History. — From the almost universal solvent powers of water, it is the most extensive pharmaceutical agent that we possess, beside being, when properly employed, a most valuable remedy for a large number of diseases. The purest water that can be obtained is distilled water, which when properly prepared in clean, glass vessels, is colorless, transparent, tasteless and inodorous, with the assumed specific gravity of unity, and with which as a standard, the specific gravities of all solids and liquids are compared. It is the only admissible water for pharmaceutic and chemical tests, as the presence of organic or saline substances in it, may decompose the articles to be dissolved, or impair its solvent power. At a temperature of 32° or lower it becomes ice; at 212° or above, it forms steam, in which its bulk is augmented to nearly 1700 fold, and its specific gravity reduced to about half that of atmospheric air ; it is likewise compressible to a certain extent. It is capable of absorbing or dissolving to a greater or less amount, all of the gases ; and even in the driest weather, it constantly exists in the atmosphere, in the form of invisible vapor. Pure water consists of one equivalent of hydrogen, 1, and one of oxygen, 8=9=HO. It is perfectly neutral, exhibiting neither acid nor basic properties, though capable of combining with each, and increasing their activity. It should always be kept in glass vessels. The solvent power of water is increased by heat.
Water is known as Soft-Water, Hard-Water, and Mineral-Water ; the soft are always preferred to hard-waters in pharmaceutical preparations, and may be known by their forming a lather with soap, notwithstanding they may contain considerable impurities. Hard-water, contains one or several salts of lime, with other impurities, curdles soap, and is unfit for internal use, or domestic purposes. An excellent test for determining the quality of water is the tincture of soap ; in distilled water it produces no effect ; in soft water, only a slight opalescence ; and in hard water, a milky appearance. We have several varieties of water, as rain, snow, spring, river, well, lake, and marsh water ; the first two are the purest, the following three come next in order, and the last is unwholesome, and ought never to be employed for domestic or medicinal purposes. Good water is limpid, without smell, and does not curdle soap ; and its transparency is but little affected by nitrate of baryta, nitrate of silver, or oxalate of ammonia.
Rain and snow-waters, are distinguished from distilled water, chiefly by their holding in solution an unusual amount of atmospheric gases. To obtain either of them pure, they must be collected in large clean vessels as the rain or snow falls toward the earth ; and this should be done at some distance from houses, commencing some time after they have fallen, in order to avoid the contamination of dust and other impurities in the atmosphere, which is usually present with the first fall of the rain or snow.
Rain-water, (aqua pluvia) may by proper precautions be obtained tolerably pure from the roofs of houses on which it falls, by allowing the impurities to be washed away in the commencement of a heavy rain. In large cities the rain-water contains nitrogenized organic matter. Both rain and snow-waters may be applied to every domestic purpose, as well as to most chemical and pharmaceutical operations. But no water should ever be used which comes in contact with lead — for the lead becomes oxydized by the oxygen of the water, which oxide is reduced to a carbonate by the action of the carbonic acid derived from the air, and the water thus containing lead may produce the poisonous effects of that metal upon the system. The more soft and pure the water, the greater the risk.
Spring-water, (aqua fontana,) is that which springs from the earth, free from large amounts of carbonic acid, or salts, and not possessing elevated temperatures ; it is the general beverage of mankind, and is applicable to all domestic purposes. Its quality depends entirely on the strata through which it flows ; those springs arising from traprocks, sandstones, transition rocks, and primitive rocks are the purest ; those from alluvial strata, limestone, and coal formations are the least pure. All however contain variable traces of the salts of lime, soda, or magnesia, which vary according to the locality of the spring.
River-water, (aqua fluvialis) especially when passing through alluvial countries and near great cities, contains suspended in it more or less earthy, and vegeto-animal impurities, which impair its transparency, but which in a short time will purify itself during its downward course. In countries where the rivers pass chiefly over primitive rocks, the waters are found to be almost perfectly pure. When moderately pure it is fit for all ordinary purposes, though if it contain much vegetoanimal matter, it is apt to occasion dysentery, and other affections of the bowels, and then becomes inadmissible in pharmacy. The Croton water of New York, the Schuylkill water of Philadelphia, and the Ohio river water, are, when filtered, sufficiently pure for all the purposes of pharmacy, where distilled water is not expressly required. Lake-water, in the United States, is generally a pure and wholesome water ; in other instances it is similar to the river-water.
Well-water, very much resembles spring-water in its qualities, its purity being proportioned to its depth and amount of use. In large cities well-water always contains nitrates, owing to the rapid oxidation of nitrogenized organic matter, which filters through the soil. These nitrates prevent the formation of any vegetable matter in water, even when long kept. A very pure water is usually obtained from the Artesian or overflowing wells.
Marsh-water being commonly stagnant, and containing vegetable matters in the process of decomposition, is unwholesome, and should never be employed for domestic or medicinal purposes.
The Journal of Pharmacy of March, 1848, gives the following process of Dupasquier to ascertain whether there is an amount of organic matter held in solution in water, above the minute quantity usually present in good water : Place into a small flask one or two fluidounces of the water to be tested, and to it add a few drops of solution of chloride of gold, free from excess of muriatic acid, enough to give the water a slight yellow tint ; then boil it. If the yellow tint remains unchanged, the ordinary proportion of organic matter is present ; but if the liquor becomes at first brownish and afterward violet or bluish, in consequence of the reduction of the gold, the water holds a greater amount of organic matter than usual. This organic matter is of the nature of ulmin or gein.
Prof. Faraday states, that "one grain of water will require for decomposition an electric current equal to a very powerful flash of lightning." The chemical action of a grain of water upon four grains of zinc, can evolve electricity equal in quantity to that of a powerful thunderstorm ; and he states, that from his experiments it would appear, that 800,000 such charges of the Leyden battery would be necessary to supply electricity sufficient to decompose a single grain of water. The Leyden battery of which he speaks, consists of fifteen jars, containing 3510 square inches, or about twenty-four and a half square feet of coated glass, charged by thirty turns of a plate electrical machine, the plate being fifty inches in diameter, and of immense power, giving ten or twelve sparks an inch long for each revolution. In relation to this an author in the Philosophical Magazine remarks, that "the estimate that 800,000 discharges of the battery of fifteen jars, equal to a powerful flash of lightning, would be necessary to resolve a single grain of water into its elements, is certainly astounding, when it is recollected that, according to Prof. Faraday, the quantity of electricity that decomposes a body, is the equivalent quantity of electricity that had previously held the elements of that body in combination ; for he, with Davy and others, conceives that electricity and chemical affinity are identical powers. Hence, in one grain, that is, one drop of water, there must be naturally existing, and constituting the affinity between its oxygen and hydrogen, no less a quantity of electricity, than 800,000 charges of a battery, containing 3510 square inches of coated glass, or the equivalent of a very powerful flash of lightning. If this quantity of electricity were converted into one spark, it would be 4166 miles in length, taking Prof. Faraday's mean estimate of one charge of his battery as the basis of calculation."
Mineral Waters, are those which present a large proportion of carbonic acid, with or without saline, alkaline, metallic, earthy and other foreign substances, and which exert an appreciable therapeutical influence on the animal economy. For all practical purposes, they may be conveniently arranged into carbonated, sulphureted, chalybeate, and saline mineral waters, for an account and list of each of which, see Appendix. When the water is elevated in temperature they are called Hot or Thermal springs ; when of ordinary temperature or lower, they are called Cold Mineral Springs.
Properties and Uses. — As a remedial agent, apart from its natural necessitous use, water internally is a tonic, diuretic, or sudorific, according to its mode of administration. Small quantities, taken cold, between 45° and 60°, and occasionally repeated, act as a tonic ; in larger doses it produces diuresis, and diaphoresis, the latter effect more especially, if the patient be kept warmly covered, and it is extensively used for this purpose in many acute diseases. Warm water, between (50° and 100°, relaxes the fibers of the stomach, and, particularly if given in large quantities, is apt to provoke nausea and vomiting. In fevers, water is a grateful drink, allaying thirst, moderating the fever, often producing sleep and relief from restlessness ; and is sufficient, unaided by other means, to effect a rapid solution of the disease, in many instances. It should never be withheld from patients laboring under febrile or inflammatory complaints, who crave it. During the operation of a vegetable emetic, cool water at 60°, is more agreeable, and fully as beneficial in assisting the emesis, as warm.
Externally, water is frequently applied as a sedative in local inflammations, as quinsies, sore-throats, ophthalmia, sprains and contusions, and as a means of restraining hemorrhage. Cloths wet with cold water and applied to the abdomen, have relieved severe pain in the bowels, retention of urine, etc. The cold dash or douche, has been successfully employed in delirium tremens, apoplexy, tetanus, hysteria, convulsions, obstinate constipation, congestive, bilious and typhoid fevers. The wet sheet is much used to allay febrile and inflammatory conditions, and to promote diaphoresis. As an injection it has been efficient in habitual constipation, and excessive tympanitic distension, as well as dysentery. Applied warm it is an excellent application to erysipelatous inflammations. Ice and iced water, as a local application, are said to be very useful in burns and scalds, also in many cerebral affections.
As a bath, water is also an important remedy. The vapor-bath accelerates the circulation, produces profuse sweating, and softens and relaxes the skin, and may be employed in a variety of cases. The hot bath has a similar effect, but is apt to be dangerous in some constitutions. The warm bath diminishes the frequency of the pulse, lessens the frequency of respiration and the heat of the body, and relaxes the skin. It acts as a soothing remedy, producing a disposition to sleep. It is useful in febrile and inflammatory diseases, characterized by frequent pulse, preternaturally hot and dry skin, and much restlessness ; also in spasms and convulsions of children, retention of urine, nephritic pains, and the like. It is contra-indicated in diseases of the head and chest. The cold bath acts according to its temperature and mode of application, as a stimulant, tonic, and sedative.
The following are the temperatures at which baths are usually applied : —
Water, cold, 50° to 75° F.
Water, temperate, 75 to 85 ° F.
Water, tepid, 85 to 92 ° F.
Water, warm, 92 to 98 ° F.
Water, hot, 98 to 112 ° F.
Vapor, if breathed, tepid, 90 to 100 ° F.
Vapor, if breathed, warm 100 to 110 ° F.
Vapor, if breathed, hot, 110 to 130 ° F.
Vapor, if not breathed, tepid, 96 to 106 ° F.
Vapor, if not breathed, warm, 106 to 120 ° F.
Vapor, if not breathed, hot, 120 to 160 ° F.
Hot air, as a sudorific, 85 to 100 ° F.
Hot air, as a stimulant, 100 to 130 ° F.
In addition to the above uses of water, it has likewise other employments, as follows : —
The Wet Sheet Packing, or Lein Tuch of the Germans. A mattress of cotton, hair, or straw, has spread over it three or four large, thick comfortables, and over these one or two soft flannels. A linen sheet having been previously dipped in cold water, or for very delicate persons in tepid or even warm water, is lightly wrung out, so as not to drip, and spread over the whole, having under it one or two pillows for the head. The patient is made to lie upon these on his back, and is quickly and snugly enveloped in the wet sheet, over which is placed the flannels and blankets, or a light feather-bed may be thrown over the top, in case comfortables are not plenty. Care should always be taken to turn the clothing snugly and smoothly around the feet and neck ; and if the feet remain cold, bottles of cold water should be placed to them. Headache is prevented or removed by the application of cold wet cloths applied to the head.
The time for remaining thus "packed," varies in different cases, averaging from half an hour to an hour, depending on the effect; the body should become comfortably warm before being removed. A disagreeable sensation of cold is first experienced, which is soon followed by a pleasurable warmth over the whole surface, and sometimes copious perspiration, though this last is not always indicated. On coming out of the "pack," the plunge, the douche, rubbing wet sheet, or towel-washing are to be employed as the case may require. If the patient experiences a chill after coming out, a thorough rubbing, followed by fifteen or twenty minutes' dry packing, will usually obviate all injurious consequences. The process of packing should never be continued so long as to cause headache, languor, muscular debility or giddiness.
This is said to act as a sedative, reducing the heat of the body, and excessive arterial action, and as an alterative, correcting morbid secretions and restoring healthy ones. In fevers, and all acute inflammatory disorders, it may be frequently renewed according to the degree of fever or inflammation, until the temperature and circulation are reduced to the natural standard, and the skin becomes soft and perspirable. Much sweating is not usually to be desired. In chronic diseases, it removes internal congestions, develops external circulation, produces a healthy condition of the skin, and may be used in many forms of this class of maladies. If carelessly attended to, the wet sheet may give rise to serious difficulties.
When the wet sheet is applied to the trunk of the body only, as in cases of feeble persons, where there is not sufficient vitality for the whole sheet, or for other purposes, it is termed the "Half Pack Sheet."
The Douche (doosh) is the application of a stream of cold, tepid or warm water, from a greater or lesser hight, and continued for a time indicated by its effects. The force of the stream, and time of application should be carefully adapted to the strength of the patient. Very nervous persons, and those subject to determinations to the brain, should resort to it with extreme caution. A strong douche should never be applied to the head, nor should it be long continued on any one spot along the vertebral column. A douche may be vertical, oblique, horizontal, or ascending. The most common are in perpendicular streams one or two inches in diameter. Its effect is to arouse the activity of the absorbent system, and is hence very useful in gout, rheumatism, paralysis, chronic enlargements of the viscera, tumors, etc.
The ascending douche will be found beneficial in piles, uterine displacements, prolapsus ani, constipation from debility, chronic enlargement of the prostate gland, impotency, etc. The stream may be half an inch to an inch, and should not be forcible enough to cause absolute pain nor serious inconvenience. Warm water douches are for the purpose of producing relaxation of the muscles of the part acted upon, and are hence useful in rigidity of the muscles, painful swellings, chronic inflammation of the joints, neuralgia, spasmodic and bilious colic, retention of urine, amenorrhea, uterine rigidity, etc. In some cases it should be followed by a momentary cold dash.
The Rubbing Wet Sheet is a large sheet dipped in water, and wrung out so as not to drip. It is then suddenly thrown around the patient's body, enveloping him closely from the neck to the feet, and the body is then rubbed for about five minutes by the hands of the attendant on the outside of the sheet. It is to be followed by rubbing with dry towels. This produces a strong and general determination to the whole surface, and is applicable in all cases where a strong determination is desired from internal organs or surfaces to the skin. It will be found valuable in the early stages of bowel complaints, diarrhea, dysentery, colic, fevers, etc.; it is likewise useful for exhaustion following mental exertion, many forms of insanity, delirium tremens, night-sweats, wakefulness, nightmare, etc. When the sheet is employed drippingly wet, (the dripping sheet) a large tub or pan is necessary for the patient to stand in, to avoid wetting the floor.
The Hip or Sitz Bath is a common tub, in which the patient sits so as to have the water cover the hips and lower part of the abdomen. A vessel made for the purpose, with a back to rest against is more convenient. The water may be of any temperature, and the time of application varies from five to thirty minutes. According to its application it is tonic, derivative, or sedative. Tonic when applied from five to fifteen minutes ; derivative when extended from fifteen to thirty minutes ; and sedative according to its effects. Derivative hip baths should not be carried to the point of producing paleness or lividity of the lips, shiverings, nausea, faintness, or headache, and according to the effect desired, and the coldness, torpor, and debility of the patient, indicate that the quantity of water should be lessened, or its temperature elevated. It is useful in debility, irregularity, obstruction, and torpor of the organs of the pelvis and lower part of the abdomen. A blanket is generally thrown around the patient during this bath.
The Shallow Bath is a circular, or oval tub, raised about twelve inches from the floor, and with water in it from four to six inches deep. The patient sits in this, while the attendant sprinkles his head, and rubs his chest, abdomen, and back. It may be employed from one to thirty minutes, and should be followed by a good dry rubbing. It is used at a temperature from 60° to 75°, and is excellent in cutaneous affections, and other cases where a mild derivative, or moderately-sedative influence is desired.
The Plunge Bath may be any vessel or place, the water being from 55° to 65°, which will allow the patient to plunge into it, head, or feet foremost as he fancies, or to quickly immerse the whole body up to the neck. The time for remaining in it, varies from a few seconds to two or three minutes, or in high fever, to ten or fifteen minutes. It is generally taken after the sweating process, and after the wet sheet, when the patient can bear the exertion ; in these cases the sheet is not to be removed until at the plunge. It is very useful in all febrile and chronic affections, but should be employed with care, or avoided altogether in consumptive, and dropsical patients, and those laboring under organic diseases of the heart.
These are the principal applications of water in Hydropathic practice ; yet there are several others of a useful character, as the Foot Bath, the Head Bath, the Shower Bath, the Vapor Bath, etc., the mode of application of which are generally well understood, as well as their effects. Cold water may likewise be used in form of a bandage or girdle, by applying one or more folds of linen wet in cold water, to the part affected, or around the abdomen, and covering it with a dry cloth or other material to retain the heat. The wet girdle or abdominal wrapper or compress, is applied around the abdomen in all acute diseases of the abdominal viscera. The bandages are applied warm or cold, according to the indications they are intended to fulfill.
Mineral waters vary in their effects upon the system, according to their constituent combination. The acidulous waters are powerful and diffusive stimulants of the nervous and circulatory systems, likewise diuretic. Generally useful in dyspepsia, passive dropsy, chronic diseases, chlorosis, and phosphatic gravel ; contra-indicated in recent palsy, apoplexy and active hemorrhages and inflammations.
Alkaline waters are antacid, antilithic, and diuretic. Useful in gout, gravel and stone. Purgative waters also possess diuretic properties, and are useful in all cases where laxatives are required. Chalybeate waters are tonic, and used in dyspepsia, all kinds of chronic cachexies, gout, and chronic diseases generally. Sulphurous waters are stimulant, diaphoretic, diuretic and emmenagogue, and are found beneficial in chlorosis, rheumatism, dysmenorrhea, secondary syphilis, chronic cutaneous diseases, and deranged conditions of the stomach and liver. They are contra-indicated 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. 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.