# Essay on the mineral waters of Carlsbad/Water and steam-baths

WATER AND STEAM-BATHS.
We have seen that the fame of Carlsbad began with the use of water-baths; that steam-baths are the third period of our medical history; and that the superiority of our present institutions is founded upon the junction of our therapeutic resources, though drinking remains the most important part of the treatment. It would be almost impossible to describe the various cases in which water-baths prove useful, but we may say in general that they assist power-fully the internal cure, in a variety of rheumatic, gouty and herpetic cases; that they often facilitate the passage of biliary and urinary concretions, and that they are more efficacious, and less productive of congestions, when the secretory and excretory action of the water on the bowels and kidneys has already commenced.
​Our steam-baths being a new institution, I shall give summarily the result of my observations during the seven years of their existence.
The vapour, rising so copiously from our wells, had never been examined before. We are indebted for its first analysis to Mr. Nentwich, apothecary at Carlsbad, who undertook it, at my request, before they were opened to the public.
“The vapour of the Hygiaea-spring, taken in the apparatus standing the nearest of the square channel, through which it rises, gave, on the 20th of December 1826, with an external atmospheric temperature of + 5 R., the following result:
* The temperature within the closed apparatus was + 36 R.
* 100 parts of vapour, + 36° R., cooled to + 5° R., were reduced to 83,333 parts of space, and that gaz was composed of 4,183 parts of carbonic acid gaz and of 79,150 parts of atmospheric air.
* The water, under the form of drops, is, with the exception of a little carbonic acid gaz, entirely free from saline parts.”
We see, therefore, that the Carlsbad vapour is composed of atmospheric air, carbonic acid gaz and aqueous vapour.
One might be inclined to question the powerful effects of such a simple mixture, entirely free from fixed particles; that power, however, will be more ​easily felt than understood, by any one who, exposing his hand or his foot to this natural heat, compares his sensation with what the same limbs will feel, when exposed to the vapour of an artificially heated water. That natural, telluric, heat is mild, penetrating and comfortable, even to 36°—40° R., which can be considered as the middle temperature of those steam-baths, supported by some patients even to 44—46° R., whilst the vapour of common water, heated in a kettle, is sharp, burning and intolerable in a few moments, under far inferior temperature. We have, as already mentioned, general and partial steam-baths, and if the patient takes only a half-bath, that is to say, if he sits in the box up to the pit of the stomach, he bears a few degrees of heat more than in a whole bath. The head is never exposed to the vapour, which on account of the carbonic acid gas, would very soon produce dangerous effects.
Few individuals support a whole steam bath above twenty minutes, but a half-bath longer. Some patients, labouring under the tic douloureux, after having tried innumerable remedies, and even surgical operations, have been, if not radically cured, at least essentially relieved. The steam-baths have proved useful in some cases of deafness; and if such patients cannot support the stream of the vapour-douche in the inside of the car, it must be directed in the neighbouring parts of that organ. In rheumatism, lumbago, sciatic, stiffness of the joints, contractions ​of muscles, the vapour offers a precious remedy, but should never be used, when attended with febrile symptoms. In herpetic eruptions, in the hepatic spots, they are useful, conjointly with the internal cure, but certainly far less than the sulfureous fumigations, which produce a much more complete desquammation of the skin than the thermal vapour.