Mineral Waters, spring waters which possess qualities in relation to the animal body different from those of ordinary water, have been used as remedial agents from a very early period. The oldest Greek physicians had great faith in their curative power, and the temples erected to Æsculapius were usually in close proximity to mineral springs; the warm baths of Calirrhoe, near the Dead Sea, are mentioned by Josephus as having been tried by Herod in his sickness. We are indebted to the Romans for the discovery not only of the mineral thermic springs in Italy, but of some of the most important in other parts of Europe, amongst which may be named Aix-la-Chapelle, Baden-Baden, Bath, Spa in Belgium, and many others; and Pliny (Natural History) mentions a very large number of mineral springs in almost all parts of Europe (see BATH, HYDROPATHY). The therapeutic action of mineral waters or spas depends chiefly upon their chemical composition and their temperature, though other circumstances, as situation, elevation, climate, geological formation, mean temperature, &c., have an important bearing upon the success of the treatment.
The best time for undergoing a course of mineral waters is, in the majority of cases, the months of June, July, August, and September. There are, however, exceptions depending upon climate; for example, at Gastein, celebrated for its thermal springs, the weather is changeable and stormy in June and July, but pleasant in May, August, and September. Early rising is usually advisable during a course of mineral waters, and, as a general rule, the water should be drunk before breakfast, at intervals of about a quarter of an hour between each tumbler, moderate exercise being taken in the intervals. In many cases bathing is of even greater importance as a remedial agent than drinking. Baths are generally taken between breakfast and dinner, and should never be taken soon after a full meal. The time during which the patient should remain in the bath varies very much at different spas, and the directions of the local physician should be strictly attended to on this point. As a general rule, the treatment should not be protracted beyond the space of six weeks or two months, but on this point the patient must be solely guided by the physician resident at the spa. Indulgence in the pleasures of the table, and excesses of any kind, frequently counteract the salutary effects of the waters, while perfect mental relaxation is an important auxiliary to the treatment. Spas are only suitable for patients suffering from chronic disorders.
No classification of mineral waters based upon their chemical composition can be strictly exact, because many springs are, as it were, intermediate between tolerably well characterised groups. The following classification, adopted by Althans, is perhaps the most convenient: (1) Alkaline Waters; (2) Bitter Waters; (3) Muriated Waters; (4) Earthy Waters; (5) Indifferent Thermal Waters; (6) Chalybeates; (7) Sulphurous Waters.
(1) The Alkaline Waters are divisible into (a) Simple Alkaline Acidulous Waters, of which the chief contents are carbonic acid and bicarbonate of soda. The most important spas of this class are the thermal springs of Vichy and the cold springs of Fachingen, Geilhau, and Bilin. These waters are useful in certain forms of indigestion, in jaundice arising from catarrh of the hepatic ducts, in gallstones, in renal calculi and gravel, in gout, in chronic catarrh of the respiratory organs, and in abdominal plethora. Vichy (q.v.) may be taken as the representative of this class of springs. (b) Muriated Alkaline Acidulous Waters, which differ from the preceding sub-group in additionally containing a considerable quantity of chloride of sodium. The most important spas of this kind are the thermal springs of Ems, and the cold springs of Selters and Salzbrunn. They are useful in chronic catarrhal affections of the bronchial tubes, the stomach and intestines, and the larynx; while the Ems waters possess a high reputation in certain chronic diseases of the womb and adjacent organs. (c) Alkaline Saline Waters, of which the chief contents are sulphate and bicarbonate of soda, such as the warm springs of Carlsbad and the cold springs of Marienbad, serviceable to patients suffering from abdominal plethora, if unconnected with diseases of the heart or lungs. These waters, especially those of Carlsbad, afford an excellent remedy for the habitual constipation which so frequently arises from sedentary occupations.
(2) The chief contents of the Bitter Waters are the sulphates of magnesia and soda; and the best-known spas of this class are those of Sedlitz, Friedrichshall, and Kissingen; although two valuable English examples are the bitter water of Cherry Rock, near Kingswood, in Gloucestershire, and the Purton Spa, near Swindon, in Wiltshire. These waters act both as purgatives and diuretics.
(3) The Muriated Waters are divisible into (a) Simple Muriated Waters, of which the chief contents are a moderate quantity of chloride of sodium or common salt. The chief spas of this class are Wiesbaden and Baden-Baden, which are hot; those of Soden (in Nassau), of Mondorf (near Luxembourg), and of Canstatt (near Stuttgart), which are tepid; and those of Kissingen, Homburg, and Cheltenham, which are cold. The muriated saline springs of Saratoga in the United States are some of them chalybeate, others sulphurous or iodinous; all of them being rich in carbonic acid gas. The Ballston saline spring near Saratoga has a very high proportion of carbonic acid. They are chiefly employed in cases of gout, rheumatism, scrofula, and abdominal plethora. (b) Muriated Lithia Waters, of which the chief contents are the chlorides of sodium and lithium. In gout they first aggravate the pain, but then give relief; and in periodic headache they have been found serviceable. (c) Brines, whose chief contents are a large amount of chloride of sodium, such as the spas of Rehme in Westphalia and Nauheim in Hesse. They are mostly employed for bathing, and are often of much service in scrofula, anaemia, rheumatism, certain forms of paralysis, and catarrh of the mucous membranes. (d) Iodo-bromated Muri- ated Waters, in which, besides a moderate quantity of chloride of sodium, the iodides and bromides of sodium and magnesium are contained in an appreciable quantity. The Kreuznach waters are used both for drinking and bathing, and are of service in scrofulous infiltrations of the glands, in scrofulous ulcers, in chronic inflammation of the uterus and ovaries, &c. The waters of Hall, in Austria Proper, have a high reputation in cases of bronchocele or goitre.
(4) Earthy Waters, of which the chief contents are sulphate and carbonate of lime, as at Wildmengen, Leuk, Bath, Lucca, and Pisa. The Wildmengen water is 'a capital diuretic, and not only promotes the elimination of gravel and renal calculi, but, by its tonic action on the mucous membrane of the urinary passages, serves to prevent the formation of fresh concretions. It is also much used for chronic catarrh of the bladder, neuralgia of the urethra and neck of the bladder, dysuria, and incontinence of urine.' The baths of Leuk, in which many patients remain nine hours daily (viz. from 4 A.M. to 10 A.M., and from 2 P.M. to 5 P.M.), until an eruption appears, are chiefly used in chronic skin diseases. The waters of Bath, Pisa, and Lucca, which are thermal, are useful in chronic skin diseases, gout, rheumatism, &c.
(5) Indifferent Thermal Waters, which usually contain a small amount of saline constituents. Of the spas of this class the most important are Gastein (95° to 118°), Tepitz (120°), Wildbad (96°), Warmbrunn (100°), Clifton (86°), and Buxton (82°). Their most striking effects are to stimulate the skin and excite the nervous system. 'They are especially used in chronic rheumatism and atonic gout; in diseases of the skin, such as prurigo, psoriasis, lichen; in neuralgia and paralysis due to rheumatic and gouty exudations, to parturition, or to severe diseases, such as typhoid fever and diphtheria; in hysteria; and in general weakness and marasmus.'
(6) Chalybeate Waters, which are divisible into (a) Simple Acidulous Chalybeates, whose chief contents are carbonic acid and bicarbonate of protoxide of iron; and (b) Saline Acidulous Chalybeates, whose chief contents are sulphate of soda and bicarbonate of protoxide of iron. The quantity of iron present is very small—from .08 to .15 in 1000 parts. Many of the chalybeate springs, especially in Germany, contain also much carbonic acid; carbonate, sulphate, and chloride of sodium is frequently present, and may help in the cure. Harrogate, Rippoldsau, Homburg, and the Putnam Spring at Saratoga are examples of chalybeate wells which are very seldom thermal. Strathpeffer has both chalybeate and sulphurous springs. Chalybeate waters are valuable in anaemia, enlargement of the spleen, and many female disorders.
(7) Sulphurous Waters, which contain sulphur-retted hydrogen or metallic sulphides (sulphurets), or both. The most important sulphurous thermals are those of Aix-la-Chapelle, Baden (near Vienna), Barèges, Eaux-Chaudes, and Bagnères de Luchon; whilst amongst the cold sulphurous springs those of Nenndorf (in Hesse-Nassau) and Harrogate are of great importance. They are extensively used in chronic diseases of the skin, and are of service in many cases in which exudations require to be absorbed, as in swellings of the joints, in old gunshot wounds, and in chronic gout and rheumatism. In chronic laryngeal and bronchial catarrh they frequently give relief, and in chronic poisoning by lead or mercury they favour the elimination of the poison, although to a far less degree than iodide of potassium taken internally. The sulphurous waters are employed externally and internally, and mineral mud-baths are believed by many physicians to form a valuable auxiliary to this treatment.
See Althans, Spas of Europe (1862); Glover, Mineral Waters (1857); Tichbourne and Prosser James, Mineral Waters of Europe (1883); Bradshaw's Dictionary of Mineral Waters (new ed. 1886); Walton, The Mineral Waters of the United States and Canada (1875); German works by Herschfeld and Pichler (1875-76), Lehmann (1877), Flechsig (1882); and the works cited at HEALTH-RESORTS.