
any injurious  effects.   In Ems a special pavilion  has  been
erected, where patients suffering from chronic catarrh of the
air passages, have to breathe air mixed with carbonic acid.
The gas is obtained from a jet of mineral water which is con-
stantly thrown up by means of a steam engine, and converted
into spray.
   If a mixture  of carbonic acid gas  with  a large propor-
tion ( 90 per cent. M. Ilcrpin)  of atmospheric air be inhaled
for some time, a state of anaesthesia  is gradually produced
without  suffocation,  without  pain,  and  apparently with-
out grave  purturbations.  The insensibility  manifests itself
without any alterations in the appearance of the face, and the
subject can easily be brought to life  again, even  after some
time of apparent death.*  Mr. ITerpin recommended the use of
such mixtures for the continuance of the anaesthetic condition
produced by chloroform.
    There  can be little  doubt that  anaesthetic  agents  act
by an accumulation  of  carbonic acid gas  in  the  veins.
They  either supply the  blood with an inordinate amount
of oxygen (Nitrous Oxide), which, by the consequent com-
bustion of animal tissue, produces more carbonic acid than
can  be eliminated by the  lungs ; or  they consist of easily
decomposed hydrocarbons ;  or  are administered in the form
of  heavy vapors, like chloroform, which, apart from their
internal  action, increase  the amount  of carbonic  acid  by
impeding  its  egress.   To  Dr. William  Detmold,  of this
city, belongs the credit of first taking this view of the action

   * E. Salva.  Du gaz acide carbonique comme analgesique et cicatrisant des
plaies.  Paris, 1860. 
15
of anaesthetic agents, and of recommending the use of car-
bonic  acid.  In a manuscript, from which we are kindly per-
mitted to quote, he says, '''•It is not improbable, if by experi-
ence the safe and necessary proportion between carbonic acid
and atmospheric air can be established, that carbonic acid gas
will supersede all other ancesthetics as the safest and most re-
liable j because we may then measure the actual amount of
gas introduced  into the system •  and in its administration,
escape the preceding stage  of excitement which is unavoid-
able in the administration of all  other anaesthetics."   This
view gains great strength from the fact that  oxygen cannot be
used as an antidote  in anaesthesia, because it finally augments
the already too large proportion of carbonic acid in the blood.
The object must be  to eliminate that gas.   It is most readily
given  out from the lungs in  an atmosphere of hydrogen, and
it is not improbable that the substitution of hydrogen for the
nitrogen of the atmospheric  air, by giving a mixture of very
small density, will prove the most efficient means for the ter-
mination of the anaesthetic condition.*
   Mixtures of  air  with carbonic  acid  gas in large pro-
portion benumb  the system,  by  paralyzing  the  nerves;
first  affecting  volition  and  sensation,  and,  if the  appli-
cation be too long continued, proving fatal.  Carbonic  acid,
on  that  account, has enjoyed  the special honor of  being
classed among the  poisons,  but we should  not  overlook the
fact  that  that  property is shared by all gases, not excepting
oxygen when inhaled in a pure state.  The blood,  in its
normal condition, contains one volume of carbonic acid in so-
lution  ; and according to the researches of I. Sachs f the free
gases of arterial blood contain 70 per cent, of carbonic acid gas.
It is as necessary to  animal as it is  to vegetable life, but over-
doses prove fatal to both.  Even plants, although built up by
the assimilation of carbonic  acid,  die if immersed in an  at-
mosphere of  that gas.
   The effects produced by the inhalation of carbonic acid gas

  * Regnault and Reissing placed a rabbit and a dog in such an atmosphere ;
the rabbit remained in it 20 hours and the dog 10 hours without any  obvious
injury, excepting that the respiration was augmented in force.
  f Archivfiir Anat., Physiol, u. wissensch.  Med. 1863, p. 345. 
16
were known to the ancients, who ascribed them to a demonic
power.  Pythia on her tripod, in the cave of Delphi, labored
under  the  influence of  this gas,  and it is no wonder that
Apollo's priests  were often accused by the unbelieving and
vulgar, of  having great trouble in finding a good Pythia.
Sibyl gave  her  oracles under similar circumstances, in the
grotto of Cumae, where a spring rises which contains carbonic
acid gas and a little sulphuretted hydrogen.  In  the  famous
grotto del Cane,  near Vesuvius, the gas accumulates near the
bottom, while the upper strata  of air remain sufficiently pure
for respiration, and travelers are treated to the suffocation of
a dog, in precisely the same manner described by Pliny nearly
two thousand years ago;  and if that writer, Rip Van Winkle-
like, could  wake  up again, he  would be astonished at the
small change which has taken place  with some habits during
his long nap.  Such a cave, near New York, would be a regu-
lar benefit.   It  would do away  with the " cruel pond," and
many a lady would be reconciled with the loss  of her  pets by
the consolation  that  they have met with an unconscious,
anaesthetic, and instructive death.
    Carbonic acid, when  applied to the eye, produces an irri-
tant action; a burning sensation is felt, tears flow freely, and
the cornea  becomes very brilliant.  The mobility of  the iris
is increased with various disturbances  of vision.   The effects
would  probably be greatly modified,  by using a mixture of
carbonic acid and atmospheric air, or by applying carbonic
acid water.
    By applying a carbonic  acid douche to the ear, tinni-
tus aurium is produced; the external meatus becomes turgid
and red, and sometimes the hyperaemia spreads to the face.
The secretion of  cerumen is augmented, and the sense of hear-
ing is rendered more acute.  The gas is absorbed by the drum
of the  ear, and carried to the brain, and often great sleepiness
follows the operation.
    A few drops of carbonic  acid water, poured into the ear,
are kept in lively motion, the gas being liberated  by  coming
in contact  with warm surfaces, and  strange noises are pro-
duced.  It  is  as if listening to  some celebrated  gas spring,
and the magnificent impetuosity of  " a tempest in a teapot " 
17
is brought close to the hearing.  Alarge quantity of cerumen
is  dissolved, and  an agreeable sensation  of heat is felt for
several hours.
   Carbonic acid produces an acidulous and astringent taste
in the mouth, a burning sensation in the uvula, and  an in-
creased flow of saliva.   When applied to the nose, it causes
tickling and sneezing, and augments the mucous secretion of
the Schneiderian membrane, but it does not seem to affect the
olfactory nerve.
   Carbonic acid gas is used in intestinal obstructions, pro-
duced either  by an accumulation of faecal matters,  or by
internal strangulations, intussusceptions and twistings.  Apart
from  its mechanical and endosmotic effects, it  acts upon the
muscular coats of the organs by absorption, and excites in the
neighborhood  of the affected  parts peristaltic contractions,
by which the obstructions may be removed.  It has been ap-
plied by Dr. J. Schnetter, of this  city, in several cases, with
marked success.  Great care is necessary in these operations.
Harm may also be done by the use of faulty apparatus  which
supply impure gas  under great pressure, whereby irritation
and  undue distension of the membranes may be produced.
The  anaesthethic apparatus of Mr. Thomas Warker  corrects
these  objections, and can therefore be safely recommended.
                          It has achieved great reputation
                          with the physicians of Paris, and
                          has been most favorably reported
                          upon by  Professor Gavarret be-
                          fore the  Academy  of Medicine.
                          Dr. E. Salva, in his  large practice
                          and remarkable researches  on the
                          anaesthetic power of carbonic acid,
                          uses Mr.  Warker's apparatus in
                          preference to  all others, and he
                          ascribes  the ill  success of  other
                          practitioners to  the circumstance
                          that by the application of highly
compressed and impure gas, the beneficial effects of carbonic
acid are overbalanced.   He  expresses  the  hope that by the
aid of Mr. Warker's apparatus, carbonic acid gas will soon
                2
 
18
 find universal application as a therapeutic agent.*  The wood-
 cut  illustrates the  working of  the  apparatus,  and minute
 printed descriptions will be furnished to all who may desire
 to use it.
   For the anaesthetic effects of carbonic acid upon ulcerated
 surfaces, cancer, wounds, etc.,  and for its influence upon the
 expulsive power of the uterus,  we must refer the reader to
 professional publications.
    A bath in dry carbonic acid gas produces a feeling of heat
 in the skin; the abdomen, the generative organs and the lower
 extremities being  especially  affected.   The  skin  becomes
 ruddy, the sentient nerves are irritated, and in delicate per-
 sons it may even result in inflammation of the skin.  By  a
 too prolonged stay in the bath, the gas is carried to the brain,
 and a  feeling of  oppression  and drowsiness is perceived.
 According to Welsh, the gas distends the intestines, and after
 the bath,  flatus and a considerable discharge of faeces often
 take place.   Such baths are generally followed  by  copious
 perspiration, and by a feeling of increased vigor and comfort.
   A  bath in  carbonic acid water has  somewhat different
 effects. According  to Althaus,  " these  vary very much ac-
 cording to the temperature of the water.   If the bath is cold,
 a sensation of burning  in  the shin and an internal chill is
felt;  but if the  temperature  is 86° or 88°, no chill is per-
 ceived.  As soon  as the  patient is immersed in water which
 contains much carbonic acid,  the  whole surface of the body
 becomes thickly covered  with  bubbles of carbonic acid gas,
 which are in constant motion ;  and if wiped off, they imme-
 diately reappear.  In the skin, a feeling  of pricking  and
 heat is produced, which,  on the  scrotum, the back of the hand
 and of the forearm, the  face {when immersed), the nipples,
 and the labia, amounts to a burning sensation.   The  more
 carbonic acid  the water contains, the m,ore pleasant is this
 1 champagne bath.''  If the patient remains quiet and  motion-
 less  in it,  the burning sensation is  to a certain degree in-
 creased, as the, gas  bubbles remain in closer contact with the
 skin ;  but if he moves about, a feeling of cold is perceived •
* Gazette Medicale de Paris, 1861. 
19
and in many  cases this continued change from cold to heat
tends to  strengthen the skin.  During the bath the pulse be-
comes fuller, but not  accelerated, the skin appears firm and
red, its papilla swell,  the scrotum is drawn upwards and
considerably contracted, and many persons feel a burning
sensation for many  hours afterwards.   In males, even  in
such as are past the prime of life, the generative organs are
powerfully stimulated.   The bath has also a remarkable effect
upon the bladder.  The same patients who can sit in. a  com-
mon warm-water bath for half an hour, without feeling an
inclination to pass the urine, are compelled to do so after hav-
ing been immersed for only a few minutes in a carbonic acid
bath.  The inhalation of the gas which, of course, takes place
in  the bath, is by no means so unpleasant as might be sup-
posed—the carbonic acid not being sufficiently concentrated to
extinguish a candle floating on  the water ;  but if sensations
of  vertigo, oppression,  etc., are produced, it is merely neces-
sary to stand up in the bath now and then, and to breathe the
pure air in the higher strata of  the atmosphere,  in order to
obtain immediate relief P
    " The  after-effect of a carbonated water bath is, in most
cases, a feeling of increased power in the limbs ; and semi-
paralytic persons are observed to walk  briskly afterwards.
This effect is chiefly marked in females  suffering from hys-
terical paralysis, and even in the commencement of  atrophy
of the  cord, amelioration may be produced ; while in  cases
of longer  standing, in which  the nervous matter is changed
into ' veritable starch] of course, no good can be expected."
    By remaining  too long  (for an hour or so) in a strong car-
bonic acid bath, respiration and the movements of the heart
are much accelerated  {Salva), the skin gets of a scarlet color,
and its strong burning sensation forces the patient to leave the
water.  Great feebleness, which  may  last for two or three
days, often follows such experiments.
    The great therapeutical importance of these  baths is at
once apparent, and we have made the necessary arrangements
to produce them artificially.   By adding to 10 or 15 gallons
of  Croton water of 110° an equal  quantity of very strong car-
bonic  acid water from a highly charged fountain, and  by 
20
finely  dividing the escaping gas, by means of an apparatus
especially constructed for that purpose,  a carbonic acid bath
of the desired temperature,  and of great strength,  can be
readily prepared.  Patients will also have the additional com-
fort of enjoying the luxury of a carbonic acid bath at home,
thanks to the march of modern improvements.  The addition
of salts, especially of chloride of sodium, with chloride of mag-
nesium, for the preparation of brine baths,  at once suggests
itself.  They exert a stimulating surface action upon the skin,
but are not absorbed by it, as has been  often supposed.  Nu-
merous and carefully conducted experiments on that point
have at least failed to prove their absorption.  But their stim-
ulating effects continue after the bath, on  account of the
hygrometric nature of chloride of magnesium, the skin retain-
ing a moist and sticky touch,  an observation which has been
often made on the sea shore.
   The most important of the hot acidulous brine springs of
Germany are those of Nauheim.   Their composition resem-
bles strongly a concentrated Kissingen Rakoczy. The Curbrun-
nen which is used  internally, is often too strong for ordinary
constitutions, and is therefore diluted with its own volume of
a common acidulous spring.   Their physiological effects have
been minutely described by Dr. F. W. Beneke, in his  admir-
able researches :  Ueber Nauheim's  Soolthermen, etc., Mar-
burg, 1S59.
  The Serpent's Spring, of Schlangenbad, in Nassau, has also
achieved great reputation.  Since the publication  of the face-
tious volume, " The Bubbles of the Brunnen," by  Sir Francis
Head, a great  number of his fair  countrywomen  have annu-
ally flocked to the spring to regain health and beauty, and of
late even " crowned leads " have deigned to immerse their
limbs in its waters, but, perhaps,  for a different object.   Ac-
cording to Althaus, " the water of Schlangenbad has a soft
velvety feel, if taken between the fingers, and imparts a most
pleasurable sensation to  the skin.  It renders this  exceedingly
soft, supple, and, delicate, and is therefore extensively usedby
ladies, especially by those of a somewhat advanced age.   Erup-
tions are scarcely ever caused, but the bath leaves a feeling of
vigor and suppleness in the whole frame" 
21
   By referring to its analysis, by Fresenius, its invigorating
effect is found to be due to carbonic acid gas.  It issues from
quarzite, at a temperature of 87°, and is very pure water, with
a small amount of alkalies, and a rather unusual percentage
of silicic  acid; and its soft velvety feel must be ascribed to
silicate of soda or so-called " mineral soap,"  which leaves on
the skin  a fine, shiny,  varnish-like glazing, and beautifully
covers over the indentations of the tooth of time.  A little of
it can be readily put in for the ladies.
    Carbonic acid water, when drunk, produces an exhilarat-
ing effect upon the system ; it accelerates  the pulse,  renders
the head clear and the mind cheerful.  It has a pleasing, cool-
ing, and pungent effect upon the palate.  Carbonic acid forms
the chief spice of all cold drinks.  It imparts a sparkling fresh-
ness to fermented  liquors, and the quarter  of a cubic inch,
which is usually dissolved in a pound of common spring water,
is sufficient to  make it  agreeable.  Rain and river water are
also slightly impregnated with it, while boiled and distilled
water, having lost their carbonic acid, have  a heavy and un-
palatable taste.   Carbonic acid water stimulates the gustatory
nerves, the flow of saliva and the secretion  of gastric j uice,
and it is easily borne by persons with whom common water
produces heaviness in the stomach, and dyspepsia.  It essen-
tially promotes  digestion by facilitating the assimilation  of
food, and re-dissolving its mineral ingredients, which may have
become insoluble by cooking, thus performing the same func-
tions  which must be ascribed to its presence  in  the bloody
namely, of keeping the phosphates and carbonates of iron,
lime and magnesia in solution.   Carbonic acid water is the
main vehicle in the absorption of those, else insoluble combi-
nations, and should be pre-eminently used at and after meals.
   It checks" too great acidity in the stomach, cures  nausea,
and is the most natural and  effective anaesthetic  known  to
overcome  a chronic disposition  to vomit.   It  promotes the
peristaltic motions of the stomach and  intestines.   Part of it
is generally brought up by eructation, another part is absorbed
and eliminated by the lungs and skin, and  a portion remains
in the intestinal canal,  augmenting its  watery secretions, and
facilitating the  discharge of faecal matters,  which, in  some 
22
persons not accustomed to its  use, may amount to a strong
purging action.
   Carbonic acid water, like all good things, can be taken  in
excess.  The symptoms in such  cases remotely resemble those
produced by the inhalation of  the ga>, and indeed are often
due  to an actual inhalation,  especially if large tumblers be
used, and  a great deal of time be taken  in drinking the water.
The gas acts mechanically, like young beer and sweet cider in
which fermentation is going on, by distending  the stomach
and intestines, and impeding circulation.  It is carried to the
brain, benumbs the nerves, and  produces drowsiness and ver-
tigo.  In delicate persons, with very impaired digestion, almost
anything—a glass  of cold water or a small  piece  of tender-
loin—will cause similar symptoms; and they should, before
drinking the water, add to it a teaspoonful  of crushed sugar,
when the excess of  carbonic acid gas will  escape with brisk
effervescence.
   Carbonic acid water is a much esteemed remedy in  acute
febrile diseases, and is ardently desired by patients on  account
of its cooling power, which is perceptible at once in  the mouth
and  stomach.   This  cooling  effect is  due  to several causes.
Carbonic acid  is dissolved in the water  in a liquid state.  By
the heat of the membranes it is parti}7 liberated, and converted
into a gas, with a corresponding reduction of temperature, all
the  heat  necessary for the  change becoming  latent.   This
phenomenon is  observed  in  all bodies when undergoing a
similar change in the state of their aggregation, and is more
fully explained in hand books, under the appellation of latent
heat.  Another portion of carbonic acid is carried to the blood
in solution, and exerts its cooling power  when evaporated
from the lungs.  But  while  in  the blood  it must naturally
increase its normal proportion of carbonic acid,  and retard its
formation, or,  in other words, retard the combustion of animal
tissue, and the heat consequent  upon it.  And carbonic acid
actually presents many of the  phenomena  of a more active
disintegration of  tissue, with  the exception of heat.  The
movements of the heart are accelerated, the pulse becomes
harder and fuller, and it seems to  act as one of the main-
springs of circulation. 
23
   Carbonic acid is the chief remedy in chronic catarrhs, not
only of the stomach, intestines, kidneys, and bladder, but also
of the air passages.  The mucous membranes of those organs
easily absorb it, and resemble in that respect the tegumen of
fishes, which enables those dwellers of the deep to assimilate
the insignificant fraction of  gases dissolved in the water.  In
colds which affect the whole skin of the body, a sponge bath
of equal volumes of tepid and carbonic acid water will speed-
ily produce an amelioration.  It would  be natural to  treat
here more fully of the application of carbonic acid in chronic
catarrhs, but as all our waters contain an excess of it, and the
muriated alkaline Spas present the additional feature of fluidi-
fying mucus, and aiding its  elimination, we refer the reader
to them.
   Carbonic acid water, mixed with syrups, is  extensively
used as a summer beverage  under the name of soda; it also
forms a constituent of  many of the compound drinks which
are pre-eminently an American institution, and looked upon
with pride by every intelligent barkeeper.  Their vocabulary
has filled with  wonder the topers of the old world, and  duly
impressed them with the genius of American invention.  It
greatly improves a claret punch, imparting to it a refreshing
and champagne-like taste, which is at present an item worthy
of consideration.  Mixed with clarets, it is  the  usual table
drink in Paris,  and during the last  decade its use has spread
in such a prodigious manner that the decrease in the mortality
of the French capital has been ascribed, by statistical report,
to the increased consumption  of eau gazeuse.
   And herein lies the  great social importance  of carbonic
acid water.  It is not only the best antidote  for alcohol, but
also lessens the desire for spirituous liquors, and it will be the
most effective advocate of healthy and temperate  habits as
long as people must drink something. 
24
         ARTIFICIAL MINERAL  WATERS.

   All our artificial mineral waters contain an excess of car-
bonic acid gas, and their effects upon the system partake of
the general character of carbonic acid water, as modified by
the mineral ingredients dissolved in it.   They contain the gas
in three different states.   It is either free, and escapes  at  the
ordinary temperature when the pressure ceases  under which
it was kept in the bottle.  But this escape is not so rapid as
is generally supposed.  Only the excess of gas goes off with
violent  effervescence.   The remaining portion  parts  very
gradually with the water, which, being a true base, must have
a great affinity for any acid; and bubbles can be seen rising
in the morning from a glass of mineral water which has been
poured out the evening before.  Even after rapidly heating it
to the boiling point, a perceptible  quantity of carbonic acid
will still remain in the water.  Or the gas is half bound, form-
ing bicarbonates, from which one equivalent of carbonic acid
gradually escapes when the water  is  exposed to the atmos-
phere.  These compounds, being soluble only in an excess of
carbonic acid, are precipitated, and  the composition of the
water is thereby much  altered.   In this state the imported
European waters usually arrive in  this country.  Or it is
bound, forming  carbonates,  from which the gas does  not
escape, and which remain dissolved when the water is heated.
   Mineral waters have been classified according to the ingre-
dients from which they derive their specific importance. They
are represented by alkaline springs, muriated alkaline springs,
alkaline saline springs, muriated springs, bitter waters, chaly-
beate waters, lithia waters, etc., and we will consider them in
this order. 
25
                   ALKALINE SPRINGS.

          Representative :  Vichy (grande grille).
          Allied Springs :  Fachingen and Bilin.

   The baths of Vichy are  situated in the Auvergne, on the
 right bank of the river Allier, 787 feet above the level of the
 sea.  They were known to  the Romans, who used them as a
 bathing station ; they were also popular in the time of Louis
 the Sixteenth, but their great fame is coeval with the present
 imperial family.  The great  Napoleon planted  the  park of
 Vichy, and the present emperor has laid out the fine promen-
 ades on the banks of the river, and done  much  to embellish
 the town, and elevate it to a first class watering  place.   He
 favors Vichy with an annual visit, and Vichy favors him with
 a handsome revenue.  The  bathing establishments and the
 sale and exportation of the  waters are managed by a company
 which is under the supervision of the crown.  There are quite
 a number of  springs at Vichy which, though  they  differ a
 great deal in  renown, are nearly  the same in  composition.
 Their chief difference is to  be found in  their  temperature,
 which lies between 50° and 108°,  and in the amount of free
 carbonic acid.  Thepuits d' Hauterive which is the coldest,
 contains about three times as  much carbonic acid  gas as the
 famous Grande grille, and has of late  made rapid strides in
 popular favor.  The composition and temperature of the same
 springs, at Vichy, is much influenced by the amount  of rain
 that may fall in  a  season.   The Grande  grille, for instance,
 had in 1843 a temperature of 89°, while at present it is 107|°.
   If we could follow our own predilection, we would express
 the chemical composition of a  spring in cubic centimeters and
 grammes or their fraction, the relation between a cubic cen-
 timeter—the space occupied by a gramme of distilled water—
 and the gramme itself being so beautiful and simple ; for the
 convenience however of the majority of our readers, we will
not deviate from the usual custom, and express in grains the
anhydrous saline  constituents which are contained  in  16
ounces of water. 
                            26

   According to Bauer, Vichy (grande grille) contains :

    Sulphate of Potash.....
    Sulphate of Soda......
    Phosphate of  Soda.....
    Chloride of Sodium...  .
    Bromide of Sodium.....
    Iodide of  Sodium.......
    Carbonate of  Soda......
    Carbonate of  Ammonia.
    Carbonate of  Lime.....
    Carbonate of  Strontia. .
    Carbonate of Magnesia. .
    Carbonate of  Iron......
    Carbonate of Manganese
    Alumina..............
    Silicic Acid............

                                          38.9061 grains.
   Carbonic acid 6.97 grains or 14.7 cubic inches.*

   It will be seen  at a glance that carbonate  of  soda forms
the predominant  feature  of Vichy water, and in whatever
way its action may be modified by the  other  ingredients, it
decides the character  of  this Spa.  The excess of carbonic
acid gas which our preparation contains,  imparts to this very
unpalatable water  a pleasant taste.   The carbonate of soda,
like all other carbonates, is contained  in  it in  the form of a
bicarbonate.
   Carbonate  of soda is  a normal constituent^ of the blood,
rendering it alkaline and increasing the solubilfty of its albu-
minous matter.  It is also found in the  saliva, the bile,  the
mucus of the throat and intestines, the milk, etc.   By admin-
istering it internally, the  alkalinity and  fluidity of the blood
are increased; the urine is  rendered  alkaline  (by 33 grains,
d'Arcet), the secretions are increased,  and menstruation is
promoted.

   * Bouquet found also 0.01 grains of arseniate of soda and traces of borate of
soda.
1.567 grains.	
. 0.904	u
0.0324	a
4.445	a
0.001	a
0.0002	a
29.194	a
0.036	a
1.9277	u
0.0178	a
. 0.271	a
(0.009)	a
(0.003)	a
. 0.006	a
. 0.492	u
 
27
   Vichy water stimulates the stomach, and increases the
appetite, but acts only as an aperient, if large doses be taken ;
its action is diuretic.  The mucus secretion  of the bladder is
rendered  less tenacious,  and small deposits  are frequently
loosened and discharged with the urine, which by a fountain
of Vichy, will generally become  quickly alkaline.   The
amount  of acidity in the stomach influences this action; if
excessive, the alkali will become neutralized  in the primae
viae, and the reaction of the urine will not be altered.  Slight
febrile symptoms, weariness, lassitude and a feeling of intox-
icationgoften appear for a few days; but they soon give place
to a feeling of increased vigor.   Should they recur, the use
of Vichy must be discontinued ; but this rule will hardly find
any application in New  York, and mainly concerns the pa-
tients who at the Spa itself, drink such prodigious  quantities
of water.  An excessive use of Vichy causes indigestion, often
inflames the membranes of the stomach and kidneys, retards
the pulse and may induce general prostration.  These effects,
with artificial preparations, are often enhanced by a deficiency
of carbonic acid, of chlorides and sulphates of the alkalies,
and carbonates of the alkaline earths,  which are necessary for
the normal condition of the blood.
    Vichy water proves very useful  in certain forms of indi-
gestion—aversion to food, depression after meals, nausea, vom-
iting,  flatulence,  heartburn, constipation  alternating with
 diarrhoea etc—provided the symptoms arise from excessive
 acidity in, or chronic catarrh of, the stomach, or from deficient
 innervation and secretion of gastric  juice.
    In jaundice caused by catarrh of the hepatic  ducts, and
 gall stones, Vichy  proves often  curative; but if there be a
 tendency to congestion and haemorrhage, and great irritabil-
 ity of the nervous system, the carbonic acid  may prove too
 exciting, and its quantity should be reduced.   (Hot milk and
 a teaspoonful of  crushed sugar.)  The ducts  again become
 pervious, the mucus is fluidified, and after a  week or a fort-
 night,  gall stones are frequently discharged,  and  the pain
 ceases.  The use  of the water should be continued for some
 months, in  order to prevent a recurrence of the disease.  Wa- 
28
ters containing a larger amount of sulphates and chlorides are
often  more efficacious.
   Vichy water has a great reputation of curing gout, espe-
cially tonic gout  connected with febrile symptoms, inflamma-
tion of the joints and regular paroxysms of the disease.  Dr.
Althaus has great faith in the powers of Vichy for gout, if the
dyspeptic symptoms are  very prominent, but he is of opinion
that Carlsbad and the muriated lithia waters of Baden-Baden
give better promise of a cure.   In cases where patients suffer
from oedema of  the  feet, and  have a cachectic complexion,
Vichy will not help.                                •
   The "Xotice  medicate sur  Vusage des eaux minerales de
 Vichy,"  which certainly  can be expected to put the most fa-
vorable interpretation upon the efficacy of the Spa, candidly
admits that  it very  seldom happens that gout is radically
cured  by Vichy.  It diminishes the frequency, the length
and the intensity of the attacks, but it cannot cure the gouty
affections of the joints, nor dissolve gouty deposits because
they usually  consist of urate of soda.*
   Uric acid diathesis is frequently checked by the use of
Vichy, and in cases of renal calculi and gravel, Vichy water
by its diuretic  action, greatly facilitates the elimination of
these formations.  It may also serve as a preventative of cal-
culus in the bladder by fluidifying and removing mucus which
might become the nucleus of  a stone.  But its reputation as
a  solvent of stone in  the bladder is without foundation.  It
simply relieves some of the unpleasant symptoms, and proves
beneficial in certain cases of catarrh of the bladder depend-
ent upon stricture of the urethra, or atony of the bladder often
observed in old persons.
   In diabetes  connected with  gout  and disordered liver,
Vichy proves often beneficial, and effects great amelioration,
but scarcely  ever a cure.
   In chronic catarrh of  the  air-passages, after the inflam-
mation has subsided, and the disease become  chronic, the mu-
riated alkaline Spas are  usually  preferred, and in abdominal
plethora and congestion of the liver, brought on by good  liv-
* See Lithia Water and Vichy with Lithia. 
29
ing and want  of exercise, the alkaline saline Spas promise
better results.
   The so-called  Vichy salt is obtained by concentrating the
water, and collecting the formed deposit, and, of course, can-
not represent the mineral ingredients of the Spa.   The pas-
tilles of  Vichy are simply a mixture of bicarbonate of soda
with sugar and gum, sometimes flavored.

                     ------*-♦-.------


             MURIATED ALKALINE SPRINGS.

                 Representative: Selters.
          Allied Springs : Ems and Obersalzbrunn.

    Selters is situated in the valley of the Ems, in Nassau, 800
feet above the level of the sea, and has been known since the
ninth century.   The wholesome and stimulating effects of this
Spa have given it a fame which is not confined to the small
Duchy, the name of Selters (Seltzer) having become a house-
hold word in all countries.
    Immense quantities of this Spa are annually exported, and
probably form  the principal revenue of the petty sovereign of
Nassau.   Hundreds of thousands  of Selters jugs have  also
found their way across the Atlantic, and are looked upon with
a sort of reverence by our German compatriots.  The water
usually arrives here in a decomposed  condition, and having
lost its principal virtue—carbonic  acid  gas—has a flat and
unpalatable taste ;  but  anything that flows out of a Selters
jug, is believingly swallowed by them as the genuine thing.
The virtues that should be in the water are thus transferred to
the jugs,  and this circumstance has been diligently improved
upon by home  manufacturers, who buy them,  and put water
in, which they call Selters.   They use the broad  seal of the
Duke, and are  little deterred from  their mischievous practice
by his formidable navy ; only the  enlightening of the public
can-stop it.
    In England,  the Brighton Company, under the  direction
of Struve, has  taken  the bold step of manufacturing Selters 
30
water under their own name, and  encouraged and protected
by such philosophers as Faraday, it has made the Brighton
Seltzer an article indispensable to our English cousins.  We
are also greatly indebted to the advice and encouragement of
our most eminent scientific men and physicians, in the intro-
duction of our waters,  and by their kindly efforts, the great
advantage which our  glass fountains possess over common
bottles, is daily better appreciated.  These fountains are the
true representatives of natural springs in miniature.  They are
portable, and come into the sick-room ;  not requiring the pa-
tient  to travel thousands of miles,  or to wait for the cure of
his ailments till the coming summer. They flow in sparkling
purity at a gentle touch, and they  need not be emptied for
fear that the remaining portion may get stale,  as the waters
preserve their effervescence for months, and remain good to
the last drop.
    Our Selters  is rigidly prepared  according to the analysis
of Struve, with an excess of carbonic acid ; and spouts forth in
open defiance of the jug water.  In our bellicose, and in the
beginning, critical attitude towards  the Duke and his pseudo-
supporters, we have always  abidingly relied upon the physi-
cians as a reserve corps,  and they have  liberally supplied us
with canister and solid shot.   We do not,  like his friends,
cunningly and slily undermine his  trade.  We stand in open
opposition to it, and are of the opinion, as far as this country
is concerned, that he had better quit the mineral water busi-
ness, which after all does not become such a  high personage,
and devote his attention to the proper government of his sub-
jects, who otherwise might some day get a notion of popular
and state sovereignty,  and secede  from him.  His spring is
good, very good indeed, and were  we on the spot, and had
none of our fountains handy, we might be tempted to drink
from it ourselves.  Perhaps we might not get  permission to
do so, for the Duke is said to guard it with parental zeal.  Ac-
cording to Dr.  A. B. Granville, "  he even maintains armed
sentinels  at the well, to prevent strangers and intruders ap-
proaching its much coveted beverage—that its sale, so  univer-
sal and forming a goodly portion of his revenue, may not be
injured."  But his spring loses life with every mile it travels, 
31
and arrives in New  York as a dead and decomposed body,
the jugs serving as hangmen and coffins.

    According to Struve, Selters  contains in 16 ounces :

    Sulphate of Potash.................  0.3970 grains.
    Phosphate of Soda.................  0.0042    "
    Chloride of Potassium..............  0.3580    "  "
    Chloride of Sodium.................17.2920    "
    Fluoride of Calcium................  0.0018    "
    Carbonate of Soda.................  6.1533    "
    Carbonate of Lithia................  traces.
    Carbonate of Lime................. 1.8686    "
    Carbonate of Baryta............... 0.0019    "
    Carbonate of Strontia............... 0.0190    "
    Carbonate of Magnesia............. 2.0000    "
    Alumina.......................... 0.0013    "
    Silicic Acid....................... 0.3020    "

                                          28.3991 grains.
    Carbonic acid gas, 30 cubic inches.

    The springs of Ems, being situated in the small Duchy of
 Nassau, cannot be far from Selters.  They issue from a gray-
 wacke  formation in  the valley of the river Lahn, 291  feet
 above the level of the sea, and are more strongly alkaline, and
 have  less  chloride of sodium than Selters.  But their  chief
 difference lies in their high temperature, which is  85° for the
 Krahnchen, and 115° for the Kesselbrunnen, with a corre-
 sponding  diminution of gaseous constituents, and on that
 account they  are preferred  in cases  of acute  catarrhs and
 pulmonary affections, where cold springs with an excess of
 carbonic acid might prove too stimulating and cause conges-
 tions.  Patients  using our muriated alkaline  waters for such
 diseases should therefore be directed to warm the Spa, by im-
 mersing the tumbler {not the fountain)  in warm  water, or
 better, by adding to it hot milk.*   The mineral constituents
 of the springs of Ems are very constant, and nearly identical.
* In order to be brief, we will call such mixtures simply " "Warm Spas." 
32
The Emser Krithnchen, according to Fresenius, contains
16 ounces:
in 16 ounces:
    Bicarbonate of Soda..............  14.8376 grains.
      (equal to 10.484(5 of Carbonate of Soda.)
    Chloride of Sodium  ............   7.0841   "
    Sulphate of Soda................   0.1377   "
    Sulphate of Potash..............   0.3286   "
    Bicarbonate of Lime  ............   1.7246   "
    Bicarbonate of Magnesia ........   1.5051   "
    Bicarbonate of Protoxide of Iron..  (0.0166)   "
    Bicarbonate of Manganese........  (0.0072)   "
    Bicarbonate of Baryta..........|            it
    Bicarbonate of Strontia........j
    Phosphate of Alumina............   0.0032   "
    Silica..........................   0.3797   "

                                       26.0255 grains.
    Carbonic acid......8.3249 cubic inches.
   The physiological effects  of  muriated alkaline  Spas are
characterized by carbonic acid, carbonate of soda and chloride
of sodium, modified by other mineral ingredients and by the
temperature of the water.
   Chloride of sodium* is a normal constituent of the blood,
and of all parts of the human body which contains from 1000
to 2000  grains  of it.   It is a very important element in the
formation  of  cellular tissue  and of  exudation matter.   It
essentially  promotes  digestion and the secretion  of gastric
juice  and bile, and also facilitates the absorption of chyle by
the capillary vessels of the intestines.  It increases the  appe-
tite, and stimulates the peristaltic motions of the bowels, and
by augmenting the secretions of internal mucus fluidifies the
faeces which  are more easily voided.   It is  only a slight ape-
rient, its action being mainly diuretic.  It effectually prevents
putrefaction and fermentation in the intestinal canal, and by
rendering  phosphates and  sulphates  of lime more  soluble,
facilitates their  absorption.  Most of it is eliminated by the
For carbonate of soda, see Vichy. 
33
kidneys, but it is not found in the urine of persons abstaining
from  its use or suffering from pneumonia, it being probably
used up for exudation matter.  It is also excreted by the skin
in persons who use considerable  quantities of it.  According
to the experiments  of  Barral, F. W. Beneke  and others, it
augments the formation of urea from 100 to  300 per cent.,
and  must be considered as the chief promoter of the retro-
gressive metamorphosis of  matter.
   Muriated alkaline Spas, especially Selters, have the most
beneficial effect upon  the human  body.  They lessen  the
acidity in the stomach, promote digestion and the elimination
of used-up  matter, and without acting as strong aperients or
diuretics,  soon regulate the functions of the different organs,
and restore tone and vigor  to the whole system.
   In  bronchitis, if caused by cold, and if cough in the morn-
ing  and evening is the most prominent symptom, or if con-
nected  with haemorrhoidal  complaints—after  measles and
hooping cough  in children,, and in  adults who suffer from
inflammatory irritation—the warm Spa  is eminently useful;
but when the inflammatory irritation has subsided, the affec-
tion become chronic, and if there is relaxation of the mucous
membrane, the cold Spa acts most powerfully.
   In catarrh of the larynx, often found in public speakers,
clergymen, teachers, singers, etc., and due to an over-exertion
of the voice, and in catarrhs where the follicles of the mucous
membranes have assumed a granular appearance, these Spas
find  great application, and are often used as a gargle.   In
Ems, elaborate provisions have been made that the gas should
reach the  suffering  air  passages, which  can be .far  better
accomplished by simply rinsing the mouth with carbonic acid
or Selters water, when a large volume of gas will be set free,
and try to find an outlet.
    In tuberculosis of the lungs,  the reputation of the warm
Spa  is only based upon the relief it affords in fluidifying the
mucus, and facilitating a difficult  and scanty expectoration;
but if there are physical signs of tubercular infiltration, their
use,  as experience has fully shown, and  as Dr. Althaus dis-
tinctly states, " should under no circumstances  be advised, as
hcemaptoe, febrile symptoms, and an aggravation of the disease
               3 
34
altogether would be the consequence."   Neither can emphysema
of the lungs be  cured  by these or any other Spas; but the
warm  Spas of this class, by promoting expectoration, and
improving  abdominal circulation, greatly alleviate the most
troublesome symptoms.
   In catarrh of  the stomach of  a sub-acute nature, the warm
Spa  should be used at first, and with concomitant symptoms
of ulcer, enough carbonic acid gas should be allowed to escape
to prevent  any  ructus or flatus.
   In  chronic  catarrh  of the stomach, the cold Spas of this
class are a  regular panacea, especially Selters, which is some-
what richer in chloride of sodium.
   The warm Spas  of this class are generally used in chronic
catarrh of  the intestines, caused  by disturbed circulation, and
in which diarrhoea  alternates with constipation ; in certain
forms of catarrh of the hepatic ducts with impeded excretion
of bile and icterus ;  in chronic catarrh of the bladder, and in
gravel and renal calculi.  In these latter diseases they  are
often preferred to Vichy, and their potency is explained by
the theory  that neither of them dissolve, but simply aid the
elimination of solid concrements, and by curing the catarrh
of those organs prevent new formations.
   The cold Spas, especially Selters, are  often prescribed in
hcemorrhoidal veins, with inflammation of  the  mucus mem-
brane  and  haemorrhage,  arising from pressure of  stercoral
matters and other causes of abdominal plethora, and with con.
sequent affections of the nerves.  But their use  should  be
regularly continued, as the disease is apt to return.  Carlsbad
and Kissingen are sometimes preferred.
   The Ems waters, especially the Bubenquelle which is used
in the form of  an ascending douche, have earned  great fame
as the chief remedy for chronic parenchymatous metritis, hys-
terical convulsions and paralysis, and other female complaints.
We have constructed a little apparatus  in order to reproduce
the douche of any desired temperature.

  The Spa passes through a fine coil  in warm water before being con-
verted into spray.  The whole apparatus is very neat and simple, and has
the appearance of a small tin pot with handle.  We respectfully invite
physicians to examine it, and see it operate. 
35
   In conclusion we should not forget to pay a just tribute to
Selters water  on account of its great importance in many
social relations.  It not only aids the solution of the mineral
and albuminous ingredients of food which may have become
insoluble by cooking, but contains itself in admirable propor-
tion those mineral compounds necessary for the formation of
blood and  tissue, and for the structure of the human frame,
not forgetting fluoride of calcium so essential for the formation
of bones, and especially of teeth.  And should the great har-
mony which the composition of Selters in many points pre-
sents with  the normal  mineral ingredients of the blood, not
be the cause of its having become a luxury water, a Spa which
always  agrees  with the system, and of which people never
tire ?  The best authorities recommend  its use to pregnant
women,  the foetus, for a healthy development, requiring a
large proportion of mineral and especially lime salts ; and to
women  nursing infants, the milk being rendered by it more
palatable and richer in mineral ingredients,  and by greater
alkalinity not so apt to coagulate in  the stomach.  Neither
can  it be doubted that  many of the scrofulous symptoms in
children are not only caused by insufficient assimilation  and
elimination of matter, but also by a want of those mineral con-
stituents in the blood  which are  necessary for the building
up of their frame.
    Selters water is also extensively used with  tart Rhine
wines.  It imparts to  them a mild and pleasant champagne-
like taste,  and is very  effectual in preventing the acidity in
the stomach,  and the  fermentation in the intestines which
generally follow their use.  After the pleasures of the table, a
glass of Selters water, taken before going to bed,  will save to
many persons  those horrible,  indescribable sufferings,  with
which, in the morning,  they have to pay for their indulgence
in the evening, and which in the German language are com-
prised by the generic term of " Katzenjammer."
    As a general thing,  the moderate use of Selters water will
go far to keep persons in good health,  and to prevent more
serious  disturbances which require the administration of more
powerful remedies. 
36
               ALKALINE SALINE SPRINGS.
          Representative: Carlsbad.  (Sprudel).
         Allied Springs: Marienbad and Bertrich.
   The thermal springs of Carlsbad are situated in Bohemia,
near the frontiers of Saxon}r and Bavaria, in a valley of the
river Tepel, surrounded  on three sides by granite mountains,
and only open to the south  and south-west.   Their great re-
nown dates as far back as 1358, when Charles  IV. was emperor
of Germany.
   There are innumerable springs at  Carlsbad, nine of which
are used  for drinking and bathing purposes.  They have a
very constant chemical composition, but their temperature
varies between 117£° and 162£°.   Becher ascribed their heat to
the combustion of iron pyrites, and  Klaproth endeavored to
prove that it was caused by an immense bed of coal set on fire
by iron pyrites ; but later investigations have established the
fact that their heat simply corresponds to the  great depth from
which they ascend.  Here the boiling waters are under con-
siderable hydrostatic pressure, and being impregnated  with
carbonic acid gas, they decompose the rocks  which  they meet
in their subterranean course.  When  ascending to the surface
part  of the gas escapes,  and the springs spout forth  in regular
interval*, and form heavy incrustations upon the earth.
   The most famous of them is the Sprudel, which spouts 18
to 20 times in  a minute, and rises from 4 to 8 feet.   It is sur-
rounded  by large beds of sprudel stone capable  of a  high
polish.  Twenty  million pounds of sulphate, and  13 million
pounds of carbonate of soda  are  annually dissolved by it and
brought to the surface; but according to the  calculations of
Yetter,* the removal of such enormous quantities of salts can-
not  produce  any serious excavations in the interior of the
earth, as the royal castle of Berlin alone, if consisting entirely
of sulphate and carbonate of soda, would supply the Carlsbad
Sprudel  for a hundred years.
   The  great  antiquity of the  springs at Carlsbad  has been
best elucidated by the researches of  Berzelius.  It was found
that they had  their  origin in a common reservoir  which  is

  * Theoretisch-practisches Handbuch der Heilquellenlehre. Sec. Ed. Berlin, 1845. 
37
roofed over by three layers of sprudel stone.  These roofs are
supported by numerous stalagmitic  sprudel stone columns of
from one to two feet in thickness, and there are in this subter-
ranean three-story labyrinth, not only passages between the
several apartments on  the same floor,  but also between the
different stories.   After the lowest story had  been bored
through, a large  and violently agitated  reservoir of boiling
water was found, the bottom of which could  not  be sounded.
How many years were required to build up such  a structure ?
  The Carlsbad Sprudel  according  to Berzelius and Bauer,
contains in 16 ounces :
Sulphate of Potash................ 0.7166
Sulphate of Soda..................19.2840
Phosphate  of Soda................. 0.0037
Chloride of Sodium................ 7.9750
Bromide of Sodium................ 0.0091
Iodide of Sodium.. .'............... 0.0001
Fluoride of Calcium................ 0.0245
Carbonate  of Soda.................10.1320
Carbonate  of Lithia................ 0.0200
Carbonate  of Lime................. 2.3700
Carbonate  of Strontia.............. 0.0070
Carbonate  of Magnesia............. 1.3690
Carbonate of Protoxide of Iron......(0.0270)
Carbonate of Manganese...........(0.0060)
Alumina.......................... 0.0017
Silica.............................  0.5770
grains
  a
                                         42.5227 grains.
     Carbonic acid......14 cubic inches.
    Gottl, who analyzed the Sprudel in 1852, found more silica
 and phosphates,  but we prefer  to adhere to  the numbers of
 the great chemist.
    The physiological action of Carlsbad water is due to car-
 bonic acid, sulphate of soda, carbonate of soda and chloride
 of sodium (see Vichy and  Selters), greatly modified  by car-
 bonate of lime and silicic acid, and by the temperature of the
 water.
   Sulphate of soda is contained in the human blood.   Small
quantities, administered internally, are excreted by the kid- 
38
 neys ; large quantities  produce diarrhoea, and  are  said  to
 abstract from the blood an amount of water equal to 12 times
 the quantity of the saline ingested, the greater portion of the
 salt being in such cases eliminated with the faeces.   According
 to Liebig, the aperient action  of sulphate of soda depends
 upon the concentration of its  solution ; ff heavier than the
 serum,  he supposed  an amount of  water to rush from the
 blood into the  intestinal canal in order to dilute the concen-
 trated liquid.   Later experiments, of Bnchheim  and others,
 have however disproved Liebig's theory by showing that the
 same amount  of sulphate of soda,  if administered in very
 dilute solution, has an increased aperient action which seems
 very natural, the purging power of the water  itself being
 added to that of Glauber's salt.   The continued use of sul-
 phate of soda  disturbs  digestion,  and causes catarrh  of the
 intestines.
    Carlsbad water has been often  compared to Vichy, and is
 prescribed in similar diseases,  but  its amount of carbonate
 and sulphate of soda differs considerably from the celebrated
 French  Spa.   It  is a very efficient remedy in diseases of  the
 liver and abdominal plethora, rendering the faecal matters
 very rich in biliary constituents, and increasing  the amount
 of phosphoric acid in the urine.  It is neither a diuretic, nor a
 strong purgative, and shares the property of all warm  Spas of
 frequently producing constipation. There are cases on record
 where patients, during the whole time  of their sojourn  at
 Carlsbad,  suffered  from excessive costiveness ;  and  it was
 popularly believed that the Sprudel  had petrified their intes-
 tines, in  the manner observed  in wood, plants and other
 objects over which it flows.
    According  to the researches of Professor Seegen, who
 experimented  on nine persons, the quantity of faeces  voided
 was considerably increased  in two persons only  ; in three it
 remained the same, and in two others costiveness was pro-
 duced, which did not yield to large quantities  of the Spa.
 Neither  did the  amount of urinary water correspond to the
increased quantity of water  taken,  a large portion of it, on
 account of the high  temperature of the Spa being probably
 lost  by diaphoresis, while the weight of uric acid was gene- 
39
rally diminished.  We have  not sufficient data to show how
far the  physiological action of  the  Sprudel may be modi-
fied by a lower  temperature, and by an increase of carbonic
acid gas.
    In habitual constipation due  to sedentary habits, and con-
nected  with disturbed abdominal circulation, the Carlsbad
waters,  especially if allowed to cool, have a mild but certain
effect upon the  bowels,  which is  more permanent than that
produced by strong purgative waters.
   In hypercemia of the liver, arising from abdominal plethora,
and not connected with diseases of the heart and lungs ;  in
fatty degeneration of the liver, and granulated liver in  its
first stage ; and in diseases of the liver arising from ague, in
which case the  spleen is also affected—the Carlsbad waters
merit their high reputation, and seldom fail to effect a cure.
    In catarrh of the hepatic ducts  and gall stones, and also in
renal calculi and gravel,  they prove very efficacious by elimi-
nating solid concrements.
    In those forms of gout in which  catarrh of the stomach,
hyperaemia of the liver and  abdominal plethora are promi-
nent symptoms, great and lasting benefits may be expected
from their use.
    Carlsbad water has an unpalatable taste, which somewhat
resembles  salted mutton broth.  This taste is hidden in our
preparations by carbonic acid, but can be easily restored by
warming the Spa, and allowing  most of the gas to escape.
                  MURIATED WATERS.
          Representative : Kissingen (Rakoczy).
Allied Springs : Ilomburg, the tepid waters of Soden and the
        thermals of Wiessbaden and Baden-Baden.

   Kissingen is situated in the valley of the Saale, in Bavaria,
800 feet above the level of the sea.  The springs issue at an
average temperature of  50°  from variegated sandstone and
conchyliferous lime stone, and are very rich in carbonic acid. 
40
The waters come up with restless  ebullition, owing to the
constant evolution of gas, which imparts to them, when viewed
in the shaft, an opalescent appearance.  The discharge of gas
varies with changes in the atmospheric  pressure, being most
violent  at a low stand  of the barometric column ; and the
inhabitants are able to  foretell changes in the weather from
the appearance of the springs.
    The composition of the Kissingen waters is subject to great
variations.   Without attaching any great importance to
analyses famous only on account of their great antiquity, and
made in an age, when it was scientifically impossible to cor-
rectly determine the ingredients of Kissingen  or any other
Spa,—but nevertheless  often adopted  in the preparation of
artificial waters even at the present time,—so much is certain,
that the whole sum  of anhydrous mineral ingredients was
pretty correctly stated.  By comparing them  with more re-
cent examinations, it appears that a most remarkable change
must have taken place in the Kissingen waters.  We cannot
imagine that the public would  be  particularly benefited, if
we should prepare the Kissingen Rakoczy according  to the
composition it was supposed to have a hundred years ago, and
we therefore  prefer to follow  recent investigations! and  to
imitate the Spa, as near  as may be, as it flows to-day from the
bosom of nature.
   According  to Baron Liebig, who, by request of the King
of Bavaria, made the analysis on the spot, Kissingen (Rakoczy)
contains in 16 ounces :
    Chloride of Potassium............  2.2034 grains.
    Chloride of Sodium.............. 44.7133    "
    Bromide of Sodium..............  0.0644    "
    Nitrate of Soda..................  0.0715    "
    Chloride of Lithium..............  0.1537    "
    Chloride of Magnesium...........  2.3331    "
    Sulphate of Magnesia............  4.5088    "
    Carbonate of Magnesia...........  0.1309    "
    Sulphate of Lime................  2.9904    "
    Phosphate of Lime...............  0.0431    "
    Carbonate of Lime...............  8.1482    "
    Carbonate of Protoxide of Iron___  (0.2425)   " 
41
    Silica ..........................  0.0991 grains.
    Ammonia ......................  0.0070   "
    Iodide  of Sodium, Borate  of Soda,
       Sulphate of Strontia, Fluoride of
       Calcium, Phosphate of Alumina,
       (Carbonate of Manganese)......   traces.

                                       65.7094 grains.
    Carbonic acid............41.77 cubic inches.

   The  physiological effects of Rakoczy are mainly due to
carbonic acid gas, to the chlorides of sodium and lithium, and
to lime and  magnesia salts.  It was formerly believed, that
the small amount of carbonate of protoxide of iron was an
important constituent, and  the Rakoczy was classed among
the chalybeate waters ; but according to Dr. Althaus, such is
not the case.  Dr. A. B. Granville, a physician of the Spa for
the last 27 years, in his  " account of the Kissingen waters,"
lays, indeed, great stress  upon " the  quarter of one grain of
carbonate  of protoxide of iron, held in almost aetherial solu-
tion in 16 ounces of  water," and he ascribes to  it greater
immediate effects than would be produced by 10 grains of
oxide of iron or its carbonate, administered in the ordinary
way.   And he is no doubt right, and might just as well have
said 10  ounces of oxide of  iron, especially if calcined.   But
the same writer mentions that the strong  chalybeate water of
Booklet, situated about 5 English miles  from Kissingen, " is
brought in bottles to the Kissingen wells every morning, to
be drank occasionally either alone, in addition to, or in com-
bination with the Rakoczy."  And it is also a fact that pa-
tients, after  having  completed their cure  at Kissingen, are
sent to Pyrmont, Homburg,  etc., in order to drink the chaly-
beate waters of those Spas.*
    The action of chloride of sodium upon the human body,
has been considered under muriated alkaline spas, and that of
chloride of lithium we will  postpone  for lithia water.  Lime
and magnesia salts are converted by the alkaline juices of the
small intestine into phosphates and carbonates (or  yielding
                      * See Iron Water. 
42
carbonates by combustion), their acids combining with soda
and potash ; and are absorbed by the blood if enough carbonic
acid be present to keep them in solution.  If administered for
.a lengthened  period, in too large quantity, or in the absence
of carbonic acid, they have an emaciating effect, and deplete
the system of carbonate* and phosphate of soda, simply affect-
ing the intestinal canal and passing off with other indigestible
matter.  By increasing the amount of lime and magnesia in
the blood,  they are probably more effective in the treatment
of scrofula, especially in its erethic form, and of abscesses and
similar diseases of the skin, caused by a faulty composition of
the serum, than the minute proportion of iodides and bromides
contained in muriated Spas.  (Direct experiments with dilute
acidulous solutions of chloride of calcium and magnesium, in
the proportion in which these bases are  found in the blood,
could not prove but highly interesting and instructive.)
    The Kissingen Iiakoczy has a  refreshing, slightly bitter,
6alty taste, and  stimulates  the  mucous membranes  of the
stomach.   Hunger  and thirst are increased.   Its action is
mainly diuretic,  and according to  Dr. A. B. Granville, it is
only aperient  if large doses, two or three glasses, be taken.  It
at first not unfrequently produces  costiveness, but its general
tendency  is to augment the secretion in  the intestines, the
action of which becomes at length perfectly quotidian and
abundant.  In habitual constipation and clironic catarrh of
the intestines,  the internal use of Kissingen is combined  with
Kissingen bitterwater.  According  to Dr. Althaus, the  effect
of Kissingen upon the bowels is more marked  if the Spa is
allowed to  stand for some time, as a great part of the carbonic
acid then escapes.   But Dr. C. Enzmann f very sharply  con-
troverts the idea that carbonic acid impairs the aperient action
of Spas.  In his opinion the aperient effects of any saline solu-
tion are considerably increased by  the addition of any acid,
and in mineral waters by carbonic acid, which stimulates the
peristaltic motions of, and the watery secretion in, the intest-
inal  canal.   This is fortunately not the first  time, where
 * Vichy patients are sent to Kissingen.
f Die Mineralwasserkuren, etc., Dresden. 
43
 Doctors disagree.  Dr. Enzmann's theory gains much strength
 by the experience with Spas poor in carbonic acid, which are
 generally  constipating ; many  observations  however  have
 proved that the effects of Kissingen are quite different in dif-
 ferent constitutions.  With some, costiveness is produced, with
 others, a gentle aperient or even laxative action is the rule.
 Judging from the chemical composition of Kissingen water,
 it cannot be a strong purgative, and the excess of carbonic
 acid,  besides  effecting  a better absorption  of the mineral
 ingredients, and increasing diuresis, may also impart sufficient
 vigor and  tone to the system to resist an action which is after
 all only abnormal.
   The Kissingen waters are very effective  in certain fornjs of
 indigestion, owing to chronic catarrh of the stomach, deficient
 secretion of the gastric juice, liver disease and  abuse of intoxi-
 cating liquors ; also in abdominal plethora in weak, irritable
 and  scrofulous patients to whom the use of stronger waters,
 by causing relaxation of the mucous membrane of the intes-
 tines, might prove detrimental.
    They have also been warmly recommended for consump-
 tive patients if suffering from troublesome catarrh, indigestion
 and disturbed nutrition, but it is advisable to dilute the Spa
 with  its own bulk of water.  Their beneficial effect is prob-
 ably due to chloride of sodium,  which is largely used up in
 pulmonary diseases (see chloride of sodium).
    In tumors of the spleen, due to ague or to suppressed  cata-
 menia and haemorrhoids, the Kissingen treatment is often
 successful,  but should be followed by the use of saline chaly-
 beate waters.
    The use of Kissingen in chronic catarrhs is based upon its
 excess of carbonic acid.  As all our waters contain an excess
 of this important gas, there is no reason why Kissingen  should
 be preferred to the muriated alkaline Spas.
    The Kissingen waters have a great reputation for curing
gout and rheumatism, and not without cause, as they contain
 some  chloride of lithium.   By exciting the secretions  of the
intestines,  kidneys and the skin, they reduce  habitual ple-
thora, and  promote a healthy metamorphosis of  matter.  The
dose (at the springs) being from 3 to 8 tumblersfull, taken at 
44
an  interval of 15 minutes each, a sufficient amount of chlo-
ride of lithium is ingested to show  its effect upon  the uric
acid in the blood.  According to Dr. Althaus, " Patients suf-
fering from so-called irregular gout, where the joints are not
much affected and no paroxysms  take place, sometimes feel
an increase in the severity of the symptoms during the first
few weeks of the Kissingen treatment, when a paroxysm of
gout occurs which lasts for a week  or a fortnight, after which
the  health improves rapidly."  This sounds hopeful enough
for  gouty persons, but we cannot advise them to undergo an
additional pain of 4 or 6 weeks, and to swallow Kissingen
water by the gallon, on account of a little chloride of lithium.
Our lithia water  acts more promptly though more painfully,
but also more effectirdy ; and should its merits be alone  due
to  lithia  salts (which is not probable), one gallon of it ought
to  produce the same result as  46 gallons of Kissingen  Ra-
koczy.
    We must also say a  few words in condemnation of the
habit of mixing Kissingen and Vichy, half and half, a habit
which  can  have only originated in the bar  room.  It is
intended  to improve the taste, and get the benefits of both
waters.  Their character  being diametrically opposite, their
beneficial  effects  are  about  as well secured by a mixture as
those of nitric acid and caustic potash would be if well mixed
 together.
                    BITTER  WATERS.

   Representative :  Kissingen Bitterwater and Friedrichs-
      hall.
  Allied Springs : Saidschutz, Sedlitz, and Pullna.

   Bitterwaters derive their  name  from the taste  of  their
chief ingredients, the sulphates  of  soda and magnesia.   If
they contain only sulphates, they are strong purgatives ; but
a prolonged use of  them  greatly disturbs  digestion.  The
fluid in the intestinal canal is considerably augmented, only 
45
 small quantities being absorbed.   Their bad effects are usually
 increased  by a  large  percentage of sparingly  soluble lime
 salts.  The waters mentioned under the head of allied springs,
 and  more especially Piillna, belong  to that class.  The Said-
 schutz water is favorably modified by a certain proportion of
 nitrate of magnesia, to which its cooling and diuretic effects
 must be ascribed.
    But if bitter waters consist of a  mixture of sulphates and
 chlorides, the bad effects due to sulphates are entirely over-
 come, and their action is so favorably modified that according
 to Althaus,  '■'they should be used with preference, whenever
 the use of bitterwaters is required."   They are gentle purga-
 tives and diuretics.  If large doses be taken before breakfast,
 they purge strongly with gentle diuresis;  if small  doses be
 administered, they purge gently and produce a strong diuretic
 action.  The latter effect is more generally observed by taking
 the  water after breakfast.  Such are the Fried rich shall and
 Kissingen Bitterwaters.  They nearly agree in chemical com-
 position, and, as might be expected, produce identical effects.
 But the Bavarian Government would not consent to admit the
 latter in  the class of safe and aperient medicaments, before
 a certain number of well-directed  and well-observed trials
 with it had been made.  The Kissingen bitterwater was accord-
 ingly tried in extenso in the hospitals of Bavaria, and in the
' hospital of Berlin of which Dr. Herzberg was Physician-in-
 Chief.  The reports  unanimously  established  the  identical
 action of the two bitterwaters.
     According  to Baron Liebig, the Kissingen Bitterwater
 contains in 16 ounces:

        Sulphate of Soda................  46.51 grains.
        Sulphate of Magnesia............39.55    "
        Chloride of Sodium..............61.10    "
        Chloride of Magnesium..........30.25    "
        Chloride of Ammonium..........   0.02    "
        Chloride of Lithium.............  0.09    "
                                 177.52 grains.
Carbonic Acid........5.9 cubic inches.
                         i 
46
   Dr. Mossier, of Giessen, made a scries of investigations on
the physiological effects of the Friedrichshall water, and as
they are applicable to  our preparation, we will give a short
synopsis of them.
   He experimented for a period of 36 days, on three persons
who took the same amount of solid and liquid food.   In the
first period of nine days, the normal condition of the body
was determined, and no bitterwater taken.   In the second and
third series of nine days each, doses of 5, 8, 16 and 32 ounces
of bitterwater were taken before and after breakfast;  and in
the last period of nine days the after-effects were observed.
   By 5 oz. of bitterwater, the fceces were increased slightly;
8 oz., taken before breakfast, increased them 2,010 grains, and
after breakfast, 1,545 grains;  16 oz.  increased them 6,750
grains in one person and only 1,155 in another;  and with 32
oz. taken before breakfast, the increase was 17,250 grains, and
after breakfast 12,240 grains.
   The quantity of urinary water, if 5 oz. of bitterwater,
were taken before breakfast, showed an increase of 690 grains;
8 oz. taken before breakfast increased it 7,380 grains, and after
breakfast 8,175 grains; 16 oz. taken before breakfast increased
the urinary water only 1,320 grains, but after breakfast, 8,760
grains ; and 32 oz.  taken before breakfast increased  it S,250
grains, after  breakfast, 13,695 grains.  The specific gravity
of the urine  remained essentially unaltered, and its reaction
continued acid.—The quantity of urea rose with small doses
of bitterwater, and  decreased when large  doses were taken.
By the free action of the bowels, some of  the urea formed
may have been eliminated with faecal matters.—The quantity
of uric acid was diminished.
   The amount of chloride of sodium  in the urine always
corresponded to  that  of urea.  After small  doses of bitter-
water, more chloride of " sodium" was discharged than  had
been ingested by the bitterwater;* after large doses of bitter-
water, a portion of the ingested chloride of sodium passed off

  * The excess of chloride of sodium is due to the decomposition of the chloride
of magnesium of the bitterwater by the alkaline juices  of the small intestine.
Compare physiological action of Kissingen, p. 41-42 
47
 with the faeces.—The  increase of sulphates  in the urine was
 entirely due to sulphates contained in the  bitterwater; but
 the  larger  portion  of them passed off with faecal  matters.
 The rate of pulsation and respiration was somewhat increased
 by large  doses of bitterwater; the  animal  temperature  re-
 mained almost unaltered.
    By the  use of bitterwater for four consecutive days, the
 weight of the body decreased 195 grains for 5 oz. of bitter-
 water,  6,960 grains  for 8 oz., and  12,255 grains for 16  oz.
 After  32 oz. of bitterwater taken for nine consecutive days,
 the body had lost 24,075 grains in weight.  The waste  of tissue
 was mainly confined to the fat.
    The amount of urinary water remained increased, and the
 urea again rose for several days after the use of the waters
 had been  discontinued; and  the weight  of the body, after
 nine days, was larger than before the commencement of the
 experiment.
    Kissingen bitterwater  can therefore be  advantageously
 used as a purgative  and  diuretic.   If a  strong action upon
 the bowels is contemplated, as in cases of considerable accu-
 mulation of faces or congestion towards the  head and lungs,
 large doses are required at short intervals and before break-
 fast.   In  abdominal plethora, if due to  indulgence in  the
 pleasures of the table, to  sendentary habits, diseases of the
 heart,  or in pregnancy, a tumblerfull in  the morning and
 another in the evening can be continued for some time with-
 out  weakening the system.   The action of  the intestines is
 thereby regulated, and  the water will, in  many cases,  be
 found  preferable  to Carlsbad.  As a diuretic, the Kissingen
 bitterwater   can  be  used  in  certain cases  of  dropsy, and
 pleuritic and other exudations.  It is also eminently useful in
 scrofula, especially in swellings of  the cervical glands,  in
 tumors of the cellular tissue, chronic  inflammation of  the
 mucus membranes and eruptions of the skin.*

  Citrate of magnesia, as prepared by us, does not exactly

  *The common bottles which we use for Kissingen bitterwater,  Carlsbad,
and Emser Krahnchen hold two-thirds of a pint. 
48
agree with the prescribed formula.  It is  simply a strong,
slightly acidulous solution of basic citrate of magnesia, with
syrup  and excess  of  carbonic  acid, and deposits  a small
amount of the salt  after several days.  It contains no  potash.
We took the liberty to  suppose  that the use  of crystallized
bicarbonate of potash was simply intended for the conveni-
ence of druggists, as a ready mode to impart effervescence to
the potion;  and as we have better means  of impregnating
the solution with an excess of carbonic acid, the  use of bi-
carbonate of potash has been dispensed with.
   Although  citrate  of magnesia is a  popular and highly-
praised aperient, we, for our own part, would far prefer to
take the corresponding  soda salt, which  is an agreeable and
gentle cathartic, and, if absorbed, converted into  carbonate
of soda.  The magnesia salts, according to the experiments of
Lersch, are far more injurious to the system than the corre-
sponding soda salts ; and, if some observations published in
the London lancet  have  not  been disproved, the same also
applies to potash salts, if ingested in large quantity.


                      -----nm i---—

                      IRON WATER.

  , The most powerful natural chalybeates  are those which
contain much carbonic acid gas, and with the  exception of
iron, only a small amount of saline ingredients.  The iron is
dissolved  in them as  a bicarbonate, and amounts  to 0.25
a 0.80 grains of carbonate for 16 ounces of water.   Chalybeates
which are poor in carbonic acid  or which contain the iron as
a sulphate, are generally  considered as unfit for  medicinal
use.  They produce catarrh of the stomach and intestines, and
impair digestion.
   The great importance of iron to the system, has no doubt
caused the habit of administering large doses of iron prepara-
tions, and as  our iron water contains only one  grain  of the
carbonate, dissolved as a bicarbonate of the protoxide in some-
w/iat less than 16 ounces of carbonic acid water, it has been 
49
often  considered as entirely too weak.  But that is not the
case ; our iron water is stronger  and more effective than the
best natural chalybeate, and far superior to any other artifi-
cial  preparation.   A  short  examination of the manner  in
which iron is  absorbed and enters the general circulation,
will, we hope, remove  all doubt on the subject.
   Iron salts when introduced into the stomach, may be de-
composed  or not;  if  combined with an  acid stronger than
lactic, they will remain unaltered ;  if given as carbonates  of
the protoxide,  they will be converted into  sparingly soluble
lactates; in both  cases a  portion  may remain  unaltered  or
combine with phosphoric acid.  Passing further on, they meet
the decidedly  alkaline juices of  the  small intestine,  and are
decomposed  with the  exception of the insoluble phosphates ;
these may be partially absorbed if carbonic acid be present,
the phosphate  of  the protoxide of iron  being  soluble  in
about 1,000 parts  of  water  containing carbonic acid.  The
other iron salts, if soluble, will  be converted into  alkaline
salts corresponding to the acids they had been combined with,
and into the protoxide of iron or its carbonate and phosphate,
and the hydrated  oxide.   Not tartrate, lactate,  sulphate  or
iodide of iron  will be  absorbed, but tartrate, lactate and sul-
phate of soda and iodide of sodium, and only a small fraction
of protoxide of iron,  if enough water  and carbonic  acid  be
present to  keep the newly formed salts partially in solution.
The remainder will be useless;  the hydrated  oxide will  be
partially reduced  to a protoxide, and  the whole mass, after
entering combinations with tannic and  gallic acids, and form-
ing sulphurets, will constipate the intestinal canal, and  be
finally  discharged  with the faecal matters.
    After the   use  of  iodide of  iron, iodine can be readily
found in the urine, and sometimes, also, traces of iron, and it
is generally supposed  that the iodide  of iron  has been ab-
sorbed, but that the iron itself has been retained by the blood,
because wanted.   There is, however, a great fallacy in the
conclusion.  The blood of the  human body in its  normal
condition contains only 60  to 70 grains of iron,  and it is
rational to suppose that only a small fraction of that  amount
can be absorbed at one time, and  that the surplus  will  be
               4 
50
eliminated.   And, indeed, doses of half  a grain of  iron dis-
solved as a bicarbonate by  an excess of carbonic acid water
can generally be  traced in  the  urine, thus showing that they
have yielded more than a sufficiency of  iron for the formation
of haematine during a certain time; and if large doses cannot
be traced or only slightly  traced  in the urine, less than half
a grain of iron must have  been absorbed by the blood—the
remaining portion simply affects the intestinal canal, of which
proofs will not be wanting.*
   Iron water should be prescribed, except in  cases of  actual
loss of blood, after a course of other  mineral waters  whose
specific action does not depend upon iron, as Vichy, Selters,
Carlsbad and Kissingen Rakoczy.  The latter is no  chaly-
beate. It deposits its iron, according to Liebig, as a yellowish
sediment on the bottom of  the tumbler, two or three minutes
after it is taken from the well, the ebullition of the escaping
gas having  simply kept the  hydrated oxide finely divided
and suspended during that  time.   (The almost cetherial solu-
tion of Granville).  A true  chalybeate  acts quite differently.
If some of our iron water be  poured in a tumbler, it will re-
main  perfectly clear for  hours together,  and finally show a
reddish film on the surface; heated  in a.test tube it  will not
give  a yellowish deposit like Kissingen, but a heavy green
precipitate of carbonate of protoxide of iron,  and a large sur-
face has to be exposed to  the  atmosphere in  order to observe
a brownish film  after one hour.  But if it be oxydized by a
few drops of nitric acid, and ammonia  water added, a heavy
light  brown  precipitate will be produced.  Ferridcyanide of
potassium (red prussiate of  potash) is the  best test; a drop of
it will produce a  copious blue deposit.
   Kissingen patients have therefore to use other chalybeate
springs, and it is no wonder that they are even sent to Briick-
enau, which, according to Scherer, contains only 0.067 grains
of carbonate of iron, or about four times less than Kissingen
Rakoczy.  But  Briickenau is after all a true chalybeate—it

  * That iron  is sometimes excreted by the kidneys, and especially when it it
taken in natural mineral waters, is Bhown by the inky precipitate the urine gives
in these cases on the  addition of tincture of galls. " Stille's Therap.  and Mat.
Med."  1864. 387. 
51
is rich in carbonic acid, poor in saline ingredients, and holds
the iron dissolved as a bicarbonate of the protoxide.
    Small quantities of iron promote digestion and the action
of the heart, and  their physiological  effects are, in  many
respects, similar  to those  of carbonic acid gas, of which all
our waters contain an excess.  On that account, and because
carbonic acid dissolves the iron salts of food, we felt justified
in omitting the minute portions of iron stated in the analyses
in parenthesis.   The error cannot be important.   In order to
ingest 15 grains of carbonate of protoxide of iron, it would
take 555 pounds of Carlsbad, 1,250 pounds of Emser Krahn-
chen,  1,666 pounds  of Vichy, and an indefinite  amount of
Selters; and it cannot be assumed that the beneficial action
of those Spas is, in any way,- due to their chalybeate nature.
We hope  our patrons will prefer our iron water plain and
simple;  it will  certainly do as much,  and more,  for  the
system, than a large dose of any martial preparation now
in use.
    The effects of iron are marked by two distinct features :
    1.  The  number of blood globules and their haematine is
augmented.  This increase, in anaemic and chlorotic persons,
may amount to one-third of the original  number.
    2.  The phosphoric  acid * eliminated in the urinary water
is diminished.
    True chalybeates  are most admirable remedies for " an-
cemia and all morbid conditions consequent upon it;  such as
certain forms  of  indigestion,  constipation  and  diarrhoea,
amenorrhea, dysmenorrhoea, blenorrhcea of the uterus and the
vagina, sterility,  and  tendency  to  abortion." "In  certain
diseases  of the nervous system, in hzadache, neuralgia in the
back, chorea, tremor, paralysis, hysteria, and hypochondriasis,
they also prove highly beneficial."
    It should be  observed  that food containing tannic acid—
as tea and many preserves—is not admissible during a course
of iron water.  A portion of the iron would be converted

  * This diminution must be partly ascribed to the formation of an insoluble
phosphate of iron in the small intestine. 
52
into an insoluble tannate, and fail to produce those beneficial
results which otherwise may be confidently relied upon.


                    ---------♦*•♦■•---------


      LITHIA  WATER  AND VICHY  WITH LITHIA.

   Lithia was discovered by Arfvedson, a pupil of Berzelius,
in 1818, and named, at the suggestion of the great  chemist,
from Udog, a stone, because it was supposed  to  occur only in
the mineral kingdom.  It is the oxide  of a  metal closely
resembling sodium and potassium, of 0.5986 sp. gr.; and was
first obtained in the metallic state by Davy.   Its equivalent
is 7, as determined by Mallet {American Journal of Science,
18, 349).  In handbooks, it is usually stated  at 6,  or 6 and
a fraction; but the methods used in its determination were
not free from error.
   Lithia is  found  in many minerals: Spodumene, (Mass.,
Maine, and Ct.); petalite, (Mass.); lepidolite, (Mass., Maine,
and Ct.); amblygonite, triphyline, lithia-tourmaline,  &c, and
in many mineral springs, as Kreuznach, Dirrckheim, Wiess-
baden, Baden-Baden (Mur and Fettquelle), Kissingen, Bilin,
Carlsbad, Franzensbad, Marienbad, and Wheal Clifford.
   It imparts to flame a crimson color of exceeding beauty.
Soda hides this color,  and this accounts for small quanti-
ties  of  lithia having been often overlooked ; but  the spec-
trum analysis  has furnished the means of separating  the
rays of each metal,  and of detecting them, if present in the
minutest quantity.   Mixtures of the  salts  of  calcium, mag-
nesium, strontium, potassium, sodium,  lithium, rubidium,
and  caesium, if heated  in a non-luminous flame, and viewed
through the spectroscope, appear each with their character-
istic rays; and 1-100,000 of a  grain  of lithia can now be
readily discovered, while one-fourth of a grain will  cause the
crimson ray to  continue for a whole hour.
   Prof. Bunsen has, by this means, found lithia to be very
widely  diffused through  nature.  He not  only discovered it
in many rocks  and minerals and in sea  water, but also in the 
53
vegetable and  animal kingdoms.  He found it in the ashes
of sea weeds, of grapes, of vine leaves, of tobacco,  of grain
of every description, of the milk of animals  fed upon grain,
and in the ashes of the  human  blood and muscles (those of
gouty people probably excepted).
   Lipowitz first observed the great affinity of lithia for uric
acid, which is  sometimes called lithic acid—a coincidence of
names rather interesting, but quite accidental.  He found
that acid-urate of  lithia,  when not too strongly dried, is
readily soluble in sixty  parts of  water at 122°; and  that the
salt did not separate out again when the solution cooled.  By
comparative experiments with potash, soda,  and other bases,
he proved the  urates of lithia to be by far the most soluble
of all urates.
   Alexander Ure, of London, profiting by the researches of
Lipowitz, found one grain of carbonate of lithia in an ounce
of distilled water at 90° to dissolve from two to three grains
of uric acid ; a much  larger quantity than  is dissolved by
carbonate of potash and soda. He exposed a  human calculus
which was composed  of  alternate layers of uric acid and
oxalate of lime, to  the  action of four grains of carbonate of
lithia, in  one  ounce of distilled .water  at 98°, for five con-
secutive hours, and found that the calculus had lost five grains
in weight; and he proposed the  injection  of carbonate of
lithia into the bladder  for the purpose of dissolving and dis-
integrating urinary calculi.
   Had he repeated the  experiment with the same calculus,
the loss would probably  have  been  much  smaller,  as  the
action of  carbonate  of lithia  would soon  be arrested by
oxalate of  lime.   The  beneficial results expected from an
injection  of carbonate  of lithia into  the bladder would, in
all probability, be greatly lessened  by the soluble  phosphates
of the urine.  (See phosphate of lithia).
   Dr. Garrod proved the urate of lithia to be more soluble
than the carbonate; a fact already established.  His mode of
procedure, however, is interesting.   When boiling an excess
of carbonate of lithia  in water, the addition of uric  acid
caused it  to dissolve with the formation of biurate of lithia.
   uThe same  observer experimented upon a metacarpal bone, 
                            54

the phalangeal extremity of which was completely  infiltrated
with a gouty deposit of urate of soda.   This was placed in a
small glass, and a few  grains of carbonate of lithia added,
and, in the course of two or three days, the whole deposit was
dissolved without having been heated.   On making compara-
tive  experiments with  the carbonates of  lithia, potash and
soda, on a cartilage infiltrated with urate deposit, he found
that the  cartilage, taken from the lithia solution forty-eight
hours afterward, had been restored to  its normal condition ;
that from the potash was much acted upon, while that which
had been submitted to the influence of carbonate of soda, ap-
peared unaltered." He brought his observations to the notice
of the medical profession, and recommended the use of car-
bonate of lithia in cases of uric acid diathesis connected with
gravel, and in cases of chronic gout.
   Doses of one to four grains  dissolved in water, aud  re-
peated two or three times a day, produce, according to Gar-
rod, no physiological symptoms, but exert a marked influence
where the  patients are voiding uric acid,  causing gravel to
diminish and even to cease.  The supply of lithia at that time
(1S57) was so  small as to preclude the possibility of an  ex-
tended series of observations.  And lithia seems to have grown
in popular favor; although now produced in  larger quan-
tities, its supply is not nearly equal to the demand.
   The  muriated  lithia waters of Baden-Baden (Murquelle)
which contain 2-3694  grains  of chloride of  lithium in 16
ounces of  water, have only recently  been employed in cases
of gout and lithiasis.   Their physiological effects are consid-
erably modified by lime and magnesia salts, and by the tem-
perature of  the  water.   They  contain,  like  Kissingen, no
alkalies, the lithium in  both Spas  being combined  with
chlorine.
    I quote Dr. Ruef's report on the  Baden-Baden waters as
given by Althaus:
   "At first they promote digestion, and a feeling of well-being is induced;
but after they have been taken for some time, and especially when in large
doses, sickness, disposition to vomiting, and diarrhoea  ensue, which in
most cases gradually disappear, but sometimes continue as long as the
water is taken.  A constant effect is an increased elimination of urine, the
amount of which is often doubled or even trebled;  after some time it 
55
becomes turbid, and large quantities of a reddish sediment are deposited
by it.  In some patients profuse perspiration came on after from five to
ten days, and continued so long as the water was taken.   In the case of a
lady who had not freely perspired for years, this perspiration  even con-
tinued two months after the treatment was finished.  It therefore appears
that  the water is a diuretic as well as a diaphoretic.  In  almost all
patients the pain in the joints increased at first, but never spread  to
healthy parts.  In joints which were perfectly contracted, crackling, drag-
ging and pulling was felt as if the articulation was being torn asunder;
but after such an attack of pain a sensation of easiness and decided im-
provement was perceived, and the mobility of the limb much increased.
In one patient a  regular fit of gout came on while drinking  the water,
under the continued use of which this patient so rapidly improved that
he could walk about again after three days.  Gouty  affections of the
joints, the sheaths of the nerves and muscles, if not of very long standing,
were cured after three or four weeks.  In periodically recurring headache
on one side, which is often due to gout, the effects were likewise beneficial.
The mode of administering the water was as follows: For patients with
whom large quantities of water did not  agree, five grains of carbonate of
lithia were added to a bottle of Murquelle, which contains five grains  of
chloride of Hthium, and the water was then impregnated with carbonic acid.
Of this one tumblerful was taken three times a day, and if an  increase of
the dose appeared necessary, two  or three grains  of the carbonate were          ♦
added to every glass.  If patients are able to retain  much water on the
stomach, they may take six or eight tumblersful of Murquelle  without
any artificial addition of carbonate of lithia.   Baths with water of the
same spring are also given, and a mother lye is prepared from it, which
may be added to  them."
    The observations of Dr.  Ruef are  encouraging enough,
and seem  to establish  the direct effect of lithia salts upon
urate deposits of the living  body.   Lithia, if administered
internally, cannot, of course, act  under the  favorable condi-
tions of Garrod's experiments with a gouty cartilage.  Being
taken in dilute solutions, and getting diffused through the
blood, it can act upon affected joints only in the proportion
they have to the general circulation,  and  its  action will  be
further modified by the mineral ingredients of  the blood and

urine,   w
    Investigations on that subject are by no means complete.
The solubility of urates has been mostly  determined for hot
and cold solutions,  while in a  physiological point of  view it is
of the highest importance to have the determination made at
the temperature of the blood. They throw, however, much
light upon the probable formation of urate deposits,  and as it
may be agreeable  to  many of our readers to have them in a
connected form, I  will  state  the solubility of uric  acid and
urates, and other difficultly soluble mineral substances, as far
as they concern the human body. 
56
    Uric acid is almost insoluble in cold, and sparingly soluble
in warm water.  It requires about 10,000 parts of cold water
for solution.*  It  is insoluble  in alcohol and  ether.   It  is
readily dissolved  by alkaline carbonates, lactates, acetates,
borates and  phosphates; also  to some extent by chloride of
lithium, and by a warm  aqueous solution of cane sugar and
glycerine.  The solution—with  the  exception   of  lithia—
cannot be effected by heating  a mixture of  uric acid and an
alkaline carbonate, and especially carbonate of soda.  Only
a little of the urate would be  dissolved, the greater portion
of it remaining suspended in the liquor, an insoluble acid salt,
and a soluble  basic salt being apparently formed.  The best
method of obtaining a solution, is  to  dissolve the  carbonate
of soda  in boiling water, and then to add uric acid in  a sus-
pended state.
    In repeating Dr. Garrod's experiment, who added uric acid
to an excess of carbonate of lithia in boiling water, and  found
it to dissolve as biurate of lithia, I observed somewhat differ-
ent reactions.  The uric acid  is dissolved, and the excess of
lithia  gradually disappears,  but without effervescence, a urate
and a  bicarbonate of lithia being evidently formed.   The
solution remains  clear,  as  the bicarbonate  of lithia is more
soluble than the  normal salt, and the addition of small por-
tions  of uric acid can be continued for  some time,  without
producing any apparent change  in  the liquor.   After the
whole amount of  lithia  which remains uncombined   with
uric  acid, has been thus  brought to the state of  a  bicar-
bonate, a further addition of uric acid causes a violent effer-
vescence, due to the escape of carbonic acid gas.  By carefully
adding uric  acid, till further effervescence ceases, trfe  liquor
becomes opaque, but continues faintly alkaline, thus  show-
ing:

    1.  That the lithia is in the state of a urate, and,
   * The solubility of uric acid, etc., has been very differently stated by dif-
ferent observers.  I give only those numbers which seem to be entitled to  most
credit. Compare: "First  Outlines of a Dictionary of Solubilities, etc." by
Frank H. Stoeee.  Cambridge, 1863. 
57
    2. That the urate of lithia is more soluble than the carbon-
ate, and less soluble than the bicarbonate of lithia.
    By  the  addition of a little  water  the solution becomes
again clear, and again dissolves uric  acid.   It assumes an acid
reaction, the lithia being now converted into the acid salt.
    In 90 parts of water,  a mixture of one part  of  carbonate
of lithia and one part  of uric acid is easily dissolved at the
ordinary temperature;  at boiling heat, one part of  carbonate
of lithia dissolves almost 4 parts of uric acid, and one part of
caustic lithia dissolves 6 parts of uric acid (Lipowitz.)
    I found a mixture of uric acid and carbonate of lithia dis-
solved easily at the ordinary temperature, and very readily at
100° ;—a very important difference between carbonate of lithia
and other alkalies, and which may be sufficient to explain why
carbonate of soda fails to dissolve  urate deposits.   Mixtures
of uric  acid, carbonate of lithia and carbonate of soda, or of
uric  acid, chloride of lithium and carbonate of soda, can be
readily  dissolved ;  the lithium  in  the  latter case apparently
acting  as a carbonate with  an equivalent amount of  chloride
of  sodium.   No  precipitate is formed by adding to a concen-
trated  solution of  urate of lithia  a concentrated solution of
bicarbonate of soda.
    The  acid-urate  of lithia, which, as stated above, is soluble in 60 parts
of water, is also to some extent soluble in alcohol (v. Schilling).
    Urate of potash is soluble in 44 parts of cold, and 30 to 40 parts of
boiling water.
   Acid-urate of potash is soluble in 780 to 800 parts of water at 68° and
80 parts of boiling water.  It is  much less soluble in an aqueous solution of
carbonate of potash than in pure water.
    Urate of soda is soluble in 77 parts  of cold, and 75 parts of boiling
water.   Carbonic acid precipitates the acid salt from its solution in alka-
lies (see  carbonic acid in the blood).  It is  also decomposed  by the
carbonic acid of the atmosphere.
   Acid-urate of soda,  according to  Bensch, dissolves in 1,100 to  1,200
parts of water at 59° and in 125 parts  of boiling water.  It is like the
corresponding potash  salt, much less soluble in an aqueous solution of car-
bonate of soda than in pure water.
    Urate of ammonia requires 480 parts of water for solution (Proust).
    Urate of Lime is soluble in 1,500 parts  of cold, and 1,440 parts of boil-
ing water.
   Acid-urate of Lime is soluble in 603 parts of cold, and 276 parts of boil-
ing water (Drs. Allan and Bensch), and much more  readily soluble in an
aqueous solution of chloride of potassium.  Lime salts, before  the reac-
tions of lithia were known, were recommended as best calculated to pre-
vent the formation of uric acid calculi. (Ann. der Chemie und  Pharm.,
LXV., p. 184.) 
58
   Acid-urate of Magnesia, according to  Bensch, dissolves in 3,500 to
4,000 parts of cold, and in 150 to 170 parts of boiling water.
   Carbonate of Lithia is soluble in 130 parts of water and in 20 parts of
carbonic acid water.
   Carbonate of Lime is soluble in 50,000 parts of water and, if recently
precipitated, in 74 parts of carbonic acid water, (more readily soluble in
chlorides).
   Carbonate of Magnesia, if recently precipitated, is soluble in 5,071 parts
of water and in 70 parts of carbonic acid water, (more readily  soluble in
chlorides).
   Carbonate of Protoxide of Iron, if hydrated, is slightly soluble in water.
It dissolves in carbonic acid water,  also in aqueous solutions of chloride
of ammonium, and cane sugar.
   Phosphate of Lithia (3LiO  cPOs),—the only  phosphate the existence
of which has been well proved (Storer),—is soluble in 2,539 parts of pure
water at the ordinary temperature.  It is readily soluble in ammoniacal
salts and in carbonic acid water.   (The other lithia salts  are very soluble,
some of them deliquescent.)
   Bone-phosphate of Lime is insoluble in water, but dissolves, according
to Berzelius, in no  inconsiderable quantity, in  liquids  which contain
various organic non-acid substances in solution.   It is easily soluble in
water which contains chloride of sodium or chloride of ammonium, and in
carbonic acid water.   One-fourth of the dissolved phosphate (in carbonic
acid water)  remains in solution after the water has been  boiled.
   Phosphate of Protoxide of Iron is insoluble in water, but  dissolves in
about 1,000 parts of carbonic acid water.

   Uric acid  is one of the final products of the disintegration
of animal tissue.   In the normal condition of the blood  it is
readily  excreted  by the kidneys in combination  with  bases.
The action of the carbonic acid of  the blood is here of the
highest  importance.   We have already stated (see  carbonic
acid gas and carbonic acid water) that the free gases of arte-
rial blood, according to the researches of J.  Sachs, contain 70
per cent, of carbonic  acid.   This gas, which is the main sol-
vent of the phosphates and carbonates of iron,  lime and mag-
nesia in the blood, decomposes urate of soda by forming acid-

urate of soda and carbonate of  soda,  or uric acid, acid-urate
of soda and carbonate of soda, thus explaining to some extent
the acid reaction of urine.*

   The maximum quantity  of acid-urate of soda which can be
eliminated by the urinary water, depends upon the solubility

of that salt at 98°.  In the absence  of a direct  determination,


   * The tribasic phosphate of soda is converted by carbonic acid into the
bibasic salt and carbonate of soda (Rose), while the bibasic salt has the property
of yielding to " uric acid " one of the two atoms of fixed base, and of being con-
verted into an acid-phosphate, (Lehmann). 
59
we will assume its ratio of solubility to correspond to the tem-
perature, which is not improbable.  As one part of acid-urate
of soda dissolves in 1,200 parts of water at 59°, and in  125
parts of water at 212°, it should, under that supposition, dis-
solve in 273 parts of water at 98°; and if the influence which
other constituents of the urine may  exercise upon  the solu-
bility of  this salt, be not taken  into  account,  1,000 parts of
urine at 98° could not hold quite four grains of the acid salt
in solution.*
    By a disturbed  excretory action of the  kidneys, urate of
soda may be retained in the blood, and being eliminated in
other  ways, become partly insoluble.   This  action hardly
depends upon  the solubility of the acid salt, as blood neither
contains  the salts of the alkalies in  the  proportion of their
solubilities, nor presents the condition of a concentrated solu-
tion in respect to any of its mineral ingredients, and it seems
more probable that the  excretion  begins  when uric acid is
present in the  blood in more than normal proportion ;\  the
crystallization of acid-urates, and their final  formation into
solid deposits  being  an after-process.   These deposits  are
usually called  urates, and  are supposed to consist of urate of
soda with very small quantities of urate of lime and ammonia,
but  a re-examination  will  probably prove them to be mainly
acid-urate of soda.
    The  behavior of uric acid  with carbonate of soda seems
to agree well  with the established  action of  alkaline Spas,
such as Yichy.   They produce a strong diuretic action, remove
soluble urates  from the blood, and prevent a further accumu-
lation of gouty deposits.  The blood is rendered more strongly
alkaline  and is  fluidified  by the solvent action of  the alkali
upon the albumen,—and  the pain ceases.   The sufferers are

   * The turbidness observed in fresh urine on cooling,  affords to Lehmann a
proof of the presence of urate of soda, because the urine becomes again clear and
limpid when raised to the original temperature.  This  applies well for the acid
salt, the great solubility of the normal salt not being essentially affected by
changes of temperature.

   f Dr. Garrod found in the blood of gouty patients 0.004 per cent., 0.005 per
cent., and in one case even 0.0175 per cent, of uric acid. 
60
usually satisfied  with that result,  and being relieved from
pain, do not mind much the remaining knotty portions.
   Lithia goes a step further.   For a short time it troubles the
gouty patient  as  little as it would a healthy man, and seems
to be  entirely occupied  with the removal of soluble urates.
But after a few days, or at once, if the patient has been in the
habit of drinking Yichy, it attacks the affected joints, and the
pain produced (for but a short period, however) by the solu-
tion  and  resorption of urate deposits  seems  to be the very
essence of gouty  reminiscences.
   Our Lithia Water  contains in 16 ounces of carbonic acid
water:
    Chloride of Lithium................  7.203 grains.
    Bicarbonate  of Soda................32.717    "
    Sulphate  of Soda  (anhydrous)........  4       "
    Chloride of Sodium..................  0.080    "
    Chloride  of Potassium..............  1        "
    Chloride of Ammonium.............  1        "

                                          46 grains.
   By equivalent substitution it will act as :
    Bicarbonate  of Lithia...............10  grains.
    Bicarbonate  of Soda................20   "
    Sulphate  of  Soda...................  4   "
    Chloride of Sodium................10   "
    Chloride  of  Potassium............... 1   "
    Chloride of Ammonium.............  1   "

                                          46 grains.
   Our Vichy with Lithia contains in 16 ounces of Yichy
two grains of  bicarbonate of lithia introduced  as a chloride*
   The question presents itself, why lithia, acting as a  car-
bonate, is introduced as a  chloride ?  It was done mainly,
because the chances of having the whole amount of lithia ab-
sorbed, seem  greatly increased by that combination, as alka-

   * Our portable glass  fountains, holding about 24 ounces of water, would
therefore contain 15 grains of bicarbonate of lithia in lithia water, and 3 grains
of bicarbonate of  lithia in Vichy with lithia. 
61
line  chlorides are very soluble and entirely absorbed by the
blood, if not taken in too large quantity.   Some respect was
also  paid to the combinations of nature.   Our most important
and  effective lithia  Spas contain the lithia combined with
chlorine, its action upon the acid-urates being induced by the
alkalies of the blood.
   A  closer  examination of  the  composition of our lithia
water will reveal several interesting features:
    1. It  approaches Yichy  water in alkalinity, but is not
sufficiently alkaline to disturb the normal acid reaction of the
urine, whereby a precipitate of phosphate  of lime might be
caused in the bladder; it will simply reduce the acidity of the
urine.
    2. After the formation of urate of lithia, the proportion of
bicarbonate of  soda and chloride of sodium will be almost
identical with  Ems water, which is eminently useful in that
 form of  catarrh which is frequently observed in gouty per-
 sons, and sometimes alternates with true paroxysms of gout.*
     3. It has a strong diuretic action.  (Compare the action of
 carbonate of  soda,  chloride of sodium, and small quantities
 of sulphate of soda.)
     4. By the presence of alkaline chlorides the formation of
 urea, and the solubility of phosphates is promoted.
     5. The excess of carbonic acid, with some chloride of am-
 monium, f  is essential.   Without them  the formation  of a
 highly insoluble phosphate of  lithia in  the  small  intestine
 could not be well prevented.  The excess of carbonic acid also
 insures the absorption of all mineral ingredients, if not taken
 in too large quantity.
     The introduction of lithia has inspired many men with
 enthusiasm, and filled others with distrust; an  occurence not
 unusual,  when old  habits and  theories have to give way to
 new ones.   We should take a common  sense view of the mat-
 ter, and not expect impossibilities from a few grains of lithia,
 because it dissolves urate deposits.   In the first place, it can-

    * J. Althaus.  " The Spas of Europe." London, 1862.   p. 327.
     f It amounts to only one-fifth of that of gastric juice. 
62
 not dissolve stone in the bladder if that should consist  of
 phosphates and oxalates  and  not of urates.   According  to
 Dalton,* stone is formed in certain diseases of the bladder by
 too long retention, and ensuing alkaline fermentation of the
 urine, whereby the phosphate of  lime is rendered  insoluble ;
 but the experiments of Wohler and Frerichsf seem to connect
 it indirectly with  the urates in the blood.  After administer-
 ing urate of potash  to a man and a  dog, those  philosophers
 found, in both cases, large quantities  of oxalate of lime in the
 urine.
    In the second  place,  it does rot meet urate  deposits in a
 favorable molecular condition.  Being deposited very gradu-
 ally,  they  must be of a crystalline nature, and  present all the
 difficulties met with in the solution of crystallized salts.
    In the  third place, the weight of  those deposits,  in some
 cases, is not insignificant, and if expressed in grains, would be  •
 represented by a pretty high figure;  and as one grain of car-
 bonate  of  lithia, under the most favorable  circumstances,
 could not be well expected to dissolve more than two grains
 of uric acid, it would take some time  to reach a normal condi-
 tion.   The atony of organic action in old persons, and serious
 changes  in the composition of the  blood,  need hardjy  be
 mentioned.
    It should be remarked in this connection, that on one occa-
sion the above formula was changed by substituting biborate
for sulphate of soda; the inducement thereto being the com-
parative  tenacity with which  a icarm solution of biborate of
soda  retains uric  acid, even  if supersaturated by a strong
mineral acid, but the  alkalinity of our  preparation and  the
presence of chlorides renders its addition superfluous.  Still,
borax may possibly find  some external application in  diseases
connected  with  uric acid.  This  acid is mainly excreted by
the kidneys, but  according to the investigations of Wieder-
hold^: also  by the lungs  and by the skin.  Is it unreasonable
to suppose, if by a disturbed action of the kidneys an undue
amount of uric  acid is retained in the blood,  that it may in

 * Dalton's Physiology  1864, p. 361.   f Ann. der Chem. u. Pharm. LXV. 335.
           % Deutsche Klinik von A. Goeschen, Nov. 18, 1858. 
63
more than usual proportion find an outlet by the other chan-
nels ?  And may not the want of  diaphoresis, often observed
in gouty^ persons,  have something to do with an accumula-
tion of uric acid ?  A warm solution of borax readily dissolves
uric acid, and a few trials might  readily determine, how far
it can be advantageously  applied in rheumatic and  gouty
affections.
   The property of lithia,—of forming  easily  soluble acid-
urates, and of dissolving uric acid and urate deposits in the
human body,—seems to assign to it an important rank in all
diseases  in  which the formation and proportion of uric  acid
is unduly increased.  According to Lehmann, an augmenta-
tion in the amount of uric acid in the urine always accompanies
the groups of symptoms usually designated as "fevers, the uric
acid either separating or remaining dissolved.  How far  our
lithia water, by increasing  the solubility of  acid-urates, and
by its strong diuretic action, can be used for  the amelioration
of these diseases, we can only hope to learn from the observa-
tions of physicians.
   There is also a  large number of diseases from  rheuma-
tism  upwards  to chronic and inveterate  gout, and uric  acid
diathesis  connected  with gravel,  in  all of  which uric  acid
is present in abnormal  proportion.  It is not our province to
inquire into their  specific  characters and differences, but we
may be allowed to  look upon them in the relation they have
to uric acid.  They  may in that respect be divided into two
groups :  1. Where the urates are formed rapidly, and are elimi-
nated with the urinary water; or, 2. Where they are partially
retained,  accumulate more  or less slowly, and being decom-
posed by carbonic acid, are finally deposited  as acid-urates of
soda or uric  acid.
   The theory has been presented  that lithia  water should be
used in the  second  group of diseases only.   Why not  in the
first, which  often merges into the second ?  If urine is often so
highly charged with acid-urates as to deposit  them on a small
reduction of temperature, it must be in the state of a concen-
trated solution, and must  have  removed from the blood a
quantity of  acid-urates corresponding to their solubility.  It
would seem  natural that  by  the introduction  of a  better 
64
solvent, as lithia, which forms an easily soluble acid-urate, the
same amount  of urinary water would remove from the blood,
during the same time,  a much larger  quantity of uric acid
without  presenting  the  character of a  concentrated liquid.
But we will  not discuss theories; we would simply mention
that living proofs of the beneficial effects of our lithia water,
in such cases,  are walking about the streets.
  The symptoms, as far as we are able to judge, closely agree
with the observations of Dr. Euef.  The disease is at first ag-
gravated, and an increased pain in the affected parts seems to
mark  the moment when urate deposits begin to be resorbed.
After several days, according to the condition of the patient,
an  amelioration  takes place.  The increase of pain seems to
be of such uniform  occurrence that it will probably serve as
a guide in the administration of lithia water.   Still, it cannot
be called a desirable property, and it may in aggravated cases
be  wise  to first  establish a  strong  diuretic  action with less
pain, by the  use of Yichy with Lithia.   The pain produced
by lithia is not a  constitutional distemper; it is simply due to
the solution of urate deposits and to a temporary increase of
uric acid in the blood, and its degree closely corresponds to the
amount of urates that for the time being may be in solution.
This  is proved by the circumstance that the pain ceases in a
brief time, if  lithia  be  discontinued;—the  dissolved urates
are excreted, the solid  deposits are no longer affected, and
the patient believes himself  almost restored.   The  pain
reappears,  however, if  the  use  of  lithia water be  recom-
menced,  thus  affording an index of the progress of the cure.
Lithia itself is  a  very harmless alkali; if taken in the same
quantity by  a healthy person, it produces no physiological
effects, and it also  troubles the patient  less and less,  as he
nears a normal condition, the pain becoming different from
the  accustomed  twinges,  and  finally  ceasing altogether.
Lithia, it seems,  has to fulfil its mission, viz.,  remove all ab-
normal urates  from the body, and the patient, in order to be
restored, must  get well under its use.  The urinary water is
discharged in  great  abundance and becomes  perfectly clear
and limpid, and  a strong diaphoresis marks, in some cases,
the approach of a perfect cure. 
65
    In gravel,  the elimination of solid deposits is greatly in-
 creased in the beginning, and lithia water has been suspected of
 causing their formation—a charge rather  too flat for disproof.*
    In order to insure the absorption of lithia water, small doses
 —a wine-glass full—should be taken at a time.  Parrish states
 the maximum dose at 4 grains of the carbonate three times
 a day, while Dr. Ruef administered even more.   Our portable
 glass fountains contain about f of the maximum dose of lithia,
 so that patients, according to those authorities, could use one
 per day without  harm.  But from the small experience that
 has been  gathered, it is hardly advisable to do so before the
 paroxysm  of the disease has been overcome ; and it remains
 also to be seen, whether the composition of  our lithia water,
 by rendering the whole  amount of the alkali effective, neces-
 sitates the use of the  prescribed quantities.   Its  use  as a
 therapeutical agent is also of too recent a date  to afford suffi-
 cient  experience  of its  physiological action ;  we may, how-
 ever, hope that the observations which may be made with it,
 will be brought to the notice of the medical profession through
 the proper channels.
    In  preparing our lithia water, we have tried to fulfill all
 conditions necessary for its complete absorption by the blood,
 and for the utmost solubility of the ingredients of a copiously
 discharged urine; and it is to be hoped that this new alkali,
 in  the hands of the medical profession, will confer great and
 lasting benefits upon many  a poor sufferer.  As its physio-
 logical effects   are  watched  with  interest by  the attending
 physician,  new and important applications will probably be
 found for it in diseases not directly connected with uric acid.
    We quote from  an article of J. Begbie, in the Edinburgh
 Med. Journ., May,  1858, p. 983:
   " So intimate is the relation, and so frequent the concurrence of rheu-
 matism with an  unhealthy condition of the uterus, that  Dr.  Todd has
 seriously proposed the question: " Whether, under certain circumstances,
 the uterus may not be regarded as a source of rheumatic or arthritic mat-
 ter ?" and has devoted one  of his interesting Croonian lectures to the
illustration of the subject.   I incline much more to the view, that the
uterus is affected  in  its functions  and structure  through the rheumatic
blood.  We know that it suffers through gout, and that the affections thus
engendered are relieved or overcome through colchicum and such other
         * See Vichy.
5 
66
means as favor the elimination of the gouty matter.   I cannot doubt that
it is similarly affected through the rheumatic clement, hence the relief ob-
tained, in so many of its disorders, through arsenic  and other remedies,
which are known to influence that particular constitution.   I have seen
cases of peritonitis in intimate relation with  rheumatism, and doubt not
the accurate observation of those who have diagnosed rheumatic inflam-
mation of the womb. The connection of rheumatism and dysmenonlHra
has long been recognized.   Dr. Rigby writes  to Dr. Todd: ' I have been
for several years aware, that many common  derangements of the uterine
organs are frequently connected  with a state of the system analogous to
what, when it attacks the limbs, is known by the name of rheumatic gout,
arthritis, etc.  This is more especially the case with certain forms of dys-
menorrhea, inflammation of the os  and cervix uteri, with albuminous
discharge and the early  stage of scirrhus uteri.'"
   The great  therapeutical  importance of lithia has already
stimulated its production, and we may hope to have an abun-
dance of this new alkali before the lapse of many years.  Its
sources arc multiplying.  Only quite  recently, the hot springs
of Wheal Clifford,  which  yield  150  gallons of water per
minute, have been found to contain in 16 ounces, 2.85  grains
of chloride of lithium ; and the American Journal of Science
(November number, lstfl) in alluding to  that important dis-
covery, very appropriately  remarks:  " Both chemists and
medical men will hail this  supply of lithium"

                      ---------«-♦-.---------

    THE LESSER  INGREDIENTS OF  MINERAL WATERS.

   In defining the character of mineral springs, according to
their most prominent constituents, we have purposely omitted
the consideration of other  ingredients  which  are present  in
smaller  quantities,  and common  to  most.    Although this
mode of  considering  the  physiological action of springs is
very convenient for  the elucidation of their characteristic dif-
ferences, it conveys  an erroneous idea  of their therapeutical
value;  a spring  being a remedy,  not on account of one  or
two  ingredients—as chloride of sodium, carbonate or sulphate
of soda, from which it takes its  character—but on account
of the sum of its mineral ingredients.   We have only to com-
pare their quantities and mixture with  the mineral portion of
the human blood, in order to at once perceive a striking re-
semblance, and to divine the importance of  the lesser ingre-
dients. 
67
   The composition of mineral springs is governed by the
rocks and strata which they permeate,  the amount of water
they discharge, with its temperature and hydrostatic pressure,
and the volume of carbonic acid gas dissolved in it; also, by
the time the springs  have been  in  contact  with the rocks.
The saline substances are not usually removed from the latter
by a simple process of solution, as mineral springs,  although
their nature depends upon that of the  rocks, never represent
their composition in  a soluble form.  Their action is a decom-
posing one, and mainly due to carbonic acid which has the
power of withdrawing from all silicates their base, if that be
soluble in carbonic acid water.  And this decomposing action
of carbonic acid water, together with its property of keeping
a number of  saline substances in solution which  would be
insoluble in common water, is the great foundation of modern
geology and of all organic life.
    Plants draw their nourishment  from the earth  in a man-
ner  which, in many respects, is similar to that of mineral
springs.  They have to a certain extent the power of assimi-
lating or rejecting mineral  substances as they may be either
necessary or  superfluous  for their growth, while the action of
springs is determined by fixed laws of affinities and solubili-
ties  of chemical  substances; but both effect a solution by
means of water and  carbonic acid, and both depend upon the
nature of the soil.  The striking differences between mineral
springs, ,as they may issue  in  a  granite, limestone, or sand-
stone region,  are reproduced on  a grander  and more varied
scale, in the  vegetable kingdom.  We find species,  genera
and whole families  of plants disappear and make room for
others,  according  to changes of soil, of temperature and the
amount of water; and if we deduct from them their organic
portion  in an anhydrous form,  we have  nothing  left but a
mineral water, or something that has been one, of a composi-
tion almost uniform  in the  same tribes.
    We can look upon food as a combination of an  anhydrous
organic portion, and the ingredients of a mineral water which
by the  addition of water and gastric juice  or  carbonic acid
are  again  made  soluble.   Fermented  liquors,  as beer,  cider
and wine, contain only a small portion of alcohol and organic 
68
matter; their bulk consists of a mineral water rich in car-
bonic acid.  And is it surprising that we should find a simi-
lar  relation  in  the  human body which is built  up by  the
assimilation  of vegetable food, or by the flesh of animals fvd
upon  it?  If we  deduct from the blood its organic portion,
we find a mineral water coursing in our veins which contains
about  30 cubic inches of carbonic acid gas  for every  16
ounces.
   The mineral ingredients  of the blood  are, within  small
limits, present  in a fixed  proportion, which  is of vital  im-
portance to  a healthy condition of the system.   They  are
all  necessary.   A man  who can be starved to death by  an
abundance of food  in which certain  organic principles are
wanting,  can   be equally starved  by the  abstraction  of
chloride of  sodium;  and a  child fed on substances which
are destitute of lime salts, would soon share the fate of the
grasses on some guano  islands which, with the exception of
silicic acid, find everything in abundance for a luxurious life,
but'soon break  down, wither  and die for want of a material
which is indispensable to the  building up of their stems.
   The great effectiveness of certain Spas should not, therefore,
be ascribed  to  one or two of its prominent constituents, but
to the very  harmony which their composition  presents with
the mineral ingredients of the  human blood.  Let us take
Selters, for example, and  compare its composition with that
of the ashes of  blood serum, according to an analysis  which
is considered as the most reliable one (by Lehmann):
                             Blood serum.          Selters.
     Chloride of Sodium.......17.292 grains.   17.2920
     Chloride of Potassium.....  1.150          0.3580
     Carbonate of Soda........  8.180          6.1533
     Phosphate of Soda........  0.900          0.0042
     Sulphate of Potash........  0.780          0.3970

    The resemblance would be still more striking, should we
compare all mineral  ingredients of the Uood  with those of
Selters ; and that Spa has, on that account, always seemed to
us, of all natural mineral waters, the most philosophically
compounded.   It is not a whim  that  has  made  of Selters a 
69
luxury ;  it is not an accident that it agrees with people, that
it is always liked, and  that they never get tired  of its use.
We explain it by the composition of the Spa; it furnishes the
normal mineral  ingredients  of the blood in a condition in
which they are easily absorbed, independently of the state of
digestion ; it must have a tendency to establish them in their
"normal fixed  proportion, and to induce a healthy metamor-
phosis of matter by reflex action.   It  is also apparent why
other Spas of more marked variations can be advantageously
used for the  restoration of a normal condition of the blood,
in  cases where its  composition has undergone more  serious
changes; and  why  carbonic  acid  water, by dissolving  the
mineral ingredients of food, will gradually produce the same
result.  The single consideration that blood contains its own
volume of carbonic acid gas in solution, shows the importance
of using water of the same condition.  The production of car-
bonic acid is largest in  a healthy state of the system, and is
always diminished in clironic diseases, and in most conditions
which interfere with perfect health; and as that gas must
form an important constituent of the gastric juice  and intes-
tinal liquids, we find such disorders usually accompanied by
impaired digestion, and the use of carbonated  waters  signal-
ized by improved nutrition.
    Exception has been taken to mineral waters, that they are
poor in phosphates, but if we take into consideration that  a
large proportion of the phosphates of food are eliminated with
faecal matters, an  artificial introduction of them seems hardly
advisable.   The excess of carbonic acid will certainly dissolve
as many as can be absorbed, and.even if bicarbonate of lime
should enter the blood, it would probably  undergo a transfor-
mation by the presence of phosphate of soda.  Or, may we
not also supply phosphoric acid, and, emancipating ourselves
entirely from the  accidental productions of nature, prepare a
normal mineral water, the composition of which  should be
in perfect  harmony with  the  normal mineral ingredients of
the human blood ?  It might form the basis of all Spas, their
differences to consist  only in  the increase  of one or two sub-
stances, as carbonate or sulphate of soda, chloride of sodium,
carbonate of protoxide of iron, etc., and if we should  honor 
70
the nqrmal mineral water with the name of Normal Sellers,
the others might conveniently be called Normal Vichy, Nor-
mal Carlsbad, Normal Kissingen and Normal Iron Water.
    But natural springs seem to provide abundant means  for
the treatment of various  diseases.   They annually restore
thousands of patients who  had been dismissed as bad  eases
and sent to them as a last refuge;  and when  the  farewell
bumper is emptied in praise of the bubbling waters, and bless-
ings are showered upon them for the new lease of life, little is
thought of the intimate relation which exists between our own
nature and that of the  springs.   They are the living beings of
inanimate nature, exhaling the same gas which  escapes from
our lungs, and often imitating the very pulsations of a living
body ; and they contain in   admirable proportion those min-
eral substances which are necessary to us  for perfect health
and a rational enjoyment of life. 
ERRATA.
Page 5, 6th line from bottom, read " Callirhoe."
Page 5, 3d line from bottom, read " into the."
Page 14,17th line from top, read " 80 to 90 per cent."
Page 15, 4th line from bottom, read " Reissig."
Page 83,1st line from bottom, read "hsemoptoe."
Page 41, 4th line from bottom, read " Spas."
Page 43,1st line from bottom, read " tumblersful."
Page 47,11th line from bottom, read " tumblerful." 
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