Guide through Carlsbad and its environs/The Warm Mineral Waters
II.—THE WARM MINERAL WATERS.
1. Names of the Springs mostly used, and their Temperature.
|1.||The Sprudel has a temperature of about 58° Fahr.|
|2.||The Bernhardsbrunn „ „ 50° „|
|4.||The Neubrunn „ „ 48° „|
|5.||The Felsenquelle „ „ 47° „|
|6.||The Schlossbrunn „ „ 42° „|
|7.||The Mühlbrunn „ „ 40° „|
|8.||The Theresienbrunn „ „ 47° „|
|9.||The Marktbrunn „ „ 35° „|
|10.||The Kaiserbrunn „ „ 39° „|
|11.||The Spitalquelle „ „ 28° „|
|12.||The Kaiser Karl-Quelle „ „ 34° „|
2. Chemical Properties.
All the warm springs contain the same mineral constituents; they differ only in temperature, and, consequently, in the larger or smaller amount of carbonic acid gas they hold in solution. The Schlossbrunn contains most, the Sprudel the least free carbonic acid gas. Consequently, it is advisable to classify them as hot and tepid springs, instead of speaking of them, as of old, as strong and weak. We can best compare these springs to a tree: the Sprudel is the trunk, the other springs form the branches; and the longer and thinner the branch, the cooler is the spring.
One pound (16 oz.) of water from any of the springs contains about 42 grains of solid constituents, consisting of sulphate of soda, above 18 grs.; carbonate of soda, 101⁄2 grs.; muriate of soda (common salt), nearly 8 grs.; carbonate of lime, above 2 grs.; sulphate of potash, above 1 gr.; carbonate of magnesia, 1 gr.; siliceous earth, about 3⁄4 gr.; and oxidulate of iron, hardly 1⁄20 gr. The proportions of all these constituents, with the exception of the siliceous earth, were stated with approximate accuracy by Dr. Becher, in 1766. Later analysis has revealed some other constituents, but only in very small quantities, namely: carbonate of iron, oxidulate of manganese, phosphate of alumina, phosphate of lime, fluoride of potassium, iodide and bromide of sodium, lithium, boracic acid, rubidium, czesium, and arsenic.
The Schlossbrunn contains (according to Wolf) somewhat over 17 cubic inches of carbonic acid gas, the Mühlbrunn 13, and the Sprudel 8, in one pound of water.
The Sprudel has the property of covering, in a short time (about three days), objects, such as wood, earthenware, the solid parts of plants, such as grains, acorns, thistles, &c., with a strong crust of a yellow or yellowish brown colour, which consists principally of lime and siliceous earth; the yellow colour is due to iron.
Concerning the origin of the Sprudel, modern Geology explains it, as follows:—The atmospheric water, by percolating to the depth of 7000 feet through the clefts of the rocks, forming the range of mountains surrounding the valley of the Sprudel, gradually rises to a temperature of 60° R.=167° F. (as usual in such depths), decomposes and dissolves, by the aid of carbonic acid gas, a portion of the mineral constituents contained in the rocks, and being impregnated with them, and forced upward, partly by the pressure of the waters behind and partly by subterranean gases, it finally appears on the surface as a hot spring.
3. Restorative Powers.
As the chemical constituents of all the mineral springs of Carlsbad are the same, there can be no question but that their restorative powers are precisely similar in their action on the human body. The principal difference lies in the higher or lower temperature of the spring in question, and is rather in relation to the higher or lower state of irritability of the vascular system, or to the constitution of the patient, than to the disease itself.
The mineral waters act—
A. By coming into immediate contact with the mucous membrane of the intestinal canal, and we notice this action—1. As animating, modifying, and soothing the nerves of these parts. 2. As healing with regard to the mucous membrane of the ventricle and duodenum, 3. As removing acidity. 4. As purging. B. By being absorbed into the system, where 5. they are found to have the power of dissolving a. the tenacious and thick bile contained in the biliary ducts, and are even capable of dissolving gall-stones which are in the course of formation; b. of removing congestion of the blood in general, but principally that in the mesenteric vein, thus accelerating the circulation of the blood in the venous system; c. of dispersing the accumulated lymph and fatty deposits in the lymphatic vessels and glandular organs of the abdomen (principally of the liver); d. of removing fatty tumours caused by fibrous inflammatory products. 6. They improve and purify the diseased state of the blood and lymph, principally when it shows itself by an accumulation of albuminous azotic compounds, and by a tendency to form urea, uric acid and stone in the bladder. They accomplish this action either by degrees, without showing any material secretion, or they are accompanied by profuse evacuations, by frequent and fetid perspirations, or by repeated secretions of fetid, clear, or viscid sedimentous urine. 7. By their diuretic influence they remove, by a mechanical process, stones from the bladder and kidneys, sometimes as large as a pea or a bean, and also free them from gravel.
These remedial actions render the mineral waters of Carlsbad of the highest importance in such affections as: chronic inflammation of the stomach; loss of appetite; cardialgia; chronic vomiting; flatulence accompanied by frequent eructations; heartburn caused by acidity; chronic ulcer of the stomach; rodent ulcer with hæmatemesis and black evacuations, containing blood; tardy motion and chronic obstinate constipation; some forms of chronic diarrhoea; enlargement of the liver, occasioned principally by the accumulation of fat or fatty granulations; and congestion through the accumulation of bile. They are, however, of little or no use if the enlargement of the liver is caused by some kinds of tumours, such as cancer, encysted abscess, ascarides, tubercles, &c., or if there is an atrophy of this organ, called cirrhosis. They often cure jaundice in its many forms; also biliousness; gall-stones; some tumours of the spleen and of the mesenteric glands; some forms of dropsy; obesity; stones in the bladder and kidneys, principally when caused by uric acid; diabetes; slight cases of albuminaria (they are of little or no use in fully developed Bright’s disease of the kidneys); chronic inflammation of the bladder; swelling of the testicles and the prostatic gland; of the ovaries and the womb; chronic bronchitis; certain forms of asthma; nightmare; affections of the bronchial tubes; morbid hiccough; tendency to erysipelas; different chronic eruptions and ulcers, as well as cellular indurations of the skin; gout in all its different forms; piles; some forms of scrofulosis and chlorosis; chronic poisoning with arsenic, lead or mercury; tendency to hypertrophy of the heart (although unable to cure heart disease, its presence is no impediment to the use of these waters); hypochondria and some hysteric affections; different forms of pain, as headache, neuralgia of the face, cardialgia, colic, lumbago, pains in the back, &c.; spasms; certain paralytic affections of the limbs; tendency to apoplexy; giddiness; want of sleep as well as somnolency; certain mental diseases; affections of the ear, such as certain kinds of bad hearing, tingling of the ears, and discharge from them; some diseases of the eye, as tendency to inflammation, &c., especially if these ailments are of a more secondary nature.
As the mineral waters of Carlsbad act in a preventive, prophylactic way, they can be recommended for their quick, safe, and pleasant influence in all those affections, arising, sooner or later, from sedentary habits, and often connected with free living and irregular action of the bowels. The patient feels unwell without being really ill; going up stairs, and even stooping, are accomplished with difficulty through the accumulation of fat; perspiration easily sets in; short breath, palpitation of the heart, giddiness and dull headache supervene; the bowels are confined; there is pruritus ani, and piles soon form; eructations, heartburn and flatulence after meals are of common occurrence, and often accompanied by a peevish, irritable temper, desponding habits, &c. This state is called by medical men, “Plethora Abdominis”, or congestion of the bowels.
The mineral waters of Carlsbad are not considered advisable where there is a tendency to active congestion of the blood, in hæmorrhage, in the different wasting diseases in consequence of suppuration of important organs, principally in fully developed phthisis; in all affections arising from great poverty of the blood and general debility; in cases of aneurism and ossification of the large blood vessels; and, eventually, they are dangerous to pregnant women, if they are at the same time weak, anæemic, and emaciated; otherwise pregnancy is no impediment to their use.
4. Use of the Mineral Waters of Carlsbad.
Any season of the year is suitable for drinking the mineral waters of Carlsbad (even during the winter); but they certainly are more efficacious if the cure is confined to a time of the year when the weather allows of walking or riding in the beautiful and rich scenery surrounding Carlsbad.
Any one of the springs is adapted to a perfect cure, but it is generally advisable to commence with the cooler waters, principally that of the Marktbrunn, then, after a time, to use the hotter springs, and finish with the Sprudel. At first, from one to four tumblersful are to be taken daily, according to the nature of the case; and it is an unusual thing at present for the patient to drink more than six tumblersful daily. The waters are to be taken in the morning before breakfast, commencing at about six o’clock, a tumblerful being taken (slowly and in small quantities at a time) every fifteen, twenty, or thirty minutes, a walk being taken in the intervals; after taking the last tumblerful, it is advisable to take a longer walk on level ground, and not to begin breakfast before the lapse ofan hour. Recently, many patients have, been in the habit of drinking one or two tumblersful of cold or hot mineral water at home, immediately after rising; those suffering from habitual constipation may also take one tumblerful before going to bed. In cases of acute and chronic diarrhœa, the Sprudel can be resorted to, at first, in doses of from two to four half-tumblersful daily, or one tablespoonful every half-hour or hour. Generally, it is best to drink as much as will be sufficient to induce the bowels to act once, twice, or even three times a day. If the motions are watery and clear, the quantity of water taken daily must be diminished: It must be distinctly understood that the action of the Carlsbad water is not purgative only, as many patients are completely cured of their ailments, their bowels acting but once a day. It is unnecessary for females to entirely discontinue the use of the waters during the time of the menses, as one or two tumblersful of a cooler spring taken at home will do no harm, and in cases of weak menstruation the Marktbrunn and others may even be taken at the spring.
Although drinking the waters at Carlsbad constitutes the principal, and, with many people, the only cure, it must be mentioned that by bathing also its effects are considerably hastened.
For bathing the waters principally used are those of the Sprudel, simply because this spring supplies the greatest quantity of water. The usual temperature for a bath is 26° R. (901⁄2° F.) to 28° R. (95° F.), seldom 29° R. (971⁄4° F.) to 30° R. (991⁄2° F.), and the time is limited to from 15 to 30 minutes, seldom longer. The proper time for bathing is an hour and a half after breakfast (between 10 A.M. and 1 P.M.); some people take their bath before breakfast, or between 6 and 8 o’clock in the evening; but bathing after dinner is most injudicious. It is not usual to bathe daily; many bathe two days following, then skip one day; generally it is best to take a bath every other day; for weak persons bathing twice or even once a week will be found sufficient. Either mineral water alone, or two parts of mineral and one part of common water, are taken for a bath, and this latter proportion is in no way calculated to diminish its action. There is no difference in the action of the waters in the different bathing establishments, and people bathe with the same effect in the Curhaus, in the Sprudelgebäude (Sprudel building), in the bath rooms opposite the Mühlbrunn (the so-called Mühlbrunn baths), or in the Neubad. The price for a bath in the City bathing establishments is, for a first-class saloon bath, 1 fl. 50 kr. in the morning or afternoon; for a second-class bath, morning 1 fl., afternoon 70 kr.; for the use of a bathing-mantle, 20 kr.; of a sheet, 10 kr.; of a towel, 4 kr.; for warming the linen, 10 kr. In the common bath of the Curhaus the price is 5 kr. for each person. The Curhaus contains, besides the mineral water bath, all the necessary contrivances for the Russian vapour bath, with cold douche, price for the vapour bath, till 1 P.M., 1 fl. 30 kr.; for the cold douche, 60 kr.; for the mud bath, with 6 cubic feet of mud, 2 fl.; with 5 cubic feet of mud, 2 fl. 30 kr.; with 6 cubic feet of mud, 2 fl. 60 kr.; with 7 feet, 2 fl. 80 kr.; with 8 feet, 3 fl.; for the warm mineral douche, 1 fl.; and for the rising douche for ladies, 1 fl. 50 kr.
Rules to be observed when bathing.
Before entering the bath the patient should ascertain, by the aid of the thermometer, that it is of the proper temperature; the bath should only be taken after a good rest. During the time of bathing it is advisable to use gentle friction of the limbs and abdomen, but it is unnecessary to submerge the head or moisten the hair with mineral water. After the bath the patient should be well wrapped up and repair at once to his apartments, where he should rest for at least half an hour in bed or on a couch. Regarding the time necessary for an ordinary cure, it is not worth while to visit Carlsbad for less than three weeks, while it is not advisable to extend the stay longer than eight weeks. The general average is four weeks.
5. Dietetics during the Use of the Waters.
An old deeply-rooted prejudice attributes to the mineral waters of Carlsbad an incompatibility with certain articles of food, and causes many to think, that their contact with the ingredients of the waters renders them poisonous to the patient. Butter, salad, and raw fruit are generally classified as objectionable; it is, however, decidedly a mistake to think them so. It is not the waters, but the constitution of the patient, that causes some kinds of food to be objectionable. The mineral waters of Carlsbad, if not used in excess, are of the most innocuous kind ever known, and allow persons, possessing a good digestion to eat or drink what they like, provided everything is used in moderation. Considering these, facts, the principal rule (as already remarked by such an authority as Dr. Becher) with regard to the diet whilst taking the waters is moderation, rather than anxious selection of food. People who want to lose 20 or 30 pounds of accumulated fat, should avoid, or at least consume very small quantities of, such articles of food as are calculated to produce fat. All kinds of puddings, German rolls, called Semmel, potatoes, &c., sugar, milk, beer are forbidden in these cases. Weak and thin persons who want to gain and not lose weight, should live quite differently; they should not be abstemious, but live well, and not, as is commonly believed and maintained, discontinue eating and drinking when only half satisfied. Here we can best quote ’s words, “The same thing is not fit for everybody.”
Generally breakfast should consist of one or two cups of coffee, with but little either milk or sugar, or of weak tea. It is better to dilute the coffee, when too strong, with hot water, rather than with milk or cream; with the beverage may be taken two or three German rolls (Semmel), which cost 2 kr. each; I repeat two or three rolls and not more, because many people visiting Carlsbad, substitute the rolls for the waters, and frequently consume a dozen of them in the course of the day; occasionally a cup of chocolate may be taken instead of tea or coffee, and if there is a tendency to congestion of the blood, only cocoa prepared from the nibs, or gruel made from roasted barley, with the addition of milk, may be taken. Patients of weak constitution are allowed to take one or two eggs in addition. Dinner should consist of soup, and of not more than two dishes, i. e., beef with sauce and a joint of any kind, provided the fatty and skinny parts are properly removed; some stewed fruit (compot), or even French lettuce, or endive salad, may be taken with the joint without fear; fish, such as trout, pike, and carp (the skin being properly removed), and such vegetables as spinach, French beans, peas, carrots, cauliflowers, and asparagus; veal cutlet, half a fowl, &c., or a light pudding, may be substituted for the meat. This diet scale applies to persons with a pretty good digestion. Patients suffering from indigestion should be very careful in the choice of their food, and experience,will teach them best what kind of food to take and what to avoid.
It is impossible to give precise directions for all cases, because they vary so much; and the diet most likely to be suitable to each individual must be left to the discretion of the patient or his physician; but it is always advisable to have the diet fixed by the medical attendant.
In addition to the diet above-mentioned (for dinner), one roll may be eaten, and most patients are allowed to drink either half a pint of red or white wine, or one pint of beer.
As I have mentioned that the patient may even eat salad, many people will ask: What kind of food is it that is strictly forbidden? The answer will be, that there are circumstances which forbid everything, and others which forbid nothing; as a general rule, however, not too many dishes should be consumed, and all articles containing much fat and being heavy of digestion, are carefully to be avoided, such as goose liver, patties, lobster salad with oil dressing, eels, smoked salmon, &c., or dried peas, haricot beans, sour cucumbers, cucumber salad, raw fruits, excepting strawberries. Dishes made palatable by adding a little lemon juice or vinegar, may be enjoyed by most of the patients. Many people are accustomed to take a cup of coffee with milk several hours after dinner, and to eat two or more rolls at the same time. This course is not to be recommended, and only a very small cup of unsweetened black coffee (or with very little milk) and one roll is advisable, but it is much better to drink nothing but Carlsbad or some other Sauerbrunn, or soda-water, during the afternoon. For supper stout people should eat as little as possible; those who have taken coffee with a roll in the afternoon, should totally abstain from supper the others should be satisfied with some stewed fruit or a plate of light soup, or a glass of beer with a roll. Weak persons may eat for their supper a few slices of cold meat or a couple of eggs, or soup with an egg and a glass of beer.
Exercise.—Plenty of exercise, carefully regulated and not over-extended, is necessary for the greater part of the patients, inasmuch as they have generally led a sedentary life before visiting Carlsbad for the purpose of getting cured. It is, however, a deeply-rooted idea that all patients must walk a great deal, as otherwise the waters would not be properly digested, and, consequently, it often becomes necessary to caution the patients against taking too much exercise. It seems to be forgotten that people used previously to drink the waters of Carlsbad while enjoying perfect rest at their rooms, either on an easy chair or in bed. The question may be asked: What are those persons to do who cannot walk at all? Experience leads to the belief that the mineral waters of Carlsbad agree best with the constitutions of those patients who only take moderate exercise (during and after the use of the waters), instead of walking fast and mounting the neighbouring hills. Strong and robust people, whose illness has been brought about by sedentary habits, may move about as much as they like; weak and thin persons, on the contrary, should walk little and rest occasionally; some of them, indeed, will derive great benefit from drinking the waters, or, at least, some tumblersful at home, and even while in bed.
Smoking is to be restricted to its utmost limits, as it very often causes disease of the stomach, and is never to be allowed before breakfast.
Cultivation of the Teeth.—Although it is erroneous to think that the mineral waters of Carlsbad are detrimental to the enamel of the teeth, it is, nevertheless, better to clean them after the use of the waters, as they are covered during the night with a mucous substance that guards them against the influence of the waters; for cleaning the teeth it is best to use fresh water with a few drops of eau de cologne, or a combination of water with glycerine soap.
Clothing.—As the temperature of Carlsbad, even in summer, frequently changes very rapidly, warm clothing should be worn. Tight cravats are to be avoided, as they may easily give rise to congestion of the blood.
Lodging.—It is immaterial whether the patient lives close to, or at a short distance from, the springs, as the first tumbler of the water can be fetched from the spring; and it matters little whether the patient walks for half an hour on the promenades round the spring, or from his apartments to it; half an hour’s walk after the last tumbler is, besides, always advisable. Every suite of apartments should be provided with a steve, which in spring and autumn will be found indispensable.
Sleeping in the day-time is on the whole to be avoided, especially by persons suffering from congestions and fatty accumulation. Weak persons, however, who sleep badly during the night, may sleep for a quarter or half an hour in the day-time, but before taking their dinner.
Occupation.—During the use of the waters, the patient ought not to apply himself to any serious occupation; frequent letter-writing is to be avoided, as also reading books requiring much thinking. The same may be said of playing at cards, which always is exciting, even if not continued long, and for high stakes.
Dietetics of the Mind.—There is no doubt that if the mind is kept quiet and cheerful during the use of the waters, their beneficial effect will be much assisted; for this reason the patient ought to receive news from home at regular intervals, and all anxiety about business matters, &c., should be cast aside; cheerful company should be sought for, and all worry about his own and other people’s ailments should be avoided; pleasant reading and a little music will benefit many, but the chief resort should be in walks and drives in the beautiful environs of Carlsbad, and the mind should thus be elevated by the cheerful influence of nature.
6. Regulations for Living after the Conclusion of the Cure.
The patient, after the conclusion of the cure, should, for at least four weeks, live in the same way as during his stay at Carlsbad. Business, if possible, should not be resumed; an hour’s walk should be taken every morning, and two or three tumblersful of warm Quellsalz or water should be taken before breakfast, with the addition (if necessary) of ohe teaspoonful of Sprudel salt. Moderation should be observed with regard to eating and drinking. Whether another bathingplace should be resorted to for the perfection of the cure, must be left to the judgment of the medical adviser.
- It is a well-known fact that the cooler the water, the more carbonic acid gas it absorbs and retains.