“Among the consequences of these endemic diseases of the Indies we must reckon: tumefactions of the liver, and the spleen, which frequently are encomous, as well as other tumors in the cavity of the abdomen: swellings and obstructions of the intestinal glands (which frequently also are the products of malignant cutaneous diseases, peculiar to the torrid zone), obstinate jaundice, spasms of the stomach, accompanied with a vomiting of food.
“The English and Dutch physicians have these many years been in the habit of sending patients of this class to Carlsbad or Wisbaden, after those of the former first had tried Cheltenham to no purpose; and these two springs produce, in the above mentioned diseases, an effect really wonderful.” 198.
Now we were told by the more cautious and candid Dr. Richter, a page or two back, that “all enlargements of the glandular abdominal organs, with debility,” were diseases not to be remedied by these waters. All these morbid growths are attended and nourished by more or less of chronic inflammation, and in these cases the Wisbaden, or any other thermal baths, are more likely to do harm than good. The aperient waters of Kissengen or Pulna are far more efficacious and safe. Dr. P. has a chapter on the efficacy of these waters in “paralysis the consequence of apoplexy.” Now every physician knows that the cause of the paralysis succeeding apoplexy is the clot of blood effused in the attack, and the damage which the brain has received in the neighbourhood of that clot. Nature, at length, absorbs the effused blood, or surrounds it with a sac, and then the adjacent brain gradually recovers its function, if within the power of nature, and the motion of the paralyzed limb is regained in proportion. How this salutary process is to be accelerated by the baths or waters of Wisbaden, I cannot imagine; but I can very easily conceive that these warm baths may readily interrupt the work of nature, and convert a paralysis into an apoplexy. Such conversions, in fact, do occur every year at the German thermal spas. He says, “paralysis arising from plethora will be cured with more facility by means of the thermal waters, than that which is caused by the accumulation of lymph in the brain or the spinal marrow.” This doctrine may be true in one sense, but it is dangerous in another. Paralysis from plethora is undoubtedly more susceptible of cure than dropsy of the brain or spine; but it must be a most hazardous attempt to try the waters of Wisbaden for plethora of the brain or spinal-marrow.
Our author’s directions for using the waters appear unobjectionable, and therefore I shall cull out some of his chief rules.
1. The waters ought to be drunk fasting, and before the bath—using gentle exercise and cheerful conversation between each draught. The cup should never be emptied at once, but sipped slowly. Some people may drink four hours after dinner, but in less quantities and at a lower temperature.
In gouty affections, and where the skin is torpid, the water should be drunk as hot as possible—and even in bed, if necessary. Some find it better to drink it luke-warm, and mixed with a little milk. Half an hour after finishing the waters, breakfast, (chocolate, coffee, or egg-milk, or broth with the yolk of an egg,) may be taken. “The less nourishment that is taken between drinking and bathing the better.” Half an hour or an hour should elapse even after the lightest breakfast, before the bath. It is dangerous to bathe when heated or perspiring. “Persons taking a whole bath, should immerse themselves into the water only by slow degrees, up to the neck, having previously sponged the chest and abdomen with the bath water.” If seized with headache or vertigo in the bath, it is too hot, and ought to be left immediately. Baths in which you perspire are too hot, spoil the appetite, weaken the patient, and put him out of humour all day. “All baths, even those of common water—sometimes cause a sensible congestion of blood in the head.” The head should then be sponged with cold water. Great care should be taken to avoid sleep in the bath—or even after a hot bath—but after a tepid bath it may be allowed.
In many cases it is very beneficial to use friction, by means of a brush or sponge, whilst in the bath. The duration of the bath is a quarter of an hour to an hour and a half. People should always begin with the short period—and not too high a temperature. Where it is desirable to encourage gentle perspiration after the bath, the patient should go to bed.
As all sudden extremes are repugnant to nature, invalids, when travelling towards watering-places, should begin to adopt the regimen and hours which they must follow at the spas. A few tepid baths of plain water are useful preparations, and light cooling diet, should be employed for a week or two before arriving at the spa.
The following sketch of the motives, hopes, and prospects which lead invalids to spas—and their routine of life and enjoyments at those places, is drawn by a Spa Doctor of twenty years’ standing. It is nearly free from the sins of commission—but not of omission. It is penned en couleur de rose—and, like the speech of an advocate, it slurs over all features of the case that might seem disadvantageous to the cause of the client. I shall supply some deficiencies at the end.
“It is owing, in a great measure, to the enlivening influence which a temporary residence at some watering-place exercises on the mind of the visitor, that the most successful results are obtained there, and which the best endeavours of the regular physician can seldom effect at home.