Aquae Minerales.—Mineral Waters.
MINERAL WATERS (Aquae Minerales) are those which present a large proportion of carbonic acid gas, with or without saline, alkaline, metallic, earthy, gaseous, and other foreign substances, and which exert an appreciable therapeutical influence on the animal economy. The chemical ingredients most frequently present are chloride of sodium, carbonates of sodium and of iron, sulphates of sodium, of magnesium, and of calcium, iodide of sodium, sulphide of hydrogen, carbon dioxide, oxygen and nitrogen. Less frequently found are arsenic compounds, lithium salts, bromide of sodium, free sulphuric acid, fluorides, and organic compounds. The ingredient in excess, or that having the most pronounced action, usually determines the classification. Space permits but a brief notice of a few of the most important mineral springs of this country and Europe. In the United States there are upwards of 250 mineral springs possessing reputed medicinal properties. Many of the springs in this country, if not the majority, are the counterpart of those of Europe. For all practical purposes, they may be appropriately divided into acidulous, chalybeate or ferruginous, sulphurous, and saline mineral waters, etc. When the water is elevated in temperature the springs are called Hot or Thermal; when of ordinary temperature or lower, they are called Cold Mineral Springs.
I. ACIDULOUS WATERS are not so frequently met with as the other forms of mineral waters, from which they are distinguished by holding in solution a free acid, other than the carbonic. Oak Orchard Springs (Genesee Co., N. Y.), is a representative sulphuric acid spring, containing in a quart, besides sulphates of calcium, iron, magnesium, aluminum and silica, 20.74 grains of free sulphuric acid. Free sulphuric acid is stated, likewise to exist in the Alum Springs of Virginia.
II. CHALYBEATE WATERS (Ferruginous Waters) contain iron (usually as a bicarbonate, occasionally as a sulphate) as their active principle, and in considerable proportion; they have a styptic taste, and become purplish-black with tannic or gallic acids. When the water contains ferrous salts, the addition of ferrocyanide of potassium causes a white precipitate, which on exposure to the air becomes blue; when the higher salts of iron are contained in the water, ferro-cyanide of potassium gives a blue precipitate, and sulphocyanide of potassium, a red one. Chalybeate waters are divided into carbonated and sulphuretted; the former being brisk, sparkling, and acidulous, the latter containing hydrogen sulphide. To be of first quality these waters should contain considerable iron and but little of other mineral ingredients, and should be highly carbonated.
A representative spring of this type is Schooley's Mountain (Morris Co., N. J.), temperature 10° C. (50° F.). Rawley Springs (Rockingham, Co., Va.), and Cooper's Well (Hinds Co., Miss.), are also typical. European springs of this class are represented by Spa (Germany), temp. 10° C. (50° F.); Brighton (England); Cheltenham (chalybeate) (England), temp. 11.1° to 11.6° C. (52° to 53° F.); Pyrmont (Germany), and Schwalbach (Germany), the latter being one of the strongest of chalybeate waters. Anderson's Spring (Bedford, Pa.), temp. 13.3° to 14.4° C. (56° to 58° F.), and Ballston Spa (N. Y.), temp. 10° to 12.2° C. (50° to 54° F.), are sometimes classed with the chalybeate springs. The Tunbridge Wells (England), are celebrated as iron springs.
III. SULPHUR (Sulphuretted) WATERS are impregnated with hydrogen sulphide, and other sulphides and nitrogen, in consequence of which they have an odor resembling that of rotten eggs. They react upon many metallic salts, causing black precipitates. They are frequently divided into muriated alkaline, and calcic sulphur waters. They are also divided into cold and thermal sulphur springs. Some of these waters are designated according to the color of the deposits yielded by the escaping water, as white (sulphur), red (oxide of iron, or microscopic algae), blue (slate), or yellow (polysulphides) sulphur waters. This class of waters is largely represented in the United States, but not all of them are decidedly medicinal. In Europe, among the chief cold springs are: Harrowgate Old Well (England); Montmorency (France); Nenndorf, Langenbrücken, and Meinberg (Germany). Of the thermal springs are: Aix-la-Chapelle (Germany), three springs, the temperature of which ranges from 43.3° to 61.6° C. (110°to 143° F.); Aix-les-Bains (Savoy); St. Sauveur, Baréges, Bagnères-de-Luchon, and Eaux-Chaudes (France); and Baden (near Vienna). In the United States the muriated sulphur springs are represented by the Columbia (N. Y.); Louisville Artesian (thermal); Upper and Lower Blue Lick, Big Bone Springs, Paroquet, Olympian Springs, of Kentucky; Massena Springs (St. Lawrence Co., N. Y.); and Salt Sulphur (Monroe Co., W. Va.). The last named, together with Sharon Springs (White Sulphur and Magnesian Springs) (N. Y.), French Lick (Orange Co., Ind.), Greenbrier White Sulphur (Va.), contain purgative, or purgative and calcic salts. The Red Sulphur Springs (W. Va.) contain also a sedative organic principle termed hydrosin or barégine. Borden Spring (W. Va.) is sulpho-alkali-saline and purgative. Yellow Sulphur (Va.), and Clifton and Chittenango (N. Y.), are calcic sulphur springs. The White, temp. 16.6° C. (62° F.); the Red, temp. 12.7° C. (55° F.); and Blue Sulphur Springs, are noted Virginian springs. The most noted American thermal sulphur waters are those of Calistoga (about 60 springs), Santa Barbara, temp. 15.5° to 54.4° C. (60° to 130° F.), Paso Robles, temp. 44.4° to 50° C. (112° to 122° F.), all of California; Middle Park (Colo.), temp. 43.8° to 46.6° C. (111° to 116° F.); Warm Springs (Ga.), temp. 32.2° C. (90° F.); Warm Springs (Va.), temp. 35.5° to 36.6° C. (96° to 98° F.). Near Sitka, Alaska, are the celebrated Warm Sulphur Springs or Geysers, temp. 35.5° to 40° C. (96° to 104° F.).
IV. SALINE WATERS owe their medicinal activity to their saline ingredients, as various salts of sodium, magnesium, calcium, potassium, etc.; an the sulphates, chlorides, and carbonates are the most common. The principal constituent is sodium chloride. They usually contain small portions of iron, and often a large amount of carbonic acid, and occasionally iodine or bromine. They are divided into Salt (Muriated), Calcic (Calcareous), and Silicious Waters. The most agreeable of these waters are the mild saline or muriated waters, best represented in this country by the Saratoga Springs, temp. 9.4° to 10.5° C. (49° to 51° F.); with few exceptions (some being muriated-chalybeate, as Hamilton, Columbian, and Pavilion Springs), Charleston (S. C.), Albany Artesian Wells (N. Y.), and Ballston Spa. The Hot Springs of Virginia, temp. 35.5° to 41.6° C. (96° to 107° F.), are representative American alkaline-saline springs. In Europe the following are celebrated: Selters, Apollinaris, Bath (England), temp. 44.4° to 46.6° C. (112° to 116° F.); Cheltenham Saline Springs (England), temp. 11.1° to 12.2° C. (52° to 54° F.); Carlsbad (Bohemia), temp. 73.8° C. (165° F.); Sprudel and Plombières (France) 32.2° to 62.7° C. (90° to 145° F.). Among the calcic springs of note are: Eaton Rapids Wells (Mich.); Sweet Springs (Monroe Co., W. Va.), temp. 23.3° C. (74° F.); Bethesda (Waukesha, Wis.), temp. 15.5° C. (60° F.), calcic alkaline; Yellow Springs (Greene Co., O.), and Gettysburg (Adams Co., Pa.). Calcic springs are rich in limestone (calcium carbonate) and gypsum (calcium sulphate) mixed with saline and alkaline salts and some iron. Some Canadian Waters, as of the Plantagenet and Caledonia, are good examples of iodo-bromated saline waters.
SEA WATER.—The proportions of the contents of sea water, as found by Schweitzer, who analyzed the water of the English Channel, are about as follows: Water, parts 29235.424+; sodium chloride 895.72+; potassium chloride 23.48+; magnesium chloride 111.12 +; magnesium bromide 0.878+; magnesium sulphate 68.81; calcium sulphate 42.6+; calcium carbonate 1.0.
V. ALKALINE WATERS.—In these waters, sodium, potassium, and magnesium carbonates predominate, the most noted of this class being those of Vichy (France), temp. of the various springs ranging from 23.8° to 46.1° C. (75° to 115° F.). In Germany they are represented by such springs as Ems, Fachingen, Salzbrunn, etc.; in England, by Buxton and Bristol; Camarés in France; and in this country by the Bladon Springs of Choctaw Co., Alabama.
VI. PURGATIVE WATERS.—These waters include those having purgative or aperient properties due to the presence of sulphates of magnesium, sodium, and potassium, modified by the presence of alkaline or calcic sulphates and carbonates, or some chalybeate compound. They constitute the Bitterwasser (bitter water) of the Germans. Some of them are highly carbonated. European waters of this class are those of Seidlitz (Bohemia), temp. 15° C. (59° F.); Friedrichshall (in Saxe-Meiningen); Kissingen, Püllna, Hunyadi János, Epsom (England); Ivánda (Hungary); and Champagne-sur-Aude (France). American purgative waters are represented by the Crab Orchard Springs (Lincoln Co., Ky.); Harrodsburg (Mercer Co., Ky.) (containing also calcium sulphate and iron carbonate); Estill (Irvine) Springs (Estill Co., Ky.); and Bedford Springs (Bedford, Pa.), the latter being a purgative-chalybeate water.
VII. SILICIOUS WATERS.—As already remarked, these are a division of the saline waters, which are occasionally met with. The boiling springs of Geyser, in Iceland, belong to this division, the silica being held in solution by the sodium compounds present.
VIII. CARBONATED WATERS.—Formerly the carbonated waters were recognized as a separate class. They include, however, many of the waters named in the other classes. They owe their qualities to carbonic acid gas, which gives them more or less of an acidulous taste, a briskness, a sparkling property, and an acid reaction. In this class were formerly included such springs as Seltz or Seltzer (Germany); Pyrmont (Germany); Spa (Belgium); Mont d'Or (France), including 4 springs: St. Marguerite's, the temperature of which is 10° to 12.2° C. (50° to 54° F.), the Grand Bath, temp. 43.3° C. (110° F.), Caesar's Baths, temp. 45° C. (113° F.), La Magdelaine, temp. 42.2° C. (108° F.); Vichy (France); Sweet Springs (Va.), etc. They are cooling, refreshing, and exhilarating, and frequently relieve nausea. They usually hold in solution ferrous carbonate, or the carbonates of one or more of the alkaline earths. Carbonated waters are contraindicated in acute diseases and in plethoric persons.
IX. THERMAL WATERS.—The indifferent thermal waters contain but small amounts of inorganic compounds, and are valuable chiefly on account of their elevated temperature, 23.8° to 71.1° C. (75° to 160° F.). The noted American springs of this type are represented by the Hot Springs (Ark.), numerous springs ranging in temperature from 33.8° to 65.5° C. (93° to 150° F.); Hot Springs (Va.), temp. 25.5° to 43.3° C. (78° to 110° F.); Warm Springs (Va.), temp. 36.6° C. (98° F.); Healing Springs (Bath Co., Va.); Lebanon Springs (Columbia Co., N. Y.). The Idaho Hot Springs, temp. 29.4° to 46.1° C. (85° to 115° F.); Warm Springs (N. C.), temp. 36.1° to 38.8° C. (97° to 102° F.); and Paso Robles (Cal.), temp. 44.4° to 50° C. (112° to 122° F.), are thermal springs not belonging to the indifferent class, but containing several active constituents. Noted European thermal waters are those of Plombières (France), temp. 51.6° C. (125° F.); Gastein (Salzburg, in Austria), temp. 30.5° to 71.1° C. (87° to 160° F.); Teplitz (Bohemia), temp. 48.8° C. (120° F.), etc.
Action and Medical Uses.—Mineral waters vary in their effects upon the system, according to their constituent combination. Added to their intrinsic value, when properly employed, the change of climate and habits, the hygienic influences, the abandonment of business and social cares, the pleasant associations, and various other aids, undoubtedly contribute largely to the successful treatment of chronic diseases as pursued at the various mineral springs. Injudiciously used, mineral waters are, of course, as liable to do mischief as is the injudicious employment of medicines. The uses of the various classes of mineral waters can be but briefly referred to in this article, as follows:
I. ACIDULOUS WATERS.—The acidulous waters are powerful and diffusible stimulants of the nervous and circulatory system, likewise diuretic. Generally useful in dyspepsia, passive dropsy, chronic diseases, chlorosis, and phosphatic gravel; contraindicated in recent palsy, apoplexy, and active hemorrhages and inflammations.
II. CHALYBEATE WATERS.—Chalybeate waters are tonic and restorative, and used in anemia, chlorosis, dyspepsia, all kinds of chronic cachexiae, gout, diabetes, leucorrhoea, chronic diarrhoea, and chronic diseases generally, especially those attended with excessive mucous and other discharges, and those not attended with plethora, fever, or inflammation. Their use blackens the stools. They increase the appetite, and improve digestion, give increased cardiac action, and improve the quality of the blood, particularly in anemic individuals.
III. SULPHUR WATERS.—Sulphurous waters are stimulant, diaphoretic, diuretic, and emmenagogue, and are found beneficial in chlorosis, gout, rheumatism, dysmenorrhoea, secondary syphilis, chronic cutaneous diseases, hemorrhoids, and deranged conditions of the stomach and liver. They are contraindicated in plethora, determination to the head, and active hemorrhages and inflammations. Waters which contain iodine or bromine, have been found of some use in goitre and scrofula. For rheumatic, gouty, and syphilitic individuals, the thermal sulphur waters are most effective, while for pulmonary and other forms of catarrhal diseases, the cold sulphur waters are preferable. These waters are especially adapted to chronic metallic poisoning, as lead poisoning, and mercurial cachexia.
IV. SALINE WATERS.—Saline waters are diuretic and aperient, particularly useful in chronic constipation, dyspepsia, with hepatic sluggishness, jaundice, biliary catarrh, gall-stones, urinary calculi, rheumatism (when alkalies are indicated), and gout, especially if anemic, and in uterine and renal irritability, and passive congestion of these parts. Abdominal plethora in the robust, is benefited by these waters. Saline baths have benefited hemiplegia and paraplegia in the early stages.
CALCIC WATERS are valuable in chronic cystitis, with irritability, urinary calculi, diabetes mellitus, and painful forms of dyspepsia.
SEA WATER.—Sea water internally is an emetic and purgative; as a bath it has all the effects of an ordinary cold bath, with the addition of exerting a more stimulant action on the skin than fresh water, owing to its saline contents. It has been found serviceable in rickets, enlargement of glands or joints, some chronic cutaneous eruptions, scrofula, and many chronic diseases.
V. ALKALINE WATERS.—Alkaline waters are antacid, antilithic, and diuretic. They may be used for the same conditions as the saline waters, being particularly useful in gout, uric acid gravel, urinary and hepatic calculi, certain skin diseases, chronic gastritis, and saccharine diabetes.
VI. PURGATIVE WATERS.—Purgative waters also possess diuretic properties, and are useful in small doses in all cases where laxatives, and, in larger doses, purgation are required. They are particularly of value in corpulency, hepatic engorgement, constipation, and abdominal plethora, especially when due to intemperance in eating and drinking.
VII. SILICIOUS WATERS.—Silicious waters are of value chiefly in chronic affections of the osseous and ligamentous structures.
VIII. THERMAL WATERS.—Thermal waters are chiefly curative by virtue of their uniform heat, and valued mostly as aids to medicines in the treatment of various chronic disorders by means of baths. They are largely resorted to for the cure of skin affections, such as lichen, psoriasis, various ulcerations, old wounds, enervated conditions, hysteria, acute and chronic articular and muscular rheumatism, gout, false ankylosis, paraplegia, gastralgia, etc. They are largely resorted to as an aid in curing syphilis.
Artificial Mineral Water Preparations.—SAL CAROLINUM FACTITIUM (N. F.) Artificial Carlsbad salt. Formulary number, 336: "I. In a dry, amorphous form (Ger. Pharm.).—Potassium sulphate twenty grammes (20 Gm.) [309 grs.]; sodium chloride one hundred and eighty grammes (180 Gm.) [6 ozs. av., 153 grs.]; sodium bicarbonate three hundred and sixty grammes (360 Gm.) [12 ozs. av., 306 grs.]; sodium sulphate (dried) four hundred and forty grammes (440 Gm.) [15 ozs. av., 228 grs.]. Triturate the ingredients, previously well dried, to a fine, uniform powder.
"Note.—The dried sodium sulphate is prepared by slowly drying the crystalline salt until it has lost one-half of its weight.
"II. In a crystalline form.—Potassium sulphate twenty grammes (20 Gm.) [309 grs.]; sodium chloride one hundred and eighty grammes (180 Gm.) 16 ozs. av., 153 grs.]; sodium carbonate (in clear crystals) six hundred and ten grammes (610 Gm.) [1 lb. av., 5 ozs., 226 grs.]; sodium sulphate (crystallized) eight hundred and eighty grammes (880 Gm.) [1 lb. av., 15 oz., 18 grs.]; distilled water five hundred grammes (500 Gm.) [1 lb. av., 1 oz., 279 grs.]. Dissolve the potassium sulphate and sodium chloride in the distilled water, and add this solution to the other two salts, previously melted in a tared capsule and at a gentle heat in their own water of crystallization. Evaporate the mixture to about 1800 Gm. [3 lbs. av., 15 ozs., 217 grs.], set it aside in a cool place, and stir frequently, so as to prevent the formation of large crystals, taking care, however, that none of the salt separate in a pulverulent form. Distribute any remaining water of crystallization uniformly over the crystals, and dry the whole mixture sufficiently by exposure to air, so that it will retain its crystalline character. A solution of about 16 grains of the dry, or about 27 grains of the crystalline salt, in 6 fluid ounces of water, represents an equal volume of Carlsbad water (Sprudel) in its essential constituents.
"Note.—The salts employed in the preparation of the crystalline form must have been purified by recrystallization"—(Nat. Form).
PULVIS SALIS CAROLINI FACTITII EFFERVESCENS (N. F.). Effervescent powder of artificial Carlsbad salt. Formulary number, 331: "Effervescent artificial Carlsbad salt.—Artificial Carlsbad salt (F. 336), (in form of dry powder) one hundred and eighty grammes (180 Gm.) [6 ozs. av., 153 grs.]; saccharated sodium bicarbonate (F. 341) four hundred and ten grammes (410 Gm.) [14 ozs. av., 202 grs.]; saccharated tartaric acid (F. 8) four hundred and ten grammes (410 Gm.) [14 ozs. av., 202 grs.]. Mix the ingredients, previously well dried, and triturate them until a uniform powder is obtained. To make Granular effervescent artificial Carlsbad salt, substitute saccharated citric acid (F. 5), (not dried) two hundred and five grammes (205 Gm.) [7 ozs. av., 101 grs.] for an equal weight of the saccharated tartaric acid, and prepare the granulated compound as directed under the general formula (F. 319, B.). A solution of about 87 grains of this preparation, in 6 fluid ounces of water, represents an equal volume of Carlsbad water (Sprudel), in its essential constituents"—(Nat. Form.).
SAL KISSINGENSE FACTITIUM (N. F.). Artificial Kissingen salt. Formulary number, 337: "Potassium chloride seventeen grammes (17 Gm.) 1262 grs.]; sodium chloride three hundred and fifty-seven grammes (357 Gm.) [12 ozs. av., 259 grs.]; magnesium sulphate (anhydrous) fifty-nine grammes (59 Gm.) [2 ozs. av., 36 grs.]; sodium bicarbonate one hundred and seven grammes (107 Gm.) [3 ozs. av., 338 grs.]. Triturate the ingredients, previously well dried, to a fine, uniform powder. A solution of about 24 grains of this preparation, in 6 fluid ounces of water, represents an equal volume of Kissingen water (Rakoczi Spring) in its essential constituents" (Nat. Form).
PULVIS SALIS KISSINGENSIS FACTITII EFFERVESCENS (N. F.). Effervescent powder of artificial Kissingen salt. Formulary number, 332: "Effervescent artificial Kissingen salt.—Artificial Kissingen salt (F. 337) two hundred and eighty grammes (286 Gm.) [9 ozs. av., 384 grs.]; saccharated sodium bicarbonate (F. 341) three hundred and sixty grammes (360 Gm.) [12 ozs. av., 306 grs.]; saccharated tartaric acid (F. 8) three hundred and sixty grammes (360 Gm.) [12 ozs. av., 306 grs.] Mix the ingredients, previously well dried, and triturate them until a uniform powder is obtained. To make Granular effervescent artificial Kissingen salt, substitute saccharated citric acid (F. 5), (not dried) one hundred and eighty grammes (180 Gm.) [6 ozs. av., 153 grs.], for an equal weight of the saccharated tartaric acid, and prepare the granulated compound as directed under the general formula (F. 319, B.). A solution of about 80 grains of this preparation, in 6 fluid ounces of water, represents an equal volume of Kissingen water (Rakoczi springs) in its essential constituents" (Nat. Form).
SAL VICHYANUM FACTITIUM (N. F.). Artificial Vichy salt. Formulary number, 338: "Sodium bicarbonate eight hundred and forty-six grammes (846 Gm.) [1 lb. av., 13 ozs., 366 grs.]; potassium carbonate thirty-eight and one-half grammes (38.5 Gm.) [1 oz. av., 157 grs.]; magnesium sulphate (anhydrous) thirty-eight and one-half grammes (38.5 Gm.) [1 oz. av., 157 grs.]; sodium chloride seventy-seven grammes (77 Gm.) [2 ozs. av., 313 grs.]. Triturate the ingredients, previously well dried, to a fine, uniform powder. A solution of about 14 grains this preparation, in 6 fluid ounces of water, represents an equal volume of Vichy water (Grande Grille spring) in its essential constituents"—(Nat. Form.).
PULVIS SALIS VICHYANI FACTITII EFFERVESCENS (N. F.). Effervescent powder of artificial Vichy salt. Formulary number, 333: "Effervescent artificial Vichy salt.—Artificial Vichy salt (F. 338) two hundred and forty grammes (240 Gm.) [8 ozs. av., 204 grs.]; saccharated sodium bicarbonate (F. 341) three hundred and eighty grammes (380 Gm.) [13 ozs. av., 134 grs.]; saccharated tartaric acid (F. 8) three hundred and eighty grammes (380 Gm.) [13 ozs. av., 178 grs.]. Mix the ingredients, previously well dried, and triturate them until a uniform powder is obtained. To make Granular effervescent artificial Vichy salt, substitute saccharated citric acid (F. 5), (not dried) one hundred and ninety. grammes (190 Gm.) [6 ozs. av., 307 grs.], for an equal weight of the saccharated tartaric acid, and prepare the granulated compound as directed under the general formula (F. 319, B.). A solution of about 57 grains of this preparation, in 6 fluid ounces of water, represents an equal volume of Vichy water (Grande Grille spring) in its essential constituents" (Nat. Form.).
PULVIS SALIS VICHYANI FACTITII EFFERVESCENS CUM LITHIO (N. F.).—Effervescent powder of artificial Vichy salt with lithium. Formulary number, 334: "Effervescent artificia1 Vichy salt with lithium.—Artificial Vichy salt (F. 338) one hundred and fifty-six grammes (156 Gm.) [5 ozs. av., 220 grs.]; lithium citrate (in very fine powder) fifty-six grammes (56 Gm.) [1 oz. av., 427 grs.]; saccharated sodium bicarbonate (F. 341) three hundred and ninety-four grammes 1394 Gm.) [13 ozs. av., 393 grs.]; saccharated tartaric acid (F. 8) three hundred and ninety-four grammes (394 Gm.) [13 ozs. av., 393 grs.]. Mix the ingredients, previously well dried, and triturate them until a uniform powder is obtained. To make Granular effervescent artificial Vichy salt with lithium, substitute saccharated citric acid (F. 5), (not dried) one hundred and ninety-two grammes (192 Gm.) [6 ozs. av., 338 grs.] for an equal weight of the saccharated tartaric acid, and prepare the granulated compound as directed under the general formula (F. 319, R). 90 grains (or about a heaped teaspoonful) of this preparation represent 14 grains of artificial Vichy salt and 5 grains of lithium citrate"—(Nat. Form.).