Chapter XII: Preface (12)

The worthy Doctor deplores the disappointments and mortifications which many invalids from far distant lands annually experience here, when they learn, to their grief and dismay, that the mineral waters are totally inapplicable to their maladies! They have then only the alternative of laying their bones in Bohemian soil, or undertaking another long, fatiguing, and expensive journey towards their native land. Dr. De Carro blames the ignorance which prevails among the faculty generally, respecting the medicinal properties of the Carlsbad and other spas. But the spa doctors themselves, and spa tourists, are not entirely blameless. The exaggerated accounts that are published respecting the _miraculous_ powers of almost every spa in Germany, are quite sufficient to mislead practitioners and patients who have no personal knowledge of these vaunted springs. One great object of the present volume is the attempt to sift the grain from the chaff, or to filter these waters and depurate them of their gross crudities and absurdities.

“The Carlsbad waters (says Dr. De C.) are detrimental when there are any symptoms of inflammation, congestion, or vertigo present. If these exist on the arrival of the invalid, they must be removed before he takes the waters; if they occur during the use of the waters, these last must be immediately discontinued.”

Dr. De C. observes, that these springs are detrimental in phthisis or any grade of pulmonary complaint—and that, in general, they aggravate _organic_ diseases of all kinds, and hasten their march. Here then is a rule which applies to many of the spas besides Carlsbad—namely, that the constitution should be free from inflammation, congestion, and structural changes in any organ, before the waters can be safely taken. Dropsical affections, even where no organic disease can be detected as their cause, are aggravated by the Carlsbad waters. Dr. De C. relates a melancholy instance of a nobleman who was sent there from a great distance—only to die of dropsy.

In chlorotic and amenorrhœal disorders, Carlsbad waters are beneficial; not so much from the minute quantity of iron they contain, as from their stimulant and deobstruent qualities. Females ought not to use these waters at all times.

A painful complaint which often presents itself at Carlsbad is _biliary calculi_. Dr. De C. thinks that the waters are almost specific in such cases. He lately attended an invalid who had come from a great distance to Carlsbad. On the third day of using the waters a prodigious number of gall-stones, of all sizes, were expelled. He has often found gravel to be expelled from the kidneys and bladder during the use of these waters; but he does not vouch for their _lithontriptic_ powers—that is, their power of _dissolving_ urinary calculi, although this quality has been attributed to them by some physicians.

It is in chronic gout, especially of the wandering and misplaced kind, that the Carlsbad waters have acquired considerable renown, disputing the palm with Wisbaden itself. It is in general necessary to take some chalybeate waters, in such cases, after the course at Carlsbad is completed. It is acknowledged by Sir John De Carro, that more than one visitation to Carlsbad will be necessary in gouty affections of any standing.

In the nervous tremors occasioned by quicksilver, these waters have been found very beneficial, both internally and externally.

THE CARLSBAD STURM, OR CRISIS.

From the age of 35 years, Dr. De Carro was subject to severe attacks of gout, each attack generally lasting ten or fifteen days, followed by much debility, with great tenderness of the feet. The intervals were of various duration—sometimes months—sometimes years. The complaint is hereditary in his family for four generations. About fifteen years ago (1825) one of the paroxysms ceased suddenly on the third day, followed by alarming symptoms—difficulty of breathing—irritation about the throat—total loss of sleep—copious muco-purulent expectoration, of an acrid and acid taste—rapid emaciation—cadaverous expression of countenance—and all the symptoms of approaching laryngeal phthisis. From these, however, he gradually emerged; but a sense of constriction in the trachea remained, occasioning loss of voice and many uncomfortable feelings. In April 1826, many of the symptoms above-mentioned returned, with considerable violence, and the Dr. removed from Vienna to Carlsbad. The waters of this spa are not beneficial in pulmonic complaints generally, but Dr. De C. considered his own malady as misplaced gout, and he commenced the waters on the 17th of May, at the Neubrunn. “During the first three days he felt no effect whatever. He had been unable to get higher than seven goblets daily; but, on the fourth day, he felt as if he were drunk—lost his appetite—staggered on his legs—had indistinct vision—burning cheeks—excited and agitated circulation—overwhelming drowsiness, and total inability to read or write. These violent symptoms continued for three days, and were _much mitigated by copious evacuations_, (tres soulagé par des evacuations copieuses) and, the storm having subsided, he continued the course of waters for six weeks, without further inconvenience. The bowels became regular, and there was a copious but fætid secretion from the kidneys during the whole time. All the symptoms of misplaced gout disappeared.”[75]

Dr. De C. observes that, had he not been a physician, he would have looked upon the above symptoms as forerunners of apoplexy. I am quite confident that they were so, and that the apoplexy was warded off by the “copious evacuations” that were procured, whether by nature or art. I have seen several instances of this “BAD-STURM,” and have no doubt of their being owing to some inflammatory action going on in some part of the body (as was clearly the case in the present instance), or to the neglect of aperient medicine taken in conjunction with the waters. The misplaced gout, such as Dr. De C. presented, is readily relieved by saline aperients, with small doses of colchicum and counter-irritation, without the risk of the “BAD-STURM,” which is a violent conflict between the constitution and the remedy. It is when the complaint is quiescent, and all inflammatory symptoms removed, that the Carlsbad and other mineral waters are beneficial.

Dr. De Carro has a short chapter on the East and West Indian invalids who resort to Carlsbad annually, for the relief of broken-down constitutions, and especially for affections of the liver, the spleen, and for the consequences of intermittent and remittent fevers contracted within the tropics. The worthy doctor, who has the usual dread of mercury, so widely infecting the Continental faculty, seems to hint pretty broadly that many of the Anglo-Oriental and Occidental diseases, are as much owing to the remedies as to the climate. Be this as it may, he gives the pagoda-complexioned gentry great hopes of benefit from the waters of the Sprudel.

The regime laid down by Dr. De Carro, is rather more liberal than by some of his confreres at the German Spas. Breakfast should not be taken till an hour after finishing the last goblet. Besides the exercise which is taken while drinking the waters, he recommends half an hour’s promenade after leaving the spring, if the patient be not too fatigued. The breakfast itself may be coffee, tea, or chocolate, according to the habits or inclinations of the invalid. Coffee is rather hazardous where there is any tendency to inflammatory action in the constitution. The bread and the cream are excellent at Carlsbad. _Dejeuners a la fourçhette_ are inadmissible here. The dinners at Carlsbad are very abstemious, as the TRAITEURS are obliged to regulate them by the orders of the faculty. They present no temptation to commit excesses. A very temperate use of plain and well-boiled vegetables is permitted. Salads, cheese, herrings, anchovies, and all raw fruit are strictly forbidden. The supper should be a little soup—and the time of going to bed is ten o’clock at the latest. Gambling is forbidden. The beer of the place, and light wines are permitted. The Bohemian, Hungarian, and Austrian wines are wholesome; but those of the Rhine, the Rhone, and Moselle may be used. It is recommended to keep the mind tranquil and contented! Alas! the prescription is easily written, but what pharmacy can supply the drug?

The season at Carlsbad extends from the first of May till the 30th of September. It is divided into three epochs. From the 1st of May till the 15th June, those who love quietude, economy, and health, will go to the spa. From the latter period till the middle of August, when the air is nearly as hot as the waters, CARLSBAD swarms, like a bee-hive, with legions of invalids and their friends, who lead, as Dr. De Carro says, “une vie bruyante,” and pay handsomely for their accommodations. The last six weeks, like the first, are more quiet, cool, and reasonable in expense. Those, too, who are anxious to have long interviews with their doctors, and pour out all their complaints into his attentive ear, will avoid the hot and fashionable season, and prefer the beginning or end.

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.

(_From the Medico-Chirurgical Review._)

Geschichte von Karlsbad. Von Dr. Hlawaczek.—History of Carlsbad.

The learned author gives a most elaborate account of almost every work that has been published on these famous waters, since their discovery by the Emperor Charles IV. in the sixteenth century. His book is, in short, a catalogue raisonnée of the writings of his predecessors. The few practical observations contained in it may be thus stated:

The medicinal powers of the Carlsbad waters are the following:

1. They invigorate the primæ viæ, and dislodge from them all impurities and accumulations. Hence in various forms of dyspepsia, arising from a sedentary life, from torpor of the bowels, &c. they are especially useful; also in chronic jaundice, obstinate head-aches accompanied with constipation, &c.

With such patients the use of the Carlsbad waters often act as an emetic for the first day or two.—Corpulent indolent persons, who feed too much and take little exercise, are always benefitted.

In all obstructed and infarcted states of the abdominal viscera, the use of the Carlsbad waters may be recommended. Hence, in many cases of hypochondriasis and hæmorrhoids, they are beneficial: also in enlargements of the liver, spleen, and mesenteric glands.

In addition to these maladies, we may enumerate many cases of amenorrhœa and dysmenorrhœa—diseases which are so often dependent upon accumulations in the bowels and general torpor and plethora of the system.

2. The Carlsbad waters have the effect of freeing the blood of acrimonious particles, either by neutralising and discharging them out of the body, or by causing a metastasis and derivation of them to the joints or to the skin. Hence in various forms of _internal_ gout and rheumatism, they are singularly useful; the disease being often drawn from the internal viscus which may happen to be affected to some outward part.

3. The Carlsbad waters cleanse the urinary passages of calculous deposits.

And lastly, they often effect a cure in a number of anomalous diseases, whose causes are not known, and to which indeed, a name cannot be given; as, for example, loss of power and feeling in the limbs, a tendency to syncope followed by cramps, some cases of epilepsy and asthma; also in certain disturbances of the mental functions. In all these cases, the Carlsbad waters seem to act as an _alterative_.

The venerable _Hufeland_ published in 1815, a treatise on the chief medicinal springs in Germany. He recommends the use of the Carlsbad waters in cases of constipation, tympanites, incipient disorganisation of the stomach and bowels and other abdominal viscera, more especially of the liver, of chronic jaundice, of congestion of the mesenteric and portal veins; also in nervous ailments, as amaurosis, hypochondriasis, and in various forms of calculous disease. He also strongly recommends them in most of the forms of gout. The Carlsbad waters, in addition to their purgative qualities, are possessed of remarkable alterative powers, so that often they effect quite a change in the state of the blood and other fluids of the body, depriving them of all acrimonious and hurtful particles, and restoring them to a condition of health. Hence their striking utility in numerous cases of cachexia, which are irremediable by ordinary medical treatment.—HLAWACZEK.

VALETUDINARIUM.

It is often more easy to ascertain the internal condition of the body through the medium of external phenomena, than that of the mind through the physiognomy of the countenance. To the experienced observer, the complexion, the expression, the eye, the gait, the tone of voice, the figure, the proportion of the different parts of the body, and many other indications incapable of description, convey very authentic information respecting the condition of organs and structures that are far removed from sight. It is in a great SANITARIUM like this, where invalids are gathered from all quarters of the world, that a young physician, under the guidance of an old one, might beneficially study the _physiognomy_ of diseases. For, although the greater number of spas have much that is common, both as respects the waters and the maladies for which they are taken, yet each spa, or at least, each class of spas, exhibits some characteristic features among the mass of visitors, indicative of the maladies which led them to the Hygeian fountains of the place. Thus it is impossible to stand long at the FONTAINE ELISÉE of Aix-la-Chapelle, without discerning a large sprinkling of cutaneous complaints, however carefully they may be concealed by the wearers of them. It is in vain that—

“Wrapp’d in his robe white LEPRA hides his stains,”

the features of the LEPER disclose the worm that torments him by day and by night. The French and Germans are universally imbued with the doctrine that the repression of a certain malady, which has got the musical soubriquet of “SCOTCH-FIDDLE,” is the cause of half the evils to which flesh is heir. On this account, the continental folks have a great longing, or rather a violent _itching_ for sulphureous waters. The slightest odour of sulphuretted hydrogen gas in a newly-discovered spring, is a real treasure—and in the old ones, it is sure to preserve reputation to endless ages!

The neighbouring mineral source—SPA—together with SCHWALBACH, BROCKENAU, BOCKLET, and other chalybeate springs, attract a different class of votaries—namely, the pallid, the debilitated, the leucophlegmatic—those, in fact, who have been sucked, and left bloodless by vampyre diseases.

The emblem of WISBADEN might be a swelled and gouty foot—that of WILDBAD a crutch, or a hobbling paralytic invalid—KISSENGEN, the tumid liver and green fat—MARIENBAD, the paunch of Falstaff, and the jaundiced eye.

But CARLSBAD presents a greater medley than any of the other spas that I have visited. When we contemplate, even for a single morning, the crowds that surround the Sprudel alone, presenting specimens of almost every human infirmity, not in solitary cases, but often in trains of twenties or thirties in succession—when we consider that, in these various specimens, there are many that are of a diametrically opposite nature to each other—yet all cured or relieved by an upheaving fountain that never varies in temperature, taste, or composition—doubts may well arise whether there is not some truth in the sarcastic remark of an eminent philosopher,—that “there are more false _facts_ than false _theories_ in physic.”—But there is something to be said PER CONTRA. 1st. Many complaints which are thought and believed to be cured by mineral waters, are only _relieved pro tempore_—and the contradiction seldom or never appears. 2d. Many different diseases are produced by the _same causes_ acting on different constitutions. Thus luxurious living and idleness will, in one person, induce gout—in a second, hæmorrhoids—in a third, liver complaint—in a fourth, rupture of a bloodvessel in the lungs—in a fifth, congestion in the brain—in a sixth, paralysis—in a seventh, stone in the kidney or bladder,—and the list might be far extended. Now, if the same cause or class of causes produce such a number of different maladies; there is nothing unreasonable in the supposition that the same remedy, or class of remedies, may be useful in abating or even removing those varied disorders.

3d. With the exception of a few specific remedies, such as mercury, sulphur, colchicum, and ergot, with the real nature of whose physiological operation on the human frame little is known, almost all the other medicinal agents act through the medium of the digestive organs, the liver, the kidneys, and the skin. Now, the mineral waters of such spas as Wisbaden, Kissengen, Marienbad, Carlsbad, &c. act through these organs also, and contain the elements of many of our most efficient remedies. They have, besides, great advantages over ordinary medicines at home, in consequence of the exercise of travelling, the change of air, and the alteration of habits that precede the course of the waters.

4. Through what channels do the noxious _physical_ agents enter the constitution and produce disease? Through the digestive organs and skin, without doubt,—to which may be added the lungs, which may imbibe the principles of disorder with the oxygen from the air we breathe.

5. But there is a great class of _moral_ causes of diseases, acting on the body through the medium of the mind—a class so extensive that PLATO considered it to be the origin of all corporeal maladies!

6. Against these moral agents the great spas possess powerful auxiliary counter-agents, _as preventives_, in the form of amusements on the spot and abstraction from cares. They also present the means of removing (if removeable) the effects which these moral causes have already inflicted on the bodily frame.

7. The far greater number of physical remedies act by altering and improving disordered functions and secretions—by evacuation—and by imparting tone to debilitated organs or the whole constitution.

8. It must be allowed that mineral waters contain, to a very considerable extent, the requisite ingredients for fulfilling one or all of the foregoing indications.

9. It is often found to be beneficial to combine tonics, alteratives, and aperients in the same formula or prescription, in order that the three indications alluded to, may be simultaneously accomplished.[77] It is undeniable that some of the spas contain within themselves this combination of chalybeates, aperients, and alteratives, either of which ingredients can be increased at pleasure on the spot.

10. The medicinal agents in the mineral waters, though in much smaller quantities than when given in prescriptions, have a much better chance of success, in consequence of their being so largely diluted by the hand of Nature, and the temperature of the diluent being so very high, in most of the springs.

11. The early hours, and the exercise taken while drinking mineral waters, have powerful influence in promoting their salutary operation. How many invalids, in England, would start from their beds at five o’clock in the morning, to drink salt and water till seven or eight o’clock, using their limbs all the time in locomotion? very few!

12. The warm bathing, which generally precedes or accompanies the drinking of the waters, has also great effect in augmenting the medicinal agency of the waters taken internally. The circulation is drawn to the surface—the insensible perspiration augmented—and various internal organs sympathise with the skin and are relieved from habitual congestion.

13. The habit of early rising, which is unavoidable at the great spas, leads to many other good habits. Early meals and early bed-going follow of course, and of consequence. The excursions in the middle of the day, undertaken while devoid of care, and free from business, contribute not a little to the efficacy of the spas, and to soundness of repose at night.

14. When I observed that many of the German spas combined tonic, with aperient, and alterative qualities, I by no means averred that these qualities were always well proportioned for all complaints and various constitutions. On the contrary, they are often very deficient in one or other of these qualities—and it is by overlooking this defect, and trusting solely to the remedial agency of the waters, that continental physicians commit a grand mistake—especially in the treatment of British patients.

15. The digestive organs of our continental neighbours are habitually in a far more tender and excitable condition than those of our countrymen, in consequence of their greasy and sloppy food, and the poverty and acidity of their wines and other drink. They cannot, therefore, bear medicines of any strength, without great suffering. Relying on identity of constitution, the mineral waters are often administered ineffectually by foreign physicians to the people of these islands. These last are washed and drenched, from day to day, and from week to week, while the glandular organs (the liver in particular) not directly affected by the waters, become torpid in function, and vitiated in their secretions. Hence it is that, after a week or a fortnight, much derangement takes place in the digestive organs—febrile irritation is set up—the nervous system is impaired—and then, when the patient declares that the waters are disagreeing with him, the SPA DOCTOR consoles him with the information that the spa-fever or crisis has come, and, if he lives through it, he will be much better than before it commenced! All this, in nine cases out of ten, might be prevented by taking a small dose of blue pill—a couple of grains, for instance—over night. In this case, a much smaller quantity of the waters would be sufficient in the morning, and the liver and other glands would be roused to simultaneous action with the bowels. The physicians of Cheltenham and Leamington act on this plan, and render the course of waters far more beneficial than they otherwise would be. The crisis or spa-fever appears to me an act of salutary rebellion, on the part of Nature, against the injudicious employment of the waters, and an effort to restore the equilibrium of function among the great organs, which equilibrium has been disturbed by the waters themselves.

16. It is a well-known fact that soldiers, sailors, and even civilians, will recover from illness much sooner in a public hospital than in their own homes—although attended by the same physician or surgeon. The same applies to infirmities of mind as well as of body. The individual who becomes insane, has infinitely less chance of recovery at home amongst his friends, than among strangers in an asylum. A great valetudinarium, like the spas, comes under the same rule. How is this to be accounted for? I have heard the aphorism of Rochefaucault quoted in explanation, viz. “that we derive pleasure from the sight of misery and suffering in others, even when they are our dearest friends.” From long acquaintance with human nature, I venture to say that, in this celebrated aphorism—or rather sophism—the author of it only stated _half_ a fact, and drew from that half fact a _false_ inference. The emotion which we involuntarily experience at the sight or the intelligence of misfortune or affliction in others, whether strangers or friends, is not unmixed—but a compound of _commiseration_ for the afflicted, and a feeling of _secret satisfaction_ (magnified by Rochefaucault into _pleasure_) at our own immunity from the evil. Two sailors are on the lee yard-arm furling the mainsail in a tempest. The ship lurches—the yard-arm is swept by a wave—and one of the sailors is torn from his hold, and plunged into the deep. Will the French philosopher persuade us that the seaman, who clings to the yard and escapes death, feels _pleasure_, unmixed with sorrow, at the sight of his drowning mess-mate? The poet, who saw and described a catastrophe identical with the above, but on a larger scale, was far from entertaining the sentiment of the philosopher.

“Bereft of power to help, their comrades see
Their late companions die beneath their lee,
With fruitless _sorrow_ their lost state _bemoan_.”

17. But there are other and adequate causes assignable for the more rapid recovery of health in public places of resort for invalids, than in private life. Man is the creature of habit; and habit results chiefly from imitation. In a great watering-place, we acquire, or at least comply with, habits which we would not attempt at home. How many delicate and fashionable invalids would start from their couches at sun-rise every morning, in London, and drink repeated draughts of nauseous compounds before breakfast? How many would dine at one, instead of seven o’clock? How many would retire to bed at nine o’clock, instead of midnight or later? How many gourmands and Bacchanalians, in England, would comply with the rigid rules of abstemiousness enjoined by the spa doctors, and which they dare not infringe, lest the disobedience might render the waters useless, or even injurious?

The revolution in social, but insalutary habits alone, would cure half the _disorders_ for which the aristocratic valetudinarian flies to the spas. If the maxim of Rochefaucault, too, have any foundation in truth, what a prodigious source of pleasure must the spa-goer find in the different watering-places, where he daily contemplates almost the whole of the moving mass of mortals around him labouring under more or less of bodily suffering! But, admitting the less humiliating explanation which I have attempted of the philosophical maxim, the result will not be materially different. Every one affected by _disorders_ at all curable, will see many around him who are evidently afflicted by _diseases_ beyond the reach of remedy. While commiserating the fate of their neighbours, they have a pleasing consciousness and assurance that they themselves are not in such a hopeless condition. As for the victims doomed to an early grave, _they_ never despair. They see daily recoveries going on around them—and HOPE, “that comes to all,” does not withhold its balmy influence even from them! The resounding Sprudel is pouring forth its healing waters for the incurable as well as for the curable, whilst the veil of mystery that hangs over its origin and source, exaggerates, on the well-known principle, “_omne ignotum pro magnifico_,” the virtues of its miraculous qualities! The season of the year in which the journey is made and the waters taken, is not a little favourable to the recovery of health, and, combined with the sanguine expectations of recruited vigour and emancipation from sufferings, gives wonderful efficacy to the spa.

GASTEIN, commonly called WILDBAD GASTEIN.

Gastein, Pfeffers, and Teplitz are triplet sisters of the same qualities, physical and medicinal. They are so pure that they may be, and are used as spring water for drinking and culinary purposes. The locality of Gastein is only inferior in romantic scenery to that of Pfeffers. It is much superior to that of Wildbad. It is situated on the frontiers of the Duchy of Salzburg and Carinthia, in the midst of mountains ten thousand feet in height, and its fervid springs, several in number, rise on the borders, and in the very middle of a cataract that foams and flies over a precipice, with a noise like thunder, into an abyss of nearly 300 feet in depth. It is the little river ACHE that descends from the mountains, and forms the striking feature of the landscape at Gastein, which was once a place of wealth and consequence, by reason of the neighbouring mines; but is now only a valetudinarium for the recovery of health. The people of this neighbourhood are of remarkably robust and vigorous constitutions, well made, and handsome in appearance—pastoral in their habits, and simple in their manners.

There are six available springs, besides those which rise in the bed of the torrent. The highest is the Prince’s Well, near the Chateau, and which is a very abundant source—furnishing 13,680 cubic feet of water in the 24 hours—the temperature being always 37° of Reamur, or 115° Fahrenheit. It is used conjointly with the water of an adjoining spring, called the “DOCTOR’S WELL,” which is one or two degrees higher in temperature. This last furnishes 3,600 cubic feet of water in the 24 hours. These two sources supply, by means of a pump, the new baths near the Chateau. Another is named after the Emperor Francis—and another still, that of the Hospital, at the foot of the Richeuibein, throwing up the astonishing quantity of 72,720 cubic feet of hot water in the day and night! All these springs are on the right bank of the ACHE; but there are other sources on the left bank also—the aggregate of all being upwards of one hundred thousand cubic feet of mineral water in the 24 hours.

There are ten or a dozen establishments for bathing at Gastein—some of them not the most splendid or convenient in the world. The practice of bathing in common is not very unusual here, and consequently upwards of 150 people may bathe at the same time. The complaint of Dr. Granville, that the baths are seldom completely emptied during the day, is not without foundation in truth. Gastein is now probably the only place where men and women bathe together.

“The common bath (says Dr. Streinz) in which gentlemen and ladies assemble together, contains 365 cubic feet of water, and requires nearly four hours to fill it. It will accommodate fifteen or sixteen persons, who can walk about in the water, or rest upon seats which are fixed there for the purpose. At each side of the bath there is a large dressing-room, one for the men, the other for the women. Around the bath runs a gallery, where the friends or acquaintances of the bathers can assemble, and enter into conversation with them.”[78]

It is quite useless to go into minute topographical details. Those who repair to Gastein will not need them—and those who stay at home will not read them. We shall therefore proceed to the properties of the waters themselves. It has been already observed that they are purer than any spring water, and so clear that you can discern particles of gravel at a depth of some feet. They spring from the earth without noise or bubbling. In certain damp states of the atmosphere, and preceding rains, some people have perceived a slight odour of sulphuretted hydrogen gas in these springs; but it is so questionable that they may be used as common beverage. They suffer no change, when exposed to the air, nor deposit any matter. Their temperature has been stated. When polished silver is immersed for four or five hours in these springs it becomes tinged of a brownish yellow colour, not easily effaced. The water leaves incrustations on wood or other articles exposed to its action, which incrustations are soft, astringent, and bitter to the taste. These waters have a remarkably vivifying effect on flowers, fruits, and vegetables exposed to their influence. In a pint of the water there is about 2⅔ grs. of solid matters, chiefly sulphate and muriate of soda, with a minute trace of iron. When brought near the magnetic needle it draws the loadstone sensibly towards it, which quality diminishes as the water cools. It has been ascertained that the Gastein water is composed of three, instead of two atoms of hydrogen to one atom of oxygen.

These waters are used as common baths—vapour-baths—and taken internally. The douches are also much employed. Their remedial powers, seeing that they have no chemical properties worth notice, have called forth much speculation—the conclusion, however, being, that the cause of this medicinal agency is veiled from human ken. This being the case, our object is to investigate the actual effects of waters so pure on the human frame. This, which is mere matter of observation, is far from being an easy matter. Spa doctors become unintentionally prejudiced—and spa tourists are often credulous—while patients themselves are often deceived—attributing virtues to the waters which sprang from various other causes that received no credit at the time. It is affirmed by Dr. Streinz and others, that the waters of Gastein, whether used internally, or externally, or both, produce a certain degree of excitation in the human constitution, evinced by some increase of temperature in the body—of power in the muscles—of animation in the eye and countenance—of clearness in the complexion—of acceleration in the circulation—of activity in the nervous system—of exhilaration of spirits. Those who bathe in them experience (as they say) unusual pleasurable sensations. The surface of the body becomes soft and smooth, with a slight but pleasant pricking, and sometimes a minute vesicular eruption. Dr. Granville’s description of the effects of the Gastein baths, however, is directly the reverse of Dr. Streinz, who observed them so long in others, and experienced them in his own person.

“The effect (says Dr. G.) produced by the water on the skin of the hands during the first ten minutes of immersion in it was curious. The bath corrugated and crisped it as if the hands had been held in very hot water for a considerable time; and on passing my hand all over the body, previously to the skin of the fingers becoming crisp—in fact almost immediately after going into the bath—instead of gliding smoothly and oilily down it, as at Wildbad, it felt ruvid, and the two surfaces seemed to meet with resistance, as if a third body, slightly rough, like the finest sand, lay between them.”

Here then we have two physicians giving diametrically opposite accounts of the physical phenomena produced by the same waters—shewing how little dependence can be placed on individual descriptions—the said phenomena varying according to the temperament, state of health, or even temper of mind of the personal observer!

It is stated by the German physicians that, after the third or fourth bath, some indisposition is usually felt—some giddiness about the head, and a relaxation, or sense of weakness in the limbs. These symptoms disappear in a day or two by repose and abstinence. The use of these waters renders people more susceptible of atmospheric impressions, of the electric kind, especially before or during a storm, accompanied by a sense of prostration or exhaustion, and heaviness about the head, with depression of spirits. The internal exhibition of these waters promotes the action of the bowels, and still more of the kidneys, attended by increase of appetite. The deposits of this water are extolled as applications to old wounds and inveterate ulcers.

“Long and multiplied experience (says Dr. Streinz) has proved that the bathe of Gastein re-animate the vital powers that were almost extinct—comfort and give tone to the flabby limbs—communicate new and vivifying heat to the blood—vigor to the nerves—and, through the medium of the magnetico-galvanic principle, re-establish the activity of the whole animal organism. Those who labour under direct debility, are those who have experienced most benefit from these waters—as those who have lost their strength from excessive efforts of the mind, large discharges of blood, or too copious and violent evacuations of any kind—those who have never perfectly recovered from severe acute diseases—who labour under disorders of the digestive organs—tremors—hypochondriasis—hysteria—neuralgic pains—inveterate gout and rheumatism—paralysis—contractions—affections of the spine—scrofula—mercurial diseases, &c. Their exciting qualities, however, render it necessary that both patient and physician should watch their physiological action on the body, and observe a very mild and abstemious regimen.”

Dr. Granville appears to be quite as confident in the efficacy of the Gastein waters as Dr. Streinz, Dr. Storch, or any of the most sanguine of his German brethren.

“I have no more doubt of the power which this mineral spring possesses, in the diseases for which it has been recommended, than I have of the effect of bleeding in subduing inflammation.”

My friend’s “grain of faith” is not like that of a mustard-seed—it is as large as a cocoa-nut! At all events, I cannot swallow it; and entertain very strong doubts indeed of the efficacy of Gastein water in such a multiplicity of serious diseases as are comprehended in Dr. Granville’s or Dr. Streinz’s catalogue. I can easily conceive that these waters, assisted by the mountain air, the romantic scenery, and the journey to the place, may produce all the effects which can be expected from such waters as Pfeffers, Wildbad, and Schlangenbad; but that they can work like magic I entirely disbelieve.

PRAGUE.

Whether we view this ancient capital of Bohemia from the bridge below, or the monastery above, we must acknowledge that, next to Constantinople, Prague is the most picturesque city in Europe. It is, however, from the central arch of the longest bridge in Germany, and certainly the most _sainted_ one, that we have the finest view of a vast amphitheatre rising tier above tier, from the broad stream of the Moldau, till the highest ridges of the precipices seem groaning under the massive piles of buildings that crown their brows. The huge structure, called the HRADSCHIN, the palace of the Bohemian kings—frowns over endless domes, spires, turrets, minarets, churches, convents, and cathedrals. The eye comes down at length to a bridge more holy, though not more handsome, than the Santa Trinita over the Arno. There are nearly as many saints standing on the parapets here as there are sinners traversing the body of the bridge! The master saint (St. John Nepomuck) was a priest, who, refusing to disclose the secrets of the confessional, was pitched into the Moldau by King Winceslaus for his contempt of court. But murder will not sleep; and a flickering flame hovered over the spot where the priest lay in his watery shroud, till he was discovered, and his body encased in a gorgeous silver shrine, which may be still seen in the cathedral (enclosed within the Hradschin) and is, perhaps, the most costly tomb in the world. The silver alone weighs thirty-seven hundred weight! The body of the sainted priest lies in a crystal coffin of great value! The lions of Prague would require a volume for description, and as Murray has dedicated twenty-seven columns to short notices of the chief objects of curiosity, I shall not say a word on this head. Three or four days, or a week, may be well occupied here, and the environs are very pretty. But it is worthy of notice that, in this beautiful and picturesque capital of Bohemia, the average duration of life, is one-third less than in London! The annual mortality in Prague, is one in twenty-two. In London it is not more than one in thirty-two. The Jews, who are here, as at Rome, crowded into a low and dirty quarter on the banks of the river, are longer lived than their tyrannical Christian oppressors. They are also more prolific.

We spent a few days very pleasantly at Prague; but when preparing to start for Teplitz, I was horrified at finding that I had lost the receipt for my passport—and that too, in Austria! The Commissionaire at the “DREI LINDEN,” seemed even more terrified than myself, and thinking he would contrive to make a job of the business, I marched off to the Bureau, and candidly stated the loss I had sustained. The officer, having cast a scrutinizing glance at me, took down a huge pile of passports, and soon singled mine out. “Voila, Monsieur, votre passport,” was all he said, and he never made the least difficulty, or seemed to consider it the slightest favour, to deliver me the precious document, without producing a receipt! I say again, and again, the Austrian police is grossly slandered. They are the most civil and polite on the Continent.

TEPLITZ.[79]

A long journey of sixty odd miles from Prague, through a country varied, and often interesting, brings us to the fertile valley of Teplitz studded with chateaux and villas, and well cultivated. The hills and mountains, for many miles before we reach Teplitz, are all conical and volcanic. This is the great WASH-TUB of Germany. What prodigious masses of exuviæ, suds, and sordes, must annually float down the Elbe to fertilize its shores! Three great public baths (and now a fourth, at Schoneau) for men, women, and children, respectively, display an immense number of human beings—all Adams and Eves without fig-leaves—immersed in water at a temperature sometimes of 114° of Fahrenheit, inhaling a dense steam, through which you could formerly have scarcely distinguished them—panting, perspiring, and streaming blood from scarifications on their backs to prevent their brains from being torn up by the excited circulation! Such _was_ a picture from which DANTE might have drawn some of his scenes in the inferno—except that here, it was not the “PURGATORY” of guilty souls, but the “expurgatorium,” of unclean bodies.[80]

The natural temperature of these waters is from 120° to 84°—and the chief ingredient is carbonate of soda—about two or three grains in the pint.[81] The private baths are upwards of eighty in number, in the town, besides the long range of most elegant new baths in the village of Schonau—decidedly the most superb bathing-places in Europe, and are in full request from morn till dewy eve. The water is limpid, and soon after immersion in a blood-heat temperature, or even lower, the surface of the body (according to Dr. Granville) becomes rough, rigid, and even wrinkled—a condition that obtains for some time after leaving the bath.[82] Perspiration also is visible on the skin, in big round drops, while the individual is proceeding to dry and dress. At a higher temperature than that of the blood—say from 108° to 112° or 114°, the action of the bath on the circulation and excitability is emphatic, and must often be extremely dangerous. The excitation first induced, is, and must be followed by a corresponding degree of depression or exhaustion. The reputation of the Teplitz baths is probably as much founded on the high temperature at which they are used, as on the composition of the waters themselves. There ought to be a mart at Teplitz for the sale of cast-off or second-hand crutches! “I may state (says Dr. Granville) that the specific virtue of these baths lies in the power they possess of restoring a cripple—it matters little from what cause—to perfect motion and elasticity.” Among the list of maladies that may be perfectly cured here, we have—“all cases of suppressed gout, chronic rheumatism, diseases of the articulations, paralytic affections, contracted limbs, old wounds, night pains in the bones, and many other diseases.”—_Granville._ Again, Dr. G. avers that—“with proper management I should not despair of recovering _from all his ailments_, the most pitiable object of gouty tyranny.” These are strong assurances. But I would strenuously caution the victim of suppressed gout respecting the baths of Teplitz, where the temperature is much higher, though the ingredients are not much stronger than in the waters of Wildbad or Pfeffers.

A physician, though young in years, yet of good promise, at Teplitz, (Dr. Richter) has written an interesting little work on these waters, and as it is in French, I would recommend it to the perusal of those who go to Teplitz for the purpose of bathing. During my stay at this celebrated spa, I had the advantage of Dr. Richter’s company and experience through the whole of the bathing establishments, and, through his influence, was permitted (being only a doctor) to visit the public baths—even those in which the women were bathing, with the greatest facility. It was at Schonau that I first saw the female bath in full operation. There might be about twenty women in the basin, when Dr. R. and myself entered. There was a slight commotion among the bathers on my first appearance, which quickly subsided, when my profession was announced and my privilege explained. Dr. R. published his work in 1840, and it is the most authentic guide and authority on the subject. I shall here give a condensed analysis of the small volume.

The various sources of the waters here differ but little in their chemical, physical, or even thermal properties. The water is limpid, and does not become turbid by standing, nor does it disengage bubbles of gas or air, with the exception of the Gartenquelle. The temperature varies from 120° Fahrenheit (the Hauptquelle), to 80° (the Gartenquelle). The tunnels and reservoirs over which the waters pass become coated with a brownish-yellow substance, composed chiefly of silex and acidulated oxide of iron. There are other depositions and incrustations into which the carbonates of lime and magnesia, as well as manganese and strontia, enter. In the wells of Steinbad, Stadtbad, and Gartenquelle, there have been observed various _thermal oscillatoria_. These waters do not present the same slowness in boiling and cooling that some other hot spas have evinced.

The great disproportion between the physiological action and the chemical composition of the Teplitz waters, has given rise to numerous speculations, and support the grand argument that there is an occult quality in mineral waters which defies our minutest chemistry. One thing is obvious, that these waters are alkaline, saline, and chalybeate—and consequently that they possess, at one and the same time, solvent and tonic qualities, which are greatly augmented by their temperature. Dr. R. very properly investigates their physical and physiological action, according as they are applied hot, warm, tepid, or cold to the body. They may be termed hot, when above 100°—very hot when approaching to 120°—warm at blood-heat (98°)—tepid, when under 90°—and cold at the temperature of the earth or air.

The very hot bath (110° to 115°) produces quickly a general excitation of the circulation and sensibility, like all other hot waters. It augments the secretions, ending in considerable perspiration—and followed ultimately by relaxation in the muscular and fibrous systems, and a general softening of all the solid parts. When the bath is very warm, we have often, in addition to the foregoing phenomena, oppression at the chest—anxiety—palpitation—vertigo—dimness of sight—heaviness about the head—syncope—and even apoplexy. It need hardly be added, that baths at such a temperature as to induce the foregoing train of symptoms, are very dangerous, and hardly ever necessary.

But even at a moderate temperature—96° or 98°—these baths produce, after a few days, sleeplessness, constipation, great disposition to perspiration, emaciation, susceptibility to cold or damp, aggravation of gouty or rheumatic pains, the aching of old wounds, prostration of strength, &c. These occur about the eighth day, and, after more or less duration, gradually disappear. After this period, there generally appears an eruption on the skin, of a whitish yellow or red colour, accompanied by considerable itching, discharging a watery humour, and finally desquamating, with occasionally some fever.

If the baths be continued longer, the prostration and lassitude increase, accompanied by great irritability and moroseness, loss of appetite, furred tongue, nausea, fætid eructations, repugnance to the bath, wandering pains in the limbs—in fine, fever is kindled up, with inflammation of the mucous membrane of the stomach and bowels. This is what the Germans call “DAS UEBERBADEN,” or over-bathing—and occurs after eighteen or twenty baths—sometimes not till after forty or sixty.