In considering the mineral baths, we are dealing essentially with sodium chloride. which exists more or less in combination with other salts; these salts collectively are given as salt or brine baths. The use of the salt baths at home has increased extraordinarily; but when given without proper consideration these are often misapplied, as when they are administered for months, even though, as is the rule, they are given in weak solutions. The salt content should average about two per cent.; in the case of delicate young children, one and one-half per cent.; in older children, three per cent. During the course of the treatment the strength of the solution reaches even as high as five per cent. The occurrence of a greater tranquillity should be increased, without allow ing this to reach the degree of drowsiness which, however, may be taken as an index of its action. Of the natural brine baths may be mentioned Ischl (comfortable and correspondingly expensive), Gmunden, Aussee, Kreuznach, Reichenhall, and Harzburg; and for cures to be undertaken in the spring and fall, Ilex-les-Salines and Kalberg, which have mild sea climates; Elmen and Salzungen are sunny; and Rosen, Sulza, Suderode, and Orb may be recommended for younger children.
In considering the brine baths containing carbonic acid, it does not matter whether they are warm when they flow from the ground or are heated afterwards. Among these are Soden, Homburg, and Oeynhausen. The baths at Rothenfelde are simpler. Nauheim and Kissingen are to be preferred in cardiac affections.
The mineral baths and the iron baths (Stahlbiider) containing car bonic acid should be considered here. In the former the sodium chloride is displaced by other salts (alkaline-mineral and alkaline-saline springs). In all these the salt content is relatively low, so that the pressure of solutions, even when of a somewhat higher specific gravity, is neutral ized by the action of the carbonic acid gas. and these baths consequently have a still milder action than the brine baths which contain carbonic acid. They may be ordered in conditions of general weakness, and irritability. in combination with the other factors which go to make up the advantages of a bath treatment (Badekur).
Among the alkaline-saline baths are Franzensbad, Elster, Marien bad. and (only for larger children) Tarasp. Of the steel baths there are Liebenstein, Reinerz, Schwalbach, Pyrmont, Flinsberg (about 3000 feet high), and St. Moritz. The latter has the greatest altitude, and should therefore be recommended only for grown children: it is expensive.
The carbonic acid baths may be prepared at home with or without the addition of sodium chloride. The carbonic acid is liberated from carbonates by the action of sulphuric or acetic acid; zinc bath tubs, if not enamelled, are easily destroyed thereby.
In this place too are to lie mentioned the peat and mud baths (Moor- and Schlarnmbilder), which depend for their action upon the constant temperature and general pressure over the surface of the body.
As full baths they would scarcely ttlniit of application to children; but, on the other hand, they may be exceedingly useful when locally applied at the site of chronic inflammations, to absorb old exudates (e.g., in appendicitis after it has run its course, in tuberculous peritonitis, in tuberculous pleurisy, or in old rheumatic inflammations). The local pack is continued daily for weeks, an hour or so at a sitting, while at the same time the rest of the body is tucked into warm blankets. They may even he applied at home, e.g., with the Fango mud; but it is better to employ them in institutions such as exist in the larger cities (e.g., Berlin), or, best of all, in the watering places where they are used in connection with a cure. The following ire a few of the many mud baths (Moorbiidern): Franzensbad, Elster, Marienbad, Konigswart, Pyrmont, Kissingen, Reinerz,lorf.
Packing in hot sand is not to be considered as a bath in the full sense of the word; but its action, when it is used in chronic rheumatism, is related to that of the mud baths.
Steam and hot air baths are not used for children. By way of excep tion, however, may be mentioned electric light baths when employed to induce sweating, and sunlight baths used systematically by exposure of the body to the sun's rays.—the head being protected the while, and one of the cold water procedures being used in completion. These baths should be administered only very carefully.
physical methods of treatment heretofore considered, had for their principal sphere of action the skin and mucous membrane. The methods which affect the motor apparatus will now be considered. Their importance depends upon the fact that they influence the circulation, heat production, and metabolism, the proper perfor mance of these functions being responsible for the feeling of well being, and the general tone. A complete rest of the motor apparatus will diminish the heat production while by enveloping the body the dis persion of the heat already produced will be retarded, thus effecting the same result as an increase of motor activity. Many local diseases require rest to effect a cure; e.g., inflammation of the peritoneum, bladder, or kidneys (surgical conditions are, of course, not included). Again, in all acute febrile diseases, in prolonged weakening conditions and in painful affections, rest in bed is sought, inasmuch as both strength and the desire to move grow less, and instinctively there arises a desire to curtail the expenditure of energy as the appetite diminishes. In litany of the chronic diseases, such as tuberculosis, inanition, and anemia from whatever cause, but particnlarly in chlarosis, rest in the fresh air (in bed or on a couch) is indicated, con tinuous at first, hut later at intervals; and this forms a most important part of the plan of treatment. At the same time the body weight may if desired he increased by forced feeding.