BALNEOTHERAPEUTICS, medical treatment by internal and external use of mineral waters, the principal constituents of which are sodium, magnesium, calcium and iron, in the form of chlorides, sulphates, sulphides and carbonates. Other substances occasionally present are arsenic, lithium, potassium, manganese, bromine, iodine, etc. The chief gases in soiution are oxygen, nitro gen, carbonic acid and sulphuretted hydrogen. Argon and helium occur in some of the "simple thermal" and "thermal sulphur waters," while others contain minute quantities of radium. In the employment of the various mineral waters, many of the spas adopt special means by which they increase or modify their influence. Of these the "pine-needle" bath has the greatest repute; it is made by adding a decoction of the needles or young shoots of firs and pines. Fir wood oil (a mixture of ethereal oils) or the tincture of an alcoholic extract acts equally well. Similar effects follow the addition to the bath of aromatic herbs, such as camomile, thyme, etc. Astringent baths are prepared in a similar way from decoctions of oak bark, walnut leaves, etc. Mud baths are chiefly prepared from muddy deposits found in the neighbourhood of the springs, as at St. Amand. They act like a large poultice 'applied to the surface of the body, and in addition to the influence of the temperature, they exert a con siderable mechanical effect. The pulse is accelerated some 6 to 12 beats a minute, the respiration number rises, and the patient is thrown into a profuse perspiration. They have very great value in gouty and rheumatic conditions and in some of the special troubles of women.
In advising balneotherapeutic treatment in any case, all the conditions and habits of the patient—pecuniary, physical and psychical—must be considered, as the spa must be fitted to the patient, not the patient to the spa. After rheumatic fever, if the joints remain painful and the heart is dilated, the thermal gaseous saline water of Nauheim, augmented by Schott's resistance movements, will often appear to work wonders. Chronic rheu matism, where there is much exudation round a joint or incipient stiffness of a joint, may be relieved by hot thermal treatment, especially when combined with various forms of massage and exercises. Simple thermal waters, hot sulphur springs and hot muriated waters are all successful in different cases. Chronic muscular rheumatism can also be benefited in a similar manner. Diseases of the nervous system are on the whole treated by these means with small success. Mental diseases other than very mild cases of depression should be considered inapplicable. Neu rasthenics are sometimes treated at chalybeate or thermal muri ated saline spas; but such treatment is entirely secondary to the general management of the case. Neuralgic affections and the later stages of neuritis, especially when dependent on gout or rheumatism, are often relieved or cured. Abdominal venosity (abdominal plethora), a feature of obesity, glycosuria, etc., are extremely well fitted for this form of treatment. The alkaline sulphated waters, the bitter waters and the common salt waters can all be prescribed, and after a short course can be supple mented with various forms of active and passive exercises. Diseases of the respiratory organs are far more suited for climatic treatment than for treatment by baths. In the anaemia depend ent on malarial infection, the muriated or alkaline sulphated waters at spas of considerable elevation and combined with iron and arsenic are often beneficial. Gravel and stone, if of the uric acid variety, can be treated with the alkaline waters, but the case must be under constant observation lest the urine become too alkaline and a deposition of phosphates take place on the already formed uric acid stone. Gout is so variable both in cause and effect that much discrimination is required in its treatment. Where the patient is of "full habit," with portal stagnation, the sulphated alkaline or mild bitter waters are indi cated, especially those of Carlsbad and Marienbad ; but the use of these strong waters must be followed by a long rest under strict hygienic conditions. Where this is impossible, a milder course must be advised, as at Homburg, Kissingen, Harrogate, Wiesbaden, Baden-Baden, etc. For very delicate patients, and where time is limited, the simple thermal waters are preferable.
For radiant heat and light baths and electric baths of all kinds, see ELECTROTHERAPEUTICS ; and for compressed air baths, AERO THERAPEUTICS. (See also BATHS, THERAPEUTICS, and the articles on diseases.)