It is remarked by Dr. De C. that a considerable number of people annually resort to Carlsbad without any other complaint than constipation of the bowels, obliging them to be constantly taking aperient medicine. “The waters of Carlsbad generally establish the regularity of the bowels, and during their use no aperient medicine whatever should be taken.” As the causes of constipation are chiefly sedentary avocations, there is little doubt but that a journey to Bohemia, and the waters of the Sprudel, will generally obviate this troublesome complaint or inconvenience; but I greatly doubt whether the Carlsbad waters will prevent its return, when the causes come again into operation.
Here our worthy author enters his protest against the codes of minute instructions which are often issued by far distant practitioners, who have no personal knowledge of the spas, for the guidance of the patients, and by which they are often led into great errors or even dangers, by neglecting to consult some physician on the spot, respecting the proper waters to drink and the best mode of taking them. All indeed that the distant physician ought to do is, to investigate well the complaint, and recommend such spa as he deems proper, leaving the details of application to the discretion of the medical practitioner on the spot.[76]
Since the publication of Dr. De Carro, many monographs on the Carlsbad waters have appeared by different authors, some of which have been noticed in the annual Almanack of Carlsbad, composed and published by Dr. De Carro himself. This little annual is of a miscellaneous nature, combining amusement with information, and never omitting one particular item—a list of all the visitors, with their titles, avocations, rank, and celebrity—where there is any fame. It may be as well to glance at some of these monographs, so as to pick out as much information from them as we can.
Dr. Bamberg, of Berlin, published a paper on the modern practice of Carlsbad, in the year 1835, from which I shall collect a few facts or opinions. Dr. B. was astonished to find at least ten drinkers at the Neubrunn or Muhlbrunn for one at the “Old Man of the Valley,” the splendid Sprudel. The Theresebrunn too, was not less frequented than her sister Naiads. It appears that a spa-doctor, now dead, had denounced the Sprudel as a most dangerous water on account of its high temperature, and prejudicing the visitors against it, by alleging, when other arguments failed, that it mounted up to the head with the same force and velocity with which it springs from its hidden source! The prejudice was erroneous. All the waters are from the same source, and the temperature of the Sprudel is generally as low as that of the others before it reaches the stomach. The Carlsbad doctors, however, are often greatly teazed by the directions brought by visitors from their own physicians, respecting the particular springs which they are to use. Some prejudice still hangs over the Sprudel, and that it is generally looked upon as of superior power to the others, is proved by the character of the drinkers there. The sick are more seriously ill—their aspects more sinister—and their figures more demonstrative of organic diseases at the Sprudel than elsewhere. But fashion comes in to the aid of prejudice. The Archipelago formed by the Neubrunn, Muhlbrunn, and Theresebrunn, is decorated so elegantly, and the temperature so drinkable, as the water rises from its source, that we need not wonder at the multitudes that crowd around them, especially when the physicians assure their patients that the waters of these fountains are precisely the same as the Sprudel.
The Sprudel possesses two very curious and clashing properties—that of creating stony concretions where they did not previously exist, and of dissolving them when already formed—like the famous sword of antiquity, whose rust healed the wound inflicted by its edge. The Carlsbad waters have the power of dissolving calculi in the human bladder, and are much resorted to for that purpose. Dr. Bigel, of Warsaw, has published his own case, in a letter to Dr. De Carro, some particulars of which may here be stated.
Dr. B. became affected with calculus after the age of 60 years, having previously passed several renal calculi, and was operated on by the lithotritic apparatus. The stone was smashed, but several of the fragments could not be discharged afterwards. He was then conveyed in a kind of litter many hundreds of miles to Carlsbad, where he took the waters under the direction of Dr. De Carro. On the third day of taking the Theresebrunn, and that in small quantities, Dr. B. became affected with fever, such as he experienced after the operation of lithotrity. This was relieved by copious perspirations. Returning to the waters, a similar attack of fever was kindled up on the fifth day—but with it the expulsion of several fragments of stone, and much solace in the organ. The fragments, which had hitherto been of a dark brown colour, were now white, and their surfaces smooth and polished. The white colour was found to penetrate to some depth from the surface. Dr. B. changed from one spring to another of higher temperature, till he finished with the Sprudel. At each of the sources he passed pieces of stone, and after their disappearance for a fortnight, the bladder was explored, and no more calculi were discoverable. All uneasiness in the bladder ceased from this time.
Dr. Creutzburg made some experiments on urinary calculi subjected to the action of the Carlsbad waters, and the results appear to be favourable to the idea that these waters are beneficial in calculous complaints. And now, when lithotrity is so frequently employed, instead of lithotomy, these waters may prove eminently useful in polishing and softening the fragments left after the operation.
But the waters of Carlsbad do not limit their powers to the solution or expulsion of vesical calculi; they have done wonders in people afflicted with biliary concretions. Dr. De Carro had a patient, aged 40 years, who evacuated daily, by means of the waters, not only large quantities of gravel, but numbers of gall-stones, of various shapes and sizes. Liver-complaints occupy a considerable figure among the maladies which are treated at Carlsbad—and biliary calculi are very frequently observed there. Dr. De Carro has related numerous instances where the baths and the waters of Carlsbad have appeared to dislodge the gall-stones, and carry them off by the bowels.
The Carlsbad baths, which are now much more used than formerly, often bring forward masked gout, rheumatism, or neuralgic pains that had lain more or less dormant in the constitution for months or years.
Before quitting these celebrated waters, I must take a short notice of a little work just published by a rising young physician of Carlsbad, whose acquaintance I had the pleasure of making there.