600

IIYDROTm-'R APY

[VOL. vi

Climacteric
arthritis

able limits. Nearl> all osteoarthntic persons trei|ucntim'. spas habitually
eat loo much. Careful iciuilaliou of the diet, more especially as regards
the quantity, will spare the patient am uiineeessaiy metabolic burdens.

Any physical measures nuclei taken should be directed to maintain
the function of the joints. For this reason spas \\ith pool baths should
be recommended for such eases.

In mcnopausul arthritis, which is often associated with an increase in
the bodily weight, the various physical methods of treatment available
at the spas are of great value.

(h) Sitiltihlc S/w
Ruxtim Buxton, about 1,000 feet above the sea-level, is the highest spa in
F.ngland. The air is very bracing. The wateis are tepid (K.T F.) and of
feeble mincrali/ation. They contain a comparatively large amount of
nitrogen which, although inert, carries the radium emanation to which
therapeutic properties are ascribed. Taken internally the waters are
diuretic. Fxternally they are employed in pool baths and massage-douches.
Buxton possesses a very complete physiotherapeutie installation.
Droitwich Droilwich. The brine baths of this spa pioduee theii ell eel as follows:
(i) The natural buoyancy of the water enables the patients to move
their stiflencd limbs through ranges otherwise impossible, the support-
ing action of brine, being much greater than that of ordinary water,
(ii) The surface action or stimulation of the skin promotes free and
copious sweating and increases the circulation in the superficial capil-
laries and lymphatics, (iii) The hot baths have the ellecls described on
page 577.
Actfiii Acqui (Northern Italy). Treatment here is chiefly confined to the
application of fango packs. Fango is an organic mud obtained from
deposits round the thermal springs.
Aachen Aachen (Aix-la-Chapelle, Germany). The springs belong to the thermal
alkaline muriated sulphur group. The large pool bath is the outstand-
ing feature of the treatment here. Hotels and bathing establishments in
many instances are combined under one roof.
Aix-ks-Bains Aix-les-Bains (France) is almost entirely a bathing spa. The Aix
massage douche is given with water obtained from two hot sulphur
springs. The water holds in suspension whitish Hakes of oily organic
nature which make it a very suitable medium for massage.
Baden-Baden Baden-Baden (Germany) has about twenty simple thermal muriated
springs and a particularly fine bathing establishment,
Budapest Buda Pest (Hungary) possesses an almost unlimited supply of simple
thermal and thermal sulphur water, mostly used for bathing. There arc
also some thermal mud pools.
Dax Dax (France). The mud employed in the baths is formed by the action
of the thermal water on the banks of mud left by the periodical over-
flowing of the river.
Pistany Pistany (Czechoslovakia). The thermal springs arise from a depth of
several hundred feet from a large enclosed basin filled with sulphur