Essay on the mineral waters of Carlsbad/Ancient and present mode of using the waters, and choice of the season
ANCIENT AND PRESENT MODE
OF
USING THE WATERS, AND CHOICE OF THE SEASON.
The very name given to the town by its founder, Charles IV, proves enough that Carlsbad acquired its first renown as a bathing establishment. Lobkowitz, singing the virtues of our springs, speaks of bathing, not of drinking:
Quisquis in hâc lymphâ fragiles immerserit artus.
Wenzel Payer tells us, in 1521, that drinking was rare, and bathing usual: Et quia hucusque (aqua) non fuit in frequenti usu quoad potum, sed magis ad m. Carlsbad being formerly recommanded to sterile women, he says that the water would prove useful to a greater number, if, instead of bathing, they would drink: Quod autem multae mulieres in hoc casu (sterilitas) redeunt sine levamine, causa est malus ordo, quia balneant in balneo (at Carlsbad) et nunquam bibunt ex eo. Persons labouring under cutaneous disorders, leprosy and other external evils, drove then to Carlsbad. We see there now more diseases arising from visceral obstructions. Mathaeus Collinus de Choterina (born in 1516, † 1566), a good poet and a celebrated professor of the Greek language at the University of Prague, (where the marble monument erected to him is still to be seen), expresses, in the following lines, his wishes that a powerful friend of his, going to Carlsbad, may be cured of the itch, and the consort of that friend, of her sterility:
Unda tepens vestros scabie, precor, allevet artus,
Foecundam sociam reddat et illa tuam
Payer’s advice was slowly adopted, and great vicissitudes have been observed, since his time, in the mode of bathing and of drinking. Formerly, and particularly during the sixteenth century, patients remained six or eight hours a day, and even longer, in the bath. A specimen of that extraordinary method, still followed at Louèche (Leuk), and in other Swiss Baths, is described in the very remarkable Journal, kept in 1571, at Carlsbad, by Dr. George Handsch of Limusa, physician to archduke Ferdinand of Tirol and his wife Philippine Velser, of Augsburg. That journal, published in my Almanach, for 1832, ch. V, is unquestionably the most instructive document we possess on thermal practice during the middle age. Philippine submitted, with an angelical resignation, at the same time, and during five weeks, not only to frequent pharmaceutic purgatives and water drinking, but she bathed six or seven hours daily. The irritation of the skin, produced by these protracted baths, gave to that method the name of corrosio cutis, in German: Hautfresser. In Switzerland it is called la pousse or la poussée.
David Becher, in his excellent Treatise on the waters of Carlsbad (Neue Abhandlungen von dem Carlsbade, 1772), speaks of the skin-biter, as completely abandoned, and draws his description from Fabian Summer’s work: De inventione, descriptione, temperie, viribus et imprimis usu Thermarum D. Caroli IV Imperatoris libellus brevis et utilis. Lips. 1571 et 1589.
The advantages of the internal use of the waters confirmed by so many favourable cases, bathing was gradually neglected, and, though never abandoned, it became at last a secondary part of the treatment. That neglect was felt, and often blamed, by national and foreign physicians of eminence. Habits of comfort and luxury increasing and spreading rapidly in the principal German watering-places, our patients shewed so little inclination to bathe in uncomfortable and narrow private rooms, that better institutions became indispensable. Maria-Theresia ordered, iu 1762, to build, at her own expense, a bath-house near the Mühlbrunn, demolished, in 1827, as incompatible with the increase of visitors, and placed on the opposite side of the street, upon a far better plan. Another beautiful bath-house was erected, in 1831, near the Sprudel, and the Hospital-Baths, without speaking of those which every one can take in his own lodgings, prepared with Sprudel water, pure or mixed with the river water, according to medical prescription. Every house owner is provided with a bathing-room, a bathing-tub, and buckets to carry the water.
According to comparative experiments made last year by Dr. Romberg of Berlin and myself, in order to ascertain a point contested by many, the Sprudel water lost 21½° R., and common water, artificially heated, 33° R, in half an hour.
The advantages of steam-baths had long been praised, and patients at Carlsbad had now and then imagined some imperfect mode of applying vapour in various ailments, rheumatism, gout, contractions of limbs, but without any methodical principles. Fabian Summer, a native of Carlsbad, speaks, in 1571, off Sudaria communia, without describing that sweating establishment, so that now no body knows whether they were, like russian baths, prepared with the vapour of common water, or composed of the Sprudel vapour, which requires another mode of application, on account of its effects upon the organs of respiration. Enormous clouds of vapour rose, during: ages, from our hot wells, lost in the wide atmosphere. The first impulse was at last given to vaporous medecine by the celebrated Mr. d’Arcet and Dr. Galès, of Paris, who invented boxes for sulphurous fumigations. Tempted by the Reports which the latter published in 1816, I established, in 1817, at Vienna, fumigating rooms, and sent a great number of my improved boxes to medical practitioners in most countries of Europe, and even two to London, for public and private establishments. The good effects of those fumigations, the perfection of the apparatus, suggested soon the idea of applying medically the steam of various hot wells. Carlsbad was one of them, and no where perhaps could one dispose of more copious vapours. On my arrival there, in Mai 1826, I found the walls of a new building erected for that purpose, above the source of Hygiaea. Knowing the experience I had acquired at Vienna in that branch of medical practice, my advice was requested by Government for the construction of the necessary boxes, and other furnitures. The Vienna apparatus were adopted, with the modifications which a vapour so different from the sulfureous fluid required; six of them and twelve small rooms compose the establishment. Some additions, but no corrections, have since taken place. The partial application of a steam-douche; the possibility of taking a whole bath or a half-bath; of applying partially the vapour to the superior or to the lower extremities, to the breast and to the ears, have given to the establishment a high degree of perfection, and met with general approbation.
We are hitherto rather deficient in the application of the water-douche, but the improvement of that important branch of thermal practice is at this moment a subject of serious consideration at Carlsbad. The want of good douches is the more surprizing that the following quotation, from Wenzel Payer’s work, seems to prove that Carlsbad was the first place in Germany, where that powerful remedy was introduced: Et miror saepe mecum quod nullus medicorum per Germaniam dutiâ (douche from gutta, gocchie) utatur, quia in nulla patriâ, magis necessaria esset. It is at least probable that Payer, having learned the utility of the douche, did not neglect to establish it at Carlsbad.
Our medical institutions can be therefore divided into three distinct periods. During the first, bathing alone was usual. The second period, and certainly the most important, dates from Wenzel Payer, on whose suggestion, in 1521, the internal use of the waters was added to bathing. The third began so late as 1827, when the application of steam was joined to drinking and bathing. The junction of these three curative means has manifestly increased the fame of Carlsbad, and, although often prescribed to the same patient, drinking remains in general the most essential part of the cure. A great number accomplish it without water or vapour-baths; but bathing without drinking is rare.
Formerly, when the purgative effect of the waters was deemed the most important, physicians encouraged plentiful drinking; but, since their alterative and slowly desobstruent action has been better understood, and since it has been ascertained that alvine evacuations are seldom proportioned to the quantity of ingested water, they have less insisted upon the necessity of immoderate drinking, and patients are in general desired not to overpass that degree of saturation, which borders on reluctance. Prodigious deeds are told of our vigorous ancestors, and good folks are inclined to consider the present moderate dose of seven or eight goblets, as a proof of the degeneracy of our species, of which Juvenal complained, about two thousand years ago, as having already commenced in Homer’s time:
Nam genus hoc vivo jam decrescebat Homero;
Terra malos homines nunc educat atque pusillos.
The fact is that patients offer very different capacities of swallowing and digesting mineral waters, as gluttons and drunkards beat sober people in eating, and in drinking wine or beer; and that we still see at Carlsbad individuals who would astonish their forefathers, if they saw them taking from thirty to fifty goblets as a daily portion. Such drinkers are rare, but they exist (Almanach for 1833, ch. IV). The capacity of our beakers being, since the middle of the eighteenth century, exactly the same (six ounces), our present observations are far more accurate than those of our predecessors, whose patients came to the wells, or drank at home, with all sorts of cups, so that we scarcely know now, when we read ancient authors, the size of their pocula, cyathi, canthari, seidlini, nosellini, etc. A celebrated Bohemian historian, Balbin (Miscell. Lib. I. c. 24), tells us, in 1697, that the Carlsbad beakers did not contain more than two ounces and a half of liquid. The coffee-cup, of Saxon porcelain, kept in the National Museum of Prague, out of which the Austrian empress Elisabeth, princess of Brunswic-Wolffenbüttel, wife of Charles VI, drank our waters in 1721, contains only four ounces and two drachms of liquid. (Almanach, for 1831, ch. XXII).
The season begins, with few exceptions, the 1st of May, and finishes with September. Our waters acting not only upon the bowels and kidneys, but promoting perspiration, and requiring of course warm weather, June, July and August are always at Carlsbad the fullest time of the season. Those who are fond of a brilliant crowd, and not afraid of paying higher prices for lodgings, should come from the 15th of June to the 15th of August; but those to whom a bustling life is rather an annoyance than a pleasure, should be here from the 1st of May to the 15th of June, or from the 15th of August to the 30th of September. Society, in the beginning and towards the end of the season, being much less numerous, invalids can enjoy the comforts of a quiet life, and they meet with fewer opportunities to transgress the laws of the cure, the length of which varies from five to six weeks, and is even, according to circumstances, continued still longer, sometimes also interrupted by a pause or an excursion, and reassumed. Such advantages offer some compensation for the greater chance of a warmer temperature, variable at all times in our deep valley. Besides, real invalids, who require frequent attendance from their physician, can better expect it than in the middle of the season, when the best will is not always sufficient to visit patients as often as some of them wish it.
