1911 Encyclopædia Britannica/Mineral Waters

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1911 Encyclopædia Britannica, Volume 18

Mineral Waters

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37107721911 Encyclopædia Britannica, Volume 18 — Mineral Waters

MINERAL WATERS. No absolute line of demarcation can be drawn between ordinary and mineral waters. There is usually in the latter an excess of mineral constituents or of temperature, but some drinking waters contain more mineral constituents than others that are called mineral waters, and many very pure waters, both cold and warm, have been regarded for ages as mineral springs.

As to the origin of mineral waters, there is much in what the elder Pliny said, that waters are such as the soil through which they flow. Thus in limestone and chalk districts an excess of lime is usually present, and the waters of a particular district have much resemblance to each other—as in the Eifel, in Auvergne, and in the Pyrenees. But this is only a partial explanation, for waters are by no means necessarily uniform throughout a particular geological formation. We do not know with any certainty the depth from which various mineral waters proceed, nor the various distances from the surface at which they take up their different mineral constituents. The source of the temperature of thermal waters remains a subject of much uncertainty. Among the assigned causes are the internal heat of the globe, or the development of heat by chemical or electrical agencies in the strata through which they arise.

Their occasional intermittence is doubtless often dependent on the periodical generation of steam, as in the case of the Geysers. A few geological facts are certain, which bear on the origin of mineral waters. Such springs are most abundant in volcanic districts, where many salts of soda and much carbonic acid are present. They occur most frequently at meetings of stratified with unstratified rocks, in saddles, and at points where there has been dislocation of strata.

The diffusion of mineral waters is very extended. Pliny was quite correct in observing that they are to be found on alpine heights and arising from the bottom of the ocean. They are found at the snow in the Himalayas and they rise from the sea at Baiae and Ischia. They are to be found in all quarters of the globe, but more particularly in volcanic regions, as in the Eifel and Auvergne, in the Bay of Naples, and parts of Greece, in Iceland, New Zealand and Japan, But there are few countries in which they are not to be found, except in very flat ones, and in deltas of rivers—for instance, in the north of France, where they are very few, and in Holland, from which they are absent. France, Germany, Italy and Spain, as well as Greece, Asia Minor, and the Caucasus, are all rich in mineral waters. The British Isles have a fair though not very large proportion of them. There are a few in Sweden and Norway. They are abundant in the United States, less so in Canada. They are found in the Azores and in the West India Islands. Of their occurrence in the interior of Africa or of Australia we know little; and the same is true of South America. But they are met with in Algiers, in Egypt, and in the Holy Land. The vast Indian peninsula has for its size a comparatively small supply.

Mineral waters, when analysed, are found to contain a great many substances, although some of them occur only in very minute quantities: soda, magnesia, calcium, potash, alumina, iron, boron, iodine, bromine, arsenic, lithium, caesium, rubidium, fluorine, barium, copper, zinc, manganese, strontium, silica, phosphorus, besides extractive matters, and various organic deposits known under the name of glairin or baregin. Of gases, there have been found carbonic acid, hydrosulphuric acid, nitrogen, hydrogen, oxygen and ammonia. Of all these by far the most important in a therapeutic point of view are sodium, magnesia and iron, carbonic acid, sulphur, and perhaps hydrosulphuric acid. These substances, detected separately by chemists, are in their analyses combined by them into various salts, if not with absolute certainty, undoubtedly with a close approximation to it. Those combinations are very numerous, and some waters contain ten to twenty of them; but there are always some predominating ones which mark their character, while, many of them, such as caesium, rubidium, or fluorine, occur in mere traces, and cannot be assumed to be of any real importance. Mineral waters therefore resolve themselves into weaker or stronger solutions of salts and gases in water of higher or lower temperature. For medical purposes they are used either externally or internally. As the quantity of salts present commonly bears but a very small proportion to that of the fluid containing them, water becomes a very influential agent in mineral-water treatment, about which it is therefore necessary to say something.

For the action of mineral-water baths see Balneotherapeutics. According to the most generally received opinion, the cutaneous surface does not absorb any portion of the salts in a mineral-water bath, although it may absorb a little gas (and alkaline water, for instance, at most acting as a slight detergent on the skin), and that neither salts nor gases have any action on the system, except as stimulants of the skin, with partial action on the respiratory organs.

It seems to be ascertained that drinking considerable amounts of cold water reduces the temperature of the body, diminishes the frequency of the pulse, and increases the blood pressure temporarily. Water when introduced into the stomach, especially if it be empty, is quickly absorbed; but, although much of the water passes into the veins, there is no proof that it ever produces in them, as is sometimes supposed, a state of fluidity or wateriness. Therapeutically, the imbibition of large quantities of water leads to a sort of general washing out of the organs. This produces a temporary increase of certain excretions, augmented diuresis, and a quantitative increase of urea, of chloride of sodium, and of phosphoric and sulphuric acids in the urine. Both the sensible and the insensible perspirations are augmented. A draught of cold water undoubtedly stimulates the peristaltic action of the intestines. On the whole water slightly warm is best borne by the stomach, and is more easily absorbed by it than cold water; and warm waters are more useful than cold ones when there is much gastric irritability. In addition to the therapeutic action of mineral waters, there are certain very important subsidiary considerations which must not be overlooked. An individual who goes from home to drink them finds himself in a different climate, with possibly a considerable change in altitude. His diet is necessarily altered, and his usual home drinks are given up. There is change in the hours of going to bed and of rising. He is relieved from the routine of usual duties, and thrown into new and probably cheerful society. He takes more exercise than when at home, and is more in the open air, and this probably at the best season of the year. So important has this matter of season and climate been found that it is an established axiom that waters can be used to the greatest advantage during the summer months and in fine weather, and during the periods most convenient for relaxation from business. Summer is therefore the bath season, but of late years provision has been made in many places, with the aid of specially constructed rooms and passages, for carrying out cures satisfactorily during the winter season, e.g. at Aix-la-Chapelle, Wiesbaden, Baden Baden, Baden in Switzerland, Dax, Vichy and Bath. The ordinary bath season extends from the 15th of May to the 20th or 30th of September. The season for baths situated at considerable elevations commences a month later and terminates some ten days earlier. Mineral waters may be employed at home, but patients seldom so use them; and this necessarily limits the time of their use. It is common to declare that the treatment should last for such or such a period. But the length of time for which any remedy is to be used must depend on its effect, and on the nature of the particular case. It is found, however, that the continued use of mineral waters leads to certain disturbances of the system, which have been called crises, such as sleeplessness, colics and diarrhoea, and to skin eruptions known as la poussée. This cause, and also certain peculiarities of the female constitution, have led to the period of three weeks to a month being considered the usual period for treatment. A certain after-treatment is often prescribed—such as persistence in a particular diet, visiting springs or climates of a different and usually of a tonic character, or continuing for a certain time to drink the Waters at home. It may be added that the advantage of having recourse to mineral waters is often felt more after than during treatment.

Since improved methods of bottling have been discovered, and the advantage of an additional supply of carbonic acid has been appreciated, the export of waters from their sources has increased enormously, and most of the principal waters can now be advantageously used at home. It may be added that many of the artificial imitations of them are excellent.

Table I.—*Typical Mineral Waters*.
	Indifferent. Gastein 95°–118°.	Earthy. Leuk. 123·8°	Salt. Kissinen.	Salt. Sea-Water.	Sulphur. Aix-la- Chapelle. 113°–140°	Iron. Schwalbach.	Alkaline. Vichy. 105·8°.	Alkaline- Saline. Carlsbad. 119°–138°.	Table Water. Seltzers.	Purging Water. Hunyadi Janos.
Solids.
Bicarbonate of soda	—	—	—	—	0·6449	0·0206	4·883	1·92	1·2	—
Bicarbonate of„ potash	—	—	—	—	—	—	0·352	—	—	—
Bicarbonate of„ magnesia	0·0017	0·013	0·017	0·45	0·0506	0·2122	0·303	0·18	—	—
Bicarbonate of„ calcium	0·0195	0·012	1·06	2·38	0·157	0·2213	0·434	0·428		—
Sulphate of soda	0·0208	0·050	—	—	0·2831	0·0079	0·292	2·37	—	15·9
Sulphate of„ potash	0·0135	0·038	—	—	0·1527	0·0037	—	0·16	—	—
Sulphate of„ magnesia	—	0·308	0·588	2·96	—	—	—	—	0·46	16·0
Sulphate of„ calcium	—	1·520	0·389	0·25		—	—	—	—	—
Sulphide of sodium	—	—	—	—	0·0136	—	—	—	—	—
Chloride of sodium	0·0428	—	5·52	25·21	2·616	—	0·534	1·03	2·2	1·3
Chloride of„ potash	—	—	0·286	—	—	—	—	—	—	—
Chloride of„ magnesia	—	—	0·303	3·39	—	—	—	—	—	—
Carbonate of iron	0·0005	0·023	0·277	—	—	0·0837	—	0·003	0·01	—
Silicic acid	0·0496	0·036	—	—	—	0·0320	—	—	—	—
Gases
Carbonic acid	—	—	3·19	—	—	5·35	2·6	0·76	2·24	0·45
Hydrosulphuric acid	—	—	—	—	trace	—	—	—	—	—

The history of the use of mineral waters can only just be alluded to. They have been employed from the earliest periods, and traces of Roman work have been found at most of the European baths which are now in favour at almost all the thermal ones. Occasionally new springs are discovered in old countries, but the great majority of them have been long known. Warm waters, and those containing small quantities of mineral constituents, appear to have remained more steadily in favour than any other class within the appropriate sphere of mineral waters, which is limited to the treatment of chronic disease. The attempt has been made to range mineral waters according to their therapeutic action, according to their internal or external use, but most generally according to their chemical constituents so far as they have been from time to time understood; and a judicious classification undoubtedly is a help towards their rational employment. But their constituents are so varied, and the gradations between different waters are so finely shaded off, that it has been found impossible to propose any one definite scientific classification that is not open to numberless objections. Thus a great many of the sulphur waters are practically earthy or saline ones. Yet because they contain very minute amounts of such a gas as hydrosulphuric acid, an ingredient so palpable as always to attract. attention, it is considered necessary to class them under the head of sulphur. The general rule is to attempt to class a water under the head of its predominant element; but if the amount of that be extremely small, this leads to such waters as those of Mont Dore being classified as alkaline or arseniated, because they contain a very little soda and arsenic. The classification in the following table, which is that usually adopted in Germany, has the merit of comparative simplicity, and of freedom from theoretical considerations Which in this matter influence the French much more than the German writers. The more important constituents only are given. The amount of solid constituents is the number of parts to one thousand parts of the water; the temperature of thermal springs is added. The waters are classified as indifferent, earthy, salt, sulphuretted, iron, alkaline, alkaline-saline—with subvarieties of table waters and purging waters.

In addition to their solid constituents, gas is present in many waters in considerable quantity. There is a little oxygen and a good deal of nitrogen in some of them; the quantity of hydrosulphuric acid, even in strong sulphuric waters, is wonderfully small; but the volume of carbonic acid present is often very large—for instance, in the case of Kissingen, Schwalbach and Selters. The immediate effect of the carbonic acid which they contain is that of pleasant stimulation to the stomach and system. Extremely little appears to be known of its actual operation on the system: a part of what is swallowed is returned by eructation, and a part passes on to the intestines; whether any appreciable quantity reaches the blood is doubtful. There is no question that carbonic acid increases diuresis. Practically it is found to aid digestion, helping the functions of the stomach, and in a slight degree the peristaltic action of the intestines. The increased flow of urine may be caused by its favouring the absorption of water by the stomach. In some baths carbonic acid is so abundant that precautions have to be taken to prevent its tendency to accumulate on account of its heavy specific gravity. Carbonic acid gas, used as a bath, proves stimulating to the skin and to the general system; but its employment has not answered the expectations formed of it.

Table II.^[1]—*Indifferent Waters*.
Locality.	Height in Ft.	Temp. °Fahr.	For what prescribed.
Evian, Lake of Geneva	1100	—	Nervous cases, dyspepsia, urinary affections.
Badenweiler, Baden	1425	—	For mild rheumatic treatment; a health resort.
Buxton, England	980	82	Gout and rheumatism (nitrogen present).
Schlangenbad, Nassau	800	80–87	Nervous cases, female disorders, skin.
Sacedon, Spain	1500	85	Rheumatism, gout, cutaneous affections.
Wildbad, Württemtberg	1320	90–101	Gout and rheumatism, neuralgia, thickenings.
Pfeffers, Switzerland	2115	99	Do. do. do.
Ragatz, do.	1570	95	Do. do. do.
Panticosa, S. Pyrenees	5110	85–95	Do. (nitrogen present); special action in phthisis.
Teplitz, Bohemia	648	101–120	Gout, rheumatism, old injuries, joints or bones.
Gastein, Austria	3315	95–118	Do. do.; soothes nervous system.

Indifferent Waters scarcely vary in chemical qualities from ordinary drinking water; but they are usually of higher temperature. Their therapeutic action, which is mainly exercised through baths, has been explained on the theory of peculiarities of their electric or thermal condition, about which we know nothing definite, and on the presence in some of them of a large quantity of nitrogen. It has also been ascribed to the various organic substances in some of them, such as glairin, which when collected is sometimes useful as a cataplasm. These waters are not often much drunk, but any efficiency they may have in dyspepsia and perhaps in neuralgic diarrhoeas must be attributed to the favourable action of hot water on the digestion. The waters of this class, especially the hotter ones in the form of baths, are extremely useful in resolving the effects of inflammation, in thickenings of the joints and in chronic rheumatism and gout. They also are often effective, especially the cooler ones, in neuralgia and in some hysterical affections. They are sometimes prescribed in urinary affections, in which case they probably assist by dilution. The effects of many of these waters are aided by the baths often being situated at considerable elevations and in out-of-the-way spots, whence the Germans called them Wildbäder. They are very widely diffused, being found in all quarters of the globe, especially in volcanic districts. There are many in New Zealand; in America the hottest are in the west and in California.

Earthy Waters.—These differ chiefly from the indifferent waters in containing an appreciable quantity of salts, among which sulphate or carbonate of lime or of magnesia predominates. The great majority of them are of high temperature. They produce the same effects as the indifferent waters, but are perhaps less efficacious in neuralgic affections, while they are more employed in some of the chronic scaly eruptions. There was formerly a tendency to consider these waters useful in urinary affections; but at the present day it is only the colder ones that have come into repute for the expulsion of gravel and biliary calculi and in the treatment of affections of the bladder generally. Some of them have also of late years been considered to exercise a favourable influence on scrofula, and to be useful in the early stages of pulmonary phthisis. This has been attributed to the salts of lime present in them, although it is known that most of its salts pass through the system unaltered. Many of these baths, such as Leuk and Bormio, enjoy the advantages of great elevation, but Bath, otherwise one of the best of them, lies low.

Table III.—*Earthy Waters*.
Locality.			Height in Ft.	Temp. ° Fahr.	Therapeutic Action.
C o l d	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \\\ \ \end{matrix}}\right.}$	Contrexéville, Vosges	1050	—	Special action in calculous affections.
		Lippspringe, N. Germany	—	—	Supposed to be useful in phthisis.
		Wildungen, do.	—	—	Special use in urinary complaints; contains iron.
		Weissenberg, Switzerland	2600	—	Resorted to for pulmonary affections.
		Pougues, France	600	—	Dyspepsia, diabetes, hepatic and urinary concretions.
W a r m	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \\\ \\\ \\\ \ \end{matrix}}\right.}$	Baden, Switzerland	1180	117–122	Rheumatism, gout, paralysis, scaly eruptions.
		Leuk, do.	4400	93–123	Do., some female complaints.
		Bormio, North Italy	4400	86–104	Do. do.; old sprains.
		Lucca, Italy	—	108–122	Do. do.⁠do.
		Bath, England	—	108–122	Do. do.⁠do.
		Dax, south of France	1400	139	Do. do.
		B. de Bigorres, Pyrenees	1800	64–123	Do. chlorosis, neuralgia.

Salt Waters are so called from containing a predominant amount of chloride of sodium. They also generally contain chlorides of magnesia and of lime, and occasionally small amounts of lithium, bromine and iodine. They further often contain a little iron, which is an important addition. The great majority of the drinking wells have a large supply of carbonic acid. There are cold and hot salt springs. Sometimes they are used for drinking, sometimes for bathing; and the double use of them is often resorted to.

The normal quantity of common salt consumed daily by man is usually set down at about 300 grains. The maximum quantity likely to be taken at any well may be 225 grains, but commonly not more than half of that amount is taken. The increase to the usual daily amount is therefore probably not much more than one-third. Still it may be presumed that the action of a solution of salt on an empty stomach is different from that of the same amount of salt taken with food. Salt introduced into the stomach excites the secretion of gastric juice and favours the peristaltic actions, and when taken in considerable quantity is distinctly aperient. We thus see how it is useful in dyspepsia, in atony of the stomach and intestines, and sometimes in chronic intestinal catarrh. Salt when absorbed by the stomach appears again in the urine, of which it increases the amount both of fluid and of solid constituents, especially of the urea. It seems, therefore, to be pretty certain that considerable quantities of salt taken into the circulation increase the excretion of nitrogenous products through the urine, and on the whole accelerate the transformation of tissue. Salt is thus useful in scrofula by stimulating the system, and also in anaemia, especially when iron is also present. In some German stations, as at Soden, carbonated salt waters are considered to be useful in chronic laryngitis or granular pharyngitis.

Baths of salt water, as usually given, rarely contain more than 3% of chloride of sodium, some of the strongest perhaps from 8 to 10%. Their primary action is as a stimulant to the skin, in which action it is probable that the other chlorides, especially that of calcium, and still more the carbonic acid often present, co-operate. In this way, and when aided by various processes of what may be termed water poultices and packing, they are often useful in removing exudations, in chronic metritis and in some tumours of the uterus, and generally in scrofula and rachitis, and occasionally in some chronic skin affections.

The French accord high praise to some of their thermal salt waters in paralysis, and some German ones are used in a similar way in spinal affections. The salt waters are sometimes so strong that they must be diluted for bathing. In other cases concentrated solutions of salt are added to make them sufficiently strong. These waters are widely diffused, but on the whole Germany is richest in them, especially in such as are highly charged with salt. The Kissingen springs may be considered as typical of the drinking wells, and sea-water of bathing waters. The air of salt-works and pulverization of the water are employed in German baths as remedial agents.

Table IV.—*Salt Springs*.
Locality.			Temp. ° Fahr.⁠	Therapeutic Action.
C o l d	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \\\ \\\ \ \end{matrix}}\right.}$	Soden, near Frankfort	—	Dyspepsia, anaemia scrofula, special for throat and phthisis.
		Homburg, ⁠do.	—	Dyspepsia, slighter hepatic affections, chlorosis, gout.
		Kissingen, Bavaria	—	In all essentials the same.
		Pyrmont, North Germany	—	Better known for its iron; has a good salt drinking spring.
		Kreuznach, near Bingen	—	A salt well without carbonic acid; used in scrofula and anaemia; bathing more important.
W a r m	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \ \end{matrix}}\right.}$	Wiesbaden, Nassau	155	Used in dyspepsia and gout; the bathing is most important.
		Baden-Baden	156	Still milder water; uses similar; gout.
		Bourbonne, Haute-Marne	114–149	Rheumatism, neuralgia, effects of malaria,
		Balaruc, South France	116·6	Do.; special for treatment of paralysis
		Salins, Moutiers, Savoy (1480 ft.)	96	Scrofula, anaemia, loss of power, sexual disorders.
		Brides, Savoy (1700 ft.)	95	Act on liver and digestive canal used for obesity.
		Acqui, North Italy	169	Rheumatism; special treatment with the bath deposit.
		Abano, do.	185	Chiefly as baths; mud of bath used for poultice.
		Caldas de Mombuy, near Barcelona	153–158	Rheumatism, sciatica, old injuries
		Cestona, Guipuzcoa, Spain	88–94	Rheumatism, indigestion, bronchitis,

Almost all the above stations have several springs of various strengths: the cold may be said to vary
from 14 to 5·8% of chloride of sodium; the warm are generally weaker, perhaps varying from 6·8 to 1·6.

Salt springs are found in many quarters of the world, but the chief carbonated groups for drinking purposes occur in Germany, and at Saratoga in America, Where very remarkable wells indeed are to be found. France and England have no springs of this class. The stronger wells, used chiefly for bathing, occur where there are salt-bearing strata, as in Germany, Galicia, Italy, Switzerland, France and England. Very powerful waters of this class are those of St Catherines in Canada.

The presence of minute portions of iodine or bromine in salt waters is by no means infrequent, and they appear in considerable quantity in some few. It is, however, extremely doubtful whether any known spring contains a sufficient quantity of iodine, still more of bromine, to act specially on the system, even if that action were not necessarily superseded by the presence of the large quantity of other salts with which they are associated. Some of the best-known springs of the kind are: Challes, Wildegg, Castrocaro, Hall, Adelheid’s Quelle, Krankenheil, Kreuznach, Woodhall Spa.

Iron or Chalybeate Waters.—Iron usually exists in waters in the state of protoxide or its carbonate, less frequently as sulphate or crenate, and very rarely, if at all, as chloride. The quantity present is usually extremely small. It may be said to vary from 0·12 to 0·03 in the 1000 parts of water. Some wells considered distinct chalybeates contain less than 0·03. Many wells, especially in Germany, have a rich supply of carbonic acid, which is unfortunately wanting in French and English ones.

Table V.—*Stronger Salt Waters*.
Locality.	Chloride of Sodium in 1000 parts of Water	Therapeutic Application.
Rheinfeld, Aargau, Switzerland	311	Scrofula, effects of inflammation, chronic exudations, some chronic exanthemas, rheumatism, uterine infiltrations.
Salzungen, North Germany	256	Do. do.
Ischl, Austria (1440 ft.)	256	Do. do.
Hall, Tyrol (1700 ft.)	255	Do. do.
Reichenhall, near Salzburg (1800 ft.)	224	Do. do.
Bex, Rhone Valley (1400 ft.)	156	Do. do.
Castrocaro, Tuscany	36	Do. do.
Droitwich, near Worcester	233·6	Do. do.
Sea Water	30·4
Rehme, Westphalia (92° F.)	24–85	Do.; special use in loco-motor ataxia.
Nauheim, Wetterau (80°–103° F.)	29	Do. do.

Table VI.—*Iron Waters*.
Locality.	Height in Ft.	Carb. of Iron.	Therapeutic Use.
Rippoldsau, Black Forest	1886	0·12	For anaemic conditions; laxative.
Homburg, near Frankfort	—	0·10	Do. do.
Elster, Saxony	1465	0·08	Do. do.
Liebenstein, North Germany	911	0·08
Schwalbach, Nassau	900	0·08	Do.; much of a ladies’ bath.
Bocklet, near Kissingen	600	0·08	Do.
Griesbach, Black Forest	1614	0·07	Do. laxative; a ladies’ bath.
Franzensbad, Bohemia	1293	0·07	Do. do.
Pyrmont, Germany	—	0·07	Do.
Spa, Belgium	1000	0·06	Do.
Petersthal, Black Forest	1333	0·04	Do.; laxative.
St Moritz, Engadine, Switzerland	5464	0·03	Do.; sought for its air.
Forges-les-Eaux, France	—	0·06	Do.
La Malou, Hérault, France (temp. 88°)⁠	—	0·08	Do.
Recoaro, North Italy	1943	0·04	Do.
Tunbridge Wells, England	—	0·06	Do.; deficient in carbonic acid.
Muspratt Spring, Harrogate (chloride)	600	0·15

It has long been the prevalent idea that want of iron in the blood is the main cause of chlorosis and of other anaemic conditions, and that these conditions are best relieved by a supply of that metal. Since the detection of it in haemoglobuline this view has been still more popular. It is pretty certain that the blood contains 37 to 47 grains and the whole system 70 to 74 grains of iron; and it has been calculated that in normal conditions of the system somewhat more than one grain of iron is taken daily in articles of food, and that the same amount is passed in the faeces; for although the stomach takes the iron up it is excreted by the alimentary canal mainly, it being doubtful whether any is excreted in the urine. It is possible by drinking several glasses to take in more than a grain of carbonate of iron in the day, equivalent to half that amount of metallic iron. It has further been ingeniously reckoned from practice that 10 to 15 grains of metallic iron suffice to supply the deficiency in the system in a case of chlorosis. It is thought probable that a portion of the iron taken up in water is in certain pathological states not excreted, but retained in the system, and goes towards making up the want of that metal. But whether this or any other explanation be satisfactory, there is no question as to the excellent effects often produced by drinking chalybeate waters (especially when they are carbonated), and by bathing in those which are rich in carbonic acid after they have been artificially heated. As regards the drinking cure we must not, however, forget that carbonate and chloride of sodium, and also the sulphate, are often present and must be ascribed a share in the cure. Thus chloride of sodium is a powerful adjuvant in the strong Stahl Quelle of Homburg and in the Putnam Well at Saratoga. A whole category of female complaints is treated successfully with these waters. Indeed, anaemia from any source, as after fever or through loss of blood, and enlargements of the spleen, are benefited by them. The stimulating action of the copious supply of carbonic acid in steel baths is a very important adjuvant; no one now believes in direct absorption of iron from the bath. Iron waters are scarcely ever thermal. They are extremely common in all countries—frequently along with sulphuretted hydrogen in bogs and near coal-measures. But such springs and non-carbonated wells generally are weak, and not now held in much esteem.

It may be added that some of the strongest known iron wells are sulphated or aluminated. They are styptic and astringent, and can only be used diluted. They are sometimes useful as an application to ulcers and sores. Such springs have often been brought into notice, but never retain their popularity. They are known in the Isle of Wight, in Wales, in Scotland, as well as in Elba, &c.; and of late years the Bedford Alum and Oak Orchard Springs, U.S., have been brought into notice, the latter containing 10 grains of free sulphuric acid in the pint. All such springs have been considered useful in scrofula, anaemia and chronic diarrhoeas.

Sulphur Springs.—Waters having the odour of hydrosulphuric acid, however slightly, are usually called sulphur ones. They owe their smell sometimes to the presence of the free acid, sometimes to sulphides of sodium, calcium or magnesia, and sometimes to both. Sulphuretted hydrogen is absorbed more freely by cold than by hot water and is therefore most abundant in cold springs. The sulphides decompose and give off the gas. Most of these springs occur near coal or shale measures, or strata containing fossils, or in moors and in places generally where organic matter is present in the soil or strata. Many of them contain so little mineral impregnation that they might as well be classed among the indifferent or earthy waters. One group contains a considerable amount of chloride of sodium, another of sulphate of lime, while a third has little mineral impregnation, but contains sulphides.

Sulphuretted hydrogen is a strong poison, and its action on the system; has been pretty well ascertained. It has been assumed that the gas in mineral waters acts similarly, though in a modified degree; but there is next to nothing absolutely known of the action of the small quantities of the gas that are present in mineral waters, and which certainly have no toxic effect. It has been assumed that this gas has some special action on the portal system and so on liver has been founded the idea that sulphur waters are useful in metallic intoxication. Drinking large quantities of these waters, especially of such as contain sulphates or chlorides of sodium or magnesia, combined with hot baths and exercise, may help to break up albuminates, but there is no proof of the action of the sulphur.

Table VII.—*Cold Sulphur Springs*.
Locality	Sulphuretted Hydrogen dissolved in Water.	Sulphide of Sodium.
Eilsen, Schaumburg-Lippe	42·3	—
Meinberg, Lippe-Detmold	23·1	0·008
Gurnigel, Switzerland (3600 ft.)⁠	15·1	—
Leuk,⁠Switzerland (3593 ft.)	44·5	—
Challes Savoy (900 ft.)	—	0·478
Enghieh, near Paris	—	0·106
Uriage, Isère, France (1500 ft.)	7·34	—
Harrogate, England	—	0·207
Strathpeffer, Scotland	—	0·026
Lisdoonvarna, Clare, Ireland	—	—

For similar reasons, and primarily to counteract mercurial poison sulphur waters have been considered useful in syphilis. But it may be well to remember that at most baths mercury is used along with them. No doubt they are frequently, like other warm waters, useful in bringing out old eruptions, acting in this way as a test for syphilitic poison, and in indicating the treatment that may be required. Sulphur waters, both hot and cold, are used in gout and rheumatism, in dyspepsia, in hepatic and cutaneous affections; and of late years inhalation of them has been popular in phthisis and in laryngeal affections. They have long been popular remedies in cutaneous affections. While so much doubt has been cast on the action of the sulphur of these waters, it may be admitted that the sulphides are probably decomposed in the stomach and sulphuretted hydrogen generated. That gas is probably a slight stimulant to the intestine. What sulphuretted hydrogen reaches the blood is eliminated by the lungs. There seems to be no doubt that the gas is absorbed in small quantities by the skin.

It is in sulphur waters chiefly that glairin and baregin occur. This peculiar organic substance has been found both in American and in European springs. Cold sulphur springs are very widely diffused throughout the world. Thermal ones are not so common. Perhaps the largest though not the strongest group of the latter is to be found in the Pyrenees. We may remark again how very little hydrosulphuric acid there is in many of the most favourite sulphur springs, including the very popular White Sulphur ones of Virginia. There seems to be something peculiarly unsatisfactory in the analysis of sulphur waters, and there has been difficulty in constructing the following imperfect tables.

Table VIII.—*Warm Sulphur Springs*.
Locality.	Height in Ft.	Temp. ° Fahr.	Hydrosul- phuric Acid absorbed in Water.	Sulphide of Sodium.
Aix-la-Chapelle, Germany	534	131–140	0·3	0·01
Baden, near Vienna	—	95–115	2·5	0·052
Schinznach, Switzerland	1060	80–92	37·8	—
Lavey, Rhone Valley	1350	92–113	3·5	—
Hercules Bad, Banat	500	110	42·6	—
Aix-les-Bains, Savoy	765	108·5	27·2	—
Luchon, Pyrenees	2000	135·5	—	0·07
Baréges, do.	4100	113	—	0·04
Amélie-les-Bains, Pyrenees	810	87–147	—	0·01
Cauterets,⁠do.	3254	71–134	—	0·02
Eaux Bonnes,⁠do.	2400	90·5	—	0·02
Archena, Murcia, Spain	—	126	—	—

Some of the most powerful cold wells are those of Challes (with its very peculiar Water), Leuk and Harrogate. Uriage has a very large amount of chloride of sodium in its springs. Cold sulphur waters are on the whole more used in liver and indigestion than warm ones. The general effects of warm sulphur Waters differ so little at the various baths as to make it difficult to mention anything special to particular localities. Schinznach has a reputation in skin complaints, Cauterets, Eaux Bonnes and Challes in laryngeal affections, the two Aix, Luchon and Archena in syphilis.

Alkaline Waters are such as contain carbonate (chiefly bicarbonate) of soda, along with an excess of carbonic acid. Of the action of those carbonates it is known that when taken into the stomach they are neutralized by the gastric juice, and converted into chloride of sodium. On their introduction into the stomach, they produce an increased flow of gastric juice. If given during or immediately after meals in any quantity, they impede digestion. They slightly increase peristaltic action, but only feebly, unless assisted by other salts. They act slightly as diuretics. Of the connexion between the biliary system and alkalies, which undoubtedly exists, not much is known with certainty. The alkalization of the blood by them is assumed by many, but not proved. It is very doubtful whether they reduce the quantity of fibrine in the blood, and thus induce a lowered state of the system, or whether they have any direct tendency to combine with fat and carry off a portion of superfluous adipose tissue. Their excess of carbonic acid, through its action on the stomach, favours the operation of alkaline waters. They have been classed as follows: (1) simple alkalines, where carbonate of soda is the main agent; (2) waters containing in addition some chloride of sodium; (3) waters containing sulphates of soda or of magnesia. All these classes may be said to be used in gout, lithiasis, affections of the liver, catarrh and obstructions of the gall ducts, in dyspepsia, chronic catarrh of the stomach and diarrhoea, in obesity and in diabetes. Some of the waters of the second class are supposed to influence bronchial catarrhs and incipient phthisis, while the more powerful sulphated waters of the third class are especially useful in catarrh of the stomach, and in affections of the biliary organs; of these only one of importance (Carlsbad) is thermal. The rival cold waters of Tarasp contain twice as much carbonate of soda. The cold ones are chiefly used internally, the thermal ones both internally and externally. The latter, besides acting as warm water, slightly stimulate the skin when the carbonic acid is abundant, and the carbonate of soda has some slight detergent effect on the cutaneous surface like soap. These waters are unknown in England. They are most abundant in countries of extinct volcanoes.

Classes I. and II. of alkaline waters may be said to have a sub-variety in acidulated springs or carbonated waters, in which the quantity, of salts is very small, that of carbonic acid large. These table waters are readily drunk at meals. They have of late years been so widely exported as to be within the reach almost of every one. Their practical importance in aiding digestion is in reality much greater than one could expect from their scanty mineralization. They are drunk by the country people, and also largely exported and imitated. They are very abundant on the Continent, and, although some of the best-known ones enumerated below are German and French, they are common in Italy and elsewhere: Heppingen, Roisdorf, Landskro, Apollinaris, Selters, Brückenau, Gieshübel, all German; St Galmier, Pougues, Chateldon, French.

Associated with Class III. is that of the strongly sulphated waters known in Germany as bitter or purging waters, which have of late deservedly come into use as purgative agents. They are almost wanting in France and in America, and there are no very good ones in England. The chief supply is from Bohemia and Hungary.

Table IX.—*Alkaline Waters*.
Class I.—Simple Alkaline.
Locality.	Carb. Soda.	Therapeutic Uses.
Vals, South France	7·1	Catarrh of stomach, gout,renal and biliary calculi, liver complaints, diabetes.
Bilin, Bohemia	4·2	Do.⁠do.⁠do.
Vichy, France (105° F.) .	5·1	Do.⁠do.⁠do.
Neuenahr, Rhineland (92°–97° F.)	1·0	Mucous catarrh; diabetes specially.
La Malou, France (97° F.)	—	Do.; sedative effect on nervous system.
Vidago, Portugal	—	Do., gout, urinary affections—“The Portuguese Vichy.”
Class II.—With Chloride of Sodium varying from 4·3 to 1 in amount.
Locality	Height in Ft.	Temp. ° Fahr.	Carb. Soda.	Therapeutic Uses.
Luhatschowitz, Moravia	1600	—	8·4	Springs rich both in carb. soda and chl. sodium.
Tönnistein, Rhine Valley	—	—	2·5	Light antacid tonic to stomach.
Ems, Nassau	—	85–115	2·0	Special in female complaints and mucous membrane.
Ischia, Italy	—	up to 170	2·0	Specially rheumatism and female complaints.
Royat, Auvergne	1400	80–95	1·3	Do. and some skin affections.
Mont Dore, do.	3300	100–114	—	Asthma, chronic laryngitis.
Bourboule, do.	2800	107–125	—	Scrofula, rachitis, cutaneous affections.
Class III.—With Sulphate of Soda varying from 5·2 to 2 in amount, and Carbonate of Soda varying from 3·55 to 0·51 in amount.
Locality.	Height in Ft.	Therapeutic Uses.
Elster Saxony	1460	Action on abdominal organs,female complaints.
Marienbad, Bohemia	1012	Do.; special use in obesity.
Franzensbad, do.	1293	Do.; specially a ladies’ bath.
Tarasp, Lower Engadine	4000	Powerful action on abdominal viscera.
Carlsbad, Bohemia (121°–164° F.)	1200	Gout, liver affections, biliary and renal calculi, diabetes.

The numerous waters of Ofen are the best known, and some of them are stronger than the Hunyadi, of which an analysis has been given in Table I. They are easily imitated. Some of the best-known are Ofen, Püllna, Saidschütz, Friedrichshall, Birmerstorff, Kissingen.

Two other classes of waters demand a few words of notice. The French have much faith in the presence of minute quantities of arsenic in some of their springs, and trace arsenical effects in those who drink them, and some French authors have established a class of arsenical waters. Bourboule in Auvergne is the strongest of them, and is said to contain 1/12th of a grain of arseniate of soda in 7 oz. of water. Baden-Baden, according to Bunsen’s latest analysis, has a right to be considered an arsenical water. It is, however, extremely doubtful whether the small amounts of arseniate of soda which have been detected, accompanied as they are by preponderating amounts of other salts, have any actual operation on the system. The following are among the most noted springs: Bourboule, Mont Dore, Royat, Salies (Bigorres), Plombières, Baden-Baden.

Designation and Locality.			Therapeutic Application.
Indiff- erent (Ther- mal).	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \ \end{matrix}}\right.}$	Lebanon, Columbia co., N.Y. (73° F.)
		Healing, Bath co., Va. (88° F.)	${\Big \{}$	Scrofulous ulcers and ophthalmia, ozoena, chronic diarrhoea and dysentery, secondary and tertiary syphilis.
		Warm, Bath co., Va. (98° F.)	${\Big \{}$	Chronic and subacute rheumatism, gout, neuralgia, nephritic and calculus diseases.
		Hot, Bath co., Va. (110° F.)	${\Big \{}$	Chronic rheumatism, gout, diseases of liver, neuralgia, contractions of joints.
		Paso Roble, San Luis Obispo co., Cal. 122° F.
		Hot, Garland co., Ark. (93–150°) F.)	${\Big \{}$	Dartrous diseases of skin, functional diseases of uterus chronic mercurial and lead poisoning.
Calca- reous and Earthy.	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \\\ \\\ \\\ \ \end{matrix}}\right.}$	Gettysburg, Adams co., Penn.		Calculus gravel, catarrh of stomach or bladder, dyspepsia.
		Sweet, Monroe co., W. Va. (74° F.)		Gravel, dyspepsia (diuretic, diaphoretic).
		Berkeley, Morgan co., W. Va. (74° F.)		Neuralgia (restorative).
		Alleghany, Montgomery co., Va.		Purgative, diuretic.
		Bethesda, Waukesha co., Wis.	${\Big \{}$	Diabetes mellitus, gravel, inflammation of bladder, dropsy, albuminuria (diuretic).
Sul- phur.	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \ \end{matrix}}\right.}$	Lower Blue Lick Nicholas co. Ky.		Aperient and alternative.
		Sharon, Schoharie co., N.Y.		Do. do.
		White Sulphur, Greenbrier co., Va.,		Dartrous skin diseases, diseases of the bladder, jaundice, dyspepsia.
		Salt Sulphur, Monroe co., W. Va.		Do.; scrofula and syphilis.
Epsom Salt.	$\scriptstyle {\left\{{\begin{matrix}\ \\\ \end{matrix}}\right.}$	Bedford, Bedford co., Penn.		Anaemia, gravel, calculus (strongly diuretic).
Common Salt.	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \ \end{matrix}}\right.}$	St Catharines, Ontario, Canada		Rheumatism, gout, scrofula, neuralgia.
		Caledonia, Ontario, Canada		Rheumatism, gout.
		Hathorne, Saratoga, N. Y.		Dyspepsia, jaundice, abdominal plethora.
		Ballston, Saratoga co., N. Y.,		Do. do. do.
Iron	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \\\ \\\ \ \end{matrix}}\right.}$	Oak-Orchard Acid, Genesee co., N. Y.	${\Big \{}$	Ulcers, diseases of the skin, passive haemorrhages, atonic diarrhoea (has 10 grains of free sulphuric acid in the pint).
		Rawley, Rockingham co., Va.		Chlorosis and anaemia generally; tonic.
		Sweet Chalybeate, Alleghany co., Va.		Do. do. do.
		Rockbridge Alum, Rockbridge co., Va.		Scrofula, chronic diarrhoea
		Cooper’s Well, Hinds co., Miss.		Anaemia, chlorosis, Chronic diarrhoea, dropsy.
Glauber Salt.	$\scriptstyle {\left\{{\begin{matrix}\ \\\ \end{matrix}}\right.}$	Crab Orchard, Lincoln co., Ky. Midland, Midland co., Mich.
Alkaline.	$\scriptstyle {\left\{{\begin{matrix}\ \\\\\ \\\ \\\ \\\ \ \end{matrix}}\right.}$	Bladen, Choctaw co., Ala. (carbon- ated alkaline)
		Congress, Santa Clara co., Cal. (saline-alkaline)
		St Louis, Gratiot co., Mich. (simple alkaline)		Dyspepsia, neuralgia, chronic and subacute rheumatism.

Of late years lithium has been discovered in the waters of Baden-Baden; and various other places boast of the amount of that substance in their springs. Indeed a new bath has been established at Assmannshausen on the Rhine in consequence of the discovery of a. weak alkaline spring containing some lithium. Not very much is known of the action of lithium in ordinary medicine, and it undoubtedly does not exist in medicinal doses even in the strongest springs. Among these springs are those of Baden-Baden, Assmannshausen, Elster, Royat, Ballston Spa, and Saratoga (U.S.).

American Mineral Waters.—The number of springs in the United States and Canada to which public attention has been called on account of their supposed therapeutic virtues is very large, amounting in all to more than three hundred. Of this number comparatively few are in Canada, and of these not more than six (St Catharines, Caledonia, Plantagenet, Caxton, Charlottesville and Sandwich) have attained general celebrity. The first three belong to the saline class, the Caxton is alkaline-saline, and the last two are sulphur waters. The St Catharines is remarkable for the very large amounts of sodium, calcium and magnesium chlorides which it contains, its total salts (450 grains in the pint) being more than three times the quantity contained in the brine-baths of Kreuznach in Prussia. The Charlottesville and Sandwich springs likewise surpass the noted sulphur-waters of Europe in their excessive percentages of sulphuretted hydrogen, the former containing more than 3 and the latter 4·72 cub. in. of this gas in the pint.

The mineral springs in the United States are very unequally distributed, by far the larger number of those which are in high medical repute occurring along the Appalachian chain of mountains, and more especially on or near this chain where it passes through the States of Virginia, West Virginia and New York. The Devonian and Silurian formations which overlie the Eozoic rocks along the course of the Appalachian chain have been greatly fissured—the faulting of the strata being in some places of enormous magnitude—by the series of upheavals which gave rise to the many parallel mountain ridges of the Appalachians. In many places the springs occur directly along the lines of fault. The various classes of mineral waters are likewise very unequally represented, the alkaline springs, and those containing Glauber and Epsom salts, being much inferior to their European representatives. On the other hand, the very numerous and abundant springs of Saratoga compare very favourably with the Selters and similar saline waters, and among the many American chalybeate springs the subclass represented by the Rockbridge Alum is unequalled in regard to the very large percentages of alumina and sulphuric acid which it contains. Besides its greater amount of mineral constituents (135 grains per pint), the Ballston spring surpasses the similar saline waters of Homburg, Kissingen, Wiesbaden and Selters, in its percentage of carbonic acid (53 cub. in.). It is also remarkable for the very large proportion of carbonate of lithia, amounting to 0·701 grains. Thermal springs are specially numerous in the territories west of the Mississippi and in California. Those in the east mostly occur in Virginia along the southern portion of the Appalachian chain; in the middle and New England States Lebanon is the only important thermal spring. Subjoined is a list of thirty American springs, the design being to represent as many of the more noted spas as possible, while at the same time enumerating the best representatives of the classes and subclasses into which mineral waters are divided according to the German method of classification.

Bibliography.—(1) German: E. Osann, Darstellung der Heilquellen Europas (3 vols., Berlin, 1839–1843); J. Seegen, Handbuch der Heilquellenlehre (Vienna, 1862); B. M. Lersch, Hydrochemie (1870), and many other works; Helfft, Handbuch d. Balneotherapie (8th ed., Berlin, 1874); Valentiner, Handbuch d. Balneotherapie (Berlin, 1876); L. Lehmann, Bäder u. Brunnen Lehre (Bonn, 1877); J. Braun, System. Lehrbuch d. Balneotherapie, 4th ed., by Fromm (Berlin, 1880); O. Leichtenstern, Balneotherapie (Leipzig, 1880). (2) French: Dictionnaire des eaux minérales, &c., by MM. Durand-Fardel, &c. (2 vols., Paris, 1860); J. Lefort, Traité de chemie hydrologique (2nd ed., Paris, 1873); C. James, Guide pratique aux eaux minérales (Paris), many editions; Macé, Guide aux villes d’eaux, &c. (Paris, 1881); Joanne and Le Pileur, Les Bains d’Europe (Paris). (3) Swiss: Meyer Ahrens, Heilquellen der Schweitz (Zürich, 1867); Gsell Fels, Die Bäder und Kurorte der Schweitz (Zürich, 1880). (4) Italian: G. Jervis, Guida alle acque minerali d’Italia (Turin, 1876, &c.); E. F. Harless, Die Heilquellen und Kurbäder Italiens (Berlin, 1848). (5) Spanish: Rubio, Tratado de las fuentes minerales de España (Madrid, 1853); Don J. de Antelo y Sanchez has recently published a work on Spanish waters. (6) English: T. Short, History of the Mineral Waters (London, 1734); J. Rutty, Methodical Synopsis of Mineral Waters (London, 1757); Granville, Spas of England (1841); E. Lee, Mineral Springs of England (London, 1841); J. Macpherson, Our Baths and Wells (1871); id., Baths and Wells of Europe (1873); and H. Weber’s Eng. ed. of Braun (London, 1875). A great portion of the literature is to be found in monographs on particular places. (7) American: J. Bell, The Mineral and Thermal Springs of the United States and Canada (1855); J. J. Moorman, The Mineral Waters of the United States and Canada (1867); C. F. Chandler, Lecture on Water (1871); G. E. Walton, The Mineral Springs of the United States and Canada (1875); I. Burney Yeo, The Therapeutics of Mineral Springs (1904).

↑ In this and the following tables a selection is given of some of the best-known mineral waters in various European countries that possess establishments. Their chief peculiarities of elevation, of temperature and constituents are briefly noted. The curative effects, necessarily alluded to very generally, are those usually attributed to them.

[513f1-1] In this and the following tables a selection is given of some of the best-known mineral waters in various European countries that possess establishments. Their chief peculiarities of elevation, of temperature and constituents are briefly noted. The curative effects, necessarily alluded to very generally, are those usually attributed to them.

[1]