“Most chronic rheumatic affections will be removed or greatly relieved by the Wisbaden baths. In the slighter cases, not of long standing, a short course, for about three weeks, will be frequently sufficient. In the more intractable cases of articular and muscular rheumatism, as also in the pains of a rheumatic nature affecting the face, head, and other parts; a more prolonged course will often be required, combined with the use of the douche. In some cases the hot bath, vapour-bath, or douche, may be advantageously employed, especially in elderly persons whose skin is dry, and seldom perspirable. Where however the complaint has supervened upon, or has been continued from an acute attack, in which any symptoms of the heart or pericardium being affected, were present—which is more frequently the case than is generally supposed—it would be well to ascertain, by auscultation and percussion, that none of those symptoms remain, as they would very likely be aggravated by the employment of the water. Those rheumatic affections depending upon long exposure to wet or cold, to which military men on duty are peculiarly subject, are especially relieved by these baths. Two or three bad cases of this kind fell under my observation last year, in which the most beneficial and unexpected results followed a full course of the waters. One gentleman in particular who returned from India invalided, was scarcely able to get about with the assistance of a stick; who was sceptical of the power of mineral waters, and not over-attentive with respect to his diet, recovered the comparatively free use of his limbs before he left Wisbaden, and was completely restored when I met him about a month afterwards, in a steamer on the Mediterranean, being on his way to rejoin his regiment.”
“Those nervous pains recurring in paroxysms affecting the branches of particular nerves of the face, head, or extremities, to which the term neuralgia or tic is generally applied, and which not unfrequently originate from a rheumatic or gouty diathesis, from the suppression of habitual discharges, or of cutaneous eruptions—which causes, though perhaps somewhat exaggerated by continental practitioners, are not sufficiently attended to in England—are more likely to be relieved and cured by a properly directed course of mineral waters, than by pharmaceutical remedies or local applications. To many of these cases Wisbaden would be exceedingly applicable, especially when the functions of the skin are sluggishly performed, and there exists a congested state of the abdominal or pelvic viscera, with retardation or irregularity of the periodical secretion in females. In those cases which appear to arise from other causes, as moral influences, a high state of nervous excitability, &c., I should be more inclined to recommend waters of a different kind, of which I shall have to speak presently. Water or vapour douches may in general be advantageously combined with the baths and the internal use of the same water—or of a water of a different nature, as that of Homburg, Marienbad, &c. according as circumstances may seem to indicate their employment.
“The state of abdominal plethora, with congestion of the liver, and obstruction in the circulation of the vena portæ, termed by the Germans Unterleibsvollblütigkeit, with its consequences, as impaired digestion, deficient or vitiated biliary secretion, piles, &c.—occurring for the most part in persons about or beyond the middle period of life, who have been addicted to the pleasures of the table, and marked by more or less protuberance of the abdomen, with diminished muscular and nervous energy—is one well calculated to be relieved by the use of the Wisbaden waters internally and externally employed. The baths, by exciting the activity of the nervous and vascular systems, and by determining powerfully to the surface, tend most materially to equalize the circulation and remove the internal congestion, while by the internal use of the water the secretions of the mucous membranes, of the alimentary canal, of the liver and kidneys, are improved in quality, and often perceptibly increased in quantity;—at the same time that the mesenteric glands and absorbent vessels are stimulated to increased activity, and the digestion is consequently improved. Even when, under these circumstances, the drinking of the water is not followed by immediate sensible effects, either upon the bowels or kidneys, it is frequently not the less efficient on that account, and unless some inconvenience be experienced, it should be persisted in, as after a certain time copious critical evacuations will often occur, and be followed by immediate relief; whereas were similar effects produced by artificial means, as the exhibition of drugs, the relief would only be temporary, and the frequent repetition of the same or analogous measures, would be necessary, and would tend but little to the permanent amelioration of the patient. In several of these cases, especially where there exists hardness or tension in the region of the liver, spleen, or in other parts of the abdomen, the douche will be of material assistance in the treatment.”
“In many cases of paralysis, baths of mineral waters offer the most efficient, and often the only means of arousing the nervous energy of the system, and of the paralysed parts; and few have a more beneficial influence in this way than those of Wisbaden; but here again it cannot always be determined beforehand, that baths of this kind will be more effectual than those of other springs containing but a small proportion of solid and gaseous substance, as the latter occasionally succeed after the failure of the former. In the obscurity which still envelops the mode of action of mineral baths, this cannot be satisfactorily accounted for, except upon the principle of idiosyncrasy, or by the supposition that the disturbing action of a thoroughly impregnated spring is less adapted to certain of these cases, than the more tranquilizing and sedative influence of a simple thermal, or slightly alkaline, warm spring. In most instances, however, where there does not exist a high degree of nervous excitability, or tendency to fulness in the cerebral vessels, the baths of Wisbaden may be used with great prospect of advantage; especially when the complaint is of a rheumatic origin, depending upon the impression of poisonous influences upon the nervous system, as malaria, the abuse of mercury, or the employment of this and some other metals by workmen; as also in those cases, where the disease appears to be of a purely local nature, not connected with cerebral disease, but arising from deficient energy of the nerves of the part, or of the spinal marrow, consequent upon exposure to cold and wet, or other analogous causes. Even in paralysis affecting a limb or one side of the body, remaining after an apoplectic seizure, baths of this and other mineral waters may often be advantageously employed, provided there be no symptoms of cerebral congestion, or organic disease. Plethoric individuals, and those whose digestive organs are disordered, will frequently require some preparatory treatment, previous to using the baths, in paralytic, as well as in other diseases. These, then, are the principal diseases which the Wisbaden waters are more especially calculated to relieve, and in which their use in the form of baths and douches is the most essential part of the treatment. There are besides various other complaints to which the external or internal use of the water, or both combined, is extremely suitable, in common with several other mineral springs; but of which the peculiar circumstances of each case require to be investigated, in order to enable the practitioner to decide upon the springs likely to be most effectual. Of these, many scrofulous affections will be cured or greatly ameliorated by the internal and external application of these waters; particularly enlarged lymphatic glands of various parts, and of the mesentery, occurring in children or young persons of a torpid habit, with tumid upper lip and abdomen, a vitiated state of the intestinal secretions, and a harsh dry condition of the skin. Here the exciting and resolvent powers of the waters are exceedingly effectual, by improving and augmenting the secretions of the alimentary canal, and of the skin; and, by stimulating the absorbent and vascular systems, mostly cause the speedy diminution of glandular or bony swellings.
“Another case, in which the Wisbaden springs are often eminently serviceable, is, where there is a general disordered state of the health, without the existence of any actual disease, or material derangement of any particular functions, except perhaps impaired digestive powers—as is very frequently seen in Londoners, and inhabitants of other large cities, closely engaged in trading, mercantile or professional occupations; as also in those who have been resident in a tropical or unhealthy climate: such a state, though relieved and palliated for a time by medicines, not unfrequently terminates in serious functional or structural disease, if allowed to continue for a long period—and nothing would tend more effectually to its removal than temporary absence from the cares of avocation, change of air and mode of life, and the employment of a mineral spring like Wisbaden, followed by that of a chalybeate water, in those cases where it is not counterindicated.
“The same may be said of several cases of hypochondriasis, with disordered digestive powers, to which Wisbaden is applicable, both on account of its waters, tending to rectify the deranged state of the digestive organs, and also from the beneficial influence which would be exerted in most instances on the patient’s morale, by the movement of the place, its cheerful appearance, the beauty of its environs, and the neighbourhood of so many objects of interest. To some patients of this class, tepid bathing with the internal use of a cold gaseous spring is most applicable. To others again, certain other mineral springs are best adapted.
“The suppression or painful performance of periodical functions peculiar to females, is frequently benefitted by the Wisbaden baths; especially, if the cause be cold, checked perspiration, or a congested state of the abdominal or pelvic viscera. Some syphilitic affections, especially where much mercury has been employed, and certain chronic cutaneous diseases, as psoriasis, impetigo, &c. where the skin is generally in a dry state; as also eruptions of the face depending upon derangement of the alimentary canal or liver, will often be removed, by baths of a warm saline water, like Wisbaden; and likewise by sulphurous or alkaline springs, either alone, or combined with the internal use of the same, or some other mineral water. In certain bronchial and laryngeal affections, with cough, and scanty or deficient expectoration, the Wisbaden baths, combined with the internal use of the water, and the inhalation of its vapour, may be expected to be of material advantage.
“On the other hand, these springs, like most others, will generally be prejudicial in organic disease of the lungs, heart, or large vessels, in disorganisation of the abdominal or pelvic viscera, with fever, profuse hemorrhagy or discharges per vaginam, either depending upon relaxation or upon the presence of hypertrophy, polypus, or other structural disease.”[19]