CARLSBAD.

The gas-baths are taken locally or generally. In the general bath the patient should be lightly cloathed, as the gas generally induces perspiration. When it is used locally, by way of douche, it may often be applied to the naked part, or with a gauze covering over the surface, especially if to the eyes. Care should always be taken to prevent the introduction of gas into the lungs—or even into the mouth or nose, lest disagreeable consequences should ensue.

This new remedy has attracted individuals of both sexes to Franzensbad and Marienbad, from the wilds of Russia, and from various parts of the South and centre of Europe. Those who come with the greatest anxiety, and with the most ardent hopes, or at least expectations, to the gas-baths, are such as have long sighed, but sighed in vain, to become—

“The tenth transmitters of some foolish face,”

placing, apparently, more faith in the physical operation of the waters, baths, and gases of the spas, than in the intercession of saints or even the prayers which they had offered up at the shrine of the Madonna herself! How far and how often the gas-baths have wrought the happy revolution, I cannot say. The doctors have firmly asserted, and the patients have willingly believed the “flattering tale.” As the gas-baths are seldom trusted to alone, it is impossible to say with accuracy, what share they have in the general restoration of health, and the consequent invigoration of the constitution. Upon the whole, I left Marienbad with the strongconviction on my mind, that its waters and baths were among the most efficient in the list of the German spas.

The valley of Marienbad is well sheltered, and surrounded by pines in the immediate neighbourhood of the spa; but we have only to mount a couple of miles on the Carlsbad road, when we get into a high open country, with a bracing air and a boundless prospect. Some parts of this route are extremely picturesque—I would almost say romantic, especially a few miles from Marienbad, where the road winds down a precipice in numerous tourniquets, into a valley surrounded on all sides by steep acclivities, some bare and rugged, others crowned with woods. A rivulet roars through the valley, and a village, a convent, and some factories, give cheerfulness and animation to the scene.

P.S.—Before quitting the subject of the Marienbad waters, I must dedicate a few lines to a small brochure on these waters, published by my friend Dr. Herzig, in the Summer of 1840.

Die Heilung der Krankheiten, mit hulfe des Kreuzbrunnen zu Marienbad. Von Dr. L. Herzig.—The Cure of Diseases by the help of the Marienbad Waters.

The water of the Marienbad springs has a soothing effect on the nervous system, and checks vomiting and pain in the stomach and bowels, in consequence partly of the carbonic acid contained in the water, and partly of its property of increasing all the secretions.

In plethoric persons it often proves stimulating, and causes headache, redness of face, and feelings of cerebral congestion—owing probably to the carbonic acid and the iron contained in it.

Its most marked effect is to increase all the secretions, especially those of the bowels, liver, kidneys and skin—large quantities of mucus are discharged with the stools. The mucous secretions of the bladder, and also of the vagina, are usually much increased at first, but subsequently greatly diminished, when these organs are in a state of weakness. Various forms of cutaneous eruption often make their appearance, and rheumatic and gouty pains are usually increased at first, but subsequently disappear during the use of the waters.

The digestive and nutritive functions are quickened and invigorated, and the patients acquire strength and liveliness, in consequence of the improved state of the intestinal secretions. The Kreuzbrunn waters at Marienbad produce similar effects to those of the Carlsbad and the Kissengen waters; but the former are more purging and evacuant, and act less upon the vascular system, and more upon the digestive functions than they do.

The diseases in which the Marienbad waters are most useful, are—

1. All congested states of theportalsystem of veins, indicated by torpid bowels, loss of appetite, hæmorrhoids, and gouty complaints; and thevarious diseases connected with inactivity of the abdominal circulation, such as hypochondriasis, dyspepsia, morbid sensibility, headaches, &c. Numerous cases of chronic rheumatism and gout, which are so frequently associated with congestion of the vena portæ, are relieved by the use of the Marienbad waters.

2. Diseased state of the mucous membranes, such as some obstinate catarrhs, affections of the mucous coat of the bladder, uterus, &c.

3. Plethora, sanguineous congestions, crampy pains of the limbs, absent or difficult menstruation, and the numerous morbid symptoms dependent upon this state.

4. Torpor of the bowels, and its host of attendant evils.

“By means of its property of increasing all the secretions and excretions of the body, and of bringing out cutaneous eruptions and gouty affections to the limbs, the Kreuzbrunn waters at Marienbad are an excellent remedy in numerous diseases which depend either upon a plethoric state of the abdominal circulation, or upon the accumulation of impurities in the bowels, or upon an unhealthy condition of the mucous membranes. At the same time, they subdue the morbid irritability of the whole system, or of individual parts; they remove congestions, plethora, and various evils dependent upon these. They are especially useful in all cases where Nature herself seems to be striving to induce either an increase of the secretions, or a flow of blood from certain parts, as the nose, anus, &c.”

When the Marienbad waters do not prove sufficiently aperient, a small portion of Glauber or Epsom salts may be added to it. In some cases, the waters will agree better, if previously heated; and in others, they are usefully combined with a little warm milk, or with a small portion of wine.

Dr. Herzig is an attentive physician, who speaks English, and may be usefully consulted by my countrymen. I have also to express my grateful thanks to Dr. Heidler, the spa physician of Marienbad, for his kindness and attention.

——fælix per secula mana,Fons sacer, humano generique salutifer esto,Redde seni validas vires. Pavidæque Puellæ,Formosam confer faciem, morbisque medereOmnibus, et patrias accedat lætior oras,Quisquis in hæc lympha fragiles immerserit artes.[66]

——fælix per secula mana,

Fons sacer, humano generique salutifer esto,

Redde seni validas vires. Pavidæque Puellæ,

Formosam confer faciem, morbisque medere

Omnibus, et patrias accedat lætior oras,

Quisquis in hæc lympha fragiles immerserit artes.[66]

Sacred Font! flow on for ever,Health on mankind still bestow—If a virgin woo thee—give herRosy cheeks and beauty’s glow:—If an old man—make him stronger—Suffering mortals soothe and save—Happier, send them home, and younger,All who quaff thy fervid wave!

Sacred Font! flow on for ever,

Health on mankind still bestow—

If a virgin woo thee—give her

Rosy cheeks and beauty’s glow:—

If an old man—make him stronger—

Suffering mortals soothe and save—

Happier, send them home, and younger,

All who quaff thy fervid wave!

This is denominated theKingof the Spas, whilst Baden-Baden is theQueen. I wish his majesty of the “Warm Wassers” had condescended to hold his noisy court a little nearer to that of his royal consort. Two hundred and thirty miles from Frankfort, through a country that is not always very smooth, or very interesting—with dust in some places half a foot deep on the roads—the thermometer at 80°—and the rate of progression five miles an hour, is a tolerable sacrifice to the hygeian goddess of the Sprudel! It is not improbable that many of those who travel to Bohemia, in search of health, might find it in various other directions, and much nearer their own doors. The journey itself requires some good stamina, as well as resolution, and, if borne well, gives promise of success at the Sprudel.[67]

I suppose Carlsbad claims the prerogative of curing by the “Royal touch,” all those maladies that resist the powers of his subject spas—and even of the Queen’s own at Baden.

I think I have discovered one cause of the great efficacy of the Carlsbad waters, which has escaped the notice of the spa doctors, including my friend Dr. Granville. In travelling to Bohemia, the invalid must, on a moderate calculation, swallow full a pound of sand and dust on the road. This being mixed with an indefinite quantity of grease, oil, and vinegar, at the hotels, forms a kind of amalgam, resembling “fuller’s earth,” theclearing away of which, by the hot and alkaline waters of Carlsbad, must leave the stomach, liver, kidneys, and other internal organs, as bright and shining as a newly-scoured copper kettle.

It is ascertained that Carlsbad is built on a thin crust of limestone, forming a dome over several immense cauldrons of boiling mineral water. At present the chief crater of this aqueous volcano offers a safety-valve for all the superfluous soda-water unconsumed by the subterranean spa-goers; but it has often been feared that the whole dome may one day fall in, when the bibbers and bathers, the ramblers and gamblers, the sick and the sound, will all have a dip in the Sprudel at its natural temperature, and without the expense of 48 kreutzers for the bath!

On some occasions the usual vent of the Sprudel has become obstructed, and then the ground in the neighbourhood has trembled and vibrated, as if from an earthquake. At one time the pent up water burst out in the bed of the river: and here they have formed a large shield of wood and stones, clasped with iron, with a plug or safety-valve in the centre, along the sides of which the steam and water now oozes out, and the aperture can be enlarged at any moment by removing the plug, when another Sprudel rises in the middle of the Teple.

Be this as it may, Carlsbad may now be considered as the grand “Maison de Santé” of Europe, where the patients support themselves, on the principle of the Sanataria in general, and where Mr. Owen might find his social system almost perfect. Thus we have at Carlsbad (and indeed at most of the great German spas,) our food in common—our physic in common—and even our physician in common. The air we breathe, the water we drink, and gardens and walks where we exercise, are all in common. The socialists might even find little reason to complain of that “accursed thing,”matrimony, for althoughmatchesare occasionally projected at Carlsbad, I believe thatmarriageis seldom perpetrated there.[68]

This great valetudinarium then presents four or five wards or hygeian fountains, of which theSprudelstands most conspicuous. I was completely disappointed at the first sight of this lion of the Spas. The descriptions and drawings of the spring are most outrageously exaggerated. One would expect to see a fountain of boiling fluid rising to a height of six or eight feet, and falling down in fervid and foaming showers. No such thing. During half the time, it does not rise above the level of the kettle in which it boils; and is often below that mark. Then it mounts a foot or so, and every now and then spirts a small irregular and ragged pillar or column of foaming water to a height of two, three, or perhaps four feet above the reservoir. More frequently, however, it squirts a jet of water to one or the other side of the kettle, which splashes into the conduits that carry it off. The whole of the kettle, reservoir, and exits are coated with calcareous deposits, and, in many parts covered with green matter, the bodies or receptacles of animalculæ. Still the Sprudel is a stupendous ebullition of hot medicinal water from some infernal laboratory, amply sufficient for the expurgation of a whole nation! The temperature of the water is 168° of Fahrenheit, each pint containing about 44 grains of solid matters, of which the sulphates, carbonates, and muriates of soda form 37 grains. A trace, and merely a trace, of iron is found in the water. Some very recent analyses have also detected traces of iodine, and of an animal substance, together with some sulphuretted hydrogen gas. Its taste is certainly not very agreeable and rather mawkish—and though clear at the fountain, it is turbid when cold. It very much resembles the Cockbrunnen in savour.

The second spring is theMuhlbrunn, whose temperature is nearly 30° below that of theSprudel; but whose constituent salts are the same. Nevertheless this difference of temperature is supposed to produce a difference in the taste of the water, and renders it more acceptable to the stomachs, or at least to the palates, of many of the drinkers at Carlsbad.[69]

TheNeubrunnis separated from the former source only by a covered walk, and marks 144° of heat. It did not appear to me to be so much in vogue at this fashionable watering-place, as the Muhlbrunnen.

Behind the Neubrunn there is a hill, cut into terraces and gravelled walks, where rises theTheresienbrunn—a spring much frequented by the ladies, and indeed by both sexes. The temperature is only 134° of Fahrenheit, and the water is almost tasteless. These three (with the Hygienequelle, close to the Sprudel) are the chief springs, which are much frequented by the great mass of bibbers at Carlsbad.[70]

The waters of all the springs deposit abundance of calcareous matters, which crystallize in stalactites of all shapes and hues, calledSprudelstein, and give employment to numerous hands in the formation of snuff-boxes and various kinds of bijoux.[71]As incrustations form on the surfaces of any woody, mineral, or vegetable substance immersed in these waters, a fear is sometimes engendered in timid minds that similar incrustations might form in the stomach, bowels, or kidneys of those who drink them! It has been proved by Dr. De Carro and others, that the stalactitious deposits will not take place on anyanimalsubstance, with the exception of the teeth. Even here, the quantity of stony matter is so small in a dozen beakers of the Sprudel, that nothing is to be apprehended to the teeth on this score. It would, perhaps, be a happy circumstance for Germany, if the Sprudel had the faculty of encrusting the teeth with a calcareous enamel! If such were the case, the whole of the five springs at Carlsbad would be insufficient to supply dentrifice varnish enough!

A serio-comic anecdote is related of a hypochondriac, who had drunk of these waters for some weeks before thepetrifyingthought flashed across his mind, (in consequence of some uneasy sensations in his stomach) that incrustations were forming in his interior. From that moment he became firmly convinced that snuff-boxes, heads of canes, Madonnas, and even crucifixes, were torturing his entrails! He drenched himself daily with drastic purgatives—but, unfortunately, no stalactites came forth: on the contrary, his inward pains and miseries were increased by the very means that were employed to expel the enemy! Whether he ever recovered from his imaginary sufferings is not known.

Another source of terror to the timid and nervous drinkers at Carlsbad has lately arisen. A learned German philosopher has discovered living fossil animalculæ in the waters of Carlsbad. Now if these little salamanders can “live and move, and have their being,” in the Sprudel at a temperature of 167°—or rather in the bowels of the earth, where the water is at the boiling point, or even in the form of steam, it may well be supposed that they would thrive luxuriously in the temperate climate of the human stomach, where the heat does not exceed 98° of Fahrenheit. However, the drinkers of the Thames water need have no fears respecting theInfusoriaof Carlsbad, which would soon be devoured by the proteiform monsters which are daily ingurgitated by the citizens of London.

I have already stated that some of the philosophic spa doctors have broached the doctrine, that mineral waters are merelysecretionsfrom one great watery being residing deep in the bowels of the earth! As the secretions from the human body are very various, so the secretions from the mother Spa are almost innumerable, and thus the infinite variety of mineral waters is readily explained and accounted for. Q. E. D.[72]

The situation of Carlsbad is very picturesque—I might say romantic. It might be pretty well characterised by a single line, descriptive of a very different locality—the valley of theUpas tree:

“Rocks rise on rocks and fountains gush between.”

The town is built partly in the valley, partly on the ledges of granite rocks that rise abruptly behind it, to a height of 1500 feet, while the lazyTeple—

“Slow as Lethe’s stream,”

creeps at a snail’s space through the vale, contrasting remarkably with the boisterous, foaming, upheaving, and boilingSprudel, that gushes from unknown and unfathomable depths in the bowels of the earth, carrying health and life to its unnumbered votaries.

Carlsbad cures, as a matter of course, nine-tenths of human maladies; but as King of the Spas, it has a royal prerogative of a curious and important nature—namely, the power of curing those diseases which resist the virtues of all other spas and all other remedies! In answer to a question, “why Carlsbad sustained its reputation undiminished?”Hufelandreplied—“C’est qu’il guérit des maux rebelles a tout autre moyen curatif.” It is true that, if we take the testimonies of the other spas, none of which admit their fallibility in any case, this prerogative of Carlsbad would be little more than a sinecure; but the promises of spa doctors, like the waters which they prescribe, must be takencum grano salis; and we may safely conclude that some maladies present themselves at the Sprudel which have resisted the Cockbrunnen, as well as many other brunnens between the Rhine and the Danube.[73]

The attestations to the power of the Carlsbad prerogative would fill a volume. One just before me, as recorded by Dr. Granville, on the authority of a British nobleman, well known in the world of wit, is worthy of notice. Lord A——, it appears, through the efficacy of the Carlsbad waters, “had lost apleuritic adhesionunder the sternum (or breast bone) the consequence of neglected inflammation in the chest, which had annoyed him for a long time, and resisted all curative means. The complaint made him short-breathed in ascending hills, and gave him a dragging sensation whenever he sneezed—all which symptoms have since disappeared.”

Whether his lordship’s breathing, and consequently his years, have been lengthened by the dissolution of substernaladhesions, or by certaincorporate reformseffected by the Sprudel, may admit of some doubt; but the narrative shews on what sort of evidence the miracles of the spas sometimes rest! Not that this evidence is worse than we have often at home—witness the attestation on oath by a nobleman, that he saw St. John Long extract quicksilver from the brain of a man who had taken mercury—and the solemn assertions of grave and learned doctors, that an Irish girl could see through her navel, and hear with the points of her fingers!!

If we estimate the number of cures by the number of candidates, this spa must be “a sovereign remedy” for many of our ills. But this criterion is not always correct. It is not always the physician who sees most patients that cures most diseases. But Carlsbad, like other bads, has a very convenient postern to retreat through, when hard pressed for testimonials. Thus, if the first season fails, the most confident hopes are held out that the second will succeed. If the second turn out a miscarriage, then the third will prove infallible! It requires no ghost to prophesy that, if the pilgrim of the spas goes two successive years to Bohemia, without relief, the third pilgrimage will, in all human probability, be to that “undiscovered country,” whence no invalids return to tell their tale of disappointment! If a patient die at home, it is because he did not visit Carlsbad—if at Carlsbad, because he came too late.

The waters of Carlsbad were formerly used almost entirely as baths—but now it is just the reverse—they are chiefly taken internally. In former times the bathers passed eight or ten hours in the baths, as they now do at Leuk, Baden, and Pfeffers. My friend De Carro thinks that, formerly, cutaneous complaints were more rife—and now, that liver and stomach affections are the prevailing maladies—hence the change from bathing to drinking at this celebrated spa. There may be some truth in this. The taste of these waters very much resembles that of weak chicken-broth, with a flat and alkaline savour. It has been seen thatsoda, combined with sulphuric, muriatic, and carbonic acids, is the chief agent in the Carlsbad waters. Soda uncombined with acids, either out of or in the body, has rather a deleterious effect on the organs of circulation and digestion. “But the Carlsbad water (says Chev. De Carro) though used for a long time, reanimates, vivifies, excites the appetite, and promotes digestion—thus with proper regimen, restoring the patient to health.” Doubtless the efficacy of the waters is augmented by the admixture, however small in quantity, of other elements, as the oxide of iron, the carbonic acid, the iodine, and materials yet unknown, diffused in extreme solution, through a fluid of a very high temperature, which enables the component parts of the spring to permeate the minutest vessels of the body. The Carlsbad salts are found in the renal secretion, as well as in the cutaneous transpiration, after being taken internally. These waters act by exciting the stomach, bowels,kidneys, liver, and abdominal organs generally, augmenting the secretions and excretions—especially those of the intestines, sometimes it is said even to purgation, when they are taken in considerable quantity. This effect, however, must be rather unfrequent, for I found no one, including myself, who experienced it. “They excite the circulation, so as frequently to produce palpitation of the heart, and determination of blood to the head. This water augments the activity of the absorbents; but it is not till after its other operations, that it acts as a directtonic.” Purgation is not considered by the Carlsbad doctors as essential to its beneficial agency, which is often produced without any action on the bowels, but only on the various secretions already mentioned. In all cases, however, it is necessary to guard against constipation, by adding some Carlsbad salts to the water, or exhibiting some other aperient. Although these waters contain no sulphuretted hydrogen gas, or extremely little, they produce fætid eructations from the stomach when drunk—but they have not a corresponding effect on the alvine evacuations. “The operation of the Carlsbad waters, in fact, is what is called ‘alterative,’ or ‘deobstruent;’ and as such they are applicable to a long list of maladies arising from congestion or obstruction in the abdominal organs, particularly the liver, spleen, mesentery and other glandular viscera, attended by debility of the stomach, heart-burn, acidity, distention, eructations, constipation, jaundice, biliary concretions, hypochondriasis, hæmorrhoids, head-aches, giddiness, gouty feelings, cutaneous eruptions, scrofula, and urinary obstructions.”[74]

This is an encouraging picture, but I have no reason to consider it as overcharged. Dr. De Carro observes, that it is impossible to explain themodus operandiof such simple and minute ingredients on the human organism. “Whoever, he remarks, has experienced a crisis (called also the spa fever—the bad-sturm, &c.) in his own person, will never doubt the power of the Carlsbad waters.”

Dr. De C. compares the action of the Carlsbad waters on the human frame to a good filter that separates all impurities from the constitution.

“Hypochondriacal affections appear nowhere under more various forms than at Carlsbad; and the misanthropic and pusillanimous feelings of those unfortunate beings, passing, without known motives, from hope to despondency, from moroseness to exaltation, deserve the greatest indulgence and sympathy. When we see so many hepatic and splenetic patients whose temper depends entirely on the state of their abdominal functions, we feel disposed to forgive the materialism of the ancients, who placed the seat of so many passions in the liver; we remember unwillingly theFervens difficili bile tumet jecur, thejecur ulcerosumof Horace, as synonymous ofjealousyandviolent love, and we understand how they could say that mensplene rident, felle irascunt, jecore amant, pulmone jactantur, corde sapiunt.”

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 themiraculouspowers 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 aggravateorganicdiseases 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 isbiliary 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 theirlithontripticpowers—that is, their power ofdissolvingurinary 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.

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 weremuch 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 theirbeing 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 fourçhetteare inadmissible here. The dinners at Carlsbad are very abstemious, as theTraiteursare 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,Carlsbadswarms, like a bee-hive, with legions of invalids and their friends, who lead, as Dr. De Carro says, “unevie 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 annualAlmanackof Carlsbad, composed and published by Dr. De Carro himself. This little annual is of a miscellaneous nature, combining amusement with information, and never omittingone particularitem—a list of all the visitors, with their titles, avocations, rank, andcelebrity—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 theNeubrunnorMuhlbrunnfor one at the “Old Man of the Valley,” the splendidSprudel. 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 springsfrom 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 favourableto 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.

(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 uponaccumulations 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 ofinternalgout 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 analterative.

The venerableHufelandpublished 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.

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 greatsanitariumlike 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 thephysiognomyof 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 eachspa, 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 theFontaine Eliséeof 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—

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