Bäder-Almanach; reports of spas, climatic stations and sanatoria in Germany, Austria-Hungary, Switzerland and adjoing countries, for physicians and patients

Almanach

ENGLISH EDITION 1912

BERLIN
OLF MOSSE

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Bader-Almanach

REPORTS

of

Spas, Climatic Stations and Sanatoria

in Germany, Austria- Hungary, Switzerland and
adjoining countries

for Physicians and Patients

English Edition 1912

BERLIN

Published by Rudolf Mosse.

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PREFACE.

The "Bader-Almanach" issued since more than 30 years by
the undersigned publisher is known to be sent in thousands of copies
free of charge also to those physicians of foreign countries who
are acquainted with the German language. But it has often
been suggested to publish the ''Bader-Almanach" in foreign
languages, too, in order to supply also physicians abroad, that are
not or not sufficiently conversant with the German language,
with such a reliable book of reference and information. Now,
some time ago, the newly founded "Association of Proprietors
of Sanatoria" chose the "Bader-Almanach" of the undersigned
pubhsher as its "official-organ" for the publication of the pro-
spectus of its members, in order to oppose to the steadily pro-
pagating exploitation of this field by so-called "guides". At the
same time, it was considered desirable to have editions in
foreign languages, too. The undersigned publisher has comphed
with this demand by issuing a Russian edition in 1911, and
now the first English edition which is being forwarded free of
charge to practitioners in Great Britain, America, and English
Colonies. Compared with the first Russian issue the present edition
has been considerably amplified and improved, in as much as the
extensive scientific section of the last German edition of the
"Bader-Almanach" (1910) elaborated by prominent balneologists»
was added.

We hope sincerely that this book will render valuable service
to the addressee, and answer its purpose of being a reliable
work of reference and a handbook in the vast field of balneology.

May 1911

Rudolf Mosse

Publisher of the "Bader-Almanach".

CONTENTS

Balneotherapy.

Pages

A. Introductory Remarks 11

B. Brief Guide for the Choice of Health -Resorts and for Determining

the Therapeutic Methods 12

I. General Disorders of Nutrition.

A. Anaemia and Chlorosis 12

B. Scrofula 15

C. Rickets 17

D. Gout 18

E. Diabetes Mellitus 18

F. OhesitVv 20

G. General Weakness and Delayed Convalescence ^'j

II. Diseases of Intoxication.

A. Constitutional Syphilis 27

B. Chronic Mercurial Intoxications 32

C. Lead Poisoning 34

III. Diseases of the Respiratory Organs.

A. Diseases of the Naso-Pharynx, of the Larynx and the Trachea 34

1. Chronic Affections of the Naso-Pharyngeal Mucosa 34

2. Chronic Catarrh of the Larynx 36

3. Cihronic Catarrh of the Bronchial Mucous Membrane 37

B. Diseases of the Pulmonary Tissue and of the Pleura 38

1. Chronic Affections of the Lungs; Residues of Acute Inflammations of

the Pulmonary Tissue; Exsudates of the Pleural Cavity 38

2. Tuberculosis and Pulmonary Consumption 39

3. Asthma and Emphysema 48

rV, Diseases of the Heart; Disorders of Circulation 51

V. Diseases of the Alimentary Canal and of the Large Abdominal
Glands.

A. Chronic Catarrh of the Buccal Mucous Membrane (Stomatitis, Salivation,
Ptyalism) 55

B. Catarrhs of the Stomach and Intestines, Nervous Dyspepsia and Habitual
Constipation / .55

C. Gastiodynia (Nervous Gastric Pain), Chronic Gastric Ulcer 63

D. Hyperaemia of the Liver, Catarrh of the Gall- passages, Jaundice, Gall-
stones 64

E. Diseases of the Spleen 66

"VT. Diseases of the Uropoetic System.

A. Chronic Affection of the Kidney 67

H. Chronic Catarrh of the Bladder and of the Renal Pelvis, Concretions in the

Kidnevs and Bladder 68

VII. Diseases of the Seznal Organs. Pa^^cs

A. Chronic Affections In the Sphere of the Male Genital Organs 68

1. Chronic Inflammatory Afifeclions of the Testicles and Epididymis GS •

2. Spermatorrhoe Impotetilia Virilis 68

3. Chronic Catarrh of the Uretlira. 69

4. Affections of the Prostate 69

B. Chronic Diseases of the Female Genital Organs 70

1. Chronic Inflammation of the Uterus and the Adnexa 71

2. i\e\v Growths o\' the Uterus and the Ovaries 72

3. Chronic Catarrhs of the Vagina and Uterus 73

4. Anomalies of Menstruation 74

5. Sterility 74

VIII. Chronic Rheumatism of the Muscles and Joints 75

IX. Diseases of the Nervous System.

A. Some General Rules 76

B. The Individual Affections of the Nervous System and their Treatment by
Bathing- und Climatic Cures 77

1. Cerebral Affections. . 77

2. Spinal Affections 78

3. Affections of the Medulla Oblongata . 80

4. Angio- and Trophoneurosis, Grave's Disease 80

5. Affections of the Peripheral Nerves 80

6. Neurosis 81

X. Diseases of the Skin 82

XI. Chronic Affections of the Sensory Organs 85

Comparative Table of the Centigrade, Reaumur, and Fahrenheit

Thermometers 86

Balneography.

Section I: Bathing Places and Climatic Health-Resorts 87-176

Section II: Sanatoria and Cure-Establishments 177-230

SanatoriaandCure-Establishmentsarrangedaccordingto their character 231

Alphabetical Index 235

Balneotherapy.

A. Introductory Remarks.

By Dr. 0. Tliilenius, Geheimer SauitaUrat, Sodcn al the Taunus.

Any heallh-resort, no matter whether it be only a dimalic one, or whether
tiuneral springs are offered for drinking — or bathing-cures, or otlier therapeutic
methods are applied as specialties, is representing an entity with more or less
pronounced climatic or social local character. In any case, the usual mode of life
of patients or those needing recreation is more or less markedly interfered with by
visiting a health-resort.

Whoever encounters the necessity of choosing a health-resort or a mineral-
spring for a given case, has to consider above all the fact that the same disease
may be treated at very different places with the same good result, and that, on the
other hand, the most various affections may be treated most successfully with the
same spring.

The explanation of this puzzling fact is. that in all climatic, mineral-water or
similar cures we have to deal with an action upon the metabohc processes, upon
the nervous functions, in general upon the totality of vital processes, and that acting
upon a definite affected organ is very frequently a secondary matter, or can only
be attained indirectly. From this follows that for choosing a heallh-resort it will be
of a decisive value to consider the constitution in general, the degree of general
irritability of a person, and much more the amount of energy with which the body is
able to answer upon the stimulating effect of the applied cure. On the basis of
these general considerations, one will be able in the majority of cases not so much
to choose a definite climate but in general to determine the group of mineral-springs
suitable for the purpose. The local organic affections or serious complications are
the next point of consideration for the special choice of a place.

A further decisive factor is the predilection at many stations to treat special
affections, the health-resort being thus "labeled" so to speak, and the physicians of
those places consequently specialists. In many cases the social and financial conditions
will have to enter into consideration.

The last .mentioned point especially gives the chief direction for this "Baeder-
Almanach" (Guide to Spas. Health and Climatic Resorts, Sanatoria etc.) giving in-
formation particularly about conditions that naturally cannot be dealt with especially
in the compends and text-books of balneolherapie.

12 General Disorders of Nutrition — Anaemia and Chlorosis

B. Brief Guide for the Choice of Health Resorts

and for Determining the Therapeutic Methods.

As to the time of beginning a cure, the official season of most of the health-
resorts is fnim beginning of May to end of September, this time being the most
rational indeed for therapeutic })urposes. At especially favourably situated stations
the cure may begin with end of April, in any case, however, on the lirst day of May.
The cure may also in many cases last up to middle of October. For good reasons
health resorts with thermal-waters and favourable climatic conditions have also
inaugurated winter-cures, and most of the special sanatoria are anyhow open all
the year round.

For alpine stations the season begins, as a rule, at the beginning of June and
ends in the second half of September. But year by year the number of health-
resorts solely adapted for a summer-season is decreasing. The most prominent
of these have sufficient accomodations as to allowing the patients also a stay
during the winter with the same effect as in summer. And so at these places the
season is going on the whole year. As regards the southern winter stations, one does
best to have the patients arrive not before the middle, still better at the end of
October, and to have them leave, as a rule, toward the end of April. In all cases
it is urgently recommended to have the patients stay for at least 1—2 weeks at
one of the so-called transitional stations, on the way there and back, in order to
have the patients gradually accustomed to the chmatic change.

During the last decade many alpine health-resorts (rising from 3500 to
5250 feet) have particularly developed winter-sport (ski-ing, bobsleigh, skating.) This
is in a rational and correctly dosed application a powerful prophylactic and
therapeutic aid.

If w-e now attempt to give a brief guide for determing healtli-resorls for the
various chronic conditions, this can of course only contain general hints; regarding
the special data, we have to point to the compends and text-books in
balneotherapy of which the "Baeder-Almanach" shall be a supplement,
but not a substitut e.

I. General Disorders of Nutrition.

A. Anaemia and Chlorosis.

By Dr. Adolf Seebohm, Geheimer Hofrat at Pyrmont.

Although the similarity of principal symptoms of both these groups of diseases
does not justify identifying them entirely as regards balneological methods, yet there
are essential points of analogy, as for instance in considering the value of iron as
the acknowledged principal therapeutic agent.

1. Balneological treatment in a narrower sense.

After many doubts as to whether the introduction of anorganic iron be of
any importance for the treatment of anaemia, or whether its reabsorption into the
organism may be taken in account at all, it is being more and more unanimously
agreed upon that this remedy is indispensable for the therapy of these diseases. This
metal, when introduced into the organism in a suitable form, seems to exert its
pecuhar catalytic influences upon the processes of metabolism, and in a lack of
haemoglobin as well as in other anomalies of oxydative energy of the body, to be
able to furnish the failing physiologic stimulant (enzyme). Our practice offers day
by day new evidence of the intimate relationship between this remedy and the
forming elements of the blood. Their number, shape, and the subnormal

General Disorders of Nutrition — Anaemia and Chlorosis 13

haemoglobin content is improved by tlie ingestion of the remedy, and as a result
of this, the albumen-and iron-re([uirement of the organism is reestablished, and
the alTection cured. In this respect we have to place foremost the observations made
at the ferruginous springs the significance of which physicians as well as patients
have estimated highly for many centuries, even at times of the most discouraging
therapeutic scepticism. — We may also add that, apart from all kinds of favourable
secondary influences, as for instance the so-called imponderable factors of a cure, the
mode of application of the iron itself, and the subsecjuent faster stimulation of
important functions seem to compete in most cases with the pharmaceutical
application of the remedy as regards security and duration of the effect. Furthermore,
the iron-therapy has no more been confined to the idiopathic and simple forms of
anaemia, as it was customary for some time. To be sure, there are complications
with a preliminary contra- indication or an inevitable modification of the iron-therapy
more frequently in the treatment of secondary and symptomatic anaemia, but after
their disappearence or due consideration, anaemia is still the actual substratum of
the treatment.

Let us try then to explain briefly on the basis of our experience the relations
of the conditions to balneotherapy, and in particular to ferruginous springs. With
chlorosis other typical pictures of idiopathic anaemia enter above all into
consideration. We have to adhere for good reasons to the well defined term of
chlorosis with its peculiar features, its aetiological relations to the age of puberty,
to the years of development of women, to its tendency to relapses and exacerbations
up to the period of involution, and beyond this age. On the other hand, unfavourable
conditions of life, bad habits, excess of work, strain, excessively active physiological
processes etc., give rise to similar pictures of pronounced "idiopathic anaemia" in a
primarily less resistent constitution. But we must not forget to mention the separate
position of "pernicious progressive anaemia'' among these conditions; it reproduces
in its symptomatology the picture of a most grave chlorosis, but it differs from the
latter in its aetiology pointing more particularly to infectious processes, and in a
still more drastic manner, in its sad prognosis. Let us therefore add here that all
the former reports on recovery or healing of this affection by mineral or bathing-
cures, and by ferruginous- waters especially, have grown silent by and by, and that
from the reports still published it can only be gathered with certainty that such
patients are extremely sensitive to any thorough cure.

The next for our consideration is the chronic form of simple secondary
anaemia, as it is often existing independently after loss of blood or lymphe, acute
diseases &c., in spite of the cessation of these processes. The milder forms are
due to a delayed conv al essence.

All the fight cases of the above mentioned forms of chronic anaemia yield to
the simple curative method of any ferruginous spring, often even to the adoption
of more favourable conditions of life. This is, however, different in the obstinate
and relapsing cases of these simple and uncomplicated anaemias. The
pure and so-called mineral springs of this group are then by afi means the most
valuable for the treatment: as they are easy of digestion, they may be administered,
to be sure, carefully at the beginning even in cases with frequent but light digestive
disorders, which mostly disappear readily. But even more troublesome disorders
of this kind may be easily helped. In addition to the stomachics of the old school,
hydrochloric acid and pepsin may be administered as an adjuvans, and caring for
regular bowel-movement is a further aid. The entire mode of life of such
patients, their diet especially has to be accomodated to the original irritability of
their functions or to the increased irritability brought about by the cure. This
ought not to be mentioned particularly, but it is necessary in view of the lax
treatment of the diet-question in iron-cures, and the more so in order to oppose a
tendency of outdoing the well-tested drinking- and bathing-cures agreeing with
anaemic patients, and deteriorating the effect of these methods by specializing
modifications in this or any other direction.

14 Gen<jral Disorders of Nutrition — Anaemia and Chlorosis

Besides these digestive difficulties, tlie symptomatology of anaemia offers many
other functional irritative or asthenic conditions in the muscular and nervous
sytsem, in the vascular apparatus of the heart, anomalies of secretion or menstrual
processes &c. They yield to the same curative method iis above under similar
simple conditions. As above, the carbonic-acid chalybeate bath is acknowledged as
an equivalent factor in addition to the drinking of these springs, provided that the
treatment is carefully individualized. But the matter is diflerent if the severity of
the above mentioned functional symptoms and their constant character suggest a greater
original or acquired vulnerability of the affected system or organs, and if, as in
secondary anaemia, the phenomena remind of residues of latent irritative conditions
or of the recrudescence of aetiological processes. Even in most pronounced anaemia,
the pure ferruginous cure is not rational. In habitual constipation of a high degree,
in severe functional disorders of the digestive tract in general, in a tendency for
haemorrhages, in the reoccurrence of haemorrhages, in various forms of haemorrhagic
diathesis for example; in extreme psychical irritability, in congestive conditions with
erethism of the heart &c., the interruption or at least modification of this
ferruginous cure is indicated; for some anaemic patients it is premature after all.
In these cases the daily practice has a field of work, preliminary treatment in
clinics or sanatoria is helpful, or going to a more favourable climate; but besides,
drinking-cures of bitter-waters of alkaline mineral-springs, or of. sodium-chloride
acidulous waters have to precede or accompany the careful application of those
ferruginous springs. This cure has to be aided by sedative thermal-baths, simple brine-
baths and mud-baths &c. — until after some time the chalybeate bath perhaps gains
prevalence again. For most of these cases, however, it is more advantageous to
refer to the groups of alkaline-brine or muriatic ferruginous springs; these are in
the first line more easily adapted to the above described severer disorders,
and are of a more preparatory character in cases where the application of pure
chalybeate baths seems desirable for a complete annihilaton of the anaemic malady,
and of the residues of tissue atony.

Let us add some remarks on the recently often mentioned "pseudo-anaemia",
with regard to balneological procedures. To be sure, the frequently considerable
disproportion between cause and effect, between the pallor of the skin and the
weakness of anaemic individuals and their lack of haemoglobin, and also the
number and shape of blood-corpuscles were often noticed before, but only the
recent general examinations of the blood gave evidence of the relatively frequent
occurrence of such "pseudo anaemic"' conditions with normal blood-findings. At the
same time, the treatment of these forms exhibited their negative behaviour toward
the curative effect of iron. These haemoglobin-tests which are very convenient and
satisfactory for practice, and can easily be rendered more scientific if necessary,
have indeed proved that there is a considerable number of cases among the
ordinary anaemic and chlorotic material, in which the condition of the blood is
found to be normal, in spite of the marked anaemic disposition. We disregard here
cases of pseudo- anaemia in lead-poisoning, nephritis, arteriosclerosis &c. — the
general tendency of such diseases to a contraction of the small vessels and of smooth
muscle-fibres, and also the chronic angiospasm of the skin-vessels may probably
account for the marked pallor in these cases. — Of chief interest, however, are
those younger individuals with a delicate organization and all the other characteristics
of chloritic and anaemic conditions. In spite of a treatment of long duration, they
show this surprising and remarkable negative blood-picture. They show mostly an
originally great nervous irritability, and we also find pretty frequently more serious
conditions in individual organic complexes, in digestion, as obstinate constipation
with symptoms of gastro-enteroptosis, — of the heart, the genital organs (infantile
disposition), or of the naso-pharyngeal sphere. A neurogenic cause, a chronic spasm
of the cutaneous vessels can scarcely be denied; it is mostly associated with a
gradually increasing subnutrition of the patient. As mentioned above, iron does
not prove very efficacious in the treatment of such cases of pseudo-anaemia. It

General Disorders of Nutrition — Anaemia and Chlorosis — Scrofula 15

may be substituted by or combined with other remedies of the j)harmacopoea or
other mineral-waters. But in the main physical, dietetic, climatic &"c. factors, in
addition to the wholesome baths will even in pseudo-anaemia allow to recognize
the value of visiting the real ferruginous baths, though this appears to be contra-
dicted by a primary negative result.

Similar therapeutic considerations are valid for the group of lulphurated
feruginous springs and arsenious ferruginous waters. Beside the more
general indication of ferruginous springs in anaemia, one will feel inclined to ascribe
to the content of iron-sulphate a particularly astringent action upon certain functional
disorders as well as marked irritations of the intestinal tract. There are perhaps
still better reasons for expecting good results in severe and complicated cases of
anaemia and nervous affections from the arsenious content of those ferruginous
springs — Levico, Roncegno etc.

For the cases of symptomatic anaemia in a narrower sense — i. e. as far
as chronic organic affections are still existing — the just mentioned directions for
a balneotherapeutic procedure are still more valuable. In some particular forms
the aetiology furnishes some hints. Thus for the anaemia of scrofulous and rickety
patients, in which of course the brine bath is prevalent in the bathing-cure, not
only the for good reasons highly estimated ferruginous springs will be applied, but
in addition the sodium- chl ride acidulous waters, the ferruginous sodium-chloride
springs; in anaemia of malaria-patients, in tropical anaemia similar principles have
to be observed, before passing over to a pure iron-cure, and this is far more true
of chronic diseases of women, of other kinds of exsudates and infiltrations of
such patients. The above made considerations will likewise hold good for gout, uric-
acid diathesis. The irregular and atonic forms of these diseases with their serious
complications in the general nutrition, and in the nervous and vascular system, are
nowadays again preferably treated with ferruginous baths, especially since the
introduction of mud-baths. For the anaemia of chronic nephritris, suppurations,
fistulae, for the anaemia of leukaemia and pseudoleukaemia, and of Grave's
disease, !he application of the pure and mineral ferrut(inous acidulous waters, and
far more of the arsenious waters is usually preferred. Even for chronic
catarrhs of the air-passages, mostly of a hypersecretory atonic character^ foi
slight consolidations, residues of pleuritic processes etc., and other not very
rare complications of anaemia, the use of the ferruginous springs, if rationally
selected, is not absolutely contra-indicated. Apart from the value ascribed to carbonic
acid chalybeate baths in the treatment of cardiac affections, as has been acknowledged
since a long time, the anaemic patients with a heart disease will often successfully
obviate the progress of anaemia by a careful cure with ferruginous acidulous
waters.

B. Scrofula.

By Dr. Bardach, Bad Kreuznach.

The opinions regarding the nature of scrofula have changed considerably in
recent times. While scrofula formerly was separated entirely from tuberculosis,
one goes nowadays as far as not considering it a special disease at all, and the
view is held that it ought to be designated only as a symptom-complex occurring
especially in childhood.

The discovery of the tubercle-bacillus has certainly helped to fix the borders
between both diseases, and above all, to distinguish the symptom-complexes in
which tubercle-bacilli are found, from scrofula. Thus we shall now separate caseated
glands, carious osteal foci, which were formerly considered scrofulous diseases, as
belonging to tuberculosis, and we shall take in account for the diagnosis the
cutaneous reaction as described by v. Pirquet.

But nevertheless there remains a pretty great symptom-complex which we
may consider scrofula. The picture of a scrofulous child may vary; there may by
solely a swelling of glands, or merely irritations of the mucous membranes, a small

1 6 General Disorders of Nutrition — Scrofula

or an extended eczema, or all these symptoms coexisting. Most of the scrofulous
children look pale, but nevertheless the adipous tissue may be very much developed;
at the same time the face is puffed, and the lips and nose swollen. This form is
designated as the torpid form in contradistinction to those cases in which the
children show a thin face and a remarkably white and delicate, easily reddening
skin with vessels shining through. These cases belong to tlie erethic form.

It is obvious that such a sickly organism will exhibit a lowered resistance
to all vicious influences, and will be more exposed to diseases, it will furthermore
overcome the latter with much more difficulty, and the diseases will relapse on a
much more trifling occasion. Among the injurious influences that may act upon
such an organism, the tuberculous infection assumes the foremost rank; for if a
scrofulous body is involved by the infection, the latter will gain ground far easier
than under normally favourable conditions, the resistance of the body being
lowered.

It is little to be wondered at that sickly children of this kind are more
exposed to the invasion of tubercle-bacilli. Very likely the port of entrance for
the latter are the air-passages, and the numerous bronchial glands are probably
attacked first of all. This explains why a number of scrofulous children are tuber-
culous at the same time, and this is probably the reason why in scrofulous patients
tubercle-bacilli are found so frequently. We may therefore have an excuse for the
erroneous identifying of both diseases. In choosing the therapeutic method,
especially the balneologic form of therapy, we have to take in account the degree
and the nature of the disease, and have to consider whether we have to deal
merely with a scrofulous disposition or with pronounced symptoms. We must
also bear in mind w^h ether we have to deal with the torpid or erethic form, and
above all, the status of nutrition and strength is to be taken in account.

If we have merely the question before us of doing away with a pathologic
disposition, our aim will be to strengthen the organism in general. In this respect
good and pure air, baths, and a careful selection of food-stuffs are the main factors,
and it is a matter of course to choose the proper health-resort.

Besides the chmatic stations, sea-baths and brine-baths enter into consideration,
the former being of value especially for strengthening the organism in general.
For a stay at the sea a longer time is required. It takes some time for the
organism to get accustomed to the highly stimulating effect of the air, and therefore
it will agree far better with adults and older children than with infants. A
stay in the mountain at a medium altitude, to the best with good forest-air, is also
beneficial. For very debile individuals, older as well as younger ones, and for the
latter if they are suspicious of a hereditary predisposition, a longer sojourn at a
climatic station (Riviera or Egypt) will be advisable.

For the erethic forms of scrofula the weak brines are indicated, as the cure
is to be carried out more carefully; in these cases baths of a short duration ought
to be taken intermittently, the particular prescriptions being left to the judgment
of the physician practising at the concerned health-resort. For the torpid forms
stronger brine-waters are suitable. These baths ought to be of a longer duration
and less warm. Regarding the indication of the North Sea or the Baltic, the former
being more stimulating and invigorating is indicated for the torpid form, while
the latter is more suitable for the erethic form; but, at any rate, the age of the
individual is to be considered.

If not merely combating a predisposition is in question, but if affections with
marked symptoms are present, a more efficacious treatment is required. Then the
strong brine-springs, especially those containing iodine, bromine and potassium
chloride are indicated, if necessary with muther-lye. Under these circumstances,
even for weak persons powerful baths may be prescribed, and the bathing-cure is
to be of a long duration, if an indication is given by the form of the affection,
without any danger of a weakening effect. Constipation complicating the scrofulous

General Disorders of Nutrition — Scrofula — Rickets 17

allection is almost always most satisfactorily influenced by a drinking-cure; for this
purpose the cold springs work better than the warm ones. For the chronic and
pertinacious affections of the mucous membranes a stay at the salt-works is indi-
cated; those containing iodine are to be preferred. The alkaline and alkaline-
muriatic springs as well as weaker brine-springs may also be applied.

For an afler-cure sea-baths or simply a stay at the sea, as well as good
forester mountain air enter into consideration : one should, however, not surpass a
medium altitude. Chlorosis and anaemia often complicating scrofula mostly
don't require any particular treatment, for they will mostly disappear as soon as
the primary affection is cured. For further treatment in such cases a ferruginous
spring, if possible situated in a higher altitude, may be taken into consideration.

As regards the attempt that has been made in recent times to estabUsh the
status JymjJhaticus (lymphatism) as a special pathologic entity, it will suffice here
to mention briefly that the signs of the status lymphalicus are found almost without
exception in scrofulous children. The treatment of scrofula will be different
according to the various pathologic symptoms. But we must always keep in mind
that persistance and patience are necessary. We do not help the patient by merely
sending him to a health-resort for some weeks, and believing that we have done
our duty to the last. Many things will have to be considered at home. Much
attention has to be paid, above all, to the nourishment in rational limits. In many
cases, especially those with a strong predisposition, bathing-cures should be repeated
for several continual years, if possible up to the time, when the bodily development
is complete. This holds good especially for patients with a hereditary predis-
position.

The choice of the health-resort is to be left to the family-doctor, all matters
concerning the bathing-cure itself are to be left to the bathing-phj-sician, who can
best of all handle these things, judge how the baths act upon the patient, and who
can interfere in unexpected events.

C. Rickets.

By Dr. Bardach, Bad Kreuznach.

The real cause of this disease is entirely unknown, but it is an established
fact that all unfavourable external conditions interfering with the nutrition and the
development of the children, may produce rickets and favour its further progress.
This is the reason, why this affection is found more frequently among the paupers
and in densely populated cities than in the country. The mode of nutrition in the
earliest childhood plays also a part, as artificially and not very well nourished
children are more exposed to this disease than those fed with the breast. But
nevertheless rickets is also found in children hving under the most favourable
external conditions. This disease begins in the first months of life, and develops
gradually as the bones are growing. According to the view of various investigators.
the organism is unable to assimilate the ingested salts; others believe that the cause
has to be looked for in an insufllcient lime content of the food. Hereditary
predisposition might be considered possible, as relatively frequently several children
of the same family may be affected. Although the aetiology is still dark, yet there
is a uniform agreement in that a successful treatment has to consist of strengthening
the general condition. The same principles are valid as have been advanced above
all in dealing with scrofula. Of baths chiefly brine-baths and especially such
containing iodine and potassium chloride are in order, furthermore sea-baths, or the
latter for a cure after using brine-baths. For the intestinal disorders often
coexisting with this disease, the internal use of weak muriatic waters is indicated;
the springs rich in carbonic acid and the chalybeate waters are also effective, and may
be continued for a long time, as the course of the disease mostly extends for
years. Much attention is to be devoted to the nourishment. For home-treatment

18 Genet-al Disorders of Nutrition — Rickets — Gout — Diabetes MelUtus

furthermore malt-baths and herb-baths are recommended, in the winter cod-Hver oil,
which is not to be considered as a drug but as an easily digestible nutritive preparation.
On the basis of numerous clinical observations, calcium phosporicum and phosphorus
combined with cod-hver oil have been acknowledged as being useful.

D. Gout.

By Dr. Emit Pfeiffer, Geheimer Sanitatsrat at Wiesbaden.

Gout is partly congenital, partly acquired by unrational nourishment. The
disease is, in the main, a chemical alteration of nitrogen-metabolism, with special
reference to uric acid. If the ingestion, especially of carbohydrates, exceeds the
requirement, uric acid is combined with salts on account of excessive formation of
acids. The excretion of uric acid is incomplete, it is deposited in the well-known
manner in the joints ^c, and this may give rise tp the severe complaints.

The fundamental points of the treatment are a rational regulation of tlie
mode of life, a simple mixed diet with a reduction of carbohydrates and all food-
stuffs favouring the formation of acid in the stomach, absolute prohibition of alcoholics,
as far as the condition of the heart or the general condition do not indicate the
contrary which is seldom the case, and an abundant supply of fresh air.

The principal factors, however, in the treatment of gout are the alkaline
thermal-waters and the cold alkaline potable-springs. The latter are
especially recommended in the intercurrent renal and vesical affections of arthritic
patients. The high value which some authors ascribe to the content of lithium of
these springs, is to be referred to the percentage content of lithium of these springs,
as lithium does not act otherwise than other alkalis. The group of sulphurated
waters, potassium-sulphate waters, and muriatic waters come into
consideration for congestions of the liver, haemorrhoids, and catarrhs of the respiratory
organs complicating gout. For the chronic catarrhs of the pharynx, the larynx and
the trachea in gouty patients, Weil bach is to be mentioned in the first place.
The ferruginous springs are indicated in general cachexia and especially in lowering
of the heart-power due to the long standing of the disease. In such cases, however,
also the alpine thermal springs have an excellent effect.

For gouty joint-affections and residues of these, nowadays as in former times,
the highly tempered natural mineral-baths are applied with great success, likewise
for subsequent peripheral palsy, neuralgia on a gouty basis &c. In recent times
the sulphurated thermal waters, the mineral thermal springs, and the
muriatic thermal waters, have been competing successfully with the natural
mineral springs. If a more powerful effect is desirable, the carbonic acid muriatic
thermal-waters are to be applied.

If the general stimulating effect of the thermal- waters is to be avoided, the
mud- and fango -baths, especially the sulphurated mud-baths, are to be used.
Favourable results have also been obtained by hot sand-baths, in general or local
application. They favour reabsorption not only by their temperature, but also by
their compressing effect. If in individual cases a thorough stimulation of the
cutaneous excretion is considered necessary, the Fioman-Jrish, the pine-needle baths,
and also certain hydrotherapeutic measures will answer the purpose. All these
forms of baths, however, do not only influence the residues of joint-affections, but
also the process in general, i. e. the gouty diathesis by preventing new attacks and
lessening the intensity and duration of the disease.

£. Diabetes Mellitus.

By Dr. Jacques Mayer, Geheimer Sanitatsrat, Berlin (formerly at Carlsbad).

Although by the experimental researches of the last years a number of
important data have been added to our knowledge of the nature of diabetes, this
can still not be regarded as fully explained by science. To be sure, the great

Gmeral Disorders of Nutrition — Diabetes Mellitus 19

discovery of pancreatic diabetes in animals is rather a considerable progress in this
line, but we are notwithstanding unable to answer the indicatio morbi. But owing
to various experimental and clinical observations, chances in this respect are best
of all in pancreas diabetes, in as much as we may assume that a diminution or
an absence of the pancreatic internal secretion which normally stimulates glycolysis,
plays a part in diaoetes, and that in a number of cases we have to deal with
alterations of the Langerhans islands, or an insular insufficiency with an intact
condition of the remaining parenchyma.

Owing to the multiform aetiology and the subsequent variability of the progress
of the disease, the symptoms occurring in diabetes are of a very inconstant intensity.
This is furthermore due to the extremely variable resistance of the organism which,
in the main, depends upon the age of the patient, disregarding many other factors.
It is in many cases difficult to form a definite judgment as to the progress of
diabetes. Cases beginning very mild as it seems, and showing at the beginning a
slight impairment of the limit of tolerance for carbohydrates, may sometimes proceed
very rapidly and vice versa. The aetiology may best of all give us a clue as to
this fact. The following aetiologic factors have to the borne in mind, 1. race;
2, age; 3, heredity; 4. occupation or profession: 5, infection; 6, psychical influences;
7. obesity; 8. gout: 9. nervous diseases; 10. infectious diseases; 11. pancreatic
affections; 12. syphilis.

It is of great importance to determine exactly the limit of toleration at different
intervals during the treatment, in order not to overlook a change for the worse, as
it is a matter of experience, that the well-known diabetic symptoms do not always
appear parallel to the degree of glycaemia. It is not of minor importance to note
carefully a transitory spontaneous glycosuria occurring with a mixed diet, as it is
often difficult to decide whether or not it will lead to diabetes. Forms appearing
harmless may, to be sure, disappear entirely after a while, but they may also result
into permanent glycosuria.

Except the elimination of sugar, however, we must also bear in mind the
condition of the circulatory and respiratory apparatus, the nervous system and the
chylopoeiic organs, and we have to consider thoroughly the symptom-complex
involving these organs. It will therefore be very important in the treatment of
diabetes not only to combat glycosuria, but to control early enough all the noxious
influences impairing the general condition of the diabetic, and giving rise eventually
to the most various complications. If in non diabetic obesity a rapid loss of flesh
is, as we know, very detrimentary to the organism, this is the more so true with obese
diabetics as, on the one hand, a compensatory over-feeding w-hich might sooner or
later be urgently indicated, may be restrained considerably on account of the very
much limited ingestion of carbohydrates. On the other hand, the store of albumen
in the organism is too little protected on account of the considerable loss of fat,
and consequently the diabetic is not able to answer the requirements of mus-
cular work, A long continued pure meat-diet is from this point of view not to be
recommended for a dietetic treatment; it is only to be applied exceptionahy, and
if so, for a very limited time, and at the same time, all the harmful effects of such
a diet have to be observed as carefully as possible. As a rule, this diet is to be
combined with copious amounts of fat and moderate amounts of carbohydrates.

Mental diet is an important factor in treating diabetes. We have to give the
diabetics in this respect just as precise prescriptions as with regard to the diet.
As a matter of fact, cases are not rare in which psj'^chical emotions, mental strain,
influence the progress of the disease far more unfavourably than a faulty diet. From
this point of view, it must be warned against occupying the patient permanently
with his affection, supervising most carefully and day by day his food by weighing
and measuring, and even having the patient himself test for sugar and albumen.

The affections of the heart are in a causal relationship to the diabetic
affection, and from this reason they deserve our special attention. Large amounts
of alcohol ought to be avoided not so much on account ot the toxic effect, but

20 General Disorders of Nutrition — Diabetes Mellitus — Obesity

rather because of the increased work thrown upon the heart. As a matter of lact,
the atheromatous degeneration of the vessels and irritations of the kidneys are
favoured very much by drinkin? alcohohcs.

Balneotherapeutic indications are dependent upon the stage of the disease
and its complications. Dividing the disease into "light and grave forms" does not
fully agree with the actual state of affairs, as according to numerous observations
light cases may become severe, and on the other hand, severe forms may become
light ones.

The course of the disease may be rapid or slow according as the diabetes
occurs in juvenile or old age, according as a sickly, neuropathic, and hereditarily
predisposed individual is affected or a strong organism free from any predisposition
is involved. Undoubtedly sometimes — which is especially true of childhood and
young age — the acijuired diabetes runs a quicker course than that based upon
hereditary disposition. It is therefore advisable to distinguish an acute and a
chronic diabetes.

The acute diabetes cannot very often be subject to balneotherapeutic treat-
ment. We succeed only exceptionally in strengthening the entire organism by such
a treatment and in retarding the course of the disease. In diabetes of children
we ought to dispense entirely with using springs, unless they be indicated by definite
complications. In the majority of cases the hygienic mental and dietetic cure at
home is to be preferred to any medicine. But on the other hand, balneotherapy
may lurnish remarkable results in the incipient as well as advanced stages of
chronic diabetes.

The most effective in this respect are the alkaline sulphurated thermal waters
and the simple alkaline waters.

For the winter in a number of cases with a predominance of complications
or sequelae ot diabetes, a stay in the south is recommended. It is then our chief
aim to increase the resistance of the entire organism, especially of the circulatory
and the respiratory apparatus and of the nervous system.

F. Obesity.

By Dr. Adolf Ott, a. o. Professor and Geheimer Sanitatsrat, Prague (formerly at Marienbad).

The excessive deposit of fat in the body is designated as obesity. It differs
distinctly from the fatty degeneration of organs mostly accompanied by marasm.
The disease is mostly acquired by unrational nutrition and mode of life, due to an
increased ingestion of food, disproportionate to the requirements of the organism
for work and production of warmth. But it is not rarely dependent upon a congenital
disposition, and a preex'sting inferiority of catabolic power as well as a slow
protoplasmatic activity of the cells favour the development of obesity considerably.
It may develop at any age of life, especially as soon as overfeeding occurs, and the
excess of food material is utiUzed for the formation of fatty tissue. A good appetite
and good digestion promote the increased intake of food, and if this has become a
habit, obesity will soon develop. At the beginning, it is merely inconvenient and
troublesome without interfering considerably with the physiologic functions; but in
a longer standing and at a higher degree, the entire organism is exposed to danger,
and pathologic disorders of organ-functions ensue which by and by may seriously
threaten life, especially on account of disorders and organic alterations of the heart
and the kidneys. These complications are observed particularly if the intake of
food surpasses the amount utilized for the normal maintenance of the organism,
or if a faulty diet and an insufficient working up of the ingested material, an
insufficiency of the muscular, cutaneous and pulmonal function bring about a
disorder of normal metabolism. Overfeeding and lowered capacity of work are
therefore the causes of a decrease of oxydative processes in the tissue cells, and of
an excessive formation of fat. The fatty tissue originates principally from the
fatty bodies and the carbohydrates ingested with the food, but it is also built up from

General Dlao? dera of Nutrititm — Obesity 21

excessively ingested albumen, though in a smaller proportion. Obesity is most
frequently found in men of 40 years, likewise in women who, with advancing age,
especially from the beginning of the climacteric period, furnish an increasing proportion
of obese patients. The body- weight may rise up to 30 — 40 per cent., the corpulence
measured above the umbilicus may amount to 140 cm. and above.

We distinguish the plethoric and the anaemic form. The former is found
by far more frequently, particularly in men, and almost always associated with a
more or less high degree of congestion and an accumulation of carbonic acid in
the blood. The latter form, however, occurs more frequently in women of young
age, mostly associated with dysmenorrhoea, sterility, and many kinds of nervous
symptoms. This form of obesity is not rarely brought about by an unrational
nutrition with a scanty or entirely failing ingestion of albumen. Both forms of
obesity may be recognized at the first glance. In the plethoric form the more or
less pronounced redness of the face, sometimes a colour of the skin passing over
into a bluish tint; in the anaemic form pallor as a result of the decrease of red
blood-corpuscles and of haemoglobin. Sometimes a transition of one form to the
other has been observed. But the plethoric form passes over into the anaemic
form more frequently than vice versa. The alteration of the figure may also be
brought about by an insufficient blood-supply of the tissue, as it occurs in alterations
of the cardiac muscle, in arterio-sclerosis, in renal affections, after profuse loss of
blood from the congested areas developed by fatty deposits, and in a reduction of
blood due to insufficient supply of oxygen, furthermore by permanent staying m
closed rooms, by lack of exercise in the open air, and qualitatively unrational
nutrition.

The proper treatment of obesity cannot be successful if it is carried out
schematically. Individualizing is the chief point here. Favourable results can only
be expected from a most thorough investigation of all conditions of life of the
individual patient. But the result will only be permanent if the dietetic prescription
is permanently supervised by a physician, not only for a short time, but for a long
period. The general condition of the patient is to be considered above all, quite
particularly the capacity of his heart-power, in beginning the treatment. All the
details of development, age, constitution, the mode of nutrition and mode of life,
the degree of obesity, and the symptoms resulting from it, have to be taken in
account very carefully, if a favourable result shall be obtained. Thus in the plethoric
form we shall have to consider the symptoms of dyspepsia, habitual constipation or
a permanent inclination to diarrhoea, haemorrhoidal troubles, irregular excretion of
bile, formation of gall-stones, congestive hyperaemia of the brain, the heart, the
lung, nose, pharynx, larynx, of the tracheal mucous membrane, the liver, spleen
and the kidneys, the genital-organs and the bladder; furthermore alterations of the
urine, indicating a disorder of metabolism (uric-acid, oxalic acid, glycosuria),
beginning arthritis, arterio-sclerosis as well as changes of the cardiac muscle. In
the anaemic form, moreover, the deterioration of blood, the anomalies of menstruation,
and nervous disorders will have to be noted very carefully.

From all this follows that the treatment must be adapted to the individual
case, according to the various symptoms, and that it will differ according to the
one or other form of the disease. As always in therapy the fundamental law is:
Principiis obsta! We shall succeed more easily in checking an incipient increase of fat in
the body than in curing a more or less advanced obesity, especially in young
individuals.

Strict reduction cures are not at all indicated in such cases, above all not in
children or developing girls. Albuminous food particularly ought not to be reduced
considerably, as the total nutrition may be impaired and anaemic conditions may ensue.
In a moderate deposit of fat, as it mostly occurs in the middle age of life, it may
suffice to regulate the mode of life as regards diet and physical exercise. Real Banting
cures are not recommendable in these cases.

22 General Disorders of Nutrition — Obesity

In all cures aiming at a reduction of fat, it will be advisable to proceed
gradually and never to force too rapid a loss of fat. Reduction-cures continued for
more than 4 to 5 weeks are to be avoided, as they threaten health and life. It is
better to be satisfied with a moderate result and to repeat the cure after a shorter
or longer interval.

The treatment is divided into a dietetic, mechanic, climatic and
balneologic one.

The dietetic treatment will always be the main thing, for it is in itself able
to accelerate the utilization of the fat deposited in the body, and to prevent a further
storing of fat. Without this dietetic treatment, therefore, a permanent and thorough
result will not be obtained. But although it is the starting point and most essential
basis of treatment, experience has taught that the result inaugurated by the rational
ingestion of food and drinks may undoubtedly and most assuredly be promoted by
the rational application of other methods. Complications of obesity may be
combated and permanently cured more rapidly in this way than by simply changing
the diet.

In regulating the diet, the principle to be observed is not to deprive the body
of too much organic albumen, not to reduce fat at the expense of the total organism,
and not to impair organic function by the reduction of fat. It is therefore most
recommendable to give a mixed diet consisting, in the main, of albuminous
substances, small amounts of carbohydrates and gluten with little fat. These food-
stuffs should not be given in too great quantities, as not only a qualitative but also
a quantitative reduction of food are required in order to obtain a favourable result.
Quantity will always be the chief thing, while quality is of minor influence. The
nutritional value or, as it is designated by von Noorden, the caloric value is the
decisive factor. If the intake of calories is inferior to the working up of them,
gain of fat will not occur in spite of its being favoured by the quality of meals.
Moreover, we want to emphasize especially that the meals should never be copious,
that they should rather be distributed over the day in small portions. This is above
all recommended to people vvho use to take a bit more frequently, or who after
certain intervals, feel weakness in getting hungry, being consequently induced to take
too much with their meals. Allowing a little something between the meals, in the
forenoon or afternoon, will help to reduce the quantity of the principal meals. The
rigorous reduction of liquids having been in favour during the past years cannot be
advocated, as it has been scientifically proved to be insignificant. Yet one will do
best not to allow taking too much of liquids, especially not during the meals. The
reduction of liquids particularly at the beginning of a Banting-cure, will lead more
rapidly to a loss of weight on account of the lowered ingestion of liquids. But
apart from this, the reduction of liquids in great eaters who are accustomed to
drink between meals, will promote loss of weight considerably and mainly by
diminishing the appetite, and thus limiting the quantity of food. But too great a
reduction of liquids is to be dissuaded, as it increases the amount of salt in the
body, and may consequently lead to serious complications in the kidneys and in the
heart. As to the question of taking alcohol, the same need not be eliminated entirely; but
in general it will always be better to omit alcohol at all. It will only be indispensable
in certain cases, in a threatening weakness of the heart, in patients accustomed to
alcohol. But it is only allowed to give light wine in small amounts repeatedly
dufing the day. The chief thing will always be to adapt the diet exactly to the
individual case, according to the constitution and to the mode of life.

Thorough observation must tell for how long a time this is to be continued.
A dietetic cure of too long duration, especially with too great a reduction, may
easily become dangerous. But with careful attention it will not be difficult to state
the point of time when to stop the prescribed diet. If a lowering of physical strength
is noticed, the diet is to be changed at once. For we know that the same kind
of diet is frequently not agreed with for a long time without a detrimental loss
of albumen. In such cases insignificant alterations of diet will suffice to reestabhsh

General Disorders of Nutrition — Obesity ' 23

the desired equilibrium of metabolism. But in order that the result obtained by
dietetic measures be not deteriorated, one will do good, especially with patients disposed
to obesity, to reduce the diet at once for a longer or shorter period. The schematic-
dietetic cures as prescribed by Banting, Ebstein, and Oertel, as well as the milk
cure recommended by Tarnier are therefore not suitable for every case, and the
continued strict observation of such dietetic prescriptions may have the disadvantage
of not rarely bringing about serious or even fatal disorders of liealth.

The best has proved to be the milk-cure according to Karell recently modified
by Brieger, Moritz, Hirschfeld, and Flosenfeld. This cure is cheap, it can be
easily adapted to any requirement, eliminates hunger and tliirst, and prevents serious
comi)lications. It has a very favourable influence, especially on cases of obesity with
an involvement of the heart or the kidneys. The same is pretended by Albu as
regards the vegetarian dietetic cure recommended by him.

Next to the dietetic treatment stands the mechanic therapy, comprising the
application of massage and the performance of bodily exercise. Both these factors
promote the loss of fat by increasing metabolism in the way of an intensified
working up of material. Massage, either local or limited to the abdomen, or general,
extending over the whole body, will stimulate the blood-circulation considerably,
diminish congestions and favour thereby the resorption of fat; it will at the same
time strengthen the musculature by stimulating the local metabolism. It has,
however, no direct influence upon the loss of fat in the body, as is often assumed.
In this connection we also wish to mention electromassage that has been
recommended recently for stimulating lowered muscular activity. It promotes
oxydation in the muscle, and has also a reviving influence upon the nervous
system.

The bodily exercise may be accomplished as an active or passive
one. In both ways it will contribute considerably to stimulating the muscular
function and the gas-exchange. Thus by the increased ingestion of oxygen, the
oxidation of fat or rather its splitting up into the end-products, carbonic acid and
water, will be accelerated. But the general condition of the body and, above all,
the capacity of the heart, are always to be considered, and the degree of exercise
is always to be adapted to these in order to avoid strain, especially of the heart,
and complications. It is always best to begin with slight muscular work, and
moderate exertion in walking and climbing, that is to say, the power at disposal is
to be raised first by slow exercise, before greater efTorts are asked for. From this
point of view, we can explain the favourable influence of increased exercise in a
pure air rich in oxygen, especially in the mountains and at the sea-coast, where
the metabolism stimulated by a rationally regulated diet can be increased
considerably. This is true particularly for cases with a high degree of congestion,
due to a lowered heart-pow-er. In these cases the heart-muscle can be strengthened,
the circulation regulated, and the general fatty deposit can be reduced by systematic
climbing up the mountains as in the so-called Oertel-cures. Climbing promotes
the reduction of fat rather than the mere exercise on plain roads, as in climbing
the qulitiy as well as the quantity of exercise is increased. As vonNoorden has
proved, the catabolism of body-substance in climbing is ten times as great as in
walking on the plain. By a deeper inspiration the intake of oxygen and the output
of carbonic acid are increased, and at the same time, work is taken from the heart
by a more active pulmonary circulation. Rationally dosed exercise by climbing will
strengthen the heart considerably, and the result will be a regulation of cardiac
movements, a gradual slowing of the pulse which is not rarely extremely
accelerated, a removal ofarythmia, and an alteration of the blood-pressure. If this
improvement has become marked, and the cardiac action has been restored to a
normal state, the basis is given for advancing still more metabolism by a greater
amount of work, and for promoting loss of fat. If chmbing must be
dispensed with, if alterations of the circulatory apparatus contra-indicate
more strenuous exercise, a stay at the sea-coast in an air rich in oxygen, will be

24 General Disorders of Nutrition — Obesity

recommended with gradually increasing exercise by walking. Swimming, rowing,
cycling, athletics, riding and all games requiring a more active exercise in the
open air, as foot-ball, tennis, golf etc, will be of the same value as chmbing. But
always special attention is to be paid to the energetic capacity of the heart, and
strain has to be avoided.

If active exercise cannot be accomplished in a sufficient degree, it may be
supplemented by passive exercise as it is applied by means of medico-mechanic
exercise, especially in institutes equipped according to Zander's device. These
procedures should, however, only be performed under the supervision of physicians
and in well-ventilated rooms, to the best in establishments in which permanent
ventilation is provided for by an uninterrupted supply of fresh air. Only under
these conditions the gas-exchange and the catabolism advanced by muscular work
will be developed to the highest degree, and the greatest success of a mechano-
gymnastic treatment of obesity will be obtained. The danger of over-exertion and
its detrimentary effects are surely avoided by the possibility of adapting all the
movements performed by means of the apparatus exactly to the individual capacity
and thus dosing exercise so to speak mathematically.

Change of air or the possibility of a longer stay in the open air are not
rarely desirable. In as much as this is attained by simply changing the habitation,
a further task of treatment, i. e. the climatologic treatment is inaugurated. The
influence of such a change of air must not be undervalued, particularly not for the
many adipous patients that have lived all the year round in cities. A stay in the
mountains, however, or at the northern sea-coasts will only be possible in the
summer-months. If in the mean time a long, stay in air rich in oxygen, and
opportunity for active muscular work by walking and climbing are indicated
urgently we have to recommend the more southern places, the climatic stations
in a narrow sense. For this purpose the places situated at the southern spurs
of the Alps or at the shores of the southern seas are fit best of all. We have to
prefer those places in which owing to their ascending mountainous or hilly surface,
opportunity is given for climbing and thus increasing work and aiding loss of fat;
places as those at the Riviera, the Upper Italian Lakes, the Lake of Geneva, the
Southern Tyrol or Abbazia.

The balneologic part of the treatment of obesity comprises the drinking-
and bathing- cures. By means of these and by a simultaneous prescription
of a proper diet and a mechanic treatment, we are able to bring about a
thorough regulation of metabr''sm, and a diminution of the development of fat,
and particularly to do away with the pathologic disorders brought about by the
former. As corpulent people much more willingly submit to a strict observance
of a prescribed diet and of increased exercise and in general to a more exact
observance of medical advice, if they apply a drinking-or bathing cure at the same
time, the latter is much more so an indication for the treatment of obesity. It is
a matter of fact that every individual case is to be considered most carefully,
that not only the fatty deposit in general, but also all the complicating symptoms
as well as the whole constitution are to be taken in account, and that balneological
measures ought to be chosen accordingly.

Among the drinking-springs, the alkaline-s ulphurated waters especially
will favour best of all a loss of fat, if they are applied rationally for a long time
without having a direct purgative effect. Their action is by no means based upon
bringing about very copious and watery bowel-movements. For this would not do
for a longer duration as the organism would be weakened too much, although at the
beginning it would bring about a slight increase of metabolism. Moreover, the apparent
loss of weight rapidly attained by these copious movements, is to be referred mainly
to an increased loss oi water, which is soon enough replaced again, and is of no
essential influence on the diminution of fat. How far the increase of tissue-
osmosis by an ingestion of the salts dissolved in the waters, promotes oxidation and

General Disorders of Nutrition — Obesity 25

a subsequent decrease of the lat stored in the body, must be made evident by
further investigations.

At any rate, it is sure that by using these waters tlie loss of fat is attained
more rapidly and easier. The alkaline-sulphurated springs stimulating peristalsis
will be indicated in cases in which the obesity is coexisting with a tendency to
habitual constipation, or in which, as is often the case, the prescribed change of
the diet the patient was accustomed to produces an intestinal torpor. These waters
will also be indicated in those cases of fatty deposit associating digestive or circu-
latory disturbances in the climacteric period. In a relaxed organism, in tendency
to congestions and more advanced congestions, the cold springs of this group are
suitable particularly; in an increased irritability of the digestive tract, in a tendency
to disorders of bile-secretion, the warm springs are recommended, and in a pre-
dominating relaxation of nerve-energy the springs located higher up in the moun-
tains. The fear which often has. been pronounced, that by applying these springs
the albuminous store of the body were endangered, is entirely immaterial according
to recent researches. On the contrary, it has been proved by these researches
that the breaking-down of N-containing substances is ralher diminished, and that,
on the other hand, the splitting up of fatty material is considerably promoted by
an increase of the elimination of GO.2 and of a consumption of 0.

Bitter-waters are less suitable for a cure, as they weaken the organism
too much, if used for a long period. But they are excellent for being used
in the house, and for those cases in which the oxydative processes in the organism
are to be increased by an increased elimination of water, and a subsequent
discharging of the circulation, and furthermore by increased peristalsis. For these
cases too is valid what has been said above concerning the use of alkaline-saline
springs. Muriatic- waters are sufficient only for cases of a lower degree of
obesity, and they are indicated in a predominating tendency to mucous catarrhs
associated with a w'eak constitution. There too we have to decide as to cold or
warm springs. The latter are recommended especially if there is a tendency to
diarrhoea. The use of these waters will facilitate circulation by diminishing the
watery content of the tissues, it will accelerate metabolism by stimulating cellular
activity, and at the same time it will reduce the fatty substances in the tissues. In
a pronounced locally developed fatty deposit, as e. g. of the breast, and in
scrofulous constitution, iodine-muriatic waters are to be applied. In those cases of
fatty deposit associated with the symptoms of a more or less pronounced anaemia,
that is to say in obesity usually designated as anaemia, mostly occurring in younger
individuals, especially in women with dysmenorrhoea or showing sterility, ferru-
ginous springs or the combined use of a ferruginous spring (Ambrosius-Quelle of
Marienbad) with the alkaline-sulphurated or (Bockletwasser of Kissingen) muriatic
springs are suiting the purpose best of all.

The increase of haemoglobin in the blood and the increase of red blood-
corpuscles brought about by ferruginous springs, and the subsequent increase of the
energy of vital functions, will assist in developing a more sound melabolism,in reducing the
deposit of fat, and in combating the tendency to storing up fat by securing a basis for more
active exercise and thus combating indolence. The most excellent result in this respect has
been obtained by the ferruginous Glauber-salt waters of Franzensbad, Elster etc.

During the use of the drinking-cures as well as without them, the application
of the various baths is a powerful agent for raising albuminous metabolism by
increasing the function of the skin, and for thus enhancing the breaking-down of
fat. All forms of baths exerting a strong stimulus upon the skin, and increasing
thereby the peripheral circulation, are suitable for this purpose. The form of bath
to be chosen is dependent upon the general constitution and the more pronounced
disorders of individual organic functions (heart, kidney, brain).

If an increase of metabolism is aimed at without weakening the organism,
as for instance in a drinking-cure Avith alkaline-sulphurated or muriatic water, the
simple acidulous waters or the carbonic acid- muriatic baths will do, the latter

^6 Obesity — General Weakness and delayed Convalescence

of a moderate temperature not exceeding that of the body and not of too long a
duration. The powerful stimulating effect of these baths on the peripheral circu-
lation intensifies the metabolism, and influences remarkably the heart by discharging
it and strengthening the cardiac muscle. This is to be considered a most impor-
tant eO'ect in many cases of obesity. If anaemia, especially with disorders of
menstruation (amenorrhoea, oligo-, dysmenorrhoea or profuse menstruation) are
predominating, or in sterility, the chalybeate-, brine- and mud-baths of a
more tonic action are indicated. Many cases showing at the same time a lowering
of nerve-energy, sea-baths as well as those hydriatic procedures which have a tonic
effect and cause a not very excessive persjiiration, will best of all suit the purpose,
when applied simultaneously with or after the other methods. They will aid in
intensifying metabolism, in promoting production of heat with an increased output
of COo and a simultaneous more active new-formation of red blood-corpuscles. Sea-
baths, however, especially those with waves running high^ are contra-indicated in
all those cases in which, as in atheroma or pathological alterations of the heart,
cerebral apoplexy or cardiac paralysis are threatening. In all the hydrotherapeulic
measures by which more or less heat is withdrawn from the body, as packings,
douches, full and half-baths, the loss of heat is compensated by an increase of the
circulation and secretion, and a pure and permanent loss of fat is attained, though
not very striking at the beginning. This is especially true if, at the same time,
intense muscular work is done which, as a matter of fact, favours the oxidation of
fat. The lower the temperature applied, the greater the difference of temperature
is in individual parts of the body, the longer the procedure lasts, the more active
simultaneous and subsequent exercise is performed, the more intense will be the
effect upon metabolism. This is for example the action of the wave-bath according
to the system introduced by Hoglauer. The thermal as well as mechanic slimuli
ehcit reflex motions, and a reduction of fat is brought about by intensifying
metabolism. Swimming-baths are of the same order. The cold stimulus inciting
muscular action will likewise augment metabolism Vigorous individuals whose
organism can stand very intense procedures without any fear of weakening, may
reduce their weight most rapidly by means of sudorific hydrotherapeutic
measures, steam or Roman-Irish baths, and the recently applied electric-
light baths, if at the same time a proper diet and the corresponding drinking-
cures are applied. One must, however, not be misled by the striking loss of
weight occurring mostly at the beginning of the perspiration-cure, as this does not
depend upon a loss of fat, but merely upon the elimination of water brought about
by a more active perspiration, a loss which is mostly very soon compensated by a
demonstrable increase of weight. In applying this method, the condition of the
heart and of the large vessels is to be examined permanently and thoroughly. With
all of these methods recommended for obesity the ever detrimentary '"too much"
has to be avoided. We cannot warn enough against a too rapid reduction of fat often
asked for urgently and carried out very energetically. Progressive decline of
physical strength and spontaneous paralysis of the asthenic heart are not rarely
the result of such exaggerated reduction-cures. In conclusion, we wish to mention
the often recommended air- and sun-baths, mostly taken in sanatoria for the
purpose of reducing fat. It is an estabhshed fact that these too are able to intensify
metabolic processes by inreasing the energy of all organic functions and thus
leading to the result aimed at. These methods may advantageously be combined
with a dietetic treatment in the sanatorium. This is especially recommended
for persons whose home-conditions do not allow observing a strict diet for a long
time, or with whom will-power and consistency are lacking.

G. General Weakness and Delayed Convalescence.

By Dr. 0. Thilenius, Geheimer Sanilatsrat. Sodeii at the Taiinus.
Here climato-therapy is of especial importance; one ought to take care of
not sending patients of this group by all means to a so-called "invigorating climate".

Diseases of Intoxication — Constitutional Syphilis -27

The climatic stimulus should always be adequate; and it is conseciuenlly advisable
to begin with sparing or moderately stimulating climatic stations (valleys, medium
altitudes), according to the degree of asthenia and, particularly, to the energy of the
nervous-system. Only after a considerable degree of strengthening, the Alps or the
sea-climate may follow (see III B, 1. page 38).

For drinking and bathing cures are suitable, above all, the simple muriatic
waters, for baths the mild brine, also pine-needle baths, and quite especially the
carbonic-acid brine thermal-waters. For a pronounced real deterioration of
the blood the chalybeate-springs and the carbonic acid ferruginous springs are of
an excellent effect, provided that the digestive organs are in working order. With
great debility and sensibility of the skin, great irritability of the nervous system, it
is recommendable to begin the cure by tepid natural baths. In any case,
the bathing stimulus should always correspond to the power of reaction. For
malaria-convalescents places free from malaria, to the best in the high
mountains, should be chosen; with these frequently hydrotherapeutic measures
are in order.

Milk- and grape-cures are to be prescribed according to general principles,
especially in emaciated patients.

.11. Diseases of Intoxication.

A. Constitutional Syphilis.

By Dr. A. Brandis, Geheimer Sanitatsrat at Godesherg, and Dr. J. Beissel, Geheimer
Sanitatsrat and Koniglicher Badeinspector at Aachen.

In the investigation of syphilis at present the Spirochaete pallida sive luis,
an organism discovered by Schaudinn, is assumed as the exciting agent of syphilis.
It seems to be of an undeniable significance in the aetiology of this disease, as this
protozoon has always been found in persons exhibiting positive syphilitic symptoms.
The sure presence of spirochaete in lesions open to infections, in soft chancres and
in herpetiform erosions, is therefore of significance for the diagnosis as well as for
the method of treatment. Tliis holds good too for cases in whicli clinical diagnosis
fails, for example recent genital or extragenital primary affections, for the differential
diagnosis of syphilitic papules and patches, or for the diagnosis of certain forms of
exanthema. In latent syphilis likewise the examinations of the glandular lymph,
obtained by puncture, will confirm a dubious diagnosis, and even in congenital
syphihs the search for spirochaete in the blood, in the glandular juice and in the
nasal secretion, in cases of coryza, will permit of coming to a definite conclusion.
As a matter of fact, in animals (apes, rabbits), after a successful syphilitic infection,
spirochaete are found in the tissues, at the affected parts, and in the glands, with
or without manifest marks of syphilis.

A great significance is to be ascribed to-day to the sero-diagnosis of syphilis
for the recognition of a still existing infection. Yet the positive reaction does not
give absolute evidence of the syphilitic nature of an ulcer or a tumour existing, as
a coexisting complication with carcinoma or tuberculosis must be taken into
consideration. Patients treated insufficiently may, however, often show a positive
reaction in the tertiary stage, although for a long time no considerable clinical
phenomena may have appeared. On the other hand, the negative result of the
Wassermann reaction will not necessarily detain us from carrying out an anti-
syphilitic cure. For with many patients who have been treated successfully as
regards the symptoms of cerebral, spinal or osteal syphilis, new chnical symptoms
will be treated with good results even in a negative reaction of the serodiagnostic
investigation, and the patients will be benefited in a considerable degree.

As we know, up-to now but in single cases one has succeeded in obtaining
pure cultures of Spirochaete, and w^e are consequently still lacking in successful
vaccination and attempts of obtaining by them an antisyphilitic serum. One has,

28 Diseases of Intoxication — Constitutional Syphilis

however, tried by attenuating the syphilitic virus by means of repeated inoculation
on susceptible animals, to get a curative serum for syphilis, which has been
variously tried on patients. But these results too do not show that in this way
a prophylactic or curative method for syphilis will be found, being as yet of any
practical value. Thus even nowadays the significance of the old antidote against
this disease, i. e. of mercury, is fully appreciated by modern syphilis-therapy, and
the value of this drug is based upon the fact of its destructive action upon the
Spirochaete, the number of which in the blood is said to decrease constantly
in proportion to the duration of the mercurial treatment, and in proportion to
the immunity of the organism against the excitors of syphilis, an immunity which is
brought about gradually by the introduction of mercury. Hence even from a
modern point of view, the old method of mercury-rubbings, known already in
1507, is to be considered justified and is to be regarded as one of the safest
methods of treating syphilis. The more specifically active mercury-molecules are
able to transgress the body, without developing too strong a toxic action, the
greater will be their effect in an antisyphililic cure. There is no safer way of
arriving at this end than by rationally applying suitable bathing-and drinking-cures
at the mineral springs, among which the sulphurated and muriatic thermal
waters must be mentioned in the first place.

Observations of centuries have proved beyond any doubt that mercury has a
remarkable effect upon syphilis. Many attemps have been made to explain
theoretically how this effect is brought about. May be that hydrargyrum acts as a
katalysator, as all heavy metals do, i. e. as a conveyor of oxygen, promoting thus
oxidation and producing a stimulus to the tissues which is necessary for the
compensation of lesions produced by the syphilitic virus. On the other hand, it
has been held that the syphilitically affected cell exhibits a special tendency for
entering into a combination with the mercurial salts dissolved in the body-juices,
and that this combination is retained in the cell up to the com.plete destruction
of the virus. The advantage of a mercury treatment together with the simultaneous
application of sulphurated and muriatic baths, would then be explained by the
intensified metabolism in the body brought about by the baths. We may by a
well-conducted bathing-cure combined with inunctions of blue ointment, introduce
the mercury into the infected cells in the shortest way and in form of a slowly
decomposing double-salt, and on the other hand, the elimination of the metal from
the cells and the whole organism, in form of an innoxious sodium-chloride double
salt may be attained under a splitting off of the proteid-molecules. We are thus
able by combining both methods to keep the syphilitic organism for a long time
under the action of mercury. By this way first an attenuation of the excitors of syphilis
is arrived at, followed in a shorter or a longer time by a destruction of the poison,
without exposing the organism itself to a mercury intoxication.

This axiom of „7ion nocere'^ is answered most completely, as experience
has taught, by an inunction-cure. The method devised by Siegmund is applied
most of all. According to this method, after a bath of 35^^ G (95,0'^ F) and
half an hour's duration an inunction of 4 to 10 gr. of unguentum cinereum is made
for 15 to 20 minutes, and the ointment left up to the next day. The order of
rubbing the parts of the body, comprising in a course of five days the thigh, the
leg, the back, the chest and the arms, is not as important as the manner of
performing the individual rubbing. This being the most important part of the
treatment must be left to the hands of trained persons, disposing of the
necessary persistence and skill. The mercury rubbed in is always to be left on
the skin from one bath to the other on the next day ; the adherent portion is then
washed off in the bath, and is replaced at once by a new inunction.

This method has been approved especially when combined with the internal
and external use of the sulphurated-muriatic thermal-waters; and we may state,
without exaggerating, that it is equalled by no other antisyphihtic method as regards
safety, innocuity, and control. It is indispensable for all cases of malignant and

Diseases of Intoxication — Constitutional Syphilis 29

tardive syphilis, for syphilis of scrofulous, cachectic individuals, and for all cases of
syphilis not agreeing very well with mercury. Ail the other variously recommended
methods of introducing mercury, either by internal application or in form of
hypodermic or intravenous injections or as an addition to the bath, were found
inefficacious in severe cases, and are far inferior to the above mentioned method,
concerning their curative power and the permanence of the effect, though the
therapeutic value of these methods cannot be denied entirely. To be sure, cases
may occur, though rarely, in which the inunction-cure has to be supplemented or
aided by the subcutaneous application of mercury, cases in which the skin of the
patient does not or not sufficiently reabsorb mercury, which can be demonstrated
by examining the urine or the faeces. Such a cure is always indicated if recovery
is not obtained by an inunction-cure.

Besides mercury iodine is of an undeniable value in the treatment of syphilis,
although its effect is often only momentary and transitory. Nevertheless, iodine is
an invaluable remedy for the treatment of tardive forms of syphilis, especially for
gumma with ulcerative-necrotic breaking-down of the bones and cartilages, of the
mucous membranes, for cerebral and spinal affections. It may be appHed internally
as a solution of potassium iodide, as Sajodin or Jodipin, or in form of the very
powerful Jodipin-injections. The passage of iodine through the body-tissue is
accelerated by drinking the proper mineral-waters and applying baths, and these
auxiliaries also prevent the uncalled for by-effects of iodine, which in abnormally
sensitive patients may often occur most acutely.

Of an undeniable value are furthermore the arsenic-preparations in form of
subcutaneous injections, especially arsacetin. acetic, as recommended by Ehrlich in
increasing and then decreasing doses. (See farther below.) Good results are
obtained with arsenic-preparations in the presence of anaemia, which is often met
with in syphilis, even a short time after the infection; but these preparations are
also useful in people returning from tropical regions, affected with syphilis in
combination with malaria.

As the mercurial treatment com-bined with a systematic bathing-cure is
without risk and nearly the only antidote against syphihs, we may unhesit-
atingly subject incipient cases of syphilis to an energetic treatment; for experience
has taught that this treatment has decidedly decreased the occurence of the gravest
forms of syphilis. If at any place of the body with or without a lesion, infection
has taken place, the syphihtic virus is spread all over the body within a few hours.
This cannot be prevented, neither can the toxic effect after an inoculation of the
syphilitic poison and the subsequent general symptoms be checked by corrosions
with carbolic acid, by iodoform, rubbings with strong calomel-ointments (25— SO^/o),
nor even by a very early excision. This fact shows that an early and energetic
mercury-treatment is required, especially if a swelling of Ihe lymphatic glands
indicates further spreading of the poison. The treatment should not be postponed
until the occurrence of secondary symptoms, as if then it might be considered
more effective. To be sure, the virus once introduced into the organism cannot
always be overcom.e by the cellular activity of the organism, nor by the introduction
of mercury; but the grave late effects often threatening life are prevented by an
early treatment. The severe affections ot the nervous system, of the spine, of the
intestines, are observed less frequently after an interference at the proper time. If,
however, the affection is established, a mercury-treatment has to be carried out
frequently and for a long time, in this lingering disease; such a cure is agreed
with best of all in combination with a bathing-cure, particularly at the sulphurated
thermal-waters. As a matter of fact, the mineral-waters are a fortunate combination
of various salts in a very dilute concentration, which in this dissociated form enter
into combinations with the mercuric oxide, acting slowly but steadily, and being
secreted from the body in a. harmless form. Now this mode of action is most
conform to the chronic course of the syphilitic affections, and it never gives rise to
salivation, gastro-intestinal catarrhs, nephritis, albuminuria, and neuritis. — For how

30 Diseases of Intoxication — Constitutional Syphilis

long a time in chronic and obstinate cases with a tendency to relapses, mercury
and iodine are to he given, when they cease to be efficacious, and when treatment
should be interrupted, all this is a matter of experience. The positive reaction of
the sero-diagnostic method of Wassermann, Neisser and Bruck, makes the
existence of lues at the time of the examination very probable indeed. But,
notwithstanding, clinical points of view will compel us, according to the individual
case, to combat the sensibility of individual patients to mercury or to iodine, to
interpose shorter or longer pauses in the treatment, and in the meantime to apply
various kinds of thermal baths, hot douches, massage, steam-baths. The body is
thereby prepared for a further application af antisyphilitic remedies. As a matter
of lact, an organism which has been subject for the first time to mercurial
treatment, will be far more sensitive than a case that has undergone long and
repeated cures.

The thermal-baths are applied with remarkable success not only in obstinate
forms of incipient or tardive syphilis of the skin, the bones, the* nerves, and the
intestines, but they are also urgently required for cases of congenital syphilis in the
early as well as old age of life. Animals vaccinated with the syphilitic virus
harbour the spirochaete often for a long lime with or without manifest pathologic
phenomena. In man too a similar condition of latent spirillosis may exist, in which
the spirochaete remain latent in definite foci of the lymphatic glands and internal
organs for a long time without causing general specific symptoms. The descendants
of parents who have suffered or are still suffering from syphilis, and are later on
affected by syphihs larda, are under the influence of such a late syphilis. They are
often, previous t'o the outbreak of the above mentioned symptoms, debile and poor
in resistance, and are prone to intestinal or bronchial catarrhs or to affections
classified under the term of scrofula. An objective diagnosis is possible nowa-
days in as much as the above mentioned serodiagnostic reactions, not regularly to
be sure, but sometimes give positive results in these patients. This is confirmed by
the result of mercurial treatment at the sulphurated and muriatic thermal springs.
The patients recuperate to a new life, they become cheerful and inclined to work and
develop their mental faculties. Solely by the mercurial treatment, the congenital virus
can be destroyed, the mfectious foci abolished. The earher this is accomplished, the
better for the patient. For if we wait until specific lesions and symptoms have
become manifest, unfortunate consequences will often enough result lor the patient.
Though some physicians may consider this view not absolutely proved, yet many
have gone this way with the same result as those who finally have been compelled
by specific symptoms to apply this method.

Which mineral-baths are best fitted for supplementing an antisyphilitic treat-
ment? — Syphilitic patients all over the world are flocking to the sulphurated baths.
This is explained by the experience that such a cure in German, French, Italian,
Russian, even Asiatic sulphurated baths, can be carried out most conveniently.
The first in rank are those health-resorts in which the bathing attendants have been
trained by an expecience of hundreds of years, and where the therapeutic methods
have been developed in the most minute details. It is an open question whether
the sulphurated springs themselves have a proper specific efficacy, which might be
explained by the chemical properties of the easily decomposed suljihurated metals
protecting the patients against the harmful effects of mercury, and enabling them
to stand extremely great doses. The favourable effect of the baths may in part be
explained by the experience of the physicians of the health-resorts, by tne excellent
provisions at the thermal-baths, by the skill and training of diplomated attendants,
the confidence with which the patient, rid of his home-affairs submits himself to
the treatment of the physician. Each health-resort has indications of its own, so to
speak its ovfn specialty, and that of sulphurated springs is, not in the last instance,
syphilis. — The conduct of the patient after the cure depends upon individual
circumstances. In the most cases, especially in young people, a regular life is the
best after-cure. But there is one point to which the attention of the patients

Diseases of Intoxication — Cmistitutional Syphilis 31

cannot be drawn often enough, and this is, that there is nothing acting more
detrimentary upon the course of syphilis than an abuse of alcohol.

The (juestion, so often asked by patients as to a definite cure, can be
answered to-day more precisely than formerly. First of all, the discovery of the
specific cause of syphilis, the spirocheate pallida, confirm.s the diagnosis in many
cases: furlhermore, serodiagnosis tells with great probability that a person has
or has had syphilis, and we may assume, that syphilis is still existing if the
result of the examination turns out positive. We are surely justified in such
a case to continue the specific treatment, if we have to deal with parasyphilitic
affections, with paralysis, tabes, syphilis of the nervous system, or cases of
hereditary lues.

For the consent of marriage the serodiagnosis alone is not decisive. The
negative reaction does not prove absolutely that a person is cured, nor does
the positive reaction show that infectious syphilis is still existing. Future
researches will as we hope throw more light on this problem. For the present,
we must consider the absence of manifest syphilitic symptoms an important
sign of a definite cure, and that, if during two or three years after the
disappearence of the last symptoms no new phenomena of the disease
have occured, and if clinical observation has been supplemented by the result of
the serodiagnoslic examination. The sulphurated thermal waters and the thorough
methods carried out at these places are known to have the faculty of calling forth
signs of a perhaps still existing latent syphilis. It is an established fact that the
occurence of secondary symptoms after an infection is accelerated by a bathing-
cure. But even in inveterate and hereditary syphilis occasionally conclusive marks
are called forth by a bathing-cure, either in form of squamous syphilides, mucous
patches, mucous ulcers, psoriasis of the palms, or the reopening of former infectious
lesions, symptoms at the bony skull, or at the tibia, accompanied by rheumatic
pains. The cure at sulphurated thermal-springs is therefore always of value for
ascertaining the existence of syphilis.

Climatic cures are only indicated if tuberculosis is coexisting. Grape-cures,
cures with grape-juice, milk or whey are recommended in suitable cases.

Persons with whom relapses are to be expected within the first two or three
years, are to be warned of going to the South, to the Riviera, Naples or Egypt.
The warm climate, it is true, is of no effect on the course of syphilis, as is shown
by statistics, but the long distance from home, and the neglect so easily occurring
in travelling, have frequently caused considerable disadvantages. The same is to be
stated of sea-voyages, as unpleasant experiences have taught.

Salvarsan(606)-treatment. Among the various substances in which Arsenic
is reduced to a tri-valent combination, in place of a quinque-valent compound,
Salvarsan (Dioxydiamidoarsenobenzol) is by far the most powerful remedy.
Ehrlich seems to have arrived here at his aim of a therapia sterilisans
magna, by which one single injection of a remedy shall destroy all the
pathogenic agents, spirilla, in the organism, at least in animal experiments. It has
also been shown in man that Arsenobenzol does not only combat the symptoms,
but, moreover, that it is a true curative agent by which spirochaete may be
destroyed in clinically and pathologically anatomic latent foci. If, nevertheless, the
results obtained in man are as yet not equivalent to those in animals, we have to
bear in mind that the dose the remedy is given in is too small, and the methods
of administering the remedy too little elaborated as to allowing a definite judi;ment.
But as a matter of fact, Salvarsan is a valuable auxiliary and a remarkable
acquisition of syphilis-treatment. For we often succeed in curing initial ulcers after
a few days, and in preventing sclerosis of the lesion by an intravenous injection.
Maculo-papulous exanthemata in part with a wet and ulcerative surface may fade
or dry and heal, leaving only flat pigmentations. Obstinate tertiary ulcers and
gumma show cicatrization and disappear within three weeks. Pertinaceous specific

32 Diseases of Intoxication — Chronic Mercurial Intoxication

angina with croupous coating become regressive in a remarkable way, and at the
same time tlie general condition shows a noteworthy improvement. These are
altogether facts proved by numerous reports in literature. Wechselmann states for
example that in primary affections, in roseola, papules, jiatches, scleroademitis, the
rapid result after one single injection is absolutely proved, and that the healing of
malignant, tertiary or visceral forms (syphilis of the testicles, head-ache, epileptic
conditions) is most astonishing. This does, however, not mean that we have to
consider Salvarsan a panacea of syphilis. Warm baths, douches, steam-baths will
always be of an unquestionable value, especially in combination with mercury.
We emphasize especially those cases in which in spite of tabetic symptoms and
cerebral affections the Wassermann reaction is ne2:ative. In these cases we should
not recoil from a powerful mercurial treatment. The result of this procedure will,
according to our own experience, fully confirm this view, while Salvarsan-injections
often fail entirely. Ehrlich even claims that grave cerebral affections, functional
disorders of the heart, angina pectoris, should not at all be subject to the
Salvarsan-treatment.

The exclusive treatment of syphilis seems to be abandoned nowadays more
and more, and an intermittent treatment with mercury is coming into favour. It
is rational to begin with a Salvarsan-injection, and to give further injections in
intervals of eight days, applying a mercurial treatment in the intervals.
Dioxydiamidoarsenobenzol produces at the place of injection an individually very
variable irritation which may persist for a long lime, and often lead to a
necrosis of the tissue or to considerable general disorders. But very frequently
injections, especially intravenous ones are born without any pain, and produce no
or no considerable by-effects. All these conditions are influenced beneficially by
warm thermal-baths.

To summarize, we may say that Salvarsan is an important auxiliary and a
remarkable acquisition of the treatment of syphilis, that, however, other methods of
treatment are by no means rendered superfluous. As yet a definite judgment
concerning Ehrlich's preparation cannot be formed. We have to take in account
the various modes of applying the remedy, its contra-indications, and the duration
of its eflect. Even in the short time that has elapsed since this remedy has been
applied, a good number of relapses and even fatal cases have been reported. The
elaboration of the technic and exact dosage of the remedy, the proper dosis curatira
(the quantity of Hata killing the spirilla with absolute certainty), all these things
are still undissolved problems. The numerous publications of modern literature are
witness of the zealous endeavours for arriving at a definite conclusion.

B. Chronic Mercurial Intoxication.

Owing to the precautions in the melting-works for quicksilver-oars and in
the distillation of this metal, and owing furthermore to the good hygienic conditions
of manufacturies applying mercury, professional mercurial intoxications are nowadays
met with extremely rarely at the health-resorts. In industry (quicksilver-mines,
looking-glass factories, in the manufactory of barometres, thermometres, galvanometres,
in the gilding-industry, in hat-manufactory) the mercurial vapours are the chief
toxic agent, as all these occupations are done at high temperature. The metal
adhering to the hands or clothes of the mechanics may give rise to acute and
chronic intoxications. The observations made in mines and in industry have added
considerably to our knowledge of the nature of chronic mercurialism of syphilis,
in which mercury is known to be applied in the most various forms. In industrial
poisonings, above all, the digestive organs are involved, and only after a continued
incorporation of small amounts vomiting, tenesm, and diarrhoea are complicated
by inflammatory swellings and ulcerative destructions in the oval cavity, by
salivation, in brief by a stoynaiitis mercurialis. The wliite infiltrations and
poorly healing ulcers are not always easy to be differentiated from specific affections

Diseases of Intoxication — Chronic Mercurial Intoxication 33

of the buccal cavity. Stomatitis occurs as an early symptom far more frequently
in the medicinal application of Hg, and particularly in people being treated for
syphilis. Some of these patients are extremely sensitive to mercury, no matter in
which form the remedy be administered, internally, subcutancously or by inunction.
It is well known that a faulty cleansing of the body, the mouth and teeth, and
uncleanliness promote the occurrence of a mercurial intoxication considerably. In
these sensitive patients, however, the minutest dosis of mercury may i)roduce
symptoms, which do not at all involve those organs in which mercury is preferably
deposited. Most frequently is to observed an exanthema spreading over the whole
surface of the body and healing only after weeks with a simultaneous profuse
des([uamation of the epidermis. One observes, furthermore, in the order of frequency,
affections of the mouth, salivation, intestinal disorders, nephritis, neuritis. The
general constitution, poor nutrition, former diseases do not seem to have any
relation to the existence of such an idiosyncrasy. Whether it depends upon a
local hypersensibility of the cells of individual tissues to mercury or whatever
else, is not known. At any rate, for such patients a well-considered plan of
treatment at the sulphurated and brine thermal-springs is required, in order to
accustom the patients to the remedy so indispensable for them, and in order to
have the molecules of hydrargyrum leave the body rapidly, and in a form not exerting
too strong a toxic effect.

Nowadays, the mercurial stomatitis with its affections of the gums, the severe
subjective complaints, the salivation, the foetor ex ore, and in high degrees with
angina, ulcers of the tongue and buccal mucosa, and occasionally with necrosis of
the maxillary margin, is found far more rarely and by far not in so dreadful a
picture as in the first days of mercurial treatment of syphilis. Cleansing the
mouth and the teeth, exercise in the open air, and a rational mode of life will
always help in preventing this tormenting condition. Slight mercurial irritations of
the gums and the mucous membrane of the mouth will disappear readily after
omitting mercury, and still more rapidly after applying a suitable gargle, the most
useful of which are alum, acetic, acid, and potassium chloride in a 5 per cent,
solution, dilute extract of gallnuts and hydrogenium peroxide (Merck). Painting the
swollen gums with tincture of myrrh and Ratanhia at equal parts, witK 5 — 10 per
cent, silver-nitrate solution, painting epithelial defects and small ulcers with dilute
chromic acid, with 5 — 10 per cent, cocain or eucain-solution or applying alcoholic
emulsions of Anaesthesin will bring about healing and mitigate especially the
subjective complaints. After a previous sluggishness of the bowels and disorders
of appetite, severe colics, tenesms with haemorrhagic stools may set in unexpectedly
during a mercurial cure. This uncalled for event will be checked by an immediate
cessation of the treatment, by a thorough cleansing of the skin from adherent
residues of mercury in a bath, if possible in a steam-bath, by a non-irritative diet,
and by opium.

People with a poor nutrition, with a lowered resistance due to previous
chronic diseases, and persons handling mercury may experience a considerable
emaciation, become pale and extremely exhausted on account of the gastric disorders
and the stomatitis aggravating the ingestion of food. For this condition a stay in
a richly wooded region with a pure atmosphere, and the application of ferruginous
waters are indicated.

In a repeated incorporation of small amounts of mercury in any form, the
picture of a pronounced mercurial cachexia may arise, manifesting itself by an
increased respiratory frequency, by anxiety and albuminuria. Symptoms of the
central nervous system are often prevailing, especially tremor and paralysis of
individual muscular groups of the face, of the extensor muscles of the arms and
finally also of the legs (Tremor mercurialis). At the same time disorders of the
mental condition of the patient are noticed, as a sensation of anxiety, restlessness, and
hallucinations, a condition designated as "erethismus mercurialis". If these disorders of
the nervous system are not too far advanced, a recovery by a bathing cure is possible.

3

34 Diseases of the Be-^piratory Organs — of the Naso-Pharyngeal Mucosa

Professional mercurial poisoning may be prevented by a good ventilation of
the work-shops, by a stay in the open-air, careful cleansing in baths, and changing
clothes before the meals, cleansing the mouth, and regulating the bowels; protecting
the mouth during work by sponges supplied at the outside with a coating of finely
distributed tin is also recommended. — For all cases of chronic mercurial poisoning
thermal-baths, especially sulphurated thermal-baths are indicated. They answer a
double purpose ; firstly, they transform the metal in the organism into an innocuous
form, secondly, they stimulate the entire metabolism and thus bring about a rapid
elimination of the metal. The powerful forms of baths (douches, steam-baths) as
appHed in these health resorts, and the perfect bathing-technic at these places,
particularly massage are, according to impartial opinions, advantages rendering these
baths in chronic mercurialism superior to similar springs.

The value of an internal application of sulphurated waters and of muriatic
springs can also not be denied. The mercurial albuminate deposited in the cells
is transformed into combinations of a smaller molecular structure, and the elimination
from the cells into the tissue-juices is facilitated not so much by the easily
decomposed sulphurous alkalis, as by the hyposulphurous and sulphurous salts of
these waters. The chlorides introduced excessively by the thermal waters, especially
the sodium chloride, form in the blood, in the secretory organs, in the stomach,
intestines, liver etc. solid salts with the mercury-molecules present in excess, which
are not dissociated and, therefore, rendered chemically inactive.

C. Lead Poisoning'.

In spite of the various technical applications of lead, chronic intoxications
with this metal occur very rarely, and are still more rarely treated at bathing-places.
The symptoms occurring in consequence of a long continued incorporation of small
amounts of lead consist most frequently of disorders of the gastro-intestinal function,
the so-called lead-colic, more rarely of disorders of the nervous system as lead-palsy,
muscular tremor and anaesthesia. The cachexia of saturnism (Tabes saturnina)
and lead-gout are rare forms of chronic saturnism of great pathological interest.

Sodium-chloride is the most rational and innocuous remedy for combating
chronic lead-poisoning, and the content of such salts in a dissolved and dissociated
form in most of the mineral waters renders them most suitable for treatment.
The sulphurated-muriatic waters are, moreover, recommended especially, as very
likely the lead in the organism is transformed into the harmless lead sulphide, by
the internal use of these waters. — Part of the good result may, however, be due
to the satisfactory bathing-technic, to the douches combined with massage and to
the steam-baths.

III. Diseases of the Respiratory Organs.

By Dr. 0. Thlleniics, Geheimer Sanilatsrat, Sodeu (Taunus).

A. Diseases of the Naso-Pharynx, of the Larynx and the Trachea.
1. Chronic affections of the Naso-Pharyngeal Mucosa.
The chronic catarrh of the posterior pharyngeal wall with its follicular and
acinous glands does almost without exception involve the nasopharynx and the
nasal mucosa to a great extent. Henoe these parts need particular consideration in
therapy.

These catarrhs, though harmless in themselves, are distinguished by their being
pertinaceous and troublesome on account of the complaints ihey give rise to.

The treatment requires a thorough experience, and good results will only be
obtained by physicians who know how to individualize. To be sure, a permanent
result is mostly rendered doubtful by the reoccurring detrimentary eflect of the
habitual mode of life, and a permanent cure is therefore not very frequent.

Diseases of the Respiratory Organs — of the I^aso- Pharyngeal Mucosa .S5

Anticipating here the knowledge of the pathological findings, and of the
clinical symptoms of the various forms of atrophic, hyperplastic and transitional
affections, we only wish lo point to their relationship to the general constitution
of the patient and to the condition of the respiratory organs. Therefore, the
most favourable results will be obtained in a health-resort in which the local as
well as general condition of the patient can be considered in therapy. If a local
treatment has preceded the cure at a health-resort, in many cases a simple
drinking-cure with or without inhalations may suffice as an after-cure,
because the organism needing rest after exhaustive occupation may be benefited
indirectly more rapidly and safely, than by a continued local treatment. In general
all colleagues will agree with the following words of B. Fraenkel: "Above all, the
local treatment is to be preferred. Nevertheless, I should not like to dispense with
bathing-places and health-resorts. The results of colleagues practising at such
places are superior to ours, even on account of the air. Moreover, they treat
patients that are rid from their daily grievances and joys and have no other occu-
pation than subjecting themselves to a cure. He who knows how to treat
pharyngitis locally in the proper way at a suitable health-resort, will surely get good
results. And this is the reason why local therapy should, not be neglected in health-
resorts, and physicians of these places should definitely quit confining themselves to
the prescription of springs and the number of glasses the patient should drink.
It is, therefore, decidedly a progress that nearly in all health-resorts measures have
been taken to make use of the natural factors for the local treatment of pharyngitis."

The group of alkaline and alkaline- muriatic springs has proved espe-
cially useful in simple catarrhs of not too long a standing, if at the same time
gastric catarrh and the condition of the abdominal organs indicate the application
of these springs.

The muriatic drinking-waters are recommended preferably in a great
irritability of the affected mucous membrane and in scanty secretion, which is stimu-
lated in a mild way by the sodium-chloride, while at the same time the swelling
of the inflamed mucous membrane is reduced; these waters are furthermore
indicated in individuals of a lymphatic-catarrhal constitution, if dyspepsia,
abdominal stasis, habitual constipation or simple hyperaemia of the liver
are coexisting. At the same time the thorough application of muriatic baths,
especially of carbonic-acid thermal brine-baths, are recommended in all cases for an
inurement of the skin and for preventing frequent relapses by catching cold. In
anaemic patients, too, the muriatic springs give as a rule better results in treating
pharyngitis than ferruginous springs. This is true for the simple as well as the
follicular pharyngitis.

The chalybeate springs are indicated only in pronounced anaemia or chlorosis
with a dinstinct relaxation of the mucous membranes, provided the gastric digestion
be intact.

Sulphurated springs are prefered if the pharyngeal catarrh has developed
on the basis of a pronounced plethoric constitution, and if haemorrhoids, slow
circulation and stasis in the portal circulation with subsequent congestive conditions,
and great irritability of the vascular system are coexisting.

Very good results are obtained by applying sulphurated springs in some cases
of inveterate dry pharyngeal catarrhs, and in follicular pharyngitis, after the atony
of the mucosa has developed to some degree, and an abnormal irritability is
existing. Sea-baths or continued influence of the sea-climate are advantageous for
an after-cure.

Mineral-waters are in a very high degree adapted for inhalation-cures, in
as much as they dilute and loosen the adherent sticky and tenacious mucus
causing irritations and, by a direct and prolongued effect upon the mucous
membrane influence favourably the tone of the relaxed vessels, the glandular
apparatus, and the local metabolism of the mucosa.

36 Diseases of the Respiratory Organs — Chronic Catarrh of the Larynx

The climate of a health resort is chosen according to the general condition.
Atrophic processes, of course, require a moist air. In particulary obstinate cases
even a winter-station in the south is indicated.

In the treatment of ozaena the primary disease, tuberculosis or syphilis, is
decisive for the choice of a balneo-tberapeutic method. The more powerful brine-
baths and the muriatic iodine-springs are especially suitable for the tubercuUnis
forms; a corresponding disinfecting local treatment cannot be dis|)ensed with in this
form, nor an antisyphilitic treatment in the other form.

2. Chronic catarrh of the larynx.

The alkaline and alkaline- muriatic springs are applied most
advantageously in the simple chronic laryngeal catarrhs, occurring independently of
.-1 pronounced general affection on the basis of neglected acute calanhs and of the
gradually increasing relapses, particularly in singers, teachers, preachers, officers,
barristers, in general in persons who have much to speak.

If the catarrh is of a longer standing, and a powerful stimulation of the
mucous secretion and an increase of intestinal evacuation are indicated, the light
sodium- chloride springs are recommended, and in case that the laryngeal
catarrh is maintained by disorders of the abdominal organs, the same springs with a
more purgative effect. At the same time,' in such cases ample use is to be made
of sodium-chloride baths.

For the chronic laryngeal catarrh in individuals with a lymphatic-catarrhal
constitution or scrofulous disease, the muriatic springs and baths, especially the
simple and carbonic acid brine-baths are recommended, as in these cases chief
stress is to be laid upon preventing relapses by strengthening the skin. For
complications with anaemia, chlorosis of development and anomalies of men-
struation, or for reflex-affections of the larynx due to uterine diseases, the cautious
application of chalybeate drinking or bathing-cures may be required,
particularly if muriatic springs and baths, which are to be tried first in the majority of
cases, have failed.

The sulphurated waters are recommended in cases for which the irritation
of sodium-chloride or sodium-carbonate upon the affected pharyngeal mucous
membrane may appear to be too strong in the individual case; furthermore, in
pronounced nervous constitution, in an abnormal plethora of the abdomen,
haemorrhoids, congested liver, tendency to congestion with an otherwise regular
function of the digestive organs.

Sulphurated waters are also required if, just as in pharyngeal catarrhs,
chronic laryngeal catarrhs are accompanied by atony and an abnormal irritability
of the mucosa.

An addition ot whey or milk or a whey- and milk-cure alone may be required
in particularly severe irritative conditions of the larynx.

The drinking-cure with alkaline, alkaline-muriatic or less powerful sodium-
chloride and sulphurated spiings is suitably supplemented by inhalation of the
vaporized mineral water.

Of great importance is the neutral effect of weak sodium-chloride solutions
on granulating ulcerative surfaces which are cleared by the water, and the young
cells of which are destroyed by rinsing the surface with pure water. As experience
teaches, inhalations are , therefore, also recommended with weak sodium-chloride
solutions in insignificant ulcers of the larynx, and in after-treatment, for example
after the corroding effect of lactic acid etc.

Severe diseases of the larynx often contraindicate mineral- water cures,
and we must mostly confine ourselves to choosing a good climate (deep valleys,
forest climate well protected against winds), milk- and whey-cures, and a suitable
local treatment.

The alkaline-sulphurated springs are suitably applied against laryngeal
catarrhs, with overfed and obese but vigorous individuals, if at the same time a

Diseases of the Respiratory Organs — Catarrh of the Bronchial Mucous-Membrane 37

more purgative and withdrawing method is indicated, or if complicating gastro-
intestinal catarrhs, swellings of the liver, chronic constipation etc. require the use
of these springs.

As regards the climate we prefer places with a moderate and ecjuahle climale,
perhaps also places in a medium altitude, but only exceptionally alpine stations. —
For an after-cure a stay at the sea is often useful. Weak persons or individuals
anywhere suspicious of pulmonary afl'ections or a predisposition for such complaints
need a stay in the south during the winter.

Complications of the laryngeal affection such as gout, syphilis or pulmonary
consumption require above all the treatment of the primary disease. Neurosis of
the larynx with lioarseness or complete aphony, the hoarseness of hysteria, the
peculiar irritation of the larynx giving rise to the so-called sheep-cough are only
to be treated by mineral waters if a catarrhal affection is coexisting, otherwise
only climatically by a longer stay at elevated or even alpine health-resorts.

Paralysis or disorders of motility of one or both vocal-cords yield best of all
to electrotherapy, after the probably coexisting catarrhal inflammatory swellings of
the mucous membrane have been cured according to the above mentioned
principles.

3. Chronic Catarrh of the Bronchial Mucous-Membrane.

The chronic bronchial catarrh is either the result of frequently
recurring acute catarrhs or it appears as a complication of other diseases producing
congestions of the bronchial mucosa (cardiac-affections, diseases of the Hver and
of the abdomen), caused by the latter independently as well as maintained by them
after having been called forth by external influences.

The balneotherapy of the chronic bronchial catarrh is in the main analogous
to that of chronic laryngeal catarrh. In recent and uncomplicated cases again, the
alkaline and alkaline-muriatic springs are the most reliable means, particularly
if, as it is frequently the case, simple gastric catarrhs with an abnormal formation
of acid and light degrees of dyspepsia are complicating the bronchial catarrh.

In a prolongued affection, in a more profuse but aggravated expectoration,
or in more severe irritations, disorders of gastric digestion, sluggishness of the
bowels, plethora of the abdomen, simple hepatic congestion, the apphcation of the
weaker or stronger sodium-chloride springs is indicated; this is especially
the case if the bronchial catarrh is to be considered a permanent complication of
the above mentioned diseases, and if the entire constitution needs recuperation,
e. g. also in complications of influenza. Likewise, carbonic acid sodium -
chloride springs are indicated for individuals, especially of young age, with a
lymphatic- catarrhal constitution or a simultaneous scrofulous disease; they are also
to be preferred in chronic bronchial catarrhs of old persons (catarrhus senilis),
^vith a simultaneous consideration of milk-or whey-cures.

For vigorous individuals with gastric catarrhs and the so-called abdominal
disorders, hypernutrition, habitual constipation, swelling of the liver, and anomalies
of gall secretion the alkaline-sulphurated springs are recommended, and that
the thermal-waters, if a sparing procedure is indicated, the cold springs of
this group, however, if more energetic interference is needed.

The sulphurated springs are applied in chronic-atonic bronchial catarrhs
with an increased mucous irritation, scanty and aggravated expectoration, and if at
the same timethe condition of the abdominal organs (abnormal plethora in the
portal circulation, haemorrhoids in a pronounced plethoric but still vigorous general
constitution) ask for the application of sulphurated waters.

The dry bronchial catarrh (catarrhe sec. Laiinnec) is also frequently
improved by sulphurated waters, far more, however, by the mild mineral
springs.

The alkaline and alkaline-muriatic springs are to be tried, if
respiratory difficulties, especially severe paroxysmatical cough are compHcating the

38 Diseases of the Respiratory Organs — of the Pulmonary Tissue and the Pleura

catarrh; sometimes the weak and tepid sodium-chloride acidulous-waters
are also successful, if the above mentioned remedies fail.

In the bronchial catarrh of arthritic patients the method applied for the
principal disease is asked for (see section I D).

In all cases the drinking-cure is to be supplemented by the corresponding
baths, in a poor function of the skin, in mechanic obstruction of the abdominal
venous system also by massage and hydrotherapeutic measures. For an after-
cure grape-cures are recommended; but very frequently, after the catarrh is
reheved or cured, the stay at the sea, for strong individuals also sea-baths for the
purpose of inuring the skin and preventing relapses.

As to the climate, preferably places with an equable climate are to
be chosen; according to the general condition also more elevated places with a
forest-climate.

For the spring and autumn the health-resorts of the southern Tyrol, the
banks of the Lake of Geneva, and the lakes of Upper-Italy are recommended; for
obstinate cases a winter-station in the south.

B. Diseases of the Pulmonary Tissue and of the Pleura.

1. Chronic Affections of the Lungs, Residues of Acute Inflammations of the
Pulmonary Tissue. Exsudates of the Pleural Cavity.

The complete resorption of exsudates into the pulmonary tissue itself and
into the alveoli after fibrinous or catarrhal pneumonia and influenza is often delayed ;
more or less extensive consolidations of the tissue are left, due to a gradual
connective tissue organization of the infiltrate which originally consisted of abundant
red blood-corpuscles and leucocytes (acute and subacute induration). The lung
does not expand completely, and the bronchial mucosa also remains in a condition
of a chronic catarrh, chiefly accompanied by a continuous and often very tormenting
cough with expectoration. The strength of the body and the general condition are
not improved. The patients may in many cases remain free of fever, but in other
cases the fever continues, though in a moderate degree, and the morbid picture
resembles that of pulmonary consumption. It is sometimes hard to tell ot what
nature the excitor of inflammation is that acts upon the tissue. Chronic interstitial
pneumonia without pulmonary tuberculosis or without tubercle-bacilli in the
tissue, are not rare, even in cases in which there is a predisposition for
tuberculosis.

These affections are especially obstinate if one or both of the lower posterior
lobes of the lung were involved. The dullness and the rales are stationary for a
long time, and the clearing up of the dull area occurs but very gradually. If
extensive adhesions to the internal walls of the alveoli have not yet occurred, the
connective tissue fibres penetrating the parenchyma like a spider-web may by and
by contract, and the con<;erned pulmonary areas may thereby become patent again
for the respiratory current of air. The conditions are, however, otherwise if we
have to deal with the action of very virulent excitors of inflammation, and if a true
pulmonary cirrhosis with a subsequent bronchiectasia develops. In the majority of
cases, intestinal disorders, gastric catarrh, deficient bile-secretion, constipation etc.
are coexisting. — The treatment is the same as in pulmonary tuberculosis. The
resting-cure is of great importance for processes going along with fever; furthermore
care for fresh air, if possible transfer to a mild deep valley or forest climate, at
the beginning in not too high an altitude. According to the predominance of catarrhal
symptoms, we recommend the alkaline-muriatic springs, above all the mild
sodium-chloride acidulous waters, the tepid sodium-chloride baths; if the
bowels are to be stimulated, likewise the invigorating and purging sodium-
chloride springs, and in addition milk- and whey-cures with an appropriate
strengthening diet.

Diseases of the Kespiratory Organs — I'ubtrculosis and Pulmonary Consuynption 39

In a very poor digestion and a tendency to diarrhoea the mineral springs
are also indicated. After reabscrption has taken jilace or after the severe irritative
phenomena have been checked, inhalations of compressed air will be rational as a
supplement to the spring- and bathing-cure.

For a definite inurement we recommend a stay in the mountains, at the sea,
or also hydriatic procedures according to the general status. In the autumn a moderate
grape-cure may be of advantage as an after-cure.

The exsudates into the pleural cavity are nowadays so frequently removed
by operation that they are rarelier than before subject to mineral-cures. But
even after the removal of exsudates the expansion and capacity of the lung
remain impaired, in as much as in disease of long standing consolidations may
have developed.

The method of treatment is absolutely the same as for the residues of
pneumonia. — If the removal of residues of pleuritic exsudates is asked for, the
greatest possible diuresis is to be aimed at by the drinking cure, and ample use
has to be made of brine-baths in particular, as these baths influence the osmotic
pressure of the blood, and thereby favour natural reabsorption.

The laws of osmosis may theoretically explain the empirical facts that
exsudates are removed by the action of drinking-cures and baths: but as a matter
of fact, the details are still unexplained.

Finally, we should hke to call attention to the fact that, as is shown
by experience, pleurisy is often the first symptom of tuberculosis;
in these cases a very careful simultaneous treatment of the primary disease is
indispensable.

2. Tuberculosis and Pulmonary Consumption.

The ingenious discovery of R. Koch that the excitor of tuberculosis is a
specific parasite, has revolutionized the pathology of the concerned diseases, and has
rendered possible a uniform consideration of these. This conception can in the
main be pronounced by the following theses: Without tubercle- bacilli no tuberculosis.
Whoever evacuates tubercle-bacilli with his sputum may convey his disease by
these expectorations to other individuals. Tuberculosis is, therefore, an infectious
disease.

There is no doubt that this knowledge was a great progress, but its value
for practice is nevertheless not quite equal to its theoretical significance. The
discovery of the tubercle-bacillus has placed us before an abundance of new
problems which to a great extent are still undissolved: new questions have been
brought up, before the old ones had been answered. To be sure, the practitioner
has acquired exact diagnostic auxiliaries and invaluable methods, but at the same
time new doubts have arisen. Although the excitor of the disease is well-known
biologically, and can be traced at any time by many accurate methods, the decision
and clearing up of the question by which way the tubercle-bacillus really enters
the human organism, has not advanced as far as laboratory results. We must
emphasize, above all, that the animal experiments, the results of which are partly
dependent upon the individual resistance of the concerned animal species, partly
upon the unnatural conditions of infection, do not appear suitable for being applied
to corroborate the observations made at the bed-side and in human pathology.
The ports of entrance into the human organism may be different for the tubercle-
bacillus. It is firmly established 1) that in man tuberculous infection occurs by
inhalation, 2) that a very low percentage of cases are due to primary intestinal
tuberculosis, and 3) that the other sources of infection, skin, genital organs etc. —
at least as regards the general spreading of tuberculosis in the body, are pretty
insignificant. But even for the cases of primary pulmonary and intestinal infection
two things are to be considered — viz., that apparently more than in most of the
other infectious diseases individual peculiarities are favouring or preventing the
infection as well as its spreading and, furthermore, that tuberculosis and consumption

40 Diseases of the Respiratory Organs — Tuberculosis and Pulmonary Consumption

are by no means identical, that an enormous amount of cases of tuberculosis may
recover, very often without having produced any symptoms at all.

The attempts of ])roducing tuberculosis by the inhalation of dry vaporized sputa, have
always been negative. An inhalation-tuberculosis is only produced if conditions are existing
wliich cannot be compared with the natural conditions prevailing in the infection of
man. But even as droplets spread about from liquid particles of sputum in sneezing
or coughing, the tubercle-bacilli do not seem to be easily transferred. Tuberculous
infection from person to person is also in this way very rare, and it has been
proved by experiments that holding a handkerchief at the mouth when coughing
will render infection rather difficulty if not utterly impossible. The tubercle-bacillus
under normal vital conditions is rapidly destroyed by the weakening and bacteri-
cidal influence of air and sunlight. The saliva contains bacilli but rarely, and the
expiration air of consumptives is free from bacteria. Moreover, the organism is
provided with natural jirotective means, in as much as all inhaled particles from dust
are moved upwards by the ciliary motion of the epithelium. For estimating the
danger of infection the statistical fact is noteworthy that the mortality from tuber-
culosis in the native population of a health-resort does not increase even if the
place in question has been visited for years by tuberculous patients. And as another
argument we wish to mention that for example laryngologists have not become
consumptives in spite of their being more exposed to tuberculous infection than
other people on account of the numerous examinations of a tuberculous larynx.
Even those who have up-to-day advocated inhalation-tuberculosis acknowledge
nowadays that the clean consumptive patient is not dangerous to adult people in
common intercourse. There is, consequently, no objection to allowing consumptives
to live with healthy individuals under the observation of hygienic rules, and to
having consumptives stay at institutes and health-resorts being of good standing as
sanatoria for consumptives and in which, contrary to other places, all hygienic
measures can be carried through far more exactly. It is an established fact that
infection by way of inhalation cannot occur as frequently as was generally held
before, and that this mode of infection can only be conceived if enormous amounts
of bacteria are introduced. It is furthermore known that the invasion of individual
bacteria is borne by the organism without any harm, and that as regards the
virulence of the bacilH, not only the quantity but also the (luality always is of
great significance.

The infection of the intestines plays but a very insignificant role in adults
as a starting point of primary tuberculosis, while it is a very frequent and
often grave complication of open tuberculosis, perhaps not rarely caused by
swallowing sputum. As to its significance in children there was a great difference
of opinions for a long time. In districts where raw milk is being used, a relatively
very high percentage of primary intestinal tuberculosis was found in children. At
any rate, intestinal tuberculosis of children is in general far rarer than primary
tuberculosis of the lungs, and if it is combined with the latter, there is mostly a
primary pulmonary infection coexisting. It occurs pretty frequently in children that
tuberculosis of the lungs or of the intestines is relatively insignificant, or heals
perhaps entirely, while that of the regionary lymph-glands develops so enormously
and becomes so stationary that it, in the further course or even from the very
beginning, predominates in the morbid picture, and brings about other complications,
above all basal meningitis or miliary tuberculosis.

An indisputable determination of the portal of entrance is extremely difficult.
For owing to the slow development of tuberculosis, the locus or the time of
infection can no more or not very safely be detected when the first distinct
symptoms become manifest. Moreover, the pathogenic properties and the virulence
of the tubercle-bacillus can be preserved in the animal organism for a long time
even in a latent condition.

The digestive apparatus of the new-born may readily offer entrance to bacteria
on account of the great permeability of the mucous membrane, not protected by

Diseases of the Respiratory Oryoas — Tuberculosis and Pu/)nonary Consumption 41

ferments. Therefore, not long ago v. Beliring has advanced the theory that the
infection with tubercle-bacilli does only produce disease if the bacilli had been
ingested in infancy, that the source of pulmonary consumption is an infantile
infection producing a predisposition for a later infection.

As a matter of fact, experiments have shown that genuine protein bodies, the
immune sera, even bacteria from tlie intestine of the new-born, are taken upon as
by a very porous lilter, that the digestive apparatus of the suckling, therefore, is
lacking in protective means which in the adult normally prevent the entrance of
pathogenic germs into the tissue-juices.

V. Behring ascribed to milk a great role as a carrier of immune-bodies,
and he advised to immunize cattle in order to use their milk on account of its
content of immune-bodies, in practice also for the immunization and treatment of
children.

Neither experiences in man nor other data give a clue as to whether the
assumption is right that the infantile infection supposed by v. Behring is healing without
any symptoms. But we shall, nevertheless, agree with the intentions and proposals
of this never resting investigator for immunizing in infancy, and we may be
anxious for times to come. For there can be no doubt that by far the greatest
majority of cases that have ac(juired tuberculosis in infancy, terminate fatally in
early age, in part by progressive pulmonary tuberculosis and very fre((uently by
meningeal atfections or miliary tuberculosis, while the tuberculosis of adults is
generally verging to a more favourable, at least protracted course.

The tubercle-bacihus alone cannot be the cause of the breaking out of
tuberculosis; the tubercle-bacilli can only become pathogenic if they meet with certain
conditions in the organism. The practitioner will never be able to dispense with
the notion of predisposition, not only in tuberculosis, but also in various other
infectious diseases. Furthermore, practical experience contrary to theory has shown
Ihat even in predisposed individuals a particular accidental cause is necessarily
active in the breaking out ot the disease. Accessory factors of this kind are anaemia,
all affections bringing about a weakening of the constitution, such as puerperium,
diabetes, syphilis, grief and sorrow, generally alterations of the entire mode of life;
furthermore catching cold, residues of former inflammations, measles, whooping
cough, and particularly influenza.

A real germinative infection has as yet not been proved; in the rare cases of
intrauterine infection a placentar infection is brought about by the tuberculosis of the
placenta. Inherited infectious diseases do not exist at all. Tuberculosis is hereditary
not as a disease but as a morbid disposition, the latter being a permanent danger, and
mostly decisive for the destiny of the individual. Predisposing factors are especially
a so-called phthisical thorax, the structure of the upper chest, the abnormal
shortness and the ankylosis of the first rib in the sternal-joint, with the subsequent
rigidity and the insufficient ventilation of the superior portions of the lungs.

If the bacillus has invaded the organs and has found a favourable medium
here, the proteid-substances produced by the microorganism will call forth a reaction
of the involved tissue, and the picture of a productive inflammation will develop.
This becomes manifest in three forms — viz., 1) proliferation of tissue as a result
of the formative irritation; 2) exsudalive inflammatory processes, leucocytic infil-
tration (focus-reaction). In both forms the connective tissue- and epithelial cells
proliferate, and a profuse invasion of the affected parts by leucocytes sets in.
The leucocytes on their account, perhaps also the tissue cells, produce bactericidal
substances, protective bodies, which have the purpose of modifiyng the micro-
organism (opsonines) : 3,i necrosis, coagulation-necrosis, the well-known tissue- and
exsudate coagulation designated as caseation which is frequently followed by the
deposit of lime as a result of the coagulation. Now the secondary invasion . of
other pathogenic microorganisms takes place, the invasion of streptococci,
staphylococci, infiuenza-bacilli. The phthisical process, therefore, is not of a
uniform character. Moreover, the clinical picture of phthisis is mostly the result

1.2 Diseases of Ihe Respiratory Organs — Tuberculosis and Pulmonary Consumption

of the concomitant action of schizophytic fungi producing suppuration and fever,
that is to say the so-called mixed infection which is the true destructive factor of
pulmonary consumption.

We designate tuberculosis in which tubercle-bacilli are found in the sputum,
as an open tuberculosis, and tuberculosis in which tubercle-bacilli are absent, as a
closed tuberculosis.

Concerning the tuberculous infection of the air-passages most of the
pathologists agree in assuming that, above all, the central bronchi are involved. In
adults the superior lobe is most frequently afl'ected (in children, however, very
frequently the lower lobe primarily), especially the ramus apicalis ascendeyis for
which the conditions are particularly unfavourable as it is very steep, and forms
an acute angle with the chief bronchus, and besides is often slightly kinked off.
At this place, therefore, catarrhs of long standing are prevailing, whereby a
predisposition is established for the fixation of tubercle-bacilli.

As we know, Robert Koch has emphasized the difference of human and
bovine tubercle-bacilli. But we know to-day that bovine tuberculosis is transferable
to man, and human tuberculosis to cattle, and that the typus bovinus seems to
catch more readily in the digestive tract, preferably in children, the typus humaniis
more easily in the respiratory tract. Besides the tubercle-bacillus of mammals there exists
also a bacillus of cold-blooded animals, and a bacillus of poultry-tuberculosis. The
question of the variability of the individual forms of tubercle-bacilli and their
probable differentiation into different species, varieties; or types, has as yet not been
dissolved.

The predominating infectious germ of man is the tubercle-bacillus occurring
in man. It has a fatty wax membrane which protects the bacillus so to speak
like a cuirass and renders it extremely resistant. Certain forms of bacilli frequently
occur in human sputum which exhibit peculiarities of growth and, above all,
considerable differences of virulence. When inoculated upon guinea-pigs, to be sure,
the same variety develops which produces suppuration of glands and, finally, nodules
in the lungs, but this tuberculosis does only lead to a fatal end after months.
Such forms of lowered virulence are not rarely the cases to show up with at
health-resorts or sanatoria.

If the course of human tuberculosis is slow in general, a newformation of
connective tissue may stop the tuberculous process, encapsulate it, and lead to the
formation of a callus and to a subsequent cessation of the disease or to a
spontaneous healing. This is the daily experience in pathologic anatomy. For
in most people that have not died from tuberculosis and who during life have shown
no or but insignificant disorders of health, scars and healed tuberculous foci are
to be found.

Judging from the present status of the question, one must admit that the
dangers to which theory has pointed, and which have given rise to so much
excitement and care, cannot be confirmed for adults. Medicine in all is an
empirical science; scientific researches should always take in account experience
based on practice.

The prophylaxis of tuberculosis is a part of the domaine of hygiene in the ,
broadest sense of the word, as all that is aimed at by and elaborated in hygiene,
is also directed against tuberculosis.

It is self-understood that an organism lowered in its resistance will be
affected far more easily than a body in its full vigour, and that the danger of being
affected is reduced in as much as a suitable prophylaxis is carried out. It is,
therefore, our aim to secure for the body a normal resistance against the strenuous
struggle for life in cases of congenital or acquired predisposition, and after weakening
diseases. The factors coming into consideration are a regular, invigorating and
not too copious nutrition, by which the lungs are rendered more resistant, and the
cardiac muscle is strengthened; furthermore, rest for the body and fresh air, suitable
clothes, muscular work adapted to the individual case and inurement by air and water.

Diseases of the Respiratory Organs — Tuberculosis and Pulmonanj Cmxsumption 43

We also try to influence the development of the thorax especially at the early
time of going to school, by systematic breathing exercise and proper carriage of
the body.

The chief aim of prophylaxis is nowadays immunization by means of tubercle-
bacilli of man and related species. But in spite of the numerous attempts of
obtaining a direct or indirect immunity by tubercle bacilli and their products, none
of the methods as yet known has been successful in man in a somewhat safe and
harmless way. Von Behring recommends, as mentioned above, for the solution
of the problem of a rational milk-hygiene, the immunization of cattle in order to
convey by the milk of highly immunized animals the protective bodies on man.
The fight against tuberculosis would then begin in the earliest childhood.

The principal task of prophylaxis is, of course, destroying the tubercle-
bacillus and preventing of its spreading about. Therefore, it is indispensable that,
even in simple cough, everybody may empty his sputum if possible into a spittoon
and, when coughing, hold a handkerchief at his mouth.

An early diagnosis is of great importance. Besides the clinical methods
of investigation, we have the tuberculin-test. The exploratory cutaneous and
percutaneous reaction (less dangerous and troublesome than the conjunctival reaction;
is probably qualified to be a substitute for the subcutaneous tuberculin-vaccination
in childhood, but not in adults. The positive result of the percutaneous reaction
(salve-test, Tuberculin Koch. Lanol. anhydric at equal parts 5.0) makes active
tuberculosis in childhood very probable. The cutaneous tuberculin-vaccination
according to von Pirquet by means of a vaccine-drill, is a simple and harmless diagnostic
method for any stage of life; the tuberculous patient reacts with the well-known
hyperaemic areola at the spot of vaccination (for adults undiluted tuberculin, for
children a 25 per cent, dilution of Tuberkulin Koch. 2.5, Solut. acid, carbol. 10.0
is sufficient).

A positive reaction does not give any evidence of the seat of tuberculosis,
and no clue as to the activity or inactivity of the process; it is even found in
clinically non-tuberculous individuals. Moreover, the positive reaction simply allows
to conclude that the body at any time and in some way has been infected by
tubercle bacilli. The negative reaction is in general indicative of an absence of
tuberculosis. Concerning the safety of diagnosis the subcutaneous tuberculin-test
assumes the first rank. The tuberculin-test in general is considered a coarse
diagnostic means, and is, therefore, of no significance in prognosis.'

If sputum is present an exact bacteriological investigation is urgently required.
The antiformin-method gives absolute evidence, and is decisive in dubious cases, if
it is performed exactly according to the prescription.

The treatment of tuberculosis is up to this time only to be based upon
the results of many years of experience.

Clinical experience has taught that the quintessence of a successful treatment
of phthisis consists in improving the general constitution. The strengthening of the
organism is attained best of all by a dietetic and hygienic or climatic
method.

The means at our disposal consist in improving metabolism, increasing the
utilization of food, the improvement of environmental conditions, ample supply of
fresh air (climate) and psychical influences. In addition to this, detrimentary
influences have to be eluded and concomitant diseases have to be cured. We must
of course aim at a combination of the just mentioned factors; the treatment at
suitable health-resorts and particularly in isolated sanatoria is, therefore, of
old in the fore-ground.

A regards 1) nutrition, the condition of the digestive organs is of the utmost
importance. As experience has shown, an efficient gastro-intestinal digestion has
proved the best protection in combating tuberculosis. Yet it is not only important
<o have the patient gain in weight as much as possible, but it is also necessary

44 Diseases oftJte Respiratory Organs — Tuberculosis and Pulmonary Consumption

to increase his cellular material, his protoplasm, in order thereby to increase the
resistance to a threatening decay of tissue, or to localize the process.

One of the fundamental factors of treatment is, therefore, the ingestion of a
very substantial and variable food containing carbohydrates, albuminous bodies, and
fat in proper proportions; this diet should, at the same time, aim at a most
complete utilization of the food-stutls. In poor appetite well -selected frequent and
small meals are indicated. We should sometimes rely u|jon the instinct of the
patient rather than on theoretical deliberation. We should, however, avoid great
amounts of liciuids, thin soups etc., on account of the useless distention of the
stomach, particularly because in such constitutional anomalies a tendency to
gastric atony is not seldom. If the digestive organs will stand it, the use of milk
(always boiled) is recommended or of substitutes for milk, such as kephir,
leguminoses, Hygiama, quaker-oats (porridge), Plasmdn, Tropon, Mellins' food
(Kindermehl) as an addition to the milk, furthermore Somatose, Nutrose, Odda,
Eucasin, and the vegetable albumin Roborat, if possible between the meals,
before going to bed and during the night. Furthermore, copious amounts of fat,
fresh butter etc. are of great advantage; we wish to mention here that virulent
tubercle bacilli, if at all, are very rarely found in butter from the market. The
nutrition is also influenced most favourably by taking alcoholic drinks according
to the individual compatibility.

A particularly important indication is the supply of air as free from dust
as possible, and so 2) the open-air treatment (open-air resting-cure), the great
significance of which in the treatment of tuberculosis has been generally acknov/-
ledged. But in considering this important curative factor, we must not forget that
we should only strengthen the organism very gradually, as the consumptive is a
very irritable and delicate patient. In combating his constitutional anomaly we have
to bear in mind that the abrupt and brisk influence of a curative factor, however
wholesome it may be, is an irritant which pretty often brings about a considerable
deterioration instead of the expected improvement. We try, therefore, to procure
the most favourable environmental conditions by which new obnoxious agents are
most carefully precluded, and the morbid process and spontaneous healing in the
lungs may run a course as undisturbed as possible. We have to avoid all chances
of acquiring bronchial catarrhs and other colds, and any catarrh present is to be
treated with the utmost care.

In the rarest instances, however, the hygienic-dietetic treatment will be
compatible with the profession and the entire mode of life of the patient. We know by
experience that the separation of the patient from his former environment and the
transgression into new surroundings benificial to the mood, are of the greatest value,
as this is the only means of arriving at a strict obeyance to the prescriptions.

It is, therefore, advisable to have the patient visit a place not too near to
his residence, and to have him live solely in care of his health, remote from his
former mode of life, from injurious influences, that have cooperated in the aetiology
of the disease. In selecting such a place the climate will naturally be decisive
above all, and we shall prefer capaciously built places, as, of course, the atmosphere
is the purer the more distant from one another human dwellings are built.

The climatic conditions of places serving for jihthisiotherapy, are different.
Subalpine and alpine places as well as the sea are extremely stimulant to the
organism, while the valleys, moderate altitudes, and the south are protected against
wind, are free from abrupt change, and are distinguished by a uniform temperature.

Valleys and moderate altitudes in the summer, the south in the winter, oiler
oj)portunity for a sparing and very little stimulative treatment; the mountains
and the sea, on the other hand, have from the very beginning an energetic and
very stimulating effect on the organism.

We shall always keep in mind the clinical experience that only gradually
increasing stimulants reestablish the efticiency of the fissue-cells, and that, on the
other hand, the abrupt action of strongly irritant and exciting climatic factors involves

Diseases of the Respiratory Organs — Tuberculosis and Pulmonary Consumption 45

dangers not to be undervalued. A rational therapy will, therefore, always be
individualizing, and will decide from case to case, whether a sparing or an exer-
cising method is to be preferred. The former will enter into question as a
beginning of the cure in weakly individuals in the initial stage, and further in cases
with an advanced morbid stage. Patients for example wo have just overcome the
incipient inflammatory invasion and are still exhibiting a condition of weakness, must
not be sent to places in which the climatic and changeable meteorological conditions,
as alpine or sea-atmos])here, ask too much of the organs, even not if the physical
findings have been but insignificant. The cure in the valleys and in medium altitudes
is of use in as much as it does not only limit the disease focus and eventually
bring about complete recovery, but also, above all, does strengthen the organism so far
that it can be exposed without danger to the more powerful climate which, on its
part, is more active in bringing about a definite cure than the level country. A
cure in valleys in the summer is often to be followed by a winter-cure in the south.
Both these cures are a preparation to the alpine or sea-cure. But entirely different
are the indications for the mountains in winter on account of the change of
climatic conditions. In this season good results may also be obtained in the
alpine regions on account of the intense insolation and the much lower moisture of
the atmosphere, provided that intermediate stations permit of gradually visiting and
leaving the health-resort.

A winter-cure in alpine districts should, however, only be recommended if
serious laryngeal or pharyngeal affections are not existing.

Although there can be no doubt that one climate is superior to the other,
and that a patient may experience a more rapid and better result if the climate is
adapted to his morbid state, sanatorium-treatment teaches, nevertheless, that a specific
effect of a climate upon this disease does not exist. To be sure, the tuberculous
patient may recover in any climate, provided that he lives according to the pre-
scriptions, i. e. according to the degree of his constitutional irritability, to the reactive
power of his organism; but just for this reason a cure can only be carried out
successfully at a place that answers certain reijuirements as to climatic conditions,
situation, condition of soil, and protection against winds etc.

About one to two decades ago, the so-called exercising method was en vogue
with its curative factors: air, water and exercise, and it was extremely deleterious
to thousands of patients that one had almost forgotten that the exercise-method
should indeed only be the goal, and that the sparing method should be preparatory.
Just as the treatment of circulatory disturbances, reducing-cures, and all the parti-
culary remarkable therapeutic measures were often going the wrong tract, phthisio-
therapy was also not spared of coarse errors. It is the merit of the treatment
in sanatoria that conditions have been changed in this respect, and that the
importance of a sparing treatment has been pushed to the foreground. For the
treatment in sanatoria is, to begin with, a test of the pov^-er of reaction; the patient
is not exposed at once to all the influences of the new mode of life, above all, not
to the climatic stimulus; he is on the contrary gradually acclimatized; by moderating
the climatic factors, for example, local climate! (by open-air resting cures in open
galleries) the patient is protected against abrupt changes of temperature, loss of
heat, catching cold etc.; with other words, the cells of the tissues are able to
accomodate themselves gradually, whereas at open alpine stations or at the sea,
they would perhaps have been exhausted. A rational open-air treatment alleviates
metabolism and all functions, and thus improves nutrition. It is, therefore, re-
commended for the treatment of all forms of phthisis, and particularly for febrile
patients.

For all phthisical processes mineral- water cures may be applied most
advantageously; and so, balneotherapy being nowadays no more based upon mere
empiricism, but such drinking-cures having an exactly scientific fundament, they
should again be favoured more and more.

46 Diseases of the Respiratory Organs — Tuberculosis and Pulmonary Consumption

There can be no doubt that the quantities of water ingested into the gastro-
intestinal canal enter into action with the salt-solutions, the tissue-juices according
to the laws of osmosis, that, consequently, the mineral-waters are able to modify the
metabolism of the entire organism. They facilitate transport of the products of
progressive and regressive metabolism ; the stagnating tissue-fluids filling the organs
are reabsorbed, the affected cells are rapidly destroyed, and new resistant cells are
formed.

The mineral-springs applied in the treatment of phthisis are 1) the simple
muriatic springs; 2) the alkaline and alkaline- muriatic springs; 3) the alkaUne-
mineral springs, and 4) the arsenious chalybeate springs.

The water assists, on the one hand, in ingesting and assimilating new sub-
stance, on the other hand, in dissolving and eliminating the consumed and wasted
substances. A systematic drinking-cure is, therefore, similar in its action to body-
exercise and may, therefore, for example be useful in an open-air resting-cure. It
is advisable for many patients to drink smaller amounts of the mineral water during
the day, in great intervals.

Anorexia and dyspepsia are common symptoms of phthisical patients. In such
cases a drinking-cure may stimulate the gastric function, and regulate the intestinal
function. As to the latter indication we wish to emphasize that e. g. muriatic
springs are principally digestive remedies, and cannot be applied for the purpose of
bringing about a strong purgative effect.

The muriatic springs are recommendable in a low secretion of hydrochloric
acid, and in an increased formation of mucus. They bring about a considerable
increase of hydrochloric acid secretion, a better chymification and a reduction of
mucus. In these mineral cures fat may be taken abundantly, as it is readily utilised
and absorbed under the action of the waters.

For the treatment of the concomitant catarrhs of the respiratory mucous mem-
brane the above mentioned mineral waters have of old assumed a prominent rank.

Variations of the concentration of the blood increase the function of the
kidney. If the osmotic concentration of the blood is increased, the tissue is freed
of water, and an increased diuresis sets in. This reduction of water in the tissue
brings about a diminution of the secretion of the affected bronchi, and as a result
of this facilitates expectoration.

It was formerly considered an empirically established fact that mineral- water
cures bring about an increase of mucous secretion and consequently a dilution of
the tenacious secretion, and a facilitated expectoration. But in drinking-cures, pre-
scribed in a favourable climate with a relatively high almosperic moisture retaining
the cutaneous and pulmonary water, the conditions are so complicated that the
balneologist can hardly decide about the question as to which factor influences the
'solution' of the catarrhs.

The result of a drinking-cure will be the safer the more allowance is made
to the individual judgment ot the bathing-physician who is guided by the know-
ledge of the local curative factors; and also the more the method of applying the
water is modified according to the individual case.

3) The medicinal treatment cannot be dispensed with. The same indication
is valid e. g. for Kreosot, Guajacol, Guajacol-Somatose, Thiocoll, Sirolin etc. These
substances, as experience has shown, improve the appetite and the nutrition.

During the past years the treatment with tuberculin has been more and
more advocated even by physicians who had formerly looked upon this diagnostic
means most sceptically and with great reserve. The tuberculin reaction is a specific
tuberculous reaction, depending upon a hypersensibility of the tuberculous individual
to the poison of the tubercle-bacillus. Tuberculin is, to be sure, no universal and radical
remedy. It belongs to the group of those bacterial proteins which only produce
a local inflammation (focus-reaction) in the specifically affected tissue, stimulating
thereby the organism itself to form protective bodies. Nevertheless, it is able to in-
fluence a definite form of pulmonary tuberculosis in so favourable a manner, as no

Diseases of the Respiratory Organs — Tuhe^'culosis and Pulmonary Consumption 47

other method of treatment is able to do. This has brought us nearer to a specific
therapy.

We differentiate the means by which active immunity, and those by which
passive immunity is aimed at. Active immunity is produced by introducing bacteria
or bacterial products which bring about the production of specific protective bodies
(aniibodies) in the serum of treated individuals. This immunization, therefore, is
indirect the organism being compelled to prepare its specific protective bodies itself,
hence the designation of 'active immunization', according to Ehrlich.

By a 'passive immunization' we understand the immunization by means of
a specific serum; the protective bodies produced by another individual are introduced
into the organism; hence the designation of 'passive immunization'. — Of tuberculins
the following different kinds are existing: Old Tubercuhn and New Tuberculin, the
bacillary emulsion. All the various tuberculins and tubercle-bacillus preparations
have in general the same effect, probably only differing in quantity.

Old Tuberculin is the simple filtered bouillon in which the tubercle bacilli
have grown; it contains, therefore, the substances soluble in the tubercle bacillus
bouillon. Deny's tuberculin is the non concentrated Old tuberculin.

The bacillary emulsion comprises a group of preparations (Koch, Landmann,
Beraneck) which all have in common that they contain the substances of the
bacillary body itself in an absorbable from. They are either prepared from human
tubercle bacilli, or according to G. Sprengler, from bovine tubercle-bacilH. As it was
known that the tuberculins prepared from bovine cultures produced a reaction in
human tuberculosis and vise versa, one was led to suppose that by introducing
tuberculins prepared from bovine tubercle bacilli, preparations could be obtained
which were less virulent but more effective. Undoubtedly, the bovine tuberculin
(Perlsuchttuberculin) is far less toxic and milder in its action than the tuberculin
prepared in like manner from human tubercle bacilli.

Apart from active immunization it has also been tried to cure tuberculosis
by passive immunization. Maragliano's immune-serum, Marmorek's Antituberculosis
serum are well-kown. Recently C. Spengler recommended the immune-blood
treatment (IK), assuming that the principal places of the production and deposit
of immune-substances were in the blood-cells, and that one only needed to liberate
the great amount of immune bodies deposited in the blood-cells of artificially
immunized animals.

It is still an undissolved problem which kind of preparation we should prefer.
The disease as well as the individualities of the patients being so variable, it is not
advisable to adhere to one preparation. Old Tubercuhn does still assume the first
rank; recently Koch's bacillary emulsion and the so-called sensibilized emulsion
(S B E. prepared by adding some tuberculosis serum containing antitubercuHn) are
particularly recommended. — The principal requirement is to find by a careful
observation of the temperature-curve and the subjective symptoms, the reactive limit
of the patient, i. e. to give the just dosis, so that particularly strong reactions are
avoided; for there is no organism, which is able to produce daily new protective
bodies in the same amount, if new toxines are being introduced every day. The
injections should, therefore, be given in due intervals.

It will always be difficult to recognize the result of a tuberculin-cure, as
tuberculosis does often heal spontaneously and on applying hygienic-dietetic
procedures.

Tuberculin-cure cannot be dealt with exhaustively within the limited space
of this book.

For stimulating metabolism, and for strengthening and improving the power of
resistance are suitable 4) cold rubbings with or without an addition of sodium-
chloride, douches, exercise, respiratory gymnastics, for sensitive patients
simple brine-baths and carbonic acid brine-baths with subsequent cold
showers. These important curative factors should, however, always be under a
thorough control and should always be individualized, and reduced to the proper

48 Diseases of the Respiratory Organs — Tuberculosis and Pulmonary Consumption

degree according to the principle: "the stage attained yesterday is to be the normal
basis for to-day."

The reason for one place agreeing better with the patient than another one
is to be looked for in the process itself, but often also in the fact that in applying
the above mentioned curative factors the degree of the constitutional irritability
and |)Ower of reaction of the organism has more or less been taken into
account.

Unfortunately in many sanatoria too little attention is paid to this chief
principle of phthisiotherapy: increase the power of reaction of the organism by a
correct dosage of the active stimulants, e. g. in the oi)en-air treatment. Thus many
a good curative result is annihilated again.

Our knowledge of the more intricate processes of the tuberculous affection
confirms still more how significant the sparing method is for consumptives. It is .
a matter of course that neither exsudative inflammatory processes (leucocytic
inliUration) nor necrotic processes should be treated by distention or strenuous
muscular exercise. But even in the productive inllammation and in cicatrization
we should wait until the new formed tissue has attained some firmness. Of how
favourable an influence is the silence-cure in laryngeal ulcers, the fixation in the
surgical treatment of joints!

As to the beginning of the cure, the patient should be sent away as
soon as possible, i. e. he should leave his domicile and be transferred to
favourable climatic and nutritional conditions. It is, therefore, the most important
task of the physician to recognize the disease as early as possible. The patient
and the consulting physician should by no means forget that the treatment of
pulmonary consumption requires a systematic and thorough cure, and that for
its duration one has to figure on months or even years, and not on weeks. Under
these conditions, of course, the chances for a good result are far better than in any
other chronic disease.

Whether the patient is to be sent to an open health resort or to a closed
institution (sanatorium), is all dependent upon the most thorough, particularly
psychological consideration in the given case. The sanatorium offers the advantage
of strict discipline, careful medical control and of a thoroughly regulated and
suitable dosage of food and air. It is, therefore; urgently demanded for patients
with whom there is no sufficient guarantee that the climatic-dietetic methods will
be carried through as persistently and strictly as it is required. The patient will
scrupulously observe a prescription, inconvenient as it Avere, in the sanatorium,
because his fellow-sufferers give a good example, and because he is generally well-
informed about the serious nature of his affection. The sanatorium, mostly
located in the mountains, offers furthermore the advantage of combining the
sparing method with the strenuous one, in other words, of applying all the auxiliary
factors required for the favourable course of the disease. But, on the other hand,
we should not undervalue the disadvantage of living in company of patients of the
same. kind.

The same result as in a sanatorium can be obtained by a climatic-dietetic
treatment (systematic utilization of open air, excellent feeding etc.) in an ojien
health-resort, provided that the duration of the cure is the same as in a sanatorium;
we should, above all, correct the erroneous view that a cure might be carried out
within six weeks.

Experience has shown that only patients should be sent to open health-
resorts who have either been trained already by a treatment in Ihe sanatorium,
or who are willing to take great pains in thoroughly observing the medical
prescriptions, becoming, so to speak, also here cooperators of the physician.

3. Asthma and Emphysema.

An emphysema may originate as a result of repeated attacks of asthma, both
these diseases are, however, entirely different from one another. By the clinical

Diseases of the Respiratoi-ij Organs — Asthma and Emphysema t9

picture of asthma we understand a condition characterized by spontaneous attacks
of dyspnoea, especially of difficulty in expiration, while no or at least no significant
difficulty of breathing is existing between the individual paroxysms. An emphysematic
patient suffering from continuous dyspnoea does, therefore, not suffer from asthma.

The true cause of asthma is not known. It remains to be proved that the
disease is depending upon an anomaly of metabolism. The uniform opinion at
present is, that the asthmatic attack is brought about by a particular predisposition
of the nervous system, by an irritation of the respiratory centre and a subsequent
spasm of the smooth muscles in the smaller bronchi. The nerve by which the
'spasm is elicited is the vagus. The irritation is either direct from the medulla
oblongata or from the peripheral tracts (irritation of the vagus by congestions of
the tracheo-bronchial glands) or by a reflex induced from various organs.

In order to denote precisely the place of origine of the neurosis in the given
case, one has proposed to speak 1) of a reflex and 2) of an intoxicative
asthma, instead of classifying as before into bronchial and cardiac asthma.

The reflex asthma is due to a neurasthenic predisposition. The attack may
be elicited from the most various organs, from the stomach, the intestines, the
sexual organs, the ear, and frequently from the upper air passages; in the latter
case the irritation is due to an increased irritability of the nasal mucous membrane.
We distinguish, therefore, a naso-pharyngeal-bronchial-asthma, furthermore an
asthma dyspepticum, uterinum. If the cause of the disease is confined to
individual zones or spots, the latter are designated as asthma-spots; sometimes the
irritation eliciting the attack is but insignificant. The intoxicative asthma is
brought about by organic alterations. Abnormal substances are formed in the blood
by a reduction of oxygen or an accumulation of carbonic acid. These substances
paralyse the respiratory centre and elicit the asthmatic attack. Cases of intoxicative
asthma are asthma cardiale due to an affection of the vascular system, or of the
heart, and asthma renale (uraemia) etc.

Into this group is to be classified congestive asthma, due to plethora
or obesity; furthermore, the forms caused by mechanic factors. In
the latter the inspiration of oxygen is likewise aggravated by a narrowing at any
part of the upper air-passages, and as a result of this a carbonic-acid intoxication
is produced. These forms are rapidly healed by eliminating the mechanic cause.

Hay-asthma and hay -fever are likewise forms belonging to the group of
intoxicative asthma. They are due to the inhalation of the flower-dust of certain
grasses. Dunbar has recently proved that pollen-grains of rye, barley, wheat, rice,
and corn, contain substances by which all the symptoms of hay-asthma and hay-fever
are elicited. But in this affection too the irritation of the respiratory centres can
only be brought about on the basis of an individual predisposition. As a therapeutic
method Dunbar recommends the subcutaneous injection of a poUen-antitoxine.

If there is no or practically no considerable impairment of breathing between
the spontaneous attacks of dyspnoea, we designate the conditions as "asthma
acutum", in contradistinction to "asthma chronicum'' which, often persisting for weeks
and months under the symptoms of dyspnoea, buzzing and whistling sounds, may
disappear suddenly under the influence of a change of residence or a cure.

The spasm of the bronchial muscles is accompanied by hyperaemia, swelhngs
and secretions of the bronchial mucosa; the secretions may be very tenacious, and
may not rarely obstruct the bronchioli. (Charcot- v. Leyden's cristals, Gurschmann's
spirals.) One has, therefore, always tried empirically to liquify the tenacious bronchial
secretion and to facilitate expectoration by inhalation of sodium-chloride,
carbonate of sodium (V2 per cent.), and by drinking-cures of alkaline-muriatic
springs, of sodium-chloride springs, of alkaline-mineral and sulphurated
springs. For the coexisting stasis in the portal system the alkaline-sulphurated
springs are likewise recommended, if the heart-action is strong.

50 Diseases of the Respiratory Organs — Asthma and Emphysema

A change of residence and a climatic Ireatment are very important.
Unfortunately definite criteria as to the advantage ot one or the other climate cannot
be etablisiied. The matter can only be decided by a trial.

In general, we may recommend a drin king-cure with small and frequent
djoses in the beginning of summer, and in addition baths, especially carbonic-acid
thermal baths ("see "Emphysema"); in mid-summer exposed places of a higher
altitude, even the pure mountain-climate of the Alps. The patients often agree
with the fresh sea-climate, in as much as expectoration is facililated, and the
condition is perhaps alleviated by a reduction of the number of inspirations. But
it is by far not always the altitude or the sea that is active. It has been found by ■
experience that sometimes even the mere change of residence, going from one
town to ' another, even the change of a house, or moving from places of high
altitude to the plain, may give the most surprising results, and we may safely state
that each asthmatic patient has his own private climate. The patient lias to avoid
as much as possible persistent catarrhs, colds which increase the bronchial irritation
and impair the pulmonary circulation. This has to be considered thoroughly when
choosing a health-resort. For the winter it is advisable to stay in a mild climate,
on the Riviera, in Egypt or, with a sufficient power of reaction, at the alpine
stations of Switzerland. A psychical treatment is also of a very favourable
influence, and furthermore a definite mode of life, especially concerning the diet,
as a disorder of digestion may elicit an attack. Sometimes the dietetic prescriptions
may be combined most successfully with inurement-cures. Among the remedies
arsenic, atropine, and potassium iodide (taken with milk) are the chief agents,
that do good service in combination with mineral-water cures. Pneumatic caltinets
and transportable appliances for rarefied and compressed air are also sometimes
useful for alleviating the condition.

Very often the general treatment will not suffice, and the affection will
only be alleviated or cured by a local procedure. It will always be our principal
object to seek for the peripheral irritative spots, and to find their place of origine.
It is, above all, necessary to care for a free nasal breathing by removing the
swellings of the turbinates and of the nasal septum; furthermore, we have to
examine the inferior turbinates, especially at their anterior margin, the adenoids,
and the tonsils, and the lateral bands, and to treat these parts if necessary. We
may then explore the nose in order to find asthma-spots and to apply galvano-
cautery for the latter, if they are still sensitive after cocaVnization. It is sometimes
only a small polypus of the nose not obslructing respiration, after the removal of
which the attacks originating by nerve-reflexes may cease to appear.

If after repeated paroxysms of asthma an emphysema has developed, the
treatment described under the following heading of emphysema is to be inaugurated

Emphysema.

For e m ph y s e ma, the permanent dilatation of the lungs not complicated by moreserious
affections of the pulmonary tissue, baths are ap])liedjn compressed air (pneumatic chamber).
For facilitating respiration we may also apply successfully Waldenburg's apparatus and
similar contrivances for the inhalation ofcompressedair, and for exspiration into rarefied air.
Balneotherapy is only of advantage in concomitant chronic bronchial catarrhs
and in comphcations of the abdominal organs, congestive catarrhs etc. ; these
conditions are often treated most successfully by the drinking- and bathing-cures
prescribed for those diseases. The waters here coming into consideration are the
alkaline-muriatic springs, the alkaline-mineral springs with inhalations of their
gases, the simple sodium-chloride springs and the carbonic acid thermal
brine-baths. The latter are to be mentioned particularly, as they produce a
cutaneous hyperaemia by the peripheral irritation of the skin, and consequently
discharge the internal organs and diminish the hyperaemia of the bronchial mucous
membrane. If weakness of the skin is coexisting, massage and a suitable hydro-
therapeutic method will also do good service.

Diseases of the Heart — Disorders of Circulation 51

IV. Diseases of the Heart, Disorders of Circulation.

By Medicinalrat Professor Dr. J. Groedel, Bad Nauheim

In the treatment of chronic affections of the circulatory apparatus climatic
and, in some cases, also drinking cures used to be the sole therapeutic factors,
while nowadays bathing-cures are being preferred more and more in the treatment
of all the affections concerned here. To be sure, it is often very difficult to device
precisely tlie balneo-therapeutic methods particularly for these diseases with their
extremely variable symptomatology, and we are often compelled to combine the
bathing-cure with other therapeutic measures (dietetic, meclianic-gymnastic, mediciiial).
This is why all that has been said in the introduction with reference to the choice
of a suitable bathing-station, is particularly valid here— viz. "that at many places
special morbid states are preferably treated, and the pliysicians of these places
have become specialists."

Drinking-cures are applied for cardiac diseases nowadays more rarely than
formerly. They enter into consideration only in cases of cardiac affections in which
the general condition is still satisfactory, and the muscular power of the heart is
rather intact, and the valvular apparatus not profusely destroyed.

The drinking-cure is directed against the eventually coexisting disorders of
digestion and of intestinal function, or against the secondary congestive hyperaemia
of the liver and the abdominal vessels.

The slightly purgative action of the potable waters of the sodium-chloride
group is able to alleviate the condition sometimes in this direction, and likewise
the careful application of bitter-waters.

For cases with adipous heart, especially in fatty desposits on the heart
of obese, but vigorous individuals, the cold alkaline sulphurated springs as
well as the sodium-chloride springs are indicated for drinking cures, and, if
symptoms of anaemia are existing, mild ferruginous waters for an after-cure,
and in some cases even for the principal cure.

In the drinking-cure we have by all means to take care that the mineral-
waters prescribed do not contain too great amounts of carbonic acid; the latter has
to be removed if necessary by heating or shaking the water, in order to avoid an
uncalled for increased action of the heart. We should, furthermore, never prescribe
mineral-waters in too great a dosis, and we should always try to deprive the body
of an equivalent amount of liquid. From this reason the drinking-cure should be
interrupted if the intended action upon the intestinal canal fails, as otherwise a
sudden, though transitory plethora of the circulation may set in which may bring
about a considerable excitement of the heart. For the bathing-cures applied in
cardiac affections are preferably used the carbonic-acid thermal brine-baths,
sometimes also carbonic-acid chalybeate-baths. The carbonic acid thermal
brine-baths are sedative, they regulate the cardiac action and act decidedly as a
tonic for the cardiac muscle. An unobjectionable strictly physiological explanation
of this effect of the baths can as yet not be given. As a matter of fact, a precise
and unhypothetical explanation of the action of baths and drinking-cures, and, as
we may frankly confess, of many drugs in general, has as yet not been arrived at.

It is sure that by stimulating the peripheral circulation the cardiac action
may be influenced to some extent. We may, furthermore, assume that the chemicaP)
and thermal stimuli acting upon the cutaneous nerve-endings may by reflexes also
act upon the cardiac and vascular nerves. This assumption is based upon well-

1) In speaking of chemical stimuli we bear in mind those actions on the organism that
are conditioned by the solid substances dissolved in water or by the gaseous constituents fixed by
absorption, without thinking here of purely chemical processes. It has, moreover, been assumed that
a percutaneous stimulative effect is to be ascribed to any substance, and that this stimulus, different
according to the chemical quality of the substance is to be designated as a chemical stimulus. The
teachings of physical chemistry have in the past years induced many investigators to accept various
views concerning the physico-chemical processes involved here. These assumptions are,
however, by no means proved. A theory advanced some time ago by Senator and Frankenhauser
seems to be very suggestive. According to this theory the stimulative effect of these substances is a

b-2 Diseases of the Heart — Disorders of Circulation

known experimenls on other cutaneous stimulations and their effect upon the
circulation, as well as upon observations on the influence of baths upon blood-
pressure, respiration etc., finally, upon the irrefutable results of these bathing-cures.
The latter can only be explained sufficiently by assuming a reflex action.

With the concerned baths we have free play in influencing the cardiac action
from the periphery of the body by modifying the thermal and other stimuli in all
degrees: We may sometimes act in the sense of discharging the heart of work,
i. e. sparing the heart, or we may act in the sense of inciting the heart to an
increased energy, i. e. cardiac exercise. The heart-muscle may lie strengthened in
both ways, either by sparing or by systematically stimulating the heart to increased
energy. We have to lay more stress upon the one or the other of these ways
according to the individual case. It is of minor importance of what nature the
cardiac or vascular afl"ection is; much more decisive are the degree of the
cardiac weakness and the malproportion between requirement and cardiac
efficiency.

According to this view, the above mentioned bathing-cures are
indicated in all cases of disorders of the circulation in which it is our
object to raise the capacity of a heart too weak for the prevailing
conditions, no matter whether the circulatory disorders be caused by a valvular
afi"ection or by an affection of the cardiac muscle or of the vessels, or whether
general disorders of nutrition (Adipositas) etc. are present.

If the affection is very much advanced, and if symptoms of an extensive
degeneration of the cardiac muscle are existing, the best is to keep the patient at
home or in the next neighbourhood of his home. It is certainly at times pretty
difficult to decide how far the degeneration of the cardiac muscle has advanced,
and, on the other hand, favourable results are sometimes obtained in quite desperate
cases with far advanced disorders of compensation, by applying a bathing-cure,
generally in connection with a medicinal, mechanic or dietetic treatment. We can
not establish definite rules and principles, and the consulting physician will always
have to form his own opinion as to whether in a given case some power of cardiac
reaclion to medicinal or other influences is present, before deciding whether it is
still advisable to send the patient to a health-resort, in the hope of obtaining thereby
an improvement of some duration.

As to the method of balneological treatment, experience has taught
that the treatment must be different according to the causes of the circulatory
disorder. A case of weakness of the myocardium is to be treated differently from
such a case with arterio-sclerosis, and a patient with mitral insufficiency difterently
from a car j with insufficiency of the aortic valves. The degree of the circulatory
disorder is also, as mentioned above, decisive for the treatment.

If the bathing-cure shall be successful and any detrimentary influence shall be kept
from the patient, we have to supervise carefully the grave as well as the apparently-
light patients. It is with this kind of diseases far less practicable than with others,
to apply the baths schematicafly. As the baths, according to what has been said
before, have to be adapted to the individual case, not many general remarks can
be made about the mode of application. The temperature of the baths should not
be too high. In the most cases baths of 32'/o— 34" G. (89,8—93,2*' F.) are
indicated at the beginning of the cure. By and by, we try to lower the temperature.

purely physical one, and is to be considered merely thermal, due to the lieat-capacity and the heat-
conduction proper to the individual gases and salts.

We may here also make some remarks on the radioactivity of mineral springs, and its
significance especially for the treatment of circulatory disorders.

We do as yet not know much about the influence of radioactivity upon the human organism.
Various observers have seen good results in rheumatic aflfections of the joints by artificial radioactive
baths. We may consider it a sure fact or at least very likely, that radium-rays exert some influence
on the physiologic processes in the human body. But it is yet to be left to future researches in what
cases this influence is a favourable one, in what cast s an unfavourable one, for which morbid conditions
a powerful radiation, so to speak, and for which a weak radiation is indicated. But the fact is stated
that those springs which are of greatest repute in the treatment of cardiac diseases have but a slight
content of radioactive substances.

Diseases of the Heart — Di'iorders of Circulation 53

if it is borne well, down to 28 " G. (82,4 '^ F.), very seldom below this degree.
For patients with an increased blood-pressure the cooler baths are contra-indicated.
The duration of the bath must as a rule be the shorter, the cooler it is; we try,
however, to prolong the bath from 5 — 8 to 10 — 15, rarely to 20 minutes. The
baths rich in carbonic-acid allow a greater lowering of temperature, more than
other baths, as by the peculiar stimulation of the carbonic acid a sensation of heat
is produced, and the unpleasant effect of a cool bath is felt less distinctly. In
contradistinction to the ordinary baths, these baths do likewise not produce so
persistent a contraction of the cutaneous arteries and a subsequent stasis in the
venous circulation; on the contrary, we mostly notice a profuse redness of the
skin due to the stimulative effect of the carbonic acid, in s{)ite of the lower
temperature. This redness can only be explained by a dilatation of the peripheral
arterial blood-supply. This fact renders in part the carbonic-acid baths superior
to other baths in the treatment of circulatory disorders. The carbonic acid thermal
brine baths are particularly in favour, as their natural temperature is most of
all corresponding to the above mentioned degrees, and the most possible graduation
and variation of the baths can be attained. If in a given case the cardiac action
is to be alleviated, the salt- and carbonic acid content of the bath should not be
too high, and the temperature has to approximate the point of indifference.
A lower temperature of the bath and a greater content of ingredients stimulating
the skin give rise to a greater activity of the heart. In carbonic acid baths,
however, the vasodilatory effect of thi carbonic acid will always counterbalance the
last mentioned strain on the heart.

Since a few years the electric baths, especially the four-cell baths and
the alternating current baths have been recommended for cardiac affections. It is
sure that these baths in some cases do good service. But we must also admit
that in other cases no result is observed, and in some instances the patients have
even complained of disagreeable effects of these baths. We are as yet not able to
form a definite opinion about their effect or about an exact indication for these
baths. The principal source of errors in this mode of treatment is the lack
of an exact measure for the dosage of the current. We can as yet only rely upon
the subjective sensations of the patient during the bath.

As mentioned above, balneologic treatment in diseases of the circulatory
organs is frequently combined with mechano-therapeutics.

A special kind of this treatment, the so-called Oertel-Terrain cure is
frequently applied in some health-resorts and climatic stations — Terrain-cure
places. This cure consists in having the patient walk systematically and daily for
greater or smaller distances in the plain or on more or less ascending hills. The
results are particularly favourable in circulatory disorders due to obesity. As to
applying this cure for the treatment of other affections of the heart, especially of
valvular insufficiency with incomplete compensation, we still adhere to the reserved
and conservative point of view we have assumed from the very beginning in this
question. Oertel's cure should only be recommended for the treatment of the
above mentioned cases of circulatory disorder in general obesity or in adipous heart,
as long as no high degree of dilatative hypertrophy has developed; furthermore, in
insufficiency of the myocardium of anaemic patients with a general muscular atony,
but never in the severe forms of anaemia or soon after exhaustive affections. In
disorders of the pulmonary circulation and their effect upon the general circulation
due to difformities of the vertebral column, to pulmonary retraction or to emphysema,
an Oertel-cure may likewise be indicated and useful; finally, in some cases of cardiac
insufficiency, especially mitral insufficiency, if the disorder of compensation is in
the incipient stage, or if an almost statisfactory compensation has been attained by
other preceding cures. The greatest caution, however, and strict supervision of the
patients is required.

A similar kind of physical therapy in the treatment of circulatory disorders
is the method of gymnastics, often superior to the Oertel-cure, because it is not

54 Diseases of the Heart — Disorders of Circulation

strenuous, easily dosed, and frequently applicable when an Oertel-cure would be
impossible. On the other hand, we should like to avoid misunderstandings, and to
state that the Oertel-cure cannot be substituted entirely by gymnastics, and that the
former is to be preferred in circulatory disorders due to obesity, as it is decidedly
more effective than gymnastics, if its appHance is possible at all.

The method of gymnastics is divided into three forms— viz., the passive, the
active form, and resistance-gymnastics. The latter is of the greatest significance in
the treatment of cardiac afl'ections. It is carried out either manually — by especially
trained persons — or by appliances as have been deviced by Zander and Herz. They
are being applied nowadays in the large towns of Germany, at health-resorts, and
in the so-called medico-mechanic institutes. Gymnastics bring about an increase of
circulation in the exercised muscles. Tliereby the cardiac muscle in discharged of
the venous blood, and at the same time the arterial circulation is improved, and
the contractions become more vigorous. This strengthens and increases the
efficiency of the cardiac muscle. Active movements, especially the more forcible
exercises — overcoming a resistance — also furnish direct motor impulses to the
heart. Just as with baths, the gymnastic method may either be sparing (slight
resistance, passive movements) or training (strong resistance). If the prescriptions
of gymnastic exercises are only given under a careful consideration of the individual
conditions, and if excess and over-exerting the myocardium are avoided, we may
often obtain very favourable results, especially in an additional application of the
mentioned bathing-cures.

The results of Oertel-cures are, in the main, explained in the same way as
those of gymnastics. The curative effect is, however, also ascribed to other factors,
such as influence upon the respiration, perspiration etc., which here cannot be dealt
with in details.

Another method practiced frequently at health-resorts is massage, usually
applied as general massage. It is supposed to increase the circulation in the skin
and peripheral muscles, to relieve venous stasis, and to facilitate cardiac work.
Massage is frequently an aid to bathing-cures and to gymnastics, and is often a
substitute for the latter, if — as it often occurs — gymnastics are not borne well, or are
contra-indicated from the very beginning, as e. g. in higher degrees of arterio-sclerosis.

Pneumatic treatment — inhalation of compressed air in pneumatic
cabinets — is sometimes applied for circulatory disorders, solely or in connection
with bathing-cures. If the circulatory disorder is combined with i)ulmonary emphy-
sema, or if the latter is the cause of the former, the alteinating inhalation of
condensed air and exspiration into rarefied air may be beneficial. Oxygen-
inhalation has apparently only a transitory and symptomatic etfect in disorders of
circulation. Further experience, however, can only permit of a definite judgment
in this respect.

Concerning the withdrawal of liquids — a method recommended by
Oertel for the treatment of circulatory disorders — we wish to state here that
liquids, especially alcoholics, should always be ingested moderately by patients suffering
from heart-diseases, especially in the stage of disturbed compensation. It is also
very useful to reduce the intake of liquids in accordance with the output. This
will surely have the most favourable influence upon other cures. But if applied
solely, this metliod will almost always fail. For, in general, a thorough result can
only be obtained by the simultaneous application of several methods as mentioned
above (baths, massage, gymnastics, Oertel-cure) in connection with suitable dietetic
measures.

Milk-cures in the mountains, at places of not too high an altitude, are also
suitable for the treatment of heart-diseases, especially in concomitant albuminuria
(in secondary albuminuria due to stasis, as well as in primary albuminuria due to
chronic nephritis). As, however, the result obtained by this cure is, as a rule, not
satisfactory, other cures will have to precede or to follow.

Diseases of the Alimentary Canal and of the large Abdominal Glands 55

Climatic cures are applicable especially after having taken batliing-cures.
Patients suffering from the heart will in general do better at places with a mild
and uniform climate than at stations \v\ih a strongly stimulating one. An oppressive
atmosphere, particularly heat is, however, not agreed with very well. On this
account, a stay at the sea especially during the hot season (at places free from too
rough winds) and in the mountains, particularly in the medium altitudes of the
Alps, will be very profitable, chiefly after preceding bathing-cures. As a rule
patients suffering from the heart should never stay for a long time at places higher
than 3150 feet. This is in accordance with my own experience. But it is to be
admitted that such patients may occasionally do pretty well in higher altitudes, while,
on the other hand, altitudes of i2800 feet and below sometimes are not agreed with.
When selecting a place, we shall always have to consider the general irritability of
the nervous system.

This is particularly true with a class of patients that should be dealt with in the
chapter on nervous diseases, i. e. patients with a nervous irritability of the
heart (nervous palpitation, cardiac erethism. Neurasthenia vasomotoria, Neurasthenia
cordis). Removing the patients from their environments, and sending them to a
suitable climatic station may often be satisfactory (sea, Alps, the solitude of a forest
etc.). In other cases, cool natural-baths, cool brine-baths, and if a more powerful
stimulation is required, also carbonic acid thermal brine-baths of a low temperature
are indicated, but, above all, mild hydrotherapeutic procedures.

V. Diseases of the Alimentary Canal and of the Large
Abdominal Glands.

A. Chronic Catarrh of the Buccal Mucous Membrance (Stomatitis,

Salivation, Ptyalism).

By Dr. 0. Thilenius, Geheimer Sanitatsrat, Sorlen at the Taunus.

Chronic catarrh of the mouth is a complication of a chronic pharyngeal
catarrh, more frequently of other affections, such as syphilis, mercurialism, dyspepsia.
The treatment is, in the main, the same as for the primary disease. Stomatitis
usually being associated to a hypersensibilily of the mucous membrane, the
alkaline, and alkaline-muriatic springs are indicated. They are substituted
by alkahne sulphurated thermal-waters, if it is indicated by the condition of the
stomach or, above all, by the pretty frequent chronic obstructions.

The tepid and mild springs of the sodi um -chloride group also furnish
good results. Springs rich in carbonic-acid are, however, too irritative, and are
only indicated in inveterate torpid forms. Against an abnormal salivation, ptyalism,
being mostly a reflex symptom of chronic gastritis, of affections of the sexual
organs or hysteria, grape-cures have proved useful.

B. Catarrhs of the Stomach and Intestines, Nervous Dyspepsia
and Habitual Constipation.

By Professor Dr. Carl Dapper, Koniglich Payerischer Hofrat, Grossherzoglich Olden-
burgischer Geheimer Medizliialrat, Bad Kissmgen.
In no other group of diseases Balneothfrapy, as far as drinking- cures are
concerned, has, as we know, ever been of so great a significance as in the domain
of digestive disorders. We may safely slate that mineral cures in these aff actions
have become an essential and indispensable therapeutic factor. In practice, a good
deal of individual experiences and old traditions form a working basis, while the
scientific explanation of the therapeutic effect is still unsatisfactory. But, notwith-
standing, matters are comparatively favourable with regard to the scientific investi-
gation of the balneotherapy ot digestive diseases^ as a great number of problems is
open to experimental research in the normal and in the affected individual. Modern
methods of examining the chemistry of the stomach, and above all the investigations

56 Catarrhs of the Stomach etc. — Hydrochloric Acid Secretvm of the Stomach

on the reabsorption of food and the influence upon metabolism, have amplified
considerably our knowledge of the effect of mim^ral-waters. C. v. Noorden and
C. Dapper have shown in the cliapler ^Einfluss der Mineralwiisser aul den Stoff-
wechser) in tome 11. of the „Handbuch der Pathologic des Sfoflwechsels" (1907),
how much balneotherapy has profiled from these researches. In this book
the investigator will find a critical synopsis of all the facts. It is to be hoped
that progress will be attained in the direction pointed to in that book. But as yet
we are far from being able to explain scientifically all the empirical data referring
to the balneotherapy of digestive disorders.

Instead of compiling the indications for the individual affections it seems to
be more rational to discuss briefly the influence of medicinal-springs on individual,
and particularly important processes. It is, however, necessary to rely solely upon
the facts, and to neglect the theories.

1. Hydrochloric-Acid Secretion of the Stomach.

In a diminution of hydrochloric-acid secretion of the stomach due
to residues of an acute catarrh, to chronic catarrhs, to the abuse of
alcohol or tobacco, or to serious exhaustive affections of any kind the systematic
appHcation of weak sodium-chloride waters (0.5— 1.2 per cent.) has a distmct influence
upon the increase of the production of hydrochloric acid, and the total peptic
secretion of the stomach. The sodium-chloride water mostly taken on an empty
stomach, stimulates the gastric function, and this is favoured particularly by a slight
content ot carbonic-acid in the mineral-water. The effect is still more marked if
the water is taken cold instead of warm. The amount of this water should not be
too great. If in the main the hydrochloric-acid secretion is to be stimulated, it is
a mistake committed pretty frequently, to give as much sodium-chloride water as
would do to bring about the most thorough evacuation of the bowels. Regarding
the result it is not indifferent whether, in the individual case, the strong or the
weak sodium-chloride waters be given (in a concentration of 0.5 — 1.2 per cent.).
Strict indications can, however, not be given in this respect. Nor are we able to
state definitely how far small amounts of other salts contained in the sodium-
chloride springs are active in influencing the gastric mucosa. The radium-emanation
of such springs, however, seems to be of significance; at least the effect of increasing
the secretion seemed to be the strongest in sodium-chloride springs containing the
greatest amount of emanation. This is a further evidence for the old experience of
the better effect of mineral-water-cures at the springs themselves.

The experiments of H. Strauss seem to have given sufficient evidence that
according to an exact law% hypertonic solutions ingested into the stomach are
reduced to a lower osmotic pressure by a "diluting secretion", and are able to
stay in the stomach for a longer time than hypotonic solutions. The latter are
therefore "sparing" to the stomach, while hypertonic solutions are "irritative".
This was fully confirmed by recent researches of A. Bickel and others. Waters
with a freezing-point lower than — 0.6 '^' are, therefore, to be avoided in gastric
diseases associated with atony or a delayed emptying of the gastric contents.
For the rest it is most advisable to adhere to the practical experiences of balneo-therapy.

When treating suitable cases, and investigating systematically the objective
status of the gastric digestion by irrigations, one will be able to notice week by
week, and sometimes day by day, a distinct diminution of mucous secretion under
the influence of drinking cures. At the same time, the motor function of the
stomach is improved, the appetite reappears, and the various symptoms are lessened.
There are scarcely more grateful patients than these for drinkingcures.

Sodium-chloride waters have been a total failure in a hyposecretion of
hydrochloric acid due to Carcinoma ventriculi, and in that form of a depression
of gastric functions, which is designated as Achylia gastrica.

The question as to whether other waters similar to sodium-chloride waters
have a similar stimulating effect on the chemistry of the stomach, can be answered

Catarrhs of the Stomach etc. — Hydrocldoric Acid Secretion of the Stowacli r>7

positively for one group of mineral-waters usually not applied for gastric affections.
The waters referred to here are springs containing bicarbonate of iron and great
amounts of free carbonic-acid. Tliey use to be applied solely for chlorosis and
other forms of anaemia. But I wish to emphasize that in some forms of hypochlor-
hydria with gastric atony these waters may prove just as beneficial as sodium-
chloride waters.

Increase of hydrochloric-acid secretion. For the many various
affections associated with an increase of hydrochloric-acid secretion (hyperchlorhydria),
the alkaline waters have of old been preferred; above all, the alkaline-sulphurated
waters of the Carlsbad-group, and the purely alkaline waters of the Vichy-
and Neuenahr-groups. They are in repute of not only neutralizing the acid present
in the stomach, but also in a long continued use influencing permanently the
intensity of the production of hydrochloric acid, and this effect is said to outlast
the drinking-cure. These facts have indeed been confirmed clinically and ex-
perimentally, and can be proved again and again. Besides a thorough regulation of
the diet which is a matter of course in all gastric diseases, there is undoubtedly no
better means for combating certain forms of hyperacidity and its troublesome
complications. We mention liere. at the first place, the very frequent acid gastric
catarrh, occurring above all in people indulging in an irregular mode of life and
an excessive diet. We always find in these cases, in addition to the well-known
subjective gastric disorders, a profuse secretion of hydrochloric acid, especially very
high figures for the so-called excess of hydrochloric acid, a certain degree of atony
of the gastric walls, a delay of the emptying of the stomach, and a slowing of
intestinal activity. We may easily convince ourselves in these patients of the
distinct influence of the treatment by systematic irrigations of the stomach. As a
rule, the acidity of the gastric contents begins to decrease after a cure of about
8 days, and the complaints are less inten.se. These results are not only attained
by applying the springs at their place of origine, but also, as most of the authors
state unanimously, by home-cures. The treatment of acid gastric catarrh by
means of alkaline mineral-waters is only to be res ricted if a considerable degree
of gastric atony and a dilatation of the organ with a considerable delay of emptying
the gastric contents have developed. The patients have to dispense with drinking-
cures until these disorders have been relieved by a most careful regulation of diet,
by systematic irrigations of the stomach, and other measures. As to selecting the
proper water it seems to me that it is one-sided to confine oneself to the simple
alkaline and sulphurated waters, and at most to allow the waters of muriatic-
alkaline springs. There is a general prejudice that these mineral-waters do not
agree with the stomach. This may be true of some forms of gastric disorders.
For the treatment of the simple acid gastric catarrh the alkaline mineral waters are
to be mentioned in the first place.

The alkaline-waters (especially those of the Carlsbad-group) are not less im-
portant than for the acid gastritis, for cures after a successful treatment of a gastric
ulcer, if it is associated with hyperacidity, as it frequently is the case, l^'or the
treatment of a fresh gastric ulcer, on the other hand, or for exacerbations of
complaints due to a chronic gastric ulcer, other measures are assuming the first
rank, so much so that the simultaneous application of an alkaline mineral-water is
practically without any bearing on the condition. But in the later stages of
treatment more stress is to be laid upon the application of the waters by which
very often hyperacidity, delaying the recovery and favouring relapses, may be controlled
successfully.

Experiences on nervous dyspepsia associated with hyperacidity show
conclusively how erroneous it is to treat any form of hyperacidity with alkaline
mineral waters. Many authors have warned against sending patients of tliis kind
to Carlsbad etc. The gastric disorders are only improved transitorily, and the
general nutrition, the constitution and the nervous tone are deteriorated considerably.
But as soon as we depart in the mineral-cure of such cases from the scheme of

58 Catarrhs of the Stomach etc. — Hydrochloric Acid Secretion of the Sloinach

the so-called cure-diet (see below) and begin to adapt the latter more to each
individual case, for example by allowing an abundance of fat, butler, and cream
etc. in cases of a poor nutrition, the results will be very satisfactory. This opens
a new field of work and success to the stations with alkaline springs.

For neurasthenics suffering from hyperacidity the application of weak
cold sodium -chloride springs, in my opinion, seems to furnish better results
than the alkaline and alkaline-sulphurated springs. G. von Noorden stated this in
a lecture delivered many years ago at Homburg. He said: "There are numerous
patients with hyperacidity of the gastric juice who will be highly benelited by
prescribing to them the springs of Kissingen and Homburg. In such cases the
following could be observed:

If the meal was preceded by 200 to 300 ccm Rakoczy or Homburg Elisabeth-
quelle, the acidity of the gnslric ingesta on siphoning was found to be lowered,
and the complaints due to the production of acid were alleviated.

This favourable effect, indistinct on the first days, became more and more
marked in a continuous use of the sodium-chloride springs. The hyperacidity
disappeared, sometimes even a subnormal acidity was ob>erved after some lime.

If after a continuous application of the sodium-chloride water the hyperacidity
had disappeared, it did not reappear after omitting the prescription. I have observed
this remarkable result so often and so obviously, that I should not like to dispense
with sodium-chloride waters for combating some forms of hyperacidity, and I would
even designate systematic drinking-cures of this kind as the by far most powerful
agent for combating certain forms of those functional gastric disorders which are
so obstinate to treatment. To be sure, this favourable effect does not hold good for
all forms of hyperacidity. This is, above all, a symptom complicating the most
various diseases. My favourable results are mostly referring to young men suffering
from gastric neurasthenia with a hypersensibility of the stomach and a fear of
eating copious food. As a rule, the condition is complicated by a slight decrease
of the gastric motility. These pathologic conditions of the gastric function always
have an unfavourable influence on the general condition, and a rapid cure of the
gastric disorder is urgently called for. In this respect the weak cold sodium-chloride
waters are unexcelled. There are, bow-ever, other forms of hyperacidity that are
decidedly influenced very badly by the sodium-chloride w-aters. We mention here
above all, the hyperacidity of anaemic girls and the hyperacidity found in gastric
dilatations with a pyloric stenosis."

I was able to confirm these statements later by numerous clinical and
experimental studies (vide: ,Ueber den Einfluss der Kochsalzcjuellen [Kissingen,
Homburg] auf den Stoffwechsel der Menschen" by Dr. Carl Dapper. No. 5 of
Noordens Sammlung, klinische Abhandlung). How this effect, apparently contrasting
to the increase of secretion in hypochlorhydria, is brought about may be left
undecided here. The facts involved here are very complicated, as is demonstrated
by the fact that salt-solutions do not only influence secretion and the motility when
ingested into the stomach, but may also have a powerful influence upon the
emptying and secretion of the stomach (Cohnheim), when , eliminating the stomach
we injection the solutions into the duodenum. At any rate, we sliall have to
consider this fact in future in order to perhaps explain tlie contradictions. I am
able to add that the favourable results are not only limited to the springs of
Kissingen and Hrmburg, but also hold good for many other sodium-chloride springs.
The waters of Soden at Taunus and of Har/.burg (Krodoquelle) particularly have
been investigated clinically and experimentally.

In the mean time, some arguments have been advanced against applying
sodium-chloride waters in hyperacidity. There is, however, so little positive
material in favour of these views that they need not be entered in here. One has
also objected that the good results were due to a regulation of diet rather than to
the spring- waters. In my opinion, it is not correct to bring both these factors in
opposition to one another, for it is a matter of course in any mineral-water cure

Catarrhs of the Stomach etc. — Emptying of the Stom.ach — Intestinal Functions 59

to have at the same time the diet regulated and adapted to the individual case.
The question is, whether in a given case the proper diet is inlluenced favourably
by the simultaneous application of the spring. This is always the case, as I have
experienced again and again.

2. Emptying of the Stomach.

A good deal of attention is to be paid to the question, how mineral-waters
influence the emptying of the stomach. The exact experiments dealing with this
problem are chiefly referring to healthy individuals or to a great number of animal
experiments (Pawlows method). The results of these researches cannot be applied
to therapy without restriction. The experiments carried out under physiological
conditions, by Quincke, Jaworski, Kussmaul, Moritz, v. Mering,
H. Strauss, V. Bdnniger, Bickel, Meinel, Heinsheimer etc. have shown that
the temperature as well as the quantity, the content of mineral constituents and of
carbonic-acid are of influence upon the time in which the stomach empties the
ingested liquids or food. It is also of some bearing, how rapidly the water has
been ingested, what position the body is in, whether after drinking the water the
body was kept resting or in exercise. These matters, therefore, are extremely
complicated, and we can easily comprehend that many contradictory statements
are existing which can be traced back to discrepancies in experimental conditions.
In general the following statements can be made:

Small amounts of liquid stimulate the emptying of the stomach, larger amounts
inhibit it, and very large amounts again accelerate the emptying of the stomach.

Hot drinks are emptied more rapidly than cold drinks. A carbonic-acid
content of the liquid accelerates the emptying. The addition of small amounts of
mineral constituents of various kinds also brings about an acceleration of the
evacuation of liquids into the intestines. By a higher concentration, particularly
in the presence of sulphates, the evacuation is mostly retarded. The tonus of the
gastric wall is, as it seems, also greatly increased by mineral-waters, as experiments
at G. von Noordens' clinic in Vienna (A. Miiller and P. Saul) did show.

As mentioned above, these statements cannot be applied directly to morbid
conditions of the stomach, and no indications for the application of the mineral-
waters can be derived from these data. Experience has proved, that the common
spring-water as well as all mineral-waters applied in a cure, stimulate to the same extent
the motor efficacy of an atonic stomach, provided that they are taken on an empty
stomach, in small amounts, and that the disease is of a slight degree. It will certainly
be difficult to find out how far the curative effect is to be ascribed to the ingestion
of the water, or to a careful regulation of diet etc. At any rate, it is a well
established fact that spring-cures are a much preferred and approved means for
slight degrees of gastric atony. For practice the following waters come into
consideration: all sodium-chloride springs with a concentration of 1,5 — 1,2 per
cent., the simple alkaline springs (Vichy-group), the alkaline muriatic (Ems-group),
the sulphurated-alkaline (Carlsbad-group), the sulphurated springs, and bitter-waters.
The choice of one of these groups will largely depend on secondary conditions.

3. Intestinal Functions.

If we ask ourselves what we know about the influence of mineral-waters upon
the intestinal function, we must confess that, as a matter of fact, balneology has been
based in former times upon superficial data only. Nevertheless, it is surprising how
many conclusions have been drawn from superficial knowledge of the processes
involved. If we wish to come to an end, we have to separate sharply well-established
facts from theory and hypothesis.

Intestinal peristalsis. The most obvious effects are those on intestinal
peristalsis and on the consistency of the faeces. This was as a matter of fact the
only sure and unobjectionable experience at hand; for all that has been discussed
and broadly dealt with on the eifect upon the intestinal mucosa, upon the plethora

60 Catarrha of tJie Stomach and Intestines — Intestinal Functions

of this or that section, upon the nervous excitabihty of this or another part, upon
inflammatory processes at various places with particular consideration of the various
kinds of waters, all this could not stand the proof of scientific criticism. In other
words, we have, to be sure, command of quite a considerable amount of empirical
data concerning the balneotherapeutic influence on normal and pathologic inteslinal
functions, but we fail in explaining the mode of action in particular.

Disregarding all the theoretical conjectures in the problem, there is but one
fact of the utmost importance, namely that mineral-waters are applied for accelerating
the movements, for rendering evacuation more frequent, softer, and more fluid, and
for combating too copious and thin evacuations. Both the stimulation and the
slowing of peristalsis may be indicated from very different reasons, in very difl'erent
diseases, and under very different concomitant circumstances. Hence it is obvious
that there is scarcely any mineral-water as might not be applied under certain
conditions for regulating the formation and evacuation of faeces. It is, therefore
impossible to deal here with all the indications, and we shall confine ourselves to
stating the most important experiences.

In acute diarrhoea due to acute toxic or infectious enteritis, to gastro-
enteritis of various origine, drinking-cures are never indicated; only a transitory
application of purging mineral-waters may come into question.

In shght degrees of acute constipation, subsequent to catarrhal diarrhoea,
to slight gastric-catarrh, to changes in the mode of life, bitter- waters have been
applied of old with excellent result (in quantities of 1 — 3 wine- glasses, to the best
in the morning on an empty stomach); Hkewise some waters are in favour containing
sodium-chloride in the main (more than 1 per cent.), and in addition small amounts
of Glaubers' salt or bitter-salt. One cannot tell whether the one is to be preferred
to the other; if such is stated, it is mostly for advertising purposes. The frequent
use of these waters is not recommended, as the intestinal tract is easily accustomed
to them.

Chronic diarrhoea has four principal causes which necessitate entirely
different indications:

a) Chronic inflammatory processes on the mucosa of the large
intestine (intestinal catarrh and chronic dysenteria). It is a matter of
daily experience that drinking-cures are here decidedly successful. For a considerable
improvement or complete recovery (cessation of diarrhoea, raised tolerance for food-
stuffs, relief of subjective complaints etc., cessation of mucous catarrh) is often
attained if a mineral-water cure is combined with a careful diet, in cases which
have not been improved by a preceding very strict diet, and many kinds of drugs
without mineral-waters.

Various springs come into question in this respect according to the individual
case. As a rule, hot springs are chosen or the water of cold springs is heated
before being taken. The waters of the Carlsbad-group have proved best of all, and
among these, in general, springs of a lower content of minerals better than stronger
waters ; furthermore, the weak sodium-chloride thermal waters poor in carbonic acid,
the weak cold sodium-chloride springs (up to the concentrations of the Rakoczy of
Kissingen, heated before use), in part also indifferent thermal-waters (Ragaz-group),
and, as I wish to emphasize particularly, weak hot sulphurated springs (or cold
springs after being heated), furthermore waters containing lime, for example Driburger
Herster, and Caspar Heinrichquelle.

The cure consists mostly in taking 1 — 3 beakers in the morning. Some
patients may take in addition a small quantity in the afternoon or before going to
bed. The diet has to be adapted to the functional condition of the intestinal canal.

b) Next to inflammatory processes the nervous system plays an important
role in the aetiology of diarrhoea, which often occurs in the most odd form. The
very frequent "nervous diarrhoea" is a complication of neurasthenia, more rarely
of hysteria, and is not at all suitable for the above mentioned cures. On the
contrary, the latter may frequently deteriorate this condition. Much more stress is

Catarrhs of the Stomach and Intestines — Intestinal Functions 61

to be laid upon a copious diet strengthening the whole body and inuring and
training the intestines. Various kinds of baths, especially those rich in carbonic
acid, are very much recommended (no matter whether sodium-chloride or iron are
also contained in the water). If one wishes to allow a mineral water in addition
to these principal therapeutical factors, for the purpose of a suggestive influence,
the most suitable would be a weak sodium-chloride water.

c) For diarrhoea due to tumors, neoplastic or infectious intestinal ulcers,
amyloid degeneration etc., balneotherapy is not strictly indicated. In indivi-
dual cases, however, it may be desirable to maintain the hopes of patients
by such cures. The baths will then be chosen in accordance with the secondary
conditions

d) Diarrhoea in constitutional diseases. This occurs sometimes, and then
most obstinately, in morbid conditions of various kinds which usually are not
associated with diarrhoea, without our being able to state its cause. Such
diseases are for example various forms of blood-affections, especially leucaemia and
certain cases of chlorosis, gout, diabetes. One does well in such cases to apply
balneological methods according to the primary diseases, if local causes are to be
excluded. In such cases, e. g. in diarrhoea of chlorotics, often rapid and
excellent results are obtained.

Sluggishness of the bowels. The physician may frequently be asked to
improve bowel-movements without a true sluggishness of movements existing.
This is for example the case in numerous chronic affections of the respiratory
and circulatory organs, in abnormal deposits of fat obstructing the circulation,
in painful affections of the abdominal walls, in chronic affections of the sexual
organs, in proctitic, and periproctitic affections, above all in haemorrhoids with
a tendency to pain, haemorrhage, and the formation of fissures. These and other
allections which by themselves have no relation to the bowel movements may be
associated with a sluggishness of the movements ; but even if this is not the case,
a more active peristalsis, a softer consistency of the evacuated faeces may be desir-
able for the purpose of sparing the abdominal press and the parts adjacent to the
intestines. In this respect mineral-water cures have occasionally proved successful
(duration 3—4 weeks). The bowel movements are accelerated and facilitated at the
time of the cure; moreover, a permanent effect may be obtained if the cure is carried
out carefully. But of course the greatest caution is demanded, as the excessive use
of purging mineral-waters is almost always followed by a period of constipation.
For occasional and transitory effects the stronger bitter-waters will do (especially for
use at home); for the true drinking-cures the springs with a small and a medium
content of Glauber's salt compete with the somewhat more powerful sodium-chloride
springs (from the concentration of the Rakoczy upwards), the alkahne-muriatic springs
and the cold sulphurated springs being the most important, but the least considered
factors. Although in the above mentioned and in many other similar pathologic
conditions it is but a symptom that ismadetheobjectoftreatment, a symptom which is only
in loose connection with the primary disease, the patient is nevertheless often benefited
a good deal, because at the same time dietetic and hygienic measures are facilitated.

A second group of conditions of constipation is comprised under the term of
habitual constipation. We understand with this a sluggishness of the bowels,
not dependent upon morbid changes of the mucosa, the muscles, the intestines, the
muscles of the abdominal press, nor upon anatomical residues of other diseases, but
which are exclusively due to anomalies of the innervation of the large intestine.
This is a frequent consequence of irrational food, of lack of exercise, and of the most
various abnormal impulses of the nervous system. In habitual constipation in-
dependent of true intestinal diseases, it is not at all feasible to place mineral-water
cures in the fore-ground; chief stress is rather to be laid upon a regulation of
the entire mode of life, especially upon a proper selection and distribution of the
food -stuffs etc. Very often the question is ventured nowadays, whether it is not
at all wrong to have the patients go through drinking-cures. It would be entirely

f)2 Catarrhs of Uie Stomach and Intestines — Intestinal Functions

wrong to confirm this. Such patients are undoubtedly benefited very much by
occasioncal, not excessive drinking-cures (sodium-chloride waters, ailcaline-suiphurated
waters) provided that such cures are not repeated year by year as a matter of habit.
But as stated above, the cure should only be applied occasionally. In addition to
the springs quoted above and the dietetic and general hygienic measures, the
following factors co'me into consideration: brine-baths, carbonic acid brine, chaly-
beate baths, occasional mud-baths, alpine stations, the sea-coast, and among the potable
springs: the chalybeate waters.

Besides the so-called atonic constipation there is a second form equally
dependent upon the nervous system, not due, however, to atony, but to spas-
modic contractions of the large intestine. It is to a far greater extent than in-
testinal atony a complication of disorders of nervous function. Unless perhaps toxic
influences are the basis of the condition (saturnism), it is almost always the con-
comitant symptom of other neurasthenic and hysterical symptoms. Together with
a profuse secretion and a collection of mucus and with attacks of pain it con-
stitutes the peculiar morbid picture of colica mucosa*) Experience has shown
that for this affection mineral-water-cures have to be dispensed with (especially of the
Carlsbad- and Vichy-group). The weak sodium-chloride waters, and probably also
the alkaline-mineral waters are the only springs which enter into consideration and
are approved. Chief stress has be laid on the general and dietetic treatment for
which the numerous health resorts with their excellent hygienic conditions, their
copious food, and refreshing baths offer good opportunity.

The third group of the various kinds of sluggishness of the bowels comprises those
forms in which the abnormal formation and movement of faeces is due to residues
of anatomical affections of the intestines or the neighbouring parts, for
example former intestinal catarrhs with diarrhoea, dysenteria with scars and
atrophy of the mucous membrane, adhesions and dislocations of intestinal
loops by inveterate perityphlitis, hernia, or other similar peritonitic processes
of the most various origine, by parametritis etc. These kinds of morbid changes
or of residues present always necessitate care for a very regular and easy movement,
as any stasis being not only troublesome and inconvenient, as in the common habitual
constipation, but even becoming dangerous. Here is a very broad, most variable,
and grateful field for the different forms of balneologic treatment. Although we are
not able to analyse the processes bringing about an improvement, it is nevertheless
a fact that very many patients of this group cannot experience a more obvious
and permanent success — neither by a careful diet, nor by massage (gymnastics,
drugs) — than by cures in which the use of mild or strong purging springs is combined
with the use of mud-baths, brine-baths, chalybeate-balhs, carbonic-acid thermal
brines, natural springs and other hydro- therapeutic measures.

As in this chapter the diseases of the stomach and the intestines were dealt
with, the chief consideration was devoted to the internal use of mineral-waters.
It would be wrong, however, to neglect the other factors of balneotherapy at disposal,
besides the drinking-cure. Of course, the indications cannot be as precise as for
the internal use of mineral-waters. The diet (see belowO, staying out-doors, the
proper dosage of rest and exercise, the correct choice of altitude, of the climate
etc., play a great part in all journeys for recreation and recuperation; but parti-
cularly for the treatment of gastro-intestinal diseases chief stress has to be laid
upon baths, rubbings, douches, and applications of the most various kinds. With
the aid of these factors everybody who is familiar with the wonderful effects of
hydrotherapy will have favourable results in cures which otherwise would have been
a failure.

I should not like to conclude this chapter without mentioning my views on
the "rational diet of mineral-cures". To speak about this subject is most suitable at

*) See on this subject „Uebcr die Sclilelrakolik des D;irms (Colica luucosa) uiid ihre Bedeutung"*
by C. Noorden and C. Dapper (Bad Kissingen) No. III. Sammlung klinischer Abhandlungen von v. Noorden,
Berlin 1903. A. Hirschwald.

Gastrodynia (Nervous Gastric Pain), Chronic Gastric Ulcer 63

this place, where we are deahng with digestive disorders. Adhering to a definite
diet, requisite by the simultaneous use of a spring, has indeed been the subject of
criticism, and has even served as a laughing-stock; a systematic criticism, however,
has first been rendered possible by C. von Noorden's and my own material of
irrefutable clinical and experimental experience. The first point of argument was
that certain food-stuffs were banished from the table, if definite mineral-cures were
prescribed — I do not wish to mention names here. The food excluded was, in the most
cases, fat of various sources, especially butter, furthermore raw fruits, mostly all
kinds of vinegar, while, I dont know from what prejudice, in contradistinction to
vinegar, lemons were allowed in great quantities. The systematic elimination of
these stulfs is by no means justified, as I wish to emphasize especially with regard
to fat. Numerous clinical and experimental researches have been carried out in
this direction, and an enormous amount of practical experience has been gattiered
at health-resorts the physicians of which used to be radical in eliminating butter.
The proof found by us, that the use of sodium chloride springs and of alkaline-
sulphurated water is not a contra-indication for taking copious amounts of butter,
this proof is an achievement which is of the utmost significance for our health-
resorts. For if one would have found that the digestion of fat or that other intestinal
functions were considerably impaired by combining the use of mineral-waters with
a copious ingestion of fat, one was compelled to keep away from those health-resorts all
those patients whith whom, apart from the favourable influence on any local affection,
an improvement of the general nutrition is called for. It is a sure fact that an
improvement of nutrition cannot be attained if fat is eliminated, even if the ingestion
of albuminous bodies and carbohydrates is increased up to an extreme. There can
be no objection to ingesting fat or carrying out an overfeeding-cure based upon a
fat-diet. This broadens considerably the curative field of many mineral-springs.
We should also like to mention here our experience gained by exact metabolic
experiments, that a moderate use of the various springs does not impair the
reabsorption of food. Loss exceeding normal limits is only brought about if profuse
diarrhoea lasting for all the day has been produced.

A second point of argument is in relation to the first. We must not only
very urgently claim that the proscription-list for certain food-stuffs be discarded,
but also that at the health resorts the schematic mode of prescribing diets be
abandoned. The same scheme which is supposed to answer the requirements of a
mineral-cure is applied for patients with hyposecretion, and with acid gastric
catarrh, with nervous dyspepsia, with gall-stones, with renal calculi, with
chronic catarrh of the large intestine and with habitual constipation.
Not the morbid condition, not the individual conditions, but the spirit of the springs
is here the commander of the diet! Fortunately this schematic way of prescribing
is being more and more abandoned, and serious studies on dietetic therapy are
more and more considered the indispensable basis for a successful development of
balneotherapy. This is of the utmost significance, and will advance balneotherapy
considerably.

C. Gastrodynia (Nervous Gastric Pain), Chronic Gastric Ulcer.

By Dr. Jacques Mayer, Gehelmer Sanitatsrat, Berlin (formerly at Carlsbad).

The nervous gastric pain is not rarely mistaken for chronic gastric ulcer,
for a carcinoma of the stomach, gastritis, peritonitic adhesions, moveable kidney,
dislocatioiiS of the stomach (gastroptosis), and gall-stone colics. The most precise
diagnosis is, therefore, indispensable for determining the therapeutic method to be
applied. For the diagnosis we must, above all, bear in mind that this gastric pain
is entirely independent of pathologic organic changes of the stomach, and is solely
caused by functional disorders of the sensitive gastric nerves leading to an increased
irritability of the latter.

Gastralgia is always the result of a neurosis of the vagus. Idiopathic gasfralgia
which is independent of demonstrable anatomical changes as well as of motor or

I I Hyperaemia of the Liver, Catarrh of the Gall-passages, Jaundice, Gall-stones

.secretory neurosis of the stomach, is very rare, in contradistinction to the secondary
and reflex gastralgia. The latter is observed more frequently than the former, and
is in the most cases due to a primary disease as chlorosis, anaemia, dyspepsia,
anomalies of menstruation, uterine affections etc. Nevertheless, as much care
should be devoted to its diagnosis as to that of the idiopathic affection, since the
true causes of gastralgia are sometimes entirely obscure. The treatment should be
directed, above all, against the primary disease. If chlorosis, or anaemia are present
the use of chalybeate springs is recommended. The pure chalybeate springs are,
however, not borne very well. It is, therefore, advisable to drink the alkaline or
alkaline-sahne ferruginous waters warm and in small doses. The main object is
strengthening the total organism, which is often greatly advanced by applying
ferruginous, carbonic-acid, brine and mud baths. The same is, however, often also
achieved by a rational and systematic nutrition, perhaps by a milk-cure, by an
open-air treatment, if possible alpine or 'sea-climate.

If gastrodynia is a complication of dyspepsia the simple alkaline and
alkaline-sulphurated thermal-waters are recommended, and the simultaneous use of
baths (sodium-chloride, ferruginous or mud-baths) will be an essential aid to the
drinking-cure.

For the treatment of chronic gastric ulcers the simple alkaline thermal waters
are very beneficial, still more the alkaline-sulphurated thermal-waters, particularly
when taken in small amounts at different times of the day and of a medium
temperature. Particular care is to be devoted to controlling the increased production
of acid and to a proper evacuation of the chyme into the intestine, and far more
to a regular bowel movement.

Special attention must also be paid to a careful regulation of the diet during
the mineral-water cure. In selecting the food the hyperacidity generally coexisting
in gastric ulcers is to be considered especially. The meals ought to be small and
frequent in order to facihtate gastric digestion and to prevent exacerbations of the
complaints due to the ulcer. Combining the mineral-water cure with a milk-cure
is often very rational, particularly if the ulcer has relapsed. The motor function
of the stomach is improved, on the one hand, by using the springs in question
here, and on the other hand, under the influence of a systematic diet.

D. Hyperaemia of the Liver, Catarrh of the Gall-passages,
Jaundice, Gall-stones.

By Dr. Jacques Mayer, Geheimer Sanitatsrat, Berlin (formerly at Carlsbad).

Hyperaemia of the liver is met with in apparently healthy individuals of the
middle age of Hfe. It is the result of an indulging or sedentary mode of life, and
may be cured entirely by a rational diet and a powerful mineral-water cure. The
affection is, hos\ever, often not subject to treatment before a considerable swelling
of the liver has ensued. The stases in the portal system may then have grown to
a high degree, and in most of these cases a number of troublesome symptoms
become manifest, such as eructation, hypogastric |iressure as symptoms of a gastric
catarrh, bilious stasis, chronic constipation, and haemorrhoids.

In such cases indication is given for regulating the blood-circulation under
the most pos.sible consideration of the aetiological factors and the complications.
This is best achieved by alkaline-sulphurated springs, by sodium-chloride
springs, or bitter-waters in moderate quantities.

If the hepatic hyperaemia is the result of menstrual disorders or of affections
of the lung, the heart, the spleen, the springs mentioned above are likewise
indicated, provided that the nutrition is not too much impaired. Individualizing is
for such cases the main thing, and it is of minor significance which of the above
springs be used, than applying them cautiously and rationally. If the constitution
shows the features of relaxation or of scrofula, the sodium-chloride springs are to
be preferred. If, however, the hyperaemic liver is in an irritated condition^

Hyperaemia of the Liver, Catarrh of the Gall-passages, Jaundice, Gall-stones 65

characterized by tenderness to pressure, we may sometimes prefer the alkaline-
sulphurated tliermal-waters or the careful use of bitter-waters. In a considerable
plethora of the abdominal vessels, in advanced haemorrhoidal afi'ections the
sulphurated springs do good service. In the incipient stage of chronic hepatitis,
amyloid-degeneration, sometimes in carcinoma of the liver, the diagnosis may be
doubtful. The thorough exploration of the previous history of the case, of the
former mode of life and the duration of tiie disease will help considerably in
clearing up the situation. In such cases we would recommend the cautious use of
purging sodium-chloride springs, of alkaline-muriatic or alkaline-sulphatic springs for
relieving the congestion.

Fatty liver. It is mostly a concomitant affection of general obesity, and due
to the same aetiological factors. It is frequently also accompanied by other consti-
tutional affections as gout, diabetes, anaemia, or it arises as the result of pulmonary
affections, particularly of phthisis. In the former case the indications are analogous
to those for obesity. The alkaline-sulphurate'd springs are above all
recommended here, furthermore the sodium-chloride springs and the alkaline-
muriatic springs. The effect of these waters will be considerably increased by the
simultaneous use of mineral-balhs and medico-mechanic treatment.

If the fatty liver is complicated by gout or diabetes, the alkaline springs are
also useful besides these groups of waters mentioned above. If the fatty liver is
associated with a pronounced anaemia, wnth pulmonary affections, with higher
degrees of adipous heart or fatty degeneration of the heart, far more attention has
to be paid to the extremely careful use than to the choice of the springs. In a
good nutritional condition and regular bowel-movements small doses of the alkaline-
sulphurated or simple alkaline-thermal-waters are agreed with, and are just as
etficacious as sodium-chloride springs. Warm chalybeate water may also be very
succesful, especially after the preceding use of the former springs. Patients of
this kind may, to their great advantage, also take a climatic cure in a not too
elevated and well-protected alpine region.

Catarrh of the gall passages with jaundic|e may be due to various
causes. It is very frequently the result of a gastro-duodenal catarrh extending to
the mucosa of the bile-duct. Chronic hyperaemia of the liver and concretions in
the gall-bladder and gall-passages may hkewise very often bring about catarrhs of
these parts and subsequent jaundice.

The balneotherapeutic treatment of a gastro-duodenal jaundice is very little
different from that of the last mentioned. Above all, the alkaline- sulphurated
thermal- waters are to be recommended, furthermore the simple alkaline and
alkaline-muriatic springs, although the latter are somewhat less powerful than the
former.

If the condition is complicated by habitual constipation w-e may just as well
administer successfully the more energetically purgative sodium-chloride springs
as the alkaline-sulphurated springs. They are in many cases combined with
moderate doses of purgative salts.

For gall-stones the alkaline-sulphurated thermal waters are of
old of the greatest repute; but also warm sodium-chloride waters are very
powerful in diluting the bile and removing gall-stones. It is irrelevant whether we
assume that the concretions are due to stasis and the subsequent concentration of
the bile or to chemical processes of decomposition of bile preceding the formation
of stones, or whether we hold that, as has been made probable by recent
experiments, and as I also assume, a primary affection of the mucosa of the gall-
bladder, and a subsequent decay of mucous epithelium is the basis of gall-stone
disease. In any case the above mentionedsprings are indicated, and first of all, the springs
of Carlsbad. Theoretical considerations, and far more the thousand-fold experience of
physicians speak in favour of their use. The powerful effect of these thermal-waters
is most obviously demonstrated by the fact that in the majority of cases gall-stone
colics appear even after a short use of the waters, although it is to be admitted

66 Gall-stones — Diseases of the Spleen

that certain occasional causes, such as active exercise, energetic peristalsis etc. may
also be answerable for the occurrence of colics or the passage of stones. We can
explain the effect of the springs concerned here l)y assuming that the portal system
is discharged, that the compression of the blood-capillaries is removed, and that the
flow of gall is promoted after the constriction of the gall-capillaries has ceased.
The generally acknowledged results are not attained by stimulating directly the
secretion of gall by the livercells and thus increasing the flow of bile. Moreover,
the elfect of the water is to remove the mechanical and chemical obstacles to the
normal bile-secreting function of the livercells, to influence favourably the circu-
lation in the liver, and in the gastro-intestinal canal. The waters also dilute the
concentrated bile by influencing favourably the catarrhal and inflammatory processes
in these organs as well as in the gafl-bladder and gall-passages, and thus increase the
flow of bile. From this it is obvious that the passage of gall-stones is facilitated,
and a decidedly lithagogue (stone expelling) effect is to be ascribed to the above
mentioned springs, but not a cholagogue effect in a strict sense.

It is furthermore obvious that this lithagogue action may lead to a permanent
cure of cholelithiasis, the easier, the smaller the concretions are and the less the
danger is of permanent incarcerations of larger stones. But even in grave and
threatening incarcerations a favourable effect may be attained, if the stones are
passed j^er vias naturales or by the way of fistulae, without other deslrimentary
results.

The above mentioned powerful influence of the thermal-waters here in
question on the catarrhal and inflammatory processes in the gall-bladder, in the gall-
passages and on the property of the bile makes us understand easily why, even
without the passage of concretions, the disease may be latent and show no symp-
toms for many years.

The bahieological treatment is in grave cases of cholelithiasis not the only
thing to be done. Moreover, great care is to be given to the dosage and the
temperature of the springs, but especially to the diet. The use of the springs should
be omitted entirely during attacks of fever.

The condition of the stomach and intestines is in the course and termination
of gall-stone disease of a far greater significance than is generally supposed. We
only need to emphasize that the gall-stone colics are most frequently elicited by
disoiders of the gastro-intestinal canal. Chronic coprostasis does not rarely lead
to cholelithiasis. By combating this condition with cool springs we exert a
powerful influence on the flow of bile, we increase intestinal peristalsis, and at the
same time the muscular forces of expulsion in the gall-passages. We try to combat
the catarrhal papillitis, a transitory consequence of chronic constipation, and we
finally check the luxuriant growth of bacteria in the bowels. We should also not
under-eslimate the diuretic effect of the springs by which a more profuse excretion
of bilious substances through the kidney is brought about, and particularly in
chronic jaundice, the dangers of hepatargia, hepatic intoxication are more or less
prevented.

The concerned mineral-baths are applied in all the above mentioned forms
of diseases, according to general principles, as an aid to the drinking-cures.

E. Diseases of the Spleen.

By Dr. Jacques Meyer, Gelieimer Sanilatsrat, Iieilin (formerly at Carlsbad),

For the treatment of swellings of the spleen several forms of this affection
have to be considered. Firstly the congestive swellings, complications of diseases of
the heart, the lung, of valvular insufficiencies, of hepatic cirrhosis etc.; secondly
tumors of the spleen due to malaria and typhoid-fever or to amyloid degeneration
as a concomitant symptom of constitutional diseases, as syphilis, rickets, osteal
tuberculosis, and finally the leucaemic tumor of the spleen. Under all precautions
a mild mineral-water cure may be applied unhesitatingly for all congestive swellings

Diseases of the Uropoetic System — Chr(/nic Affections of the Kidneys 67

of the spleen. These cures will indirectly also influence the organs which are the
seat of the primary disease. The best are the alkaline-sulphurated springs
and the alkaline-muriatic waters. If the total constitution of patients suffering
from Malaria-spleen tumors is not too much broken down, the alkaline-
sulphurated springs are likewise recommended; but a chalybeate spring should
be used hereafter. In the opposite case the ferruginous sodium-chloride
springs or genuine ferruginous springs should be used at once, if possible combined
with mud-baths. The same holds good for swellings of the spleen being a residue
of typhoid-fever. Arseniate and ferruginous springs (Levico, Roncegno and others)
are often of an excellent result in cases of the latter type. The entire constitution
is often also most favourably influenced by a stay in alpine climates of not too high
an altitude. The stay in the mountains may sometimes be combined with thermal-
baths (Gastein, Wildbad, Plombieres), especially in individuals weakened very much
by a long sojourn in the tropics.

The balneological treatment of the spleen-tumors coexisting with the named
constitutional diseases is analogous to the treatment of the latter.

VI. Diseases of the Uropoetic System.

By Dr. W. Marc, Geheimer Sanitatsrat, Wildungen.

A. Chronic Affections of the Kidney.

Recent inflammatory conditions of the kidney are of course no object of a
balneological treatment. Patients with a very high degree of albuminuria, may it be a
genuine disease or due to cardiac affections, are likewise not fit for a health-resort.
They ought to stay in bed and should not be left without care at home or in a
sanatorium. It is, however, a fact known for a long time that hot baths with
subsequent packings and moderate sweating-cures will do good service in these
conditions. Such a treatment is particularly indicated if hydropic conditions have
developed.

Balneotherapeutic measures are only indicated if this disease has
advanced to a more chronic stage. We may then allow travelling to a health-
resort, and mineral-cures with alkaline and alkaline-muriatic springs are
indicated in the first line. In the most conditions of this kind the careful
stimulation of diuresis is usually very beneficial. It is strictly requisite to have the
patients under a permanent control, as not all of them agree with such a drinking-
cure. Many patients may show even in the chronic stage an increase of albuminuria,
and an aggravation of the morbid status which compels us to interrupt the drinking-
cure at once, and to . confine ourselves to the use of sodium-chloride baths or
natural baths.

If only hyperaemic conditions of the kidney are present, we recommend the
use of warm baths, that do not irritate the skin too much, of a temperature of
34—45° G (93,2—113" F), and, besides, a cautious drinking of simple alkaline
acidulous- waters.

In all cases the eventually existing primary disease, especially cardiac affection,
requires the utmost care. The nutrition and the general strength of such patients may
be improved by sending them to forest health-resorts of not too high an altitude, and
having them take milk- and whey-cures and drink alkaline-acidulous waters, in the
autumn also take grape-cures. In a very chronic course of the renal affection, with
slight hydropic symptoms, and a pronounced anaemia, the cautious use
of light chalybeate springs is indicated in small doses, to the best
distributed over the whole day. As experience has shown, the Wildungen
Vic tor- Quelle is of the most favourable influence. If carefully applied
this spring will improve the nutrition as well as the anaemic condition, it will regulate the
cardiac and digestive function and often do away entirely with albuminuria. The
effect of the Victor-Quelle is most favourably aided by carbonic-acid chalybeate baths,

68 Diseases' of the Sexual Organs

by the excellent forest-climate of Wildungen at an altitude of more than 1050 feet,
and by the opportunity for Oerlel-cures, if they are indicated for a disordered
cardiac function.

B. Chronic catarrh of the Bladder and of the Renal Pelvis.
Concretions in the Kidneys and Bladder.

In comparatively recent cases of chronic vesical catarrh , as long as pronounced
sensibility and frequent urinary pressure are still present, the alkaline and alkaline-
muriatic springs when taken in moderate quantities, will do good service. If the
irritation has subsided, we may pass over to a more copious use of the alkaline-
mineral springs. They exert an excellent influence on patients who are still able to
empty their blad'ders entirely. If this is not so, we should never allow taking
larger quantities of fluids, as this would increase the troubles of the patients instead
of lessening them. Of sodium-chloride waters we should at most only allow
the very weak acidulous waters with a slight degree of alkalinity.

The baths, especially hip-baths, are suitably applied as an aid to the cure;
but the greatest caution is requisite, as almost all patients suffering from vesical
affections show a tendency to colds. If the vesical catarrh has developed on a
rheumatic or gouty basis, or if at the same time a pronounced stasis is existing in
the abdomen or a habitual constipation, drinking cures with alkaline waters containing
lithia, or alkaline-sulphurated springs are indicated, in some cases also sodium-
chloride baths.

In a prolongued use of alkaline and mineral drinking-waters, great attention
is to be paid to the reaction of the urine. Alkalinity of the urine should never
occur. The excellent results of a direct treatment of the mucosa of the bladder
are known well enough, and we may dispense here with mentioning them
especially. At any rate, we should never omit this treatment if the drinking-cure
does not give a good result in a short time. In urinary gravel and concretions
in the kidney and bladder, above all, an exact determination of the chemical
composition of the concretions is demanded. Although in many cases dilution of
the urine and a thorough irrigation with warm water — the waters of natural
springs are the best for this purpose — are the main thing, it is more rational to
apply the alkahne waters for uric-acid and oxalate-concretions, and the alkaline-
mineral waters on account of their more diuretic action; for phosphate concretions
we should apply the simple acidulous waters. — Warm baths will be an aid to the
cure in all cases. They are particularly beneficial in kidney-stone colics.

The catarrh very frequently accompanying the concretions is to be considered
particularly. If the concretions are too large to be removed^ by a spring-water cure,
we must of course think of a suitable surgical treatment at the proper time.

VII. Diseases of the Sexual Organs.

A. Chronic Affections in the Sphere of the Male Genital Org-ans.

By Ur. W. Marc, Geheimer Siinitalsrat, Wildungen.
1. Chronic Inflammatory Affections of the Testicles and Epididymis.
The treatment of these affections by means of drinking- and bathing-cures is
in the main analogous to the treatment of chronic prostatic affections described
below. We only wish to add here that mud- and sulphurated mud-baths, as
well as local applications of mud and sulphurated mud, fango etc. are often
successfully applied.

2. Spermatorrhoea, Impotentia virilis.
These extremely important affections with their detrimentary effect on the
psychical condition and on the nervous system, and their bearing on the entire
constitution, require a very dillerent treatment according to their aetiology. In the

Diseases of the Sexual- Organs 69

first place the nervous system is to be considered. It will be our main object to
strengthen it and to revive the lowered spirits. According to the power of reaction
which is, as a rule, pretty exhausted, the patient will he benefited by carbonic acid
thermal brine-baths or chalybeate baths, in combination with drinking-cures of
carbonic-acid sodium-chloride or chalybeate springs, according to the
complications in the digestive organs. If a sufficient power of reaction is present or
has been regained, the hydrotherapeutic method, sea-baths and sea-climate
will give excellent results. A high degree of general asthenia and irritability of the
nervous system sometimes necessitaie a cure at natural mineral springs, especially
the tepid springs in a high altitude, or the sulphurated thermal waters at elevated
places. We must above all take into account that spermatorrhoea and impotency
are frequently the result of a previous gonorrhoea. We shall have to examine the
case, therefore, in this direction, and in positive findings begin a suitable treatment

3. Chronic Catarrh of the Urethra.

In general, the chronic catarrh of the urethra is not subject to balneotherapeutic
measures. As it, however, in most cases is associated with a catarrh of the collum
of the bladder, it is relatively often to be treated by the bathing-physician. — The waters
recommended above for the treatment of vesical catarrhs, are also here applied,
and they Influence the affection most favourably. — But as a rule it does not yield
solely to the use of mineral-waters, and requires a rational local treatment for a
definite cure.

Although this can be carried through by any surgeon, we cannot deny that
this disease affecting also to a great extent the entire nervous system, will be more
favourably influenced at health-resorts with physicians especially trained for the
treatment of this disease, when the patient is at the same time removed from his
customary occupation, and is living solely for sake of his good health. — If a
vesical catarrh is not associated with chronic gonorrhoea, if there is only a
mucous discharge free froom pus and cocci, a cold-water cure is indicated above
all, in addition to careful local treatment.

4. Affections of the Prostate.

Swellings and indurations of the prostate occur as symptoms of senility or as
a result of infections of a gonorrhoeal, tuberculous or syphilitic nature. In the
latter case an antisyphilitic treatment is to be carried through above all. As the
tumor, however, often does not yield to the treatment, it is often treated with
brine-baths, especially baths containing iodide or bromide, and also by the
internal use of iodide drinking springs, unfortunately not always successfully. If
the affection is of a tuberculous nature, the just mentioned treatment is also justified,
the more so as direct treatment is always unsuccessful. In these cases the sensiti-
veness of the external skin is to be considered carefully, and if the condition of
the skin is satisfactory, above all that of the scrotal skin, local applications of brine
or iodous water may be used in addition.

The chronic inflammation and swelling of the prostate may be complicated
by a vesical catarrh or a catarrh of the renal pelvis. These complications may be
due to previous gonorrhoeal affections of the posterior part of the urethra, or they
may result from an incomplete emptying the bladder and a subsequent decom-
position of the urine. In all these cases the treatment is the same as stated above
for vesical catarrhs. Simple mineral- or bathing-cures, however, will in such cases
not furnish a favourable result, if the bladder is not emptied by catheterism and
thorougly disinfected by irrigations. — Of an excellent influence are the iodous
brine- baths, prescribed best of all in form of tepid hip-baths. The senile swelling
of the prostate requires the same treatment, althrough, unfortunately, balneotherapy
cannot be of an essential value in this respect.

70 Chronic Diseases of the Female Genital Organs

B. Chronic Diseases of the Female Genital Organs.

By Dr. Bardach, Bad Kreuznach.

In all chronic diseases of women with very few exceptions, balneotherapy
plays a considerable part, and not many health-resorts can be found in which
diseases of women do not find a broad field of indications. This is so for good
reasons, since every bathing-place has the effect of stimulating and modifying
metabolism, of raising the capacity of the organism to eliminate pathogenic
substances and deposits, and strengthening it. These are in particular the indica-
tions which have to be answered in the treatment of diseases of women. There-
fore, undoubtedly all kinds of baths are indicated for the latter. They may be
applied most advantageously; some of them are, however, particularly distinguished
by being especially powerful, and are of old in great repute. We speak, of course,
of those which exert a more powerful influence upon metabolism and the reabsorptive
functions of the organism.

As balneological treatment in the disease here referred to is of great impor-
tance, it might be useful to make some general remarks before entering into the
discussion of the individual forms of diseases. There was a time, less than one
generation ago, when the conscientious and experienced physician at a health-resort
confined himself to treating the patients under his care in the traditional way
sanctioned by long exi)erience, i. e. he applied the spring in its various modes of
application and, for the rest, dispensed with any direct treatment of the disease, or
restricted himself to the very necessary things. This has become different nowa-
days. Very often the springs with their diflerent modes of applicalion and the other
curative factors of a health-resort are simply applied as auxiliaries to a local treat-
ment, chief stress being laid on the latter. Both ways do not lead the right tract;
formerly to little, nowadays too much is being done. Many a case that might have
been cured more smoothly and rapidly if in addition to the baths etc. a rational
gynecological treatment had been carried through, required formerly much more
time for a cure. This does, however, only hold good for a small number of cases;
— in most of the cases such a rational treatment had preceded for some time,
generally with an incomplete result; and it was surely better to have the
patients be benefited by the other powerful curative factors, mental and bodily
rest, enjoying the fresh air as much as possible, and to quiet and strengthen the
nerves irritated by too long and annoying a treatment.

Nowadays, the physician practising at a health-resort considers it his duty,
unfortunately too often, to apply, with the patients under his care if possible, all the
factors that might appear suitable for combating the affection, no matter whether
equal or similar - means had been applied before or not. It must appear very
doubtful whether the patients are benefited hereby. I should not like to be misunderstood.
I do not suggest that the physican should confine himself in all cases strictly to applying
the curative factors. There wih always be cases enough, in which a systematic
gynecological treatment will be indicated in addition to the cure, and very frequently
patients are sent by their consulting physicians just for this purpose to the
colleagues at health-resorts who are experienced in these things. What I wish to
combat is the uncrilial application of gynecological methods in every case
especially of methods that are en vogue at present. What a nuisance is nowadays
the gynecological massage in many instances? In my opinion a gynecological
treatment should only be combined with the bathing-cure if alter a due exploration
of the given case the physician expects from this combined procedure an abbre-
viation of the cure.

We scarcely need to emphasize especially that bathing-cures are only indicated
if we have to deal witli chronic conditions. As long as the process is acute
powerful baths are contra-indicated, and in the extreme case only simple tepid
baths are allowed which may be taken at home. On the other hand, it is
not advisable to begin a bathing-cure too late, as it is a sure fact that a result

Chronic Inflammations of the Uterus and the Adnexa 71

will be obtained the more rapidly the more recent the case is. It is often not
very easy to detemnine the time when to begin. We may in general state that a
bathing cure may be inaugurated, and mostly should begin, if the patient is able to
stand all the troubles and fatigues of travelling witlioiit fear of a relapse. The kind
of treatment indicated for the individual case can in general scarcely be fixed.
Yet in most ol the cases the external application of the springs will have to be
combined with an internal cure or at least with any other solvent water stimulating
the intestinal function.

It is obvious that in cases which have frequently persisted for years, a bathing-
cure of a short duration cannot be successful. The longer the morbid condition
has existed, the more the patients are broken down, the more time is required.
The duration of the cure is mostly fixed for too short a time; six to eight
weeks are almost always necessary in order to get a good result. It is up to the
consulting physicians to give more attention to this point, and to prepare their
patients for a longer duration of the cure.

We scarely need to emphasize particularly that patients who have to go
through a strenuous cure should abstain entirely from bodily exertions and
excitements during the cure, and should not take part in the life at a health-resort.
A permanent stay in the open air, moderate out-door exercise are necessary, and
on the other hand, exerting walks as well as enjoying the entertainments may
interfere with the good effect of the spring.

After the cure the patient should, if such is possible, not immediately return
to her home where all the secret detrimental influences are threatening her; she
should go through an after-cure for some weeks, or if that is not possible, at
least for eight days. This after-cure may be had at any place where the air is
good, the living comfortable, the food satisfactory, arrd society pleasant. It is in
general irrelevant whether there is more or less forest, whether the place is situated
some hundred feet higher or deeper. The patient should live quietly at this place,
and should not try to compensate the long lasting rest at the health resort by
taking part in amusements or in fatiguing excursions.

If the patient cannot afford to go through an after-cure, which for obvious
reasons is unfortunately true in the majority of cases, the physician should insist
upon having this after-cure carried through at home. For this purpose it will often
suffice that the patient spares herself for some weeks, stays in bed for a longer time,
avoids fatigue, society-life, in brief that she returns to her former mode of life but
slowly and gradually. This is a point of strict attention. Disobedience to this old
rule is only too frequently to be blamed, if the patient and the physician did not
get the result of the cure which they otherwise were fully justified to expect.

1. Chronic Inflammations of the Uterus and the Adnexa.

By this designation Ave understand those morbid conditions which are
usually denominated as metritis, endometritis, peri- and parametritis, oophoritis,
salpingitis, pelvic cellulitis, pelvic exsudate. They are frequently found associated
with one another, being due to the same cause and open to the same treatment.
Hence it seems correct to deal with these conditions in common. This is, however,
not the place to enter into the nature, the causes etc. of the various affections.
Here, before all, we are only interested in the question, how far these conditions are
an object of balneological treatment. From this point of view it will be necessary
to enter briefly into the causes, and also into their influence upon the total organism
as this often gives the direction for the treatment.

As in all these affections the question arises of removing the pathologic
products, all those springs will come into consideration here by which the reabsorptive
functions of the organism are stimulated. In selecting these springs the chief point
w^ill, however, be -what condition the general organism is in, w^hether a morbid
disposition is existing, how the general strength is, and furthermore, how far the
other organs of the body have been involved.

72 New-G roicths of the Uterus and the Ovaries.

We may establish tlie general rule that in all these affections brine-baths are
above all iudicated, the simple ones as well as those containing iodine or bromide.
Mud-baths assume the same rank, likewise natural-baths and sulphurated thermal
waters, if there is a pronounced irritability. 'I'he choice of one of these battis is,
above all, dependent u|)on the factors mentioned above.

If in these affections the body is otherwise healthy, showing no mark of mor-
bid disposition and being as a whole not very much involved by the affection, the
powerful brine-springs are indicated, in the first place those brine springs which
can be optionally made more powerful by the addition of mother-lye rich in bromine
and calcium-chloride. If individuals are concerned that were or still are scrofulous,
a complication found pretty frequently and unduly delaying the cure, it will be of
importance which form of scrofula, whether the torpid or the erethic form are
existing. In the former case we may apply the most powerful brine-springs, while
in the latter case weaker springs as well as carbonic acid sodium-chloride thermal-
waters will be more suitable. If a gouty disposition is the cause of the delayed
reabsorption of pathologic products, the springs active for gout are recommended,
in a tendency for putting on fat, the alkaline-sulphurated waters are indicated.
If chlorosis and anaemia are coexisting the ferruginous mud-baths as well as the
ferruginous acidulous-waters are indicated, the latter more for after-cures after the
recovery from the jirincipal symptoms.

If symptoms of the nervous system are more in the foreground, the natural
mineral-baths come into question in the first jilace, but, in addition, weak brine
thermal-waters and sulphurated springs may be of advantage. The application of
these waters will have to precede the use of stronger brine-springs instead of being
applied first as is often prescribed, if considerable residues of inflammation have
yet to be removed. Sea-baths and climatic cures can only enter into question for
after-cures, and they are only indicated if the process of reabsorption has terminated
or is at least steadily progressive.

The choice of the springs will furthermore depend on the condition the other

organs are in, especially on the function of the intestines. If, as pretty often, a

■great tendency for constipation is existing, the more solvent springs, the saline

purgative waters or alkaline sulphurated springs will he recommended for an

internal use.

In the first place baths are active and applied. The more inveterate the
process is, and the more resistant the patient, the stronger the bath may be, and
the longer its duration.

But besides all the other modes of applying, springs are prescribed to a
great extent, such as wrappings, douches, and especially the prolongued hot douches,
up to 50" G (=122"^ F), which is easily borne while in the bath. Steam-baths,
especially those "with brine-steam, have proved particularly powerful means for
reabsorption.

The internal use of the springs will considerably support the external
application, provided the springs be suitable for drinking-purposes.

2. New-Growths of the Uterus and the Ovaries.

There are many controversies nowadays as to the question whether fibromy-
omata of the uterus — we have to deal with these in the first place — are at all in-
fluenced by internal or external means, or by a balneological treatment. The most
that is admitted by some authors is an influence upon the general condition and
upon the regulation of the circulation. This must be strictly refuted. It has been
proved undoubtedly by a broad experience that in many cases, perhaps in all of
them, the tissue of the tumor itself is indeed influenced. It cannot be con-
ceived theoretically why this should not be so, as the possibility of reabsorption is
given in a uterine fibromyoma, though the conditions are here quite unfavourable
on account of the scanty vascularization and the narrow juice-canals. We cannot
understand why a reabsorption should not take place under favourable conditions.

Chronic Catarrhs of the Vagina and the Uterus 73

A demonstrable reduction in size of the tumors has undoubtedly and nol infrequenlly
been observed, also a delay of growth for a considerable length of time.

But, of course, we must admit that this action upon tlie tumor is not the
most striking effect of the cure; it is rather tne influence on the general condition
which is greatly improved, and on the symptoms, such as sensation of pressure, pain,
haemorrhage that becomes manifest. With the exception of a few cases we may
always be sure to improve the general condition of the patient by a sufficiently
long bathing-cure, to stop haemorrhages or at least to reduce them considerably, and
to relieve jtain and pressure. The effect will, of course, in every case be different
and depending upon the individual conditions.

Besides the effect upon the tissue of the tumor itself, we can also notice an
influence on the hyperplasia and thickening of the uterine tissue, in the neighbourhood
of the tumor, and Ibis is unanimously admitted.

The springs to be applied for the treatment of uterine tumors are almost ex-
clusively the strong brine-waters, above all those containing iodine and bromine, with
their strong lyes containing calcium-chloride. Mud-baths are less recommendable,
and they should only be applied very cautiously, especially where there is a tendency to
haemorrhages. For such cases the strongest baths, cool and prolongued are borne
well, and should be taken frequently. It is surprising that often anaemic and very
weak patients agree best of all with these baths. Besides baths, douches, strong
applications of mother-lye etc. are indicated.

For an after-cure chalybeate baths as well as climatic stations are useful,
mountain- and sea-climate especially after an exerting bathing-cure. Sea-baths are
contra-indicated if there is the slightest tendency to haemorrhages. Other tumors,
above all ovarian cysts, are no object of a balneological treatment. This
must be emphasized here, as patients with such tumors are still being sent to
health-resorts. The same is true of carcinomatous affections for which bathing- cures
are highly detrimental.

3. Chronic Catarrhs of the Vagina and the Uterus.

The balneological treatment of chronic catarrhs is dependent upon the cause
of the disease. The most various conditions may be answerable, as for example
scrofula, chlorosis, anaemia etc., or it is a concomitant symptom of other affections
of the uterus and its adnexa. In all these cases the treatment of the catarrh will
be analogous to that of the fundamental disease, and only local applications, hip-
baths, douches etc. will be added.

For cases in which we have to deal with a simple catarrh the alkaline-
muriatic springs, therefore, will be indicated. If the catarrh is a complication of chlorosis the
ferruginous springs are indicated; invigorating forest- and alpine-climate, and last
not least, the sea-climate are very benefical for a principal as well as an after-
cure. One should, however, take care of not taking cold and prolongued sea-baths,
especially in a delicate constitution. A too much rarefied air is also not borne well
by many anaemic patients. Douches should only be applied very cautiously, baths
but shortly and not warm. In an extreme irritability of the nervous system the mild
brine-baths, perhaps better the natural baths are indicated. If scrofula is existing,
this condition is to be treated above all; the catarrh will then often disappear
spontaneously.

In catarrhs of the cervical canal and the uterine cavity we shall mostly not
get along without a local treatment. The latter is, however, considerably aided by
a balneological treatment, combating the primary disease. In a tendency to obesity
the saline-muriatic springs are in order, and the sodiumchloride waters, if consti-
pation is coexisting.

Specific catarrhs are, of course, subject to a specific treatment; yet they may
be considerably improved by a bathing-cure. The strong brine-waters are especially
recommended for such cases.

74 Anomalies of Menstruation — Sterility

4. Anomalies of IHenstruation.

Amenorrhoea. If this condition is not due to anomalies of the uterus or
of development, it is mostly the result of constitutional disorders, scrofulous or tuber-
culous predisposition or a high-degree of chlorosis, sometimes also of obesity. In the
latter case the primary diseases are to be treated, and for this purpose the above
mentioned springs enter into consideration.

The general measures for strengthening the patient should, however, not be
neglected, such as staying in a refreshing and stimulating mountain- and forest-
climate; alpine stations are also very beneficial. Sea-baths are extremely efficacious,
or rather the sea-climate, as cool sea-baths are only to be taken very cautiou.<ly,
and under a thorough consideration of all conditions. If amenorrhoea is the result
of local anomalies of development of the concerned organs, it is obvious that these
disorders should above all be cured, if possible. Balneotherapy can only influence
this condition indirectly. Besides carbonic-acid brine-baths, ferruginous- and
ferruginous mud-baths have proved effective, in nervousness particularly the
indifferent thermal waters ; for an after-cure sea or alpine climate. In some
instances a not too powerful hydropathic treatment with or without massage,
gymnastics, bicycling etc. may be very beneficial.

Menorrhagia. By far the most cases of this kind are due to affections of
the genital organs, and the treatment is analogous to that of the primary disease.
Menorrhagia is but rarely the result of a general morbid condition, of scrofula,
chlorosis, gout, plethora, general weakness etc. In these caseS; too, the treatment
of these conditions is the main thing. Special attention is to be paid to the
haemorrhages occurring pretty frequently during the climacteric period. The
haemorrhages are sometimes symptoms of constitutional anomalies, and not rarely
of a plethoric condition; if so, the alkaline-sulphurated springs are indicated in the
first place. The greatest care" and the most thorough supervision of the patients
are always requisite, in order not to overlook a malignant disease.

Dysmenorrh oea is rarey met with as a genuine disease; it is mostly the
symptom of some other morbid condition. But is does not rarely occur without
any demonstrable changes, particularly with young girls at the age of development
or even later. In these cases we may perhaps blame an abnormal irritability of
the genital nerves. Such conditions are, above all, beneficially influenced by
indifferent thermal waters; sea-baths, hydro pathic treatment may be indicated
combined with the rational application of gymnastics.

5. Sterility.

This is probably always the result of a pathologic condition of the genital
organs, and no 'genuine disease. There is. however, quite a number of cases in
which the most thorough and painstaking examination does not reveal any anomaly
or pathologic alteration. We are then compelled to assume some anomaly in the
Organism against which our treatment is to be directed.

Syphilis is not very rarely the cause of sterility, even without any manifest
symptoms. Much more frequently gonorrhoea can be ])roved, or rather the
sequelae of this disease which are so hard to be treated. But pretty often
balneological treatment may be successful here. The sodium-chloride springs
containing bromine and iodine are especially recommended for these cases. Let us
never forget that the true cause of sterilily is pretty frequently to be looked for in
the man, instead of in the woman. We should, therefore, in such obscure cases
always examine the husband thoroughly before subjecting the wife to a
thorough cure.

In sterility due to weakening influences the well-known and repeatedly
discussed remedies are to be applied.

The tendency to habitual abortions is often a grateful object of
balneological treatment, as the essential cause of this condition is to be looked for
in a weakness of the organism, if not local causes are interfering. We have to

Chronic Bheumatism of the Muscles and Joints 75

consider most thoroughly and painstakingly all the conditidiis before deciding about
the best that can be done. We must always bear in mind that Ihe condition
frequently depends upon a latent or manil'est syphilis. A thorough inunction-cure
combined with very powerful molher-lye baths containing calcrum-chloride are often
of a striking effect. The husband has to undergo the same treatment.

Before concluding this chapter I should like to consider with a few words
the question whether a bathing cure is to be allowed if pregnancy is existing. If
there is an inclination for abortions, we shall, of course, dispense with a cure, and
as, with a primipara, this is an open question we shall have to be very careful.
A healthy pregnant woman may, however, unhesitatingly undergo a bathing-cure, at
least in the first months, if the cure is not too strenuous. This will, however, only
be recommended, if there is a definite, urgent indication for a cure.

VIII. Chronic Rheumatism of the Muscles and Joints.

By Dr. Jimil Pfeiff'er, Geheimer Sanitatsiat, Wiesbaden.

According to all the experiences made hitherto the external application of
heat combined with a powerful stimulation of the cutaneous function and the pro-
duction of profuse perspiration, is the most efficacious means among all the methods
as yet known for both these forms of chronic rheumatism.

We apply accordingly balneotherapeutic warm baths, preferably the natural
warm baths of all groups of mineral-waters.

Whether one should apply the natural springs or the sulphurated
thermal waters, the brine-baths, carbonic acid thermal brine-waters,
or should have recourse to mud- and fango-baths, or finally to pine-needle
baths, to baths of a higher temperature in form of Roman-Irish-, of Russian
steam-baths, of warm sand-baths, hot air and electric-light-baths, all this is
merely depending upon the consideration to what extent the skin and the total
organism will be able to react to thermal stimuli.

For the purpose of attaining the required increase of the cutaneous function,
we may perhaps add mechanical stimuli, such as massage, electricity, douches.
The latter which we use to apply as an auxiliary to bathing-cures, should only be
given with the utmost caution, as the cold as well as the hot douches ate very
powerful irritants which may very easily produce an increase of the irritative
condition uncalled for in the affected part. The mixed (Scotch) douche is
relatively the least irritant and, from this reason, very much recommended, parti-
cularly for chronic articular rheumatism. The local application of mud- and fango-
packings, wrappings in sand, hot-air baths are used to a great extent with satis-
factory results; hkewise electric fight-radiations, hydrotherapeutic packings etc.

In rare instances only, with individuals that are still pretty resistant, hydro-
therapeutics may be applied from the very beginning, experience having shown that
cold irritants are badly agreed with, if symptoms of rheumatism are still manifest.

To the drin king-cures themselves a special curative effect on chronic
rheumatism cannot be ascribed. They are, however, always of great value for
combating complications in individual organs or for influencing the metabolism in
general. We shall accordingly choose the one or the other group of springs. For
drinking-cures the simple acidulous-watei's, the sodium-chloride springs, as wefi as
the alkaline-muriatic springs may be used unhesitatingly; on the other hand, all the
purely alkaline waters, as well as alkaline-sulphurated and alkaline-mineral springs
should be avoided, as they would increase the alkalinity of the body-juices, which
is anyhow abnormally strong in chronic rheumatism. As a result of this, phos-
phaturia would be increased by taking these waters, and the disease would grow
worse.

For choosing an individual health-resort, the location, the chmate, and the
season are also decisive factors; in winter, for instance, more protected
places, in the hot season more elevated natural baths etc. will be preferred.

76 Diseases of the Nervous Sydem

Unfortunately the balneotherapeutic methods result very rarely into an actual
recovery; but quite a considerable improvement, often almost a recovery may be
attained, or, let us state more correctly, an intenniltence of the rheumatic
complaints. The bathing-cures have to be repealed consequently every year, or
even every half year.

Nevertheless, a good number of cases will be under the permanent influence
of the weather, will be prone to relapses of the rheumatic affections, especially of
the pain which becomes usually manifest before the occurrence of a change of
weather.

For that reason it seems to be very important to try an inurement by hydro-
therapeutic procedures, if ])ossible even by means of sea-baths, staying in an
invigorating climate (alpine or sea-climate), for the purpose of an inurement
against external influences, and of combating the asthenic condition of the skin;
these attempts for inurement should, however, not be made before the after-effect of
thermal-balh cures, i. e. before the 6 th to the 8 th week after terminating a thermal-
cure. These attempts should even be omitted entirely as long as distinct inflamma-
tory or painful swellings of the joints are present. In such cases simply staying at
the sea or in the mountains may even be very injurious. For patients of this kind
a stay in sunny regions protected against winds in the summer, or the south
(Italy) in the winter, are most suitable.

The nature of rheumatic affections of the joints and their complications
calls for surgical interference in the majority of cases.

The same therapeutic measures as for chronic rheumatism are recjuired for
rheumatic diathesis, i. e. the inclination to frequent acute affections of the muscles
and joints, for example the inclination to acute articular rheumatism, lumbago etc.
In these cases, too, we try to combat the rheumatic diathesis by thermal cures, and
to prevent a relapse of the attacks by inurement.

For articular- and osteal affections of a non-rheumatic nature,
in the main, the same mode of treatment is to be applied as has been stated before.
As far as constitutional factors, such as scrofula, rickets, syphilis or gout are concerned,
the kind of drinking- or bathing-cures to be applied is conform to the special indi-
cations given by the primary disease.

For chronic osteal- and periosteal inflammations of a traumatic as well
as of a constitutional origine, a special curative effect is often attributed to the internal
and external application of iodine-waters or brine-waters containing iodine.

After the healing of gunshot-wounds or other kinds of traumatism of the soft
parts as well as of the bones, swellings or exsudates into the tissues of the soft parts,
of the bones, and joints are often persisting, and also a certain degree of general
irritability of the entire nervous system. The thermal baths, especially the
natural baths and the simple as well as carbonic acid brine thermal-waters, furthermore
general as well as local brine- and mud-baths (fango) have proved most efficacious and
favourable in almost all of these cases, and even after years.

IX. Diseases of the Nervous System.

By Dr. Fr. W. Voigt, Geheimer Sanitatsral, Oeynhauseu.

A, Some General Rules

for the treatment of diseases of the nervous system by bathing- and climatic cures.

1. As with all diseases, we should also with those of the nervous system
try, above all, to satisfy the indicatio causae. From this reason we should in
the cases where the real or only probable cause of the disease may have been
recognized, choose those health resorts, above all, which, as experience has shown,
are able to influence favourably that cause by their particular curative factors.

2. The choice of a health-resort does not only depend on an exact diagnosis
of the case, important as it were; just as important, perhaps in many cases still

Cerehral Aff'cclions 77

more important is the proper consideration of the individuality of the
patient. The more irritaljle his entire nervous-system is, tlie more intensely he
reacts to cutaneous irritants, the less he is ai)le to bear bodily and psychical troubles,
the more diriicult it is to the patient to abstain from the comfort and conveniences
he enjoyed at home and in his family, the more we must beware of sending
him to health resorts which can only be reached by long and fatiguing journeys, or to
places where social life is exciting, or where the location, and the climate are too
irritant or too relaxing. We must, in such cases, also be cautious with regard to the
temperature of the baths, particularly with baths which in themselves are jiowerful
irritants an account of their content of solid and gaseous constituents. Tlie more
their natural or intentionally fixed temperature differs from the thermal point of
indifference (about 35'^ G = 95° F), above or below, the more irritative the bath
usually is. Baths Qf too long a duration or taken in too short intervals, or continued
for too long a time may hkewise easily be detrimental.

3. No less important for the choice of a health-resort is the consideration
of its particular conditions. Among the places which are ecjuivalent in a given
case with regard to their location, climate, baths etc., we shall by all means prefer
those which on account of their hygienic contrivances, the conditions of living and
society, the promenades^ service, therapeutic appliances, special training of the
physicians etc., are particularly suitable to answer all the requirements of the irritable
and helpless nervous patients who are often suffering so much.

4. For the treatment of organic atfections of the nervous system by sea-baths
it is of value to know that only the warm and sedative baths of the southern coasts
are particularly suitable.

5. We have to take care in not prescribing to the nervous patient bathing
cures following too c|uickly one upon the other. It is, above all, not rational
to prescribe various kinds of baths within too short intervals. The affected nervous
system must be given time to recuperate from the irritations of the individual
cures. It is, however, favourable in many cases to have bathing cures alternate with
suitable climatic cures, particularly if the latter follow immediately upon the former.

B. The Individual Affections of the Nervous System and their
Treatment by Bathing" and Climatic Cures.

1. Cerebral Affections.

1. Hyperaemia of the Brain. Active cerebral hyperaemia, the inclination
to congestions in the head, probably due to an inherited (habitus apoplecticus) or
to an acquired (masturbation, alcohol etc.) abnormal irritability of the vascular-
nervous-system, may be successfully combated by hydrolherapeutic cures (tepid half-
baths, tepid washings). Natural baths in the plain or in a medium elevation, as
well as brine-baths, especially carbonic ac'd sodium- chloride thermal waters may
also prove useful, provided their temperature lie somewhat (1 — 3" C) below the
thermal point of indifference, or at any rate do not surpass this point. Drinking-
cures with purgative sodium-chloride, and bitter-waters are an aid to the bathing-cure.

The passive (congestive) hyperaemia can only be combated by doing
away with the primary causes. But it may be of use to give relief especially to the skin
and to the bowels by applying the just mentioned baths and springs.

2. For the syphilitic affections of the brain, above all their most
frequent form, the gummatous inflammation of the basal meninges,
with or without a concomitant involvement of the spinal meninges,
the mercury or iodine-cures which are necessary in the first place, may
be aided by a simultaneous or subsequent use of sulphurated baths, and
with the same advantage by natural-baths, brine- and thermal brine-baths,
even by cold-water cures. The latter must, however, be mild, and the
temperature of the sulphurated, the natural, and weak brine-baths should at least
not exceed the thermal point of indifference, and the temperature of the stronger

78 Spinal Affections

brine- and thermal brine-baths should be for some degrees lower. It is to bo
mentioned that a good result does often only become maniiest some time after the
cure, and sometimes only after a longer lasting after-cure in a southern climatic
station (Oppenheim).

3. The usually unilateral paralysis due to cerebral haemorrhage may be
influenced favourably by brine- and thermal-brine baths, by mild natural baths, cold-
water cures, most favourably, of course, if the motor tracts have not been destroyed
by the extravasate, but only injured by pressure etc. In those cases in which
hemiplegia is persisting during the first months after the apoplexy in a slightly or
not at all varying degree, a noteworthy result will not be obtained by the bathing-
cure. The same is true of cases in which contractions have ensued; the bathing-
treatment may perhaps help to prevent a progress of the disease, but it will never
lead to a complete recovery. The treatment with baths is, therefore, preferably
recommended for patients who have experienced a subsidence of the paralysis, day
l)y day, from the very beginning. When to begin a bathing-treatment with these
patients, is a c[uestion yet open to controversy. The author of these lines does
not consider it correct to begin the treatment not before the S^'^ — 6"' month
after the apoplectic attack, as it is customary to do. He obtained very good
results with a number of patients who were subject to a thermal-brine bathing-
cure but a few weeks after the attack. In general, the bathing-treatment should
ah^ays be cautious and sparing, no matter which bathing-place is chosen. As in
the majority of cases concerned here an atheromatous degeneration of the arteries
is existing, any abrupt or too powerful increase of blood-pressure is to be avoided.
Climatic cures are recommended for a temporary sojourn.

4. The paralysis due to the embolic or thrombotic obstruction of
certain cerebral vessels may also be treated by the above mentioned baths
and climatic cures, if all the precautions are duly observed. We shall, however,
scarcely be able to boast of remarkable results in these cases.

2. Spinal Affections.

It should always be the foremost principle of a bathing-treatment of these
affections to apply neither very cold nor very warm baths, and to dispense with a
simultaneous application of strong mechanic procedures. As many experiences
teach, hot baths, steam-baths, sea-baths, at the most when taken in the very warm
season and if the sea is very little stirred, forced cold-water cures, strong rubbings
in or after the bath, dorsal douches etc. will not only be not useful, "but in many
cases even detrimental. It is likewise mostly noxious to have the baths follow too
closely one upon the other, to apply baths of too long a duration, and to administer
too many baths during the time of the cure. We should, therefore, choose for
natural-baths and for the sulphurated-alkaline and weak salt-baths 'J, which all are
of almost the same physiological effect, temperatures of 33 '^G (91, i" F), for brine-
and thermal brine-baths of a greater salt-content, above all, for the brine- and
ferruginous-baths rich in carbonic acid temperatures of 29— 31*^ G (84,2^^— 87, 8^ F),
The single bath should not last longer than 20—25 minutes. We should only
give at most 4 — 5 baths, and as a whole not more than 10 — 25. As to the
hydrotherapeutic treatment, we should adhere to the rules of Winternitz who almost
exclusively administers demi-baths of a temperature of 30 — 22° G (86,0— 71,G " F),
and a duration of 10 — 6 minutes, and who "at the same time never gives rubbings
but at most simply a massage or a packing and washes the back rather than
douching it with high pressure."

Of the various spinal affections:

1. Tabes dorsualis and the combined posterior - lateral - cord
sclerosis are preferably treated by cold-water cures and carbonic-acid thermal brine-

') How far lliis view is correct, will only be determined by continued researches. At present
we know from definite results (after the discovery of radium) of recent idiysico-chemical investigations
that, apart from the as yet known thermal and mechanic stimulative elfects of the baths on the skin,
curative potencies are in the springs which are superior to the former (Determann).

spinal Affections 79

baths, occasionally also by simple brine-baths, natural-baths, or sulphurated baths.
The latter are almost only applied if at the same time an inunction-cure is considered
suitable (compare with reference to this point what has been said in I,:2). For after-
and intermediate cures a longer stay at favourable climatic stations is recommended,
especially at places of a low or medium elevation which are neither relaxing nor
too stimulating; for the winter, southern stations. By all these baths and climatic,
cures, the effect of which may also be improved by air-baths, and especially open-
air resting-cures in many cases, a definite cure is unfortunately not obtained. But
in a great number of cases the progress of the disease may be checked or some
symptoms may be alienated, at least the progress of the disease may be retarded.

2. The spastic spinal paralysis (lateral-sclerosis) and the
congenital or early acquired spastic paraparesis may be treated with the
same baths. Yet the result is usually insignificant. The baths when taken at an
almost inditlerent temperature, may relieve the spasms, but mostly only for a
short time.

3. All tlie baths are ineffective for hereditary Ataxia (Friedreich!.

4. The palsies due to poliomyelitis anterior acuta of children and
adults are but slightly influenced by natural-baths, pine-needle-baths, brine-baths.
Brine- and thermal-brine-baths are mostly recommended in the beginning, cold-
water cures in a later stage.

5. In poliomyelitis anterior subacuta and chronica, as well as
amyothrophic lateral-sclerosis all the baths are ineffective.

6. For the various forms of progressive muscular atrophy baths are
also mostly applied in vain. Simple and carbonic acid thermal brine baths and
mild cold-water cures seem to be of some advantage in individual cases by
retarding the natural course of the disease. The disease is, however, only rarely
checked entirely.

7. The lesions of the spine and of the nerve-roots due to arthritis
deformans, to fractures and luxations of the vertebrae, and the
so-called compression-myelitis so frequently produced by spondilitis
tuberculosa (caries) are not rarely considerably improved by indifferent highly
tempered thermal-waters (Wildbad, Gastein), sulphurated-, mud-, hot sand-baths,
above all, simple brine- and carbonic acid thermal brine-baths. Particularly in the
cases of compression- myelitis air-baths, open-air resting-cures, and after-cures at the
sea or in the mountains are often useful.

8. In cases of pachymeningitis cervicalis hypertrophica we
recommend natural-, brine-, and thermal brine-baths of an approximately indifferent
temperatures with subsequent sweating.

S. In cases of primary spinal inflammations (myelitis transversa,
myelitis disseminata, perimyelitis!, as well as in complications of acute
leptomeningitis, above all. brine-, and thermal brine-baths, furthermore natural-
baths, sulphurated baths, chalybeate baths, and cold-water cures are suitable. In
the more acute cases, however, these baths should only be applied if the affection
does not show a progressive tendency. That for cases with a predominance of an
increased reflex-irritability and spastic s}-mptoms one should beware of carbonic
acid thermal brine-baths is contradicted by experiences gathered at Oeynhausen.
It is, of course, necessary to apply the proper temperature and bathing-method.
Result of bathing-cures: rarely a cure, often in part a great improvement.

10. Palsies due to a primary haemorrhage in or around the spinal
cord are in some cases cured, in others more or less improved by simple brine-
baths, but especially by carbonic acid thermal brine-baths, and occasionally, by
natural mineral-baths, and mild cold-water cures.

11. The same baths are used for the treatment of multiple sclerosis,
syringomyelia, and gliosis of the spinal cord, both the latter, as a rule,
without any, the former only in rare cases with a noteworthy success.

-i> Affections of the Peripheral Xervcs

12. The bathing-cure for meningitis chronica syphilitica as well as for
other spinal affections of a true syphilitic character is not ditferent from
that described sub I. !2.

3. Affections of the Medulla Oblongata.

For paralysis due to bulbar affections the baths recommended for myelitis
are applied occasionally; but with none of them remarkable results can be
boasted of.

4. Angio- and Throphoneurosis, Grave's Disease.

Hydrops articulorum intermittens, acro-paraesthesia, Raynaud "s-disease, erythro-
melalgia are refractory to any bathing-treatment. Grave's disease is most
favourably influenced by cold-water cures, carbonic acid thermal brine-cures,
ferruginous baths, especially when combined with a drinking-cure of ferruginous
waters, alpine and mountain-climate, short daily travels at sea.

5. Affections of the Peripheral Nerves.

1. Simple and multiple neuritis. The baihing-treatment of neuritis, as
we know by experience, should not be ushered in, unless the natural recovery of
the intlammatory symptoms favoured by absolute rest has commenced; we must
begin the treatment if the recovery is unduly delayed or if it runs too slow or
tardive a course. In this case we should in the first place prescribe short tepid
(33—28 0 C = 91,4—82,4° F) brine- or better carbonic acid thermal brine-baths,
furthermore, mild water cures or natural mineral-baths of an almost indifferent
temperature. In very obstinate and inveterate cases one may proceed to powerful
cold-water cures or" stronger salt baths (up to 10 per cent, salt and more), to higher
temperatures of brine-, carbonic acid thermal-brine and natural-mineral baths, and
one may also try general and local mud- and fango-baths. In the summer, the
patients may be sent to inland climatic stations, in the winter, to southern places.
Which of these stations or places should be chosen is entirely dependent upon the
question wether in the given case a more stimulant or a sedative permanent effect is
desirable. The results of the above treatment are mostly satisfactory. The author
observed complete recovery, in many cases, especially by the use of carbonic acid
thermal brine baths.

2. Neuralgia. In the treatment of neuralgia by baths our first object must
be to do away with all those conditions which in the given case must be regarded
as the cause of neuralgia. Many a case of neuralgia due to anaemia, chlorosis and
exsudates etc., may be cured by chalybeate-, brine-, thermal brine- and other baths.
In all the other cases the main thing will always be the application of the most
sedative baths and bathing-methods, since the affected nerve is in a certain
condition of irritability. Such neuralgic patients are from this reason preferably
sent to natural mineral-baths, perhaps also to sulphurated or brine-baths with a
slight salt-content. The baths ought to have an approximately indifferent temperature,
which is lowered for patients with an irritable nervous system and raised in
inveterate rheumatic or traumatic forms. There can be no doubt that by such
baths many a case of neuralgia may be improved or even cured. But it is likewise
undoubtedly true that there is (juite a number of patients who are not benefited as
desired. We must then try "to compensate the circulatory disorders caused by
direct or reflex nervous irritations in the affected nerve by a stronger nerve irritant
bringing about a powerful reaction" (Winternitz). For this purpose we apply cold-
water cures, steam-baths (Baden-Baden and others), strong simple brine-baths,
carbonic acid thermal brine or chalybeate baths of at least indifferent temperature,
hot sulphurated and natural mineral-baths, general and local mud- and iango-baths,
hot sand-baths, strong douches etc. VVe are unfortunately lacking very often in
characteristic symptoms giving a clue as to the application of the one or the other
bathing-cure, of a sedative or a stimulant one; we are, therefore, mostly confined
to finding out by a trial. As for the rest, climatic cures combined with open-air

Neurosis SI

resting-cures, especially a sojourn in a worm and uniform climate, or with exhausted
or depressed patients a slay at the sea-coast or in a mountain-region of a medium
or high altitude, are of a favourable influence on the course of some cases
of neuralgia.

6. Neurosis.

1. Hysteria. As in hysteria chief stress is to be laid upon influencing the
patient psychically in a suitable way, a treatment in a sanatorium is, as we know,
for many hysteric patients the best. Now experience has shown that in many
cases of hysteria a combination of a hydrotherapeutic with a psychical treatment is
particularly beneficial. Such patients should from this reason be sent to sanatoria
the directors of which are familiar with both these therapeutic methods. Not all hysteric
patients, however, will submit to this combined treatment, and there is even quite
a number of cases in which we have to dispense with it, at least temporarily, from
somatic, psychical or other reasons. For such cases the chalybeate-, simple brine,
and carbonic acid thermal brine-baths are principally applied, especially if we have
reason to trace back the hysterical condition to a primary or secondary anaemia,
to scrofula, to persistent diseases of important organs (uterus etc.). It is obvious
that the good result which is often enough obtained after applying these baths
is, to a great extent, to be attributed to the confidence of the patients in the well-
known and far recommended curative power of the concerned springs. The
influence of climatic cures, air-baths, resting-cures (a stay at the sea-coast [to the
best in sanatoria], in the forest, in mountains of a medium and high altitude, at
winter-stations on this side or that side of the Alps), which are exclusively applied
for hysteria, in the most cases after or between bathing-cures, is frequently very
beneficial. Yet not rarely the condition remains unaltered or is even deteriorated.
This is in the nature of hysteria, and the climate of the concerned health-resort
cannot always be made answerable.

2. Neurasthenia. In the treatment of neurasthenia, too, hydrotherapeutic
cures taken best of all in a closed sanatorium, play a great part; favourable results are,
however, often obtained by natural mineral-baths, ferruginous, brine- and thermal
brine-baths. As the carbonic-acid thermal brine-baths are known to agree well with
and to be taken willingly by weak, exhausted patients needing much heat, even
when taken at comparatively cool temperatures, just these baths may compete
successfully with hydrotherapeutics in neurasthenia as well as in hysteria. At any
rate, it is sure that a great number of important symptoms of these affections
(insomnia and vertigo, head-ache, nervous dyspepsia, palpitation of the heart, cardiac
neurasthenia etc.) is influenced in the same favourable way by both these methods of
treatment. Sea-baths as well as daily short travels on the sea and sea-voyages of
a longer duration have proved useful in many cases of neurasthenia, they are,
however, almost exclusively indicated for strong individuals in the incipient stage of
the disease. Climatic cures are in the average more useful in neurasthenia than in
hysteria; these cures are, however, to the best also taken in closed sanatoria com-
bined with the simultaneous abundant use of air-baths and open-air resting-cures.
V.'hether this be done in a wooded plain, at the sea-coast, in mountains of medium-
or high altitude, is altogether dependent upon the degree of irritability and asthenia
of the nervous system. One should take care of not sending very irritable or
prostrated patients, or those suffering from insomnia or arteriosclerosis, to the alpine
regions or to sea-baths, which, as most of those situated at the North-Sea, ask too
much power of resistance of the nervous system. We should also avoid
prescribing to neurasthenic patients with prevailing depressive symptoms a stay in a
moist and cool insular or coast-climate; at any rate they will agree far better
with a dry alpine climate. The same is true of patients with cardiac neurosis.

3. The morbid conditions known as anxiety, compulsory, delusions,
astasia, abasia, akinesia algera develop usually on the basis of hysteria or

S"2 Diseases of the Skin

neurasthenia; the bathing and climatic cures are consequently the same as for
the latter.

4. The treatment of the cases grouped under the so-called traumatic
neurosis which is so frequently associated with hyslero-neuraslhenic symptoms, is
not different from the treatment usually applied for hysteria and neurasthenia.

5. Hemicrania (migraine) offers no grateful, field for bathing-cures. If,
however, anaemia is playing a part in the afleclion, we do not rarely succeed in
alleviating or perhaps curing the attacks by ferruginous-baths and drinking-cures,
and, if obstinate constipation is existing, by purgative spring-cures. Cold-water
cures, brine or thermal brine bathing-cures, climatic cures in mountains of a medium
or high altitude, at the sea-coast or at winter stations may also, now and then, act
favourably upon the course of migraine by improving the general condition.

0. Idiopathic as well as reflex epilepsy are never improved by bathing-
drinking-, or climatic cures ; we may, however, succeed in reducing the doses of
bromine the patient was accustomed to take, by applying a mild hydrotherapeulic
treatment.

7. The various localized muscular spasms may, as we know by experience,
sometimes be benefited in those cases in which there is a causeal relation to some
general nutritional disorder, above all, however, to hysteria or neurasthenia: if so,
the cures indicated for these conditions are recommended.

In other cases, especially in Chorea minor, the mild cold-water cures are
of particular value, occasionaly also carbonid acid thermal brine-baths, provided the
patient may have, at the same time, as much repose as possible (resting-cures in
or out-side the room).

In cases of paralysis agitans most of all an undisturbed stay in the
country is recommended; besides, mild hydrotherapeulic measures may also be
of some advantage.

X. Diseases of the Skin.

By Di'. B. Brandis, Geheimer Sanitatsrat, Godesberg, and Dr. J. Beissel, Gelieinier
Sanitatsrat and Bathing- Inspector, Aachen.

Balneotherapeutic methods have most naturally their principal point of attack
on the general coating of the body. The mechanical action of the baths, their
content of chemically not indifferent substances, their thermal irritation on the peri-
pheral cells and nerves of the skin call forth a reactive function in the whole body
manifesting itself in centrifugal flow of juices from the internal organs to the skin.
This flow of secretion breaks the vital contact of the cells of the epidermis, and
dilates the mashes of the connective tissue cutis. By this flow of juices toxines
and pathologic substances of any kind are excreted, as the different bath elicits an
increase of metabolism in the whole body. As the skin, however, itself is involved in
a great number of internal diseases, it is obvious that a bathing-cure will indirectly
be a powerful remedy for diseases. The bath is, however, in the first place also
directly of a very great influence on the external integument of the body. The
cutaneous congestions are removed by baths, the vital functions of the skin are
increased, and the local inflammatory products are reabsorbed. The bath is
an indispensable means for cosmetics and for removing uncleanhness of the
skin, for which purpose some mineral-waters are especially suitable on
account of their content of alkalis^ their soapy property, and their content of
carbonic acid. The removal of deposits of pathologic substances on the skin, of
scales and crusts by means of baths is a valuable aid to the application of the
remedies applied in dermatology, since only the cleaned and softened skin is prepared
for the effect of those remedies. This purpose may be answered by general as
well as local baths, especially with flowing water or vapours. The sparing removal
of dried secretions, scales and crusts which furnish a permanent culture medium
for numberless microorganisms and exert irritations on the affected parts of the skin,
is particularly one of the requirements for a successful treatment of skin diseases.

Diseases of tlie Skin 83

A further advantage of a bathing treatment of skin-diseases consists in
isolating the alTected skin from the irritative influence of the external air. Patho-
logic exsudates are removed by the bath, and a drying up of secretions is prevented.
As the salt content of the latter is increased by drying, and the secreting part of
the skin is irritated thereby, the brittleness of the skin, and fissures, and the
formations of cracks on the affected part of the skin will be prevented in the bath,
and also for a long lime after having taken the bath, if suitable dressings, salves, pastes,
gelatine are applied at once. From this reason a bathing cure furnishes for example
"in eczema almost without exception the most grateful results obviously only to
be attributed to the mode of treatment".

According to their duration, their temperature, and their salt content mineral-baths
may either mitigate an inflammation or, when in a prolongued contact with the skin,
irritate it and produce dermatitis. The "To- and fro-bathing" of our
ancestors, as it is still en vogue at Leuk, aimed at producing a dermatitis by hot
baths continued for hours which proved pretty useful in scabies and psoriasis. —
The reddening, urticaria, the formation of pustulae even after baths of a shorter
duration, occurring especially in brine baths in sensitive individuals, show distinctly
to what an extent the affected skin is altered by the baths. For dermatosis due to
animal and vegetable parasites with a mostly acute course, there is nowadays a great
number of antiparasitic remedies at disposal, and we may in these cases, consequently,
dispense with powerful bathing-methods. On the other hand, the culture medium
for many pathogenic germs and microbes is altered, the germs are destroyed, or
at least prevented from producing detrimental vital products — toxines — by baths.
According to recent researches the radium-emanations of many mineral-waters are
very likely of a bactericidal influence in many skin-diseases.

Cold baths, i. e. baths below a temperature of 35** C (QB** F) mitigate the
inflammation, particularly in subcutaneous inflammations, phlegmones and ulcers. ■ —
The same bath is recommended for lowering a hypersensitiveness of the skin, for
anomalies of cutaneous secretion, for comedones, acne, inclination to urticaria, erysipelas
and erythema.

Hot baths, especially thermal steam-baths (in form of box-steam-baths,
or currents of vapour or steam-douches) are specific remedies in congestions, in
nodules or denudation of the cutis, as for example in furunculosis, in phlegmone,
acne, lupus vulgaris and erythematosus, ulcers of the feet, in which cases the
heahng is to be ascribed to active hyperaemia.

The internal application of mineral-waters is likewise not immaterial for the
treatment of skin-diseases. It influences the general nutrition, increases the
metabolism, of the whole body, raises the cutaneous function, the secretion of
sweat, the urinary excretion, it calls forth an increased respiratory exchange
and raises the intestinal function. The affections of internal organs which
very often constitute the cause of a cutaneous affection or give rise to relapses
of the latter, are favourably influenced by drinking the proper mineral-waters, and
the cutaneous affection may also be improved. All the vital functions of the body may
be modified in the way of assisting in the improvement of the cutaneous affection,
which under the influence of the detrimental effects at home was aimed at in vain.

The drugs prescribed internally for cutaneous affections, as arsenic, mercury,
iodine etc. are more agreeable when combined with a mineral- water cure, ar d their passage
through the body is accelerated. This explains their less toxic and greater curative effect.

Though efficacious, however, mineral-water cures may be for skin-diseases,
they are yet not suflicient for the cure of many cutaneous affections. But a great
number of indispensable skin-remedies is not only agreed with very well just when
combined with a bathing cure, they develop, moreover, a remarkably favourable effect.
Letusonlymentionherethe application of tar-preparations which are extremely efficacious,
particularly when applied in a bath; furthermore, chrysophanic acid, chrysorobin,
pyrogallic acid etc., the pyrogenic effect of which is lowered by the baths, so much
so that they can only by applied in sensitive patients when combined with baths.

S4 Diseases of the Skin

There are but few skin- diseases that are not treated at the various health-
resorts. The most frequent affectioas are the various forms of eczema, urticaria,
exanthema, for example drug-exanthema after the use of iodine and bromine, derma-
titis particularly in diabetes and jaundice, prurigo, intertrigo, acne, hypertrophy and
atrophy of the skin, lupus, neurosis, functional disorders of the skin, and especially
psoriasis, which on account of its various forms and extention is often a grateful,
but often also quite an obstinate object to treatment at mineral-baths. —

For the choice of a bathing-place in all these diseases not only the form of
the cutaneous disease, but in many cases the affection which is to be considered the
cause of the cutaneous affection, are decisive. Anaemia, chlorosis, scrofula, gout,
rheumatism, diabetes, congestions of the liver and the portal circulation are known
by experience to be conditions which are associated with cutaneous affections and,
as the cause of the latter, are of a determinative value when selecting a health-
resort.

The alkaline sulphurated - sodium - chloride thermal waters are most
frequently recommended for skin-diseases. They owe their repute not so much to
the small amounts of unstable sulphurous compounds contained in them as to the
non-irritative property of the baths, and to the rational modes of application.
Psoriasis is pretty often improved or cured by these baths, as chrysophanic acid,
strong preparations of precipitate ointments and tar-preparations may be applied in
strong concentrations when combined with such warm prolongued baths. The
latter remove the psoriatic scales, the douches and steam baths applied promote
perspiration and have a tonic effect upon the hyperaemic layers below the psoriatic
efflorescences. The internal use of the sulphurated water is apparently not without
influence upon psoriasis on account of its curative effect on the coexisting gastro-in-
testinal catarrh. Eczema is cured very rapidly by the use of the above mentioned
thermal waters with or without the simultaneous application of salves, pastes, or
dressings. Douches, especially in combination with massage, are very suitable for
the treatment of acne and sycosis; prolongued full-baths for prurigo. An indication
for the apphcation of sulphurated thermal waters is given in lichen with a slight
degree of irritation, chronic impetigo, mtertrigo, cutaneous neurosis, especially
pruritus cutaneus.

Strong sodium-chloride waters and brines are especially indicated for
cutaneous atTections on a scrofulous basis, for eczema of infants and non-scrofulous,
eczematous psoriasis; they may also be applied for the treatment of skin-diseases
in which an infectious agent, for example tubercle-bacilli, have penetrated into the
deeper layers of the skin, and can only be attacked by balneological procedures
acting upon the surface of the skin. Furunculosis, lupus, scrofuloderma, hchen,
lichenplanuswithasimultaneous internal or subcutaneou.streatmentby arsenic,acne rosacea,
are treated with brine-baths. These serve, above all, as an aid to the local treatment
and the phototherapy necessary for these conditions. — Although sea-baths are
mentioned here as strong sodium-chloride waters, we must especially warn of
applying North-Sea baths for psoriasis. — Chalybeate-springs, especially the
ferrugious acidulous waters rich in carbonic acid, are used as tonic agents in skin-
diseases. They should be applied if the latter are associated svith pathologic alterations
of the blood, with disorders of the gastro-intestinal function, with diseases of the
female genital organs. In urticaria, acne rosacea, individual forms of eczema,
atrophic conditions of the skin, great success may be expected from using
ferruginous waters.

Special attention is to be paid to arseniate-ferruginous waters, above all, in
combination with tonic baths. They are recommended for urticaria, psoriasis,
eczema on an anaemic or scrofulous basis, in atrophy of the skin, applying at the
same time stimulant or sedative douches.

Bitter-waters and Glauber's salt-waters are in the right place for treating skin
diseases if toxic substances are to be eliminated from the body, as particularly in
drug-exanthema, and urticaria. They are principally indicated in those cutaneous

Chronic Affections of the Sensory Organs So

affections which seem to be due to diseases of the liver or disorders in the port;il
system, among others in pruritus cutaneus and ani, intertrigo, furunculosis.
dermatitis, acne rosacea, and in pigment-atrophy of the skin. Profuse secretion of
sweat, often a symptom of fatty and lymphatic degeneration, may be cured by the
combined apphcation of bitter-waters and ferruginous waters, provided the mode of
life be rational.

Alkaline springs and alkahne sodium-chloride thermal waters are applied in
suitable cases of anomalies of secretion of the sebaceous glands as well as in
hypertrophy of the epidermis (sclerodermia, ichthyosis, elephantiasis). For the
treatment of dermatitis due to diabetes, of prurigo vulvae, and of the rare impetigo
herpetiformis gravidarum, these waters are of an undeniable value.

For the cure or mitigation of prurigo on a neuropathic basis many health-
resorts are visited. For a direct alleviation of the condition and a gradual modi-
fication of the cutaneous nerves those bathing-places might, however, be the most
efficacious, the springs of which permit of a prolongued stay in the bath or a
frequent repetition of the bath, as for example the sulphurated thermal or the
indifferent thermal baths.

Herpes, pemphigus, erythema exsudativum, multiforme and nodosum cannot
be benefited very much by babieotherapy.

XI. Chronic Affections of the Sensory Organs.

By Dr. 0. Thiknius, Geheimer Sanitatsrat, Sodea at the Taunus.

Formerly when opthalmoscopy and otiatrics were not on as high a stage of
development as nowadays, drinking- and bathing-cures were often applied for chronic
affections of the eye and the auditory organ. Nowadays, they are only taken into
consideration, if comphcations, especially catarrh of the mucous membranes of
neighbouring organs or circulatory disorders in the abdomen, are influencing the
blood-circulation of the eye or the ear.

Drinking-cures with sodium-chloride springs, alkaline-
sulphurated waters, and bitter-waters serve to this purpose according to the
individual case. Bathing-cures are only prescribed with regard to the general
condition.

COMPARATIVE TABLES

OF THE

Centigrade, Reaumur, and Fahrenheit Thermometers

Cent.

Eeaum.

Fahr.

Cent.

R^aum.

Fahr.

Cent.

Reaum.

Fahr.

O

o

o

o

o

o

o

o

o

100

80 '0

212-0

66

52-8

150-8

32

25-6

89-6

99

79-2

210-2

65

52-0

149-0

31

24-8

87-8

98

78-4

208 -i

64

61-2

147-2

30

24-0

86-0

97

77-6

206-6

63

50-4

145-4

29

23-2

84-2

96

76-8

204-8

62

49-6

143-6

28

22-4

82-4

95

760

203-0

61

48-8

141-8

27

21-6

80-6

94.

75-2

201-2

60

48.0

140-0

26

20-8

78-8

93

74-4

199-4

59

47-2

138-2

25

20-0

77-0

92

73-6

197-6

58

46-4

136-4

24

19-2

75-2

91

72-8

195-8

57

45-6

134-6

23

18-4

73-4

90

72-0

194.0

56

44-8

132-8

22

17-6

71-6

89

71-2

192-2

55

44-0

131-0

21

16-8

69-8

88

70-4

190-4

54

43-2

129'2

20

160

68-0

87

696

188-6

53

42-4

127-4

19

15-2

66-2

86

68-8

186-8

52

41-6

125-6

18

14-4

64-4

85

68 0

185-0

51

40-8

123-8

17

13-6

62-6

84

67-2

183-2

50

400

122-0

16

12-8

60-8

83

66-4

181-4

49

39-2

120-2

15

120

59-0

82

65-6

179-6

48

38-4

118-4

14

11-2

57-2

81

64-8

177-8

47

37-6

116-6

13

10-4

55-4

80

64-0

176-0

46

36-8

114-8

12

9-6

53-6

79

63-2

174-2

45

36-0

113-0

11

8-8

51-8

78

62-4

172-4

44

35-2

111-2

10

8-0

50-0

77

61-6

170-6

43

34-4

109 4

9

7-2

48-2

76

60-8

168-8

42

33-6

107 6

8

6-4

46-4

75

600

167-0

41

32-8

1058

7

5-6

44-6

74

59-2

165-2

40

32 0

104-0

6

4-8

42-8

73

58.4

163-4

39

31-2

102-2

5

4-0

41-0

72

57.6

161-6

38

30-4

100-4

4

3-2

39-2

71

56 '8

159-8

37

29-6

98-6

3

2-4

37-4

70

560

158-0

36

28-8

96-8

2

1-6

35-6

69

55-2

156-2

35

28-0

95-0

1

0-8

33-8

68

54-4

154-4

34

27-2

93-2

zero.

zero.

32-0

67

53-6

152-6

33

26 .-4

91-4

87

Balneography.

SECTION I.

Bathing Places and Climatic Health-Resorts.

Bad Aachen (Aix-la-Chapelle).

(Aachen-Burtscheid.)

Situation and Climate: Bad Aachen {Aachen-Burtscheid) is situated in a pleasant
basin-shaped valley, 6 km distant from the frontiers of Belgium and Holland. The town has
156 008 inhabitants, and many kinds of industry (cloth- and needle-manufactory). On
account of its sulphurous springs it is a health-resort renowned since thousand years.
Toward the south and south-west the basin-shaped valley of Aachen is closed by large
forests, passing over toward south-east into the romantic Eifel-mountains. The soil is
porous and well drained. The drainage-system answers all the requirements of modern
hygiene, and there is, besides, excellent water-pipe sj'stem supplied with water originating
from the chalky mountains in the south-east.

Curative factors: Alkaline-sulphurated sodium-chloride thermal waters originating
from 10 springs at Aachen, and IS springs at Aachen-Rurtscheid. The temperature of
the various springs is 73,4^ C. — 3S '^ C. (164-0 _ 100,4" F.), and they belong therefore
to the hottest springs to be found in Middle-Europe (Carlsbad Sprudel 7^2,h^ C. = IGl.e*^ F.).
The waters are applied for single baths, douches, steam-baths, inhalations and for drinking-
cures. The thermal waters are extremely copious, yielding in 24 hours the amount of
5000--6000 cc. of water, which would be sufficient for as many baths.

Indications: The cure in Aachen is recommended for the following diseases:

1. Rheumatism and gout for which the cure of Aachen, especially the douches,
are of an almost specific effect.

2. Affections of the nervous system such as: a) Affections of the central-
organs (brain and spinal-cord), and complications as paralysis, muscular atrophy, radiating
pains etc.; b) Affections of the peripheral nerves, particulary sciatica, toxic palsy
due to alcohol or metal poisoning; c) general nervousness, especially irritability and
insomnia.

3. After-treatment of inflammations, of traumatism and com-
plications.

4. Affections due to mercury treatment, to lead- and arsenic-
poisoning.

5. Scrofula.

6. Skin-diseases, especially eczema, acne, furunculosis, pso riasis, prurigo, pruritus
cutaneus, and ulcers of the legs.

7. Diseases of the blood.

S. Torpid conditions of the liver, spleen, of the stomach, the
intestines, and chronic dysenteria.

9. Chronic catarrhs of the mucous membranes, of the naso-pharynx
and the air -pass ages.

10. After-treatment of inflammations of the female sexual organs.
Entertainments: The Kurhaus in Camphausbadstrasse is open all the year round*

Concert-halls, playing and reading-rooms, parlours and bars etc. In the reading-roora
permanently 200 newspapers and journals of any political colour. A second Kurhaus
with magnificent park is situated in the district ofBurtscheid in the Kurbrunnenstrasse.
Excursions to the delightful surroundings. The grand forest of Aachen is to be reached
within a few minutes by the electric tram.

Aachen is situated on the route Antwerp and Ostende to Cologne, and is reached
in about 12 hours from London via Calais, Ostende or Flushing.

Detailed illustrated prospectus (in German, English, French), and medical descriptions
are sent free of charge on application to the Kurdirektor.

88 Section I: Abbazia

Abbazia (Austrian Riviera).

Winter heallli resort. Open all the year round.

Topography. On the eastern coast of Istria, latitude 45*' 29, longitude 31*^58, one
hour irom Fiunie, protected from north-west liy Uie Monte Maggiore, 4S86 feet high, and
from the nortli by the huge spurs of the Dinaric Alps, surrounded by an abundant
southern vegetation and extensive iaurei-groves, is situaleJ Abbazia, the principal climatic
co3st spa oi Austria.

Climate: The climatic conditions are extremely favourable, owing partly to tlie
equalizing effect of tlie ocean on the temperature, partly to the protection offered by tlie
high mountains from the north. The mean aiinual temperature is 13.2" C.
(55,5^ F.); the mean winter temperature 7,9" C. (4-6° F.) Thus approaching that
of Nice (8,5 ^ C. =47° F.). The relative moisture of the air in Abbazia amounting to
78 "/o in the average, is superior to that of the Riviera. Atmospheric pressure 700,2,

Curative factors and Sanatoria: Warm sea- and fresh-water baths. Hydrothera-
peutic institutes with separate departments for ladies and gentlemen. Carbonic acid sea-
baths and ozet-i)aths. Electric baths, system Prof. Gartner and Dr. Schnee, electric light-
baths, appliances for galvanization, faradization and franklinization. Massage and
apparatus for Swedish vibration-massage, Finsen light-treatment, Arsonvalization,
Rumpf-app aratus, inhalatorium, air- and sun-baths, medico-mechanic Zander-institute
of Dr. Stein, Rontgen-institute. Dr. Mahler's Sanatorium for heart-diseases, NeAV Kurhaus
(Dr. Franz Schalk), Sanatorium of Dr. K. Szego. Milk-, kephir- and whey-cures,
mineral-water and grape-cure, roads for Terrainkur, sea baths at the coast from end
of April to beginning of November (instruction in swimming). Mean temperature of
water in May 19" C. (66,2 F,), June 23,1" C. (73,5° F ), July and August 25-26'' C,
(77—78° F,), September 22° C. (71,6" F,), October 18,1" C. (64,5" F,). Very high
salt-content: 88 — 39 per mille.

Indications; Diseases of the circulatory organs (chron. myocarditis, adipose heart,
valvular lesions, atheroma, cardiac neuroses including Grave's disease). Functional and
organic nervous affections. Hay-fever, chronic laryngeal catarrh, catarrh of the pharynx
and bronchial catarrh (particularly during the moist months of October, November, De-
cember, March and April). Apical catarrh and infiltrations without fever (in spring and
in autumn as a transitory station). Pleuritic exsudates, scrophulosis, grave con-
valescence.

Physicians: Regierungsrat Prof. Dr. Glax, leading physician, and 32 physicians.

Hotels: Numerous Hotels of l^^^ and ll"d class, excellent pensions, private-boarding
and country houses. In all the large pensions you don't only find electric light and an
excellent w-ater-supply from the Mon te-Maggiore spring- aqueduct, but also rooms
with good stoves, double Avindows and boarded flooring as well as rooms heated with
hot-air. Prices of pensions (room including full board) range according to location, size
and furnishing of the room from 7 to 20 Kronen per day and person. Excellent
canalization (biological system), clean removal of rubbish and combustion of refuse.
Vacuum-cleaner and other suction-apparatus. No mosquitoes.

Amusements: Kur-orchestra, tennis-lawns, theatre, concerts, Adria-club, international
swimming races and lawn-tennis matches, boat-races. Magnificent smootji strand-
promenades wholly free from dust (9 km long); splendid parks with subtropical
vegetation, long and well kept promenades to the surrounding mountains; daily short
excursions by water. Trips by water to the islands, and as far as Venice
and Dalmatia.

Kurtaxe: 3 Kronen, and 2 Kronen music- tax per week and person. Physicians
and their families free.

Means of Communication : Al)bazia is half an hour distant from the Southern
Railway-station Abbazia — Mattuglie, whence an electric branch-line runs to the health-
resort in 30 minutes. Travellers arriving at Fiume with the Hungarian States railway
reach Abbazia within an hour by car or within 40 minutes on the steamers passing every
hour between Fiume and Abbazia.

Running-time. Abbazia can by reached from Vienna in 12, from Berlin in 24, from
Munich in 18, from Paris in 29, from London in 34 hours,

Abbazia— Triesl with jiost-automobile in 3 hours.

Number of visitors: 45 000 persons a year.

Information is given and prospectus promptly delivered by the

Kur- Committee.

Section I: Acqua^ossa — Alexandersbad 89

Acquarossa.

Situation: Tlie bathing establishment of Acquaropsa is situated in the Val Blenio
(Canton of Tessin, Switzerland), about 10 km. from the Got'.hrird-line station ot Biasca.
From Biasca to Acquarossa 20 minutes' drive by electric railway. It can be reached in
about Ihrce hours from Lucerne as well as from Milan. The baths are in connection with
a large Hotel offering all modern comfort (large drawing rooms and SO beds); il is standing
on a hill dominating the valley. There are large pine-forests close by; there is likewise
no lack of opporiu.".ity for excursions to Flora, Disentis or to the Oberland of Grisons.

Clirrate: Acquarossa oaers the advantages of a moderate climate, even mild in
mid-summer (18 — 2'i" C = 64,4 — 71,G''F): 2100 feet above sea level. The lofty mountain
crest of the Rheinwaklhorn gives shelter against rough winds, and moderates
disagreeable heat.

Bathing-cures; The thermal spiings of Acquarossa contain iron, arsenic and
lithium. The analyses made by Professor G. Bertoni, and Professor Scarenzio's
experiences of many years, confirm fully that these baths are of an extreme efficacy in
skin-diseases (eczema, lupus, psoriasis), in anaemia, weakness of the genital
organs, and likewise in urinary diseases and gout.

Fango is especially applied for chronic eczema, rheumatic exsudates,
gout, and chronic arthritic affections, and certain complications of fractures.

Many certificates of physicians abou he effects of the baths and of fango are at
disposal.

Drinking-cure: At the grotto of the spring, according to special prescription of
the physician. Kurtaxe 15 frcs. for the entire duration of the cure.

Doctors; There is a resident physician in the hotel during the whole season,
under the supervision of the leading physician Professor Bertazzoli of Milan.

Alexandersbad in the Fichtelgebirge,

Chalybeate-Bath, Mud- and Pine-Needle Bath.

Alexandersbad is situated at the foot of the renowned and most picturesque rocks of
Luisenburg, protected against winds, amidst grand pine-needle forests extending for miles,
near Bayreuth and Hof, and also near the Bohemian health-resorts of Franzensbad,
Marienbad, Carlsbad, in a mountainous region, 2065 feet above sea level. Aromatic air,
rich in ozone and free from dust. No oppressive heat in midsummer. Favourable
combination of alpine and forest climate, bracing and invigorating.

Curative Factors of the chalybeate bath: 1. Three ferruginous springs: a) Eonigin
Luisenquello. b) (bored in 1905) Prinz Ludwigsquelle, c) die alte Quelle. The pure
acidulous chalybeate spring (0,058 bicarbonate of ferrous oxide, 1,214 carbonic acid,
temperature 9,4" C. = 48,5° F.) rich in carbonic acid, is amongst the best ferruginous
waters. It agrees well even with a weak stomach, and is excellent for natural carbonic
acid baths. The latter are prepared in the bathing establishment enlarged in 1902 by
two new wings, and furnished in the most modern style. 2. Mud-baths prepared from
excellent mud with the above mentioned chalybeate water. 3. Pine needle baths, prepared daily
by extraction from fresh needles. 4. Pine-needle vapour inhalation in two cabinets equipped
for this purpose. 5. Alpine and forest climate with aromatic air, free from dust. Very
quiet place. Besting-cures in large parks and in the adjacent forests. 6. As the health-
resort also owns a "Kuranstalt", visitors ot the bath may take advantage of all the
hydrotherapeutic, electric, mechanic and dietetic methods, and also of the sun- and open-
air baths of this institute.

Indications: Chlorosis, anaemia, nervous affections and myasthenia caused by anaemia,
exhaustion due to puerperium and severe opeiations, delayed convalescence after affections
of internal organs, diseases of women, rickets, scrofula, muscular and articular iheumatism,
gout, paralysis, inveterate exsudates, chronic bronchitis.

Resident physicians: Dr. Haffner, and Dr. Scharff, consulting physician.

There are at the chalybeate bath station more than 150 rooms for lodging in
Schloss Ludwigsburg, Marienburg and Schweizerhaus. Price for room with 1 bed from
Mk. 1.25 per day according to size and furnishing. Up to June 25 ''i and after September l^i^
reduced rates.

90

Section I: Alexandersbad — Bad-Altheide

Boarding: Excellent cooking. Meals a la carte or pension Mk. 5:00 per day.
Restaurant in the new Kurhaus with tlie dining-rooms for "Kuranstalt" and "Stahlbad",
connected with boarding houses by colonnade; verandas and bar-rooms.

Playing-grounds for children and adults, tennis, croquet, nine-pins, gondoling,
fishing, library, great variety of excursions.

Kurt axe including tax for music: For 1 person Mks. 10, for 2 persons Mk. 15,
for 3 and more persons Mk. 18. Prices for baths at fixed tariff (carbonic acid baths
Mk. 1.50).

Post- and telegraph-office, 4 telephones. Spring- water supply and W, C. in
all houses.

Season from Mai IS'h to October 1st.

Means of communication: Railway-station of Markt-Redwitz within 40 minutes'
distance, station of all express trains of the lines Berlin — Hof — Munich and Francfort —
Nuremberg — Eger — Carlsbad — Vienne. Fiscal motor-post for the principal trains from and to
Alexandersbad. Travellers coming from the north may also get off at Holenbrunn —
Wunsiedel. Carriages are most willingly sent to the station on application lo the
Administration.

Information and detailed prospectus by the

Badeverwaltung.

Bad-Altheide in Silesia.

Situation: Bath Altheide protected against the wind, 1400 feet above sea level,
situated at the outlet of the romantic HoUental, and enclosed by a girdle of wooded
hills. Owing to its salubrious springs and its splendid situation between forests and
hills, this place Avas visited already in mediaeval ages by people wanting health and
recreation. During the past 7 years, however, this bathing-resort gained considerably in
importance, after 2 enormous carbonic acid springs (sprudle) had been drilled, and a
magnificent Kurhaus as well as 50 country-houses Avere built. Pleasant chains of hills
easily ascendable, and 2100 to 3150 feet high, enclose a deep valley on the bottom of
which the springs originate. From the hills down almost to the springs there extend
huge old fir- and pine-forests, imbuing the air for long distances with their
resinous scent.

Climate: A uniformly-refreshing mountainous and forest-climate; mean seasonal
temperature 17,4" C. (63 » F.)

Curative factors: 1. Ferruginous springs rich in carbonic acid: the "Grosse
Sprudel", "Charlotten-Sprudel", "Josephs-Quelle", the ''Badhaus-Quelle" spring with a total
capacity of 2 millions of liters daily. 2. The physico-hydrolherapeutic appliances:

Section I: Bad-AUheide — Alvaneu-Bath 91

hydrotherapy, oleclric l)aths, in general al! contrivances procured by modern science in
the direction of hydro- and electro-therapeutics. 3. Dietetic cures Milk-, whey-, feeding-
cures etc.)

The natural carbonic batlis of Altheide, acting as an extremely refreshing and
invigorating stimulus, belong to the most excellent of tiieir kind.

The ferruginous mineral mud employed for mud-baths is obtained from the fen-
district belonging to the bath. It is rich in active principles, such as particularly
sulphate of ferrous oxide, sulphuric alkali, formic- and sulphuric acid, humus-acid.

Indications; Especially heart-diseases (valvular lesions, dilatation of the heart,
cardiac neuroses, adipose heart, arterio-sclerosis), anaemia, the various kinds of anaemia,
constitutional debility (especially after malaria and long stay in the tropics), chlorosis,
women's diseases of various kinds, light nervous disorders, rheumatic affections of the
muscles and joints, gout with its various symptoms, people wanting recreation, and
convalescents.

Physicians: (according to the time of their establishment): Dr. Klose, Sanitiilsrat
Dr. Beerwald (during Winter in Berlin), at the same time leading physician of the
sanatorium, Dr. Pohl, Dr. Bauke, Dr. Fundner, Dr. Lewinsohn.

In 1905 a new Kurhaus was built, in which the comfort of a first class hotel is
associated with a more intimate family-character. In a side-wing of this Kurhaus are
the well-aired, fine bath-rooms, supplied with all contrivances of modern technique for
natural carbonic-acid and mud-baths. The Kur- and bathing-house is surrounded by large
parks extending as far as the forests.

There is a great number of recently built country-houses in Altheide suitable for
the constantly increasing number of visitors, and, in addition, in the village of Altheide
an abundance of cheap and good boarding places with and without pension. A first class
Sanatorium is opened during the whole year. The prices are moderate and the natural
spring baths of Altheide can be taken in the Sanatorium.

Amusements: There are to be mentioned, above all, beautiful excursions through
the Hollental or, on the other side, to the Heuscheuer Mountain, or beyound Falkenhain
to the Glatzer Schneeberg. — Concert of the Kur-music band in the Kurpark three times
a day, reunions every week, many concerts and theatre-performances, garden-parties,
lawn-tennis, children's-parties and play-grounds.

Kurtaxe: For one person Mk. W, for a family of 2 persons Mk. 26, of 3 and more
persons Mk. 35. Children below 10 years of age free.

Prices of Baths: 1 carbonic acid ferruginous bath Mk. 2, 1 full mud-bath with
cleansing-bath Mk. 3.50, 1 half-bath with cleansing-bath Mk 2.75, 1 pine needle-bath
Mk. 2, steam-bath Mk. 1.75, electric light-bath Mk. 3, 1 full-massage Mk, 2, 1 demi-
massage Mk. 1.

Divine services: Protestant every Sunday in the Kurhaus, Roman-catholic daily
in the conventual church of Altheide, and in the parish-church of Oberschwedeldorf.

Means of Communication : Altheide is a railway-station on the line Breslau —
Glatz — Altheide -Cudowa. To be reached from Glatz in 20 minutes wilh the express.
All fast trains stop at Altheide (bath-trains). The Kurhaus can be reached with a car
in 10 minutes. The omnibus of the bath-administration is at the raihvay station on the
arrival of every train.

Prospectus and information by the

Bath 'Administration Altheide^ Silesia.

Alvaneu-Bath.

(3500 feet above sea level close by station Albula-Railway Engadine.)
Season from June 1st to September lb^\

Climatically a very favourable and quiet place with picturesque -surroundings.
Comfortable Kurhaus with 150 beds.

Climate: mild, moderately stimulating and invigorating. Air pure, free from dust
and fog.

Curative factors : Strong sulphurous springs suitable for drinking and bathing
cures. All modern appliances. Good curative results.

Indications: Gout and all forms of chronic rheumatism; nervous diseases; chronic
catarrhs of the respiratory organs; chronic gastro-intestinal catarrh, swellings of the
liver and spleen, congestions; chronic skin diseases; diseases of women; chronic catarrhs etc.

'.t2 Section I: Ah-aueu-Bath — Andermatt — Arosa

Alvaneu is to be recommended quite especially as a transitional station to the
Engadine. — Abundant opportunity for excursions.

Resident Physician: Dr. Ed. Schmidt-Elorinet.

Prices of Pensions: from 7 Frs, upward per day including rooms. Telephone.
Maildelivery and telegraph near the house. H. Toggweiler, Proprietor.

Andermatt.

5054 feel aljove sea level.

First-class Summer- and Winter-station.

Andermatt, situated in tlie centre of the Gothard-massive and embedded in the
sunny valley of Urscrii (Urserntal) offers all the advantages of the high Alpine climate.

Excellent spring-water, canalization, electric light. Owing to its magnificent
surroundings, Andermatt is of an old and good repute as a summer health-resort.

Season: June to October.

As a winter sporting place Andermatt is especially favoured by nature. (Beside
several ice-fields and sledging-roads the slopes of the Gothard-massive offer great
diversity for ski-tours: Oberalp— Colmot, Sellatal — Gothard-Hospice, Wyttenwassergletscher,
Furka, and Rhonegletscher are renowned as first-class ski-roads.)

Entirely free from fog.

Sporting-season from December 1st to March 15^11.

A cure in the winter in Andermatt is especially to be recommended in cases of
anaemia of different kind, of insomnia and exhaustion, for neurasthenics and convalescents.

Resident physicians: Dr. Th. Monteagle, Dr. C. Schonbachler.

Kur-orchestras in the hotels.

Divine services: Roman-catholic service in the village church; Protestant,
Enghsh.

Means of Communication; Andermatt is situated 5 km from the station of
Goschenen of the Gothard-express-line; all fast trains stop at Goschenen. Running-time
from London 23 hours, from Paris 13 hours.

Information by the Travelling- Office.

Arosa.

Arosa, a climatic summer- and winter-station, hotels and pensions, 6020 — 6510 feet
above sea level, situated in the highland valley of Plessur extending from north-east to
south-west and parallel to the highland valleys of Davos and Upper-Engadine. This
valley forms the upper part of the south-western branch of the Schanfigger-Valley
extending from the east to the south-west, through which the larger part of the Coire-
Arosa mail-road (81,9 km long) is running.

The railway-station of Goire is in direct express-communication with all the larger
cities. The mail-coach goes three times a day to Arosa over Langwies, a ride of
51/2 hours (down hill S^/o hours) through an extremely attractive scenery, during the
time of snowfall in a closed sledge supplied with feet-warmers.

The climate of Arosa is tliat of the High-Alps. The mean atmospheric pressure
is 610 mm. Excessive temperatures, in summer above 20 '^ C. (68,0^ F.), in winter below
10 0 C. (50 0 Y.) are extremely rare. The summer is inoderately warm, the winter uni-
formly cold. The situation at a free slope and the neighbourhood of the forest have a
moderating influence upon the temperature. The relative moisture is in the winter 62 ^Jq
in the average. Arosa is almost entirely protected against winds, better than any other
mountain air station. The clouding is less than in the plain, especially in the winter,
when tlie duration of sunshine, according to the registrations of the sunshine-autograph,
is greater than in any otlier mountain air station of which registrations are existing.
The great intensity of the sunbeams and the relatively high temperature of the ground
are corresponding to the altitude of Arosa, as almost half of the amount of atmospheric
vapor is below, and the more rarefied atmosphere does not absorb so much solar heat.
In the winter there is in, addition, a considerable reflex of heat from the snow. Fog is
very rare, mostly ascending from the foot of the mountain-chain opposite Arosa. The
purity of the air is due to the altitude above the sea level, to the absence of smoke
and to the wide spaces between the houses. In the summer there is almost never any

Section I: Arosa 93

considerable tliisl, while in the winter the snow lying for almost five months protects
against it. The vicinity of large pine-forests adds remarkaljly to the advantages of the
altitude of Arosa. Numerous smooth and slightly ascending promenades with benches
run through these forests, the sunnier roads being open all the winter round.

Travellers are attracted during the sunmier by a variety of excursions, and pro-
mising mountain-trips. There is also opportunity lor rowing on two beautifully
situated lakes. In the winter healthy visitors enjoy the splendid skating-grounds and
sledging-roads.

Instruction in all branches is provided for by a sufficient number of quahfied
teachers.

There is a high-pressure aqueduct with excellent sprhig-water in Arosa, likewise
a rinsing-canalization; furthermore, telephone-communication to Coire and electric light
over the whole place.

Indications: Debility of constitution, anaemia, pulmonary tuberculosis, malaria,
neurasthenia, nervous asthma, convalescence after acute diseases.

Contraindications: Atheromatosis, non-compensated cardiac lesions, nephritis,
leucaemia, pernicious anaemia, advanced pulmonary affections with serious complications
of respiration.

Resident physicians: Sanitatsrat Dr. E. Jacob! (Sanatorium), Dr. 0. Herwig
(house of his own), Saniliitsrat Dr. W. Romisch, Dr. 0. Amrein. Dr. A. Pedolin,
Dr. E. C. Morland, Dr. F. Bauer, Dr. G. Hartmann, Dr. F. Lichtenhahn, Apothecary:
Dr. A. Schauble. — Dentist: Dr. nied. G. Weber, two Rontgen-Institutes : Dr. med.
A. Pedolin, Dr. med. F. Lichtenhahn.

Hotels and Pensions (open all the year'): Hotel Pension Alexandra (C), Hotel
des Alpes and Villa Ziirrer (C), Pension Alpina (C). Hotel Arosa-Kulm and Villa Berg-
fried (C*), Pension Beaurivage (C), Hotel Pension Bellevue (C), Pension Bergheim (C),
Hotel Pension Bristol and Schweizerhaus (C), Pension Daheim (C), Hotel Pension Eden (C),
Hotel Excelsior (C). Pension Freia (C), Pension Furka (C), Villa Gentiana (Engl. Sanat.) (C),
Grand Hotel (C*j, Villa Dr. Herwig (C), Hotel Hof Arosa (C), Hotel Pension Hohenfels (C),
Chalet Jugendheim (C), Kinder-Sanatorium Dr. Pedolin (C), Hotel Merkur (C*), Pension
Quellenhof, Hotel Rhatia and Villa Germania (C), Sanatorium Arosa (C), Sanatorium Villa
Montana (C), Hotel Pension Seehof (C), Chalet Soldanella, Pension Sonneck (C), Pension
Sonnenschein, Chalet Tanneck (C), Hotel Pension Valsana (C), Hotel Victoria (C), Hotel
Waldhaus (C*), Waldsanatorium. Arosa-Maran (6125 feet): (C), *Hotel Pension Hof Maran.

Private houses, letting flats and single rooms: Kornmann, Weisshorn, Semadeni,
Hafely, Anna, Silesia, Waldrand, Helvetia, Valbella, Midi, Flora, HohenzoUern, Haider,
Schoneck, Franca, Domenig, Edelweiss.

Very pleasant social life in the hotels. Kur-music, amateur-concerts, excursions,
picknicks, pleasure-trips to the mountains, photographic exhibitions and bazars.

Kurtaxe : 1,40 Frs. per week for every person, children and servants excluded.

Means of Communication: Mail-coach three times a day both to and from
Coire. Coire has very good communication to all neighbouring countries. Night-train
Zurich— Gothardt, through train Basle— Paris; Basle— Frankfurt; Basle— Metz- Luxembourg;
Zurich — Schaffhausen— Stuttgart; Sargans — Buchs— Feldkirch — Vienne or Brenner— Meran;
Sargans— Rorschach — Lindau— Munich or Augsburg, Nuremberg, Hof, Leipzig, Berlin,
Hamburg.

Direct cars from Salzburg, Amsterdam, Hamburg and Francfort on-the-Main to
Coire and back

Detailed information supplied free of cost by the

Official Enquiry Office Arosa.

Arosa, Sanatorium Gentinana, Morland M. B, B. Sc. London, see Section II.
"Sanatoria and Cure-Establishments".

Arosa, Sanatorium for Children, Dr. A. Pedol'n, see Section II, "Sanatoria and
Cure-Establishments".

^) Hotels marked with * take no invalids. — „€/ means Central-Heating.

94 Section I: Axen-Fels

Axen-Fels.

Climatice health Resort

2,!20O feet above sea level.

Topography; Axen-Fels is beautifully situated amidst woods and green meadows,
on the Lake of Lucerne, standing above it on a liuge massive terrace of the celebrated
Frohnalp, and is protected on the North and East by mountain ranges, whilst on the
South commanding a superb panoramic view of the Lake.

Climate: Axen-Fels possesses all the great advantages of a subalpine climate.
Amongst the many factors influencing this climate, may be mentioned the pureness of
the air, the absence of dust, and the delicious odour of the pine-forests.

The temperature is always between 18 — 28" C (65—83° F) even during the
summer, the daily variations being slight, the evenings being beautifully mild.

Axen-Fels is undoubtedly a very suitable stopping station for those going home
from the South, or to the Alps, and vice- versa.

Health Indications: Extremely favourable results are derived from this climate
of Axen-Fels, in connection with cases requiring biacing air during convalescence after many
kinds of exhausting diseases, as well as in cases of all forms of neurasthenia, in general
debility, in anaemia, and chlorosis, but no consumptives are admitted. To those who have
been undergoing a cure at other Health Resorts, Axen-Fels can be specially recommen-
ded chiefly on account of its stimulating air, and of the unique facilities, which are to
be found for taking exercise of all descriptions.

Palace Hotel: This Hotel may very aptly be called the "English Resort" above
the Lake of Lucerne. It is a first class hotel, standing in its own spacious grounds,
standing well above the Lake, and commanding unique views of Lake and mountain
scenery. The House is massively built and can accomodate 250 guests, and is hand-
somely and tastefully furnished. The hygienic and sanitary arrangements are excellent.
Special suites of apartments and bedrooms, with adjoining bathroom and toilette, can be
obtained. Electric light is installed throughout the building, and there is a lift. Most ot
the apartments open on to a balcony, and all the rooms command a magnificent view.
The rooms on the first floor facing the Lake, open on to a veranda 14 feet in breadth.
The public rooms on the ground floor: the spacious lounge and vestibule, the three airy
dining rooms, the billiard room, the ladies' drawing room, the library, the nursery, and
the glass hall — offer ample accomodation for guests, even when the hotel is full. Several
of these public rooms open directly on to a magnificent roofed veranda, li feet broad,
and runnmg the entire length of the building, a distance of 255 feet. Guests can sit
here at any time (wet or fine) enjoying the open air, and in bad weather plenty of
exercise can be taken. This veranda is furnished with comfortable cane chairs, lounges,
and small tables, each supplied with an electric lamp for reading purposes, in addition
to the general electric lighting. It is here the guests love to congregate in the evenings
after dinner, and listen to the concerts, which are frequently given.

The Park in which the Palace Hotel stands, is one of the finest in Switzerland,
situated high up on the Lake side, and extending for a distance of over one kilo-
metre. It is very tastefully and artisticaUy laid out, and there are many shady walks,
providing an excellent exercise ground for any patients who may be suffering with cardiac
trouble. Over one hundred comfortable seats are provided, each seat being cleverly
arranged, so as to command a peep of some distant mountain or Lake scene.

Sports: The Axen-Fels Golf Club has rapidly become one of the most popular in
Switzerland, and is managed by an English Committee, elected annually by the permanent
members of the Club. The Club House, which is within two minutes' walk of the Hotel,
is most commodious and comfortable, providing on the ground floor, rooms for Men and
Ladies, and a Professional's shop, where Clubs and Balls and all the requisites can
always be obtained, and on the first floor, a reading and writing room for the exclusive
use of the permanent members, a very large general Tea room. Secretary's office, and
Bar. All these rooms opening on to a balcony some 6 feet wide, and from which an
extensive view of the Course can be obtained. The Committee have recently acquired
ground, which they have laid out for the use of the Professional for giving lessons.

Cnptain: Dr. E. F. Eliot, F. R. C. S.; Hon. Secretary: Douglas Charnley Esqre.

There are three full sized Tennis Courts attached to the Hotel, as well as a Cro-
quet Lawn.

Concerts and Balls are arranged frequently during the Season.

Section I: Axenfels — Axenstein — Bad-Gastein — Bad-Ischl 95

Railway communication: Owing to its central position on Lake Lucerne, Axen-
Fels is very easily leaciied from all directions.

The railway station at Brunnen is on tlie St. Gotthard Railway, and from this
station and tlie steamer pier at Brunnen, Axen-Fels is readied in ten minutes by the
Electric Cog railway. Axen-Fels can be reached troni London in 22 hours.

Excursions: Axen-Fels is in the centre of a historically interesting country, and
there are innumerable excursions to be made, the most important being to the Rigi,
Pilatus, Slanserhorn, iVlielhen, Stoos-Frohnalpstock, Bauen, Urirotstock, etc.

Terms: In the early and after Seasons, the Pension Terms are from Francs 10,
in the high Season from Francs 14 a day. Resident Physician.

Church Services: English Church Service in the Hotel. Roman Catholic Church
in the Village of Morschach (four minutes' walk from the Hotel). Protestant Service in
the Church at Brunnen.

For copy of prospectus and album (free), please apply to the Proprietor
(P. Schnack). Palace Hotel. Axen-Fels.

Axenstein on the Lake of Lucerne.

Topography: 2625 feet above sea level. Notoriously the finest climatic alpine
station on tlie Lake of Lucerne with a wonderful and charming scenery, 875 above
Brunnen. Queen Victoria of England said of this place: "Axenstein is the loveliest spot

1 met with on my journey through Switzerland", and Berlepscli in his book "Luzern und
der Vierwaldstatter See" says about Axenstein: "Its reputation in Europe is due to the
wonderful location of this establishment and to the large forest park." From Lucerne it is
to be reached within 1 ' .2 hours. Large, world -renowned forest-park extending for

2 hours. Odoriferous and aromatic pine-forests close by the hotels. Many smooth and
well-kept promenades.

Climate and indications: Axenstein is recommended above all as a climatic
station by native and foreign medical authorities of first rank. The influence of the stimu-
lating and pure alpine atmosphere, the regular change of air by the currents coming from
the lake and descending from the mountains, and the permanent ventilation due to the
persevering insolation, add to the therapeutic influence of the forest park.

Hotels: a) Grand Hotel with Dependance "Villa Victoria". A massive and stylish
edifice furnished according to the most up-to-date comfort. Best hygienic conditions. Drainage
directly into the lake. Rooms with separate bath and W. C. — Price of pension,
all included: from Frcs. 9 in the early season; during the season from 12 Fres,
upwards.

b) Park-Hotel, smaller, first-class family hotel. Large roofed veranda. Price
of pension in the early season from Frcs. 7, during the season from Frcs. 9. — upwards.

Entertainments : Permanent music-band. Balls. Fire-works. 2 Lawn-tennis.

Kurtaxe : Frcs. 2,50 per week and person. Reduced fee for families.

Divine Services : Protestantic and Anglican in the English Church in Axen-
stein-park.

Roman Catholic in the parish-church at Morschach (10 minutes from Axenstein).

Means of communication: Electric railway from Brunnen; half hourly service of
Trains. 15 mi-nutes' drive. One hour's drive by road. 40 minutes' walk.

Elegant cabs. — Post- and telegraph-office, telephone in the house. Open from
the beginning of May to beginning of October.

Illustrated prospectus free of charge on application.

Resident physician: Dr. med. J. Eberle. Brunnen- Axenstein.

M. Theiler-Eherle, Proprietor.

RjjH-P JIQ"i"Pin -A^ustria, Duchy of Salzburg, 3000 feet above sea level, sheltered
■■^^^"^^^ ^*^^**j from all sides against rough winds; eighteen springs, of which
eleven are utilised for drinking and bathing cures. Very high radioactivity of the waters.

RsH-TqitIiI Austria, Salzkammergut, 1600 feet above sea level, situated in a
•''"■""^^^"V valley where the rivers Traun and Lchl join Climate is very mild and
equal)le. Ischl is very frequented for its brine-baths.

'JO

Section I: Baden-Baden

Baden-Baden.

Grnnd Duchy of Baden — Alkaline sodium-chloride balhs. Thermal spring with
greatest as yet known content of lithium. — Arsenious sprinjr.

Baden-Baden is situated in the Oos-Valley of tlie northern Black-Forest, about
700 feet above sea level, protected against winds, surrounded by mountains more than
3500 feet high, and by large leafy and fir-pine woods extending as far as the city.

The climate of Baden is mild, slightly stimulating, the mean annual temperature
9,69 0 C. (about 50 "_ F.).

From a hygienic point of view are remarkable the airing of the valley by a
current of air in the evening; the })erviuusness of the soil and the subsequent rapid
drying of the paths after rain; the absence of dust in the air; the excellent drinking'
water supplied by the municipal aqueduct; the recently finished canalisation of
the town.

Curative Factors: The thermal springs, about 20, of a temperature of 69 ^ C.
(15G,2" F.). yielding more than one million ofliterswithin 24 hours, belong to the alkaline
sodium-chloride thermes. They contain 2,7 — 2,9 solids per liter consisting of 2 g. cliloride
of sodium, 5i mg. of chloride of lithium and 0,264 mg. of arsenic.

According to the latest researches the thermal waters of Baden are classified
among the most radioactive waters, and the mud among those substances which contain the
greatest quantity of radium and the rare>t ot all bodies — viz., radiothorium. The tepid spring
"Biiltquelle" of Baden is the most radioactive spring of Germany.

The analyses of the principal springs made by Geheimrat Dr. Bunsen at Heidelberg,
show as the most essential constituents:

Constituents in 10000 parts of water
(gravimetrical)

Hauptstollen-
quelle

Fettquelle

Biittquelle

Murquelle

Chloride of sodium

Chloride ot lithium

20,1474
0,5367
0.0070
1,2734

22,1050
0,8060
0.0068
0,6610

18,9810
0,4270
0,0041
1,2470

19.4280
0,2950
0,0067
0,4250

Silica

The drinking-cure with radioactive springs has been considerably advanced by
the knowledge, that radium-emanation is most safely brought into the organism and made
active by drinking the water containing emanation.

In the grand-ducal drinking-hall, with its large roofed colonnade for promenading,
the thermal springs are used internally as well as for gargling. Besides, all the most
frequently applied native and foieign mineral waters are served here, where also the
products of these sources are sold.

Several public therm£(l springs are open to everybody at different parts of the
city. The water of the Friedrichquelle is exported in order to answer the great demand.
Information referi-ing to this will be given by the Grand-ducal Administration of the
drinking-hall. Recently the thermal water of Baden with an addition of carbonic acid has
become renowned as a table-water.

For bathing purposes the springs are used in form of thermal baths, of
thermal spring-baths (Wildbad), and as steam-baths, the latter being unique in
Europe on account of their being prepared by the natural steam of the
thermal water.

Indications for drinking- and bathing-cures: Gout with all of its symptoms
(urinary gravel with irritations of the renal pelvis and of the bladder). Other disorders
of metabolism and constitutional anomalies (anaemia and chlorosis, scrophulosis etc.),
malarid, syphilis.

Rheumatism of all types (subacute and chronic articular rheumatism, muscul.ir
rheumatism, arthritis deforman-^).

Catarrhs of the upper air-passages (nose, pharynx, larynx, bronchi), ^ also
inhalation-cure. Diseases of the organs of locomotion (sequelae of injuries and l^^sions,
of fractures of the bone, shot-wounds etc., of inflammations of the bones or
soft parts).

Sciatic pain, neuralgia of any kind, neuritis.

Sequelae of apoplexia, inflammation of the spine and its integument.

Neurosis, neurasthenia and peripheral neurosis.

Skin diseases (itching, furunculosis, chronic ulcers of the leg).

Women's diseases (catarrhs and exsudates of the pelvis).

Section I: Baden-Baden 97

Convalescence after diseases, and all conditions for which a mild climate, thermal
baths, and all the therapeutic means of physical therapeutics are indicated (e. g. cardiac
and nervous diseases).

The chemical contents of the thermal waters permit of the most various medicinal
additions to the baths.

The grand-ducal bathing-establishments: Friedrichsbad (for men), and Kaiserin
Augustabad (for women) — unexcelled model baths as to their equipment and elegancy —
offer likewise:

a) termal baths in tubs;

b) natural thermal baths, single or in common (thermal spring);

c) large swimming-tank;

d) vapour-baths (Irish-Roman and Russian, single and in common);

e) steam-baths in boxes, local steam-baths;

f) electric baths and light baths; four-cell baths and sinusoidal alternating
current baths;

g) department for cold-water treatment;
h) carbonic acid baths;

i) inhalatorium with latest systems (special house since 1900);

k) fango- treatment;

1) Tallermann's apparatus for local treatment with over-heated dry air.

Besides, there are in both grand-ducal bathing establishments magnificent halls for
therapeutical gymnastics and massage (medico-mechanic institutes. Dr. Zander's system).
In all departments well trained persons are at the disposal of the patients.

The grand-ducal establishments are open all the year round, and in winter all
the halls and stair-cases etc. are well heated.

A Raiium-Emanatorium has also been established, taking its emanations direct
from the Biittenquelle.

All the physicians of Baden practise in the grand-ducal bathing
establishments, and are allowed to treat and supervise their patients here in
all departments.

Apart from the grand-ducal bathing establishments, thermal-water b.-iths
may be taken in the following hotels and bathing houses: Badischer Hof, Hotel
zum Baldreit, Darmstadter Hof, Peters' Hotel zum Hirsch, Zahringer Hof. Tlie prices and
arrangements of the baths correspond to the class of the house chosen. Persons not
living in these hotels and bathing houses are equally admitted to these baths. Bath-
porters provide thermal-water for tub-baths fin private houses, pensions and hotels.

The municipal river- and swimming-bath with two large tanks and a number
of single baths give opportunity for river baths.

There are furthermore applied:

Cures with kephir, whey and fresh cows' and goats'- milk from the dairy under
veterinary supervision; cures with fresh juice of herbs; grape-cures.

Terrainkur for the treatment of obesity, cardiac diseases, disorders of circulation
etc. for which the situation of Baden in a valley, the excellent paths ascending in various
degrees, are particularly suitable.

Pneumatic cures in the grand-ducal inhalatorium and in the pneumatic institute
(director: Geh. Sanitatsrat Dr. Schliep) with two chambers for four persons each, and the
best appliances for heating and cooling the air (compressed air).

The municipal hospital, and a number of sanatoria see below.

Physicians (according to the report of the grand-ducal district-physician.): Drs. Apfel,
Auerbach (Diseases of the larynx and ears), Baumann, Baumgartner sen,, Baumgartner jun.
(Gynecologist, in the winter in Monte Carlo), Barth, Becker, Beissinger, Belzer, Berberich
(Lichtenthal), Berton, Brijgelmann, Burger (gastro-intestinal diseases), Dengler (Sanatorium
Frey-Dengler), Dreyfuss, Ebers (Sanatorium Ebers), Erlanger, Frey (Sanatorium Frey- Dengler),
Giese (Sanatorium Schambacher-Giese). Groddeck (Sanatorium), Griinen, Heiligenthal,
Heinsheimer, v. Hoffmann (Sanatorium for eye-diseases), v. Hoffmann jun., Hiibner (Lichten-
thal), Klare, Krebber, Krieg, v. Langsdorff, Lippert (Sanatorium), Lobell, Maver,
Jos. (Sanatorium Quisisana), Mayer, Arthur (Sanatorium, for drug habits), Modrze
(Ophtalmoiogist), Moller, Muggenthaler, Muser (Gynecologist), MuUer, Neumann, Obkircher
(Bathing-physician), Oster, Roitt (Surgeon), Rumpff (Sanatorium Ebersteinburg), Schacht
(in the winter in Assuan), Schafer, Schambacher (Sanatorium), Schindler, Schussele (Ophtal-
moiogist), Schliep (Sanatorium), Schmid, Schwarz (Homoeopath), Stuffer, Thomann
(District physician). Vermeil, Zacher (Sanatorium Ebers). — 7 dentists, 14 masseurs
(7 male, 7 female), 3 apothecaries.

98 Section I: Baden-Baden — Baden near Zurich.

Grand-ducal Committee for Bathing-Establishments: Council: Geh. Ober-
Regierungsrat Lang; members: Freiherr v, SteUen, first commissioner of woods and
forests, Geh. Hofrat Dr. Obkircher (Grand-ducal bathing physician), district superintendent
of building-operations Forschner, Medicinalrat Dr. Thomann (Grand-ducal district physician),
Oberbiirgermeister Fieser.

Kur-committee: Oberbiirgermeister Fieser, Kurdirector Graf Vitzthum and
Dr. ROssler.

Municipal Enquiry Office: Luisenstr. 1. (Information and prospectus free of
charge. Payment of the Kurlaxe.) Director: O. Kessebring.

Kurhaus with mognificent concert-halls, dancing and reading rooms, restaurants,
open all the year round. — Great concerts, symphony and quartett-soir6es, extra-
concerts of excellent artists. Bals-par6s, Reunions. — Children's parlies. — Excellent
municipal band (52 members) with solo-players. Concerts three times daily. — Military
concerts. — Exhibitions of prominent pieces of art, painting and sculpture. — Opera
and theatre. — Fire- works and illumination. — Illumination of meadows. — Fine lawn-
tennis and croquet-golfs with recently built pavilion. — Excellent horse-roads and
velo-path at the Lichtenthaler Allee, wonderfully situated. — Golf-links. — Shooting-
grounds. Pigeon-shooting. — Hunting and fishing. — Great international
races in the last week of August. — First German air-ship station.

Baden-Baden is surrounded by a number of splendid country houses and beautiful
villas. It is situated amidst a vegetation favoured by the best climatic conditions, and
it grows and is improving every year by new buildings and establishments. It is, therefore,
not only one of the most frequently visited health resorts, but also one of the finest
and most pleasant residences for healthy people and those needing recreation.

Communications: From Berlin 11%, trom Hamburg IB^U, from Cologne 6V2. from
Frankfurt 3, from Strassburg 1, from London 17, from Vienna 15, from Paris 9V4, from
Basle 2V2 hours.

Sanatorium Dr. Burger I Sanatorium Dr. Heinsheimer

Sanatorium Dr. Ebers | Sanatorium Dr. Lippert

Sanatorium Dr. Groddeck | Pneumatic Institute Dr. Schliep

see Section II ("Sanatoria and Cure-Establishments").

Thermal Health-Resort Baden near Zurich,

Switzerland,

The thermal-springs of Baden rise from a considerable depth in numerous
branches on both banks of the Limmat. The curbed springs furnish daily more than
one million liters of mineral water at a temperature ofiS'^C. (118,4 F). Above and near
the various springs, 14 Kur-hotels have been built with altogether more than 1200 beds
and more than 650 bathing-tubs.

The principal constituents of the springs are: sulphuric acid, chloride, sodium,
calcium, and carbonic acid. The thermal water is used for full and local baths, for
steam-baths, shower-baths, for inhalation, drinking cures etc. Further effective resources
are : massage and medical gymnastics as well as Oertel's Terrainkur, electric light-and carbonic
acid-baths. Brine-baths, pine-needle-baths and artificial ferruginous baths are likewise
prepared. — All kinds of native and foreign mineral waters can be obtained in the hotels.

Indications: Excellent results in subacute and chronic gouty, rheumatic, and
pseudorheumatic affections of the joints, muscles, tendon-sheaths, and synovial bursae etc.,
in typical gout during the latent period, and as a prophylactic after acute articular
rheumatism ; in urinary gravel, in neuralgia and neuritis (especisilly sciatica with and without
lumbago) ; in traumatic articular and muscular affections ; in chronic catarrhs of the various
mucous membranes; in women's diseases, especially chronic peri- and parametritis.

Resident physicians (alphabetically arranged): Dr. W. Jann; Dr. A. Keller;
Dr. E. Markwalder; Dr. med. et phil. Josef Markwalder; Dr. A. Mauchle; Dr. A. MQnch;
Dr. J. Nietlispach; Dr. E. Steffen; Dr. H. Zehnder; Dr. J.Zellweger; Mrs. Zellweger- Wyss.
M. D. Speciahsts: Dr. F. Diebold (practice limited to nose and throat); Dr. Kalin-Benzijer
(ophthalmologist).

Entertainment is provided for by concerts etc. in the Kursaal and performances in
the summer-theatre.

Religious needs are satisfied by three churches. English church service.

Section I: Baden near Zurich — Bad-Reichenhall 99

In the vicinity of Baden is a great number of beautiful promenades and hills with
surprising views.

Baden is a principal station of the Switzerland union-railways on the route of
Berne-Basle to Zurich.

Kur-Hotels a) Hotels on the left bank of the Limmat: Hotel Baren (K-Gugolz-Gyr),
Hotel Blume (A. Borsinger-Walser), Grand Hotel (W. Hafen), Hotel Limmathof (Jos. Bor-
singer), Hotel Ochsen (R. Diebold), Hotel Quellenhof (W. Amsler-Hunerwald), Hotel
Schweizerhof (A. Baumgarten), Hotel Verenahof (Jos. Borsinger) ; b) Hotels on the right
bank of the Limmat: Hotel Adler (BIunschi-Markwalder), Hotel Hirschen (Family Trzcinski-
Suter), Hotel Rebstock (H. Heitz), Hotel Schwanen (G. Kupfer), Hotel Sternen (A. Bucher-
Werder).

Detailed information by the Kurverwaltung.

Bad-Reichenhall.

Renowned brine-bath, first-class climatic health-resort and summer residence, very
popular station for tourists in the Bavarian Alps.

Bad-Reichenhall, yearly frequented by 17 000 visitors and about just as many
travellers, is situated amidst the south-eastern Bavarian Alps near Salzburg. Starting
point of the line Bad-Reichenhall-Konigsee, about 1640 feet above sea level, centre of the
Bavarian salt- work district.

Curative Factors and Principal Indications: Bad-Reichenhall is situated in an
entirely plain valley of about 4 — 5 km. diameter, protected against rough winds by
dolomite mountains about 7000 feet high. The air is mild, pure, and entirely free from
dust, the temperature is favourable. On account of the evaporation of more than
400 000 liters of brine daily, the salt-content of the atmosphere is extremely high. Owing
to all these advantages, furthermore to the aromatic perspiration of the extensive pine-
forests of the vicinity, and above all to the most favourable hygienic conditions answering
all requirements, as the standard high spring-aqueduct, the thorough canalization, and
the establishments for disinfection, Bad-Reichenhall is a climatic heath resort of first
rate, particularly for chronic catarrhs of the air-passages, the various forms of shght
phthisical affections, bronchiectasia etc. Excellent results are obtained by treating
emphysema and various kinds of asthma, shortness of breath, capillary bronchitis,
particularly in children, catarrhal disposition. By the use of pneumatic cabinets good
results are obtained in cases of residue of pleuritic exsudates.

The brine-and mother-lye baths are also applied for scrophulosis (joints and eyes),
chlorosis, rickets, for delayed convalescence after grave diseases, particularly influenza,
for chronic affections of the sexual organs of women, as well as for the acceleration of
the resorption of exsudates in the various organs. Dwarf-pine-extract baths and mudbaths,
fsiugo- and radium-mud-packings are generally approved remedies for rheumatism and gout.

In connection vdth the above mentioned curative factors and the climatic conditions,
the net of well kept roads of altogether 250 km, length with all degrees of incline have
rendered the place a health-resort for Terrainkur according to Prof. Oertel's method under
the personal approval and instruction of this capacity, the place being provided with all
the requirements concerned (board of distances, graduation of ways, rational regulations
of diet), and suitable for exercise-cures especially in the spring and autumn for patients
with affections of the circulation (asthenia of the cardiac muscle, insufficient compensation
of cardiac lesions, adipous heart and obesity, disturbances of the pulmonary circulation etc.)

The following curatives are supphed:

1. The Reichenhall Edelsole, which is known to be the strongest brine on the
continent with a salt-content of 24 per cent., and on account of its content of bromide
superior to the renowned Kreuznach mother-lye; furthermore, aU kinds of baths, as
carbonic acid baths, dwarf-pine-extract baths, mud-, radiogen-oxygen-, and wave-bath;
most up-to-date cold-water therapy, electric light-and altemating-current-baths, steam- and
sunbaths; fango-and radiogen-mud-packings.

2. The greatest establishments of the world for pneumatic chambers and for all
kinds and the best systems of inhalation; recently built graduation house and brine -
fountain,

3. Reichenhall drinking-brine and bitter-water, as well as mineral waters of all
kinds and origine. Milk, goats'-whey, kephyr, koumiss and Yoghurt, juice of alpine herbs
and radiogen.

4. Professor Oertel's Terrainkur and h medico-mechanic institute.

100 Section I: Bad-Reichenhall — St. Beatenberg

Physicians: Drs. A. Bulling, K. Harl, S. Goldschmidt, Gg. Cornet, J. Loeb,
6. Orteman, K. Schopner, L. Krez, B. Alexander, C. v. Heinleth, J. Posplsil, D. Winter,
0. Schroth, W. Siegel, K. Achilles (ophthalmologist), L. Dresdner, M. Schreiner, A. Schwarz,
H. Schreiber (gynecologist), H. Schmid, G. Roth. G. Reisinger, G. Zeppenfeld, F. B. Sluben-
voU, F, Koch, A. Muszkat. O.Pachmayr, F.Seufferheld, H. Ahlemann, Uebel, Lewy, Hans Cornet.

Season : May to October.

Kurtaxe: In Zone 1 15 Mk. for one person or the head of a family, 5 Mk. for any
relative, 2 Mk for children and servants. Physicians and their relatives free. Reduction
of price in Zone II and III and from September 1 st.

Great program for entertainments: concerts, parties, theatre and other artistic
performances, excursions and trips to the mountains by foot, car or railway; royal Kur-
haus with reading rooms and playing grounds. New Graduation-House and, recently
built, the spacious heated promenade. Water for fishing-sport extending for more than
50 km. with an abundance of trouts.

Boarding in hotels of I st, II nd and III rd class and in numerous elegant villas
down to the most modest rented rooms.

Illustrated elaborate prospectus in English furnished free of charge and also any
other information by the Kurverein.

Sanatorium Villa Romana, Dr. Dresdner, see Section II ("Sanatoria and
Cure-Establishments").

Sanatorium Bad Reichenhall, Dr. v. Heinleth, see Section II ("Sanatoria
and Cure-Establishments").

St. Beatenberg

above Lake Thun — 3773 ft. above sea level.

Climatic Health Resort and Loftiest and Best-Appointed Swiss
Hydropathic Establishment.

Spa Physician and Director of the Establishment: Dr. B. Tschlenoff, Professor at the

University of Berne.

Beatenberg is one of the best known of the health resorts of Switzerland.

Its climate is mild, yet invigorating and bracing. This is due, first to the fact
that it is sheltered from the north and east, by a high mountain range and its south
aspect, and secondly to its altitude nearly 4000 feet above sea-level and proximity to the lake
of Thun which lies some ISOO feet below.

Beatenberg stands on a beautiful plateau and has the advantage of a level stretch
of road nearly three miles in length.

Owing to the slight variations in temperature and the relative humidity of
the atmosphere, vegetation is rich and varied. The surrounding pastures and woods
are a mass of beautiful flowers, and shady walks abound in all directions.

Formerly Beatenberg was the resort of many consumptive patients, but during
the last twenty years Sanatoria for their special treatment at Davos, Leysin, Weissen-
burg, and other places have attracted these cases, and the Hotel proprietors no longer
accept phthisical patients.

Beatenberg is now chiefly visited by holiday-makers and those requiring rest
and recuperation. It is specially suitable to nervous and neurasthenic cases.

In 1903 a hydropathic establishment was erected here in connection with the
Hotel Victoria, a first-class Hotel situated in the centre of the village. Owing to its excellent
equipment almost all classes of cases may be advantageously treated here.

The Hydro (fitted up by the firm of Fischer & Kiefer, of Carlsruhe and Zurich) is
one of the foremost institutions of the kind in Switzerland. In particular the douches, which
often leave so much to be desired, here work admirably. The water, both cold and warm,
is supplied at a unifoim pressure of 3 atmospheres, and this ran be reduced at pleasure.

The institute contains two large and lofty saloons for gentlemen and ladies, where
all the treatment by modern hydro-therapeutics can be carried out Washings, packings,
rubbings, massage, half-baths, douches of all kinds, sitz-baths, foot-baths,
local cold and warm baths, and massage under water, are all employed.

The institute also possesses electric light baths for general and local treatment,
as well as an apparatus for carbonic acid baths.

Section I: St. Beatenberg — Berchtesgaden — Bex-les-Bains 101

There is a complete electrical installation, and the latest and most perfect
apparatus for the application of all methods of treatment: as Faradisin, Galvanisin
vijjratory massage etc.

Meals are taken in the Hotel Victoria ((-onnected with the institute by a covered,
passage) where a special dietary can be obtained as ordered by the spa physician.

The institute is open to visitors staying at any hotel in Beatenberg, so that every
patient can select an Hotel or boardinghouse suited to his means and taste.*)

The fitting up of an air-bath is also under consideration for the coming year.

Its dehghtful climate, its well equipped Hydro render it especially suitable to the
following cases :

1. Neurosis and incipient organic nervous disorders (neurasthenia,
hysteria, morbus Basedowii, tabes, etc.).

2. Diseases of the digestive organs (stomach and intestinal complaints),
disturbances of nutrition and tissuechange (anaemia, gout,
obesity, etc.).

3. Incipient catarrh of the air-passages, asthma, remains of pulmonary
diseases.

4. All cases in which a toni c, strengthening, and dietetic treatment is
indicated.

'np|.pl.XpQ^A|r|pv| Germany, Upper Bavaria, near Bad-Reichenhall. Climatic air
Del l/Il LCoy allCll^ station, besides saline and brine baths, 2500 feet above sea level.

Bex-les-Bains.

Canton de Vaud (Switzerland).

Bains and Grand Hotel des Salines (1515 feet above sea level).

(Note exactly the name of the hotel).

The bathing-establishment and the Grand Hotel des Salines are situated
1 km north-east from the village of Bex (in the Rhone- Valley about 20 km to the east
of Montreux), amidst a large park and in the immediate neighbourhood of the forest.
Grand scenery with high mountains in the vicinity. Numerous promenades and riding-
roads. Mountain-railway up to Gryon-Villars-ChesieTes.

Very mild climate with an air pure and free from dust, and with stimulating pro-
perties, owing to the vicinity of the mountains.

Hotel furnished according to the latest comfort. Two lifts. Central heating.
Apartments with bath-room and W. C. — Large Hall, beautiful dining-room.

Curative Factors: Brine containing 309 grs. of chlorides per liter. Mo the r-
lye with 316 grs of chlorides and 0,20 grs. of magnesium iodide per liter. Baths of any
concentration, inhalations. — Cold sulphurated water, with 20—40 cc. Ho S.
Drinking-cure, inhalations. — Very pure drinking-water, 47 "^ F, for hydrotherapeutics.
Douche-massage de Vichy etc. Carbonic acid baths. Fango di Battaglia. In-
candescent light-baths. — Electricity, massage. Milk- and grape-cure.

Bathing-establishment in the building of the hotel (special lift).

Indications: Lymphatism, scrofula, rickets. — Diseases of women, chronic
inflammations, exsudates, fibroms, sterility. Anomalies of development and of climacteric
period. — General disorders of nutrition. Chronic rheumatism, arthritic rheumatism.
Cardiac affections, arteriosclerosis. Diseases of the nervous system.

Patients with pulmonary tuberculosis are not admitted.

Season from April \^^ to end of October.

Resident physician: Dr. Eugene de La Harpe (speaks English).

Kurtaxe: 2,50 Frs. per week.

Divine services: English church and Roman-CathoHc church in the village.

Means of Communication: Bex is a station of the Hne Lausanne-Simplon-Milan.

Autobus meats all trains.

Electric tram between the station and the hotel.

Illustrated prospectus (English) sent free of charge on application to

G. Heinrich, Direktor.

*) Beatenberg possesses about 20 hotels and boarding-houses, with terms ranging from Frs. 6 to
Frs. 16 per day. The managing physician or proprietor will be pleased to give any desired information
regarding them.

102 Ostseebad Binz — Birmenstorfer Bitterwasser — Blankenberghe — Blankenburg a. E.

Ostseebad Binz.

(Baltic-sea Resort, Island of Riigen.)

International Family- and Children-Bath,

25000 visitors (4500 foreigners),

Season: June 1 si to end of September (high-season: July/August.)

Season for Climatic-Cure: May to October.

Binz can be reached: 1. via Berlin— Stralsund—Putbus (railway), 2. via Berlin-
Stettin — Riigen (railway and boat), 3. via Berlin — Greifswald — Riigen (railway and boat).

Prince Henry landing-stage (2100 feet long.) Railway station of the Hne Putbus —
GShren.

Ostseebad Binz is the most frequented and undeniably finest of all bathing-places
of Riigen, situated directly at the Baltic-sea, bordered and protected by the most
wonderful forests.

Beautiful Surroundings: Putbus (park, castle, preserve park), princely
hunting-seat, barrows; Sassnitz (ferry-harbour), the famous chalkcliffs (Konigsstuhl,
Wissower Klinken), Cape Arcona (marine-station, naval-artillery station), Greifswald Oie,
sandy beaches, island of Hiddensoe.

Ostseebad Binz offers opportunity for all kinds of sport and amusements.
Answering any demand of comfort, — 20 hotels, 200 boarding-villas. — New
Kurhaus.

Physicians and dentists, apothecary, drug-stores, trained nurses.
Sanatorium for orthopedic treatment, Zander-appliances.

New Family-Baths. Baths for ladies and gentlemen. Warm baths.
Arrival of German men-of-war every year, naval manoeuvres.

Kurtaxe: 1 person 4—8 M., 2 persons 6 — 12 M., 3 persons 8—16 M., 4 and more
persons 16 — 20 M., according to length of stay. Moderate prices of baths.

Reduction of cure-rates for physicians. Illustrated guide, also in English
and French, and information free of charge by the

Direction of Ostseebad Binz Insel Bugen.

Birmenstorfer Bitterwasser.

Canton of Aargau, Switzerland.

Francfort on the Main 1881 honorary diploma, Xizza 1884 golden medal,
Paris 1885 silver medal, Gent 1889 golden medal, Paris 1889 honorary diploma, Spa 1891
golden medal, Haag 1892 golden medal, Chicago 1892 golden medal, Grenoble 1902,
Biarritz 1993.

Since 50 years the most renowned and well known S\viss bitter-water, highly
recommended by medical authorities. No other bitter- water than this one may be
taken continuously without doing any harm to the digestive organs. The Birmenstorfer
bitterwater has been designated by the certificates of many physicians as the most
cleanly gathered bitter-water.

Its use always warrants a good and sure success principally in the following
diseases: habitual constipation with hypochondria, jaundice, insidious hepatic inflammation,
enlargement of the liver, .various haemorrholdal affections, adipous heart, diseases of the
female genital organs etc.

On sale in all large mineral-water stores and apothecaries, as well as directly from
the proprietor Max Zehnder.

Note: Samples are willingly sent to physicians free of charge on application.

Blankenberghe,

Belgium, on the North-Sea. Much frequented sea bath, at a
distance of 15 km from Bruges, and of 21 km from Ostende.

R^Qnl/PTlHllTTf a Hill"7 ^"^ °^ *^® ™''^' beautiful town in the "Unter-
JJlalllVCllUUiy a. nai^, harz", with about 12000 inhabitants. Very
frequented climatic health re.-oit. Electric Light. Drainage. Mountain Water Supply.

Section I: St. Blasien 103

St. Blasien

2700 feet above the level of the sea

situated near the Feldberg, in the romantic Albtal, the most wonderful of the valley
extending from the Feldberg to the Rhine. St, Blasien is undeniably one of those places
of the southern Black- Forest favoured most of all by nature. It is a small district-town
of 2000 inhabitants, the seat of various governmental boards. Owing to its situation and

its climate, St. Blasien is not only a delightful summer-residence, but also a much esteemed
climatic station. The mountain crests bordering the valley ascend for more than 1400 feet
above the bottom of the valley. The grand old alpine pine-forest, in part intermingled
with beech-groves, comes ch'se to the houses of the town on all sides, and is crossed by
well-kept promenades extending for miles in all degrees of incline. Bad pedestrians find
benches and sheltering huts allowing a long stay in the forest. There is a great variety
of promenades and excursions in the forests enlivened by purling brooks and gurgling
cascades, and the most various views are obtained of the Black-Forest and the crests
of the Alps. Thus even in a longer stay, change and stimulation are warranted, and yet
there is complete quietness in the immediate neighbourhood of the place.

As to the geological topography, St. Blasien is situated amidst the large granite-
massive, south-east to the Feldberg, only in part interspersed with gneiss and porphyritic
formations. The glacial origine of the upper Albtal is proved by a glacier extending from
the Feldberg ,and by the boulders covering in part the bottom of the valley and the
lower declivities, and existing in part as moraines at various places.

The hygienic conditions of the town are good: all the houses are supplied with
excellent drinking water by the pipe-system, and are in connection with the canalization.
There is also electric light, an establishment for disinfection, a steam-laundry, and a
hospital with some rooms reserved for visitors.

Climate: Owing to the very well protected situation, to the large forests
surrounding the place, to the porous condition of the soil drying very rapidly after rain,
St. Blasien has a mild and extraordinari) -constant climate in spite of its alpine site.
Nevertheless the climate does not lack of a stimulative and invigorating character.
On account of these advantages the repute of St. Blasien as a summer-residence is well
established since the past 40 years. In the months of spring the temperature of the air
rises to a high degree in consequence of the strong insolation, the rapid disappearence
of the melting snow by flowing off, evaporating or by being soaked up. This makes
St, Blasien a suitable residence for the spring. But it is also recommended as a transi-
tional station for those coming from higher situated places such as St. Moritz, Arosa, Davos &c.
or those going from the mild climate of the Riviera, Meran, Montreux, Baden-Baden &c.
to higher situated places.

104 Section I: St. Blasien — Bordighera

As the clouding begins in the autumn and winter in a relatively low altitude.
St. Blasien in an altitude of 2702 feet is already above the clouds, and there is consequently
an extremely high number of sunny days in autumn as well as in winter. Thus a
permanent stay in the open air is rendered possible. Owing to abundant sunshine, to
the protected situation, the moderate relative moisture, and the absence of great
variations of temperature, St. Blasien occupies a prominent place among the number of
autumn and winter-stations. Snow is in general lying from the beginning of December
to the middle of March, and after a stronger snowfall the roads are made free very
soon. It cannot be emphasized too much that St. Blasien in the months of September,
October, and November as well as in the real winter-months is especially suitable for
patients with the most various affections, for those needing change and recreation as well
as for amateurs of sporting.

Curative Factors: Climatic and Oertel-cure (most of the roads have signs stating
the distance and the incline according to Prof. Oertel.) Baths and douches of all kinds,
appliances for electro-therapeutic treatment, dietetic cures; massage, Swedish gymnastics;
open halls for out-door treatment. Milk cure, whey, kephir, fresh mineral waters.

Indications: Nervous diseases, chronic diseases of women, disorders of circulation,
affections of the respiratory organs, constitutional anomalies such as chlorosis, obesity &c.,
chronic catarrhs and affections of the digestive organs, rheumatic affections of any kind.

Resident physicians: Hofrat Prof. Dr. Determann, Medicinalrat Dr. Sander, Grand-
ducal District Medical Officer Dr. Kautzmann, Dr. Wiswe, Oberarzte Dr. Fischer, Dr. Happich,
Dr. Broking, Dr. Allendorf.

Entertainments: In the proper season ivrice a day concerts of the music-band in
the park, at times in the hotels and establishments. Saturday reunion in the Kurhaus.
Concerts and recitals of foreign artists. Illumination of a fountain, 175 feet high, and of
the Kurpark several times during the season. Excellent roads for cyclists. During the
winter ski- and sledging-sport, skating.

Kurtaxe: In the season 2 Mk. per week and person, during the winter 1 Mk.

Divine services: Roman-Catholic and Protestant regularly, at times Old-
Catholic service.

Instruction in languages and other school-branches.

Apothecary, post-office, telegraph and telephone.

Means of communication: Via Freiburg to Titisee with the "Hollental" Line; from
Titisee to St. Blasien (29 km) daily several motor-cars joining the chief trains, from
May 1st to October Ist^ and besides mail-coach twice a day. Furthermore, from June to
September twice a day, and otherwise only in the morning mail-coach from Albbruck,
station of the line Basle (Badischer Bahnhof) — Constance, through the Alb-Valley (26 km).
From Waldeshut during the Summer motor-cars twice a day and permanent mail-coach.
Also in the winter regular daily autobus to Titisee, as far as snowfall allows it.

Cars of the hotels on order from and to the stations. Price for carriage and
pair 26 and 24 Mks.

Freight and dispatch-goods to be addressed: St. Blasien, Station Titisee.

Detailed information and prospectus on application to the Kurverein.

Sanatorium St. Blasien, see Section II ("Sanatoria and Cure-Establishments").

Sanatorium Luisenheim, and Hotel and Kurhaus St. Blasien, see
Section II ("Sanatoria and Cure-Establishments").

Bordighera, Riviera (Italy).

Bordighera is in the opinion of many travellers the most delightful and, certainly,
the most healthy place on the Riviera

The older part of the town is picturesquely situated on the top of a headland,
projecting into the Mediterranean. The "Visitor's Bordighera" lies to the west of this
promontory, amidst luxuriant thick vegetation: to the north and north east, rise the
protecting hills, which extend to the slopes of the Maritime Alps. While standing on the
headland the eye is first of all involuntarily attracted by the imposing sight to the west;
for here we see in the foreground Venlimiglia, further on, Mentone and Montecarlo, above
the latter La Turbie, and on the south western horizon, the Esterelle Mountain, beyond

Section I: Bordighera 105

Cannes, If we now turn to the east, our glance will fall upon the less imposing, hut
peaceful looking little bay of Ospedaletli, with Coldirodi above it on the picturesque
mountain ridge. From November to April, the snow clad peaks of the Maritime Alps,
though at a considerable distance, shed their gleaming light over the lower hills in front.

The amazing tints of the Mediterranean, the splendid colours of the sky, parti-
cularly in the mornings and evenings, convince us that what we are apt to consider an
exaggeration of the painter?, is true to nature.

Looking down from the old town to the new Bordighera, we notice — apart from
the closely packed row of houses along the sea coast — what looks like a pale green and
multicoloured natural park extending for several square miles, with a variety of ground
formation, now rising, and now sinking, and again rising more and more until it reaches
the pine region: the whole of this looks as if it had been accidentally strewn with
pleasant country houses, of brilliant white, or pale pink, or pleasant green and also of
severe English grey. Here and there rises the fine faqnde of a hotel with its terrace in
front, where one can enjoy the lovely view. Clean roads and paths through private
gardens appear as light coloured stripes. There is a sharp distinction between the large
district where the visitors live, and come and go, and the closely packed houses of the
old Italian village, which is the result of conditions existinj,' at the lime it was built.

A promenade on the sea front, made in the winter of 1900, together with the
picturesque rocks at the Chapel of St. Ampeglio, are the rendez-vous of all visitors.

In speaking of the climate of Bordighera, the Senator Prof. Mantegazza says
amongst other things: "Not all places of the Riviera are equally favoured by nature.
Many of them lie back in hollows formed by hills: Bordighera alone hes close to the
foot of great elevations, upon a projecting point of land, so that it is evident that the
air striking it, after having passed across the sea, carries particles of salt, depositing
them on the soil, for the benefit of animal and vegetable life. Bordighera has, though
it may seem strange at first sight, far less rainfall than the rest of the Riviera; even
less than places in close proximity and continuous gentle rain almost never occurs.

Nice has an average, duhng the winter, of 36 days of rain compared to an
average of from 90 to 100 days of rain in Northern Europe. Bordighera, on the other
hand, has far less than 36."

The refreshing sea breeze, which, owing to Bordighera's peculiar position, blows
over the sea-promenade and lower parts of the town, makes it an extremely pleasant
place from early autumn to late spring. This sea winds do not reach the higher,
sheltered portion of Bordighera above the Strada Romana, where in recent times Villas
and first class Hotels have been built. This important fact should be taken note of by physicians.

Curative Properties: Equable and bracing climate: much sunshine (8V2 hours
on she shortest days). Warm and cold sea baths. Modern hydrotherapeutic establishment,
with all up to date baths etc.

Indications: Chronic affections of the heart and vessels — Metabolic diseases
(gout, diabetes, chlorosis, rheumatism) — Organic and functional nervous diseases — Convales-
cence after severe affections, especially in ca~es of delayed reabsorption of pneumonic
and pleuritic exsudation. Chronic catarrhs of the upper air passages. Nervous exhaustion
after overwork.

English Physicians: Dr. Bogle, Dr. Hamilton, Dr. Hubbard, Italo-anglo
Physician: Dr. Agnelli.

Bordighera offers more well-kept promenades and paths, free from dust, leading
nlo the picturesque and woody mountains of the near neighbourhood, than any other
similar place on the Riviera. The sea front promenade extending for several kilometres,
is neither accessible for motor cars nor carriages. There is a great variety of excursions
into the vicinity, with extremely pretty and picturesque scenery. The botanical gardens of
Mr. Ludwig Winter, which are opened to the public, are justly very famous.

Hotels and Pensions: Hotel Angleterre, Hotel Belvedere, Grand Hotel et lies
Britanniques, Hotel Bristol, Hdtel Central Cosmopolitain, Hotel el Kurhaus Cap Ampeglio,
Hotel Hesperia, H6tel de Londres, Hotel de la Reine, Royal hotel. Union hotel,
Bordighera & Terminus hotel, Hotel Viktoria, Pension Villa Conslantia, Pension Quisisana.

Monte Carlo and Mentone may be easily visited in half day trips. The trains to
Sanremo only take 20 minutes, while the electric trams take you in the same time to
the frontier station of Ventimiglia.

A somptuous Casino erected hard upon the seashore, offering good daily concert^
reading rooms, hot sea-baths, will be opened in December 1912.

106 Section I: Brunneyi — Btirgenstock

Brunnen at the Lake of Lucerne.

1540 feet above sea level.

Situation: Brunnen is situated at that wonderful curve of the Lake of Lucerne
where the Urner Basin, extending from Uhe South to the North, passes over into the
Basin of Gersau westward, near the north-western foot of the Wasiwand, a spur of the
Frohnalpstock, and in front of the extremely beautiful meadows extending from the North
to the South, declining here from both Mythen, and bordered towards the west by the
densely wooded Urmiberg belonging to the Rigi-group.

Climatic conditions: Owing to its position open on all sides, Brunnen offers all
the advantages of fortunate combination of a forest-, sea- and subalpine climate. Even
the abundant vegetation of the vicinity gives witness of the advantages of this place.
The heat in the summer is moderated by the evaporation of the sea, and also by regular
light winds from the mountain, the valley, and the sea, permanently renewing the air,
and acting as a stimulant and refreshment. There is in Brunnen an excellent aqueduct
of the very best mountain spring water of a cristaUine brilliancy and a refreshing taste.
Bathing establishments give opportunity for invigorating sea-baths. — In addition to the
pure air, there are as further curative factors : an excellent Swiss-milk which is recently,
for good reasons, often prescribed in many diseases; promenades and excursions in an
unlimited variety and, last not least, the splendid panorama of the sea and the grand
mountains.

Indications: A stay at Brunnen is particularly beneficial in nervous and
psychical affections, after mental strain, in hysterical and hypochondriacal conditions, in
nervous prostration (neurasthenia), furthermore for convalescence after grave affections,
for example pleurisy, pneumonia, malaria, in cardiac affections, especially if caused by
obesity, and in insufficiency of the cardiac muscle of anaemic patients with a general
relaxation of the muscles. To such patients abundant opportunity is offered for Oertel's
Terrainkur on promenades from the plain quay to the gradually ascending Axenstrasse
(Axenstreet), and to the more ascending forest-paths. A transitional station from the higher
situated health-resorts to the lowlands for chronic, non-febrile catarrhal affections of
the chest organs. For metabolic disorders and digestive affections etc.

Hotels: Pensions and private-houses. Detailed prospectus sent free of charge on
application to the "Travellers' Bureau".

Resident Physicians: Dr. P. Auf der Maur. Dr. J. Eberle.

Entertainments: Kur-boating on the sea. Public concerts.

Divine Services: Roman-Catholic and Protestant church.

Means of Communication: Almost all the international express trains stop at
Brunnen. Brunnen is unique as a station for excursions on boat, railway, and by foot

Burgenstock.

Climatic Health-Resort near Lucerne on the Lake of Lucerne.

Situation and Climate: Immediately above the "Kreuztrichter" of the classical
Lake of Lucerne, between Rigi and Pilatus, rises the entirely isolated Burgenstock. Its
broad foot is washed on three sides by the clear waves of the lake, 3045 feet above
sea level, the splendid Kur-houses of Btirgenstock furnished with the most modern
comfort (room for 600 visitors) are situated on a wonderful meadow land surrounded
by dense beech- and fir-pine forests. The variety of magnificent views to the most
famous High-Alps of Switzerland, and also the attractive view vertically downward,
unique in the entire region of the Alps, render this location unexcelled. On account
of the rare and ideal association of all climatic advantages, Btirgenstock has often
been called the "Ideal of a Health-Resort" and is generally designated as the "Pearl
of the Lake of Lucerne". Owing to the extremely interesting electric cable-railway vrith
25 steam-boat junctions to all stations — steamboat station Kehrsiten — Btirgenstock
has become the centre of the most renowned places and heights on the Lake of
Lucerne and the most convenient starting point for trips and excursions. A list of the
very numerous and manifold tours by foot and car, and a map on a large scale are at
the disposal -if the guests.

Tne grwnd forest- park extending over the entire crest offers an abundance of most
attractive sylvan scenery and meadows, winding paths running through and promenades
made at high cost. The recently finished rocky path excelling by far the renowned
Axenstrasse (Axenstreet) in the grandeur of its foundation, and the marvellous views down

Section I: Burgenstock — Buxton (England) 107

to the lake is unique and of world-wide fame, likewise the electric lift, 580 feet high, up to
the highest summit of the Burgenstock (Hammetschwand).

Cure-Establishments: The health-resort of Burgenstock consists of several
establishments as: The Palace Hotel opened 1903, the Grand-Hotel with dependance (Chalet),
the Park-Hotel. As annexed buildings are to be mentioned: the large restaurant with beer-hall
in the vicinity of the railway station, Pension Helvetia with restaurant (simple and reasonable),
various villas, and the large playing hall for children. All the three hotels have rooms
for fiOO guests. The new Palace Hotel is furnished according to the most modern
comfort. There are separate family apartments with parlours, various bed-rooms, bath-
rooms and rooms for servants.

All the three hotels have splendid verandas with views of the sea and the
mountains — all the rooms with the most beautiful view. Prospectus free of charge.

Resident physician in the hotel. Hydrotherapeutic bathing-establishment. Electric
light. Three lawn-tennis fields. Price of pension with room up to end of June 9 Fres.,
from July 1 ^t. from 11 Frcs. daily, in the Palace-Hotel from 13 Frcs.

Travelling-Literature: Europaean Tourists maps No. 51 and 52 ,Der Biirgen-
slock", pubhshed by Orell Fiissli & Co. — on sale in any book-store. Tschudi, /fourist
in Switzerland'. Berlepsch, .Southern Germany and Switzerland to the Alps". Dr. Gsell-
Fels, ^Bathing-Resorts and Climatic Stations of Switzerland" and others.

,Der Kurort Burgenstock" sent free of charge by Bucher-Durrer, Prop.

Buxton (England).

Buxton! The name, to anyone familiar with the town, is suggestive of stately
buildings, pleasant gardens, well-kept walks and drives, clean streets, high hills, baths, mineral
waters, good music, and, given a reasonable amount of fine weather, a feeling of satis-
faction with things in general, and with the health-imparting qualities of the place in
particular! For Buxton is, and has ever been, a health resort par excellence . People
come in to get rid of various complaints and contrive to amuse themselves during the
process. They invariably go out satisfied that Buxton Baths and waters do all they claim
to do, and the result is that by means of the influence exercised by that ubiquitous dame
Recommendation the town receives every year its full share of visitors.

That the town possesses all the virtues of a fashionable spa, and has many great
attractions for the pleasure-seeker, will be evident to the most unobservant stranger who
decides lo sojourn here for any reasonable length of time.

Climatic Conditions: Buxton with an altitude of 1000 feet above sea level enjoys
the distinction of being the highest town in England, and its air is remarkably dry and
bracing. During the winter months the air is colder than in many health resorts, but
everybody knows that a dry heat in the summer and a dry cold in the winter are
infinitely preferable to greater moisture in the air at either season of the year. The
record of sunshine during a year is usually very high. The average annual rainfall is
not heavy and tlianks to the nature of the limestone subsoil, the roads at Buxton dry
very rapidly after the heaviest showers.

Other important matters relating to public health— water supply, drainage, sanitary
conditions, lighting &c., are looked after in an admirable manner by the local authorities.

The waters : The thermal springs, which are the property of the town, issue in
the valley near the bathing establishments. The waters are of the uniform temperature
of 82 « F., beautifully bright, soft, and clear, and when seen in the mass, of a hght-
blue colour.

The waters belong to the Radio-Active Thermal Group and issue from nine springs,
from one of which alone about 2 000 000 litres flow daily. A regular supply of radium
emanation is thus constantly kept up — an important point in comparing these waters
with artificial radio-active baths which rapidly lose their activity and so deteriorate.

Large bubbles of gas continually rise and discharge on the surface, which gas
consists of Nitrogen 59,78 % and Carbon (Dioxide) 40,22 %, and it also contams Argon,
Helium, Neon, and other rare elements.

The radio-activity of the gas is about ten times that of the water.

The waters have recently been examined for Radium by Dr. Makower of
Manchester University, and it was found that the principal springs gave the following
results:

Gas collected from the surface 10,9 units.
Water „ „ „ „ 1.2

108 Section I: Buxton (England)

Sir Wm. Ramsay speaking of these waters has said: "It is unfortunately impos-ible
to compare these amounts with the statements of the radio-activity of foreign waters as
the latter are stated in uncertain units".

The baths : The Thermal Baths are the attraction of Buxton, which has been one
of the chief bathing resorts in England for many centuries. Tiie bathing establishment
consists of two portions, situated at the west and east ends of the Crescent, and both
supplied with water from the thermal springs.

The natural baths: In this bath-house the waters are administered at the natural
temperature of 82 ^ F., at which they rise Crom the spring. The baths consist of separate
suites of swimming and private douche-immersion baths for ladies and gentlemen. These
baths are paved with slabs of perforated mirble, through which a stream of thermal
water is constantly flowing from the springs. The beautiful blue colour of the water is
strikingly exhibited in the large swimming baths, and bubbles of. the radio-active nitrogen
gas, with which the waters are highly charged, may be seen rising to the surface. Spray-
rooms, for treatment of the throat, nose, eyes, and ears, have been fitted with appliances
specially designed for the Buxton mineral waters.

The hot baths: In these baths, the mineral waters are raised to any temperature
that may be prescribed. A handsome stone front of classical design has been erected,
and the internal alterations to the buildings have provided much additional accommodation
for baths, together with the spacious waiting-rooms and a ticket office. There are
.separate suites for ladies and gentlemen. This bathing establishment comprises every
form of hydro-therapeutical appliance, and includes the celebrated Buxton Douche-
Immersion Bath — the finest of its kind in Europe; here every kind of douche is
administered, the force and temperature of which can be regulated with the greatest
accuracy. Vapour baths of many kinds and with various combinations are largely
employed, needle and sitz baths are given, and the Plombiferes douches for colitis etc.,
have been installed, and excellent results are obtained.

The Buxton Douche-Massage, whi(!h has been in use for many years, is an
important feature in this establishment, and the increased demand has necessitated
additional baths, recently opened. Aix and Vichy douches have also been installed, and
facial sprays and massage are much used and in increasing demand. Dry, electric and
all forms of massage, either combined with the baths or separately, are given.
Appointments can also be made for treatment at private residences by experienced
masseurs and masseuses.

Moor baths and Chalybeate baths: The many inquiries for Moor Baths (mud
baths) and Ciialybeate Baths have led the Council to take advantage of tiie natural
surroundings of Buxton in this direction. The extensive peat moorlands adjoining the
town and inexhaustible supply of Chalybeate Spring water, enabled them to offer all the
advantages of the continental "Moorbader", and these baths have now been added to the
establishment. The moor-mud contains a large proportion of iron and organic acids.

Chalybeate Baths are included in the installation. .

Supplementary treatments: In addition to the special Buxton baths and treatments,
the Council have installed all the most recent supplementary forms of treatment. The
Electrical Department comprises : Electro-water baths and Schn^e four-cell baths, with
all forms and combinations of electric current ; the d'Arsonval High Frequency and the
Static current; the latest apparatus for Electro-mechanotherapy ; the Dowsing Radiant Heat
and Light treatment; the "Greville" hot air treatment and Electric Light Baths with
various coloured or arc rays and electro-vibratory massage. The electric current can
also be combined with the various mineral waters.

Nauheim Baths, Carbonic Acid Radioactive oxygen Baths, and Schott Movements
for heart affections are largely given, and Fango Mud Treatment is also administered.

Experienced attendants and assistants are in all parts of the establishment, and
everything that modern science can devise has been supplied to ensure the comfort and
convenience of the "cure guests".

Diseases for which the waters are used: The diseases deriving benefit from
the waters and climate of Buxton include gout, rheumatism, rheumatoid arthritis,
sciatica and various nervous diseases, disorders of digestion, and skin disease?, the after
treatment of malaria and other tropical diseases. Muco-membranous colitis and similar
conditions, diseases of the throat and air-passages.

The treatment of heart cases. The early stages of arterial sclerosis. (Buxton is the
only health resort in Great, Britain where this treatment is administered.)

Anaemic conditions and convalescence from pro'onged illness are favourably in-
fluenced by the climate and the use of the Chalybeate Spring.

Section I: Buxton (England) — Cairo (Egypt) 109

Relaxations and Amusements: Tlie Spa provides exceptional opportunities for
entertainment and recreation, no matter what the weather may be like.

It possesses perhaps the most extensive and finest pleasure gardens in England,
where an excellent orchestra may be heard thrice daily, and tennis, croquet, bowls,
boating etc.

There are sufficient excursions, drive*, and walks from Buxton to provide the
visitor with a fresh "trip" every day for weeks, and the famous Crescent in the mornings
and afternoons, with the numbers of coaches and Charabancs starting laden with pleasure
seekers is indeed a sight worth seeing.

To the golfing devotee, Buxton is a Mecca as this ancient game may be enjoyed
on one of the finest inland 18 hole courses in the country. In addition there is an
excellent 9 hole course.

The visitor who has a leaning toward concerts, theatres etc., is also amply
catered for with one of the prettiest Opera Houses in the country, where the latest
London successes may be seen, an excellent Variety Theatre and frequent concerts, and
illuminated feles in the gardens. Buxton has also of late years gained a considerable
reputation for its winter season (when incidentally the "cure" may be taken with quite
as good an effect as in summer), and has been christened the English Grindelwald on
account of the frequency in which sucii alpine sports as tobogganing, ski-ing, sleighing
etc., may be indulged, the rare dry cold making these pastimes a pleasure indeed.

Buxton as a residential and educational centre stands "par excellence", the
magnificent bracing air, excellent drainage, lighting arrangements, freedom from fogs,
low death rate, and the many splendid colleges and schools making the "Mountain hfpa"
a most desirable place in which to live, in fact the best advice that can be offered
anyone, whether invalid, pleasure seeker, or lor residential purposes is, "Go to Buxton".

Cairo in Egypt.

Topographical conditions: Preeminent winter station of Central-Egypt, capital
with about 700 000 inhabitants, of whom 75 000 are foreigners, 2 km from the right
bank of the Nile, 70 feet above sea level. Residence of His Highness the Khedive of
Egypt. Garrison of Egyptian and English regiments. Seat of ministry and high boards.

Climatic report: The climate of Cairo is dry and warm. The days of winter
are equal to the finest days of a European spring, and almost uninterruptedly of the
same character. One may rely with certainty upon an almost stable weather. Rain only
very rare and for a short time. The sky is almost always clear, the air extremely pure,
on account of the immediate neighbourhood of the desert extending close to the borders
of the town. The so much feared Chamsin, a southwest-wind carrying hot air from the
desert, does never occur in the winter, and if it does not fail entirely, it occurs during
the time of middle of April to end of May, lasting usually for three days. At any rate,
this wind is not at all injurious to the human organism, especially not to the respiratory
organs. During the winter, the mornings and evenings are cool (mean temperature
53,6*^ F = 12'^ C). But even during the coldest period, in January, the temperature does
never sink below 9 o C (48,2 ^ F). The temperature at noon is 20 » C (68 o F) in the
average. The time of early winter, i. e. from end of October to end of December, is the
best season of Egypt, the extreme heat being over and the days resembling then the
finest European summer-days (without rain or thunder-storm), with a pleasant cooling in
the evening and the refreshing morning. In the middle of April the hot temperature
sets in, rising in May to the level of a European summer. The moisture of the air is
very slight. Northwest- and north-winds predominating which always carry a fresh and
invigorating air.

Curative factors and indications: Cairo has of late grown up to a winter-
station par excellence, and is frequented more and more every year. Cairo is at
present visited in the winter by about 20 000 foreigners of the best society from all
countries; it is growing in repute, and will in the next decade probably rise to an
unforeseen prosperity. The climate is working wonders in cases of chronic rheumatism,
gout, renal affections, diseases of the chest and the heart, nervous diseases, anaemia and
chlorosis, the good effect being due to the stable temperature, the dry and pure air of
the desert, and to the abundance of sunshine. On account of the elementary accidents
which occurred during the last years at the Riviera and in Italy, the number of patients

110 Section I: Cairo (Egypt) — Davos

flocking to Egypt has grown still more, and they all emphasize as a particularly
distinctive feature the relative number of hours usefully spent in the open air, as
compared with those other places. There are no contra-indicalions for Cairo.

All specialties are present in a most excellent variety. The very liest apphances
for any kind of hydrotherapy (cold-water treatment, Roman-Irish-Russian baths,
swimming-tank, electric-bath etc.), massage, Swedish gymnastics, electro-therapy in the
new and splendid bathing- estabhshment called "Hammam", near the world -renowned
Hotel Continental.

Physicians: Hess (Swiss), Wild (surgeon), Engel Bey, von Becker, von Hebentanz
(otologist), Heymann, Hegi, Wermer (during the summer at Carlsbad), Comanos Pacha
(Greek, graduated in Germany). In addition, a great number of English, French and
Arabian physicians.

Apothecaries. Numerous apothecaries of all nationalities, among others that of
Karl Simmermacher, successor of Dr. Kiippers, in Hotel Continental, and that of Zechini
in Savoy-Hotel.

Hotels: Savoy-Hotel, first hotel in the town, distinguished by the visit of His
Imperial and Royal Highness the German crown-prince. Splendid new edifice with
modern and hygienic outfit, large verandas, southern location, centre of fashionable world.
— Grand Hotel Continental, first-class hotel, 350 rooms, 450 beds; isolated central location
opposite the world-renowned Ezbekieh-garden, large verandas from which the foreigner
may watch the picturesque and extremely attractive bustle of oriental life. Renowned
cooking and wine-celerage. — Hotel d'Angleterre, quiet and comfortable family-hotel,
wonderfully located in the Ismaila quarter, near the Ezbekieh-garden and the opera-house.

At the foot of the pyramids is the often mentioned Mena-House Hotel, to be
reached by car or tram in 45 minutes, or within 20 minutes by automobile. The hotel
is built in the very peculiar Arabian style, and comfortably furnished. It is especially
suitable for a longer stay. Horses, asses, camels and sand-cars are at disposal for trips
to the desert and hunting-picknicks. Cooking and service is satisfactory in all hotels, and
the prices are reasonable.

Consulates: British Consul-General : Viscount Kitchener of Khartoum, K. P., G. C. B.,

0. M., G. C. S. I., G. C. M. G.

British Consul: Arthur David Alban, Sharia Suleiman Pacha, Cairo.

Divine service: Regular service in all languages and confessions.

Costs of cure according to mode of life and comfort desired. The rumour that
Cairo is an extravagantly expensive station is unjustified. Health can be cared for, and
entertainment secured in any form and at the same rates as in any large European
health resort. Cars cheaper than in Europe, likewise articles for daily use, as hats,
clothes, shoes, and under-wear. Excellent opportunity for shopping in oriental bazars in
which the most precious goods are stored up (rugs and embroidery etc.)

Price of pension in first-class hotels 20 Frs. per day, second class 12 — 15 Frs.
and less.

Season : From middle of October to middle of ApriL

Whoever considers Cairo too noisy may go to Helouan, three miles southern to
Cairo (about 12 English miles), with tepid, sulphurated springs

Detailed prospectus by the Directory or by Hotd National, Zurich.

Davos, Switzerland.

Alpine Health-Resort; open all the year.

Situated in the midst of the Rhaetian Alps, Canton of the Grisons, in a large
valley, 5200 feet above sea level, well sheltered to the north-west and east, open to
the south.

Climate has the main characteristics of the Alpine region. There is much fine
weather, little wind, very little fog. comparatively small amount of cloud and precipitation,
dry air, powerful sunshine (especially in winter), great intensity of light. Mean tem-
perature 2,6 "^ C (summer 8,6^, winter 3,25^). Actual duration of sunshine = 4 hours,
55 min. daily, or 54 ^/'o of the possible. Annual summary of observations and monthly
weather charts on application to the Curverein, Davos-Platz.

indications: 1. Prophylaxis against tuberculosis in cases of hereditary tendency
and where there is in any way a predisposition to the disease. 2. Lung complaints of a
chronic catarrhal and infiltrative nature. 3. Chronic bronchial catarrh without any high

Section I: Davos — Droitwich — Bad Durrkeim 111

degree of emphysema. 4. Pleurisy and its after-e£fects. 5. Asthma. G. Scrofula in all
its forms. 7. Neurasthenia. 8. Graves' Disease. 9. Malaria. 10. Convalescence.

The Cure consists mainly in individually prescribed alternation of rest and exercise
in the open air, for which the fullest accommodation is provided, not only in the sanatoria,
but also in all hotels, boarding-houses, villas etc., where invalids are received, there being
the widest possible range of accommodation to meet all purses. Seats and shelters in all
parts of the resort, especially in the woods. All the requirements of modern treatment
on sanatorium or home lines: Oerlel's system of exercise on selected grounds and gradients.
Hydropathy. Massage, Swedish gymnastics. Milk and Kefir cures, etc. EngUsh and
English-speaking doctors. School-Sanatoria.

English Church with permanently resident Chaplain. Roman Catholic and other churches.

Kurtaxe: 25 cts. per day. Reduction for famihes on prolonged visit.

Route: Shortest direct route from the United Kingdom is via Folkestone and
Boulogne, Laon, Basle, Zurich, and Landquart, in about 24 hours from London.

British Consul: Dr. B. Hudson, Schweizerhaus, Davos-Platz.

Further information from the Davos Public Interests Association, Davos-Platz.

Sanatorium Davos-Platz, Dr. A. Schnoeller, see Section 11 ("Sanatoria and Cure-
Establishments").
Forest-Sanatorium, Prof. Dr. J essen, see Section II( " Sanatoria andCure-Eslablishments").
Schatzalp-Sanatorium,Davos-Platz,seeSectionn("SanatoriaandCure-Establishments").
Dr.Turban'sSanatorium,Davos-Platz,seeSectionll("SanatoriaandCure-EstabIishments").

Droitwich. (County Worcester, England.)

Season : Throughout the year. Baths, Waiting Rooms, Coohng Rooms &c.,
efficiently warmed.

Railway station: Droitwich. Joint service Great Western & Midland Railways,
21/2 hours direct service from London (Paddington). Splendid service to Scotland,
Ireland &c., via Birmingham (20 miles).

Climate &.c. : Fairly bracing with absence of fogs and mists; well protected from
north and north-east; fertile and most picturesque country.

Waters: Natural Brine Springs, ten to twelve times stronger than sea water; total
salts to gallon 22212.880.

Baths: Reclining Douche, Aix Douche, Needle, Nauheim &c., three Brine
Swimming Baths.

Indications: Rheumatism, gout, sciatica, neuritis, rheumatoid arthritis &c.

Amusements: Golf, tennis, hunting (2 or 3 packs), Band in Brine Baths Park
and Salters Hall, Theatricals &c., H, M. Guards' Bands & illuminated fetes in summer.
Coaching; excellent roads for motoring, cycling &c. Excursions to adjoining Shakespeare
country and numerous historic and picturesque places.

Full particulars from J. H. Hollyer, 80 Corbelt Estate Offices, Droitwich.

Bad DUrrheim in the Black-Forest.

2460 feet above sea level — the highest brine-bath of Europe, and head-station of
the line Villingen — Marbach — Bad Durrheim, branching off from the Black-Forest-raihvay.
Owing to its saturated brine, to its situation protected toward the south and east by
magnificent pine forests, and to its atmosphere free from dust, this station combines the
advantages of a brine bath and a mountain health resort.

Season from April to end of October. The "Landessolbad" (National Brine-Bath)
and Childrens'-brine-bath of the Ladies' Association of Bade are open all the year round.
3 Physicians, apothecary, post-office.

Boarding according to demands in the Kurhaus and other hotels, in boarding-
houses, and privately.

Entertainments are particularly provided for.

Curative factors: Brine, brine-steam, carbonic acid, brine-electric-light; air and
sun baths. Brine inhalations, massage, hydrotherapy; diet, Oertel and drinking cures.

Indications: Scrofula, rheumatism, gout, organic and functional nervous diseases,
chlorosis, anaemia, rickets, exsudates, diseases of women, affections of the respiratory
organs (except tuberculosis), cardiac and skin- diseases, delayed convalescence.

Detailed information by the „Kur- und Verkehrsverein".

112 Section 1: Bad Elster — Empfing — Engelberg — Evian-les-Bains

Bad Elster (Saxony).

Royal Saxon Mud- and Mineral-Bath.

Junclion of the line Leipzig— Eg-er, also D-trains and L-lrains (express and trains
de luxe). Post-, telegraph- and telephone-office. 1050 feet above sea level. The health-resort
is surrounded by a forest extending for miles with moderate slopes protecting against
the influence of rough winds, and passing over directly into an extensive park kept in a most
ideal manner. Moderate mountain climate. Number of visitors constantly increasing, in 1911
Elster was frequented by 16 738 persons. There are practising 15 physicians, 2 lady-physicians.
Spring-water aqueduct, canalization, electric light.

Season: May l^^ to September 30 ''i; but also open for cure all the year round. Before
the 15th of May and after the 1st of September reduced prices. In September only half of
the Kurtaxe, in Winter no Kurtaxe at all are charged. Bad Elster has 12 alkaline-saline
ferruginous acidulous waters of all degrees, from the milde«t to the strongest. Four of
these are used for drinking cures, as the Konigsquelle with a proportionately high content
of lithium-chloride, and the Marienquelle rich in sodium-chloride and carbonic acid. The
Salzquelle is one of the few sources of Germany containing large amounts of sodium-
sulphate, this source being the invaluable treasure of Bad Elster. As to composition and
effect it is almost equal to the Kreuzbrunnen of Marienbad.

The following baths are used: mud-batlis (since half a century renowned as being
excellent), ferruginous or mineral baths, thermal-, brine-, sprudle- and pine-needle baths,
electric baths. There are two emanatoria, filled by the Emanation of the strongest
Radiumquelle in the world, a medico-mechanic institute with Rontgen- laboratory,
electric-light baths, steam- and hot-air baths.

There are furthermore a hydropathic institute, an inhalatorium, as well as a large
sun- and air-bath with swimming-tanks.

Indications: Excellent results are obtained in general debility, chlorosis and
anaemi a, in cardiac diseases, nervous diseases, especially neurasthenia, hysteria, neuralgia
(sciatica) and paralysis. The extraordinary use of mud-baths for combating all kinds of
exsudates, especially in diseases of women (peri- and parametritis, nienstrual
disorders, sterility etc.) is just as well known as their effect in gout and rheumatism, in
affections of the bones and joints. The sodium-sulphate spring is of a most favourable
influence in chronic gastro-intestinal catarrh, in atony of the intestines, constipation,
haemorrhoids, and especially in reducing cures (obesity).

Entertainments: Two concerts of the Royal Kur-musicband daily; symphony and
evening-concerts. In the Albert- theatre daily performances. On the stage of the
wonderfully situated natural theatre, allowing room for 4000 persons, every week one
performance. (The performances of the Hermann and Dorothea plays are given three
times in every season, very likely middle of June, July and August). Dancing-soiree in
the Royal Kursaal. Park and forest-parties, fire-works on the large gondola-pond, rowing,
abundantly supplied play-grounds for children, donkeys for riding, tennis-fields. In
the winter large sledyring-road and sleigh-driving. In the Kurhaus 2 reading-rooms, ladies'-
parlour, billiard- and card-rooms. Permanent exhibition of paintin;.'s.

Sanatorium Bad-Elster, Sanitatsrat Dr. Kohler, see Section II ("Sanatoria and
Cure-Establishments").

Dr. R. Schmincke's Sanatorium, see Section II ("Sanatoria and Cure-Establishments").

Empfing,
Engelberg,

Bavaria, near Traunstein, 1300 feet above sea level. Indifferent waters;
climatic air station.

Switzerland, on the Lake of Lucerne, 3560 feet above sea level. Climatic
mountain station of world-wide fame.

Fvi Jill -IpQ -RjlinQ France, Upper Savoie, on the lake of Geneva opposite
U Vi€lll'*lCO "IJCIIIIO, Lausanne. Calcareo-bicarbonated waters and climatic air
station. A very agreeable sojourn for tourists as well as patients. Excursions in great
variety into the forests and mountains.

Section I: Bad Ems 113

Bad Ems (Germany)

in the province of Hessen-Nassau. 340 — 1560 feet above the sen-level, has been renowned
for many centuries as an international health resort and watering place; it was mentioned
as far b.ick as the eleventh century. It is situated in a most ch;irming spot on both
banks of the river Lahn, some 8 miles from its outlet into tlie Rhine.

Ems is a station of the railway line from Coblenz to Giessen, at wliich
all express trains stop, and has through railway connection in all directions.

It has a population of about 7UOO and is visited during the months May till October
by about 25 000 people.

The season lasts from the 1 ^t of May till the 1st of October, but both before
and after these dates ample opportunity is provideil for treatment at Ems.

The climate of Ems is very mild. Being encircled by mountains the town is
well protected against strong winds. The Lahn, which runs through it, the extensive
forests surrounding the town, and the shady side valleys impart a most pleasant freshness
and coolness to the air, even on the hottest days of summer.

The mean temperature during the season is 56 *' F.

Maladies: Specially suitable tor treatment at. Ems are: Catarrhal affections
of the mucous membrane, especially those of a chronic character, such as catarrh
of the respiratory organs, the nose, the naso- pharynx and the Eustachian tubes; tinnitus,
catarrh of the pharynx, the trachea, the air passages and bronchial tubes, as well as
the sequelae of snch diseases, emphysema and asthma. The after effects of influenzal
catarrhs, of inflammation of the lungs and pleurisy, catarrhal affections of the digestive
organs, chronic gastric catarrhs, hyperacidity of the stomach, catarrh of the large and
small intestines, jaundice (as a consequence of catarrhal diseases of the gallducts). gall
stones, (the passage of the stones being greatly assisted by the power of the waters to
stimulate the expulsion and flow of mucus); cataniial inflammations of the vagina, the
cervix, the uterus and the Jallopian tubes, as well as para- and perimetritis, sterility (if
caused by the before-mentioned diseases), idiopathic catarrh of the bladder and the membrane
of the kidneys.

In addition to the diseases of the organs of respiration and blood circulation it is
now possible to treat successfully at Ems such diseases of the heart as have, hitherto,
been deemed capable of being treated only at certain watering places which are specially
suited for them. This is achieved by the recently tapped "Neuquelle" spring, which

114 Section I: Bod Ems

yields a strongly carbonated alkaline-muriatic thermal water of various degree.?. Successful
treatment can al-:o be effected by the internal and external use of tlie waters in the
following diseases: gout, many forms of nephritis and chronic rheumatism of the joints
and muscles.

The lenf,'th of time required for a cure at Ems varies from 4 to S weeks

Contra- Indications: The use of the Ems cure is prohibited in the following
diseases: acute maladies or those accompanied by fever, especially those of a tuberculous
nature, as well as in any tendency to haemorrhage of the lungs and in conditions of
excessive weakness.

The drinking cure (internal use of the waters): The medicinal springs at Ems
are, with one exception, carbonated sodium thermal waters, containing' sodium chloride,
and have a temperature of 83 — 152" F.

For drinking purposes the following are prescribed:
1. Kraenchen I, 5. Kaiserbrunnen,

'i. Kraenchen II, 6. Victoriaquelle,

3. Kraenchen III, 7. KOnig-Wilhelm-Felsenquelle and

4. Kesselbrunnen, 8. Stahlquelle (cold iron spring).

These springs, all of which belong to the Prussian State, were newly tapped
during the last few years in accordance with the latest approved systems anil are protected
in such a manner as to exclude any possibility of their coming into contact with the
external air or being contaminnted by dust or any other impurities.

In their chemical constituents the warm springs are very similar to each oilier.
At a varying tem.perature of individual springs ranging from 83 — 152 ** F. their average
proportion ot bicarbonate of soda is 2 grammes, of sodium chloride 1 gramme, of free
carbonic acid 500 — 600 ccm per liter. Only the cold iron spring, a weak acidulated
chalybeate water, shows a different chemical composition.

We will quote here only the result of the investigation:^, carried out in 1903 by Geh.
Regierungsrat Prof. Dr. Heinrich Fresenius, of the best-known drinking spring Kraenchen I,
as published in the German Book of Spas (Baderbuch).

The mineral water in its composition is about equal to a solution, containing in
1 kilogramme: Grammes

Potassium chloride (KCl) 0,04050

Sodium chloride (NaCi) 0,9926

bromide (NaBr) u,000487

iodide (NaJ) 0,000020

Sulphate of soda (Na^SO^) 0 06248

Hydro carbonate of soda (NaHCOa) 2,194

„ lithia (LiHGOg) 0,01)4302

Ammonia-chloride (NH4CI) 0,001438

Hydro-phosphate of calcium (CaHPOj) 0,0i)1296

„ -carbonate of calcium [CalHCOs).,] 0.2615

„ strontium [Sr(HG03lo] . O.002243

„ baryta [BaiHGOglo] 0,001138

„ magnesia [IMglHCO^).] 0.2371

„ iron [Fe(HGO:i) ] 0.004045

„ manganese [Mii(HCOs).,] 0,000185

Silicic acid (meta) (ILSiOg) " . 0,06141

Total 3,865

Carbonic acid, entirely free (COo) . 1,100

Total of all constituents 4,965

Gargling rooms: On the groundfloor of theRoyal Kurhaus, in immediate proximity
to the drinking springs, are three large gargling rooms, two for men and one for women,
each divided into about 30 separate compartments. Here also are appliances for nasal
douches. Running springs, with warm and cooled mineral water, in every room.

Thermal baths: The bathing establishments are supplied with thermal water
from the "Neuquelle" — on the left bank of the Lahn — (Government property).

In the "New Bath House", wliich was entirely rebuilt and redecorated during the
winter of 1910/11, pure natural carbonic alkaline-muriatic thermalbaths, so-called "Ems
Baths", can be had, in addition to the ordinary tliermalbaths. The alkaline baths can
be regulated to various degrees of strength and constitute a novelty to be found in
Ems only.

Section I: Bad Ems 115

The "New Batli House", which is partly fitted with hathing saloon?, contains hot
air. vapour and electric light hatlis, electric hatlis with two and tour compartments and
a hydrotlierapeutical section. This latter, as well as most of the other bathing compartments,
has fittings for the supply of cold and hot douches and of all kinds of shower-baths.
Douches for internal use can be supplied only on a doctor's prescription, wliich must stale
the strength, temperature and duration of the application.

Massage and any other medical prescription appertaining to the use of the baths,
especially those for the preparation of saline and other medicinal baths, receive llie most
conscientious attention.

Massage and cold water treatments are carried out by trained attendants, not only
in the rooms set apart for the purpo-e, but also at the patient's home.

Inhalations; In tiie Royal lulialation Establishments nothing else is used
but the miupial waters from the government spring-, which at the patient's request are
frequeully strengthened by the addition of some natural Ems spring salts.

The "'Neues Hadeiiaus" contains a large general inhalation room for free-spraying
by means of central sprayers "Imperator", but separate inhalation compartments can also
be obtained tliere.

Apart from the Government Establishments there are a number of privately
owned inhalatoria with apparatus and fittings of various kinds, including those for iniialing
finely sprayed medicaments. Ample arrangements for pneumatic inhalations, as well as
pneumatic chambers of thf most modern type, are provided.

Cure-Tax: The cure- tax, for which cards (Kurkarten) are Lssued is, for the whole
season, Mk. IS.— for a single person or the head of a family; and Mk. 9. — for every
additional member of a family.

These cards are obtainable at the offices of the "Kurkommission" (in the
Kursaal), who, on application, will be pleased to forward;, post free, fully illustrated
prospectuses of Bad Ems.

Doctors and members of their families are exempt from the cure-tax; further,
nearly all the State bathiny: arrangements are at their disposal free.

River, air, light and sun baths: A bathing establishment in the river affords
opportunity for bathing and swimming in the Lahn; air, light and sun baths can also be
had in another section of this establishment.

Milk, whey and kefir can always be obtained fresh and in good condition. Goats'
milk and Avhey and sterilized cow's milk is to be bad in the drinking hall at the usual
drinking hours in the morning.

The air health resort Hohenmalberg 1267 feet above the sea -level
and situated on the left bank of the Lahn, can be reached by shady and gently ascending
wooded paths, or by means of the rope-railway (6 minutes' journey).

Amusements: Kursaal with covered promenade, situated in the midst
of the Park Grounds on the right bank of the Lahn — beautiful concert, reading and
playing rooms — rendez-yous for visitors. Dancing, flower carnivals, symphony and vocal
concerts, children's entertainments. Theatre; concerts three times daily, in the
Kurgarten, by an orchestra of 50 musicians. Artistic illuminations and
fireworks, regattas, water carnivals &c. Up to date tennis grounds;
fishing and boating. There are also opportunities for hunting, walking and excursions
into the woods, both in the immediate neighbourhood of the town and some distance
away from it.

Places of Worship : Two Protestant, two Catholic, one English and one Russian
church, and a Synagogue.

Sale and despatch of Ems water and the Ems spring products. Whilst
everything has been done at Bad Ems itself to enable visiting patients to take the fullest
advantajre of the medicinal properties of the springs and to derive the utmost benefil
from ttieir stay at Ems, the authorities have by no means overlooked the needs of the
vast number of sufferers who are unable to take the cure on the spot. In order that
these also may benefit by the curative virtues of tlie Ems springs, arrangements have
been made for the packing and despatch of Ems Mineral Waters and the various products
made and derived therefiom (Pastilles and Springs salts), to any part of the world and
iit any time of the year.

For this reason there exists a widespread and ever increasing demand for the Ems
waters, for home use, in all parts of the globe.

In 1911 about 3 millions 400 000 of vessels have been despatched.

116 Section I: Bad Ems — Faldo — Franzensbad

The Natural Ems Spring Salts are obtained by the Ems Mineral Waters being
evaporated by means of a vacuum evaporation plant fitted with all the latest technical
appliances.

By the process employed all the natural qualities of the mineral waters are retained
in the same proportion in the soluble salts.

The natural Ems Spring Salts are principally prescribed and used for gargling and
for douches in chronic catarrhs of the nasal cavities, mouth and throat, for iniialations,
sprays and eye-lotions, also as a refreshing dentifrice and as a powerful addition to the
Ems mineral water.

As a guarantee for the genuineness of the natural Ems Spring Salts insist on the
following: 1. Square bottle with rounded corners, 2. Trade Mark on cap and label,
3. Unbroken seal and undamaged cap and label.

Ems Pastilles : These well known Pastilles are made from the pure natural salts,
in the Pastilles factory, which is attached to the Evaporating station and which is under
government control.

Each Pastdle is stamped with the registered trade-mark ''Konigl. Ems", whicii
insures their genuineness.

The Ems Pastilles are packed in aluminium tubes, made air-light by a process
patented in all civilised countries.

Medical experience, extending over many years has proved the Ems Pastilles
beneficial in:

1. Catarrhs of the respiratory organs, especially in alleviating cough irritations
and in catarrhs of the pharynx and trachea,

2. Catarrhs of the stomach and intestines, especially in relieving heartburn and
other signs of excessive acid formation.

Laboratory : A laboratory eciuipped with all the most modern appliances has been
established for the continual supervision of the springs, their productiveness, quality and
germ contents, as well as for the control of the preparation of the salts and the
manufacture of the Pastilles.

Doctors: Sanitatsrat Aronsohn, Barthels, Baur, Falk, Feigen, Koch, Meuser, Muller,
Nehab, Oldengott, Pescatore, Sanitatsrat Reuter, Samter, Slemmler, Geh. Sanitatsrat Vogler,
Albert Vogler, Werner.

For all other details write to the

Royal Prussian Baths and Springs Directorate, Bad Ems [Germany).

Faido, Canton Tessin, Switzerland

Climatic Health Resort for thie Summer (Spring and Autumn),

2625 feet above sea level.

Eaihvay-terminus of the Golhardt-line, station of all passenger-trains and fast-trains
as well as of most of the express-trains. Faido with 1000 inhabitants is an air station
with many climatic advantages, and furnished with any kind of modern comfort. Pure
mountain air saturated with the balsamic perfume of the neighbouring pine forests and
cooled by a grand cataract. Very suitable for a longer stay in summer. Very much in
favour as a pleasant station in the spring and autumn for those going to or returning from
the Riviera. — The visitors have become enthusiastic about Faido, and many of them
have bought propriety and settled there, in order to restore health.

Indications: Chlorosis, anaemia, nervous and neurasthenic conditions are influenceii
favourably. Very suitable too for convalescence and exhaustion. Children particularly
that have gone down-hill in the atmosphere of large cities, recuperate in a remarkably
short time.

Boarding: Excellent hotels and many fine summer residences. Very much reduced
prices lor pensions in the months of June .-md September. Physicians and apothecary.
Guides for mountain-tours.

Prospectus and information on- application to the „Versch6nerungsverein".

pKmiTPnQViaH Austria, Bohemia, 1600 feet above sea level, situated near Eger;
n ali^ClloUaU, the first mud bath of the World. Surrounded by richly wooded
mountains. Air rich in ozone.

Section I: Friedrichroda 117

Friedrichroda in Thuringia.

Climatic Summer and Winter Health Resort. Winter Sporting Station.

Topography: Friedricluoda is situated in the northwestern part of the Thuringian
forest, 15 km south- western to Golha, and 1500 — 1600 feet ahove sea level. The whole
place, including- the castle of Rheiiihardsbiunn, has altogether 4500 inhabitants. It is
surrounded and protected by densely wooded hills rising up to the heiglit of 2550 feet.
Wonderful forest-walks of various decline and a tola! length of more than
90 km extend tlirough the whole region, allowing even to weak persons to enjoy all the
beauties of this grand natural park reaching as far as the 320'J feet hi^rh Inselsberg.

The climate is mild and equable, owing to the altitude and latitude of the place.
It is intermediate between the climate of the West-European coast and the climate of
the East-European continent, and it is undouliledly the best example of a German
mountain and forest climate. The average dnily temperatures are afcording to the
observations of many years: in January — 2.7" C ; Februarv — 1.3»; April 2.8" G (ii7.2" F) ;
May 12.6« G (55o F): June 15.1«G (59» F); Julylfi.QoC (62.50F); August 16.8" G (6-2" F);
September 13.8" G (57" F); October 7.7° C (46.2° F); November 2.2" G (35.7" F);
December — 1.5" G. The relative moisture during the summer months is 70 per cent,
in the average, in winter somewhat more. These favourable climatic conditions
together with the wonderful parity of the air and tlie excellent water — radio-
activity of the springs 1,3 Mache units — constitute the natural curative means
of Friedrichroda.

The public hygienic conditions answer the highest demands of a first class
health resort. There is a water-pipe system supplied by the purest mountain
springs, a deep canalization with setting-reservoir on biological principles, obligatory
removal of sweepings, legular cleansing and sprinkling of the streets, two public
bathing establishments, swimming bath in the open air, sun and air bath of
the municipal administration. There is also a recently built city hospital, and, in
addition, five comtorlably furnislied sanatoria supplied with all modern thera-
peutic appliances. Gas and electric light.

Indications: The above mentioned curative means and, in addition, the excellent
situation of the place, the influence of which upon the psychical conditions cannot be
appreciated too much, have proved particularly favourable in the following conditions:
Delayed convalescence aiier severe diseases, disorders of nutrition, such as
nnaemia, chlorosis, subnutrition, obesity, diabetes, weakness and irritability of the
nervous system, affections of the heart and of the vessels, nervous and clironic
catarrhal affections of the respiratory and digestive organs, tropical
diseases and malaria. Owing to the varying firmation of its ground, Friedrichroda
is suitable for Oertel-cures and is especially jjreferred as a station after a cure at
Wiesbaden, Nauheim, Ems, Kissingen, Garlshad. Marienbad etc.

Physicians (see also sanatoria): Geh. Sanitalsrat Dr. Kothe, Dr. Max Bohm,
Sanitat?rat Dr. Lots, Dr. Goering, Dr. K. Bielin?, Dr. Wanke, Dr. Hartz, Dr. Ortlepp,
Dr. J. libbers. — Bottsack & Hering, dentists. — Dispensaiy and drug-store; supply of all
known mineral waters and specialties.

Boarding: The numeious hotels answer the most various demands regarding
provisions and prices; tliere is also a great number of highly recommended boarding-
houses anil pensions. Apartments for annual rent are increasing, as the influx of
private families is constantly growing. As a result of this, a private high school
for boys and girls has been estalilished in addition to the middle-class school.

Entertainments: The summer season lasts from beginning of May to end of
September. During this time the Kurhaus is open with its concert, reading, and playing-
rooms; concerts are given daily by the music-band, symphony- and chamber-music soirees,
theatre, reunions, and other entertainments arranged by the administration of the bath;
besides tennis-matches, horse-races near Gotha — Bocksberg <SlC. During the winterseason
there are less entertamments of the just mentioned kind, but there is vivid winter-sporting
in various forms, such as ice-skating, ski-ing on fine slopes, toboganning-run of 910O feet
lenght, bobsleigh-run of 5050 leet length, sleighing-drives through the whole superb forests
with their beautiful snow laden fir-trees.

Kurtaxe: 5-12 Mks, to be paid only in summer.

Divine services: Protestant and Lutherian all the year round; Roman-Gatholic
only in the summer.

118 Section I: Friedrichroda — Gardone- Riviera — Godesberg

Means of Communication: Friedrichroda is easily reached by leavini,' the main-line
Berlin — Francfort on Main at station Frotlstildt. For the western and northern part ot
the town, the station of Reinhardsbrunn is the most convenient. Berlin and Francfort
are to be reached within 5 hours, Leipsic in 4, Dresde in 6, Cologne and Hnmburg in 8
Amsterdam and Munich in 10 hours. For the vicinity mail-coach, omnibus and autobus
communications as well as cabs controlled by the administration.

Illustrated prospectus sent free of charge by Die Stiidtische Kurverioaltiing

Vorsitzender: Br. Kothe.

Sanatorium Friedrichroda, Geh. Sanitatsrat Dr. Kothe, see Section II
("Sanatoria and Cure-Establishments").

Sanatorium Tannenhof, Friedrichroda, Dr. Bieling, see Section II ("'Sana-
toria and Cure-Establishments").

Gardone-Riviera on the Lake of Garda, Italy

situated at the northern edge of the bay of Salo, in a delightful locality protected against
winds by the spurs of the Alps (7000 feet). Unlimited view to the south upon the
sea-like lake with the Isola di Garda of Prince Borghese. Up to the end of November
the character of the scenery is that of the latter part of summer. Also in winter the
evergreen olive-trees and laurels predominate in the landscape.

Climate; The mean temperature in Gardone-Riviera and the adjacent Fasano is,
according to the observations of physicians, higher than at any place northern to the
Ligurian Riviera. The horizon being open toward the south, only a few minutes of
the sunny day are lost. The moisture of the air is of a mean degree and but slightly
varying. The greatest advantage, however, of Gardone and Fasano is their being protected
against winds ; calm air was in more than 80 per cent, of observations made three times
a day, i. e. in * 5 of the entire season (September to June)

Indications: Convalescence after acute diseases, chronic affections of the throat
and chest, irritability of the nervous system, anaemia, scrofula, affections of the circulatory
apparatus, of the kidneys etc. Residence for overworked people needing rest.

Physicians: From Germany: Hofrat Dr. Krez, Sanitatsrat Dr. Rohden, Dr. U. Koeniger,
Dr. Koch, Dr. Brix. From Austria: Dr. Boral. From Russia: Staatsrat Dr. v. Clemens,
Miss Frenkel M. D. From Italy: Dr. Molinari. Dentist: A. Hruska — Nursing is provided
for. Apothecary at the place.

Lodging: First-class hotels and pensions furnished according to modern comfort;
besides, simpler hotels and pensions as well as private houses in sufficient number. Prices
of pension from about 7 Lire per dav. Number of visitors in 1910 — Htll more
than 15 000.

Entertainments: Wonderful promenades and excursions in great number and
variety. Large new strand-promenade, rowing, motor boating and sailing. Electric tram
to the vicinity. Private club in the Kurkasino. Two great concerts daily in the new
large Kursaalkasino,

Means of Commucation: 1. Via Simplon or St, Gothardt to Milan-Desenzano,
from here by steamers to Gardone (but also by car in 2 hours). 2. Over the Brenner
(Tyrol) to Riva on Gardasee (change at Mori). 3. Over the Brenner to Verona-Desenzano,
from here as sub 1.

Prospectus and information sent free of charge on application to the Kurverein.

Mineralbath Godesberg on the Rhine.

Situation: In the most charming part of the entire Valley of the Rhine, close to
the wonderful river, and opposite the ever-beautiful Seven Mountains Chain, rises aloft
the basalt-hill of Godesberg like a tower, bordering the valley from the west; and around
this hill adorned with grand old castie-ruins, the health resort of Godesberg has developed
in the south, the east, and the north. Godesberg is situated at 24,45'^' eastern longitude
and 50,41 ^' northern latitude, about 28S feet nbove sen level, in the Prussian administrative
district of Cologne, on the left bank of the Rhine. 7 km southern to the university-
town of Bonn. 33 km. from the district-c;ipital of Cologne.

Climate: As can be gathered from the development of the plain of the Lower
Rhine, the conditions of the ground are extremely favourable in the whole region.

Section I: Godesberg — Hall — Heligoland — Heringsdorf 119

likewise the climatic conditions. Tlie air is mostly slightly stirred, and has a moisture
favourable to the entire organism of man. There are at Godesberg neither stagnating waters
nor swamps, nor factories and other establishments deteriorating the atmosphere. Large
shadowy forests extend close to the place, and there are for good walkers the most
attractive forest -walks leading as far as the town of Bonn. The meteorological
observations of many years have proved that Godesberg has the mildest winler-chmate
among all health resorts of Germany, and that it, therefore, more than any other station,
is suitable as a Avinter-station for exhausted patients.

Curative factors and indications: The old radioactive, alkaline-muriatic
ferruginous-spring' at the Draitschbusch, known already at the limes of the
Romans, was restored and curbed five years ago, by the spring-engineer Scherrer; one
of the seven springs was directed to the Kurpark 1 km distant, to form here a second
drinking spring. According to the analysis of Prof. Fresenius at Wiesbaden, the
Draitscliquelle is rich in free carbonic acid, and contains of dissolved mineral
bodies preferably bicarbonate of sodium, sodium chloride, bicarbonate of
magnesium and bicarbonate of calcium, furthermore sodium sulphate and
considerable amount of bicarbonate of ferrous oxide. There is also present
a considerable amount of bicnrbonate of lithium. The temperature of the
water is 12 " C. == 53,6 'J F.

Indications for applying a cure w-ith our spring are given for all the diseases
requiring particularly action of iron combined with carbonic acid, i. e. for
chlorosis, for catarrhal affections of the respiratory and digestive organs,
furthermore for all diseases of the female sexual organs associated with
anaemia and of the nervous system, especially for hysterical and
neurasthenic conditions. For these affection not only the drinking cure but,
above all, the Hpplication of the nerve-strengthening and invigorating
natural carbonic acid baths comes into question (Bathing-house near the spring).
The application of the baths has also proved successful for rheumatic
affections as well as for affections of the liejirt, and of the circulatory
organs.

Table-water. The table-water obtained from the Draitschiiuelie is of great
repute as "Godesberg table-water", and has been for many years the favourite
table-water of the Royal English Court. Export to all places. The mineral
cure-water is likewise exported for cues at home. For all information apply to the
Administration of Godesberg on the Rhine.

Godesberg has five sanatoria and hospitals, two general hospitals. Twenty
physicians are practising at tiie place.

Administration: "Kurdirektion" and "Verkehrsverein" give information on all
items about Godesberg. Prospectus free of charge.

Season: All the establishments are open all the year round, likewise the baths at
the mineral-springs.

Summer-season: May to September.

Means of communication: Godesberg is one of the principal stations of the Royal
Railway on the left bank of the Rhine, station of the Cologne— Diisseldorf steam-ship
company, furthermore of the local steamer-lines Bonn— Konigswinter, and of the electric
railway Bonn — Godesberg — Mehlem.

Dr. Franz Miiller's Sanatorium Schloss Rheinblick, see Section II
("Sanatoria and Cure-Establishments").

Dr. R. Schorlemmer's Sanatorium, see Section II ("Sanatoria and Cure-
Establishments").

LI«1| Upper - Austria, 1300 feet above sea level, with highly favourable climatic
ndll^ conditions. The waters contain iodine and bromide.

Hpliftnlj^nH (Helgoland), much frequented North-Sea bathing place. Its wholly
ndiyUlClIlU insular position warrants fresh pure i-ea air; the salt content of the sea
is very high.

HPKinnQHnKf Germany, in the Prussian province of Pomerania; much frequented
ncl lliyoUUI 1^ sea bath, surrounded by large beech forests. Season: June to September.

120 Section I: He'ouan

Helouan (Helouan les Bains) in Egypt

Situation: For a winter healtli resorl Helouan is entitled l> lie considi.'reJ
exceptionally favourably in view ol its excellent jiosilinn. Situated within easy reacli of
Cairo, wliicli is only sixteen miles distant and with which town it is connected hy half
hourly service of tiains, it yet has the advantages of being surrounded by deiert, thereby
ensuiiiig a wonderfully pure air. It also is tJie fortunate possessor of a magnificent
bathing establishment supplied by sulphur saline water of exceptional strength, which is
produced from a number of springs which ancient Egyptian records state to have been
in existence as early as 16G0 B C. The town which lies at the foot of the Mokkatam
hills is three miles distant from the Nile and 150 feet above it.

Season: The winter season commences in October, and visitors will not find it
unpleasantly hot even as late as May

Climate: Daring tlie winter months the average amount of daily sunshine is eight
hours, the average maximum temperature amounting to 70" F., in the evening the
average minimum being 60" F., at night the average minimum during the same period
is 50 F. It is important to note that there is no sudden fall in temperature, the change
from maximum to minimum being a graduate one.

Helouan is singularly free from dust despite its desert position, which is attributable
to the fact that the gianules of the sanil are larger and of higher specific gravity than
particles of dried cultivated soil, and consequently less easily disturbed by any wind

Sulphur Saline water. The natural sulphur saline water employed al the Bathing
Establishment has a temperature of91"F. in the springs, and in the b iths can be further
heated by steam if desired, the amount of steam recjuired being exceeilingly small; thus
the water is practically used in its natural strength. It is sjjecially rich in chlorides,
sulphates and sulphuretted hydrogen. The ideal climate which this hedlth resort will be
seen to possess during the winter months makes it a unique spot for a bathing cure at
such a period of the year.

The Bathing Establishment. The Bathing Establishment itself is worthy of its
wonderfully strong wator which by comparison of its analysis with other sulphur waters,
shows it to be stoni:er than any u-ed for bathing puiposes in Europe.

The building has been fitted with every comfort that visitors can require, and is
magnificently equipped with numerous kinds of baths. Special attention may be drawn
to the "Helouan Bath" by which the body is submerged in a continual supply of
stiong sulphur saline water and accompanied by massage under the water. In addition,
there are electric light baths of the latest pattern, baths supplied by faradic and galvanic
electricity, Vichy baths, steam baths, sun baths and all kinds of douches. A highly
trained staff of European masseurs and masseuses are in attendance.

In connection with the establishment there are two magnificent open air swimming
baths: one for gentlemen 60 yards long and 25 broad, and one for l.die- which is
slightly smaller.

Indications for Invalids: From a climatic point of view, Helouan with its equable
climate, the average yearly rainfall being only one inch, its pure dry air free from dust
and germs, offers exceptional advantages to those suffering from early chest troubles,
chronic bronchial conditions, renal diseases, albuminuria, enlarged glands, asthma and
anaemia. In addition, persons suffering from nervous breakdown, overwork, and con-
valescence after severe illness will find the healthy conditions which prevail in such a
place as Helouan, most suitable in which lo regain their health.

The Baths with the helpful .influence of the climate are famous for the treatment
of rheumatoid and osteo-arlhritis, gout, sciatica, syphilitic affections, lumbago and skin
diseases, such as psoriasis and eczema.

Doctors: Dr. 0. Kobson, Government Medical Director of the Bath-:. Address:
Villa Sakkarah, Helouan. (Summer: 31 Grosvenor Street, London.)

Dr. J. Berninger. Address: Bue Ragheb Pascha. (Summer: Bad Nauheim, Germany
6 Alicenplatz.) Dr. A. Haas. (Summer: Steyr, Austria.)

Dr. Glanz, Dr. Preminger (Summer: Marienbad in Bohemia), Dr. Rabinovitch,
Dr. Haas, Dr. Ackerley, Dr. Safuat.

Zander Institute: A well equipped Zander Institute, the only one in Egypt and
under medical Direction, has lately been opened at Helouan.

Hotels: Grand Hotel Helouan. Patronised by Royalty. Splendid position;
adjoining the Casino and gardens; within five minutes from the Baths and Golf Course.
Cooking of highest order, special diet for those suffering from kidney disease, williout
extra charge.

Section I: Helouan — Bad Homburg 121

A special feature is its large luxurious Hall rlecoraled in Moorish slyle, comfortable
reading, uriling, and card room?;, and l)illiard room.

Private suites of rooms willi bathrooms attached.

Pension from I'i 3 to 20 (i. Manager: A. Pdrtj.

Hotel Pension des Bains. Comfortalile family hotel close to the Bnths, magnificent
private garden. Special diet lor tho-e suflering from kidney disease, without extra chariie.
Pension from 8)3 to 12 3.

Prospectus willi fullest irifoimation as to the Baths, Hotels etc. sent free on
application to tl]e Manager of the I'aliis or Giand Hotel Helouan.

Amusements. IS hole golf course considered the finest in Egypt with its own
comfortalile Club house. English professional in attendance with all golfing requisites.

Tenuis club possessing several magnificent courts, frequent tournaments during
the season. Unrivalled opporlunities for riding. Quail, duck and snipe shooting can be
obtained at very modeiate rates.

Excursions. Admirably situaled for visits to the Pyramids of Sakkarah, Memphis
the ancient capital of Egypt, caves ot Massarah, and the various places of interest in
Cairo, such as the Citadel, Mosques, Museums etc.

Bad Homburg in the Taunus.

2G minutes from Francfort on the Main.

Eight Mineral-Springs. Six cold cariionic acid sodium-chloride waters among
which the recently bored Solsprudel, Landgrafenbrunnen, and Auguste Vicloria-
Brunnen are especially distinguished by their high content of carbonic acid and salt; two
ferruginous springs.

Drinking and Bathing Cures of a thorough effect in diseases of the digestive
tract (gastro-intes^tinal catarrh, residues of perityphlitis, haemorrhoids, hepatic and bilious
affections), in cardiac diseases (regulation of cardiac action and strengthening of the
heart-muscles), as well as in nervous affections, neurasthenia, sciatica etc., furthermore in
disorders of metabolism (obesity [loss of weight without any loss of albumen], diabetes,
gout, chronic rheumatism, scrofula) and Avomen's diseases (chronic metritis, residues of
l)arametritis), chronic kidney diseases.

The ferruginous springs easily digestible on account of their sodium chloi'ide
content, of a good effect in chlorosis, anaemia and asthenic conditions due to exhaustive
diseases (influenza etc.)

In the Kaiser Wilhelms-Bad, furnished according to the most modern comfort'
natural carbonic acid baths and simple sodium chloride baths (the former according to the
method of Schwarz), pine-geedle, mud, electric light baths. Shower-baths, swimming- tanks,
inhalatorium New: gargling-cahinets, common inhalatorium, and pneumatic inhalatorium.

Homburg clay-mud-packings. For winter-cure purposes the recently built
Kurhausbad has been united with the colonnade of the Kurhaus. The same kinds of
baths as in the Kaiser Wilhelrasbad; besides steam and hot-air baths (Roman-Irish), milk-
cure etablishment, orthopedic institute connected with appliances for electro-therapy.
Cold-water sanatorium. Homburg diet.

Homburg is situated on a well-aired moiintain-crest, 670 feet above sea level.
There are large parks close to the forest The place is also recommended as a climatic
station especially to nervous patients and convalescents. Excursions (electric tram) to the
near Taunus Mountains and to the Saalburg (Roman castle).

The Kurhaus is open all the year round. Summer and w'inter-sport (tennis, golf,
croquet, bob-sleigh and ski-sport.) Concerts daily, likeAvise theatre-performances, balls,
reunions, lectures etc. Continuation of drinking cure in winter in the heated
colonnade which has a length of 160 yards.

Homburg has excellent hygienic establishments, mountain-water supply, rinsing-
canalization, electric light, high-schools, young ladies' school.

Export of mineral water during the whole year

Prospectus and illustrated descriptions free on application to the

Ktirverioaltuvg (Administration).

SanatoriumDDr. Pariser-Dammert, see Section II ( ' Sanatoria and Cure-Establishments").

Sanatorium Dr. Baumstark, see Section II ("Sanatoria and Cure-Establishments"}.

122 Section I: llidla — Bad Kissingen

liidza in Bosnia.

Bosnia and Herzegowina.

New and extremely interesting countries for tourists.
Landeskuranstalt Ilidza.

National cure establishment near Surajevo (Bosnia). Sulphurous thermal spring
of 57^ C. (134,6 0 F.) especially indicated in rheumatic afTections, gout, neuralgia, rickets,
and in all syphilitic and bone affections. Particularly good results in women's
diseases of any kind, as there are also excellent and elegantly equipped mud baths
(vegetable mud from Zepce). Carbonic acid baths, sanatorium for hydro-
therapeutics according to the system of Prof. Dr. Winternitz. Cold river-baths,
sun baths, recommended by first medical experts as: Prof. Dr. Chrnobak, Hofrat
Prof. Dr. Neumann and Prof. Dr. Ernst Ludwig.

Season from May 15tli to end of September.

Electric light. Elegant Hotels Interurban telephone.

Moderate rates. Best comfort. Beautiful excursions. Trips to the mountains.
Train and mailcoach to all principal routes. Prospectus and information fiee
of charge by the Directory of the Landes-Kuranstalt, (at the same lime Information-
Bureau for Travellers.)

F^PirlQllJiH Bohemia, 1200 feet above sea level, on both banks of the small river
rVdlloUCtU^ Tepl. Health-resort of international reputation.

Dietetic Institute "Villa Ritter", Karlsbad, see Sektion II ("Sanatoria and
Cure-Establishments").

Sanatorium Kaiserl. Rat Dr. Tyrnauer, Karlsbad, see Section II ("Sanatoria
and Cure-Establishments").

Konigliches Bad Kissingen.

Situation and Climate: Kissingen, authentically known as a saline since the year 824,
as health-resort since 1544, is a town of 5671 inhabitants. It is situated 7035 feet
above the level of the North Sea, in the Northern part of the kingdom of Bavaria, in
the governmental district of Unterfranken and Aschaffenburg, at the south-eastern
slopes of the Rhon-mountain, in the picturesque valley of the Saale-river. The valley is
protected against rough winds and against rapid changes of temperature by gently
ascending hills and mountains. As the mean summer temperature is 17.2U" C = 62,5" F,
and the medium atmospheric moisture amounts to 74,4, the air of Kissingen can compete
with any summer-station. The cooling off at night is most refreshing and of the greatest value.

Duration of Cure: The season proper is considered to be the time between
April 15t'> and October 15tli, baths are, however, given from the beginning of April to
the end of October. The driuking-cure may be applied all the year rouud.

Number of Visitors: Season of 1911: 33 980 visitors and 14 003 travellers.

Curative Factors: In the Kurgarten the three potable springs close by one
another — viz., the world renowned Rakoczy, the Pandur and the Maxbrunnen. The two
brine -springs: Salinensprudel and Schonbornsprudel, very rich in carbonic-acid
(1440 58 cbcm. per liter); they are applied for carbonic-acid brine baths with or
without addition of "Gutsole", of mother-lye and Kissingen bathing-salt, for
carbonic-acid baths with wave and douche, for brine-baths poor in carbonic-
acid with various degrees of saltcontent; brine baths free of carbonic acid with various
degrees of salt-content ; the "Neue Sprudel". Kissingen bitter-water; Bocklet Stahlquelle
(chalybeate water); Avhey; mineral-mud baths; fango-lreatnienl; graduated brine and
mother-lye: graduation-salt air: pneumatic, hydrotherapeuthic, medico-mechanic treatment;
massage: inhalatoria; Rontgen-institutes; grapes of the Tyrol; all kinds of milk,
kepliir. yoghurt; river-bath and swimming-tank; light-baths, air- and sun-baths;
Oertel-cures.

Indications: Cronic catarrhs of the pharynx, the stomach; deficient or excessive
gastric-acid secretion, chronic catarrhs of the jejunu m and colon, habitual constipation;
disorders due to gaslro-intestinal ulcers and appendicitis, congestion in the portal circulation,
haemorrhoids, congested liver, diseases of the gall-passages, and gall-stones; organic and
functional affections of the heart and vessels; diseases of women; chronic catarrhs
of the respiratory organs, asthma, emphysema; residues of pneumonia and pleurisy;

BadKissmgen - Klampenborg— Kolberg— Krankenheil— Krapina-TopUtz- Klosters 123

disorders of metabolism and constitutional ano:nalies, anaemia, rickets, gout, diabetes,
obesity, diseases of the nervous system: disorders of the loconjotor organs; chronic
affections of the urinary organs; diseases of tlie sensory organs; skin diseases.

Bathing Establishments: Theie are at disposal three bathing establishments,
among these the Priiiz-Regent Ijuitpold Bad, a grand monumental edifice, greatly enlarged
and most completely furnished according to modern requirements, and the Salinenbad,
Avith altogetlier 387 bathing cabinets, of which 322 are for brine and f'andur-baths
including wave-baths, and 43 for mineral mud-baths, furthermore fango-treatment in
separate apartments for ladies and gentlemen.

Physicians (arranged in alpl abetical order): Apolant, Dr. Edgar; Bamberger,
Dr. J.; Bergeni-run, Dr. P., Specialist for ear, nose, throat, and chest diseases; Bergrath
Dr. R., Specialist for skin- and venereal diseases; Chlapowski, Dr. F. v., Sanitatsrath
Dapper, Dr. C. Piofessor. Geheimer Medicinalrat and Koniglicher Hofnt; Dengg, Dr. H.
Dielz, Dr. W.. Koniplicher Hofiat. Inhalatorium, pneumatic cabinet; Dietz, Dr. A.
Dietz, Dr. B. ; Diruf, Dr. E. K., Hofrat; Diruf. Dr. Osk. v., Geheimer Hofrat; Ehren
reich, Dr. E.; Forster, Dr. A.; Geithner, Dr. 0.; Gleissner, Dr. J.; Gress, Dr. F.
Helfreich, Dr. University- Piolessor, Ophthalmologist; Hesse, D. A.; Hi rschkowitz
Dr. P.; Janssen, Dr. V.; Jsin^, Dr. J., Koniglicher Hofrat; Kellermann, Dr. K.
Koniglicher Hofrat; Koziczkovvsky, Dr. E. v., Koniglicher Hofrat; Kramer, Dr. H.
La u dien , Dr. H., Snnitiitsrat; Leusser, Dr. J. K., Koniglicher Hofrat ; Lingenberg, Dr.
Lochner, f?aron K.; Loewenthal, Dr. J.; Maar, Dr. F. K., District- Physician
Maciejewski, Dr. J.; Marcjuardsen, Dr. E,, Koniglicher Hofrat; Meyer, Dr. F.
Modrakowski, Dr. G.; Mohle, Dr. H.; Miinz, Dr. P.; Norwitzky, Dr. H.; Pick
Dr. A.; Rheinboldt, Dr. M.; Rosenau, Dr. A.; Rosenthal, Dr. J., Sanitatsrat
Scherpf, Dr. L., Koniglicher Hofrat; Schneegans, Dr. G.; Schutze, Dr. Ghr.
Schuster, Dr. P.; bo hi or n. Dr. Baron E.; Sender, Dr. 0.. Medico-mechanic Zander
Institute; Sorger, Dr. Fr., Hofrat, Ophthalmologist; Sotier, Dr. P.; Steinbach, Dr. H.
Tritschlei', Dr. H.. Specialist for ear, nose and throat-diseases; Unger, Dr.: Veith
Dr. A., Roentgen-Laboratory; W'ahle, Dr. S.; Weber, Dr. S., University-Professor
Welsch, Dr. H., Koniglicher Hofrat; Wolf, Dr. Th., Koniglicher Hofrat, Railway
Physician.

Bathing-Directory and Administration: The chief directory is the "Koniglicha
Bad-Kommissariat". Orders for mineral-water are to be directed to: "Vervvallung der
koniglichen Mineralbader zu Kissingen".

Information and prospectus solely on application to the "Kurverein".

Prof. Dr. C. Dapper's Sanatorium ,"Neues Kurhaus", see Section H ("Sana-
toria and Cure-Establi«hments"j.

Hofrat Dr. Dietz' Sanatorium, see Section H ("Sanatoria and Cure-Esta-
blishments").

Hofrat Dr. von Koziczko wsky's Sanatorium, see Section 11 ("Sanatoria and
Cure-Establishments").-

Hofrat Dr. Leusser's Sanatorium, .=ee Section H ("Sanatoria and Cure-Esta-
blishments").

Hofrat Dr. Mar quardsen's "Neues diatetisches Kurhaus und Kuranstall", see
Section H ("Sanatoria and Cure Estabhshments").

1^1 QlYIHOnViniTf Denmark, near Copenhagen; a much frequented sea bathing place.
I\lalll[JUllUUiy, Cold seabaths, good sandy beach.

J\01U6rQ^ Prussian province of Pomerania, on the Baltic. Seabaths and saline waters.
KrcinkCnhGll^ Bavaria, see TblZ, page 167.

lYl apina." 1 OpilXZ^ Hungary. Beautiful situation; climate mild and healthy,

l^lnctPTQ Switzerlaml, Canton of Grisons, 4000 feet above sea level. Cold sul-
IVlUoLCIo^ phurous waters.

124

Section I: Krcuznach

Radium Brine-Bath Kreuznach.

Highly Radioactive Brine-Baths for Internal and External Use
containing Jodine, Bromide and Lithium, free from Sulphate of lime.

Topography: Prussian town in the Rhine-province Avith ^4 000 inhabitants, station
of the Rhine Xahe hne, 15 km. from the Rhine. Kreuznach is situated in the wonderful
and legendary vahey of tiie Nahe, on the banks of this river, bordered by densely wooded
mountains and vine-clad hills. It is one of the oldest and most-renowned l)rinebaths.
Its highly active brine-waters containing iodine, bromide, and lithium, have secured
recovery to hundred thousands of patients.

Principal Season from May 1 to October 1; grape-cure. Also winter-station
from Oclolier 1 to April 30.

Curative Factors: The well-known brine-springs of Kreuznach: Elisabethquelle,
St. Martinsquelle. Victoriaquelle, Inselquelle, Orauienquelle, ami numerous springs of the
municipal salt-works Krirlshalle and Theodorshalle situated in the salt-work valley. The
first mentioned springs are used for drinking-cures, the other Avalers for bathing-cures
and for the production of sodium-chloride and the world-renowned Kreuznach mother-lye.

All the brine-springs of Kreuznach are highly radioactive, containing not only
gaseous radium-emanations (up to 60 Mache-units per liter), but also radium-salts in such
a quantity as to allow the preparation of the latter on a big scale, in a special radium
laboratory attached to the city-saltworks. The only establishment of this kind in Germany.

These radium-salts of Kreuznach are used in part for the production of Kreuznach
radium-water for drinking-and bathing-cures, and in part lor the manufacturing
of radium-preparations for local application. The Kreuznach radium- emanation-
baths with a very high original emanation contain, in addition, more than 10 000 Mache-
units of natural emanation from the Kreuznach radium-salts: the dosis fur radium-
drinking- cures is 200—1000 Mache-units per day.

The new natural radium inhalato rium , an elegantly equipited liall in the
Kurgarten serves for radium-inhalations. In a mining-drift, several centuries old, passing
through the porphyritic rock and opening into the Kurgarten, a very high emanation-
activity was discovered in 1911 showing in jjarls up to 59 Mache-units per liter of air.
This radioactivity emanating from the fissures of the porphyritic rock is conducted direct
to a recently built hall, serving here for radium inhalations. We have thus an entirely
new and unique establishment for natural radium-iidialation.

Radium-baths and radio-electric air-baths are prepared in the splendid batliing-
house for radiotherapy, built in 1911. Radiations with radium are also performed here.

There are, furthermore, carbonic-acid baths, electric four-cell baths, hydroelectric
baths, electric-liL'ht baths, .-ihower-haths of various kinds, mud-baths. Russian brine-steam
baths, Roman-Irish baths, most modern appliances for single and common inhalation,
Zander-institute, Roentgen-cabinet etc. In the Kurpark 2 graduation-w'orks: the graduation-
air is an excellent remedy for affections of the respiratory organs, acting in general on

Section I: Kreuznach

125

account of its ozone as a refreshing and invi^jorating agent upon sick as well as healthy
persons. There are also ol)taiiiable. for curative purposes whey, fresh and sterilized milk,
goats'-milk. kephir. yoghurt, grapes in the autumn. We may also mention t'.ie river-batlis,
the air-and suii-l)aths in the Salineiital (salt-work valley), furthermore, the roads made
according to Oertel's system in the hills no.ir the cure-establishments.

The climate of Bad Kreuznach is very whole-ome, warm and mild; almonds,
peaches, and grapes id an excellent quality tiirive here.

Indications: in part especially for radium-therapy:

t. Constitutional diseases and metabolic disorders; scrofula, rickets, gout, rheumatism,
affections of the myocardium, obesity, syphilis, an.iemia, and arteriosclerosis.

"2. Chronic inflammations of the bones, joints, and soft parts; scrofulous, tuberculous,
rheumatic, gouty processes, neuralgia, sciatica, inflammations of the uterus, the ovaries etc.,
chronic suppurations, suppurations of the ear and nose, exsudates, chronic inflammations
ot the eyes, chronic catarrhs of the respiratory organs, the bladder, urethra, uterus,
and vagina.

3. Skin-diseases.

4. Asthenic conditions of senility after diseases and operations etc.

5. Bacterial diseases.

6. New-growths (tibroma, myoma etc.).

For the reception of visitors Bad Kreuznach has a great number of modem well-
furnished hotels and private pensions, most ot them surrounded by gardens. Rates for
room and bed from 5 Mks. per week, boarding from 3 Mks. daily. Information about
boarding through the Administration. Visitors are urgently warned of servants, coach-drivers,
and commissionaries at the railway station recommending places for boarding.

Kurtaxe for the whole season: Mks. 20 for one person, for each additional person
of the same family. Mks. 10 and 6. Physicians and their families are free.

The centre of the liealtl.-resort is tlie Kurpark with its large Kurhaus, its bathing-
establishments, springs, inhalatoria etc. The Kurhaus, at the same time hotel, has large
verandas with bar, reading r om, parlours, card-rooms etc. In the park a roofed colonnade
connected mth the drinking-hall, g-aduation-works. lawn-tennis grounds, skating-rink etc. ;
concerts 3 times daily by an excellent music-band, furthermore symphony-concerts and
performances of artists, balls, illuminations, flre-works, water-corsD, boating in gondola,
theatre, races, hunting, and fishing. Magnificent promenades, wooded hills, excursions to
the romantic valley of the Nahe extremely interesting from a scientific and historial point

im

Section I: Kreuznach — Landeck — Langenschwalbach

of view, trips to the near Rhine. Several branch-lines, electric trams and suburban trains.
Interesting Gothic-English church where services are held every Sunday. — la tlie
neighbouring Salinental 10 graduatiou-works, more than 5750 feet long, in part with
colonnades and seats.

For further information as well as for the sale of motherlye, bathsalt, mineral
water, etc. ajjply to the . Kurverwaltung Bad Kreuznach.

Sanatorium for Children Dr. Bartenstein, see Section II ("Sanatoria and
Cure-Establishments").

I JinrlPPl^ Prussian province of Silesia, situated near Glatz, 1500 feet above sea level.
LrfdllUCUxv^ AlkaUne-saline and sulphurous springs.

Royal Prussian Bath Langenschwalbach.

Chalybeate and Mud-Bath, Bath for Cardiac Diseases,
Bath for Diseases of women.

Situation and climate: Langenschwalbach is situated at the northern slope of
the Taunus, 1113 feet above sea level, one hour's distance from Wiesbaden. The upper
part of the city, the cure-district proper, extends through the Weinbrunnen-Valley and tlie
Stahlbrunnen-Valley close to the mountain-forest. The climate is a subalpine one
moderately dry, in midsummer cool, with a refreshing air free from dust and smoke.

Oolf links. Langenschwalbach.

Curative factors: 1. The drinking-rure. Langenschwalbach has cold ferruginous
acidulous waters (9 — 10*^ G = 48 — 50*^* F.). They contain according to the "Deutsches
Baderbuch" per Kilogramm:

the "Weinbrunnen" the "Stahlbrunnen"

bicarbonate of ferrous oxide 0.0643 g. 0.0933 g.

free carbonic acid 1425 cc. 1571 cc.

2. Pure natural extremely gaseous carbonic acid baths (chalybeate batlis).

Section I: Langenschwalbach — Lenk (Bernete Oberland) 127

3. Mud-ballis.

Physicians and their families get mineral baths free of charge, mud baths at half
thj pri ce.

4. Climatic cure: Open-air and resting-cures in the Kurpark are a special feature
of Langenschwalbach.

Most important indications: 1. Diseases of the blood, chlorosis and anaemia, all
nervous and other affections associated with anaemia and chlorosis or related conditions.

2. Affections of the heart and the circulatory organs.

3. Diseases of women, gout and rheumatism.

4. The invigorating forest- and mountain-climatic renders Langenschwalbach a
climatic station for convalescents &c.

Physicians (alphnbetical order): Dr. W. Bartel. — Dr. FrickliSffer, Sanitatsrat. —
Dr. Hiidepohl. — Dr Miiller. — Dr. Oberstadt, Geheimer Medicinalrat (district-physician). —
Dr. Pfeifer. — Dr. Strakosch. - Dr. Weiss. — Dr. Wilhelmy.

Dentists: Groell. — American dentist Dr. H. Bethel.

Season: 1 ^i of May to end of September.

Kurtaxe (fees for waters included): For the first week 6 Mks., for the season 20 Mks.,
second ticket 15 Mks. Physicians and their relatives free of charge, likewise children
below 10 years of age.

Eniertainments: Three times daily concert of the well-known Bliithner orchestra
of Berhn; furthermore symphony-concerts and performances of leading artists, reunions &c.
In the "VVeinbrunnentai" are at disposal lawn-tennis and croquet-grounds, and also newly
prepared golf-links. Abundant opportunity for hunting, fishing, and excursions. In the
neighbouring Adolfseck opportunity for target-practice and pigeon-shooting.

There are 2 Proteslaiit, 1 Roman-Catholic and 1 Anglican church and 1 synagogue.

Means of communication: Langenschwalbach has a post- and telegraph-office,
telephone to all important places. From England it is best reached via Cologne —
Wiesbaden. Omnibus and carriages at the station.

Information about all items of health-resort, especially boarding, by prospectus sent
free of charge on application to the Verkehrs-Verein Langenschwalbach.

Sulphurous-Springs and Climatic Health-Resort
of Lenk, Bernese Oberland.

Obersimmental, Canton of Berne, Switzerland, not to be mistaken for Leuk
in Wallis. situated 3625 feet (1105 metres) above sea level, in one of the most beautiful Alp-
valleys of Switzerland. Extremely favourable situation of the cure-establishment, facing the
south, entirely protected against winds, in a grand scenery, with wonderful pine-forests.
Delightful view of the mountains, glaciers and cataiacts. Shadowy promenades in the
vicinity of the Kuranstalt. Excellent summer-station for convalescents. Exceedingly pleasant
short and long excursions by foot, car and on horse-back. Mountain- trips to the Wild-
horn, Wildstrubel etc.

Curative Factors: Two sulphurated springs and one ferruginous spring.

The stronger sulphurated spring "Bahnquelle" contains, according to several agreeing
analyses, 44.5 cc sulphuretted hydrogen per 1000 gr. liquid. As to its content of sulphuretted
hydrogen it is only surpassed by the spring in Nenndorf. It is used especially for baths,
local douches, inhalations, and for gargling. New conduction of the spring to the esta-
blishment under complete elimination of air, so that now any loss of sulphuretted hydrogen
is avoided. The weaker "Hohliebequelle" is, however, exclusively used internally.

Indications: Chronic catarrhs of the lungs, larynx, and nose, of the ears and
intestines; chronic skin-diseases, especially eczema, furunculosis and psoriasis ; affections
of the liver, the kidneys, and the bladder: chronic muscular and articular rheumatism, and
anaemia.

The Cure-Etabiishment allows boarding at present for 250 visitors in 180 rooms.
35 bath-rooms. Shower-baths. Inhalatorium of latest system. Milk-and whey-cures. Full
board including room and light from 8.50 frs. per day. Electric light in all rooms.
Jlu^ic-band. Concert-Hall.

Resident physian: Dr. G. Jonqui^re of Berne.

Railway-station Lenk Simmental.

Prospectus and detailed description of the bathing-resort free of charge by

P. Vernier, proprietor.

12S

Section I: Leysin

Leysin (Switzerland).

Climatic Mountain Health Resort, 5075 feet above sea level.

(Open all the year round) .

Situation: The mountain health resort Leysin is situated in the centre of the
Vaudois Alps, on the southern slope of the Tour d'Ai-chain. These mountains
protect the region against the north-wind, whereas the scenery is widely open toward
the south, and freely exposed to the snn-heains.

The open air establishments (sanatoria and ciuiicsi, the pensions and chalets are
built in terraces above the village of Leysin at an altitude of from 4550 to 5250 feet
above ea level.

Climate: The advantages of the chmate of Leysin are to be attributed, on the
one hand, to the influence of the altitude above sea level, guaranteeing a sunny and dry
climate, and on the other hand to the neighbourhood of the Lake of Geneva, the wide
water-surface of which moderates the temperature considerably. The air is very pure
and dry. The mean annual temperature is 5,3 o C (41'^ F), in winter 1,8 o C (35" F), in
spring 3,8 'J C (39 « F), in summer l^,^'^ C (53,8° F), in autumn 6,8 « C (48'^' F). — The
relative humidity is in the average 64 per cent., sinking sometimes down to 30, and even
to '20 per cent. The site of Leysin and the great distance of the mountains opposite the
health resort favour an intense insolation, which may last in November for 8 hours and
!20 minutes, in December for 7 hours 30 minutes, in January for 7 hours 50 minutes, in
February lor 9 hours, in March for 10 hours. The actual insolation exceeds 50 per cent,
of any possible solar radintion. There are So per cent, calm days at Leysin.

It is possible and beneficial for patients to stay in the open air all the year round.
Owing to the dryness oF the air and the calm atmosphere, they can easily stand the low
temperatures of the winter. Also the temperatures sink less than at other stations of the
same level. The stay during the summer is very pleasant on account of the cool tempe-
rature of this season. Thus a cure can be carried out beneficially all the year round.

Curative Factors: At Leysin the advantages of hygienic and dietetic measures
are combined with those of an Alpine climate. Sanatoria, clinics, and pensions are arranged
for open-air treatment in public and private galleries. Most of them have provision for
sun cure, bath rooms and douche a])jmratus.

The sanatoria and clinics are under medical supervision.

The basis of the treatment is the application of hygienic and dietetic measures.
Living in the open air, rest-cure alternating with individually prescribed exercise, copious
and invigorating food, general or partial insolation, and the treatment by speciahsts
give sulliciciit guarantee to the patients for improvement and cure of their complaints.

Suitable cases: Constitutional general weakness. Tendency for tuberculosis. Pul-
monary infiltrations of any degree, especially incipient tuberculosis, torpid and afebrile
forms. Asthenic conditions, due to rapid growth of the body, convalescence after severe
disease?, chronic bronchitis, asthma, exsudative pleurisy with a slow or delayed reab-
snrption. Surgical tuberculosis of the viscera, of the bones, joints, and glands. Neu-
rasthenia, Graves' disease, malaria.

Section I: Leysin — Levico-Vetriolo 129

Unsuitable cases: Very much advanceil pulmonary tuberculosis with permanont
fever and cardiac weakness, ■ severe neurasthenic conditions, uncompensated cardiac
lesions and advanced arteriosclerosis, j)ulmonary emphysema with dilatation of the heart.

Hygienic Conditions: Abundant supply of very good drinking-water, laundry
working by steam, appliances for disinfection. Sinks set up with particular care. Dis-
infection of rooms. Electric light. Isolated house for contagious diseases.

Amusements: Libraries, concerts, tennis- and croquet-grounds, skating-rink. Suitable
slopes for tobogganing and bobsleighing. Ski-ing. Splendid forests and meadows. Numerous
walks. Rich alpine flora. Sporting-club. Photo-clul).

Chalets or Villas and Private Residences owned by the Societe climaterique
de Leysin are to be rented close by the sanatoria.

Communications: Electric railway from Aigle (station of the Swiss Federal Railway
15 minutes from Montreux) to Leysin (1 hour's ride), horse and livery-stables. Post-
office, telegraph and telephone.

Divine Services: Roman-Catholic church, Protestant chapel. Service in French,
German and English. Catholic minister: canon Wolf. Protestant ministers: pastor Favez,
pastor Dartique. Reverend Teesdale (English Chaplain).

Newspapers. Numerous papers on sale. "Journal de Leysin" appears once
a week.

Sanatoria of Leysin, see Section II ("Sanatoria and Cufe-Establishmeuts").

Levico-Vetriolo in Southern Tyrol.

Historical: The arsenical ferruginous springs of Levico-Vetriolo have been known
as medicinal waters since the 17t'i century. The first primitive bathing establishments
were at Vetriolo. In 1860 the springs were conducted downhill to Levico, where a large
euie- and bathing establishment was founded, a model institute under the conditions of
that time. This was the beginning of the development of Levico as a health resort. —
In 1910, January l«t, the springs and all the property of the former "Societa balneare"
passed over to a German company by which the "Altes Kurhaus" situated in the
large and shadowy park, was entirely renovated. They also built a "New Cure- and
Bathing-Establishment" in the centre of park-grounds of more than 100000 square metres.
These new establishments answer all the demands of modern hygiene, comfort and luxury,
and have all the curative factors of a most up to date cure-institute. The two large
hotels in connection with the two cure-establishments were likewise furnished in the
most modern style of first class houses.

Thus Levico might be placed on an equal level with the best equipped health
resorts as far as cure-establishments and hotels are concernpd. — In Vetriolo too
the German society has renovated the old cure-estabhshment and built a new
bathing house.

Situation and Means of Communication: Levico is situated at the foot of the
Monte Fronte, 350 feet above the ground of the Sugana- Valley, one of the most picturesque
valleys of the southern Tyrol. The wooded Panarotta-crest ascending more than 7000 feet,
forms a wall protecting against the north. — Levico is the railway-station of the
Valsugana line leading from Trient to Venice, a line rich in the most varying mountain
scenery — IV4 hours from Trient by railway. — Trient is the station of the Brenner-
express line and is to be reached without changing cars from Vienna in 17, from Berlin
in 24, from Rome in 19 hours.

Vetriolo is situated at the southern declivity of the Panarotta, 5500 feet above
sea level, directly above Levico. — It is to be reached from Levico on a good and new
mountain-road in 2^2 hours by car or on horse-back, in 2 hours by foot on shorter
roads for tourists.

Climate and Duration of the Season: The climate of Levico is mild and
subalpine. Owing to the elevated situation and the surrounding high mountains, the
summer-temperatures are not too high. In the morning, the evening, and at night there
is always a sufficient but not too great cooling down, on account of which Levico is
really visited as a summer-station by people coming from Italy. — Very little moisture
of air, no dew or white-frost up to the late autumn, no spring- or autumn-fogs, very
little rain — about 350 mm (April — October). This place is, therefore, especially suitable
for cures in the spring and autumn (April — June, September, October).

Season from April 1st to October.

130

Section I: Levico-Vetriolo

In Vetriolo the climate is mild and high-alpine; a milder variety of the climate
of Davos. — Season from June 1 ^t to end of Septemher.

Springs: Tliere are 2 sprinc;s at Levico-Vetriolo, viz. the Le vico-S tarkfjuelie
(Strong-spring) and tlie Levico-Sch\vacii(iuelle (weak spring); both originatin,' from tlie
summit of tlie Monle Fronle, and conducted to Levico as well as to Vetriolo by receuUy
made water-pipe systems. These springs are classified among the groups of arseniferous
ferrous-sulphate springs. In particular, the Le vic(j-Stark({uelle is tlie most
ferruginous and most acid spring of this group especially and in general of
all ferruginous waters.

Analysis of Springs.
According to Prof. Dr. E. Ludwig and Dr. von Zeyneck.

In 10000 gravimetric parts of Water
are contained:

Anhydrid of arsenious acid .

Acid sulphate of potassium ,

„ „ „ sodium . .

y, „ „ ammonia .

Sulphate of calcium . . . .

,, ,, magnesium .

„ zincum . . . .

„Stark-" or
„Badequelle"

on sale as

,Starkwasser"

(red labels)

copper .
lead . .

„ „ manganes"

„ ,, ferrous oxide

„ „ aluminium

Free sulphuric acid

Anhydrid of silicic acid

Organic carbon

Bicarbonate of iron

Free Carbonic acid

Lithium, strontium, cobalt, nickel,
antimony, chlorine, jdiosphoric acid,
titanic acid

0,060
0,068
0.108
0,081
3,581
4,773
3,178
0,723
0.1.119
0,145

46,(-)27
2,697

16,660
0,330
0,127

traces

II.

„Schwach-"

or
„Trinkquelle"

III.

„Schwacli-

wasser"

on sale with

blue labels.

V;i.,Starkciuelle"

' and -|3

„Sch\vach-

quelle"

traces

0,048

0,094

2.753
2,214
0,197

0,040
3,704
0,044

0,155
0,123

0,f)95
0.683

traces

0,020
0,072
0,143
0,027
3,030
3,050
1.188
0,241
0.006
0,072
18,154
0,941
5,278
0,213
0,124

0.898

Total of dissolved constitu nts.

Specific gravity

Temperature of springs . . . .

78,577
1,00714
14 "C. (57,2 OF.)

9,759 1

:« C. (48 » F.)]

32,426

Curative Factors: 1. Levico-Starkquelle used for bathing-cures, drinking-
cures, and local applications. — 2. Levico-Sch wachquelle, used for drinking-cures.
3. Levico-ochre earth (a natural sediment of the "Schwachquelie"), applied for mud-
packings. — 4. Hydrotherapy, electrotherapy, massage (at Levico and at Vetriolo),
Swedish gymnastics (System of Zander), electric-light bath, hydroelectric bath, Roentgen-
institute (only at Levico, new Kurhaus). Swimming-baths in the lake of Levico
(Levicosee).

The Levico drinking-cures are carried out at Levico as well as at home in
form of cyclical cures, beginning with "Schwachwasser", proceeding to "Starkwasser".
The daily dosis increases slowly up to 3-6 table-spoonsful taken before, during or after
the individual meals, and always diluted. Duration of a drinking-cure 6 — 8 weeks, mostly
occupying the entire sojourn at the heajth-resort.

The Levico- "Starkwasser" (red labels) -and Le vico-^Sc h wa ch wasser"
(blue labels) are on sale in all apothecaries and stores for mineral -waters of all
countries.

The Levico bathing-cure comprises warm tub-baths with additions of
"Starkwasser" (^5 — ','2 of the volume). Concentration, temperature and duration of the
baths are adapted to the kind of disease and condition of the patient. Tiie action of
the baths is considered equal to that of mild mud-baths. The baths are only administered
on prescription of the competent physicians of Levico and Vetriolo. The duration of a
bathing-cure is usually from 4 to (i weeks. Taking in account the nature of affections
treated at Levico-Vetriolo and the longer duration of a diinking-cure, it is advisable, just
as in other feiruginous or arseniferous baths, not to choose too sliort a time for the
entire cure.

Section I: Levico-Vetriolo — Locarno 131

Indications: 1. All primaiy and secotiJary diseases of the blood and
haematopoelic oitrans (spleen, hone- marrow, lyniphalic glands): anaemia, oIi{,'0( ylhaemia,
rlilorosis, leucaemia, pseudoleucaemia, scurpy, Weilhofs' disease and haemophilia. —
2. Functional, reflex and organic nervous diseases, especially r.euraslhenia,
hysteria, migraine, Graves' disease, sexual neurosis, chorea, neuralgia (facial neuralgia,
sciatica, lumbago). — 3. Diseases of women such as anomalies of menstruation, fluor,
vaginal and uterine catarrhs, chronic para- and perimetritis, defective development and
pathologic innervation of the pelvic organs, sterility and habitual abortion. — 4. Scrofula,
chronic malaria, and cachexia due to malaria, gout, diabetes, chronic muscular and
articular rleumatism, arthritis of non-rheumatic origine, disorders of the digestive organs
on a nervous or anaemic basis or depending upon gout or malaria. — 5. Chronic
dermatoses such as psoriasis, lichen, fungous affections, chronic eczema, seborrhoea with
acne, ichthyosis, prurigo, alopecia. — H. Diseases of children such as rickets, lymptiatic
diathesis, chorea, broken down condition after severe diseases of children, detective
development, habitual scoliosis. — 7. Delayed convalescence, general weakness.

In mentioning these indications, above all only the natural curative factors of
Levico-Vetriolo were taken in account. The complete equipment of the new Kurhaus
with modern therapeutic appliances allows of a considerably broader domain of indications
for this health resort.

Consumptive patients with expecloration are kept away from Levico; so much
better the station is suitable for invigorating cures, slight cases of appendicitis and in
plilhisical disposition.

Physicians: At Levico: Leading physicians Dr. Liermberger, Dr. Gazoletli,
Dr. Struckl; resident physicians Dr. Crandi, Dr. Prati. — At Vetriolo: Dr. Reyer.

Lodging and Boarding of the most various classes. Grand Hotel (in the new
Kurhau=), Grand Hotel Levico des Bains (in the modernized old Kurhaus); Edenhotel
Caliari: Hotel Bellevue; Hotel Germania, Voltolini, Corona, Konkordia and numerous
smaller hotels, German and Italian pensions, rooms for weeks kc. — Prices according
to the class of houses from 5, 7 or 10 Kronen upward. Electric light in the city, the
hotels, and in many private houses. — Vetriolo: Pension Trento, Hotel Milano, Hotel
Mottte Fronle, and several country-houses.

Entertainments: Regular concerts of the music band, military and artistic concerts,
5 lawn-tennis grounds, play-grounds for croquet, boccia, athletic grounds, play-grounds
for children, skittle-alley, Russian skittles Sec. Popular fetes, illumination, fire-works &c.
Promenades, excursions by foot, by car or by railway into the surroundings of Levico with
the grandeur and variety of its scenery; long and short mountain-tours. Boating on the
Lake of Levico. — Kurkasino with hall for concert, ball and theatre, card- and reading-
rooms, ladies' parlours and music-rooms, caf6 being built.

Kurtaxe : The administration charges a small fee.

Prices of Baths: I^t class 4 kr., II "d class 2,50 kr.; other curative means
according to special tariff'

Privileges: Physicians, their wives, and children residing in the same domicile, are
exempt from any charge for curative means. 6 places of the Austrian Whiie Cross free
of char! e for curative means.

Informations and Prospectus, descriptions free of charge by the

Administration of the Levico-Vetriolo Medicinal Springs Co. Limited
at Levico-Tyrol.

Locarno on the LagO Maggiore, Southern Switzerland.

Climatic Station for Autumn, Winter and Spring.

714 feet above sea level.

Terminal station of the Gothard -railway. Direct communication by cars with
Lucerne, Zurich, Basle. Steamers to the Borromaeus Islands and to the Simplon-railway.
Railway to Milan and Genoa. Excellent roads for cycling and for automobiles. —
Roman-Caiholic, Protestant and Enghsh divine-service. The influx of foreigners is steadily
increasing from year to year, and the most prominent native and foreign physicians are
recommending this health resort. These facts are the best proof of the superiority of

132

Section I: Locarno

the climate. Locarno has a newly built water-system, canalization, parks and quays,
large tennis-lawns and golf links. In the new city-kursaal performances are given in the
winter, spring and autumn. Medicinalrat Dr. A. Martin, Royal Bavarian University Professor,
says in his excellent essay on Locarno, among other things: "The air in Locarno is pure,
entirely free from dust and fog, mildly stimulating and moderately moist. The sky is
mostly clear, during the winter-season invarial)ly blue and extremely transparent.
The number of sunny days with a remarkably strong insolation is very great, while the
number of rainy days is relatively slight. This allows a daily walk in the open air, especially
because after rain the ground is rapidly drying. Locarno is that place on the Lago Maggiore
which is most of all" protected against winds, as it is surrounded from all sides by high
mountains, especially towards the north. The abundant southern vegetation is the best
evidence of the well protected site." Electric railway to the Maggia- Valley and to the
Madonna del Sasso. A new railway will be built between Locarno and Domodossola (Simplon).

Meteorological Statistic concerning Locarno,

(compiled by the Federal Meteorological Office at Zurich).

For ttie whole year

Summer Months April to September

Winter Months (Ol(tober to March)

Orte

1907

1908

1907 1

1908

1907-1908 11 1908-1909

Numbjr of days

Number of days

Num

jer of days 1

Number of days

Numberof days ! Numberofdays

Final Overt. ! Rain j Fine | Overt.l Rain i' Fine | Overt. 1 Rain i

FimiOvert.lRain

Fine 1 Overt.|Rainl Fine ' O/ert.. Rain

Zurich

52

139

1.55

44

157

149

35

55

76

32

58

81

12

89

82

16

86

62

Basle

36

156

159

54

141

145

22

61

82

24

58

80

19

96

81

29

77

58

Neuchatel

89

165

142

34

174

134

23

61

73

27

51

72

8

121

76

11

107

66

Geneva

.52

162

132

57

150

106

86

58

62

45

40

56

10

111

71

18

93

58

Montreux

99

112

128

103

119

116

55

53

68

57

46

68

33

76

63

54

68

46

Iiocarno

148

74

114

148

58

91

64

30

67

58

28

60

78

41

34

80

35

41

Lugano

129

108

118

132

94

93

60

45

65

.52

.50

61

66

61

.54

73

54

40

Berne

45

143

147

33

155

130

29

59

74

26

.54

72

7

99

74

14

92 53

Lucerne

50

142

157

51

165

157

28

54

K5

38

63

93

18

91

75

10

96 1 64

St. Gall

.54

143

161

62

162

155

39

58

82

31

65

91

23

92

77

24

92

62

70
74

123
139

161
1.59

113
89

120
133

114
154

32
31

61
73

86
88

36
20

73

78

83
97

49
40

60
70

68
71

69
67

40
43

57

Eigbi

57

Local Observations concerning Locarno.

Average temperature during the last 20 years in degrees centigrade

a

c2

1

<

May
June

3

fcc
<

o
O

>
o
!2;

o

whole
year

Temperature

2.0

4.2

7.4

11.8

15.6 19.5

21.9

20.7

17.6

11.6

6.7

8.2

11.8

Average Rainfall in millimetres

72

68

131

161

217

182

187

234

217

243

145

83

1940

Average number of rain days

6.1

5.6

8.7

11.7

.14.3

13.1

11.9

10.8

9.9

11.6

9.5

6.8

120.0

„ „ of fine days

13.9

11.4

11.5

8.8

8.0 8.5

10.8

11.7

11.2

9.6

10.1

14.2

129.7

„ „ of overcast days

7.8

5.6

7.4

8.3

7.5

4.8

3.3

3.7

5.7

8.3

9.8

6.1

78.6

Professor Dr. Martin sa3's furthermore: "Thus at Locarno the extraordinarily mild
average temperature (12,74^ C = 54^ F) and the excellent hygienic boarding and pension
as well as an abundance of grand sceneries, are factors adding to the many other rare
advantages rendering this place undoubtedly a first-class climatic winterstation."
Locarno is indicated 1. in cases of chronic catarrhs and inflammations of the respiratory
organs, especially of the pharynx and larynx; 2. in cases of asthma and bronchiectasia;
3. in chronic induration of the lung tissue; 4. in pleuritic exsudates; 5. in chronic nephritis;
6. in various affections of the central nervous-system, such as mental strain, insomnia etc.
It is finally reconnnended for convalescents alter acute diseases, and especially for children
alter measles or whooping-cough, in anomalies of bodily development, and for all people
needing a change. There are at Locarno 8 physicians, among these Dr. C. Strauss-Zurich,
Dr. E. Bally-Berne.

Payment of a Kurtaxe is not obligatory.

Hotels and Pensions: The above mentioned advantages of a long wintercure at
Locarno are made more valuable by the excellent opportunity for lodging and boarding
which visitors of all nationalities find in the wonderful hotels. There are to be mentioned:

Section I: Locarno — Lovere (Upper-Italy) — Lucei-ne — Luxor 133

Beds II Beds

Grand Hotel Locarno 200 i| Hotel-Pension Terminus, Siebenmann. . 15

Hotel Reber au Lac 135 1 Kur- u. Erholungshaus Wartburg, Monti 15

Hotel du Park , . 130 | Deutsche Pension Daheim 15

Hotel- Pension Metropole au Lac 75

Hotel Victoria 60

Hotel Pension du Lac 45

„ „ Belvedere 40

„ „ Beau-Rivage et d'Angle-

terre 35

,, ,, Siebenmann, Orselina . . 35

Pension Splendide 30

Hotel-Pension Bahnhof et Tourist 25

Pension Villa Erica 25

„ Muralto 21

,, Quisisana 20

Villa Camelia 20

Pension Villa Eden Schweizerheim. . . . 15

Hotel-Restaurant al Sasso, Orselina ... 15

Hotel Kurhaus, Orselina 12

Hotel-Pension Helvetia 12

Pension Villa Liberia 12

„ Rossa 12

Diatetische Pension Villa Frieda 12

Pension Seerose 10

Hotel -Pension St. Gotliard 10

Pension Graf, Minusio 10

Pension Germania 10

English Pension Villa Palmiera 10

Pension Villa des Lilas et Maison de cure 10

Pension Stella, Orsehna —

Familienheim Villa Elisabeth —

For further particulars and prospectus direct application should be made to the houses

named.
Information and prospectus by the Travelling Bureau. Bally, Kurverivalter.

Lovere on the Lake of Iseo (Upper-Italy).

Lovere is situated at the upper end and western side of the Lake of Iseo, which
is 18 miles long, 3 miles broad, and 875 feet deep, and abounds in fish. Lovere is
surrounded by wooded slopes, and shapely mountains, with splendid view of the Adamello
range. It is a place especially suitable for lovers of Nature, for those suffering from
disordered nerves, and for such as need recreation. Its chmate is excellent, particularly
in autumn, winter and spring; but even in summer it is never too hot, on account of
the refreshing breezes coming from Val Camonica. Owing to the wonderful climate, the
vegetation is of a southern character.

Lovere is the starting point for alpine tours to the Adamello region. The plateau
of Bossico, affording a marvellous panorama, can be reached by a mountain cart-road.
The level road excavated in the rock, and leading along the right bank of the Lake, is
of the highest interest.

Accommodation is available at the Hotel Lovere (Mr. L. Preto, proprietor), by the Lake,
It is a first class house, elegantly furnished, and managed in the most up-to-date manner.
There is a number of rooms with central-heating, loggias, and balconies ; facing the lake
is a large veranda and loggia. Baths and lavatories, fitted with the most modern
appliances, and every kind of comfort will be found, and the terms are very moderate.

Doctor, Chemist, and Telegraph office, all close at baud.

Travellers choosing the new route Milan — Rovato — Iseo — Pisogne — Edolo reach
Lovere most conveniently from Iseo by railway or steam-boat. Lovere can also be
reached from Bergamo via Sarnico on the steam-boat or by the tram Bergamo-Valle
Cavallina-Lovere. Trips on the Lake, on the excellent steamers of the Lake-Navigation-
Company are most attractive, and enjoyable.

1 llPPfnP Switzerland, charmingly situated on the bank of the Lake of Lucerne,

almost alongside the Rigi and opposite Pilatus.

Sanatorium Sonn-Matt, Lucerne, see Section II ("Sanatoria and Cure-
Establishments").

1 llYOr Upper Egypt, south of Cairo, on the right bank of the Nile, opposite the
IrfUAUl^ ruins of Thebes. Very Irequented in the season, from December to March.

134 Section J: Martenbad

Marienbad in Bohemia.

.Season 1^^ of May to 1^' of October.
Number of visitors (last season) 35000, and 100000 travellers.

Topography: Marienbad is situated in the north-western part of Bohemia (county-
court district of Eger), iiiiOO feet above sea level, in a valley only open toward the south,
and entirely surroumlcd by densely forested bills. In the magnificent park which has been
renovated in the last years at great expenses, and is crossed by well-kept promenades,
are the most splendid country-houses and residences. Their grouping allows to enjjy an
open view of the rich natural scenery of Marienbad. The dense pine forest exiends
as far as to tlie houses, and it supplies the health resort with an abundance of ozone
scarcely to be tound in such a degree at any other place. Promenades extending for miles
pervade the forested hills of the surrounding, rich in idyllic retreats and grand panoramas.
Marienbad is station of the lines "Vienna Eger" and "Marienbad-Eger".

The climate is in general mild. Mean temperature of the season 15" C (59" F)
at 6. a. m, 20 « G (68.0 0 F) at noon, 18^ C (64,4 « Fj at 6. p.m. Mean atmospheric
pressure 708,5. l\Iarienbad is protected, on account of its situation, against rough
winds from all sides. Number of rainy days relatively low. Even if Marienbad had no
medicinal springs, it would be an excellent climatic station, as has been staled by experts.

Curative Factors: A. Springs. They are used for drinking and bathing cures,
which are supplementing one another at Marienbad. The springs are divided into four
chief groups — viz., 1. the alkaline-saline springs, a) the stronger springs Kreuzbrunn,
Ferdinandsbrunn, b) the milder springs Alfredsquelle, Alexandrinenquelle, Waldqiielle.
The former are the most prominent representatives of the Glauber's salt waters. The
Ferdinandsbrunn e. g. contains per 1000 gr. of water 4,715 sodium .sulphate
(Glauber's salt), 1^712" sodium chloride, 12,58 bicarbonate of sodium, 3,179 free carbonic
acid: temperature 10,3° C (50,2° F). The latter springs are successfully applied
for affections of the respiratory organs. 2. The ferruginous springs. The Ambrosius-
and Karolinenbrunnen. The latter is only used for bathing purposes; the former one
is the richest in carbonate of iron among all the known medicinal ferruginous waters.
It contains per liter 0,16 g. bicarbonate of iron and 2,29 free carbonic acid. Temperature
9,6°C(50°F). 3. The mineral-akaline springs, of which the R udolfsquelle is
tlie representative; it is equal to the "Wildungen springs, containing per 1000 gr. of water
1,116 gr. calcium bicarbonate, 0,670 gr. magnesium bicarlionate, and being free from
calcium sulphate; temperature 10,5° C (50,3° F); its application _ in uric-acid diatl)esis
and gout is growing year by year. 4. Tlie Marienquelle: this is the most powerful
spring; it is, to be sure, poor in solids but extremely rich in free carbonic acid, and so an
ideal means for natural carbonic-acid baths.

'B. Bathing- establishments. For bathing cures are at disposal three bathing
houses with a most modern comfort, luxuriously furnished, yet most practically equipped;
these are the Neubad, the Centralbad, and the Moorbad.

In these establishments are administered: 1. natural carbonic acid baths (in
five different degrees); 2. chalybeate baths; 3. mud baths; 4, pine needle
baths; 5. gas baths (carbonic acid baths); 6. steam and hot air baths; 7. electric
light baths; 8. cold water application; 9. massage (applied on special medical prescription
in Centralbad and Neubad); 10. inhalations (for this purpose an inhalatorium in the Central-
bad), and in Neubad a recently established BuUing-Inhalatorium. 11. Radium-Inhalatorium
fitted up in the most modern manner.

We must here especially point to the above mentioned Marienbad mud baths
and carbonic acid baths.

The mud is only obtained from the genuine fen-country in the vicinity of the
health resort. The old Marienbad mud surpasses in its iron and sulphate contents tlie
bog-earth of any other health resort. In 1909, however, new fen-districts were disco-
vered in liie neighbourhood of Marienbad and bought by the town. The iron and
sulphur content of these surpasses for the three- and four-fold all tliat has been
known up to this lime. Mud baths are applied in all kinds of exsudates in the
joints, muscles, peritonaeum (after appendicitis in combination with saline waters),
in the paramelrium, in sterility, nervous diseases (Neuralgia). The preparation of the
mud baths may be supervised by the patients tliemselves. Annual amount of mud-
baths administered more than 100000.

The Marienbad carbonic acid baths are exclusively natural carbonic acid
baths prepared with the natural mineral springs, containing from 1,5—3,2 gr., and up

Section 1: MarUnbad 1'-j'>

to 5 gr. to'al carbonic acid per liter. Carbonic acid batlis are applied for affections of
the heart and vessels, for arteriosclerosis and circulatory disorders.

Zander-Institute, (proprietor Dr. Eduard Kraus), with electric light baths and
massage.

Medico-mechanic Institute, Proprietor Dr. Wilhelm Preminger.

Notewortliy establishments are furthermore a) the hygienic and balneological
institute, the fust institute of this kind, with most modern Ia])oratory-equipmeMl and
physicians' reading room; leading physician Dr. med. Zorkendoiler. Regular chemical,
physical-chemical, microscopical, and bacteriological observations of the medicinal springs
and baths, of the drinking water, physiological and pathological researches, and investigation
of foods are carried out in this institute. All tlie hygienic and curative establishments
are also under the supervision of the institute, and thus are guaranteed the very best
protection agninst the invasion and spreading of infectious diseases, and a thorouLdi
conlrol of viciuals. b) The hospital equipped according to the most modern demands
of hygiene, under tlie supervision of approved physicians of internal medicine and surgery,
and provided with trained nurses. c> The salt-graduation works in which the
natural products of tlie springs are manufactured — viz., l.the natural Marienbad Brunnen-
salz (powdered and ciistalline salt). '■2. the Marienbad Biunnenpastillen, 3. the Marienbad
Brunnenseife (mineral-soap), 4. the Marienbad Brunnenlauge (mother-lye). 5. the Marienbad
Multerlaugensalz (mother-lye salt); d)Cen!r;d dairy, furnishing exellent cows' milk and butter.

Indications: I. General affections, such as anomalies of metabolism,
e. g. obesity, gout, diabetes; diseases of the blood, such as anaemia, chlorosis, furthermore
scrofula, il. Organic affections: 1. Diseases of the digestive organs as a) chronic
catarrh of the stomach and gastric ulcer, b) Chronic intestinal catarrh and chronic
appendicitis, c) Congested liver, d) Catarrhal jaundice, e) Non-malignant (carcinomatous)
tumors of the liver and sp'.een, for example tumors due to malaria. 2. Affections of
the respiratory and circulatory organs: a) Chronic pulmonary catarrh (congestive
catarrh) and emphysema, b) Adipous heart, c) Diseases of the myocardium (myocarditis),
d) Arteriosclerosis, disposition for apoplexy. 3. Affections of the urinary organs:
a) chronic catarrhs of the renal pelvis (pyelitis), b) Chronic vesical and urethral catarrh.

c) renal calculus and gravel. 4. Affections of the female genital organs: a) chronic
vaginal catarrh, b) chronic para- and perimetritis, exsudates. c) chronic uterine catarrh.

d) amenorrhoea and dysmenorrhoea. e) sterility and disposition for abortions, f) affections
of the climacteric period. 5. Affections of the peripheral nerves and of the
locomotor system: a) sciatica, b) peripheral palsy, c) chronic rheumatism and
exsudates in the muscles and joints.

General Remarks. 1. All matters pertaining to the health resort are
tended to by the Mayor together with the City-Council. The bathing-establishments
and springs are owned by the Praemonstratenser-Convent of Tepl, the directory of which
is in the Centralbad.

2. Physicians: The following physicians (arranged according to the time
of their settlement) are practising at Marienbad: Drs. E. Heinrich Kisch, Eduard
Opitz, Hans Kopf, Alois Grimm, Stanislaus Prager, Felix Wolfner, Hugo Schlesinger,
Max Porges, Ferdinand Baruch, Jo'n von Kalinczuk, S. Reinhold dentist, Sigmund
Salacz, Wladislaw Harajewicz, Wilhelm Pachner, Ernst Ott, Oskar Rosenberg,
Elemer von Fornet. Julius' Witz, Eduard Kraus, Eduard Fodor. Max Horowitz, Hugo
Schmiedl, Eugen Wolf, Wladislaw Mladejovsky, Heinrich Floderer, Camillo ZintI, Hans
Turba, Ernst Pflanz, Josef Schermant, Leo Mai fens dentist, Philipp Steiniger dentist, Emil
Waclitel, Ernst Augstein, Heinricli Lowenthal, Rudolf Reiniger, J. Sandbank, Max Lowy,
M, Mauksch, Ludwig Sternberger, Wilhelm Preminger, Benedikt Ritler von Kwiatkowskl,
Oedon Tuszkai, Carl Zorkendorfer, Hnns Zickler, Hans Klepetaf, Hans Herzig, Carl
Matousek, Adolf Stark, Rudolf Ko!b, Franz Kisch, Stanislaw Uhlif, Liebeskind, Oskar
Goldstein, Ferdinand Eicbhorn, Z. Szczepanski, O. Strauss, Wohl-Ecker dentist. E. Menyheit,
J. Wnuczek, Fritz Harnish dentist, J. Schutz, G. Pincherle, F. H. Schildbach, J. Schless,
J. Ehrlich, N. Goldberg, R. v. Obminski, Walacb, Miss Maria Jasinicka.

Marienbad can be reached from Petersborough in 39^/4 hours, from Chrisliania in
39\'2 hours, from Constantinopel in 393/4 hours, from Rome in 32';2 bours, from London
in 30 hours, from Stockholm in 27 hours, from Ostende in 24 hours, from Paris in
22V4 hours, from Breslau in 16' '4 hours, from Bud^ipest in 13'/o hours, from Hamburg in I'^^U
hours, from Berlin in 6V-2 houis, from Vienna in 6^,4 hours, and from Munich in 6 hours.

The health resort of Marienbad has eleclric light all over the town; the canalization
is excellent. A mountain water-system suppUes all houses with the best water for
drinking and other purposes.

136

Section I: Marienbad — Meran

There are in the town elegantly furnisbed hotels and boarding-houses, district
police-court, parish-court, post- and telegraph-office, custom-house, interurban telephone,
two abundantly supplied reading rooms, electric light and trams, magnificent colonnade,
new Kurhaus, salt graduation work, three to four limes daily concerts of the music band,
frequently military and other concerts, balls and dancing-reunions, theatre- performance.T
daily. Golf (9 holes). Tennis. A Roman Catholic, Protestant, Anglican, and Russian church,
and a synagogue.

Season from May 1st to September 80'''. Number of visitors: ooOOO and of
travellers: 100000. Natural carbonic acid baths are administered from April 15''' to
October 15 't>. All foreign mineral waters in the drinking-hall.

Prospectus are sent free of charge on application to the

BiirgermeisUramt (Major's Office).

Meran in the German South Tyrol.

The town of Meran and the neighbouring villages of Obermais, Untermais and
Gratsch unite to form the famous health resort. — It lies 1100 to 1500 feet above sea-
level in the fruitful valley of the Etsch, and is surrounded on three sides by high

• -i^^

i

. -".f ""'?'■ ^^

^^^Hi

':-^^^a^kjMiA\

f

r."- --^v

yH^^ri^H^^^^HBI^

HK. m .}m.:

.-,"•■ -■

v^H^^W

w/gsb^

^^B^ElHiJ^I^IV

W^st^'-' ■ '■' ' ■ ' '■^u,^:^^^'. '■■" ■

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||i^/*^£M'!^2Ss^fe^y

l^^l^^^SBB^KSl^^^^^n^9^^^fl

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■M

"M;y- --:'''-Xs

mountains of 7000 — 10500 feet. — Being situated on the south slope of the Alps the
valley is entirely ])rolected towards the north, east, and west, but is open to the south;
its mild and unilorm climate is relatively warm even in winter; the sky is very clear,
it seldom rains, and the air is almost perfectly calm during the winter months. — It
ranks with Davos and Cairo among the so-called dry health resorts. — The winter is
shorter than anywhere else in the Alps, and on account of the great clearness of the
sky and the perfect calm it is so warm that even sensitive patients can sit in the sun,
or take a Avalk during the warm hours from 11 to 3 o'clock. — According to observations
made during ten years by one of the visitors, Mr. Thilo von Tchirschky, there are in the

days

month of:
November
December
January
Febiuarv

for sitting out of doors for walking

13
16
16
13

for liome

G

5

The olficial season is from September to June
of travellers to the Orller and Oetztaler glacier;; pass Meran
ha$ increased from 706 in 1S60 61 to 3i 000 in 1911.

11
10
10 8

8 7

During the summer a large number
The number of visitors

Section I: Meran 137

Curative factors: Meian offers a variety of curative factors as no other health
resort place south of the Alps. The luxurious Kurhaus has departments for hydrotherapy of
all kinds, common baths as well as carbonic acid, oxy^'en, brine, pine-needle, ferruginous and
other medicinal baths, an easily heated hall for swimming, open all the year round, steam
bath, douches, light-baths, electric partial-ligiit treatment, hot air treatment, mud and fango
packings, radium-emanation treatment, radioactive baths and the recently established
radium-emanation inhalatorium, electric full and four-cell baths, treatment with galvanic,
faradaic, sinusoidal (alternating-current) electricity, franklinization; Zander-institute, Swedish
gymnastics, Swedish massage, exercise-thernpy; departii:ent for inhalation, general and local
inhalation according to varioussystems, pneumatic chamber; air and sun baths. Grape and fruit
cure. Milk and the various milk-preparations, mineralwater and herb-juice-cures. Large
roofed colonnades; drinking halls at the winter colonnade. First-class Oertel-
cure resort. Extensive promenades, roads and mountain paths according to the
original prescriptions of Oertel. Open- air wintergarden.

Sanitary arrangements: Several mountain-water-supply systems built at great
expense, perfect drainage, new slaughter-house with modern equipment, municipal
hospital with internal, surgical and ophthalmological clinic; also rooms for first-class
patients. Separate pavilion for infectious diseases. Modern sanatoria. Establishment for
disinfection. Strict observation of hygienic and prophylactic measures. Permanent super-
vision of the market.

Indications: Owing to its protected situation, its splendid climate and the
great variety of modern therapeutical and other aids to health, Meran is the most
suitable place for any one needing a long stay in the open air during the colder season,
or for those wanting a mineral-water drinking-cure, cold-water baths and gymnastic cure._
Furthermore for those wishing to escape the roughness of a northern climate, but
choosing at the same time a stimulating and invigorating climate. It is also adapted
for patients needing the use of inhalations, carbonic acid- and radioactive baths,
electric cures, grape-, milk- and open-air resting-cures; in brief, particularly for
convalescence, for cardiac affections, arteriosclerosis, pulmonary
affections in the incipient stage, nervous diseases, renal diseases, all
diseases of metabolism (gout, diabetes, obesity).

Contraindications: Great irritability of the nervous system, dry catarrhs of the
larynx, especially with a simultaneous tendency to haemoptoe and permanent fever.

The administration of the health-resort is in the hands of the secretary of the
adininistation: [Kurverwaltung] who answers any letters asking for information and
sends prospectus free of charge.

Physicians: There are now 76 physicians here. The list of physicians is pubhshed
from time to time in the newspaper of Meran ("Meraner Kurzeitung"), and can be
obtained at the administration bureau.

Hotels and boarding-houses: There is a great number of first-class hotels in
Meran, Ober- and Untermais; they are at the same time pensions. Also
numerous good boarding-houses, refined and modest pensions, middle-class boarding-
houses and restaurants. Thus all tastes can be satisfied. Prices for board and lodging
range from 7 — 14 Kr. daily, not including light, heat, and drinks; during the
high season in the spring (February to May) increased rales. There are also
many completely furnished private flats provided with linen and plate, and fine
country houses for visitors in great variety; some of the historical castles with splendid
artistic furniture are also to be let for the season. Single rooms 20—120 Kr. per month;
flats of 3 — 10 rooms and kitchen about 120 — 800 Kr. per month; the total expenses of a
stay at Meran amount to about 1.50 — 400 Kr. per month and person. {£ 7, — to £ 15. — )

Kurtax: The Kurtax is for the first 10 weeks of the stay: 70 heller per day
for the first class, 50 heller (about 6 d.) per day for the second class, 35 heller per day
for the third class. Children below 15 years of age pay half of the lax, the fee for
servants is 15 heller per day. After 10 weeks no further tax is levied for the season.
Physicians with their wives and children under age are exempt from the tax; they have
to pay 1 kr. per week for music-tax, up to the limit of 10 Kr.

Entertainments: New large sport-grounds for driving, riding, cychng, tennis,
foot-ball, golf, and croquet; in spring meeting of gentlemen-riders, trotting-match, spring-
festivals, corso of carriages, in spring and autumn the renowned open-air plays, "Andreas
Hofer" etc.; besides concerts twice a day, also in summer, military music-band, and
concerts of well known artists, theatre, reunions, balls, promenade-festivals, chamber-
music soirees; in the reading-room of the Kurhaus a great selection of daily and
illustrated papers, circulating library, riding-club, gentlemen's club, chess-club, club for

138 Section 1: Meran — Mma House — Mentone — Misdroy — Montana

athletics, nlpine rlub, winter-sport clubs, fishing-club, opportunity for fishing trout in
the Etscli- and Passer-iivers, for shooting etc. Artist's club, singing-club, Sclilara(tia etc.

Divine services: Roman-Caliiolic, I^rotestant, Russian, Anglican and Hebrew.

Instiuction: Higli classical school, school for modern sciences, commercial academy,
public anil middle-class schools for boys and i^irls, Froiiel's Kindergarden. Many good instructors
tjive lessons in all modein lanp-iia^-'cs, in mu<ic, painting, wood-carving, athletics and riding etc.

Means of communication: Meran is the chief station of the Dozen — Meran and
Vinschgau-railways, and is in direct communication with all trains of the great Breniier-
route stopping at Bozen. From England communication via Ostende — Strassburg — Basle
in 32 hours. Communication from Meran to the Ortler- region; for tours by car to the
grand surroundings of Meran rich in historical reminisrences, carriages and autos are to
be had at officially fixed rales. Trams everywhere. Mounia n-railvvay to the Vigiljoch.

Middle-mountain tram being built to the village and castle of Tyrol.

Sanatorium "Villa Stefanie ", Dr. Binder, see Section II ("Sanatoria and
Cure-Establishments"). -

Sanatorium "Martinsbrunn" Sanitatsrat Dr. von Kaan, see Section 11
("Sanatoria and Cure-Establishments").

Health-Resort Mena House (Egypt).

Most Renowned Climatic Desert Station of the World.

Most distinguished and in favour on account of- its pure and dry desert-atmosphere
and a maximum of sunshine. Remarkable results in cases of gout, rheumatism, and
neurasthenia. Excellent station for convalescence and recreation. Owing to its unparalleled
climate and to the direct neighbour! lood of Cairo, it is preferred as a permanent
winter-station to the health-resorts of Upper-Egypt, and is also chosen as a transitional
station for those coming from or going to Luxor, Assnan or the Sudan. The Mena House
Hotel is located within 30 minutes' distance from Cairo, at the border of the desert, and
close to the Great Cheops-Pyramides and the Sphinx. Refined first-class
family-hotel furnished according to the most up-to date comfort, and on account of its
model hygienic management and its large marble swimming tank, classed in the first
rank among the best hotels of Egypt. Apartments with bath-rooms. Large drawing-
rooms. The spacious dining-room built in Moorish style is considered a remarkable
architectural object of interest. First-class pension and service. Well-known and
recommended cooking. Excellent wines. Separate spring-water supply, best drinking-water
of Egypt. Large farm and house keeping. The cows kept for providing fresh and
wholesome milk are under veterinarian supervision. For tours to the desert and hunting-
picknicks horses, asses, camels, and cars at disposal. Physicians, apothecary, lift, post,
telegraph, and telephone in the house. Large sport-grounds, tennis, golf and croquet.
Most heartily recommended by medical authorities. Moderate rates. Special arrangements
for a longer stay.

Under the same Direction as Savoy-Hotel, Hotel Continental, and Angleterre at Cairo.

Prospectus directly or on application to Hotel National at Zurich.

A. Wild, General Director.

iyrp|^4-n»|p France, Department of Alpes Maritimes, on the Riviera. Winter station
I'iUllLUllv^ of first importance, and sea-baths.

lUliorltTiXr Pru.ssian province of Pomerania well-frequented sea bathing-place on
iTlloUIUy, the Baltic.

Montana (Valais, Switzerland).

5600 feet above sea. Summer (golf) Season. — Winter (Sports) Season.

Position: 21 hours from London (via Folkestone). Funicular Railway
(40 minutes) from Sierre, Rhone valley, on Simplon line.

Distance Sierre-Lausanne by rail 2 hours. Sierre is on the main line Paris —
Lausanne — Milan, also near the great Lotschberg tunnel connecting the Bernese Oberland
with the Rhone valley.

Section I: Moyitana — Monte Carlo {Monaco) 139

Distance: Monlnna— Milan by rail 5 houis, Montana— Lago inagL,'iore S'/-^ hours by
rail, Montana— Zermatl 4 hours by rail.

Largest Alpine Plateau of Switzerland at an allilutle of above 5000 feet.

On the southern slope of the gigantic niounlain chain which separates the Bernese
Oberland from the Rhone valley and protects the plaleau of Montana from any
cold winds.

Almost level walks for nearly 4 miles from east to west of the plateau,
partly through pine woods, parlly through alpine pastures, along several little lakes.

Exceptionally rich Alpine Flora in June at its best.

Immense i^anorama of the .Southern Range of the Swiss Alps from Mont
Blanc to Gollhard mountains--.

Climate: The Alpine Plateau of Montana is the Ideal Mountain Health Resort.
Its alpine character benefits of the mild climate prevailing in the central part of the
main valley of the Swiss Rhone river, the protection offered by the high mountains and
its southern position account for the mild climate of that part of Switzerland.

Summer at Montana: In summer the themperature is refreshing during day
time, due to the cooing influence or the woods, the lakes and the proximity of the
glaciers, and also on account of the altitude which ensures cool nights.

Winter at Montana: During winter the days are sunny and warm (frequently
between 80-1-20 dgr. F. in the sun). The sun has free acce.-s, rises earlier and sets
later than on the plains below, where its action is impaired by mist and fog, which are
extremely rare at Montana. — The yearly average amount of watery vapour in the air,
(which depends on the degree of exposure to the sun, of the greater or less local facility
of tlje exchange of air, the altitude and the geographical position) amounts only to 61
per cent, at Montana. — The high average daily temperature during winter at Montana
is the result of the altitude combined with southern climate of the surrounding region
and tlie full exposure to the sun. Tims, although there is, owing to the cool nights, in
every winter conslanlly enough snow and ice at Montana to ensure skating, ski-ing and
tobogganing etc. up till March, yet at the same time there is so much daily sunshine
to allow of sun baths being taken in the open air, with the body totally stripped of
any dotliing.

The snow melts as a rule in April, but owing to the natural dryness of the
air, there is little moisture to be lelt, the watery vapour being easily absorbed into
the air.

Therapeutic Factors : Mild, high alpine climate, sunny and stimulating.

Extensive level walks, through pine woods and pastures, along several picturesque
little lakes and in the lace of one of the most magnificent alpine panoramas. Very little
fog and rain.

Medical Establishments: The Chalet (Dr. Hensler, M. D., M. R. C. S., L. R. C. P.)
for hygieno-dietetic treatment: Open air jest, graduated exeicise, sun baths, hydropathics,
electricity, massage, Keflr, ' Grape cures" (no consumptives received).

Cases suitable for treatment at Montana: Constitutional debility, anaemia (too
rapid growth, overwork, slow convalescence after exhausting diseases, or weakening of
the organism by intermittent fever, prolonged stay in the tropics, Giave's disease, chronic
diabetes, incipient leucaemia etc.)

Bronchial asthma, chronic bronchitis with little tendency to expectoration (non-
tuberculous), del lyed absorption of pleuiitic effusions and impaired respiratory function
after pneumonia, status lymphaticus, adenoids etc.

Monte Carlo (Monaco).

Owing to its site on the Mediterranean and to its being encircled by steeply ascending
mountains, Monaco has a warm climate, with a pure air free from dust.

The centre of the "cure life" is the "Casino", the favourite place of all who wish
to enjoy the warming sun, a magnificent view of the blue Mediterranean, and further
on towards the West, of Monaco standing upon a high bulwark, with its historical palace
of the Prince of Monaco, and to the East, of the promontory of BorJighera reaching
far into the sea. The sanitary arrangements are the most modern of the world. The
superb pleasure-grounds have recently been enlarged and embellished. Concerts (in sumrner
out of doors, in winter in the splendid ":?alle de Theatre" of theCasino)operettas, comedies,
ballets, and the world - renowned opera - performances with the help of the most

140 Section I: Monte Carlo — St. Moritz-Bad — Bad-Nauheim

reputed artists of the world, satisfy the most luxurious demands of people asking for
enjoyments ot this kind.

There is a bathing establishment with all up - to date curative means, and a
"Zandersaal"; moreover, a drinking hall where all known mineral-waters are to be had.
Among the great number of elegant as well as simpler Hotels, pensions and private
lodgings there is especially recommended:

The Grand Hotel des Anglais & St. James, situated opposite the Casino. In
summer 1908 it was united with the Hotel St. James, and wholly renovated; it contains
a large assembly-hall; apartments and rooms with bath and toilet.

St. Moritz-Bad (Engadine).

Grand Hotel Neues Stahlbad.

New iron baths.

First class bathing-establishment in direct connection with the hotel itself.
Newest high class family hotel. Splendid protected situation. Central heating. Orchestra.
Tennis, Golf, large gardens, playing grounds for children.

Prospectus on application to the Management.

Grand-Ducal Hessian Bath "Bad-Nauheim"

near Francfort-on-Maine.

(Oldest and most renowned bath for cardiac affections.)

A town in the Grand Duchy of Hesse, express railway station of the chief line
Hamburg — Francfort-on-Maine — Basle, to be reached from Francfort-on-Maine within
45 minutes, 504 feet above sea level, at the eastern declivity of the Taunus. Mean
temperature in May to October 1.5,5 ^ C = 59 ° F, mean atmospheric pressure 749 mm.
Invigorating air, especially near the large graduation houses of the salt works. All the
cure and bathing establishments are located in the large splendid park of 370 acres, with
a pond measuring about 20 acres. Close to this park are large forestry districts extending
as far as the neighbouring wooded Johannisberg. All these places offer beautiful and
shadowy promenades and cool walks even on hot summer days. In the immediate
vicinity fine timber-forest with stock of enormous oaks.

Canalization. New Vogelsberg spring-water supply.

Roads free from dust. The general hygienic conditions are very good. Baths in
the governmental bathing establishment from middle of March to end of November, and
in the municipal bathing establishment "Konitzkystift" all the year round. Season from
April 16tli to October 15ih. Number of visitors 1911 = 34 793 (excluding travellers),
474 719 baths. On account of the steadily increasing influx of visitors of Bad Nauheim,
the Grand-Ducal Hessian government, owner of the bath, decided to have all the
establishments and institutes for cure entirely renovated. The diet of the federal state
granted the raising of the necessary means by way of public loan, the interests of which
sinking fund were to be paid from the income of the health resort. And so six
new massive bathing houses were built, two new administrative buildings, an engine-
house for electric-current works, central-heating work, ice-work, and a large steam-
laundry. Furthermore the veranda of the Kurhaus was enlarged, and a concert-garden
planted. A new concert-hall giving room for 140O persons was also built, in order to
enable visitors of the bath to attend the concerts even in unfavourable weather. In autumn
1909 the old roofed colonnade was pulled down, and a new one was built with an elegant
cafe in the centre facing the tennis-links. The latter were likewise improved and
enlarged. The complete renovation of the drinking cure establishments and the
reestablishment of the salt works in the east of the town, was performed in the
years 1910 11.

Curative factors: a) Bathing-springs. The three higlily effective and strong
springs serving for warm saline baths of 29,9" C (86 " F) — 34,4 « C (93,2 « F)
temperature, very rich in free and half-bound carbonic acid, spring No. VII (Grosser
Sprudel, 558 feet deep), No. XII. (Friedrich Wilhelm Sprudel, 630 feet deep) and No. XIV.
(Ernst Ludwigquelle, 731 feet deep). These three springs contain 2,5—3,4 per cent, solid
constituents and 1511 — 2021,3 cc. carbonic acid per liter brine. Of solid constituents in

Section I: Bad-Xauheim 141

greater amounts: sodium-chloride, lithium-chloride, potassium-chloride, calcium-chloride
and iron-salts. Nine bathing establishments Avilh altogether 400 spacious and easily heated
bathing cabins.

Forms of baths: Carbonic acid brine-baths with diflferent temperature and a
salt-content of 1 — 4 percent.; furtiiermore of each one of the three springs carbonic-acid
naturally -warm thermal-baths, thermal-sprudel baths of natural temperature, rich
in carbonic acid, and the unexcelled sp rudel-baths with entirely pure and not
decomposed brine and full carbonic acid content of the brine springing from the
interior of the earth. Of each one of these balneologic forms also flowing baths are given,
with a permanent renewal of water during the entire bathing-time. Thus there are 19
different forms of baths at disposal. The above mentioned baths are also administered
on medical prescription with additions of the very powerful Bad Nauheim mother-lye.
In addition, sitz-baths, fresh-water baths, douches and cold baths are given.

b) Drinking-springs: The Kurbrunnen and the Kartsbrunnen (saline
waters) as well as Ludwigsquelle (alkaline acidulous water) serve for drinking-cures.
The neighbouring Schwalheimer Sauerbrunnen as well as the Lowenquelle
and the Germaniabrunnen are excellent natural mineral and table-waters rich in
carbonic acid, and similar to Nieder.-elters or "Wildungen.

The bottling and sale of these 6 springs is in charge of the "Versandstelle der
Grossherzoglich Hessischen Trinkquellen" in Bad Nauheim (Grand Ducal Hessian Springs).

c) Inhalatorium and Graduation-works. In the inhalatorium, established 1901/2
are 2 rooms for common inhalations (Wasmuth- and Heyer-Apparatus), and 6 rooms for
single inhalations with 27 apparatus according to Goebel and 10 according to Heyer. Besides
appliances for compressed and rarefied air. One of these rooms is used for oxygen-
inhalation. The inhalatorium is considered a model institute. For sprays the Bad Nauheim
brine free of gas is apphed, for single inhalations the various mineral springs of Nauheim,
likewise foreign waters, and medicinal solutions.

In the drinking cure establishment rooms for gargling.

d) Other curative factors: Whey and milk cure establishment owned by a native
of Appenzell. Air rich in ozone (saturated with salt particles) near the graduation works
of the saline, on grounds with wicker-chairs. Treatment with electricity, vibration-
massage &c. by the physicians. Electric-light baths, four-cell and alternating current
baths in the Zander-institute, furthermore mud and sand baths in the bathing establishment
of the Konitzky-Stift.

Manual (Swedish) gymnastic and massage in connection with bathing-cures for
various pathological conditions.

Medico-mechanic Zander-institute (medical gymnastics only according to medical
prescription), separate gymnasium for ladies and gentlemen.

e) Governmental Roentgen-Laboratory with skiagraph for the heart.

f) Emanation-cabin in the bathing-establishment No. 9.

Indications: Disorders of circulation due to cardiac affections and to
diseases of tiie vessels (arteriosclerosis), residues of acute articular rheumatism,
chronic articular and muscular rheumatism, gout, obesity, spinal affections
(especially tabes) and diseases of the peripheral nerves (neuralgia, palsy),
neurasthenia, scrofula and rickets; diseases of women, anaemia and
chlorosis, chronic catarrhs of the respiratory and digestive organs, habitual constipation,
prostration and delayed convalescence after acute affections (influenza) or surgical
operations &c.

Entertainments: The Kurhaus, in a w-onderful location, has a large dancing-
hall connected with the theatre, rooms for society, reading rooms, billiard room and bars.
Large concert hall. In front of the Kurhaus and at the side large roofed veranda.

The music-band (50 musicians) play three times a day; also military concerts
and performances by solists. Dancing-parties, firework displays &c.

The Kurhaus-theatre gives performances of drama and comedy three times a
week, also operetta during the height of the season.

Gondola-rowing, fishing, shooting-stand, playing-grounds and
athletic-grounds. In the park large tennis-links and croquet-golfs with special
bar; not far from the pond beautifully located golf-link. Excursions to the next and
more distant surroundings such as Taunus (Winterstein and Feldberg), to the Lahn,
Yogelsberg, Rhine, Bergstrasse, Francfort-on-Maine, Darmstadt, Heidelberg Sec.

Kurtaxe: For the whole season Mks. 20 per person; for families Mks. 20
for the firsts Mks. 10 for the second person, for each additional person Mks. 5, children
under 12 years and servants are free. (As belonging to the family are considered

142 Section I: Bad-Nuulteim — Nenndorf — Nervi — Nmenahv

married couples and their unmarried cliildren still under a^e, furtheriiiore unmarried
sisters and brothers l)elon£rint< to the same hou.-eli'ild in the native town). Physieians
and the members of llieir families are free of duties. No taxes from Octohi'r 10''' to
April lyti'.

information as well as prospectus and list o( I)oarding-places by the GrandDucal
directory. Address: Geschattszimmer Kurhaus

Export of Bad-Nauheim Original brine bath salt, "Badesalz 11", and of liquid
and crystallised mother-lye by the "Grossherzofjliche Salinenrentamt Bad Nauheim".

Divine Services: Protestant, Roman-Gatholic, Knglish, Russian, and Hebrew. For
an after-cure the fiscal Bad Salzhausen (station of the line Friedberg— Nidda) is very
much reconuiiended. It is a beautifully located small and quiet place near Nidda, with
fine forest promenades, brine bath, drinking-springs and excellent climate.

Sanatorium Sanitiitsrat Dr. Hugo Schmidt, see Section II ("Sanatoria and
Cure-Establishments").

Royal Prussian Radioactive Bath Nenndorf near

Hanover.

Sulphur-bath. Brine-bath and Mud-bath.

1 hour's ride by railway from Hanover.

Four very strong mineral sulphurated springs used for drinkingcures, baths and
inhalations. Brine (6 per cent.) for baths and inhalations. Sulphurated mud for llie
preparation of excellent mud-baths.

Ideal, elegantly equipped new bathing-establishments. Good hotels. Large park.
Fine surroundings. Mountain-spring water supply, canalization. 6 resident physicians. —
Theatre, music-band, entertainments of any kind.

Indications: Gout, rheumatism, arthritis deformans, tabes, neuralgia, especially
sciatica; many skin-diseases (chiefly furunculosis, dry eczema, and psoriosis
vulgaris); diseases of the respiratory organs, hemorrhoids, scrofula, rickets, diseases of
women, various kinds of neurosis, syphilis, haematic dyscrasia and metal-poisoning.

Detailed prospectus free of charge on application to the

Konigliche Badeverwaliung in Bad Nenndorf b. Hanover.

Private Sanatorium Bad Nenndorf, Sanitiitsrat Dr. Cb. Michelet,
see Section II ("Sanatoria and Cure-Establishments").

Nprvi ''■''^^J' riiviera di Levante; well-frequented winter-station; climate exciting and
11 UI Vlj tonic, rather humid. Vegetation is luxurious. Nervi is a place highly suitable
for patients who desire repose.

Dr. Ortenau's Family Pension "Hygiea", Nervi, see Section 11 ("Sanatoria and
Cure-Establishments").

Neuenahr in Rhineland.

Topography and climate: Bad Neuenahr, 3!20 feet above the level of the North-
Sea, is situated in the romantic valley of the Ahr, a side-valley of the charming Rhine,
in the Prussian district of Coblenz, at the foot of the basaltic rock of "Neuenahr" wooded
with magnificent leafy woods. It is to be reached in I'o hour's railway-ride from Cologne
or Coblenz. The climatic conditions are the most favourable, owing to the mildness and
purity of the atmosphere, the uniformity of temperature, to the rapidly drying porous
ground of the valley, and to the site of the place protected by wood-clad hills against sharp
winds. The meaji temperature during the five months of the season is 21,7° C (71,5'^ F.),
the average atmospheric pressure 765,5 mm (referring to zero).

Curative factors: There are at Bad Neuenahr five medicinal springs, the principal
ones being "der grosse Sprudel" and "the VVillibrordus Sprudel" which Fresenius classifies
among the alkaline acidulous springs. Among these they occupy a most peculiar position as
alkaline thermal-waters, the only ones in the whole Germany. It is to this
peculiarity and to most unique curative results obtained thereby, as have never been arrived at
in any other health-resort of Germany, that Neuenahr owes its world's fame and the appreciation

Section I: Neuenahr — Nice 14-3

nnd recommendation by all medical authorities. Temperature at the mouth of the spring
36" C. (96,8'^ F.). The chief constituents are bicarbonate of sodium, lithium-ammonia,
lime, ma;;nesia, ferrous oxide, manganese oxide and zinc-oxide, sodium- and potassium -
sulphate, chloride, bromide, and iodide of sodium, sodium phosphate and arseniate,
biboracic sodium, silicic-acid and carbonic acid. In 1000 cc. of water are contained
777,91 cc of fiee carbonic acid. The "Grosse Sprudel" yields within St hours, in a
iree outflow, about 2000 cc of water. The yield of the "WiUibrordus-Sprudel" is not
inferior to this enormous amount of water. Both sprin;^s are used for drinking- and
bathing-cures. The baths, douches, and the inhalatorium are equipped according to the
most recent methods; sprudel- and wave-baths, sand-baths, Fango-baths , carbonic-acid
baths. Roman-Irish and Russian baths. Radium - Emanalorium. Splendid bathing-
establishment, rebuilt in 1S9!). Also whey- and grape-cure.

In order to allow a first course at home, a second course after the stay at the
health resort or a winter-cure, but also in order to give an opportunity for going through
a drinking-cure with Neuenahr waters to those not being able to stay at Neuenahr,
the Neuenahr sprudel is exported at a price of GO Pfennig per bottle. Orders are to i)e
addressed to the "Kurdirection in Neuenahr". The waters are also ou sale in all
apothecaries and mineral- water stores.

Indications: The Neuenalir medicinal springs are distinguished by their mild and
stimulating action : even in a continuous use they to not weaken the organism, but have
an invigorating effect. They are indicated in diseases of the digestive, respiratory, and
urinary organs, in gall-stones, enlargements of the liver, rheumatism, chronic indammation
of the kidneys, diabetes mellilus, gout, renal calculus, scrofula, affections of the mucous
membranes, of the uterus, in influenza and its sequelae.

Kurdirektion: F. Riitten, director of the Bad Neuenahr Company. Illustrated
booklet on application from the Kurdirection.

Physicians: Geheimer Sanitatsrat Dr. Paul Unschuld: Sanitiitsrat Dr. Ad.
Teschemaoher ; Sanitatsrat Dr. Wilh. Niessen: Sanitatsrat Dr. Albert Lenne; Privatdocent
Dr. Carl Grube; Dr. Georg Kuhn; Dr. Jos. Weidenbaum; Dr. Schwenke; Dr. Wendriner;
Dr. Kulz; Dr. Goldberg; Dr. Weissenteld; Dr. Graul; Dr. Bluth; Dr, Kaufmann; Dr. Dapper;
Dr. Mosheim; Dr. Ernst Rosenberg: Dr. Callus, ophthalmologist; Dr. Ufer; Dr. Claessen;
Dr. Friedrichsen; Dr. Haffner; Dr. Wolf.

Hotels: Kurhotel, isolated situation in the Kurpark, the only first-class hotel
directly adjoining the thermal bathing establishment; electric hit. Steam-heating, electric
light: the other hotels have no thermal baths. Moreover, about 50 boarding-houses,
and many private residences with vaiious rates.

Sanatorium Dr. Graul, Neuenahr, see Section II ("Sanatoria and Cure-Esta-
blishments"').

Sanatories for Diabetic Patients, Dr. Kulz, see Section II ("Sanatoria and
Cure-Estabhshments").

Sanatorium Dr. Rosenberg, see Section II ("Sanatoria and Cure-Establishmeuts").

Nice.

Central station of the Riviera, largest international health resort and winter station.
Splendid town rich of gardens and countryThouses, and framed by the sea and hills, free
from dust. Mild climate. Any kind of comfort. Much change and grand cure-life. Best
hygienic and sanitary accomodation.

Recommendable hotels:

Terminus Hotel: l^t class establishment, directly opposite the railway-station.
Hot-water heating in all rooms. Electric hght and lift. Vacuum-cleaner, likewise for
the hotels meniioned below. Apartments and single rooms with balh and VV, C.'s
Completely renovated in the summer of 1906. Luggage-delivery from and to the station
free of charge, H- Morlock new proprietor.

Hotel de Berne; II "d class establishment. Near the railway-station close to the
entrance at the left. Managed according to Swiss manner. Very comfortable house
renowned for good cooking at moderate rates. Lift. Hot- water heating.

Hotel de Su6de: 1*^ ckss establishment. 36, Avenue Beaulieu. Located in the
centre of the health resort. Most modern. Hot-water heating in all rooms. Electric
light and lift. Hall and dining rooms facing the garden. Refined French cooking. Very
pleasant for a long stay. H. Morlock, Proprietor.

144 Section I: Oherhof — Oeynhausen — Ospedaletti-Ligure

in Thuringia, 2900 feet above sea level; mountaii
for summer and winter (winter-sports of all kinds).

AUpy.U>^-p in Thuringia, 2900 feet above sea level; mountain climatic health resort

Op\/llll31IQPn Prussian province of Westphalia; 5 vigorous thermal saline springs,
V/Cjr llllCtUOCll^ rich in carbonic acid. Surrounded by wooded mountains. Climate
healthy and bracing.

Sanatorium Oeynhausen, Sanitatsrat Dr. Reckmann and Sanitatsrat
Dr. Huchzermeyer, see Section II ("Sanatoria and Cure-Establishments").

Ospedaletti-Ligure.

Topographical and Climatic Conditions: The health resort (1000 inhabitants) is

situated between San Remo (4 km) and Bordighera (5 km). With its picturesque bay, it
is one of the most lovely places on the Riviera. It is distinguished from all other
stations in that it is entirely protected against cold winds by a semilunar crest of high
mountains (N\V, N and SE winds), and consequently this place has the advantage of
the most uniform winter-climate and the most protected situation. According to the
exact scientific observations of many vears, the mean temperatures of the 6 winter months
are: November 14,15'^ C; December U,15"; January 10,25" C; February 10,88f C; March
12,29*^' C: April 14,5" C. At the same time, the absolute maxima and minima of the
individual days show variations of only 4 — 5" C, and interdiurnal variations even of
only 0,7 — 1,12" C. The atmospheric pressure is uniform (mean 767 mm Hg.), with a
moderately dry air (65 per cent, with very minute variations of day and night). Amount
of rain slight. Clouding rare. Fog almost never. Insolation even on the shortest
winterdays for 9 hours I

The foreigners' quarter itself is situated apart from the town amidst wonderful
gardens and flower-beds, in a considerable altitude above sea level. It is pretty far off
from the railway and surrounded by a large net of clean, very sunny promenades and
roads protected against winds. There is also excellent canalization, and the very best
supply of mountain drinking-water.

Curative-factors and Indications: Besides warm sea baths the above mentioned
advantages render the station suitable for out-door cures during the winter in disorders
of circulation and metabolism (diseases of the heart, the vessels and kidneys, rheumatism,
gout, anaemia, diabetes etc.), affections of the respiratory organs (excluding severe and
progressive phthisis), light cases of neurasthenia, nervous diseases, furthermore for patients
needing a change and recreation in geneial.

Resident physicians: Dr. Altichieri (Italian), Dr. Enderhn (Swiss), Hofrat
Dr. Oster (German), Dr. Semeria (Itahan).

Boarding: Grand Hotel de la Reine. Hauser Brothers. First-class house in
an excellent southern location amidst large gardens, protected against winds and free
from dust, with beautiful view upon the ocean. Large roofed veranda. Private-baths,
warm-water heating, electric light, lift. Prospectus.

Hotel Royal Guglielmina. In a paiticularly fine southern location, protected
against winds. First-class management. Modern comfort (lift), warm-water heating, eleclric
light, baths. Tuberculous patienLs are not admitted.

Hotel-Pension Riviera. Family-house. Quiet and sunny location; very much
protected garden. Inlaid floor, electric light and warm-water heating in the whole house.
Baths. Moderate rates.

Hotel Metropole. Family-pension with large garden. Numerous rooms facing the
south protected against wind and dust. Central-healing, and electric light everywhere.
Baths. Post and Telegraph in the house. Moderate rates for pension. Prospectus.
Tuberculous patients are not admitted.

Private boardi-ng: Villa Dr. Oster. Sanatorium for internal diseases excluding
consumptives etc. For further details see section II "Sanatoria and Cure-Establishments".

Section I: Ospedalelti-Ligure — Ostende — Fassuyg

145

Entertainments. Casiuo (reaJing-rooms, concerts etc.).

Great flower- market and tlower-gardens. Excursions (mules, sailing boats).

Kurtaxe is obligatory.

Divine Services: Roman-Catholic ami German-Protestant.

Communications: All trains of the line Genoa- Ventimiglia-Marseille stop here (also
express trains and trains de luxe).

Sanatorium Villa Dr. Oster, see Section II ("Sanatoria and Cure-Establishments").

Oq^PhHp Belgium, world-reputed sea bathing-place on the North-Sea, with very

broad, line sandy strand.

Bad and Kurhaus Passugg.

2900 feet above sea level, three quarters of an hour from Coire (Switzerland).
First-class hotel with 220 beds, parlours, apartments with bath. Electric heating. Open from
May to October. Wonderful situation, free from dust, 5 minutes from the romantic
Rabiosa-ravine. Extensive level promenades in the neighbouring forest.

Topography: All the springs originate from the Rabiosa-ravine, of which the
geologist Prof. Theobald says in his book: "Naturbilder aus den Rhiitischen-Alpen": "If
any massive of Switzerlund has ever puzzled science it is the Plessur-mountain." This
geological fact may indeed be the real reason why the health-resort of Passugg with its
various mineral springs may be considered unique, as in a certain measure the curative
factors of four entirely different health-resorts are united here.

The fact that Passugg during the last decade has been visited more and more by
international travellers, is not the result of a noisy bustle (casinoes or theatres etc.), but
of the excellent curative success, the excellent diet and the very pleasant sojourn for
patients and people needing change.

Curative Factors: 1. Ulricusquelle, a strong alkaline- muriatic acidulous water
beating Vichy, Fachingen, Ems, Niederselters etc. as to its content of sodium and
alkalinity. 2. Fortunatusquelle, an iodine-spring with high sodium and chloride-content.
3. Helenenquelle, a mild alkaline acidulous water.

Comparative Analysis.
In 10 000 gr. (figured on ions) are contained:

Passugg Ems Vichy Fachingen sellers

Ulricus Krancben „ Gr. Grille

Sodium 20,420 10,067 18,471 13,469 13 OOO

Chlorine 4,955 5,958 3,240 4,019 14,251

Carbonic acid .' 27,733 19,935 23,921 19,537 8,020

Total of solid constituents . . 58,858 35,192 52,774 40,952 38,020

Free carbonic acid .... 11716,0cc. " 5284,0 cc 463,0 cc 6598,0 cc 11594,0 cc

Alkalinity. ....... 93,3- 66,61- 82,09- 65,98- 27,46-

Passugg Tolz Passugg Wildungen

Fortunatus Bernhard Helene Helene

Sodium 23,8610 2,214 6,8629 6,7460

Chlorine 5,5666 1,797 1,3054 6,3340

Jodine 0,0120 0,013 — —

Carbonic acid , 31,4048 1,901 15,7456 14,7840

Total of solid constituents 65,9946 6,4403 31,3899 34,7940

Free carbonic acid 22 365,2 cc 777,lcc 17 465,6 cc 18756,0-cc

Alkalinity 105,0 6,7- 53,26 . 51,61-

4. Belvedraquellen , acidulous springs for drinking-and bathing-cures.
5. Theophilquelle, an excellent table-water. 6. The most modern and

10

146 Section I: Passugg— Pegli — Postyen — Pfaefers

completely equipped hydro-and hydro-electric bathing establishments of
Switzerland. Photo- and aero-therapeutics. 7. Radiogen-therapeutics. 8. Massage
and exercise- therapeutics. 9. Dietetic cure.

Indications: Gastro-intestinal diseases; gall-stones; affections of the liver, the
kidney sand llie bladder; pyelitis and bacteriuria : general asthenia, chlorosis and anaemia:
diabetes, ol)esity, gout; affections of the myocardium; sequelae of tropical diseases; abuse
of alcohol and nicotine; glandular affections, goitre; scrofula, arteriosclerosis, prostatic
hypertrophy, opacity of the vitreous body.

Of other affections for which the mineral water of Passugg, the invigorating and
sedative subalpine climate together with tlie bathing-cure and the most suitable diet are
particularly effective, we mention nervous diseases, sucli as general irritability of the nervous
system, insomnia, congestions of the head, and spinal-cord; neurasthenia and strain.

In obesity, gout and diabetes as well as in phosphaturia special cures are applied
without weakening the organism.

Special diet for diabetics and patients suffering from the stomach.

All spring-waters are exported.

Resident physician: Dr. J. Scarpatetti. Director: A. Brenn.

Pegli, near Genoa

10 km. from this town, and in communication with it by railway and tram. The place
has 10 000 inhabitants, and is considered one of the most renowned winter resorts of
the Riviera, with the finest forests, and the most beautiful and numerous promenades.
It offers the advantages of a medium moist and warm sea-climate, and combines in a
climatic point of view the dry and stimulating Riviera di Ponente with the more moist
•^nd sedative Riviere di Levante, being the golden mean between the two and having
iqual part in the climatic advantages of both coasts.

In the summer and autumn, Pegli is one of the most popular sea-bath stations of
the Mediterranean.

Indications: Neurasthenia, nervous insomnia, anaemia, constitutional gastric and
metabolic diseases; diseases of the respiratory organs, convalescence, asthma, cardiac atony;
for people wanting recreation. Consumptives are not admitted.

Curative factors: Climatic winter cures from September to June. Sea-baths open
from April to December. Fresh- water- and sea-baths at any sea- on. Hydrotherapy,
electrotherapy, electric-baths, massage, carbonic-acid fresh-water and sea-baths (effect of
Naulieim). Dietetic cooking for diabetics and patients suffering from the stomach. Trained
bathing-attendants. Resident physician.

Grand Hotel M6diterran6e: I*t class establishment with splendid park of the
largest palm trees of Europe. 110 rooms. Apartments with fresh-water and sea-water
baths and toilet on every floor. Best sanitary equipment. Excellent and renowned
cooking. Lift, steam-heating, electric light. Price of pension Lire 9 — 14 per day. German-
Protestant Divine Service in the hotel. Anglican Clmrch at the outlet of the park.

Electric tram in both directions. Post-office, telegraph. Theatre. Station for all
trains. Casino of its own and open-air galleries at the sea-shore.

Kurhaus Pegli, Dr. Ernst, see Section II ("Sanatoria and Cure-Establishments").

pXQ4-«rpv| in Hungary, on the line Vienna-Budapest, 3 hours from Vienna by Through
r UoLjrUll Trains. The Natural hot Radium mud Baths liO'^ F. are world-renowned for
their sovereign healing power. Highly efficacious in: Gout, rh^unialism, sciatica
Neuritis, chronic leucorrhoea etc., even in old-standing and obstinate cases. Postyen
Radium Mud and Mineral Water are exported to all parts of the world for home cures.

Pfaefers, Switzerland, Canton of St. Gall. See RaQaZ, page 150.

Section I: Pierre a Voir

147

Pierre a Voir above Martigny, Switzerland.

Simplon line of railway.

Climatic liealtli resort.
4665 feet above sea level.

The most convenient way to reach "Le Grand Hotel" from the railway station at
Martigny is a carriage drive of 3 hours. The Proprietor will gladly send on application
the tariff for carriages and luggage. In regard to luggage, the simpliest way is to send
it in advance by post, which can be done from any post-office in Switzerland, at reasonable
rates. "Le Grand Hotel" is entirely built of stone, the staircase is stone likewise, and
there are two large entrance-doors at each side of the building. There is electric light
throughout the house, and bath rooms with hot and cold water are on each floor, and
the drinking water is excellent. A resident physician in the house during the season, a
very good tennis court and golf course.

Pension Terms: for at least a stay of 8 days from 7 to 14 Frs. a day according to
room. All the rooms have sunshine, on one side in the forenoon, on the other side in
the afternoon.

Prices for travellers: Room from 3 to 8 frs. (including attendance and light;.

Breakfast Fr. 1.50

Lunch „ 3.50

Diimer „ 4.50

The mean duration of sunshine in the year amounts to 1800 h.

The mean clouding is about 4 hours.

A stay at Pierre a Voir is most highly recommended to all who are in need of rest
and quietness. As the hotel is at considerable distance from the nearest village, there is
no glaring road, no noise, no dust, and there are no smells. For overworked nerves, for
weakness after illness or for advanced age no more ideal spot could be found than Pierre
a Voir, nothing could be more satisfactory than "Le Gd. Hotel", surrounded by soft moun-
tain sward, the vivifying aroma of pines and larches w'ith glimpses of snow capped
mountain peaks: and where there are level paths in most directions.

148 Section I: Plombiercs — Pontresina

PlniYlHlPKAQ ^ ^^^^' known French s]ia, situate J about 1400 feet aljove sea level,

1 lUIIlUlvI Co^ in a deep and narrow valley of the Vosges Mountains. Season from
May to September.

Pontresina.

Topography; Pontresina, a small place of tlie Upper Engadine (Switzerland), witli
800 inhabitants, has become during the last decades one of the most popular climatic
summer stations of the High Alps, and of late a firsl-class wintersporting place too. It
owes this popularity chiefly to its Avonderful situation, 6030 feel above sea level. As the
place is leaning against the steep rock of the Languardstock, it is protected against
north-eastern winds. Toward the south it faces the largest glaciers and the highe-t
mountains of Grisons, the Bernina-Gioup. The village is embraced by the neighbouring
cembra-pine and laich-tree fo'-ests with shadowy paths. Convenient roads are leading to
summits Avith distant views and to alpine and club-shelters rich in scenery. All this and,
in addition, the glaciers and summits offer the most unique variety of wonderful tours
on account of which the place has become one of the most excellent tourist-stations.
Pontresina has also developed of late as a climatic winter-station and winter-sporting
place, and the beginning has been most promising. Owing to the situation protected
against winds and even in the winter very sunny, and to the abundant opportunity for
sporting, Pontresina is already classified among the very well known and most renowned
Aviuter-sporting places and winter-station 5.

Climate: The climate is that of an alpine valley, rendered mild by the sunny
situation in one ot the side-valleys which is protiscted against the local winds regularly
blowing in the chief valley on fine days. — Meteoiological data will mislead when the
thermometer freezes in the shadow while one is perspiring in the sun. The summer is
characterized by a pleasant coolness, and only from 11 — 3 o'clock the temperature rises
exceptionally to 20—23° C. (68—73,4*^ F.) It is never warm in the evening and morning,
and during the night nobody ever has been kept from sleeping by heat. On the other
hand, it sometimes gets pretty cold, and even in mid-summer snowfall has occurred. Sensitive
patients should never omit adapting their clothes to these conditions. — There is the
very best drinking-water yielded by springs that are curbed high above all human
domiciles and farms, and are conducted in cast-iron pipes of best quality to the village
and into the houses.

Indications: Nervous affections of functional character, nervous palpitation of the
heart, mental strain, insomnia, neuralgia, neurasthenia acquired by strain as well as
sexual anomahes, convalescence, chlorosis, general weakness and anaemia of a moderate
degree, malaria and its complications, phthisis in the first stage, residues of pleuritic
exsudates, and pleuritic adhesions, asthma of the juvenile age, chronic catarrhs of the
intestinal tract, diabetes, not too far advanced obesity (Oertel-cure).

Contra-indications: Organic anomalies o( the cardiac muscle or the larger vessels,
especially far advanced adiposity of the heart (fatty heart), grave arteriosclerosis,
pronounced and especially uncompensated valvular lesions, advanced consumption,
extensive emphysema, or such complicated by bronchitis in aged people, ulcers of the
intestinal tract, parenchymatous nephritis^ great asthenia and anaemia (there must be still
a good deal of registance).

Physician: Dr. med. Paul Gredig.

Hotels: Fourteen hotels, partly simple, partly elegant ones, and many private houses
offer accomodation for about 2200 visitors. The hotels (arranged in alphabetical
Older): Bernina, Collina, Engadinerhof, Grand Hotel Kronenhof and -Bellavista. Languard,
Miiller, Palace-Hotel, Pontresina, Roseg, Saratz, Schweizerhof, Steinbock, Weisses Kreuz
and Parkhotel. The sanitary conditions of the hotels and better private houses are
throughout perfect. The excellent boarding, at relatively moderate rates, is likewise well-
known (in the high-season 9— 2U frcs. per day, in June and September reduced prices.)

Divine Services: Every Sunday for Prote.stants, for members of the Anglican
Church and of the Presbyterian Church, for Roman-Gathohcs in St. Moritz or Samaden,
both places situated in the neighbourhood of Pontresina.

Kurtaxe: Every adult person is charged a daily tax of 20 cts. for the purposes
of the cure-administration.

Prospectus of the health resort free of charge by the

Kur- and Verkehrsverein.

Section I: Bad Pyrmont 149

Bad Pyrmont

Summer-residence of the Prince of Waldeck and Pyrmont, district capital in tlie Nortli-
west of Germany, situated 420 feet above sea level, in a wonderful valley. Bad Pyrmont
is surrounded by the richly wooded spurs of the "VVeserbergland" and tlie "Teutoburger
Wald". It is consequently very well protected against rough winds, The hygienic
conditions being excellent, epidemics are unknown here. Good drinking water supplied
by new pipe-.sy3tem. Canalization. Streets are lighted by electricity.

Curative factors: I. Ferruginous acidulous waters; II. sodium chloride springs;
III. moor-beds. Inhalalorium, milk-cure, resling-cure, Terrainkur (up-hill exercise),

I. The three principally used acidulous chalybeate waters are: a) Hauptquelle;
b) Helenenquelle; c) Brodelbrunnen. These springs contain according to Fre.-enius per
1000 gravimetric parts of water at a temperature of 12—12,7" G.

Hauptquelle Brodelbrunnen Helenenquelle
Bicarbonate of ferrous oxide 0,077073 0,074381 0,036654

Bicarbonate of manganese oxide 0,006201 0,007436 0,003458

free and half combined carbonic acid 1476,0 1541,0 1486,0 cc

the specific gravity being 1,0029—1,0037.
The chalybeate springs known already at the time of the Pvomans were notoriously
used for curative purposes as early as the beginning of the fourteenth century.

1. Ferruginous mud from the inexhaustible mud beds in the immediate neigh-
bourhood of the chalybeate springs; it is entirely equal in value to the mud of Franzens-
bad and Marienbad, according to the chemical investigations made by Professor
Kreussler at Bonn

II. The acidulous muriatic springs contain according to Professor Wiggers
per 1000 gravimetric parts of water at a temperature of 10 — 15^ C.

Salzbrunnen Alle Salzquelle Bohrlochsalz
Sodium chloride 7,05747 9,53660 32,00550

Ferrous oxide — ■ — 0,06018

Carbonic acid 954,0 647,0 373,0.

the specific gravity being 1,002 — 1,028.
The bathing-eslablishment "Unteres Badehaus" (brine-bath) at the graduation
work has 60 comfortably equipped bathing-apartments for strong and weak brine, for
mixed baths, and also for additions (as pine-needle extract, mother-lye etc.).

In the bathing-establishment "Oberes Badehaus" are 143 most comfortably furnished
bathing cabins, where chalybeate, brine, mixed- and mudbaths are given. Besides, it con-
tains a cabin for sick people, and two particularly elegant bath-rooms (the so-called
"FUrstenbiider"). In addition to this: 1. cabinets for electric tub- and light-baths, and an
arclamp reflector for local treatment; furthermore, a universal appliance for single to
three-phase alternating-current and galvano-faradic baths.

2. The inhalatorium (system Inhabad) in two rooms close to one another. Whey,
fresh cow's and goat's milk, and foreign mineral-waters can be purchased at the Haupt-
quelle and in the new milk-cure establishment (under medical supervision).

Curative value and indications: Owing to the great variety of the curative
factors ot Pyrmont, the number of various diseases treated here successfully is very great.
The most important may be mentioned here briefly:

Diseases of metabolism, renal and nervous diseases, diseases of the blood, the'
heart, the liver, the respiratory organs, the digestive and sexual organs.

Main season: From the beginning of May to the Ib^^ of October. Number
of visitors in 1911 more than 40 000, and among them 14 300 cure patients, more than
120 000 baths were taken. There is also a winter-season now in which aU the springs
and bath-, except mud-baths, and all forms of inhalation can be used.

Physicians: Dr. Buchwald; Dr. Otto Daude; Dr. Enters; Dr. P. Grosch; San.-Rat
Dr. A. Holscher; San.-Ral Oberstabsarzt d. L. Dr. S. Marcus; Marine-Stabsarzt a. D.,
Specialist for throat, nose, and ear diseases. Dr. M. Muller; Kgl. Preuss. San.-Rat, Physician
forDiseases ot the blood and metabolic diseases (diseases of the digestive apparatus included),
Dr. H. Muller; Nervenarzt Dr. Otto Pohl; Kgl. Preuss. San.-Rat Professor Dr. Schuckmg;
Dr. A. Schiicking jr.; San.-Rat Dr. C. Seebohm; Stabsarzt a. D. Dr. F. Weber; Fursti.
Waldeck. San.-Rat Dr. Weitz; S;ui.-Rat, district physician. Neurologist, Dr. R. Wichmann.

Dentists: Dr. Wege; Tappe.

All matters pertaining to the cure are under the supervision of the Cure-
Administration of the Principality of Waldeck represented by the Kurdirektor von Beckerath.

150 Section 1: Bad Pyrinont — RigazPfaefers

Kurtaxe. For the duration of the main season for one person Miis. 20; for each
additional member of the family Mks, 10; for children of 6 — 10 years and servants Mks. 2,
children below liie sixlh year of age free of chart,^e.

Boarding and pensions are those of a large health-resort. Apartments are at
disposal in great number, prices varying according to location, size, furnishing and to
the duration of the slay.

Hotels. Furstiiches Kurhotel with 200 beds, lift, electric light, in direct communi-
cation with the Princely ''Oberes Badehaus",

Grosses Badoliotel, Hotel Rasmussen, Lippischer Hof, Hotel zur Krone etc.

Cure establishments. The newly built princely Kurhotel answers the most
modern requirements.

Concert tbree times daily by the princely music-band (40 musicians).

Kurpark with model p'aying-grounds for lawn-lennis, croquet etc. Opportunity
for hunting and fishing, racing, fire-work, theatre. Excursions and promenades
are numerous and well worth making.

Means of communication. Pyrmont, station of the Hannover — Altenbeken line,
head-stalion of D-trains Paris — Cologne — Hildesheira— Berlin, can be reached easily
from all directions (Hanover 1 '/a hours, Berlin 5, Hamburg 6, Francfort on the Maine 7,
Amsterdam, Dresde S, Paris 13, London 18 hours).

Detailed information by Furstlicli Waldeck. Kurverwaltung.

Sanatorium Pyrmont, Sanitatsrat Prof. Dr. Schiicking, see Section H
("Sanatoria and Cure-Establishments").

Sanatorium Pyrmont-Saline, Dr. Wichmann, see Section H ("Sanatoria and
Cure-Establishments").

Ragaz-Pfaefers.

Canton of St. Gall (Switzerland).

The long known and famous springs of Pfaefers (constant temperature at the spring
30*^ R. = 37, -5 0 C. =99,5'^ F.), akratic thermal-waters, provide all the baths and springs
of Ragaz and Bad Pfaefers with a continuous current of thermal water.

Ssason: Bad Pfaefers from end of May to end of September, Ragaz from middle
of Mav to middle of October.

"Bad Pfaefers. Hotel Bad Pfaefers (2290 feet above sea level, at the entry of
the world renowned Pfaefers-Ravine, protected against winds, 3 km distant from Ragaz.
Good road from Ragaz to Bad Pfaefers. The air is rich in ozone, and free from dust. 24. baths
built in Dutch tile, and 8 large common baths. Douches of thermal water, and cooled
thermal water in the bathing-establishments. Temperature of the baths 28,5^ R. =
3.0.5 " C. = 96 « F. Treatment with electricity and massage. Resident physician and
masseur in the establishment. Concerts three times a week, at noon and in the evening.
Good cars to Bad Pfaefers on the arrival of the trains at the railway-station of Ragaz.

Helvetian post-olfice, telegraph, and telephone.

Bad Pfaefers is especially recommended for people requiring rest.

Indications as in Ragaz (see below).

Physician: Dr. Kuchenbecker.

Prices of Baths: Fr. 1. — Dutch-tile bath; Fr. 0,60 common bath.

Divine Services: Protestant and Roman-Catholic in the chapel of the
etablishment.

Ragaz, 1823 feel above sea level. Topography. Ragaz is situated on the
southern border of the St. Gall side of the Rhine, amidst multifariously shaped valleys,
and surrounded by a grand mountain scenery. The rails leading from Zurich through
the Linth- and Wallensee-Valley and through the lower valley of the Rhine from the
Lake of Constance and from Arlberg, run close to one another in this region. Towards
south Ragaz is the junction of the Praetigau- Valley leading to Davos, and of the valley-
and mountain- roads leading from the Engadine, Splugen, and the Upper Alps to the valley
of the Rhine. This very favourable situation has rendered Ragaz a centre of a considerable
influx of foreigners, and it is now the direct starting point for tho.se going to the
Confederate health-resorts ofSLMoritz, Tarasp, Samaden. Maloja, Arosa, Films, Davos t^'c,
as well as to the Italian lakes. The broadening of the Rhine- Valley is at Ragaz very
considerable, tlius the sun has free access and the traveller's eye enjoys an unrestrained
view of the wonderful and most abruptly varying mountain formations and the

Section I: Bagaz-Pfaefers

151

charming scenery of the valleys embracing the health-resort in a semi-circle. The Rhine
flowing through the middle of the valley, and the inii)etuous river Tamina leading its bed
near Ragaz and flowing into the Rhine, add to the vivacity of the scenery. Ragaz is
situated on tiie bottom of a valley gently ascending from the Rhine. This valley has
been formed in course of time by the deposit of boulders through the Tamina. The
course of this river is now changed by massive embankments, and the river can, therefore,
only deposit its boulders into the Rhine. The ground upon which Ragaz is standing,
consists mainly of gravel, sand, and rubble-stones. Owing to this fact and to the favourable
fall of the river toward the Rhine, the mountain water has a constant and rapid flow not
allowing any stagnation of subsoil-water.

Climate : The abundant vegetation within and around Ragaz as well as the
neighbouring leafy and pine-needle-woods are favourable for the development of a
wholesome atmosphere rich in oxygen. During the hot season the air is cooled in the
night by the wind coming from the rocks of the Tamina Ravine. The mean daily variation
of temperature is 5^ C. (41,0*^ F.) from May to October, the mean atmospheric pressure
at 0** C, (32° F.) is 716.27; the average relative moisture of the air is 78.36. A temperature
higher than 31" C. (87,8'^ F.) has not been observed as long as the Ragaz metereological
station is existing (i. e. since the year 1871). Heavy thunder-storms are very rare. Heavy
fall of hail has not occurred within the memory of man. Fog is only in the valley
during the wintermonths of November and December, and even then but seldom. The
forests and the "Luziensteig" — (foot-path) and "Flascherberg" keep away heavy northern
winds. The climate of Ragaz is characterized in general as a mild, but invigorating
mountain climate. The local meteorological station has registered observations for 10 years,
showing for the season — iVIay to October — the following exact mean figures;

Temtieiature

Temperature of air

1883—1892

\\ absolute absolute jl 7 h
jlminimum maximuml! a. m.

1 h
p. m

9 h
p. m

mean
maximum

minimum
mean

Relative

moisture

mean

•Clouding
I mean

May

June

July

August . . .
September
October. . .

11,3
13,2
13,1
9,7
4,5

29
29
30
29
29
21

11,1
14,1
15.5
14,8
12,0
6,3

17,4
19,8
21.0
19,9

17,8

11, T

12,6
15,1
16,4
16,2
13,4
7,7

13,7
16,5
17,7
17,0
14,4
8,5

16,0
18,0
19,9
19,0
16.1
10.2

81,0
86,0
86,3
90,7
90,9
91,4

4,9

5,8
5,0
4,3
5,0
5,2

Curative Factors: The bathing establishments (with 90 different Dutch-tile baths),
of which three (Miihle-, Helena- and Neubad) are situated near the Hotel Hof Ragaz and
Hotel Quellenhof on the right bank of the Tamina, while the fourth bath-establishment
(Dorfbad) is situated on the left bank of the Tamina, in the centre of the village of
Ragaz. The swimming-tank is on the right bank of the Tamina, in the centre of the
cure establishments. It is a large roofed reservoir filled with thermal water, and furnished
Avith galleries and a suffic'ent number of dressing-iooms, a swimming-tank unique of its
kind (24 m long, 9 m broad).

Temperature of single baths 27— 28° R. = 33,50 — 350 C. =93— 91." F. or on
demand with cooled thermal water: temperature of the water in the swimming- tank
23—26 0 R. = 29—32" C. =84-90,5" F.

Analysis of Pfaefers Spring-water.

made in 1895 by Professor Tread well.

10000 gr. of water contain in grams:

Iron 0,00101

Aluminium 0,000863

Calcium 0,552340

Strontium 0,007036

Barium 0,001760

Magnesium , ■ ■ • 0,155180

Potassium 0,0.:l5543

Sodium 0,292570

Lithium 0,001842

Ammonium 0,000576

Cs., Bb., TL, Cu traces

Silicic acid . .• 0,209960

Carbonic acid 1.062600

Directly determined 2.970000. Specific gravity 1,00031. Temperature 36,85" C.

Phosphoric acid 0.003000

Sulphuric acid 0,292450

.Iodine 0.000092

Bromine 0,001220

Chlorine 0,346330

Fluorine 0,000280

Nitric acid 0,005080

Boracic acid 0,004150

Arsenic acid 0,000060

Ferrous oxide —

Organic substances 0,000900

2,974849

96,5" F.

The great advantage of the baths of Ragaz-Pfaefers consists in the continuous
current of fresh water rendered possible by the abundance of springs, and in the constant
temperature of the thermal water in the bathing-tubs; the radioactivity of the thermal
waters adds considerably to the significance of these baths.

Ry the bacteriological examination of the thermal waters, Prof. Tavel and
Dr. Ed. V, Freudenreich of the Bacteriological Institute at Berne proved in 1896 that it is
an excellent drinking and table water, poor in bacteria.

152 Section I: Ragaz-Pfaefers

Warm and cold spouting, rain, and local douches in the baths. Carbonic acid
thermal baths, brine baths.

Recently established medico-mechanic Zander-institute for Swedish gymnastics
(71 different appliances). Electrothermal treatment (hot-air treatment).

Most modern appliances for electro-therapeutics. Treatment wilh galvanic, faradic,
and static eleclricily. Both institutes are situated in the centre of the cure establishments,
and are under the medical supervision of Dr. F. Bally.

New establishment for hydropathy and for the application of common water. Cold
and changing douches (Scotch-douches), demi-baths &c.

Scientific massage (system of Metzger). The bath- cure is aided by gOats' whey
brought daily from the Alps, by excellent cows' and goats' milk, kephir, strawberries from
May to September, and in autumn sweat grapes of the vicinity. All the known mineral-
waters on sale.

Indications: The thermal waters of Pfaefers have been applied for centuries with
great success especially for the following diseases:

a) Almost all kinds of nervous diseases, such as general irritability of the nerves,
neurasthenia, hysteria, cerebral and spinal paralysis after the stage of inflannnatory reaction,
spinal irritation, tabes, spinal congestion, peripheral palsies, various forms of neuralgia.

b) Diseases of the locomotor organs, such as chronic muscular and articular rheumatism,
arthritis nodosa, gout, stiffness of the joints, muscular contractions, scars.

c) Skin-diseases: disorders of cutaneous excretions (seborrhoea, acne, comedones &c.)
pachydermia (ichthyosis), chronic urticaria, prurigo.

d) Diseases of the digestive organs, such as gastrodynia (nervous cardialgia), chronic
gastric ulcer, nervous dyspepsia, clironic intestinal catarrh and diarrhoea, enteralgia &c.

e) Diseases of the genito-urinary organs, such as vesical catarrh wilh predomniatiiig
irritative symptoms, irritative conditions of the urethra.

Of menstrual disorders: amenorrhoea anddysmenorrhoe; someforms of chronic metritis
and endometritis; many disorders of the climacteric period, chronic parametritis, perimetritis,
and pelveo-peritonitis (in combination with massage.)

f) Constitutional and general affections, such as the erethic form of scrofula,
chronic mercurialism, palsy due to lead-intoxication, general weakness during
convalescence after severe diseases, senility; for a cure after a stay at other health-resorts
in uric-acid diathesis ani diabetes, especially after a cure at Carlsbad and Marienbad.

g) Diseases of the respiratory and circulatory organs, such as laryngeal and bronchial
catarrh with dryness and severe irritability, but without fever. Not too severe cardiac
lesion-i after articular rheumatism iSL'c.; nervous palpi ation of the heart.

Ragaz is specially suitable as a station after a cure at Carlsbad, Marienbad,
Franzensbad, Vichy, Tarasp.

Physicians: Resident physicians Dr. Staehelin-Burkhardt, Dr. Jaeger, Dr. Haslebacber,
Dr. Dormann.

Hotels, Boarding-Houses and Pensions: a) Bathing and cure establishments,
situated on the right bank of the Tamina, overtopped by the ruin of Wartenstein, grey
with age. Fine and large parks extending up-liill into pine-needle and beech-forests,
toward the Rhine into meadows abundantly planted with fruit trees, and embracing the
magnificent buildings of the cure establishments. These consist of the two large hotels
*Quellenhof" and "Hof Ragaz", with a number of country houses (family-houses),
of the annexed bathing establishments: Neubad, Miihlebad, Helenabad and Schwimmbad,
the drinking-hall, of a proper building for the mcdicomecljanic Zander-institute and
hydropathy, and finally of the building of the Kursaal with its magnificent colonnade.
Several pavilions scattered in the parks, serve as beautiful magazines. Both the above
mentioned hotels answer all the demands of a first ciass hotel. They are in direct
communication with the above mentioned bathing establishments, the appliances of which
also comply with the most various desires.

b) Hotels and Pensions in the village of Ragaz. On the left bank of the
Tamina are the following hotels and boarding-houses: Hotel Tamina, Hotel Schweizerhof,
Hotel Krone, Hotel Latlman, Hotel Melropol, Hotel National, Hotel St. Gallerhof, Villa
Flora, Hotel Rosengarten, Hotel Ochsen, Hotel Lowen, Hotel Sternen, Hotel Central, Hotel
Bristol, and also furnished apartments in the houses: Post, Home Villa, G. Bislin,
0. Lehmann, Bellevue, Neuhof, Villa Alpenrose, Strafehl, Kaltenbacher, Sunderhauf.
Furthermore hotel and pension Wartenstein (*^800 above sea level), in comnmnication with
the Kurort Ragaz by a funicular railway (10 minutes' ride); fine panorama.

Kurtaxe and Prices of Baths: The Kurlaxe amounts to 50 cts. per day.

section I: Ragaz-Pfaefers — Bapallo 153

Prices of baths: Neubad (duration of balh in tubs and in svviniiuinL,'-tanii not
exceeding three quaiters of an hour inclu(Hng time for dressing) 2.50 frs. per hatli ; Helenabad
1'— 2.50 frs., Muhlbad '2. frs., Dorfbad 2 frs., Holzbad 1 fr., Swinuiiing-bath in the
forenoon 2 frs., in- the afternoon 1 fr. per person. Bathing-clothes 20 cts. per bath.
A complete bathing-dress ' .^ fr. per bath, bathing drawers 20 cts. per bath. Bathing-
tickets are sold in the central-bureau of Hof Ragaz.

Entertainments: Music, dancing, lawn tennis, playing at nhie-pins, croquet, golf,
fishing, excursions, concerts by artists.

Stations for Tourists: Interesting excursions to the mountains, t>ad Pfaefers
(2390 feet above sea level) and Quei:enschlucht, W artenstein, Dorf Pfaefers (2877 feet
above sea level), Tabor (2950 feet above sea level), Calleuser and Weislannental, Calenda
(9800 feet above sea level), Pitz Aiun (5180 feel above sea level), Dorf Valens (2800 feet
abo ve sea level), Dorf Vaettis (3328 feet above sea level), Monte Luna (845(i feet above
sea level), Palkuis (8980 feet above sea level), Gonzen i6t90 feet above sea level), Staetzer-
horn (9016 feet above sea level), S'cesaplana (10 380 feet above sea level), Graue Horner
(89G0 feet above sea level), Alvier (8270 feet above sea level), Speer (6877 feet above
sea level) and Siintis (8764 feet above sea level).

Excursions by Car and Railway: Bad Pfaefers (Quellenschlucht), Luziensteig,
Dorf Pfaefers, Rayol, Vattis, Valens, Weisstannen, Seewis, Coire, Davos, Schynpass, Vianiala,
Engadine, Flinis, Rotenbrunnen, Fruhbacli, Wartau, Wallensee, Obstalden, Murg, Weesen,
Ziirichsee, Glarus, Klonlhal, St. Gall. Feldkirch &c.

Divine Services: Roman-Catholic: Village-church and Quellenhof-chapel;
Protestant: German and French in the Protestant parish church; English in the
English church.

Means of Communication: Railway, post-office, telegraph, telephone; one-, two-,
three- and four-horse cnrriagrsto the heallh resorts of Canton Grisons.

Literature: Details about the history, topography, the climate, medical effect &c,
are to be found in Dr. J. E. Kaiser, Die Therme von Ragaz-Pfaefers. 5tli edition
St. Gallen 1869; Dr. A. Schadler, Ragaz-Pfafers, the curative effects of its thermal wateis,
."^t. Gallen 1886 — Jwan Tschudi, Ragaz-Pfaefers and the united Swiss railways. —
F. Kaiser, Zur Erinnerung, Gedirhte (Poelry), Ragaz 1876. — F, Kaiser, Ragaz-Pfaefers
und ihr Excursionsgebiet. Ragaz 1880. — Ragaz-Pfiifers 1891-. published by Preuss,
Ztirich. — Dr. F. Bally, Die medico-mechanische schwedische Heilgymnastik und das
Zander-Institut in Ragaz. Basel 1894. — Naturkundliche Forderungen im Gebiete des
St. Caller Oberlandes, Badbezirk Ratjaz-Pfafers. Vortrag von F. Kaiser, Reallehrer-
St. Gallen 1894.

Further information, prospectus, descriptions and bath-literature on application to the
"Bade- und Kurverwaltimg Eagaz-Pfaefers" and "Kur- und Verkehrsverein Ragaz".

Rapallo near Genoa.

Riviera di Levante.

Rapallo is situated at the eastern Riviera, about 28 km south to Genoa, in a
picturesque site, at the end of the Gulf of TiguUio.

Climate: Rnpallo belongs to the stations having a medium moist- warm coast
climate. The temperature during the year is pretty equable, owing to the standing of
the place on the coast of the Mediterranean.

The Ligurian Apennine offers good protection against the rough and cold north-
winds sweeping over the shore but doing no harm, as they only hit the sea.

The bottom of the valley in which the town is situated, is sheltered on west by
the cape ofPortofino, on north and east by the mountain-crest of the Ligurian Apennine,
it is widely open in the south and south-east towards the sea so that the warm Italian
sun gains everywhere free access to it

This mountain-chain is interrupted by two valleys in the north and east. Both
these valleys are the natural ventilators of the place, bringing about a permanent change
of air, and preventing the development of a moist-warm hot-house air. By virtue of this
latter circumstance particularly Rapallo is distinguished considerably from many other
health resorts of the Riviera; the climate does not weaken, it is rather stimulating and
invigorating, and from this reason special indications are indispensable.

154 Section I: Rapallo

According to the registration of meteorological stations of the Pharmacia anglaise
the following mean temperatures of winler-mon'hs have been found:

November 12,2 0 G (53,5^' F) December 8,8" C (49" F) Januarv 8,1" C (46,5" F)
February 8,9" C (48,1" F) March 10 3" C (50" F) April 14,4" (57,5" F)

Thus the average temperature of winter-months is 10,45" C = 50,2" F. With this
relatively high temperature even in the winter, a long stay in the open air is possible,
and all the conditions are favourable for an open-air resting-cure.

The most frequent winds are south and soutii-east winds. North and north-east
winds are rare and little noticed on account of the protected site of the place.

The relative moisture of the atmosphere is not as high at Rapallo as should
be expected from the neighbourhood of the ocean. It amounts to 60 per cent, in the
average, and is at places near the sea level greater tlian at higher situated spots.
Regarding the rain-fall there are about 25 bright day-; in the average, 3 changeable and
2 rainy days. The thin and constant rain of Middle and Northern Europe is unknown
here, but instead there occur some few heavy showers. The amount of rain is 3,85 feet.

Fog is never observed at Rapallo.

The duration of sun shine is very long at Rapallo, as the place is situated
for the greatest part on the south-east coast.

Owing to its situation at the ocean, and to the absence of any industrial establishment,
the air at Rapallo is clean, with but little dust, all the streets being paved. Argillaceous
slate forms less dust than the clay-soil of the Riviera di Ponente. Rut besides any dust
formed is kept down by dew and by the abundant vegetation.

An important advantage of Rapallo is the variety of promenades in the charming
surroundings. There is scarcely a region that offers a variety of promenades similar to
that on the coast of the Gulf of TiguUio. One may wander through the country for
months, but again and again one will be surprised by a new load, a new vista of the
blue Mediteiraneen, the steep and rough rocks, and the hills of Liguria covered with a
swelling green.

The climatic factors of Rapallo may be summarized here briefly as follows:

1. Relatively warm temperature with sufficient change of air.

2. Moderate moisture, purity of air, and relatively little dust.

3. Absence of fog.

4. Strong insolation.

5. Opportunity for promenades.

Curative means: Sea-baths in the ocean, temperature never below 59" F.
Warm sea-baths, carbonic acid sea-baths, alternating -current baths, hot air-baths,
gymnastics, vibration-massage with inhalation. Salt content of sea-water about 4 per
tliou-and, milk, whey and kephir, mineral- waters. Opportunity for air-and sun-baths,
roads fitted for Oertel-cures. Furthermore, all methods of physical therapy can be
applied, as well-trained masseurs (male and female) are present.

There are well-equipped apothecaries in the town.

Indications: Diseases of the circulatory organs (chronic myocarditis, adipous lieait,
cardiac neurosis. Grave's disease, valvular lesions, and arteriosclerosis), nervous diseases
(tabes and neurasthenia), diseases of the respiratory organs (chronic catarrhs of the upper
air-passages and bronchi, apical catarrhs, infiltrations, pleurisy, bronchial asthma, kidney
diseases (interstitial nephritis), anaemia and convalescence. Consumptives are not admitted
in hotels and pensions.

Resident physicians: German: Dr. Brunk, Dr. Schmincke (in the summer at Bad
Elster). English: Dr. Winslow; Italian: Queirolo, Marengo, Pingio, Sturla.

Apothecaries : Tonolli, Ghighizola, Voigt, Dr. Bacignlupo.

Lodging and boarding: The hotels and pensions are either located at the ocean
or in fine gardens near the neighbouring declivities of hills. Thus there is everywhere
offered open access to air and light. All the houses have central-heating, electric light
and W.C's.

The prices of pension are Avithin reasonable limits, 7 to 15 frcs. daily for full
pension and board, according to location and size of room. Boarding is good, consisting
in general of breakfast, lunch at 12 o'clock, and dinner at 7. p. m.

Entertainments: Music in the cityparlc, and concerts in the hall of the Kurliaus,
playing-room, balls, lawn-tennis grounds, flower-corso. Excursions on boat to Zoagli,
Chiavari, Santa Maigherita, Porlofino, San Fruttuoso. By car or by foot to Ruta,
Montallegro.

Divine Services: Roman Catholic, German-Protestant, and Anglican (English
Church).

Section I: Rapallo — Beinerz — Bigi-Scheidegg

15r>

News-paper: "Rapallo Revue" foundeil in l')01 (list of arrivals). In the Kursaal-
Kasino many English, German, and French papers nre on file.

Means of communication: Rapallo is a station of the line Genoa — Pi^a — Rome,
and is in direct communication with Genoa, Milan, Basle, Munich, Berlin, and Rome. All
express and Dtrains are stopping here. The railway-station is near the city, and cars and
omnibusses of the hotel are always at disposal. Post-office, telegraph and teleplione.
Daily steamers from and to Genoa with luggage-delivery.

For travellers coming from the western part of Germany are best available the
lines Basle— Milan — Genoa, for those coming from Eastern-Germany and Bavaria the line
Munich— Milan. From Berlin to Rapallo it takes about 30 hours. From January l«t daily
express-trains run between Berlin and Genoa.

Information by the travellers' office

Comitato Rapallese deU' Assoclazione del Movimento del Forestieri in Italia.

Dpinpr7 Prussian province of Silesia, about 1800 feet above sea level. Alkali-saline
QCillCl £ij ferruginous waters. Climate very vigorating.

Rigi-Scheidegg near Lucerne.

Climatic Station, Dietetic and Cold-water Cures
(5445 feet above sea level).

"This large establishment stands on the eastern plateau of the Rigi in an
entirely free and sunny position amidst wonderful Alpine scenery, lib feet above the
highest station of the railway: Vitznau— Kallbad— .Scheidegg. (Lucerne— Rigi — Scheidegg
2V2 hours). The hotel can be reached from the Ftation within a few minutes (Carriage
at the station).

Owing to its being situated outside the range of the rush and noise of the Tourist
traffic, Rigi — Scheidegg is the quietest of the larger Rigi Resorts, and is therefore
especially suitable for all those requiring real Rest. Rigi— Scheidegg is especially
distinguished by its stimulating air, entirely free from dust, and by its high degree of
insolation.

Well-kept promenades lead to the neighbouring woodlands and sheltered resting-
places. Longer excursions may be made by the various Rigi-railways.

156

Section I: Eigi-Scheidegg — Sckeveningen — Spa

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The spacious Hotel and Kurhaus has 150 rooms (:^00 beds), a large number of
which are supplied with steam-healing or porcelain-stoves. More than a third of the rooms
have large balconies. Electric light all over the house. The ground floor contains
many most comfortable halls, large dining-rooms, restaurant, mu<ic-room, reading-room
(newspapers and library), ladies' drawing-room, smoking- and biljinrd-room, and also play-
room for children; all these rooms are heated when necessary.

The sanitary appliances and drainage are arranged according to the most modern
hygienic principles. The excellent springs yield the best drinking-water. Laundry in
the house. Hair-dresser in the house. Post-office, Telegraph and Telephone.

Indications: 1. Anaemia and chlorosis, as well as the sequela of these.
2. The various forms of neurasthenia (irritable weakness of the nervous system).
Rest- and feeding -cure (Weir - Mitchell cure). 3. Diseases of the digestive
organs. (Chronic gas tro-intestinal catarrh, gastric ulcer, nervous
dyspepsia and disorders of secretion etc.). Special dietetic cooking under
the supervision of the physician. 4. Metabolic diseases. Special diet for diabetics.
5. For persons needing rest and recreation after febrile diseases, for people
having a predisposition for Malaria, and for Europeans living in hot climates
and visiting Switzerland for a summer change. Rigi— Scheidegg is one of the most
suitable stations warranting restoration of health and vigour.

Physician: Dr. R. Vogel-Sarasin, during winter at Basle.

Special care is devoted to the dietetic cooking, and also to the individual diet
ordered on medical advice. The application of cold-water is facilitated by hydrotherapeutic
appliances under the supervision of the physician and the service of trained nurses
(masseur and masseuse).

Further information as to rooms and prices, also prospectus and map are seiit

at any time by the

Scheveningen,

Director of the Hotel Rigi-Scheidegg near Lucerne.

Holland, situated near the Hague. Very well-frequented sea-
bathing station; very fine sands, strong turf. Climate is bracing.

Spa

Belgium, near the German frontier: 9 hours from Paris; Ferruginous and acidulous
J waters; air bracing and healthy.

Section I: Solbad Rheinfdden — Bad Salzhrunn 157

Solbad Rheinfelden (Brine-Bath) Switzerland,

Railway-Line Calais-Basle-Rheinfelden.

Tlirough-Tickets Paris-Rheinfelden.
Rheinfeklen, 980 feet above sea level, a small town of 3700 inhabitants, is situated
nt the norlliern border of Switzerland, on the left bank of the majestic Rhine. The
immediate surroundings of this place are formed by rich meadows and large forests,
and gently rising hills encircle the lovely scenery.

Rheinfelden is getting more and more known as a transitional station for those
coming from the mountains.

Curative Factors: Brine-baths, carbonic-acid brine-baths (Nauheiin cure), hydro-
therapy. Baths in the Rhine. Baths of pine-needle extract. Massage and Swedish
gymnasticts. Electric-light baths.

As the following comparative table shows, Rheinfelden assumes the foremost rank
as regards its rich content of salt.

Solid Constituents Ciiloride of sodium

Rheinfelden 308,8 gr 302,4 gr

Biarritz 307,0 , 295,1 ,

BesanQon 298,0 „ 283.6 „

Suhl 264,5 , 248,8 ,

Diirrheim 262,5 , 255,4 „

Sahnes de Beam .... 257,9 , 229,2 ,

Bex 170,2 , 156,6 ,

Nnuheim 35,3 , 29,3 ,

Salins (Jural 26,0 , 22,7 ,

Kreuznach 17,6 , 14,1 „ '

The brine and carbonic acid baths of Rheinfelden are indicated in conv.ilescence,
anaemia, chlorosis, lymphatic conditions, scrofula, rickets, and osteomalacia ; diseases ot
women, affections of the bones and joints, diseases of the nervous system, cardiac diseases
(Nauheim cure), chronic exsudates. Chronic catarrhs of the nose, pharynx and larynx.
Dry eczema.

Physicians: Dr. Grawehr, Dr. Herzer, Dr. Keller, Dr. Kern, Dr. Muller, Dr. Welti.
Music, lawn-tennis, hunting, and fishing.

Hotels: Grand Hotel des Salines in the park (family apartments with brine-baths,
sin:-rle rooms with brine-baths), price of pension from 10,50 Frs.

Hotel Dietschy near the Rhine; price of pension from 7 Frs.
Hotel Sciiiitzen; price of pension from 6,50 Frs.

Any further information and prospectus 'roe of charge by the above nientioned
Hotels.

Bad Salzbrunn in Silesia.

Bad Salzbrunn, station of the Breslau— Nieder-Salzbrunn — Halbstadt Railway, is
situated at the foot of the "Hochwald" (2975 feet above sea level) in a protected valley
of the Waldenburg mountains, a massive intruding between the Riesengebirge and the
mountain-district of Glatz. Running-time: London— Berlin 20 hours, Berlin— Bad Salz-
brunn 6 hours.

The climate is mild and, at the same time, a stimulating alpine climate;
1407 — 1465 feet above the level of the sea. More than 346 acres of park-grounds with more
than 24 km of promenades, besides the "Hochwald" with its forests comprising
1482 acres.

Natural Curative factors are the mineral springs, cold alkaline acidulous waters,
furthermore the alpine site, the fine promenades and parks.

The "Oberbrunnen", known among physicians since 1601, the "Kronenquelle" and
the "Muhlbrunnen" are used for drinking cures, the " Luisenquelle" for bathing purposes.
The "Marthaquelle" is an excellent dietetic table-water.

Comparative Table of the most important constituents of

Oberbrunnen Kronenquelle Muhlbrunnen

1. Bicarbonate of Sodium . . . 2,413 0,8762 1,810

2. Bicarbonate of Lime 0,4928 0,7091 0,564

3. Bicarbonate of Magnesia 0,5403 0,4045 0,577

4. Free Carbonic Acid 1,877 1,570 1,400

158 Section I: Bad Salzbrunn — Salzbrunn Kronenquelle

Of modern cure establishments are to be mentioned: I. Two common inhalatoria,
(systems of Heyer, VVasmuth and Reif) and appliances lor single inhalations (improved
system of Jahr); 2. Pneumatic single apparatus (system of Goebel — Ems), pneumatic
chamber (Reicbenhall system), and an apparatus for oxygen inhalation according to
Dr. Brat; 3. Two gargling-halls, one of them with single chambers; 4. Batliing-
establishment in Felsenhof for simple and compound baths and individual procedures of
hydropathy: 5. the New bathing establishment for tub-baths of any kind, electric Iwo-
aiid four-cell baths, two departments for all kinds of hydropathic measures, electric-light
baths and radiations, massage, Fango- and radiogen- mud packings; 6. Medico-mechanic
Zander-institute; 7. Establishment for milk- and whey-cure; 8. Light- and air-bath;
9. Chemical- bacteriological bath-laboratory.

Salzbrunn is of therapeutic value in acute and chronic catarrhs of the larynx, the
nose and the pharynx, of the air -pipe and the lungs, in emphysema and asthma, in
diseases of the digestive organs, in affections of the kidney and the bladder, in gout and
diabetes, as well as after influenza.

The health resort has high pressure spring-water supply, canalisation, electric light
and incandescent gas-light on the streets.

Season from May 1st to September 30t'\

There is a sufficient number of apartments answering all demands of a modest
or refined comfort. The price for lodging is according to the situation, the furnishing
and the time of the season from 7—70 Mks. per week. Full pension from 3 Mks. daily.

The Grand Hotel established 1910, a splendid building of the Adam-style, most
comfortably furnished, with verandas and gardens, has rooms for representation, for
society, and restaurants, besides 130 rooms with 200 beds. There are also a number of
other hotels, pensions, and more than 170 lodging houses.

Entertainments and Society-Life: Good music-band of 36 men, symphony-concerts
and soirees of leading artists; artistic concerts, permanent theatre, social clubs and
dancing-parties. Five-o'-clock tea in the Grand Hotel; the unique and world-renowned
illuminations of the park; reading rooms and libraries. For sporting purposes 5 tennis-
links, great tennis matches, shooting-stand for pistol and rifle; riding-school. For
communication and excursions into the charming surroundings good cars, automobiles
(also auto-buss), and electric street-cars of the district ofWaldenburg are at disposal, the
latter leading to the immediate neighbourhood of the mountains.

Adress for ordering Ober- and Miihlbrunnen: "Versand des Oberbrunnens, Bad
Salzbrunn in Silesia"; for Kronen- and Marthaquelle "Administration der Kronenquelle,
Bad Salzbrunn in Silesia."

Literature, prospectus, other printed matters, and information of any kind by the
Fiirstliche Brunne^i- und Badedirektion in Bad Salzbrunn in Silesia.

Bad Salzbrunn in Silesia

Owned by His Highness Prince von Pless.

I. Kronenquelle

(Alkaline Acidulous Spring.)
Hygiene-Exhibition Dresde 1911: Grand Prix.

On account of its relatively high content of lithium and its favourable composition,
the Kronenquelle is indicated in renal and vesical diseases, urinary gravel and calculous
affections, in the various forms of gout, diathesis, as well as articular rheumatism.
Furthermore, in catarrhal affections of the larynx, the lungs, and in gastric and
intestinal catarrhs.

Many patients cannot afford travelling to a distant health resort. For the treatment
of such patients, physicians will, therefore, greatly welcome natural mineral waters, which
not suffering alterations of their constituents and properties by a long transport, are
therefore most suitable for cures far from the spring. Such a rational mineral water is
the Kronenquelle, offering the advantage of being applied at any place and any lime of
the year at home.

As to the great stability of this mineral-water Prof. Poleck says in his complete
analysis publisiied in autumn 1882: "The mineral-water of the Kronenquelle stands
without any impairment of its effect a long preservation in glass-bottles, in which it is
also exported. Water kept in my cellar for almost one and a half years, has remained
entirely colourless and free from odour, and preserved the pure taste particular to the

Section I: Salzbrunn Kronenquelle and Marthaquelle — Salzungen 159

Kronenquelle. Of its ingredients only the small amount of bicarbonate of iron had
changed by oxidation into hydraled oxyde of iron; for the rest, it had remained
unaltered".

According to the analysis of Prof. Poleck the water of the Kronenquelle contains
per 1 liter 2-3305 gr. solids-viz.,

Chloride of Sodium 0.05899 gr. Bicarbonate of Strontium 0.002SO gr.

Sulphate of Sodium 0.18010 „ Bicarbonate of Magnesium 0-00181 ,

Sulphate of Potassium 0.04086 , Bicarbonate of Iron 0.00918 ,

Bicarbonate of- Sodium 0.87284 „ Phosphate of Aluminium 0.00036 ,

Bicarbonate of Lithium 0.01140 , Alumina O.O0O47 ,

Bicarbonate of Calcium 0.71264 „ Sihcic acid 0.03460 „

Bicarbonate of Magnesium 0.40477 „

In imponderable amounts: bromine, iodine, boric acid, barium, and nickel. The
amount of free carbonic acid is 1.5663 gr.

Form and appearance oft he bottles: Claret wine bottles with blue labels and white
metal capsules; corks branded ^Kronenquelle Salzbrunn".

Sole consignees for the United Kingdom : Schacht, Warner & Co. 55 Fore
Street, London E. C. (Near Moorgate Street Stations.)

Telegrams: "Schacht, London". Telephone: 48 London Wall.

II. Marthaquelle

The Marthaquelle, somewhat weaker than Kronenquelle, has a delicious taste, and
is in high lepute as a table-water. It is especially suitable for mixing with wine and
fruit juices.

Geheimer Medizinalrath Prof. Dr. Erich Harnack, director of the Pharmacological
Institute of the university of Halle, says at the end of his elaborate expert analysis of
Marthaquelle: "Taking all in all, the new Martha Spring can without partiality
or exaggeration boast of exceptional advantages. As the purest undisturbed
product of Nature, it must be placed in tiie first rank of similar waters,
and will soon win for itself, without doubt, universal popularity , not as
a medicinal spring, but as a healthy, refreshing daily drink for the healthy
and invalid alik'e. It can also be most warmly recommended in our
colonies, where the greatest abstemiousness is enjoined as regards
alcoholic liquors".

Sole Agents: Ingram & Royle L^'^, Bangor wharf, 45 Belvedere Road, London S. E.,
and at Liverpool and BristoL

Brine-Bath and Inhalatorium Salzungen (Thuringia)

situated in the finest part of the Werra- Valley, at the line Eisenach— Meiningen, 917 feet
above sea level. Mountain-spring water-supply, canalization. Electric light. Mild alpine
chmate, protected against rough winds from the north and north-east.

Number of visitors: 4849 in 1911 (excluding travellers). Season: beginning of^May
to beginning of October. Abundance of brine very rich in iron, salt-content from 5 — 27 per
cent, (saturated).

Curative factors: Brine baths with any medically prescribed salt-content, as well
as addition of mother-lye rich in iodine or bromide; brine pine-neeJle baths, brine mud-
baths, carbonic i.cid baths; natural vaporisation of 27 per cent, brine at the thorn-walls
of the graduation houses particularly built for cure purposes. Large inhalatoria with
modern equipment for common and single inhalations, systems Wassmuth, Heyer,
Korting, Schnitzler etc. Pneumatic chambers and apparatus. Drinking-cure at Bernhards-
quelle containing, in addition to chlorides, principally magnesium bromide, potassium
sulphate and calcium carbonate.

Indications: Scrofula, rickets, anaemia, gout, rheumatism, heart-diseases,
inveterate exsudates, and most of the diseases of women. Furthermore, chronic catarrhs
of the respiratory apparatus as well as affections of the lung-ti.s-^ue it'-elf, such as
catarrhal pneumonia, infiltration of the lung, emphysema, and the incipient stages of
phthisis, affections of the naso-pharynx and the auditory organs.

Prices: Baths: 1 brine- bath including bathing -clothes 1,25 Mk.; inhalations:
from 25 Pfennig to 1 Mk.; Kurt axe: 10 Mks.; 2 Persons 15 Mks.; a family of 3 and
more persons 20 Mks.

Physicians: Dr. Fischer, Dr. Thaler, Dr. Wagner, Dr. Wegener, Ducal physician.

160

Section I: Salzimgoi — San Bono

Hotels and boarding-houses in great number and variety. Especially recommen-
dnble is the Kurhaus with its villas standing in the large shadowy Kurpark; recently
provided with balconies and verandas willi view upon the lake and surroundings. Private
apartments, rooms fi-om 6 Mks. upwards per week.

Amusements: Concerts, theatre, reading-room, dancing - parties, gondoling,
illuminations, children's entertainments, forest-parties, fishing, excursions into the Thuringian
forest and the Rhon-Mouutuins. Very pleasant social life. Forest close by.

Detailed information and prospectus sent free of charge on application to the

Badedirektion.

San Remo

Grand Hotel Bellevue and Kurhaus.

Winterstation for Recreation and Internal Diseases.

Situation and climate of the health resort: San Remo, the pearl of Liguria, is
situated between the green and black cape at a bay of the Mediterranean, open toward
the south. The new part of the town surrounded by exubeiant green, extends along the
strand, whilst the old part of the town rises aloft further inland on a hill. From both
the capes steep mountain-crests run towards the north uniting witii the Ligurian Alp.-.
These mountain-crests reaching their greatest altitude (4550 feet) in Monte Bignone,
surround the bay like a wall protecting it entirely against rough winds.

The climate of San Remo is mild, equible, dry, and stimulating on account of the
protection ngainst nortii-east and north-Avest winds, on account of the situation at the
ocean and tlie intensive insolation as well as of the great capacity of the soil of
absorbing moisture, and of the considerable slope toward the strand. The vegetation of
San Remo is almost to be called tropical. A dense olive-forest covers the hills for miles
towards the north. Tiiere are lemon- and orange-groves in the deep valleys of the
mountain-brooks; date-palms, agaves and cactus-plants. During the whole winter, roses
witli sweet perfume and carnations enrapture the eyes. This renders San Remo especially
suitable for a longer stay in the winter, particularly on account of the stimulating, never
relaxing air. The excellent effect of this climate is well known, and it has been
emphasized for gooJ reasons that a senile organism does actually grow juvenile in this
climate. As the neighbouring Bordighera, San Remo too may be called, as Mantegazza says
"the paradise of the aged".

-^—^"^-^frfl

■-'iVi

Grand Hotel Bellevue and Kurhaus San Remo is situated on a small hill upon a
ground with good hygienic qualities, at the eastern bay close to the Villa Zirio which has
become historical by Emperor Frederic 111. In summer 1912, the hotel was amplified by
larger buildings, and was made an establishment unique for the whole Riviera. The
purpose of this establishment is to make the very favourable climatic advantages

Section 1: Sa)i Remo — Schlangenbad 161

accessible also to such persons needing recreation and to such patients tliat do not want
to dispense with the comfort of a first-clnss liotel, but on the other hand wish to take
advantage of the facilities of a medically directed institute. Tiie Grand Hotel Bellevue
has, as a whole, preserved its original feature, as merely new furnishing of parlours and
of a number of guest-chambers has been provided for. Furthermore, double doors have
been supplied everywhere, in order to have every room as quiet as possible. Tlie number
of beds in Hotel Bellevue amounts to 125.

For cure purposes in general the Kurhaus was built, situated on a large garden-
terrace in a lofty location between the Hotel and Villa Zirio, with an open panorama.
The house was built according to the most modern hygienic principles of house-building.
In its four stories are only apartments an 1 boarding-rooms, apartments with parlours
and baths. The entire house is fire-proof (fire-proof construction). Number of beds 75.

All of the boarding rooms are facing the south and have loggias for out of door cure.
Noise is absolutely excluded by double doors, double roofs and walls. There are no
dining rooms in the Kuriiaus; meals may, however, be provided for in the Kurhaus and
taken in the rooms. Tliore is of course inbotli houses warm-water heating, electric light,
and lift. A roofed and easily heated colonnade leads from the Kurhaus to the hydro-
therapeutic instituie, and further on to the first floor of Hotel Bellevue. The establishments
are also connected with one another by a servants' passage in the basement, by which
the management of the house is entirely separate. Above the hotel is the medical
institute (hydrotheiapeutics) with the most modern equipment. There are all possible
appliances for an exact diagnosis of diseases, for example a modern richly supplied X-ray
laboratory, a radium-inhalatorium. all the provisions for medicinal baths, massage,
gymnastics and electric treatment, four-cell baths. The rooms for medical treatment are
in direct communication with the boarding-rooms for the patients. Dietetic cures and,
above all, special dietetic cooking are provided for with particular care.

Indications: The station is recommended for all internal diseases, excluding
consumption and mental disorders. Particular indication is given for diseases requiring
an exact clinical and dietetic treatment; for patients needing rest, for nervous and cardiac
affections, disorders of metabolism, for gastro- intestinal diseases.

The leading physicians are Dr. Broking and Dr. Allendorf, in the summer in
"Hotel and Kurhaus St. Blasien in Baden" (Black-Forest). — Swedish gymnastics: Caspar
Andre from Swede, in the summer "Hotel and Kurhaus St. Blasien". Best season from
end of November to middle of May. Stay during autumn and spring especially
recommended.

Entertainments: No other place of the Riviera offers such an abundance of
beautiful promenades and excursions along the strand and to the mountains as San Remo
does. International sporting-club: tennis, croquet, hockey, golf-links, quiet harbour for
yachts, fashionable social life, flower-corso, regatta. Carnival, concours hippiques &c.
Steamers as well as special trains to Monte-Carlo and Nizza. New fine classical Casino
with splendid theatre.

Schlangenbad.

The Nassovian natural mineral-water bath in the administrative district of Wies-
baden, situated at the southern declivity of the Tamius, in a beautiful valley, is of an
old repute as regards the curative effect of its thermal waters. It owes its character of
an excellent forest-station to its situation amidst the forest, to the pure and invigorating
air, and to the refreshing climate as wdl as to the broad and shadowy forest-promenades
iree from dust.

In the well-kept gardens are situated the seven Royal cure-establishments including
three bathing-estabhshments, dining rooms, parlours, and boarding-rooms, furthermore
numerous hotels and private houses at disposal for visitors, the springs and a colonnade.

The hygienic conditions of the place answer the most modern requirements (water-
supply, rinsing-canalization and removal of sweepings.)

Indications: Schlangenbad is of a particular repute as a sedative for the nerves,
and is indicated in chronic diseases of women, in skin-diseases, and disorders of
metabolism.

Curative-factors: The new thermal springs belong to the tepid natural thermal
waters with a temperature of 28—31" C (82,4'^'— 87,8'^ F). They are used for baths, in
their natural temperature or heated. The effect of the baths is, in a most excellent way,
supported by the drinking-cure. For the latter purpose the Schlangenquelle and the

102

Section I: Schlangenbad — Schinznach

Marienquello are used. Accnnliii^ to Freseiiius (1878) the thermal water contains per
liter 0,4 solids, among which are 0,270 sodium cliloridc; 23 free carbonic acid;
10,9 nitrogen; 3,19 cc. oxycren. There is also opportunity for milk- and Oertel-cures, for
applying hydrotherapeulic.-i, electrotherapy (baths, electric massage), electromngnetic therapy
and massage.

Boarding: In the Royal Cure-houses are apartments at any price, likewise in the
numerous private jieiisions and hotels.

Physicians: Dr. Hannappel, Dr. Miiller de la Fuente.

Administrative boards: Mayorship, Royal Bath- Administration, during the season:
Royal Cure- and Police-Administration.

Kurtaxe: 3 Mks. per week, up to the maximum fee of 12 Mks. Children from
5 — 1.5 yeais a third of this fee. Children below b years and servants free.

Special allowances: Physicians and their not independent rela'ives are free of
any charge and have the baths free too. Petitions of others in this respect are to be sent
to the Royal Batli-Administration (Konigliche Bade-Verualtung) three weeks before the
beginning of the cure, and not later than August 10 th. The certificate of a physician
and an official statement of the annual income, must be enclosed.

Divine services: Roman-Catholic and Piotestant church at the place. During the
season also English service.

Communications: Post-office, telegraph and telephone. Branch-line from Eitville
(station of the line Francfort-Cologne) to Schlangenbad.

Prospectus delivered free of charge by the "Konigliche Badevervvaltung" and the
"Verkehrsverein".

Export of mineral water in flasks by the "Konigliche Badevervvaltung".

Schinznach-les-Bains

formerly called Hapsburg-les-Bains, Switzerland. Railway Station.

Famous Hoi Sulphur Springs for gout and gouty disorders, rheumatism and skin
di.seases. Schinznach-les-Bains lies 1150 feet above sea level, in the lovely valley of the
Aare, at the foot of the Wiilpelsberg, on which stands the ca-tla of Hapsbuig. This valley
and the neichbourhood of Schinznach-les-Bains, with its hdls and mountains, wooded to

the tops, its many cables and ruins, picturesque villages and towns, may be truly
considered the finest part of the "lovely Aargau", wiiich reminds English people of
the beautiful scenery of Scotland.

The supply of the sulphur springs is amounting to half a million gallons a day.
The temperature is 95 degrees F. and heavily impregnated witli sulphuretted hydrogen.
The results of an analysis of one litre of water drawn .''rom tiie twelve piincipal sulphur

Section 1: Sch'mznach — Salsomaggiore — Sirmione ■ 163

springs of Europe {including Great Britain) siiowing the quantity of sulpliuretted hydrogen
that each contains, prove that the hoi sulpliur springs at Schinznach-les-Bains contain a
heavier charge of sulphuretted liydrogen than any of the other celebrated sulphur springs
(Gases in cubic centimetres per litre: Sulphuretted hydrogen 55, Carbon dioxide 111).
The sulphur baths and douches are given in all forms, and the methods of treatment
are the same as at all the great hydropathic establishments, but in certain details the
Schinznach system has characteristics wliich make it unique. For instance, the pulveris-
ation treatment has been more extensively employed tlian elsewhere, as a complexion
restorer. As a spray of atomised water it reaches llie patient, in the form of sulphur
milk, having been converted into water and pure melalHc sulphur m statu nascciidi, owing
to the oxidation of the sulphuretted hydrogen. It is in this way that the sulphur milk
has been administered so successfully, both as an inhalation for catarrh, and as a spray
for the rejuvenation of the skin. The massage treatment, which is carried out by fully
qualified men and women, is equally successful in cases of rheumatism and for the
removal of superfluous fat. Disorders in which the waters are also very beneficial are:
diseases of the bones and joints. — Hot Sulphur. Mud application.
For illustrated pamphlets apply to the management.

C'^lomviorfrtinvA /T+oUA situated in a shallow valley at the foot of the
OalOUlllciyyiUIC ^^llCtiy^ Apennines, 20 miles from Parma, 5 miles from
Borgo SanDonnino, on the main line between Milan and Bologna; surrounded by vine-clad hills.

Sirmione on the Garda Lake, Italy.

The hot sulphurated spring originating in the centre of the lake, near the eastern
bank of the beautiful and world-renowned peninsula of Sirmione, is owned by the Italian
government. It yields about 500 liter per minute. Some years ago this spring was
curbed and conducted on land in order to apply it in the newly built sanatorium open
since 1897. The therapeutic results were so remarkable that the number of visitors has
rapidly increased, and the bathing estabhshments as well as the adjoined hotel had to
be amplified considerably.

The season is from March 1 st to December 15 th. The constant and extremely
mild climate, however, allows bathing cures all the year round.

Curative Factors: The spring contains, according to the analyse made in the
chemical laboratory of the Italian Home Office, per liter: sodium chloride 1,52 grams,
potassium chloride 0,13 grams, magnesium chloride 0,06, calcium chloride 0,16, calcium
sulphate 0,28, sulphate of magnesia 0,0^2, calcium carbonate 0,23, magnesia 0,01, lithium
chloride, liihium, sodium bromide (0,004), iodide of sodium,- silicic acid etc. in small
amounts, altogether 2,48 gr of solid constituents; in addition free and half-free carbonic-
acid 77,7 cc;' sulphuretted hydrogen 11,0 cc; nitrogen 103,2 cc. The spring has also
a strong content of radium. Thus the composition of the spring is uncommonly
manifold, allowing the most various therapeutic applications. The temperature is con-
stantly 65 0 Q (1490 F.), at the point of origine. The water is used for baths as well
as for drinking cures and inhalations. The new watei'-system furnishes a greater supply
of water.

Indications: Rheumatic and gouty affections, skin diseases, disorders of
metabolism involving the digestive organs and the urinary apparatus, nervous diseases,
diseases of women, sequelae of traumatism and osteal affections, some forms of chronic
pharyngeal and bronchial catarrh.

Contra-indications: All forms of advanced tuberculosis.

Physicians: German and Italian physicians.

Lodging: The Kurhaus in connection with the bathing establishment (Prospectus)
offers greatest comfort at moderate rates (pension from 9 lire!). Baths 2 lire.

Hotel Sirmione (Prospectus by A. Gennari, proprietor). Pension from 8 lire
upwards. For visitors special cooking at request.

The great advantage of Sirmione is not only its wonderful situation in the
neighbourhood of Roman ruins and the Skaliger castle, but also abundant oportunity for
excunsions to all places of the lake and to the battle-fields of San Marino, Solferino and

104

Section 1: Sirmione — Bad Soden (Taunus)

Cuslozza with their monuments, furthermore opportunity for any kind of water sport,
bathing in the lake, and good roads for cyding. The hygienic conditions are very favourable.
Means of Communication: Twice a day steamers lo Desenzano (Milano —Venice
Railway) and Riva (railway to Mori on the Rrennerbahn). Gars ready at the station of
Desenzano (9 km). Large automobile-garage. Opportunity for motor-boating on the lake.
Detailed information by tlie

Administration (Direzzione dello Stabilimcnlo balneare) in Sirmione.

Bad Soden in the Taunus.

Head-station of the brancli-line Huehst — Soden, is to be leached by railway within
half an hour from Franctort on the Maine. Bad Soden is situated 1-90 feet above the level
of the North Sea, at the southern slope of the Taunus, in a valley protected against rough
winds by riciily woodclad hills in the north, east and west; amidst the most beautiful
sceneiy of the Taunus range.

The climate is mild and refreshing, very equable and not stimulating, and therefore
most suilable lor irritable and sensible patients needing a mild climatic influence. The
local winds coming from the neighbouring mountains bring about a sufficient cooling off
during the niglit; the transition, however, is gradual and not abrupt as in alpine regions
and in deep valleys of rivers. Even in the cool months and in the winter, the climate
of Soden is distinguished by the absence of rough winds, and a relatively mild average
temperature. The relative moisture is in the mean 7 per cent, with but slight
variations.

These observation-: show that Soden during the summer months is not inferior
to the health-resorts with a subalpiue character, as regards climatic conditions. It is,
moreover, evident that Soden is not only a health-resort for the summer-months
warranting the most excellent results, but that it is a prominent transitional station in
spring and autumn tor those going to or coming from the winter-stations of the Alps and
the Riviera. A slay at Soden during the winter will in many cases even have the same
effect as at those winter-stations them-elves. The great value of tiie climatic conditions of
Soden during the winter months has been proved by an experience of twenty years
regarding winter-cures, in one of the sanatoria of this place.

Of the 25 springs existing, those applied most of all contain the following
constituents in 1000 parts.

Milch-
brunn.

Nr. 1

Warm-
brunnen

Nr. 3

Solbr.
Nr. 4

WiJh.-
brunn.

Nr. 6 a

Nr. 6 b ! Nr. 7

Wiesen-
brunn.

Nr. 18

Champ.- Sol-
brunn. sprudel

Nr. 19 1 Nr. 24

Sodium chloride

Potassium chloride

2,4255
0,1366
0,0126
0,4593
0,2807
3,0079

3,34755
0,083624
0,020666
0,616061
0,361355
0,0110828

14,2328
6,6560

1,3131
0,1421
0,0152

13,5549
0,3295

0,1920
0,1677

0,0394

10,0732
0,8386

0,9367
0,1563

0,0282

14,4008
0,5300

1,3503
0,1871
0,0289

11,2311
0,2659

1,0899
0,1852
0,0282

6,5273
0,0831

0,6509
0,4126
0,0200

14,5610
0,5707

Calcium carbonate

Magnesium carbonate

Carbonate of ferrous oxide

1,2956
0,0756
0,0664

Total of solid constituents

Free carbonic acid in cc. .

Temperature p<

Radioactivity

3,3990

951,4
24,00
75,2"

4,537294

1022,82
23,10
73,50

16,9259

845,1
21,10

70°

14,4476

1200,0
18,70
64,60

11,6454

1550,0
16,20
60,90

16,7370

1069,8
200
688
0.79

12,9681

1312,5
150
590

7,7447

1389,3
150
590

16,8739

1525,6
30,50
86.20
2,99

According to this table, the springs are characterized as muriatic waters more or
less rich in carbonic acid, of various temperature, and with a .slight content of iron. They
are applied for drinking and bathing, for douches, packings, gargling and inhalation.
Owing to their individual qualities and the great divergence of their composition, these
.springs allow a far going individual application. Their effect is as follows:

1. Dilution and modification of secretion of mucous membranes, especially of the
digestive and respiratory tract, increase of diuresis.

"2. Stimulalion and regulation of the function of the skin, of the circulatory organs
and of the nervous system, and as a result of this, by way of reflexes, an influence upon
the entire metabolism and upon the reabsorption of pathological exsudales and deposits.

While the tepid and weak springs are merely influencing the gastric mucosa, the
cool and more powerful water.? have a slighily purgative effect; they discharge the
intestines and the portal system, and are, theietore, to be classified among the springs of
Kissingen and Homburg, as regards their therapeutic value. As a matter of experience

Section I: Bad Soden (Tounus) 1G5

their application offers the advantage of precluding any stronger irritation of the vascular
and nervous system. The long-known therapeutic influence of these springs on the air
passages is due, on the one hand (in the weak springs), to the favourable influence of
the reabsorbed sodium chloride upon the mucous membranes, and on the other hand (in
the stronger waters) at tlie same time indirectly, to the elimination of disorders of the
portal vein and pulmonary circulation.

Indications: 1. General affections: scrofula of the erethic type, rickets,
convalescence after severe diseases, complications of influenza, gout and
rheumatism.

2. Diseases of the respiratory organs: chronic nasal, pharyngeal and
laryngeal catarriis, bronchial catanh, bronchial asthma and emphysema with
congestive catarrhs of the abdomen, delayed reabsorption of pneumonic and pleuritic
e.xsudates.

3. Cardiac affections: Compensated cardiac lesions, dilatations of the
heart after over-exertion, diseases of the myocardium, neurosis of the heart, and
arteriosclerosis.

4. Diseases of the digestive organs: Gastric catarrh, chronic intestinal catarrh
(diarrhoea), habitual constipation.

5. Diseases of women: Anomalies ot menstruation, chronic metritis, inveterate
exsudates of the peri- and parametrium.

6. Chronic affections ot the bones and joints.

7. Chronic renal affections.

8. Chronic diseases of the nervous system: tabes, neuritis, and neuralgia.
Cure-Establishments: City bathing-house with brine-baths and natural carbonic

acid baths, sprudel-baths, electric four-cell- and light-baths, modern equipment for
cold and tempered douches, central heating. Spacious drinking'hall with cabinets for
gargling. Laigest and most, richly furnished InhaJalorium in Germany, offering in the
perfectest manner the most known methods for common and individual inhalations, with
every degree of moisture. Large pneumatic chambers, apparatuses for rarefied and
condensed air, for medicinal evaporation according to the various best systems.
Complete medico-mechanic institute with original appliances according to Zander and
Herz, in the upper floor of the bathing-establishment. Rontgen-laboratory; for these latter
institutes the special physir-ian Dr. Frentzel-Beyme. Resting halls. Trained nurses for
hydrotherapy, mas-age and attendance of patients. Milk-cure (cow's milk, whey, curdled
milk, kephir, yoghurt, goat's milk).

Hygienic conditions: Owing to the country-house character of the health-resort,
the copious sprinkling of the broad and clean streets, and the total absence ot industrial
establishments, any deterioration of the air is excluded, and those needing recreation are
sure to find here beneficial rest. Excellent spring-water supply. New drainage, separating
system wilh filtering appliances, electric light.

Fresh air can be enjoyed to the greatest extent not only in the hotels and boarding
houses supplied abundantly wilh balconies and surrounded by many roseries, but also
on shadowy piomenades and avenues, in the ma'jnificent park and in the adjoining forest
of Soden ("Sodener Wald") crossed by gravelled paths.

Entertainements : City Kurhaus with electric light and central heating, renovated
according to modern requirements, music-terrace and large roofed hall. Spacious
conversation-hall, richly supplied reading-rooms, music-, playing- and billiard-rooms.
Performances of the music-band three times a day, symphony concerts and performances
of leading arti.sts, reunions. Garden-parties with Italian night, fire-works, and attractive
illumination of the Kuipark, lawn-tennis and croquet-grounds. Forest-parlies, opportunity
for promenades and excursions with carriages and autos to the picturesque Taunus
Mountains.

Boarding: Boarding-houses: Stadtisches Kurhaus, Hotel Colosseus, Grand Hotel,
Europaischer Hof, Russischer Hof, Hotel Uhlrich, Hotel Adler, Park-Hotel, Quellenhof,
Restaurant Weigand, Jewish restaurants Stern and Neuhof. If desired, pension at all
these places.

Single rooms and complete flats for lamilies furnished or unfurnished, for a
permanent or transitory sojourn, in the numerous lodging houses and villas. Prices of
rooms from 7 Mks. per week, full board from 28 Mks. per week upwards.

Soden is especially suitable as a permanent residence for families.

166 Section I: Soden (Taunus) — Bad Bonder — Stachelberg

Official season: Middle of April to middle of October.

Export of all potable waters by the firm of Ph. H. Fay & Co., administration of
the springs of Bad Soden in Taunus. Boxes with samples are most willingly sent to
physicians.

Pliysicians (arranjjed according' to the time of their settling): Geh. San.-Rat
Dr. Thilenius, Dr. Hughes Dr. Gunzel, Dr. Rothschild, Dr. Js-er'in, Dr. Prorok,
Dr Haupt, Dr. Wiechert, Dr. Thilenius jun.

Prospectus are sent free on appliiation to the Aerztecerein. Kurverwallung.

Bad Sonder

above Teufen, Canton of Appenzell, Switzerland.

3-220 feet above sea level.

Christian Kurhaus. In a very beautiful, sunny and much protected situation.
Pure and mild, but still alpine climate, air free from dust. Magnificent view of the
Santis-crest and Lake of Constance. Pine forest with promenades and retreats. Much
recommended by physicians to fatigued and nervous people, to chlorotic patients and
convalescents &c.

Pension including room from frs. 5.50 to 7. — . Also very favourable for a stay
during the autumn or winter.

Detailed prospectus by A. Biippanner, Proprietor.

Stachelberg, Canton of Glarus, Switzerland.

Climatic station w-ith alkaline sulphurated spring, 2320 feet above sea level, five
minutes from Linthal, situated in a valley unexcelled in its grand Alpine scenery. Stachel-
berg is particularly recommended as a starting point ior greater or smaller trips to the
mountains, and as a transitory station for those going to or coming from higher regions
of the mountains or climatic stations.

The health resort consists of four buildings established at different times. They are
in connection with one another by covered corridors and beatable glass hall. 150 rooms
and private parlours, elegant dining room for 300 persons, ladies' drawing room, dancing-
room, bar, billiard-rooms, warm-water heating, rooms partly with electric heating. Forest-
park, wonderful maple groups, extensive promenades. Station of the funicular railway
to Braunwald.

Curative means: Use of sulphurated waters for 1. drinking-cure?; 2. bathing-
cures; 3. inhalation-cures. Apparatus system Matthieu, i e. direct inhalations, and system
Wassmuth (Inhalatorium). New appliances for direct inhalation, system Goebel. Furthermore,
all kinds of hydropathy, electric incandescent light bath, sun-and air-baths.

The sulphur water rising in a grotto 1/2 hour above Stachelberg, has a temperature
of 8° C = 46"4 F, and a specific gravity of 1.0009. The small specific gravity and the
absence of calcium sulphate, render the Stachelberg water the most palatable and most
digestible sulphur water. It is very suitable for exportation, and can be kept for many
years in well corked bottles.

Analysis. The quantitative combination preferred by Dr, Simmler shows in
10 liters 5,794 solid constituents as follows:

Sulphbydrate of sodium 0.478 I Bicarbonate of lithium . . . . . 0.032

Sulpldiydrate of lime 0.(529 ! Bicarbonate of lime 0.418

Hyposulphite of sodium 0.042 j Bicarbonate of Matiiiesia .... 1.525

Sulphate of sodium 1.438 | Aluminium phosphate ... 0.040

Sulphate of potassium 0.109 | Aluminium silicate 0.123

Chloride of sodium 0.056 i Organic substances 0.838

Gaseous matters: Free carbonic acid 1.139 (578 cc). Free sulphuretted hydrogen in varying
quantities. Nitrogen 16 cc.

Indications: 1. Chronic catarrhs of the respiratory organs (Inhalation-treatment).
2. Chronic catarrhal affections of the digestive canal (liver and bile ducts). 3. Chronic
catarrhal affections of the bladder, uterus, and vagina 4. Various chronical skin diseases
and old ulcers. 5. All forms of scrofula and afl'ections due to it. 6. Rheumatism and
gout. 7. Nervous diseases, residues of apoplexy. S. Lead and mercury poisoning.

Section I: Stachelbei-g - TepUtz-Schonau — Taormina Tulz-KrankcnheiJ 1G7

Finally, Staclielberg- is recommended to convalescents of any kind, on account of its protected
situation in a moderate altitude, its air free from dust, and the great conitort offered here.

Moderate prices of pension, still reduced in May and June and from September to
tlie end of the .sea-on.

Divine services: Protestant and Roman-Catholic in the viUage of Linllial; English
(in AuLiusl) in the hotel.

Resident physician: Dr. H. Ludwig. Direction: Glarner.

Teplitz-Schonau,

Bohemia, in a Valley of the Erz-Mountains, sheltered from
north winds. Hot alkali-saline Avaters: mud baths.

Taormina,

'^A.

hi

4U/^

*^ j>» ""Ti ^ ,;; - -vti %M, ^^^ 13 0^

fcs fsS-'f :^

Grand Hotel International.

First class hotel, in every respect with all modern comforts. Charminiily situated
with superb view on Etna and Cireek Theater. Apparlments Avith private bath. W. C.
Terrace. Garden. Garage. Reasonable terms. Prospectus on request.

E. Jnfanger, ivanager.

Bad Tolz-Krankenheil (in Upper Bavaria).

Situation: 58 km railway-distance from Munich. Ruining-time V,.,— -! liuurs.
Situated at the foot of the Bavarian Alps in the wonderful "Isarwinkel" (on the river Isar).
In the direct neighbourhood ('/a — 1 day's tour) are: Kochelsee, Walchensoe, Tegernsee,
Schliersee, Starnbergersee, Achensee. Mountain-tours. All kinds of communication. Fixed
tariff for cab-drivers.

arienquello

Lauge III

Salz

0.01757

0.6020

7.3045

0.01516

0.5202

0.30:!4

^2.26777

78.2050

913.1998

0.10969

3.1080

32.9626

0.04819

1.718

—

0.04909

—

14.8302

168 S'Ciion 1: Bad Tolz-Krankenheil -- Thusis

Climate: Subalpine, owing to the location of Tuiz, 2350 feet above sea leve'.
Temperature June to September maximum 19,6^ C. ^= 66,5" K., minimum 13,2'^ C.
55,5*^ F., mean temperature 16,2 ^ C. = 70" F. Intense insolation rendered mild
by permanent motion of air. Moisture 68%. Yearly lainfall 1301 mm per square
decimetre. Numerous forests, there are no factories, and so the air i« pure and rich in
ozone. A!! in all the climate is stimulating. Anaemic and nervous patients
and convalescents recuperate very rapidly.

Curative factors: Krankenheiler iodine-springs for drinking and bathing
cures. Iodine-spring salt, mineralt-salt lye, mineral- water-soaps, soap spirit, pastilles. Lye-
inhalatorium. soap-massage by trained nurses. Mud, pine-needle, brine, carbonic acid
electric baths.

Radio activity has been proved in all iodine springs ofKrankenheii.
In 1000 gr. are contained in Jodlrinkquelle
Sodium iodide 0.00124

Sodium bromide —

Sodium chloride 0.28101

Magnesium chlo;ide —

Sodium carbonate 0.40^30

Magnesium carbonate 0.03030

Potassium sulphate 0.01846 — —

Sodium sulphate 0.00437 - — —

Free carbonic acid 0.02033 O.0O268 — —

Sulphuretted hydrogen 0.00142 — - —

Indications: It has been established by many years of experience that the use of
a cure at Krankenheil stimulates metabolism, improves blood-production, and
stimulates reabsorption of exsudates and inflammatory swellings. Consequently, the cure
at Tolz is indicated in affections of the female genital organs (catarrhs of the
vagina and the uterus, chronic endometritis and inflammation of tlie ovaries, myoma of
the uterus, exsudates); scrofula and its localization on the skin, the gland-, bones.
joint«, and sensory organs; syphih's, especially tertiary forms; chronic skin -diseases
(eczema, psoriasis, acne, furunculosis, chronic ulcers of the skin); chronic catarrhs of the
nose, the phaiynx and larynx, of the bladder; chronic glandular swellings (goitre,
lymphoma, swellings of the prostate, inflammation of the testicles and epididymis);
diseases of the eye and nervous affections; arteriosclerosis; gout.

Physicians: Dr. Forlner, Medicinalrat; Or. Hofler, Hofrat; Dr. Jungmayer,
Stabsarzt; Dr. 3Iorgenstern; Dr. Resch; Dr. Schwarzmayer; Dr. Wittenberg; Dr. Selz,
Opthalniolo-isi

Kurtaxe: 1 Person 10 Mks., 2 persons 15 Mks., more persons 18 Mks. — Physicians
are exempt from such taxes.

Board: Besides the boarding-liouses of the administration Kurhotel and
Kurhaus and Pension Kur- and Badehaus, in direct communication with the iodine-
baths and answering modest as well as luxurious demands, there are numerous good
private hotels, pensions and villas. Price of pension 5 — 10 Mks. per day.

Winter-cure: The bathing-establishment has central-heating and is open
in summer and winter. Resident physicians also present in the winter.

Winter-sport. Bobsleigh-road 15 750 feet long. Mountain-shelter on the
Blomberg 4375 feet high. Ski-ing ground.

General remarks. At Bad Tolz all the benefits of ruralizing in the Bavarian
Alps combine with the hygienic and other advantages of a health resort, such as
drainage, water-pipe system, electric light, telephone, many wonderful
promenades, well-kept roads, benches, charming views of the mountains. Kurgarten,
colonnade, music, theatre in the seasons, reunions, tennis-links,
swimming-batlis and bathing-cabins, interesting national dress festivals &c. &c.

Richly illustrated prospectus on application to the

Baths' Directorate Bad Tolz, Oberbayern.

Thusis

with the Soliser Jodide-Ferruginous Acidulated Water.

Topography: Thusis is situated in the centre of Grisons, 2620 feet above sea level,
station of the Albula-Line. Entrance to the world renowned Viamala-Gorge.

Section I: Thusis — Tribern — Vichy — Villenpuve

\m

Subalpine stimulating climate, very little rain, extended pine-forests. A great
variety of wonderful promenades and excursions with all degrees of incline.

Curative Factors: Drinking- and air-cure-, Oertel-curcs, hydro- and electro-therapy.

Donatusquelle. Jodide- and bromide-ferruginous acidulous water with a high
percentage of sodium sulpliate and ferrous oxide, strongest iodide-spring of Switzerland.

Indications: Goitre, scrofula, osteal tuberculosis, cardiac affections, anemia,
residue of pleuritic and peritoneal exsudates, diseases of the genital organs, neurasthenia,
rheumaticand metabolic diseases, gout, kidneys, calculus of the urinary and gall-bladder,
obesity and diabetes.

Very well furnished large and snull hotels, pensions with nearly 400 beds.

Physicians and apotliecaries. Protestant and Roman-Catholic church.

For guides, prospectus, and information apply to the

Officielles Verkehrsbureau.

Triberg.

2450 to 3500 feet above sea level.

Most splendid station on tlie Baden
line of the Black Forest. First-class climatic
station for summer and wintei-. Number
of visitors in 1911: 17 500. not including
travellers. Black Forest industrial
Exhibition with historical department.
Splendid location, amidst grand pine-
forests, well-protected against winds.
Wonderful Alpine scenery.
Largest Cataracts of Germany. Many convenient promenades. Magnificent
excursions. Look-out towers worth while visiting. Swimming-bath, air- and sun-bath.
Physico-dietetic therapy. Tennis.

Prospectus and list of prices free of charge by the

Stddtisches Verkehrsbureau.

Vichy

France, department of AUier; the type of alkaline waters; called "the Queen of
J theraial watering-places"; very much frequented.

Villeneuve near Montreux (Switzerland).

Hotel Byron. 1st class family Hotel.

150 Beds.

Apartments with private Bath, Cabinet de Toilette. W. G.

The Hotel' Byron is situated on the shores of Lake Leman, in close proximity
to Montreux. It is surrounded by a large park and fitted with all modern comforts.
No other station more adequately supplies all the requirements of nervous and convalescent
persons and, generally speaking, of those who need thorough rest.

A Hydropathic establishment wnth carbonic acid baths has lately been added
thereto, enhancing the attractions of a stay at the Hotel Byron.

Being quite close to the Saline baths of Bex, the mother waters for carbonic acid
baths are easily obtained, and these new baths can be favourably compared with the well-
known ones of Bad-Nauheim.

With this new Installation the Hotel Byron can be highly recommended as an
excellent resort for persons suffering from anaemia, chloralism, neurosis, rheumatism,
digestive, constitutional and other ailments including that of heart trouble, if the
latter be not in an advanced stage.

The inclusive terms of "pension" vary from 8 Frcs. upwards, according to the
position of the rooms. Baths and medical treatment not included. The Hotel is open
the w^hole year round.

Regular Tram Service with Montreux.

J. Fugner, Manager.

170

Section J: Vidiiera-Tarasp

Vulpera-Tarasp, Engadine, Switzerland.

4455 to 4550 feet above sea level.

The most distinctive fenture to which Vulpera owes its proiuiiieiit signi-
icance and its great power of nttraclion, is its most exceptional and
plendid situation. Being enframed hy the gnuid dark and odoriferous pine-forests
on an exquisite and picturesque meadow-terrace of the Lower-Eng.idine, it looks
down upon the narrow valle}', where on a confined place at the river Inn the drinking-
hall with the renowned springs of Tarasp is to be seen. On the plateau inundated within
sunshine and light, but at the same time most ideally protected, tlie splendid hotels and
pensions are scittered about. They are to the greatest extent new and constructed according
to modern principles. Vulpera may also boast of answering the most modern
demands of a first-class health resort. Its abundantly rich curative means — climate,
springs, baths, liydrotherapy, diet etc. — are applied in the most correct m inner.

Far fiom the bustle and dust of the road-, and lying in a relined and idyllic
seclusion in the midst of an extensive net of various iileal promenades and foot
paths, especially fitted and used for Oerlel-cures, Vulpera offers an enviable stay with
a full effect of all advantages of the wonderful alpine climate — the low barometric
pressure (average 653 mm), great coolness (for the season 13° C = 55,4^ F), rarefied
atmosphere, exceptional dryness and purity of the air, plenty of sun, excess of ozone,
wonderful vegetation, and so on. At the same time, Vulpera as a matter of fact does
agree very well and without exception with very nervous people — for these the spring
and autumn months are most recommendable (May, June, September), on account of the
more quiet time — with patients suffering from light heart-diseases, and with aged people
(also liglit degree of arteriosclerosis) ; all such people derive the greatest benefit from
a sojourn here.

Beside the carriage-road several altogether convenient foot-paths lead from the
individual hotels In a few minutes to the Trinkhalle, where the well-known Tarasp
alkaline a cidulous- waters — Lucius and Emerita — and the alkaline-eartliy
iron-spring Bonifacius ai-e housed and drunk; a few steps further on are located
the alkaline carbonic acid ferruginous baths.

Curative means: Alkaline-saline springs, alkaline-earth y-iron springs, alkaline
and carbonic-acid baths, therapy, dietetic cooking, alpine climate in a beautiful scenery etc.

The following table allows one to compare the Luciusspring at Tarasp with the
most celebrated European alkaline-saline-waters (Carlsbad, Marienbad etc.) on the one
hand, and with an important type of the Sodium Chloride springs (Kissingen) and the
simple alkahne springs (Vichy) on the other hand.

In 1000 parts are
contained

;2 S

y:

"S 2

"Si

sM

2 Si

fnVr.^

"H.'"

c s

o —

3-3

o

CO O

cc

15,1

2,24

5,4

2,4

10,1

4,7

8,5

—

7,9

0,3

a ..* 2

•eg-

rt - ==
« o'C.

•ss

!- K O

S == '

Tarasp (Luciusquelie) .
Carlsbad (Sprudel) . .
Marienbad (Ferdinands-

brunnen)

Kissingen (Rakoczy)
Vichy (C^Iestins) . . .

1250

370

630

200
'.^30

4,31

2,0

2,0
4,9

3.88

1,0

1,7
5,8
0,5

0,02

0,005

0,07
0,03

1608

104

1128

ia.6

532

50C =
72,5

= 410^
C =

10,3'
10,7
12"

Cr=
C =

C =

1

1610 F

500 F

50,80 F
53.60 F

Indications:

1. Diseases of the digestive organs:

a) Chronic catarrhs of tlie stomach and intestines, atony and nervous diseases
of these organs (constipation, chronic diarrhoea, nervous dyspepsia), chronic
ulcers of the stomach, Iiaemorrhoids.

b) Enlargement of the liver, first stages of cirrhosis of the liver, catLirrhal and
chronic inflammatory conditions of the biliary ducts, gall-stones.

2. Nervous affections:

a) Neurasthenia, particularly the exhaustive and depressive types.

b) Grave's disease (Exophthalmic goitre).

c) Mogrim and neuralgia.

Section 1: Vulpera-Taraap Weilbach 171

3. Disorders of metabolism and nutrition:

a) Obesity and the allied and resulting disturbances.

b) Diabetes.

c) Uric-acid diathesis, gout, gravel, stones in the kidneys, chronic rheumatism.

d) GIdorosis and anaemia; (hr nic tumnrs of the spleen after typhoid fever
and miliaria; scrofula, general weakness in childhood, certain forms of
albuminuria.

4. Chronic infections and intoxications:

a) After-effects of tropical diseases.

b) Consequences of the abuse of nicotine and alcohol.

5. Diseases of the circulatory organs.

a) Insufficiency and hypertrophy of the heart in less pronounced cases.

b) Compensated valvular affections of the heart.

c) Fatly degeneration of the heart.

6. Affections of the respiratory apparatus.

Chronic catarrhs of the throat, chronic bronchial catarrh, emphysema of the lungs,
bronchial asthma.

7. Diseases of the urinary apparatus:
Catarrhs of the kidneys, and the bladder.

8. Diseases of the female sexual organs:

Chronic endometritis and metritis, chronic pelvic exsudates.

Contra-indications: Severe heart-diseases, advanced cachectic conditions.

In Vulpera itself is a completely equipped hydrotherapeuti c establishment
(in Hotel Waldhaus) which possesses a complete hydropathic installation, and where, besides,
brine, pine needle, carbonic acid-baths, electric light-baths etc. are applied. There are
in the health resort a sufficient number of male and female masseurs, experienced in
every sort of massage-work and exercises.

Considering the fact that a proper dit is one of the most important factors of a
cure, there is not only at Vulpera the customary Table d'hote (by the way as simple as
possible and carefully modified) and the opportunity for dining separately according to
demands, but particular dietetic tables for obesity, for gastro- intestinal diseases, gout and
diabetes etc. under medical supervision have been provided for at fixed rates.

But not only the Tara?p cures are most conveniently and correctly carried out at
Vulpera. Moreover, a great deal of healthy persons, and families -with children, too, stay
hero, considering the place as a summer-residence and a climatic station. It is
highly recommendable, indeed, as an intermediate hailing station on the way to or from
the considerably higher located places in the Upper Engadine, as well ;is a resort for
supplementary or after-cuie after treatment at Carlsbad, Marienbad, Franzensbad,
Levico etc.

Boarding : Hotel Waldhaus with Dependences (400 beds), Hotel Schweizerhof with
Dependences (250 beds), Pension Villa Engiadina (30 beds). Pension Villa Silvana with
Dependence (40 beds). Pension Villa Maria (30 beds).

Duration of season: 15 t^ of May to middle of September.

Physicians residing at Vulpera: Dr. Leva, in the winter at Berlin; Dr. Miiller,
in the winter at Florence.

Kurtaxe : 17 Frcs. per person and for the whole season (only for drinking-cure).
Reduced fees for families of more than 2 persons.

Means of Communications: Vulpera-Tarasp can be reached from the stations of
the Pihetian Railway Bevers (Engadine) within 5 hours on the valley-road, or from Davos-
Dorf by G hours' journey over the romantic Fluela-Pass; from the station of Landeck of
the Arlberg-Railway per automobile up to Pfunds on the Swiss border, and from there
within 3 hours' drive. — From the above mentioned head-stations there are several post-
communications daily directly to Vulpeia.

The new electric narrow-gauge railway from Bevers to the health resort of Vulpera-
Tarasp will be opened in the summer 1913.

For further details on Vulpera see special prospectuses issued by the above mentioned
hotels and pensions, as well as by the Verkehrs- und Verwaltiingsbureau Vulpera.

\A/oilVl2lpVl Prussian province of Nassau; southern of the Taunus Mountains; Climate
YV CliUdiUll^ highly favourable. Sulphuious alkaline iodurated waters.

172 Section I: Weissenstein — Westerland-Sylt — Wiesbaden

Weissenstein near Solothurn, Switzerland.

Climatic Station.

4550 feet above sea level, willi the climate of alpine valleys. This climate has a
stimulating and tonic effect upon the organism, and is indicated particularly for
convalescents and for individuals mentally and bodily relnxed by a strenuous prolessionnl
life. Anaemia, chlorosis, uervou< affections of a light nature are influenced favourably,
and many surprising results have been obtained.

Resident physician: Dr. Manfred Bott.

Kurhaus Weissenstein — situated in a location free from dust — is an
establishment most comfortably furnished, with 70 rooms, parlours, and apartments with
baths for families, large dining room. Excellent cooking. Electric light, central-heating,
mail-delivery and telegraph in the house. Greatest alpine p.norama of Switzerland, of
the Vosges-Mountains and the Black-Forest, 60 km of forest-promenades on own property.
Own Alpine dairy-farm with large establishments.

Summer season from June to end of September.

Winter sport.

Illustrated prospectus by K. JIU, Proprietor.

Westerland-Sylt,

well-frequented seabathing station in the Korlh-Sea;
heavy surf.

Wiesbaden.

Wiesbaden, the pearl of all stations of the Taunus range, is the capital of the
Royal Prussian district of the same name. Since the establishment of the new railway-
station it is joined to the great lines of international traffic. Wiesbaden is situated in
50° 4' latitude and ^5° 54' longitude, 400 feet above sea level, at the southern
spurs of the abundantly forested Taunus-mountains, about an hour's walk from the Rhine.

Wiesbaden visited by more than iOO 000 persons in the average every year, is
flourishing more and more, not only as a health resort but also as a permanent residence.
New edifices for hotels and private houses with the most up-to date out-fit, public
buildings worth seeing, new streets etc. are constantly being built. The electric tram
crosses Wiesbaden in all directions, connecting the town by many lines with the
surrounding forests and the neighbouring places as well as with the near Rhine ; there
is also a communication with Mayence, and the new Kaiser-bridge between both towns
renders Ihe most lively traffic possible.

The situation of Wiesbaden is undoubtedly one of the finest in Germany.

The climate is mild and pleasant. During the summer the valleys opening
towards Wiesbaden, make the air refreshing and cool, while during the Winter the
mountain-crests of the Taunus protect the town against the cold northern winds.

The hygienic and sanitary conditions of the town are extremely favourable.

Cure-season and entertainments at Wiesbaden are going on all the year round.

Curative Factors: The 32 thermal waters of Wiesbaden, up to 65,7 '^ C, belong
to the class of sodium-chloride thermal waters, the principal spring being the "Koch-
brunnen". There are in addition 31 other springs of the same composition, yielding
about 1350 1. of water per minute, and applied for bathing, drinking, and inhalaliou-
cures. Almost 900 Thermal-baths, to a large extent with shower baths and douches,
hydrother apcutic institutes, pine-needle, Russian, Roman, and medicinal
baths of any kind. Medico-mechanic institute (System of Zander). Ortho-
pedic and gymnastic establishments. Pneumatic appliances. Electricity.
Renowned hospitals for eye diseases. Milk cure establishment, whey-
and goats' milk cures, massage. Special institutes for nervous diseases, for patients
with drug-habit, gastric diseases etc.

Mineral waters of any known spring. — Inhalalorium. — Fango - mud
treatment, vibration-massage, grape-cure.

Section I: Wiesbaden

173

Diseases against which the bathing cure is indicated: Gout and rheu-
matism, especially muscular ami arthritic rlieumatism, articular diseases of various kinds,
paralysis and neuralgia, particularly sciatica, as well as the residues of inflammatory
processes and enlargement of oigaiis, swellings of the joints after lesions, alterations of
the glands with and without suppuration, osteal diseases after traumatism, inflammations
and suppurations of the lontr bones, of the joints and vertebrae, some diseases of women,
hypertrophy of cellular tissues, especially in the lower extremities with and without
ulceration after phlebitis, cutaneous affections, wounds and ulcers, cardiac diseases,
affections of the nervous system, diseases of the kidneys and bladder.

Diseases against which the drinking cure is applied: Affections of the
respiratory organs: nose, pharynx, larynx and bronchi, diseases of the digestive organs,
chronic catarrhs of the stomach and intestines, and especially certain constitutional
diseases such as gout and obesity, swelling of the liver and spleen

The drinking cure is naturally mostly combined with the bathing cure.

Diseases against which the inhalation cure is applied: Pharyngeal, laryngeal,
nasal and bronchial catarrhs, acute coryzn, suppurations of the nose, hoarseness etc.

Indications for the grape cure: Constipation and haemorrhoids, gaslro- and
intestinal catarrhs, chlorosis, obesity, rennl and hepatic diseases etc.

Owing to its excellent curative results in all the concerned diseases, Wiesbaden
may be considered a bathing resoit recommended most of all, at any time;, by medical
capacities.

About 3U private bathing- houses. — Koniglich Bad ha us Wilhelms-
Heilanstalt, only for military persons. — City bathing-establishment "Zum
Schutzenhof". — City Hospital with baths for poor people. In the private
bathing establishments besides tiie baths, lodging and full board.

The bathing establishments are almost all fitted up for winter cures.
Tiie rooms are in communication with the bath rooms by roofed corridors.

Winter cure and winter residence: Numerous visitors stay at Wiesbaden during
the winter months, partly on account of the favourable climate, and partly in order to
attend the special entertainments arranged during this season by the Kur\erwaltung, the
Royal theatre, the Residence-theatre etc.

Physicians: Apart from the manifold curative factors the advantage of the large
health resort of Wiesbaden consists in the fact that any patient has the possibility of
consulting renowned specialists.

Municipal Administration of the Bath: Kurdirektor v. Ebmeyer.

Abstract of Orders of Kurtaxe: Every visitor staying in Wiesbaden more than
five days, including tlie day of arrii'al, will be required to pay a Kurtaxe; visitors,
however, who can prove that their slay is for exclusively other purposes than those of
cure recovery or amusement, are exempt. In receipt for the payment of the Kurlax,
three kinds of cards will be issued : 1. the "Kochbrunnen card", entitling the holder to
visit the Kochbrunnen and take the Drink Cure, .and also attend the concerts given there.
'■2. the "Kurhaus Card", entitling the holder to visit the Kurhaus and all the rooms of
the Kurhaus open to the public, and all the regular concerts in the Kurliaus and Kur-
garten. The ticket does not admit to the "Kiiustler-Konzerte" and other special enter-
tainments. 3. The "full card" admits to both Kurhaus and Kochbrunnen.

The holder of a Kurtaxe card may obtain supplementary cards for the members
of his household. (For the Kochbrunnen alone, however, such supplementary cards will
not be issued.)

Tariff.

For a stay, the first five day of
which are included, of

Kochhriinnen and

Kurhaus including

Cloakroom

Supple-

First card

raentary
card

Kurhaus including
Cloakroom

Supple-
mentary
card

First card

Koch-
brunnen

10 days .
3 weeks
6 weeks
3 months
6 months

12 months

M.
10
20
35
50
60
70

12
22
30

-to

50

M.
7
14
24
35
45
55

M.

4
8
14
20
25
30

14
20

30

174r Section I: Wiesbaden — Wildhad (Wurtemberg)

It is in tlie interest of the visitors to procure a card at once in onler that they
may be able, from the very heg-hining of their stay, to enjoy the advantages to wliich
its possession entitles them. If a visitor has not taken out a Kurtaxe card within the first
five days of his stny, the amount of the card will be at once collected. -

Besides, day cards will be issued entitling the holder to visit the Kurhaus and (he
regular concerts, as follows: day cards at Mks. 1.50 valid for the whole day, and Entrance
tickets at Mks. 1 valid for entering once only

Entertainments: The newly built Kurhaus is open all the year round. Con-
cert halls, play rooms, bars, conversation and reading rooms etc., the lalter
with about 400 news-papers. — Fine gardens and parks. — Excursions into the attractive
surroundings, Beautiful beech forests to be reached witliin a few minutes. Trij)s on the
Rhine. — Fetes of spring, summer-festivities, rose-fete etc. — Visits to the "National
Monument". — Condoling. Excellent tennis-links.

The "Kurkapelle" (music-band) consisting of 60 musicians, plays during the
whole summer season three times daily, in the winter twice a day.

There are also national celeltrations, promenade and artistic concerts, garden-fetes,
illuminations and firework displays, corso, lectures of iamous scientists, carnival-concerts,
masquerades etc.

Divine services: Protestant, Roman-Catholic, Old-Catholic, free church (German-
Catholic), English, Russian-Greek, and synagogue.

Lodging: Is to be had at any time at various prices according to situation and
comfort, furnished and unfurnished.

Number of visitors: 1896 = 106511, 1897 = 116080, 1898 = 118995, 1899
= 123 192, 1900 = 1.36011, 1901 = 131.521, 1902 = 132G95, 1903 = 124 12.5, 1904
= 146 044, 1905 = 156 515, 19(16 = 159.535, 1907 = 180848, 1908 = 186 131, 1909
= 193407, 1910 = 179 183, 1911 =- 177 135.

The enormous amount of visitors adds considerably to enlivening the traffic on the
streets and promenades and to giving the impressinn of a metrojiolitan and cosmopolitan
life. Apart from the regular visit of the Imperial Family, a great number of princely
personages, and numerous members of aristocracy as well as famous personages of art
and science are accustomed to sojourn for curing purposes at Wiesbaden.

Detailed prospectus sent on- application to the

" Stddtische Kurvtrivaltung" .

Sanatoria and Cure-Establishments at Wiesbaden, see Section II
("Sanatoria and Cure-Establishments").

Wildbad in the Kingdom of Wurtemberg.

Wildbad, royal bathing resoit in the Black-Forest, situated 1500 feet
above sea level, in the picturesque Enz-Valley surrounded by the most wonderful
pine forests. Wildbad has been appreciated as a luineral spring since the 14tli century,
and has been visited all the time from all parts of the world. It still owes its worlds'
fame to the unexcelled curative effects of the thermal Avaters originating directly from
the primitive rocks.

The health resort of Wildbad with about 3800 inhabitants, is the terminal station
of the Enztal-railway, 23 km. long, branching off at Pforzheim from the great international
route Vienna — Paris.

The season at Wildbad begins officially Mai 1st and lasts until the ZQ^^ of
September. A part of the thermal baths, however, is open for use all the year round.

During the last 20 vears the number of visitors of Wildbad has increased up to
the threefold (189^J: 5-6000, 1909: 16—17 000, 1911: 20600).

Large hotels of first class, good middle class lodging-houses, pensions, villas, and
private houses are in great number at the disposal of visitors. The map and the list of
hotels and boarding-houses, added to the prospectus, give information as to situation and
prices of the individual places.

Sanitary conditions and mortality of Wildbad have always been favourable. There
is a well-kept canalization in the town, and a mountain-water system supplies good
drinking water of unusual purify.

Wildbud (Wiirfemberg) Wlldimgcn — Woodhall Spa { England) 175

Tlie climate of Wildbad is also very favourable, owing to tlie characteristic
advantages of the Black-Forest, to the fiesh air, rich in ozone, to the cooling in the
morning and evening, on account of which tven in mid-summer oppressive heal of long
duration never occurs. The valley itself is protected against rough north- and east- winds,
due to its natural situation.

All the bathing and cure establishments as well as the large parks with the Enz-
promenade are owned by the Stale. The eslablishmenis are of Ihe first class, perfect
and new.

The thermal waters of Wildbad constitute its natural curative factors of old
repute. The-e curative waters spring from 36 drilled sources with a temperature of
33—37" C (91.4-98.f)" F) and run directly into the tubs.

Further curative factors: Electric, steam, and hot-air bath, swimming tanks,
medico-mechanic institute (System Dr. Zander), massage, and thermal drinking-water.

Indications: According to the experiences of centuries, the following diseases and
affections have been treated and cured at Wildbad, or at least mitigated: rheumatism and
gout, sequelae of traumatism, acute and chronic inflammations of the bones and joints
(scrofula and rickets), spinal-affections and paralysis of any kind, nervous affections,
especially nervous irritability (neurasthenia), neuralgia, metal poisoning, exhaustion, catarrhs
of the air passages, uiinary affections, diseases of women. There are also appliances
suitable for the treatment of cardiac affections, anomalies of constitution, and dyscrasia of
the blood (obesity, stoutness, disorders of digestion &c.). Wildbad is likewise recommended
quite especially as a summer residence and climatic station.

The large mountain-plateau can be easily reached by anybody in taking the wire-
tramway which leads from the centre of the town to the Sommersberg, 2550 feet above
sea level (1050 feet above the valley).

Plain promenades running for many hours' distance through the mountain-forest are
in close connection with the mountain station. A mountain-hotel furnished according to
the most modern comfort receives visitors for a permanent climatic cure.

Physicians: Royal Physician in chief Geheimer Hofrat Dr. Weizsacker, Dr. Grunow,
Sanitatsrat Dr. Haussmann, Dr. Hiller, Dr. Josenhaus, Dr. Layer, Dr. Lorenz.

Entertainments: Orchestra, theatre, concerts, and performances. Elegant I'eading-,
nmsic, and card-rooms, dancing parties, lawn-tennis and croquet. Opportunity for target-
practice, for hunting and fishing (water rich in trouts).

Divine services: Protestant, Roman-Catholic and English in churches of their
own. Hebrew hall for prayer-meetings.

Means of communication: Telegraph and telephone to the largest towns of
southern Germany. Railway, mail coach, cars and cabs, messenger-office.

Literature: Numerous publications concerning Wildbad, guides, maps, and pictures
permanently in stock at J. Paucke, book-dealer at Wildbad.

Prospectus with map of Wildbad and a list of hotels and boarding-houses free of
charge by the KonUjUche Badeverivaltung (Royal Administration).

\A/ilfilllinPri ffermany, Principality of Waldeck; a very charming place; with cold
If lltlUliyCll^ alkaline ferruginous waters of great efficiency.

Woodhall Spa (Lincolnshire, England).

This Spa and Health Resort lies midway between Lincoln and Boston.

Topography and Climate: Picturesque Town, population 1450, built upon gently
rising gravel soil, altitude 50 feet above sea level, sheltered by extensive woods on North
and East, bracing air from Moors and Pine Woods; 20 miles inland from sea; dry and
temperate cliinate, rainfall small 22 inches.

Mineral water (Heilmittel): Strong Bromo-Iodine saline water, rich in chlorides
of sodium, calcium, and magnesium (vide Thoipe's Analysis 1911).

The Spa bath establishment recently enlarged contains numerous immersion
mineral baths with undercurient and local douches, nose, throat and eye mineral sprays
and douches; modern accessory treatments, including Aix and Vichy Douche Massage,
thermal light and electrical installations.

176 Woodhall Spa (England) - Zugerberg (Schweiz)

Season : April to November.

Indications: Rheumatism, gout, and scrofula, diseases of women, tind tumours.

Doctors: Drs. Caltlirop, Gwyn, Williams, and Boys.

Hotels: The "Victoria" adjoining the Spa Baths, "Ea^le" and "Goring".

For information apply to Medical Superintendent: The Spa Baths.

Zugerberg (Switzerland).

Grand Hotel Felsenegg.

(3339 feet above sea level).

Climatic station of old repute. Electric railway fi-om the station of Zug. Wonderful
situation with a charming panorama, large pine-forests, plain promenades of long
distance.

Resident physician. Modern appliances for hydro-therapeutics. — Massage. —
Electric light Central-heating.

Indications: Exhaustion from mental overwork, chlorosis and anaemia, asthma and
failing nutrition.

J. Bossard Ryf, Proprietor.

177

SECTION II.

Sanatoria and Cure Establishments.

Arosa.

Villa Gentiana.

The only private English Sanatorium in the Alps.

Combining the advantages of tlie Mountain climate wilii
the careful medical supervision and nursing of an Englisli
Sanatorium. Facililies for all modern methods of treatment:
a well-equipped bacteriological laboratory, Ronfgen rays and
massage are available.

Prospectus and suggestions for equipment and journey
on application.

Egbert Morland, M. B , B. Sc. London.
Miss Wright.

Children's Sanatorium Arosa.

Dr. med. P. A. Pedolin.

Founded 1904, since the autumn of 1907 in a new house built especially for this
purpose, above Arosa, situated amidst the forest, 6335 feet above sea level. Location
entirely free from dust. Large roofed open-air galleries, spacious parlours and school-
rooms. Warm-water healing, ventilation, electric light, spring-water supply, canalization.

School sanatorium for a limited number of weak child i en, prophylactic patients,
asthmatics, patients with glandular tuberculosis. Individual treatment.

Open pulmonary tuberculosis is not admitted.

As soon as the health and the constitution of the children allow, they receive
regular instruction in all chief and side-branches in small classes. Boys up to the
fourteenth, girls up to the 17 th year of age. Lowest limit of age 5 years.

Details about the health-resort Arosa see page 92. Cable-addre-s: Hohwald Arosa.

Detailed prospectus sent on application to the proprietor Dr. med. P. A. Pedolin.

Baden-Baden.

Sanatorium of Dr. Burger.

for gastro-intestinal diseases, disorders of metabolism, alfections of the liver and

kidneys, diabetes, qout, and other affections, anaemia, neurasthenia; for convalescents

and individuals needing recreation, for reducing and feeding-cures.

The sanatorium is situated in one of the most hygienic, beautiful, and quiet
parts of the town, surrounded by shadowy gardens and parks, not far from the Gonner-
park, the playing-grounds, and the Lichtenthaler Alice. It is furnished with the most
modern comfort, and equipped with all modern therapeutic appliance-. In the house are
applied electricity in all forms, all kinds of baths, most elegantly arranged (carbonic acid
baths, electric-ligbt bath, four-cell bath, sun-bath etc.], massage etc.

Prospectus and information by tiie leading physician

Dr. med. H. Burger.

178 Stiction II: Baden-Baden

Baden-Baden, Sanatorium Dr. Ebers

For Internal and Nervous Diseases, Recreation and Convalescence.

Open all the year rounr].

The sanatorium of Dr. Ebers is located about 10 minutes from the centre of llie
town, half-way up the Annaberg, opposite the Grand-Ducal palace, amidst an old and
shadowy park of 6 acres. Owing to its elevateil location above the bottom of tlie valley,
yet protected by the higher mountain-crests, the establishment enjoys even in nv!d-summer
a cooler and more refreshing atmosphere than the town lying in the valley.

The house built up as a sanatorium, has besi le the conversation rooms (winter-
garden, dining-room, music- and lailies'-saloon, billiard- and ?moking-rooml, 40 rooms for
visitors, and is furnished according to all the requirements of comfort and rest, but
without any exuberant luxury. (Central-heating, electric light, warm and cold water
supply in each room, lift etc.) — Balconies in most of the rooms. In a distance oi
about 50 leet from the house there is a villa, built 2 years ago as a dependance, and
containing beside the lodging of one of the phy^icians, 10 fine rooms for visitors (with
balconies).

In the medical treatment chief stress is laid on observing a dietetic and rational
mode of life, and on psychical influence upon patients infirm in their willpower and
initiative. Furtherrnore, all the physical, dietetic, and medicinal cures, approved by
experience are applied. For this purpose the establishment is provided with the most up-
to date appliances for Hydrotherapy; such as full- and semi-baths, flowing sitz- and foot-
baths, cold and tempered douches of any kind, carbonic acid baths, sinusoidal alternating
current bath'^, electric sudatorium, and light-bath for the whole body and single
limbs, electric four-cell baths (W. Schnee), medicinal baths of any kind, appliances lor
hot-air treatment etc.

Electrotherapy. Contrivances for constant and induced current and for Frank-
linisation, vibration-massage; Roentgen - apparatus for diagnostic and therapeutic pur-
poses etc.

Gymnastics. Complete equipment for exercise-therapy according to Frenkel,
resistance-appliances etc.

Open-air treatment. There is a large air- and sun-bath in the adjoining park,
furthermore, in the house a laboratory for the examination and permanent supervision
of all excretions and secretions.

The cure is indicated for convalescence after acute, somatic and psychical
affections as well as for people needing recreation; anomalies of development, and meta-
bolic diseases (anaemia, chlorosis, gout, obesity, diabetes), functional and organic affections
of the respiratory organs, of the heart and the vessels, diseases of the gastro-intestinal
tract, of the male and female urogenital-apparatus; chronic intoxications, (alcohol, nicotin,
moiphine etc.). Insanes, epileptics and patients with infectious or offensive diseases are
not received.

Prices for room, full board, heating, light and use of all curative factors of the
sanatorium from Mks. 12 daily upwards A-arying according to choice of room.

Detailed information by prospectus as well as by the leading physicians.

Telephone No. 174. Cable-;iddress: Sanatorium Ebers.

Pliysicians: Dr. Paul Ebers (Proprietor), Sanitdtsrat Dr. Theodor Zacher.

Baden-Baden.

Sanatorium of Dr. Groddeck.

The sanatorium established by Dr, Groddeck in 1897, offers care and treatment to
any kind of patients except those suffering from infectious or mental diseases. Only
15 patients are taken in at a time. The results of the sanatorium are due to this
limitation of the number of patients.

The aims of this sanatorium are most evidently shown by the consideration- that
have induced the leading physician Dr. Groddeck to establish this institute. In his
medical practice among a constantly increasing number of patients of all nations, with
chronic diseases, also the so-called "given-up" cases, Dr. Groddeck became convinced that
for any medical treatment the fundamental rule is, at least in difficult cases, to have the
patient live under simple conditions easily to he investigated, overlooked nnd controlled by
the physician. For the patient is undoubtedly the product of his own life in the broadest

Section 11: Baden-Baden 179

sense of the word. If we do not want to leave success to mere chance, but wish to
achieve it ourselves, on tlie basis of a thoroughly elaborated plan and with medical
intelligence, we must eradicate or at least render innoxious all the factors of life that
have in the given case made the patient sick or are still working to make him sick. For
this, however, it is necessary to recognize these factors clearly, and to have a thorough
insight into tlie patient's life. If we have the patient live under simple and easily
controlled conditions, the physician will very soon learn, whore the vicious factor of life
is, and he is then able either to cure the disease or to modify it in a way as to giving
the patient his former strength, or at least rendering the affection tolerable. The
physician is also able to teach the patient how to live in order to remain as healthy as
possible in future.

Such a control of life is often not possible neither in the private house nor in hotels and
in the crowded modern sanatoria. But three things are necessary above ail-viz., an
institute directed by a physician entirely independent of other people and under his sole
responsibility; secondly all the provisions allowing the greatest freedom of the patient, but
at the same time giving certainty to the physician that nothing can be done with the
patient without the physician knowing it; thirdly the greatest possible limitation of patients
which allows the physician to devote his entire energy to each patient. These
considerations have inaugurated the establishment of the sanatorium with its peculiar
organization, and the efficiency of the institute has been proved by the experiences of
15 years.

The patients of the sanatorium are treated exclusively by the leading physician
himself. All therapeutic measures (massage, gymnastics, electric treatment &c.) are carried
out by the leading physician personally.

The situation of Dr. Groddeck's sanatorium in the direct neigbourhood of
the Kurhaus and of the forest, far from the bustle of life, in the finest part of Baden-
Baden, allow a view of the town, of the castle and of the mountains of the
Black-Forest.

Detailed information by the leading physican and proprietor Dr. Groddeck.

Baden-Baden.

Dr. Heinsheimer's Waldpark-Sanatorium.

Gastro - Intestinal Diseases. Disorders of Nutrition and Metabolism
(especially Diabetes). Weir-Mitchell- and Banting-cure.

Most complete appliances. Very best comfort. Delightful situation at the margin
of the forest. Large park.

Two physicians. — Open from March to December.

Prospectus on application. — Cable -address: "Waldpark". Badenbaden.

Baden-Baden. Sanatorium of Dr. Lippert

for gastro-intestinal diseases (also of a nervous origin), diabetes,
hepatic (gall-stones) and renal affections, Banting- and Weir-
Mitchell cures.

The sanatorium situated near the Gonner-parks is in a splendid, open, and
quiet location with a favourable climate, near the Lichtenthal Allee, It is provided
with all the therapeutic, hygienic, and comfortable equipment of modern times.

Individual and strictly scientific medical treatment: massage, electro- and
hydro-therapeutics. Limited number of patients. Most painstaking dietetic
cooking. The sanatorium is open from March to December.

The expenses of a stay are, according to tiie choice of the room, for full board,
hght, heating, complete dietetic pension, including baths, all prescribed applications
and curative means, and ordinary nursing 13 — 25 Mks. per day. The honorarium for the
physician is according to the individual treatment.

Detailed prospectus by the proprietor and leading specialist

Dr. med. Hugo Lippert,
formerly, for many years, first private assistant to
A (.* Geheimrat Prof. Dr. Fleiner at Heidelberg.

180

Section II: Baden-Baden — Bad-Reichenhall — Ballenstedt-Harz

Pneumatische Anstalt Baden-Baden.

Compressed air baths.

Treatment for Calarrh of tlie respiratory orgfans and ears; Bronchial Asthma;
Empliy.-emn : Pleuritic exsudations; Whooping cougli; Anaemia; Venosity; Dysmenorrhoea;
Adipositas; Gout.

Duration of Treatment: 30 days. Season: April — October.

Apply to: "Direction der Pneumatischen Anstalt, Baden-Baden, Kaiser Wilhelm-
strasse 2."

Bad-Reichenhall. Sanatorium Villa Romana.

In this firsl-class sanatorium (::i4 beds) situated close to the Royal Kurpark amidst
gardens, are treated especially: 1. Asthma and all forms of chronic dyspnoea;
2. complications of affections of the respiratory organs with di-orders of the
cardiac and renal function, of the gastro-intestinal funciion, of metabolism &c.; 3. the
sanatorium is of extreme value for dietetic cures with patients applying at the same
time the curative factors of Bad-Reichenhall, and in general for dietetic cures
of any kind, on a fcientillc basis. (Most remarkable results in dietetic treatment!)
Institute highly approved during the seven years of its existence. — Genuine
therapeutic agents! Modern comfort. Open from April 5t'i to November 15th.

Detailed information by the proprietor and leading physician

Dr. L. Dresdner.

Sanatorium Bad-Reichenhall.

(In the Bavarian Alps.)

Summer and Winter Station.

prospectus on applicaiiou.
not admitted.

Patients

Recently built, central situation, near the
Royal Kurgarten. Furnished with the most modern
and hygienic comfort. — Quiet establishment;
apartments with cold and warm water in the
rooms; Roentgen-cabinet; gymnastics and massage;
dietetic cooking and curative remedies of the
health resort. Auto with berth in the house.

Indications: Internal diseases, conditions
requiring recreation, heart diseases, especially dis-
eases of the organs of respiration (asthma and
emphysema); scrofula; diseases of women and
surgical (atler-)trealments. Specialists. Detailed
with mental diseases and open tuberculosis are
Direction: Dr. v. Reinleth.

Ballenstedt-Harz.

Sanatorium Dr. Rosell.

The sanatorium of Dr. Rosell takes in patients with clironicaffeclions
of internal organs. The examination is carried out with all special
methods of modern science. The treatment consists above all in a care-
lull y individualizing diet, and in physical measures by appliances provided
for the use of the patients in a most complete manner, in the institute for
physical therapy completed inOctober 1909.

Topography: Ballen?tedt is situated in the climatically favourable and picturesque
Eastern Har/, on a wooded mountain-crest separating the largest and most beautilul
livers of tiie Harz, the Selke and Bode, from one another. The town towers up a
inountuin declivity in an altitude of 840 — 1190 feet. The sanatorium is excellently
located upon a small hill, declining somewhat to the east, south and w'est, above the
south end of the town. Although it is almost entirely framed by forests, there is still
an open view of all sides. Sunshine is at no time of the day kept away from the
sanatorium by hills, hou-:es etc.

Section II: Ballenstedt-Harz ISl

Climatic conditions: In the above menlioned altitude our climate favouis alike
the processes of nutrition, metabolism and excretion, without, in a favourable contra-
distinction to the sea, to alpine region; or to the south, forcing the sick organism to
adapt iiself to the climatic properties of the various places.

This is the greatest advantage of our location witii regard to the purposes
of our sanatorium. Our climate does not interfere with pathologic processes, moreover
it allows full control of the latter by the curative factors of the sanatorium iti^elf, and
thus an individually dosed treatment. Further climatic advantages of Ballen-
stedt are the dry climate (only 455 mm of rain during the year); the almost entire
absence of fogs (on account of the absence of rivers and valleys); the great number of
sunny days, especially in winter. The location in the neighbourhood of the margin
of the mountain warrants uniform daily and annual temperature, i. e. warm evenings in
the sprintr and autumn, cool summer, mild winter.

Owing to the heavy stone formation, dust cannot arise even at dry times of long
duration.

Indications: 1. Diseases of the circulatory organs: cardiac weakness and
dilatation, cardiac neurosis, lesions of the heart-valves, affections of the myocardium,
adipous heart. Arteriosclerosis, vicious distribution of blood, varicocele, vertigo; Graves'
disease. 2. Diseases of the digestive organs: gastro-intestinal catarrhs, — ulcers
— haemorrhages, dystopia of organs, constipation, haemorrhoids, congestions of the Hver,
jaundice, bilious gravel. 3. Metabolic diseases: chlorosis, anaemia, incipient
leucaemia, scorbutus, gout, muscular and arthritic rheumatism, arthritis deformans in the
incipient stage; rickets, diabetes, obesity, emaciation, scrofula. 4. Diseases of the
muscles, bones and joints: periosteal irritations, ankylosis and curvatures; chronic
arthritis. 5. Sexual diseases: impotence, invelerated syphilis, chronic gonorrhoea
and complications. Diseases of women: dysmenorrhoea, disorders of the climacteric
period, dislocations, chronic inflammations and catarrhs, sexual anaesthesia and sterility.
6. Diseases of the air passages, of the organs of sp eech and of the respiratory
organs: catarrhs, reflex-neurosis, asthma, emphysema, residues of pleurisy. 7. Diseases
of the excretory organs a) of the skin: chronic dermatoses on an inflammatory
basis; b) of the urinary organs: chronic nephritis, Bright's disease, renal gravel,
floating kidney, vesical catarrh, weakness of the vesical sphincter, prostatic disorders.
8. Nervous diseases: neuralgia, palsy and irritative conditions, writers' cramp,
insomnia, hysteria of light stages, neurasthenia, migraine, tabes, 9. Diseases of the
sentory organs as far as they are connected with general affections. 10 Fistulae,
glandular swellings and suppurations, poorly healing wounds. Excluded from
admission are: Consumption, mental diseases, epilepsy, contagious and repugnant
diseases.

Diagnostic aids: Beside the generally applied methods of investigation:
inspection of the body-cavities (endoscopy), functional tests, kinematographic registration,
e. g. of pulse-curves, of heart-sounds, of the eletrocardiogram etc., ortho-
diagraphic Rontgen-fluoroscopy and instantaneous x-ray photographs. A
very large chemical, biological and bacteriological laboratory with all technical
appliances allowing any kind of inve-tigation. Our diagnostic means are con-
stantly kept on the highest level of scientific research by a permanent supply of new
appliances.

Curative agents: 1. A carefully individualizing- diet under the permanent control
of the physician. 2. Massage according to the Swedish method. 3. Medical gymnastics
in our Zander hall (70 feet long) furnished with all appliances. 4. Resting- and Oertel-
cures; exercise- and occupation-therapy. Athletics, sporting and games. 5. Hydro-
therapy, steam-applications, fango-packings, hot air-baths and douches, sand baths, electric
incandescent and arc-light baths, brine and carbonic acid baths, electric water baths.
6. Heliotherapy by means of iron-light, uviol-lamp and Rontgen-light etc. 7. Electricity:
galvanization, faradization, electrolysis, kataphoresis, galvano caustic, Arsonvalisation by
autoconduction, direct application and condensation, voltaization, static electricity, thermo-
penetration. 8. Electromagnetism. 9. Radium for drinking, balhingr^ and inhalation cures.
10. Inhalation of compressed air, of nebulized air, of steam and warm air. 11. Appli-
cation of condensed and rarefied air to the lungs. 12. Air and sun baths. 13. Psychical
treatment.

The Sanatorium has 100 beds. Electric light and central heating by distant. heating
engine for all rooms. Three large buildings serve for lodging the patients, while the
fourth building, the Kurhaus proper contains, in its three large flats, a model equipment
of all physical aids. In the ground floor are large rooms for douches with all kinds of

182 Section II: BaUenstedt-Harz — Bendorf

slio-\ver baths, a swimming tank, all kinds of tubs for all methods of hydrotherapy, baths
with natural carbonic acid, electric-bath tubs, sand and fango baths, rooms for gargling
and enema etc. In the first floor are the most various sweating-boxes for full and partial
steam and hot air baths, the polysol-Iight and arc light bath, the electrothermal apparatus,
the refractor, hot air douches, places for massage, berth and resting halls. To this is
annexed the large vestibule from which one goes to the consultation room, the operation
room and the office. In the second floor is another vestibule, the room for occupation
therapy, the inhalatorium, the Roentgen cabinet, the room for electro-medical a])paratus,
the large Zander room, and tlie sun baths for ladies and gentlemen. All the flats are
connected with one another by electric lifts, and by convenient stairs. A resting hall
and four large air baths are located in the beautiful pine forest close to the building.
A number of drawing rooms, verandas, well-kept gardens make the establishment complete.
Tlie kitchen was entirely renovated in 1910, and is now an object of greatest interest which
is willingly shown. There are the most various cooking vessels and grills. Any desired
temperature can be obtained in the heating tables and boxes, the water-bath with central-
steam heating on the hearth, a fire-place tor cooking, in the grill and spit-rack, and also
in the pastry fireplace. An electron. otor of 2 horse-powers runs an ice-machine for
ice-cream, a stirrer and a kneading-machine, a separator, a whisk and a machine for
whipped cream, a universal grinding-and cutting-machine,' a coffee-mill, a meat-chopper,
and a machine for skinning potatoes etc. A refrigerator according to the sulphuric-acid com-
pression-system keeps two rooms at a temperature of 3 and 6*^ G and makes artificial ice.

The sanatorium is open all the year round and, owing to tiie
appliances answering the highest demands, frequented exclusively by the
best classes.

The advantages of winter cures being more and more acknowledged, visit during
the winter has grown considerably. Opportunity for sport of aU kinds. Exaggerations
and neck-breaking performances are, however, not allowed here.

Prices for adults per week:

1. Pension in rooms with 1 bed: 2 £ 16 sh— 4 .;£ 11 sh, with 2 beds: 5^5 sh—
8 aC 15 sh, according to choice of room. For the months of November, December, and
January price for pension 7 sh less.

2. For the cure including medical treatment: 1 .£ 1 sh for 10 — 20 single prescriplidns,
and \ £ 15 sh for 20—30 single prescriptions per week.

First examination 10 sh. At a second stay for cure this fee is no more charged.

No extra fees for any additional thing. One has to bring with oneself only 1 large
bath-towel and blankets for restiiig-cures. In the rare cases which do not agree with
this bulk, special agreements are made.

Persons needing recreation without a regular cure and companions pay the pension-
price only.

Servants accompanying the visitors may have their meals with our servants and
pay \ £ 1 sh per week.

For Children the price of pension in rooms together with the adults is 1 <;£ 1 sh
up to tlie fifth year of age, 1 ^ 8 sh up to the tenth year, and from 15 years upwards
1 £ 15 sh; for the cure 7 sh less than adults per week.

All the visitors of the sanatorium have to give notice 8 days before departing.
Detailed information in the prospectus.

Means of communication: Ballenstedt is about ^/^ railway-hours distant from the
stations of Halberstadt or Aschersleben of the main hne Hildesheim — Halle— Leipzig,
at the branch-line Quedlinburg — Aschersleben. Here are two railway-stations; drive as
far as Schlossbahnhof Ballenstedt.

Further information by prospectus, printed descriptions and by the undersigned
proprietor. Br. Rosell.

Bendorf on the Rhine.

Dr. Erlenmeyer's Sanatoria for Patients with Nervous
and Psychical Affections.

For the various forms of mental and nervous diseases are three special and
separate establishments:

I. Sanatorium for Psychical and Nervous Affections, situated at the north-end
of the city of Bandorf. Also lor patients addicted to al.:ohol, for morphinists, and
pileptic patients.

Section II: Bendorf — Bayrisch-Zell

183

Pavilion-buildings. Workingr rooms. 13 acres of parl< witli gardening and tennis-
links. Electric light. Central heating.

II. Hydrotherapeutic sanatorium "Rheinau". Kurhaus for nervous patients
and «Hch needing recreation. Situated near the Rhine, south-west to the town. Especially
for neurasthenics, patients with spinal affections, with henrt-di'-eases, arteriosclerosis. Cure
of drug-habit. No insanes admitted. Electric light. Central heating. 14 acres of park.
Best hydrotherapeutic-physical appliances.

III. Kolonie "Albrechtshoi", establishment for agricultural occupation for invalids,
convalescents, juvenile weakness. Situated eastern to Bendorf.

Total area of establishments = 580 acres.

For each one of these establishments special prospectus.

Bendorf is a small city of GOOO inhabitants situated between the south-western
spurs of the Westerwald-mountains and the Rhine, in a region rich in forests. Protestant
and Roman Catholic church, synagogue. Middle-class school. Station of the line Ehren-
breitstein — Neuwied on the right bank, of the Rhine. Fast train station of Bendorf is
Engers (2.5 minutes distance). Bridge-station of Rhine-steamers. Electric tram to Ehren-
breitstein — Coblenz (30 minutes).

Leading physicians: Geheimer Sanitiitsrat Dr. Erlenmeyer, Dr. Max Sommer,
and one or two assistants.

Sanatorium Tannerhof in Bayrisch-Zell (Uppep-Bavan'a).

Physical-dietetic Sanatorium and Country Home for Recreation
with family character.

2940 feet above sea level, at the foot of the Wendelstein (6433 feet high, with the first
Bavarian mountain-train), protected against vfinds; alpine character. About 345 acres of

garden, lawns, forest
and alpine pasture
up to an altitude of
4480 feet. Weak car-
bonic-acid mountain-
spring.

Large air-light
baths on wooded
decUvities up to the
alpine pastures. Two

boarding-houses.
Cottage-colony at
the mountain for one
or several persons
and families. Resting-
halls.

Help-system, i.e.
well bred young girls
under the personal
direction of the lady
owner, for domestic
work; no servants
and tips. Limited
number of visitors.

Recuperation of
the entire meta-
bolism (patients with
grave or contagious
diseases are exclu-
ded), preferably
lacto - vegetable
diet without stimu-

lants, very little meat
no alcohol, milk
from the pasture
from a dairy under
control of our own.
self- baked whole-
meal bread; 3 meals
per day. — All simple
liydrotherapeutic
applications without
complicated appa-
ratus, special hot
partial steam-baths,
hay- and pine-needle
baths, massage,
also nervemassage
according to Ober-
stabsarzt Dr. Cor-
nelius, carried out
by Dr. v, Mengers-
hausen himself.

Sun- and air-
baths with gym-
nastics, under the
supervision of special
instructors, and with
Oertel-cures. In-
struction in rational
and hygienic mode
of life. Helping
work in house, gar-
den, lawns and forest.

Especially suitable ground for winter-sport. Ski-ing and bobsleigh for beginners
near the house; for advanced people on the neighbouring Sudelfeld (well known winter-
sporting place in Upper-Bavaria).

184

Section II: Bayrisch-Zdl — Blrkmwerder

Prices: 42—^70 Mks. per week. First consultation 10 Mks. Baths and medical
treatment (3—10 Mks. per week.

Railway-communication from Munich to Bayrisch-Zell 4 to G times a day.
Prospectus by the owner and director

Dv. med. Chr. v. Mengershausen and Barbara v. Meugershausen,
geb. V. Kummer.

Sanatorium Birkenwerder

near Berlin

(Nordbahn, 45 minutes from Stettiner Vororts-Bahnhof).

Telephone: Amt Oranienburg 40.

Sanitatsrat Dr. Sperling.

Office-hours: Berlin Charlottenburg, Joacliimsthalerstr. 30 40,

Monday, Friday 4 — G. Telephone: Amt Charlottenburg 8175.

^

Sanatorium Birkenwerder, suitable also for cures in the autumn and winter, is fitted for
heart-diseases, acute or chronic cases, as a station after a cure at Nauheim &c.; for
diseases of the circulatory orgm-, and beginning affections of the blood-vessels; in such
cases especially good results have been obtained; for acute bronchial catarrh or
convalescence alter catarrhs, pneumonia, influenza &c. The large pine-forests (about
80000 acres) surrounding the sanatorium in the east and north, offer the patients an
aromatic air rich in ozone, pure and free from dust. — Resting-cures in roofed and
open-air galleries are suitable for such persons; for convalescents and those needing
recreation, for people that have overworked and over-exerted themselves, and wish to
enjoy rest, the regular mode of life in the sanatorium, the good air and the opportunity
for walking, driving and riding in the surroundings. With over-exerted inhabitants of
large cities it has become a habit to live for a longer or shorter time in the sanatorium
and to attend here to a part of their buisness matters; for women alter confinement,
wishing to recuperate thoroughly and to get rid entirely of the sequelae of confinement
(relaxed abdominal wall, pendulous abdomen, constipation, depression, endometritis or
dislocation of the uterus); for digestive affections — including diseases of reabsorption and

Section II: Birkenicerder — Blankenburg — Blankenhain 185

asi^imilation of foodstuff as well as of metabolism in general — constipation, liaemorrlioids,
dyspepsia, tendency to irritation of the appendix and to the formation of bilious and
renal cnncretion, obesity and emaciation), for which an individually adapted diet is
.required, and in which the patients after recovery want to know how to live.

For all such cases the treatment of the digestive o gans which is here the essential
part of a general and local treatment (diet, thermal treatment, gastro-indestiiial massage),
is an excellent aid. The lunction of the digestive organs is to use the chemical energy
ot the food-siuff; for Julius Robert Mayer, the discoverer of the law ot conservation of
eneri^y, has already proved that the chemical energy of food-stuff is to be con-idered a
general source of energy for all functions of man and animal. Modern natural sciences
and medicine (Rubnerj hold tTle same view. We are thus justified to consider a false
nutrition the cause — in the widest sense ot the word — of a great number of diseases,
and we are also justified to place the question of nutrition — again in the widest sense
of the word — into the centre of our treatment. Therefore, our approved principles
are — training the digestive organs lor a proper di-'estion — instruction in proper made
of nutrition with regard to choosing food and drinks as to quantity and quality —
practical advice in securing a proper assimilation of the food by batliing, gymnastics,
air-baths — conservation of health reestablished by the cure.

For detailed information on these points see our illustrated prospectus. Also articles
about gastro- intestinal massage, assimilation of food-stuff, circnlatory di-tuibances &c.
are at disposal. The sanatorium has been made still more pleasant and comfortable by
some improvements and new establishments.

Price of cure 10 — ]!2 Mks. per day according to choice of room. Medical treatment,
baths, diet, boarding are included in this price. The first examination, night-call, and
medicine are charged extra. For physicians and their relatives special reduction for cure
and stay in Sanatorium Birkenwerder.

For sake of physical power and freshness of life it should become a custom to
visit the sanatorium and to consider it much more a hyirienic- prophylactic institute.
Principiis obsta — oppose the beginnings; it is far easier to nip in the
bud than to subdue the flames.

DlonlynnViiivn /^Uqi^t^ Kuranstalt MuUer-Rehm; Establishment lor phvsical-
DldllKUllUUry i^ndrZ;, dietetic treatment.

Blankenburg (Harz), ^T!^. ''^'''' ^''°'"''"' ''"''''"'''

Blankenburg (Thuringia).

Villa Emilia.

Sanatorium for Nervous Diseases.

Three doctors. Chief physician: Sanitatsrat Dr. Warda, formerly first assistant to
Geheimrat Binswanger at Jena.

The sanatorium is charmingly situated at one of the finest spots of Thuringia.
Visitors find there clinical treatment and family life. Beside the approved physical
curing methods, particular stress is laid upon Psychotherapy.

Price for pension: 9 to 20 Mks. a day.

Blankenhain in Thuringia.

Sanatorium for Diseases of the Tiiroat and Lungs.

The sanatorium for diseases of the throat and lungs al Blankenhain is the only
private sanatorium of this kind in Thuringia. It is existing since the year 18S5, and
can look back upon a great number of cured consumptives. The sanatorium is situated
in a quiet location protected against winds, and it offers the best chances for healing
tuberculosis. The establishment is provided wilh excellent open-air galleries, with a high-
pressure water-system, electric light and vacuum-cleaner.

18G

Section II: Blankcnhain — St. Blasien

Chief stress is laid upon the dietetic treatment and upon rpspiratory exercise. This
is always performed under tlie control of the physician. The price of pension is about
TO-Si- Mks. per week, according to choice of room, including full-board, lodging, and
all extra expenses, such as heating, light, baths and rubbings etc. Ordy medicines and
drinks are charged extra.

Detailed information by prospectus and the leading physician

Dr. Leo Silberstein

Sanatorium St. Blasien in the Southern Black-
Forest of Baden.

Sanatorium for the treatment of diseases of the Lungs.

2800 feet above sea level.

Directing physician: Medi-iiualrat Dr. Sander.

The sanatorium is situated amidst extensive pine-foresis on the southern slope of

the Botzberg which is 4290 leet high. It was built in 1881 by Dr. med. Haufe after a

careful investigation of the climatic conditions, and is being conducted since 1895 by the

present directing physici;ni
Medizinalrat Dr. Sander.
In 1900 and 1908 it was
entirely renovated and
rebuilt according to the
demands and progress of
the modern hygienics of
the building technic.

The approved thera-
peutics of the sanatorium
is a hj'gienic, dietetic nnd
strictly individual method.
Thorough medical super-
vision and instruction of
patients, open air cures,
liydrotherapeutic treatments
adapted to each individual
case, copious and variable
nourishment. — The efficacy
of this therapeutic method
has been sufliciently proved
by the permanent results
obtained during a period of
30 years with the treatment
of diseases of the Lungs,
at all seasons of the
year, in the Sanatorium
tot. Blasien.

There are in the sana-
torium apart of the drawing
rooms, 95 looms fur
patients, most of which are
exposed to the south and
have balconies. Pavilions
in the Forest for the open
air cure. Summer and
Winter, modern baths and
douches of up-to-date construction,- Roentgen Rays cabinet, central-heating, lift, electric
light, special ventilating system, linoleum-flooring, oil painted walls and rounded corners,
strictly hygienic provisions all over the premises combined with every comfort.

Full board, medical and liydrotherapeutic treatment 7,50 Mks. per dny. For
physicians G Mks. and accompanying persons 5,50 iMks. Rooms from 2 to (i Mks. per day.
Illustrated prospectus on request free of charge,

Section II:- St. Blasien

187

Sanatorium Luisenheim, St. Blasien.

For Diseases of the Internal Organs, Disturbances of Digestion or of
the Nervous-System, or of the Circulation of the Blood, as well as

for Convalescents.

Open all the year round.
Medical Direction Prnfessor Dr. Deterninnn Hnfrat, Dr. Wis we.

it

a

Luisenheim, situated in tlie finest pnrt of St. Blasien, at
the southern slope ol the densely wooded Botzberg, was built in
1897 and amplified in 1905. It has 30 rooms with 38 beds, parlours,
warm-water heating, electric light, lift, hydrotherapeutic institute
of its own and colonnade. The quiet location and the small
capacity of the establishment warrant sufficient rest and thorough
The establishment was united in December 1908 with

treatment of the individual patient,
the Kurhaus.

Owing to the very much protected location of St. Blasien, to the long duration of
sunshine (7—12^0 hoursj in the winter, to the very favourable temperature in December,
January and February (only 0,9" C in the average) the estabhshment which is
open all the year round, is a remarkably suitable station for winter-cures, particularly
for partients that have to remain in a permanent recumbent position, and still want to
have the beneficial effect of a strong insolation on sheltered verandas. Further advantages
of the winter-cure are offered by the winter-sport rendered possible by a permanent
snow-cover, and a stay during the winter is recommended to all those whose treatment
allows or requires taking part in winter-sport.

The establishment is equipped particularly for dietetic cures. In addition to a
strictly individualizing dietetic therapy, all other scientifically approved therapeutic methods
are applied, such as hydrotherapy, medicinal baths. Roentgen- and thermo-penetration
apparatus, electricity, massage, gymnastics, open-air resting-cures, Oertel-cures, air- and
sun-baths on, a wonderful meadow embraced by a fine forest, as well as internal treatment.

According to its situation, to the appliances and curative factors the sanatorium
is preferably suitable for:

1. All disorders of metabolism (diabetes, obesity, gout, severe cases of anaemia),
which require a thorough dietetic cure; 2. those affections of the gastro-intestinal c:inal
and the nervous system that require a special consideration of diet and thorough nursing;
3. chronic renal affections, functional and organic diseases of the heart, in which a long
continued supervision of the mode of life and nutrition are required.

Consumptives and insanes are not admitted.

Prices of pension: Room including three meals according to the prescription of
the treating physician, light and heating, from 10—20 Mks. per day and person. From June
1st to October 1st 25 per cent, more for boarding and pension. For visitors living outside
the house prices by arrangement.

Medicines, drinks and baths are charged extra. — Honorarium for the physician
according to the individual case. — Prospectus are to be had on application to the Director.

1S8

Section II: St. Blasim

Department for Physical Therapeutic Factors of
Hotel and Kurhaus St. Blasien.

(Consumptives are not admitted.)

5^ Blasien, Hotel and Kurhaus. — Total vieiv.

Owing to its alpine situation, 2612 feet above sea level, protected against wind,
and amidst endless pine-forests perviated everywhere by the most beautiful paths, this
establishment is one of the most highly located and most renowned of the German
mountains. It was considerably improved in 1900 1901 by a renovation and subsequent
enlargement of ground, increase and more elegant equipment of bathing- and packing-
cabins, and by the provision of very effective top-light.

The hydropathic establishment has a complete equipment for all the methods of
hydrotherapy, for ladies and gentlemen in separate apartments, all kinds of baths and
douches, including mud-baths, carbonic acid brine- and electric-hght baths, electric tour-
cell bath, and practical rooms for packings and for resting. In the neighbourhood of the
establishment is an elegant colonnade 115 feet long and more than 14 feet broad; furthermore
two open-air galleries 175 feet long with fine views, one of them provided with resting-chairs.

The methodof treatment is strictly individualizing. Very well trained attendants
for bathing.

Chief physician: Professor Dr. Determann, Hofrat.

Massage and Swedish gymnastics: Mr. Casper Andre from Swede, and a lady assistant.

In the Kurhaus are open and closed glas-verandus (42 dining-tables.) — Electric
light. — Lift. — Air-baths, separate for ladies and gentlemen on a meadow of about
3000 square-yards, embraced by forests, playing-giounds, skittle-ground, gymnastic
apparatus, opportunity for hunting, (hunting grounds owned by the Kurhaus) trout-fishing.

The garden extending between the institute and the Kurhaus offers a splendid view
of the Menzenschwand Valley with the two "Spiesshorner". Tliis garden was renovated
in the style of a park and laid out with a number of resting-chairs and, at the end
of the pretty flower-beds, with large playing grounds for lawn-tennis, crotjuet, nine-pin-^
and other games. At the end of this park is a milk-cure establishment with a roofed
hall, the model of a modern and practical establishment.

Pension; For the various forms of diseases special diet according to medical
prescription at fixed prices and at special tables.

Indications; Nervous diseases, circulatory disorders, especially in afifeciions of the
heart, chronic catarrhs and atony of the digestive organs. — Constitutional anomalies, such
as chlorosis, anaemia, obesity, diabetes, uric acid diathesis, and gout. — Chronic diseases of
women. — Affections of the respiratory organs, as asthma, emphysema, chronic bron-
chial catarrh, residues of severe pleurisy, sensibility, tendency to frequent cold, cures for
inurement etc. C!onsumptives are not admitted.

For further details see the illustrated prospectus of the Kurhaus.

Section II: Carlsbad (Bohemia) — Champel — Clavadel 180

Carlsbad in Bohemia (Westend).

Dietetic Institute "Villa Ritter".

This establisliment receives patients neediiin: a more thorough dietetic treatment and
attendance in addition to the cure at C;irlsbad. Treatment only for diseases of the
stomach and intestines and adnexn of the gastro-intestiiia! tract (liver), furthermore, disorders
of metahoh-m. Patients with infectious diseases are not admitted.

Tlie vdla has not room for more than 27 beds. It is located in the Westend district,
surrounded by gardens, near the forest and meadows. Jilfost modern and comfortable
furnishini? (electric light, lift, etc ). For the colder seasons of spring and autumn central-
healing on the slair cases, the corridors and the W. C.'s etc. Honorarium for treatment
acco.ding to requirements. Detailed information on application.

Medicinal-Rot Lr. Ritter.

Carlsbad (Bohemia).

Dr. Tyrn auers' Institute lor Swedish Gymnastics (Zander-Apparatus), Medical
Massage, Hot-air treatment. Radium-treatment (Newly established).

Kaiserbad. Dr. Tyrnauer, J. C.

Superintending physician.

Etablissement Hydrotherapique de Champel

with Hotel Beausejour in the same park
10 minutes from Geneva (Switzerland).

There can scarcely be a more delightful place than Champel on Arve, and
especially for a cure-establishment this magnificent location offers the best advantages
conceivable.

All good things are united here, such as a bubbling curative water, extended
promenades on a magnificent plateau ; wonderful shadowy retreats. The hotel is located
at the bank of a river on a hill, sulficiently high as to allow a permanent change of air,
and to offer a charming view of the surroundings. Unequalled station for spring
and autumn.

Tl:e institute provides all curative factors, such as cold and warm douches of the
most various kind, with regulation of pressure and temperature, Scotch douches, cold
hip-baths with flowing water, douches from below, p'scines with flowing waier, rooms
for packing, for half-batl s. Sun- and air-baths, electric light baths, steam-douches. All
kinds of electro- therapy. The temperature of the water of the Arve-river is
90 c -=48,2« F.

Indications: The diseases treated especially in Champel are affections of the
nervous-system, anaemia and neurasthenia, nervousness, diseases of the
digestive organs, convalescence after severe diseases.

The hydrotherapeutic institute was established in 1876 under the protectorate of
the Corps medical of Geneva.

Resident physicians: Dr. A. W. Fioelirich (speaks English) Dr. M. Egger,
Dr. Rolhlisberger (speaks English). Electric tram from Champel to Geneva from
7 to 7 minutes.

Open all the year round.

Clavadel near Davos.

Sanatorium for Lung- Diseases.

5500 feet above sea level.
The sanatorium Clavadel (price of pension including room, medical treatment, full
board, packings, baths etc., ligtit and heating, from 14 — 20 Frcs. per day according to
size and location of the room; reduction in the summer) was built in 1902/03, and
established as a sanatorium for lung-diseases according to the most modern requirements
as regards sanitary and hygienic equipment. The chief aim was to give the rooms a
home-like and comfortable appearance as far as it was possible. 60 rooms, most of

190

Section II: Clavadel — Chateau d'Oex

them with roofed and very spacious balconies, warm and cold water in all bed-rooms,
electric liLzht, low-pressure steam-heating, lift. iS'umerous baths, douches, operation-room,
most modern Roentgen-appljances, laboratory, coiffeur, dark-room. Near the house two
large isolated, protected and well-ventilated open-air galleries. — Two physicians, trained
English nurses.

Leading physician: Dr. H. Bodmer (formerly at Geheimrat Dr. Turban's,
Davos- Platz).

The treatment is carefully adapted to the individual case, and considers all
aids of modern therapeutics (Tuberculin, artificial pneumothorax). Management by
Miss Ga<hner. Special attention is paid to good cooking and use of first-class food stuff.

For further details see prospectus.

La Soldanelle, Chateau d'Oex.

Dietetic Kurhaus.

La Soldanelle is situated 3400 feet above sea level, in one of the finest regions
of Chateau d'Oex, close to the forest in a park of its own, with playing-grounds, tennis-
links, summer- and winter-sport. Open all the year round. Modern comfort, central
heating, electric light, lift.

Climate: Owing to its very sunny and protected position. Chateau d'Oex has a
mild alpine climate of essentially tonic action; thus a sojourn there is highly favourable
for all seeking health and recreation; another item in the beneficial effect of the cure
there is the very dry and calm air.

Indications: Gastro-intestinal diseases, affections of the functions of nutrition (diabetes,
obesity, gout), anaemia, general weakness, Grave's disease, convalescence, station after
strenuous balhing-cures.

Curative factors: Hygienic invigorating diet of first-class quality, dietetic cooking for
gastro-iniestinal and affections of the functions of nutrition. Open-air cure, sun-cure (helio-
therapy) restmg-cure, massage, hydrotherapy, electrotherapy( faradization, gal vanization.electric,

Section II: Chateau d'Oex — Davos-Plalz

191

baths, four-cell baths, light-bRth, Dowsing), Arsonvalizalion, Roentgen, cures for inurement.
Attention is especially called to the suncure by which more and more splendid results
are being obtained.

Terms: Price of pension 9 to 18 frs. daily (for at least 5 diys). Included in this
price are: room, pension with 4 meals (breakfast, lunch, afternoon-tea, and dinnei)
including diet accordiner to medical prescription, central healing, electric light. 5% of
the bill is chari;ed for service. It is requested not to give tips.

For the sake of the vi=ilors the house- regulations posted in every room have to be
strictly observed.

Contagious diseases (especially consumptives), in-anes and very nervous cases are
not admitted.

Means of Communication: Chateau d'Oex is a station on the line Mont re x —
Bernese Oberland, one of the most interesting electric railways of Switzerland ; from
Monlreux, Chateau d'Oex can be reached in 2 hours, from Lausanne and Inlerlakeu in
3 hours.

Sanatorium Davos-Platz

Davos-PIatz (Switzerland).

First-class Establishment. Open all the year round.

Medical director: Dr. A Schnoller.

This well-known sanatorium for lung-complaints is situated in a sunny position
above the health resort, free from dust and smoke, and sheltered from wind. The house
is close to the borders of the pine-woor]s and offers an extensive view of Davos.
In front of the building stretclies a terraced-garden with graduated ascents, which
facilitate methodical walking exercise, and at the back, a bridge specially constructed
for the tOiivenience of the visitors, enables them to reach without any effort the wooded
mountain paths, where a magnificent view of the valley and lake of Davos, and a panorama
of the Grison Alps is obtained.

The interior arrangements of the sanatorium are most complete and hygienic. All
the south-rooms are built with separate covered balconies, which allow the patients to

192

Section II: Bavos-Platz

enjoy the invigoraling air from morning till evening. The near vicinity of the pine-forest
with its easy paths makes the sanatorium an ideal sojourn in summer. The treatment
under the i ersonal supervision of the leading physician Dr. A. Schnoller is a hygienic-
dietetic one, following the principles of modern psychotherapy, avoiding any exaggeration
and individualizing as much as possihle. In gastro-intestii al disorders special diet is
prepared by medical prescription, witl.out any extra fee being charged.

Prospectus with detailed information as to indications, terms of admission etc. are
sent on application.

Terms from 14- francs (11/3) to 19 francs (15/2) per day including board and
residence, medical treatment, douches, frictions, baths, heating, light and attendance.

Davos-Platz, Orisons. Switzerland.

Altitude GOOO feet.

Schatzalp Sanatorium,

For diseases of the lungs. 1000 feet above Davos-PIatz.
Reached in ten minutes by funicular.

Physicians: Dr. Lucius Spengler. Dr. Edward C. Neumann.

The Schatzalp Sanatorium stands away from the town of Davos on a windsheltered
terrace getting maximum sunlight. Surrounded by 50 acres of own private park. The
house is provided with every comfort. Electric liglit, central beating, private and public
curing galleries. Rooms with private bathroom etc. attached can be had. Terms: 2£ 18 sh.
weekly tor medical attendance, i-ervice, light, heating, baths, douciies and six meals a day.
Rooms from 1 sh. G d. to 4 sh. a day, without private curing gallery; rooms wit!i private
curing gallery from 4- sh. 8 d. per diem.

For all information write to Dr. Edward C- Neumann. Tl:e Sanatorium is open all
the year round.

Prospectus gratis on applicalicn.

beciion II: vacos-riaiz — liegersheim 193

Forest-Sanatorium of Professor Jessen
at Davos -Platz.

Sanatorium for all Forms of Tuberculosis.

350 feet above Davos-Plafz, situated close to the forest embracing the establisli-
ment- from the east and r.oith, whibt toward the south the entire Valley of Davos is
open. Maximum of insolation. The first sun-ray over Davos touches the eslablishment.

The sanatorium has 70 beds; all the rooms are faring the south, and have their
own large berth-halls, hot and cold water. Bed-iidden patients may be brought into the
open air in their beds.

Warm water central-beating, three lifts for persons, laundry, and meals. Vacuum
cleaner. Instead of bells light-signals are fiiven, whereby as much quietness as possible
is secured. Private apartments with special bath and private telephone.

Rinsing drainage, disinfecting apparatus, spring-water. All tal)le-requisites are
disinfected.

Inlialnlion-rooms, great hydrotherapeutic equipment, swimming-tank, sun-bath.

Aseptic operation-room, first-class Roentgen-appliances. Operation-room for the
larynx, large laboratory, two dark-rooms.

Climate: Alps of calming character.

Climatic-hygienic as well as specific and operative treatment applied. All forms
of tuberculosis, it not too far advanced, are admitted.

Leading physician: Professor Dr. F. Jessen (speaks English fluently).
Admission only certain if previously guaranteed by the directory.

Detailed prospectus are sent free of charge.

Dr. Turban's Sanatorium at Davos-Platz.

Sanatorium for Lung-Diseases.

Situated entirely free toward south, 5500 feet above sea level. Principal house with
lift. Three country houses connected witli the establishment, and Dependence with 90 rooms,
the most of which are facing the south. New elegant furniture of parlours and dining
room. Low pressure steam-heating, warm water-heating, ventilation, electric light,
spring water, drainage, disinfection-apparatus, dark-rooms, large shadowy parks.

Treatment in the sanatorium according to special principles regardless of season.
So-called prophylactic patients, and such with an incipient or not far advanced pulmonary
tuberculosis as well as with bronchial asthma and pleurisy are admitted.

Leading physician: Geheimer Hofrat Dr. Turban.

For further information see the detailed prospectus.

Degersheim, Switzerland.

"Sennriiti", Alpine Sunbath Establishment, and Wintersport Resort,

Altitude 2870 feet, mountain climate, southern exposure, pure and bracing air,
high intensity of solar radiation, magnificent views, pinetree forests, excellent opportunity
for practising ski-ingand luging in Winter. Modern comfort, central heating, electric
light, hot and cold water.

Complete installation for Hydropathy and for Sunbaths, Air Huts, 4 extensive
wooded Airbath parks. Constant medical supervision.

Prices 5 to 7 sh without treatment, 8 to 10 sh treatment included. — Open the
whole year. English spoken.

For Prospectus apply to the medical adviser

F. V. Segesser^ Dr.^ med. (Diploma Univ. Zurich).

13

194

Section II: Dresden- Loscltw'dz — Ebersteinburg — Elgershausen

Dresden-Loschwitz.

Dr. Mdller's Sanatorium.

Institute for Dietetic Cures according to Schroth.

The saiialoiium is al Loschwilz (a suburb of Dresden) in great repute on account
of its wonderful situation on the hills bordering the Elbe river. The centre of the fine
capital and town of arts, so rich in diversion, can be reached from Loschwitz within
20 minutes.

In the sanatorium the method of Schroth is applied in an individualizing scientific
manner. This dietetic method is in great repute on account of its excellent results even
in inveterated cases. The individual curative factors are: action of moist heal, partial
elimination of albuminous food, substituting it by white bread and dry vegetables.

Restriction of liquids and periodical allowance of a light wine or fruit-juice free
from alcohol.

The almost universal effect of this cure is due to the immensely increased
metabolism, whereby all waste-products of metabolism, especially uric acid are thrown
into the circulation and oxidized or excreted by the organs of excretion showing an
increased function.

The same occurs with bacterial toxines and other detrimentary substances ingested
with drugs, such as mercury, iodine etc. If the individual cell by this cure is freed form
the poisonous load, it can develop again and take up its normal function. The privations
in this cure are fully compensated by the results obtained by it.

Indications: Gastro-intestinal diseases, affections of the nervous system, diseases
of metabolism, of the blood, and uric-acid diathesis, chronic catarrhs of the ears, the
eyes, and upper air-passages. Cutaneous affections, inveterated sexual affections, and
mercury-intoxications.

Prices: 8 — 14 Mks. per day according to cure and room.

Description and illustrated prospectus in English, German, Russian, and French are
sent free of charge.

Dr. Rumpf's Sanatorium Ebersteinburg
near Baden-Baden.

1470 feet above sea level.

Refined house only for ladies.
Prophylactic cures and light pulmonary affections.
Open all the year round.
Illustrated prospectus sent free of charge on application to

Dr. med. Rumpf.

Waldhof Elgershausen.

Dr. Georg Liebe's Sanatorium for Lung-Diseases.

Situation: Post- and railway-station Katzenfurt of the line Giessen-Cologne, 1225
feet above sea level, in the Westerwald, entirely surrounded by forests, with a free vista
of the charming valley.

Section II: Elgershauscn — Bad Elster 195

Curative factors: Sanatorium for lung-diseases, on modern principles. Special
care is devo'ed to physical-dietetic therapeutics as well as to a hygienic instruction of the
palients. High-pressure water-supply of its own, central-heating, berth-halls close to the
pine forests, air- and sun-baths, gymnastic exercise?, common excursions, and other
entertainments. Lectures on hygiene. (On demand vegetariaa diet.) Annexed is a
sanitary educational home for .'■ickly and infirm childien.

Indications: Only light cases of pulmonary diseases and prnphylaclic patients
are admitted. Severe laryngeal and intestinal diseases, and other severe complicalions aie
refused.

Prices: Waldhof Ejgershausen is a sanatorium for the middle-classes. 8 — 9 Mks.
per day. Children: 5 Mks.

Bad-Elster (Kingdom of Saxony).

Dr. R. Schmincke's Institute for Heart-Diseases
and Disorders of Metabolism.

The eslablishment is a supplement to the natural curative factors of Bad-Elster.
The physical curative methods are applied preferably.

For cardiac affections all the modern methods of examination, such as cardio-
graph, x-Ray photograph, are at disposal; for therapy the various forms of massage and
gymnastics, high=frequency current, alternating current etc.

Of metabolic diseases special attention is paid to uric acid diathesis (gout).

Radium. Drinking- and inhnlation-cure from the strongest Radium spiing in the
world (Brambach) are the principal therapeutic measures besides diet and application of
heat in form of hot-air treatment.

Literature: Bad-Elster, a health resort for diseases of the heart and vessels, by
Dr. Schmincke, published at Hirschwald's, Berlin 1911.

Dr. nied. R. Schmincke.

Bad-Elster (Kingdom of Saxony).

Sanitatsrat Dr. Paul Kohler, Sanatorium Bad-Elster.

Open all the year round.

Quiet and protected location amidst a large park, close to the drinking- and
bathing springs of the royal Bad-Elster.

Comfort and rest are provided for in any respect (numerous parlours, lift,
central-heating, water-pipes in the rooms, a number of rooms with separate baths and
toilets etc.).

The advantages of the climate due to the forest, to the air entirely free from dust,
the medium high situation, the calmness of air, are added to the following curative
factors :

1. All natural curative agents of Bad-Elster (alkaline-muriatic acidulous springs,
sodium-sulphate springs, carbonic- acid ferrujjinous- and mineral mud-baths).

2. In addition, the neighbouring radium spring of Brambach, the strongest radium-
spring of the world (alkaline, mineral-saline ferruginous acidulous spring with 2200 Mache-
units), used for drinking purposes, and supplying the spring emanatorium.

3. All modern scientifically approved physical methods (all hydrotherapeutic
and heliotherapeutic methods, air- and sun-baths, Swedish gymnastics, manual and vibra-
tion massage, electricity in all forms of application.

4. Individual psychical treatment.

5. Dietetic cures under the strict control of the physician as regards quantity,
form and manner of preparation (Over-feeding cure, restricted diet, diet for gout, diabetes,
renal affections etc.) — 4 Specialists.

Admission for convalescents and people needing recreation, besides

a) patients with anaemia, neurasthenia, gastro-intestinal affections (catarrhs,
constipation) heart-, liver-, and kidney-diseases, arterio-sclerosis, metabohc
diseases (gout, diabeles);

b) Affections of the abdominal organs;

196 Section 11: Eisttr — Endmidh-Bonn — Ermatingcn — Friedrichroda

c) disorders of motion in paralysis, neuraliria, spinal affection-, diseases of the
bones and joints (rheumatism, sequelae of traumatism).
Especially suita})le for cures in tlie winter (applying the curative factors of
the spa).

Total price 12 to 25 Mks. per day. — Detailed pro'^pectus on application.

Endenich-Bonn.

Private medical establishment for mental and nervous diseases.

The establishment was founded by Dr. Richarz in the year 184-i. It is situated
at the foot of the Kreuzberg. The garden encloses 10 acres and has a fine view.

Physicians: Geheimer Sanitatsrat Dr. Oebeke (for regular consultations),
Dr. von der Helm, leading physician, as well as one assistant.

Kine different buildings.

Rooms for 61 persons (ladies and gentlemen).

Terms: First class: from 13 £ 15 sh. upwards a month; second class: 11 £ 5 sh.
a month.

The establishment can be reached by tram from the station of Bonn within 10 minute-.

Prospectus to be had from Dr. von der Helm, Bonn-Endenich.

Ermatingen on the Untersee (Switzerland).

Medical New-School "Villa Breitenstein".

Topography: Beautiful family-home surrounded by shadowy parks, witii
magnificent view of the idyllic Untersee (Lake of Constance), in one of the most lovely
regions of Switzerland; situated about 1585 feet above sea level. Quiet country-life,
abundance of sun, air free from dust. Lake and large forests close by. — Ermatingen
is a much favoured climatic station and summer residence, station of tlie line Schaff-
hausen — Constance, and he id-station of steamers on the Untersee and the Rhine.

Curative means: Combination of medical and psycho-pedagogic treatment.
Individualizing psychotherapy, instruction in hygiene of life, regulation of metabolism,
tub-baths, sea and sun-baths, massage, gymnastics, occupation-therapy, games and sport,
tennis, croquet, rowing, swimming, skating, slide-driving, ski-ing. Pedagogics : Education
in occupation and self-reliance by harmonious development of all valuable functions of
the organism in the mode of a "JSiewschool". Individualizing instruction in the branches
of the lower and middle schools. Great reduction of school-time by individual teaching
and Instruction in small classes. Academically trained teacher, lady teacher with states
diploma. Intimate cooperation of physician and pedagogue.

Indications: All infantile and juvenile forms of psychoneurosis, as far as they
can be treated "openly" and influenced pedagogically. especially p=ychicKlly infirm and
bodily delicate children with a one-sided talent, tiied of school, needing recreation, finally
'Holiday-home children".

Prices: Boaiding and pension from 6 Fs. (5 Mks.) per day, according to the
age. requirements as regards physician and teacher and choice of room. "Holiday-home
children" from 5 Frs. (4 Mks.) per day. Fee for instruction 5 Frs. (4 Mks.) per week;
single hours by special arrangement.

Illustrated prospectus (in German and French) and information by the proprietor
and director Dr. med. Rutishauer, neurologist.

Sanatorium Tannenhof, Friedrichroda
in Thuringia.

. Dr. med. Ku7-t Bieling.

Sanatorium for physical, dietetic and psychical treatment.

Situation: The establishment is most wonderfully situated on the Herzogsweg 19/21
amidst a park about 2,5 acres large, directly at the grand forest; sunny and entirely
protected against winds.

Section II: Friedrlchroda 107

Accommodations: The Iwo couiitiy-Iiouses connected with one another by a
wintergarJen, are e.-tabhsheil as a first-class sanatorium witli liigh. well-venlilated,
and light rooms, all furnished most comfortably. Bath-rooms fitted up accord ng to the
most modern comfort are in the house. Air-baih and several open shelters in the park.

Winter-cures: All the rooms of the house have electric light and central-heating.
The establishment is, therefore, especially adapted for wintei -cures, the more so as there is
opportunity for winter-sport in Friedricliroda for patients wanting it. (Ski-ing and skating,
sledge-driving nnd bob-sleigh on a sledging-run 87-")0 feet and a bob-sleigh-run 7700 feet long).

Treatment; The following methods are applied: Hydrotherapy, electricity,
massage, Swedish and German gymnastics, mechanotherapy and e.xercise-
tlierapy, x-ray method, Radium-drinking and bathing-cures, Radium-Inhalation. Air-
baths, Terrain -cures; liglit-treatment, all forms of psychical treatment.

Special attention is paid to the nourishment without allowing any schematic
treatment in this direction. The diet is in general an excellent mixed food with copious
amounts of vegetables and fruits. Furthermore, any desired rational diet is provided for.
(Vegetarian diet, or food free from uric-acid, Banting-diet).

Indications: The treatment is indicated for a general inurement and strengthening
of the body, for convalescence after seveie diseases, for nervous diseases of any kind,
circulaloiy disorders (cardiac affections Sec); for diseases of the respiratory organs
(consumption excluded), chronic renal diseases; disorders of metabolism or general
.■itfectioiis, complications of muscular, arthritic or osteal affections or lesions; tropical
diseases, such as malaria and its complications; anaemia and chlorosis. Gout, Rheumatisms,
gastric and intestinal complaints.

The sanatorium is also open for people needing a change, and is recommended
especially for an after-cure or as a resting place for winter-sport.

The social life in the house is that of a convenient home-like family- life.
Prices: Lodging, full board, medical treatment, cure, heating, and electric light
12to2uMks., no extra fees being charged for medical baths, electric treatment ifcc.
The sanatorium is frequented very much in summer and winter.
Route: One stops at the railway station of Rheinhardsbrunn.
Telephone: Amt Friedrlchroda '21. Cable-Address: Tannenhof, Friedrlchroda.
Prospectus and information by the leading physician and proprietor

Dr. iiied. Kurt BieUng.

Sanatorium Friedrichroda in Thuringia,

1.500 feet above the sea level.

First class health resort for aU nervous di-eases, derangements of heart and blood-
vessels, of development and as-imilation, affection of digestion, chronic intoxication--,
general weakness and delayed convalescence after severe illnesses and operations, also an
eminently suitable place after mineral-cures at Nauheim, Kissingen, Carlsbad, Ems, Baden-
Baden, Marienbatl. All arrangements for treatment are of the highest standard and
include everything, that the present standpoint of science and hygiene ask for — even a
i^adium emanatorium ami Roentgen laboratory and the whole electric apparatus called for
now in medical cases.

The Sanatorium was subject to a tiiorough enlarging and renovation during the
winter 1911/12 and answers now without question to the higliest demands of well being.
Very comfoitalde drawing and living rooms wilh fine views from the windows, bath on
every floor, lift, Vacuum-cleaner, electric liglit. Large park with beautiful fir trees — quite
near the forest, the situation is extraordinarily beautiful, quiet and healthy in summer as
well as in winter. Opportunity for out-door entertainments and all kinds of sport.

Friedrichroda is readied by leaving the main line Berlin — Francfort Maine at the
station of Froitstedt. All further information and illustrated prospectus will be sent willingly
on application to the proprietor and leading physician

Dr. rned. Kothe, Geh. Sanitdtsrat.

198 Section II: Godesberg

Bad Godesberg on the Rhine.

Dr. Franz Muller's Sanatorium Schloss Rheinblick.

special sanatorium for Alcohol and Drug- Inebriety, Neurasthenia

and Insomnia.

The sanatorium established in 1S99 i-; a free institute for the withdrawal of
morphine (opium, heroine, cocaine, codeine, dionine, bromine, soporific drugs etc.) and
alcohol. Nervous patients (especially such suffering from insomnia) and pensioners are
also admitted. The establishment is one of the most modern, most completely equipped
and finest special sanatoria much visited and of international repute.

The sanatorium in the new Schloss Rheinblick built for this purpose is siluated
in a beautiful park, 7 acres of grounds, near the fore-it. It offers a charming view
of the valley of the Rhine (from Cologne to Bonn, to the Seven Mountains Chain
as far a-; Remagen). Most comfortable and hygienic; electric-light supply of its own,
central-heating, warm and cold water-supply tlirougiiout the house, double windows,
inlaid floor, drainage, large elegant drawing-room*, billiard-room, large resting-hall of
about 80 square yards, rooms with their own bath-room (W. C), and rooms for
servants, elegant bath-rooms etc.

The curative factors are as follows: 1. All the curative factors of Bad Godes-
berg itself: Chalybeate spring and elegant bathing-establishment (6 minutes' distance
from the sanatorium) and the climatic advantages etc. (cool in summer, warm in winter);
2 refined comfort and rest in the whole place in general as well as in the sanatorium
itself; living with people of equal breeding under the permanent supervision of the
physician (specialist); 3. most excellently trained attendants; 4. dietetic cures, milk,
feeding and reducing cures etc.; 5. hydrotherapy, elegant bath-rooms on every floor.
Porcelain tubs. Full-, partial-, and hip-baths (also with running water), foot-baths etc.;
douches, rubbings, pickings, carbon c-acid, oxygen, brine-baths, pine-needle baths etc.;
6. electrotherapy. All methods of faradic and galvanic treatment, also baths. Alter-
nating-current baths. Incandescent- and arc-light baths (blue and red); 7. manual
and vibration-massage; 8. air- and sun-bath; 9. hot-air treatment for the trunk and the
extremities, also steam douches; 10. gymnastic appliances; 11. psychotherapy and occu-
pation therapy; 12. at any time, for special cases, au horities of the near University
of Bonn.

In a practice of more than ten years the undersigned has elaborated an original
method of treating drug inebriety. This method consists in the main of two equivalent
components — viz., 1. the psycho-therapeutic and 2. the medicinal treatment.

Chief stress is laid during the whole cure upon the patients' feeling entirely well
and "at home" in their rooms as well as in the house. The refined character of the house
precludes all those well known and disagreeable harassings, and the undersigned always
takes great pains in securing by all means the comfort any visitor is accustomed to —
and more than that. The social life in the house is of a family character. The food
i< the very best, taking regard of the international character of the establishment.
Only the patient treated here knows of how remarkable a psychical influence such
a house and such surroundings are.

The sanatorium is no modern Kurhotel, and it offers only room for 20 patients;
thus the greatest attention can be paid to the individual patient. The undersigned is in
permanent contact with his patients, and can therefore always control all tlieir doings
simply by way of conversation; this will spare the patient the troublesome and often
incomprehensible and long-winded "instructions"; he is, moreover, quite unconsciously
directed to do the right thing.

Compulsion and restraint are precluded, as relapses are only pre-
vented with those who have learned in the institute to renounce the drug
voluntarily.

A permanent cure is the main final purpose of the treatment.

The withdrawal of morphine (and all opiates) is facilitated particularly by a
special medicinal treatment. It eludes from the very beginning all the symptoms of
abstinence, which could not be avoided before (restlessness, loss of appetite, insomnia,
pain and dragging in the calves and in the small of the back, diarrhoea, yawning, sneezing,
vomiting etc.).

Under the influence of the medicinal treatment applied here, the morphinist omits
the syringe at once voluntarily without having the slightest craving for it or its content.

Section 11: Godesberg 199

At the same lime liis geueral condition is usually lietter tiian at liome. In this way
complete willidiawal is attained within 4 — 6 weei^s in llie averasre. (Specially dilficull
conditions (primary diseases) may naturally delay the complete recovery, or render it
inijuissible.

Primary diseases are, of course, also considered and treated most thoroughly.

Alcohol inebriety, too, is treated by a method adapted 1o the case. See
"curulive factors" (farther above).

Alcohol is withdrawn at once under the iniluence of the method recommended
here, and of the patient's own accord. Complications are prevented ])y medicinal pro-
phylaxis. Drinks free from alcohol. In suitable cases hypnosis and method of disgust.
If desired, joining societies for abstinence.

Duration of treatment: accordin;-' to the case an average residence of G to 8 weeks
is sufficient.

Any arrangements reminding of a hotel or a hospital are by all means precluded.
The physician has no office-hours, but is in contact with the patients thioughout the day.
Every patient lives so to speak under the eyes of the doctor. The sanatorium offers thus
a true home-life, but notwithstanding provisions are made, and all the means supplied lor
devoting the most thourough and up-to-date cure even in severe cases. The sanatorium
is, therefore, [jarlicuhirly suitable for the treatment of neurastiienics needing quite a
special nursing, or showing insonmia as the most tormenting symptom.

Pensioners are also received.

Terms: 16 to 20 Mks. incl^usive per day and room according to treatment and
requirements, medicine excepted. Complete flats with private bath-room or servants'
room according to arrangement.

Detailed information and elaborate illustrated prospectus gratuitously and free of
charge on application to Dr. Franz H. Miiller.

Godesberg near Bonn on the Rhine.

Dr. R. Schorlemmer's Sanatorium

for Gastro-Intestinal and Metabolic Diseases.

Topography: Godesberg is situated 227,5 feet above the level of the North-Sea
at 24,45 '^ eastern longitude, and 50,41 ^ northern latitude. Owing to its most charming
location, it is one of the finest places on the Rhine, and is resemblinij a large garden with
well-kept, shadowy roads and avenues. The beautiful views of the "Godesburg"
and the Seven Mountains Chain add to the pleasant character of this garden-town.

Climatic details: According to many years' observation, the temperatures in
winter are the lowest of Germany: in summer they are mostly below 25 '^ C = 77,0*' F;
there are about 00 rainy days during the year.

Dr. Schorlemmer's Sanatorium is located in the country-house quarter, inthe Rheinallee,
one of the finest streets of Godesberg, at about 10 minutes' distance fromihe steam-ship station,
from the railway-station, and from the Rhine-promenade which extends for 4 kilometres. It
stands entirely isolated amidst a shadowy garden, remote from any disturbing noise. The
principal establishment rebuilt in 1905 06, and the "Dependaiice" established in 1908, answer
any demands as regards hygiene and comfort. Electric light, central heating, vacuum-cleaner,
stuffed double-doors, Saluhra wall-paper to be wa^^hed off in all rooms, balconies in most of
the rooms. The establishment offers hygienic accomodations and a home to a
limited number of patients (35) of best classes. It maintains the pronounced feature
of a most comfortable, home-like, and refined residence; but at the same time it offers
all the advantages of a hospital equipped according to the most approved experience,
without showing at the first glance the character of such, neither inside nor outside.

Medical appliances for diagnosis and treatment: 1. The laboratory is equipped
according to the most approved scientific experience, with all the auxiharies required for
an exact microscopic-histological, chemical, and bacteriological diagnosis. There are also
apparatuses for any kind of applied electricity, vibration- massage, translumination of the
stomach, intestines and oesophagus, and for a thorough examination of metabolirm and
blood. 2. The Roentgen-laboratory with the complete equipment for photos, fluorescence,
radiation and radiometry of in lividual organs. 3. The bath-rooms are most completely
furnished. — Porcelain-tubs, douches of any degree of temperature, Scotch douches,
full- and hip-baths, caibonic acid and steam baths, baths with medicinal additions,
light-baths, electric four-cell and electric full-baths with faradic, galvanic, and pulsating

200 Section II: Godesherg — Hohenhonnef — Hornegg

continuous current, with alternating and sinusoidal faradic current. Appliances for
massage. Packings. Bier's heat-boxes. 4. The orthopedic room with universal apparatus
for rowing-^ climbing- Sec. movements, witli Ergostat for an exact dosage of work.
Velolrab for riding motion, apparatus for improving disorders of gait in spinal affections:
appliances for general gymnastics, sach as dumb-bells, clubs &c. h. Resling-hall, for
open-air cures. 6. An operai ion-room with north- and top-light, and the adjoining
rooms for physicians for sterilizing and washing.

Diseases treated here: Admittance exclusively for patients with affections of the
oesophagus, the stomach and intestines, of organic and nervous origine, affections of
the liver and gall-passages, of the pancreas, patients with diabetes and gout: determination
of tolerance, for anaemic and for convalescents after operations on the digestive tract. —
Feeding and reducing cures under control of metabolism.

The establishment is open all the year round.

Charges for board and lodging: These are from 15 Marks upwards per day
according to size, appointment, and position of the room, including electric light, healing,
nursing, massage and packings Special prices for a second bed. Beverages are chargiid
extra. Rooms are to be paid for from the day on which reserved. Notice to be given
in the office five days before departure. Bedioom with bath and parlour can also be
provided if desired.

Baths and Rontgen-lreatment according to tariff, night-watch and extra nurse
likewise.

Honorarium for physician: First examination^ including chemical analysis, and
fixing plan of cure Mks. 20. — For the rest, the honorarium is fixed according to the service
in the individual case: it is to be paid at the end of the cure.

Besides the dining-room, a drawing-room, winter-garden, and a smoking-room are at
the disposal of the guests, likewise comfortably furnished halls on every floor and
a billiard.

Kurtaxe: During the months of May to September the community of Godesberg
charges a Kurtaxe of Mks. 9, and Mks. 3 for each additional person of the same family:
where as visiting the concerls, kur-park and reading rooms, are free of charge.

Protestant, Roman-Catholic and Anglican Church at the place, synagogue
at Bonn.

Godesberg is a railway station on the left bank of the Rliine, 10 minutes from
Bonn, 40 to 50 minutes from Cologne and 60 minutes from Coblen/. Station of the
Cologne— Diisseldorf steam-ship company; communication with Bonn and the Seven
Mountains Chain also by branch-line, within half an hour; electric branch-line is being
prepared. Access to the Seven Mountains also from Godesberg by crossing on an
electric ferry.

Illustrated prospectus in three languages free on application.

Detailed information most wiHingly given by the leading physician and proprietor

Dr. B. Sdiorkmmer.
Specialist for gastro-intestinal and metabolic diseases.
Dr. C. UliI, second physician.

Hohenhonnef on the Rhine, Seven Mountains Chain

Sanatorium for Lung-Diseases.

Leading physician: Prof. Dr. Meissen.

Sanatorium Schloss Hornegg.

Establishment furnished witii modern comfort, conducted like a clinic, with all
provisions for the treatment of nervous and internal diseases, especially cardiac anol
gastro-inlesiinal affections. Psychotherapy, and all physical and dietetic methods.
Charmingly situated in the pleasant richly wooded valley of the Neckar-river, near Heidelberg.
English speaking pliysicians and attendant.

Price from Mks 14 per day upwards all included. See prospectus.

Leading physician San Rat Dr. Roemheld, lor many years clinical assistant at
Heidelberg.

Section II: Ilowbtirg

201

Homburg v. d. Hohe.

Sanatorium Drss. Pariser-Dammert (Clara Emilia).

special Sanatorium for Gastro-Intestinal and Metabolic Diseases.

The sanatorium of Drss. Pariser-Dammert is known to be a special institute
for the treatment of all gastro-intestinal diseases, and disorders of
metabol'sm as well as of general nutrition.

Besides local diseases of ths stomach, the intestines, liver and bilious affections,
the following conditions enter into coTisidera'ion: general subnulrition (feeding cures),
iimemia, nervous prostration, obesity, (reducing cure), diabetes^ gout, anaemic affections,
and diseases of the vascular system.

Apart from this special domaine, however, the sanatorium receives and treats patients
suffering from any internal disease, and convalescent^.

In addition to the baths and springs of Homburg and all the curative factor.? of
this place itself, all the scientifically approved therapeutic methods are applied, and great
care is devoted to an individuahzing treatment of every disease.

Especial attention has been paid to the application of strictly
scientific dietetics provided for in a kitchen under a special conduction.
The daily diet is known to be prescribed in every detail by the physician.

Strictly scientific laboratory, examination of anomalies of metabolism, gout,
diabetes &c.

Roentgen-laboratory with mo-t modern equipment. Furthermore, in addition to the
medicinal treatment indicated, physical therapy of all kinds is applied according to
individual inilication. We mention of the latter:

Electricity in all approved forms, hydrotherapy, hot-air treatment, fango- and
Homburg clay-mud treatment, massage, inhalations in a special inhalatorium, radium-
emanatorium, gymnastics and exercise-therapy.

■20i

Section II: Homburg

The sanatorium is located at one of the finest spots of Homburg, remote from
the noise and dust of streets; it offers an open view of the Taunus. The house is
close by the grand Haardtwald and the Kurhaus with its parks, and owing to this favourable
location, the springs and baths of old repute can be used most conveniently.

The sanatorium is thoroughly fitted up according to a refined comfort, especially
adapted for those needing recreation: low-pressure steam lieating and porcelain stoves; —
electric light in every room to provide sufficient comfort; — double doors and muffled
wails; — model baths — ■ and douches (separate departments for ladies and gentlemen) &c., &c.

A park-like garden more than six acres large, with fine old groves is adjoined to
the sanatorium. Open, half-open, and entirely closed resting-halls and
colonnades give opportunity for staying in the open air, and for resting cures even in the
late autumn and Avinter in unfavourable weather.

The results of cure are independent of the season.

Medical treatment by the undersigned physicians.

Assistant, trained attendants.

Prospectus and information by the office of the establishment.

Dr. Curt Pariser and Dr. Franz Dammert.

Homburg vor der Hohe.

Sanatorium of Dr. Baumstark.

The etablishment is most favourably located in the south, free on all =ide-, in rai
old and very quiet paik of about 18 000 square yards belonging to the sanatorium. It
is, neveriheless, but a few minutes distant trom the springs, tlie Kurpark and the Kurhaus.

The house is supplied with all modern comfort, as lift, central-healing, vacuum-
cleaner, running warm and cold water in the bed-rooms, ventilation for every room,
balconies and verandas for restingcures, fine drawing-rooms (Sec, and furnished most
comfortably without being excessively luxurious. Curative factors are the well-known
invigorating and refresljing climate of Homburg, the mineral-waters, the natural carbonic
acid baths, the mud-baths kc.

In addition, the sanatorium is equipped with all the appliances lor any physical or
dietetic method, as for example all balneological, hydro-, electrotherapeutic appliances.

Section 11: Homburg — Interlaken — Kaltenleutgeben — Kissingen

203

massage, gymnastics, Ronlgen-cabinet, sun-bath, Radiumenianatorium. Especial stress ia
laid upon dietetics on a scientific basis adapled to the individual case.

The sanatorium is, therefore, indicated lor all people needing recreation and for patients
with any internal disease (excepted tuberculosis), especially gastro-intestinal diseases,
disorders of metabolism, obesity, diabetes, gout, rheumatism, for nervous patients, for
feeding and reducing cures.

Prospectus by the bureau.

Dr. vied. K Baumstark,
formerly Assist.-Phys. to Geh. Rat Erb-Heidelberg,
Geh. Rat Ewald-Berliu, Prof. A. Schmidt-Halle.

Kurhaus Beaulieu at Interlaken.

2000 feet above sea level.

For recreation, dietetic- and alpine-cures.

2 country-houses
in a quiet location with
large parks for subalpine
lesling- and climatic -
cures, anaemia, general
asthenia and convales-
cence. Rational dietetic
and physical cures
for disorders of
digestion, for ner-
vous (Grave's- disease),
renal and metabolic
affections (diabetes, gout,
albuminuria), for Weir-
Mitchell and Banting-
cures. Oertel-cures for
cardiac affections and
asthma. Hydro-, bal-
neo- and electrotherapy.
Modern comfort. — Ceiitral heating. Open all the year round.
Prospectus are sent free on application to

Dr. E. A. Grandjean, leading physician.

Hydrotherapeutic Institute Kaltenleutgeben.

Hofrat Prof. Dr. W. Winternitz.

The institute of old repute founded by Hofrat Professor Winternitz in 186.5, has
rooms for more than 300 persons. Provisions for all physical and dietetic therapeutic
methods. The establishment is situated in the beautiful Wienerwald, at 40 minutes'
distance from Vienna.

The institute is visited by high class native and foreign people, and has obtained
a world-wide reputation on account of the strictly scientific conduction and the individualizing
therapeutic methods.

Hofrat Professor Dr. W. Winternitz is the consulting physician. Professor Dr. Alois
Strasser leading physician, and Kais. Rat Dr. Carl Pick superintendent physician.

Bad Kissingen.

Hofrat Dr. v. Koziczkowsky's Sanatorium

for Gastro-intestinal-, Nervous-, Cardiac- and Metabolic Diseases. Open from March to
November.

Prospectus free of charge on application to

Hofrat Dr. v. Koziczkowsky.

204

Section II: Kissingen

Bad Kissingen.

Prof. Dr. C. Dapper's Sanatorium "Neues Kurhaus".

Especially i'or gastro-intestinal diseases*), for disorders of inetaholism
and of nutrition (diabetes, gout, obesity*), anaemia, for functional and
oriranic heart- and vascular-diseases , for chronic renal affections*), and

disorders of the
n e r V o u s s y s t e m f n e u-
r a s t h e n i a. migraine,
neuralgia, sciatica)
elc. Sliictly individual
dietetic treatment
and care according to
scientific demands. A]i-
plication of all scieoli-
lically acknowledged
Iherapeutic methods,
ilieteti'^ and Oertel-cures.
electricity, baths and
douches of any kind,
^^ymnastics, massage
only by physician), in
addition to all the
I'urative factors of
Kissingen.Reducing-
cures wilh exami-
nalion of metabolism la
the completely equipped
laboratory of the sanatorium. Feeding-cures. The sanatorium rebuilt entirely in 1893, is
located at one of the finest spots of Kissingen, at the fool of the Stalionsberg and the Boden-
laube, close to the Kurgarten, surrounded by a large garden of 15 acres. The elevated
location allows a wonderful view of the valley of the Saale river and Ihe Rhon-mnuntains.
The four country houses are connected with one another by a closed colonnade, well-
heal able for the greatest part. For the purpose of a convenient cure in spring and
autumn all rooms of the new villa, the drawing-rooms, the corridors, the large veranda
and the colonnade are provided with central-healing. Electric light everywhere. Special
house, built and equipped on the most recent scienlific principles and experiences, for
the application of the entire field of physical therapy. There are in this house appliances
for carbonic acid-baths, for brine- and pine-needle batlis. Arsonvah'zation and Franklinization,
elecliic alternating- and four-cell baths, galvanic and faradic baths, electric-lijht and steam-
baths, appliances for all kinds of tempered douches, half- and full-baths, flowing tempered
foot- and hip-baths, fango-treatment and inhalation in separate cabinets; room for Zander-
gymnastics and exercise-therapy. Radium-Inhalatorium and Roentgenlaboratory. Open from
March to December.

Physicians Dr. E. Jflrgensen (foimerly private Assistant to Professor von Noorden
Vienna). Dr. F. Tecklenburg (for many years Assistant to Professor Fleiner, Heidelberg)
and Professor Dr. C. Dapper, koniglich bayerischer Hofrat, Grossherzoglich Olden-
burgischer Geheimer Medizinahat (Proprietor).

*) See: "Ueber den Slofifwechsel bei Entfettungskuren" von Dr. C Dapper, Bad
Kissingen; Zeitschrift fiir klin. Medicin. Band XXIII. 1 — 2. und "Ueber den SiolTwechsel
fettleibiger Menschen bei Entfettungskuren"' von Prof. v. Noorden, Berlin, und Dr. C. Dapper,
Bad Kissingen; Berliner klin. Wochenschr. 1894, No. 24 "Untersuchungen uber die
Wirkung des Kissinger Mineralwassers auf den Stoftwechsel der Menschen" von Dr. C. Dapper,
Bad Kissingen; Berl. klin. Wochenschr. 1895, No. 31. "Ueber den Einfluss der Kochsalz-
quellen (Kissingen, Homburg) auf den Sloffwechsel der Menschen" und "Ueber die so-
genannte kurgemasse Diiil" von Dr. C. Dapper. Bad Kissingen (see reprint from Zeitschrift
ffir klin. Medicin. Vol. 30. No. 3—4. 1896) "Ueber Entfettungskuren" Ton Dr. C. Dapper,
Bad Kissingen: Archiv fiir Yerdauungskrankheiten 1897; "Ueber die Indicationen der
schwachen Kochsalzquellen (Kissingen. Homlnirg) bei Augenkrankheiten" von Dr. Carl
Dajiper, Bad Kissingen; lecture delivered on the 17 1'> Congress of internal ijiedicine at
Carlsbad 1899, and Berliner klin. Wochenschr. 1899, No. 39. "Ueber die Schleimkolik

Section II: Kissingen 205^

des Darnis (colica mucosa) und ilire Behandlung"' von Prof. Carl v. Xoorden uml Dr. Carl
Dapper 1903; published by A. Hirschwald. Berlin. "Ueber den Einttuss vermehrler und
verminderter Fliissigkeitszuiuhr auf die Punktioii erkrankler Nieren". Beitrag zur Diiitetik
der Nierenkrankheiten von Dr. C. Dapper, Kissingen. und Dr. L. Mohr, Zeilsehrift fiir
klin. Medicin. Vol. 50, No. 5 — 6. "Ueber den Einfluss der Kochsalzquellen (Kis.singeu,
Hoinburg) auf den Sloffweclisel des Menschen" von Carl Dapper, Bad Kissingen. No. 5
of ,,SanimIuDg klin. Abiiandlungen iiber Patliologie und Therapie der Sloffweclisel und
Ernahrungsstorungen" von Professor v. Noorden. Published by A. Hirschwald, Berlin 1904.
,Der Einfluss der Mineralunsser auf den Stoffwechsel" von Carl Dapper und Carl
V. Noorden. Handbuch der Pathologie des Sloffwechsels. Vol. II, Berlin 1908. Published
by A. Hirschwald.

Bad- Kissingen.

Sanatorium for Internal Diseases, of Hofrat Dr. Dietz, formerly

'Tneumatische Anstalt".

Sanatorium especially for affections of the air-passages (nose, tiiroat, lungs, asthma,
and complications of influenza), diseases of the heart, the stomach, intestines, disorders
of metabolism (obesily, gout, diabetes), and for nervous affections. Application of all scientifically
approved physical and dietetic methods.

Curative factors; Large, high, and well- ventilated inhalation-rooms for inhalation
in common, separate inhalation-cabinets, direct inhalation-apparatus according to the most
various systems, oxygen-inhalations, pneumatic apparatus, especially pneumatic chambers
with patented contrivances for exhaling into rarefied air, gymnastic appliances, appa-
ratus for electromassage and vibration, general and local electric light-baths, electric
four-cell baths, apparatus for general and local application of high-frequency currents-
(Arsonvalisation), thermopenetration, radium-, drinking-, bathing- and inhalation-cures,
entirely new Rontgen-Laboratory for distance, and instantaneous-photographs for exactly
determining the borders of the heart etc., cai'bonic-, acid-, oxygen- and pine-needle baths,
laboratory of the sanatorium with modern equipment for chemical and microscopical
examination of urine, gastric contents, blood, and faeces etc. Feeding- and reducing-
cures wiih examinntion of metabolism. Great stress is laid upon dietetic treatment.
Pension with room from Mks. 9 upwards.

Tuberculous and insane patients are not received.

Detailed information by the owner and leading physician Hofrat Dr. Dietz or the
assistant physicians Dr. A. Dietz II, Dr. B. Dietz III.

Bad Kissingen.

"Neues diatetisches Kurhaus und Kuranstalt" of
Hofrat Dr. E. Marquardsen

(formerly first Assistant to the Medicinal Clinic of Jena, to the Gynecological Clinic of the
University of Wurzburg, and to the Diakonissenhaus of Geheimrat Kussmaul and

Professor Fleiner of Heidelberg.)

The Sanatorium newly built in 1901/2, is located at the foot of the Altenberg,
the forests of which are extending down to the garden of the establishment. The rooms
and balconies of the sanatorium offer a magnificent view over the whole valley of the
Saale-river and the old castle-ruin. The establishment can be heated in all parts. It has
a moderately elevated situation in a quiet place, conveniently close to the Kurgarten
and the springs.

The house answers to all requirements of an hygienical order and is fitted with all
modern comforts desired. A lift supplies direct communication from the rooms to the
baths, douches, Veranda for open-air cures &c. &c.

Modern appliances based on the most recent scientific experiences and principles
are to be bad: half-baths, hip- and full-baths, steam-baths, exactly tempered
douches and electric baths of any kind.

The treatment is strictly individualizing, taking into consideration all the
approved and scientifically acknowledged methods, and the rational application of the
curative factors of Kissingen. Most careful dietetic treatment according to the individual

206 Section II: Kissingen — KreuzUngen — Kreuznach

case. Oertel-, feeding- and reducing-cures (.special laboratory for examina-
tion of metabolism in tbe institute), massage and electricity.

Indications for cures are i^iven concerning all diseases of the stomach
and intestines, of metabolism and the blood (diabetes, gout, obesity,
reducing-cure), anaemia, functional and organic affections of the heart and
disorders of the nervous system (neurasthenia, sciatica, neuralgia and
migraine). Furthermore are received convalescents after diseases, and persons with
subnutrition.

The establishment is open from April to November. For further details see
prospectus. Hofrat Dr. E. Marquardsen.

Bad Kissingen.

Hofrat Dr. Leusser's Sanatorium "Villa Thea".

The ,'=anatorium is open for patients suffering from cardiac- and gastro-
intestinal diseases, disorders of metabolism (diabetes, gout, rheumatism,
anaemia and obesity), renal- and nervous affections, and for people needing
recreation. — Strictly individualizing treatment and application of all suitable scientific
methods such as electricity, hydrotheiapy, massage, gymnastics, dietetic cures
(feeding and reducing-cure), and Oertel-cures, besides the approved mineral waters
of Kissingen. Quiet location, free from dust, in a large and shadowy garden close
to the baths, the springs, and the promenades. Modern comfort.

Open from April to November. — For further details see prospectus.

Kreuzlingen, Sanatorium Bellevue.

Dr. Binswanger's Sanatorium, founded in 1857.

Leading physician: Dr. Ludwig Binswanger. Superintendent physicians
Dr. Haymann, Dr. Reese, one assistant. Manager: Dr. phil. Otto Binswanger.

Combined institute for nervous and psychical disease-. Sepnrate country-house
system, allowing the thorough separation of the various forms of diseases. Seven villas
for neurosis, nervous prostration, slight depressive conditions and convalescence. Three
villas for psychical afflictions. Complete equipment for hydro-electrotherapy, gymnastics,
massage, sea-baths, garden-work, weaving etc. Intimate family-life. Price of pension
including medical treatment, heating and light, excluded under-ware and medicine, sh 12
per day (Frcs. 15), rooms from sh 2 upwards. Private nurse, if necessary, sh 6
per day (Frcs. 7,50). For drawing-rooms or several rooms special terms.

Address: Kreuzlingen, Canton Thurgau, Switzerland.

Haus Bartenstein, Bad Kreuznach.

Home of Recreation for Children.

Newly built house located on a plateau close to the graduation-works, well-pro-
tected, with all modern hygienic provisions, such as drainage, central-heating, electric
light, vacuum-cleaner free from dust etc. Large park witli playing grounds belonging
to the iiouse; furthermore playing -rooms, winter-garden, inhalatorium for dry inhalation,
room for athletics, and fun-baths.

Admittance of sickly children or such needing recreation, alone or accompanied by
relatives. Contagious diseases not admitted.

Curative factors: Brine-baths with Kreuznach mother-lye, radium-baths, brine
and radium drinkiiig-cures, inhalations, dietetic and resting-cures, massage and gymnastics.
Opportunity for school-instruction.

Season throughout the year. Ow-ing to the favourable southern situation, where the
almond is growing, cures are also taken most successfully in the winter. Price of pension
from Mks. 5,50 upwards.

Detailed information by prospectus. Dr. Bartenstein, Pacdiater.

Sektion II: Kiisnacht — Leipzig-Lindau — Leysin 207

KUsnacht on Zurichsee.

Dr. med. Th. Brunner's Sanatorium for Nervous and
Psychical Diseases.

Located close to the bank of the lake, t-urrounded by shadowy parks with lontj
promenades and a wonderful view of the mountains. The sanatorium serves tor the
treatment of nervous and psychical diseases, for people needing recreation and attendance,
and for convalescents of the upper classes. Treatment of people suffering from Morphia
and Alcohol Inebriety. Individualizing special treatment. Clountry-house system. Modern
hydrotheiapeutic equipment. Sea-, air- and sun-baths. Two physicians. Open all the
year round. Price altogether from Frs. 12 upwards. Illustiated prospectus with references.
Dr. med. Th. Brunner, leading physician and proprietor.

Leipzig-Lindenau.

Sanatorium for Cosmetics, Diseases of the Skin and Hair.

Dr. med. Jhle and Dr. med. Bottger.

Careful special tieatment. Best attendance. Large establishment consisting of three
country-houses standing amidst»park-ground3. Lawn-tennis, gondoling, billiard &c.
Detailed illustrated prospectus free.

Alpine Health Resort for Chest Complaints of Leysin

open air Establishments.

The four following establishments are owned by the Societe de la Station
climaterique de Leysin (President Dr. Morin).

1. Sanatorium Grand Hotel.

Excellent establishment (5075 feet above sea level) at the border of the forest,
facing the south, and entirely protected against north and east winds. Large veranda
with "splendid view to the Rhone-Valley, the Mont Blanc range and the Dents du Midi.
180 rooms and sitting rooms, very comfortable apartments.

Bath-rooms and shower baths. Private verandas for each room facing the south.
La rye open ah tiaJleries, solaria, central heating and electric light, lifts, excellent ventilation,
luxuriously furnished winter-garden, large library, billiards. Excellent cooking. Tennis-
ground and skating-rink.

Prices: From 12,50 to 25 Frs. per day, including room, board, heating, light, and
medical treatment.

Physicians: Leading physician: Dr. .Jaquerod; Assistant: Dr. Mamie; Manager:
Mr. J. A. Bossi.

2. Sanatorium du Mont-Blanc.

Large establishment next to the railway-station and the post-office. 140 rooms
and parlours, good ventilation, central heating, electric light, lift. Fine winter-garden, open
air galleries in direct communication with the principal building. Numerous shops, hair-
dresser, noted for its cooking, library, billiard, tennis. Large skating-rink close by.

Prices: From 11 to 16 Frs. per day including room, boarding, heating, light, and
medical treatment.

Physicians: Leading physician: Dr. Meyer; Assistant: Dr. Tecon; manager:
Mr. J. Rubli.

3. Sanatorium du Chamossaire.

Large establishment -with 150 beds, furnished simply but comfortably. Beautiful
situation facing the south. Magnificent veranda near a pine-forest. Central heating, lift,
electric light, broad open air galleries and private verandas. Library, billiard, good cooking.

Prices: From 9 to 13 Frs. per day including room, boarding, heating, light, and
medical treatment.

Physicians: Leading physician : Dr.Sillig; Assistant: Dr. Roule; manager: Mr. Hasenfraz.

[08

Sect' on II: Lei is in

Liebenstein

4. Sanatorium Anglais.

Recently opened establishment, furnished accordinp^ to the latest hygienic demands.
]">() beds. Baths and douches. Private verandas and common open air galleries Solaria.
Excellent cooking, partly worked by steam; central-heating, lilt, electric light, library,
English billiards.

Large hall with magnificent panorama.

Prices: From 12 Frs. including room, boarding, heating, light, and medical treatment.

Physicians: Leading pliysician: Dr. De Peyer; Assistant: Dr. Dieudonne; manager:
Mr. A. Genelin.

Sanatorium Liebenstein

At Bad Liebenstein, TliUringer Wald.

Proprietors Sanitatsrat Dr. Fiilles and Dr. Otto Meyer.

Clinically conducted Sanatorium for Physical, Dietetic
and Psychical Treatment.

Situation: At the southern slope of the "Thiiringer Wald"', I'iSS feet above sea level,
in a most favourably situated scenery close to the forest, stands the sanatorium amidst a
park of its own. Wonderful surroundinirs with many pronionndo.q and roads.

Climate: Pure
forest- air free from
dust. Spring is
beginning early;

summer with me-
dium temperatures
and always cool
nights; autumn of
long duration; mild
winter w ith snow for
two to three months.
No fog at all. Owing
to the favourable
climatic conditions,
the health-resort is
equally suitable for
all seasons. Useful
transitional station
for patients coming
from the south.

Curative factors:

The sanatorium pre-

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tSanatonum Liebenstein

sents itself now as the type of a sanatorium on a broad scale, with

therapeutic appliances, its principal aim being a combined and strictly individualizing

treatment of its patients under the special consideration of modern methods of treatment.

Large and. light bathing-houses with all contrivances of modern hydrotherapeutics.
Larce air-bath with swimming-tank of about 220 square yards, sun-baths. Large resting-
halls and balconies. Gardens for garden-working. Work-shop for applied art under expert
conduction (metal-work, tarso-teclmique, wood-carving, painting, book-binding etc.).
Gymnastic cures (training of nerves and organs, individual gymnastics). Electiic cures
(all methods of apitlying the elecliif current). Rontgen-cabinet. Dietetic cures of all kinds
(feeding and reducing- cures, metabolic-diet). Massage. Air-, light-, open air resting-
cures. Resling-cures, exercise-cures. F^sycbical treatment. Application of the powertul
carbonic acid ferruginous-arseniale spring of Liebenstein, for bathing- and drinking-cures.

Indications: All curable functional and organic nervous disea-es, as neurasthenia,
hysteria, hypochondriac prostration, depressive conditions Neuralgia. Tabes, Grave's
disease, chorea, migraine, paralysis etc. — Anaemia. — Organic and nervous heart-
affections of any kind. — Gastro-intestinal disease-, such as chronic catarrhs, ulcer of the
stomach, constipation, — Subnutrition, obesity, gout, diabetes, renal affections, rheumatic
affections.

Sektion II: Liebenstein — Lindmfels — Lucerne {Switzerland).

'im

Insanes, epileptics and tuberculous patients are not admitted.

Very suitable station for cures after Kis.<ingeri, Carlsbad, Marienbad etc.

The sanatorium is open all the year round.

Leading physicians: Sanitiitsrat Dr. Fulles, neurologist; Dr. Meyer, neurologist.
Dr. Strassner, specialist for internal diseases.

German, Russian, French, and English spoken.

Terms: Price of pension (including board, meals, treatment and baths) Mks. 10 to 18
per day according to choice of room. From October 1st to March 31st a iQ per cent,
reduction.

Communication: Visitors coming from England and Amerika take the line Hamburg
or Bremen — Hanover via Eisenach — Immelborn, coming from South-Germany via
Meiningen — Immelborn to Bad Liebenstein.

Large detailed prospectus sent free of charge on application to the leading
physicians.

Kurhaus and Sanatorium Lindenfels

between Darmstadt— Heidelberg, 1400 feet above sea level, in the most beautiful forest

district of the Odenwald.

Most modern comfort, all curative factors at disposal. Electric light, central
heating. Large park and own fine timber-forest. Most favourable station for diseases of
the nervous system, of metabolism, of the heart (especially suitable for a cure after a
stay at Bad-Nauheim or Wiesbaden), and chronic internal diseases, (tuberculosis excepted).

The establishment is open and frequented all the year round. Moderate rates.
Prospectus. Sanitdtsrat Dr. Klaus Schmitt.

Pension Villa Maria.

Lindenfels.

First-class hotel, open all the year round. Most modern comfort. Electric light,
central heating. Price: IVlks. 4.50 per day. Prospectus.

Sanitdtsrat Dr. Klaus Schmitt.

Sanatorium Kurhaus Sonn- Matt, Lucerne
(Switzerland).

525 feet above the Lake of Lucerne — 2100 feet above the sea level.

Open from April to November.
Absolutely quiet location, free from dust, amidst meadows and forests. Extensive

view of the lake and
the mountains.

200 000 square
metres of own pro-
priety — 10 minutes'
drive by auto to the
station. 80 beds.
Home-like comfort
— Perfect sanitary
conditions.

The establish-
mentisconducted
by physician. It is
fitted up particularly
for physical the-
rapy and dietetic
cures.

Large bathing-
house (hydrotherapy,
massage etc.). Air-
and sun-bath.
Individualizing treatment of metabolic disorders: Obesity, Gout, Diabetes.

14

210 Seclion II: Lucerne (Switzerland) — Mammet-n {SwitzerlavdJ — Meran

Diseases of the Circulatory and Digestive Organs: Cardia; affections, incipient
arleiio-sclerosis, gastro-inteslinal disorders, liver affections and bilious diseases. Nervous
Affections.

Pleasant home for convalescents and recreation.

Persons suffering from infectious diseases and insanity are nol received.

Prices: Pension (room, meals, light and healing) from Frcs. 10 per day upwards.

Cure : Frcs. 25 per week.

Detailed information by prospectus.

Leading physican: Dr. Heinrich Hots.

Hydrotherapeutic Institute Mammern (Switzerland).

Sanatorium for Nervous and Internal Diseases.

The well-known and comfortably furnished establishment is standing on the nio-st
charming spot of the Untersee (Lake of Constance), at the foot of a forest-clad mountain-
crest rich in castles, and surrounded by a very large park washed by the waves of the
lake. (1435 feet above sea level.) In H)01 a villa was built in order to have a great
number of very quiet rooms at disposal for patients particulary sensible to noise, and for
persons wishing to live as quietly as possible. Tills villa, most wonderfully located at the
lake, is provided with all modern comfort and answers the utmost requirements.

The climate of Mammern is of a subalpine character, the sea-air is very pure and
free from dust. The following curative factors come into consideration: scientific
medical treatment in general; all the methods of hydrotherapy with all modifications in
an absolutely mild and sparing treatment; carbonic acid baths, electricity (electric baths),
hght-baths, massage (vibration-massage), gymnastics, exercise-therapy, diet, rational mode
of life, roads for Oertel-cure, psychical treatment, great attention paid by the family to
cooking and nutrition.

Corresponding to these curative factors, treatment is indicated for the most various
nervous disorders, such as nervousness, neurasthenia, hysteria, organic diseases of the
nervous system, neuralgia, spasms, neuritis, pal^y, spinal affections, Grave's disease,
furthermore anaemia, chlorosis, scrofula, delayed convalescence, intermittent fever, rheu-
matism, inclination for catching cold, catarrhs, digestive disorders, nervous dyspepsia,
chronic constipation, chronic inflammations and relaxation of the abdominal organs, neurosis
of the heart, and degeneration of the heart, arterio-sclerosis, obesity, gout, diabetes, renal
affections, disorders and insufficiency of the sexual organs.

Proprietor and leading physician: Dr. Oskar Ullmann.

Price: Frs. 10 to 12 per day.

Life at Mammern is very home-hke, but not noisy. Opportunity for various and
and well paying excursions in the vicinity, by foot, by carriage, steamer or railway.

Mammern is a station of the line Ztiricb — Schaffhausen — Constance. Steam-ship
station of the line Constance — Schaffhausen.

Detailed prospectus free of charge on application.

Dr. Binders Sanatorium *'Stefanie" at Meran

for Physical and Dietetic, Open-Air and Oertel-Cure.

Season from September l^t to June 1st.

Climate and Topography: The magnificent climatic advantages of Meran, such as
intense insolation, great dryness of air, protection against winds and subalpine location
(1000 feet above the Adria-Sea) permit of the most thorough application of all
methods of mechanical treatment during the whole winter, and especially the use of
liydrolherapy and all medicinal baths, as well as of open-air and sun-cures in any form.

Owing to the favourable topographical conditions of Meran, to its situation at the
slope of the gigantic mountain crests, owing to its splendid promenades, roads, and paths,
partly smooth and partly gently ascending, made in the course of decades at great
expenses, Oertel-cures for strengthening the cardiac muscle, respiration, and for stimulating
metabolism can be carried out in the most variable way and with the minutest dosage.

Advantages of the Sanatorium treatment: These exceedingly favourable climatic
and topographical conditions warrant the most remarkable curative results obtained in a

Section II: Meran 211

great number of diseases by a systemalic dietetic and mechanical treatment in the satia-
toriuin; nay, there are even affections and diseases for which a permanent medi'jally
superintended Oertel cure, a control of the effect of the climate and of the diet, are a
conditio sine qua non; such cases being left to themselves and to the exerting lite in
a hotel, will surely derive little advantage, sometimes even suffer harm, from a slay at
the health resort.

Provisions of the sanatorium. The sanatorium "Stefanie" established in 1903 and
renovated according to the most up-to date requirements in 1910. coml)ines the most
modern comfort of a hotel with the most practical and hygienic provisions of a sanatorium.
It stands in a somewhat elevated local on, remote from the street to Obermais, opposite
the parks of the Archduchess Valerie. Towards south is extending the park of the
sanatorium itself, about 10000 square yards large, by which an abundance of air and sun
as well as beneficial rest are provided for.

Two reception-halls, Avaiting-rooms, well-ventilated rooms for cure, bath-rooms and
gymnastic-halls in the ground floor. Larger diuing-room, lunch, reading, smoking room,
and a conversation-ball in the first floor. All this serves for the comfort and the recreation
of the visitors

There are in the establishment, including a d^pendance, 55 most comfortably
furnished rooms for patients, also separate apartments with parlour, bath-room and
W. C's. Double doors, double windows, Venetian and outside-blinds, fine roofed and open
balconies, comfortable berths for an open-air bath, linoleum flooring, electric light, vacuum-
cleaner, warm-water central heating, hot water everywhere, lift, noiseless management,
central ventilation.

Diet and attendance. Chief stress is laid upon palatable cooking on hygienic
principles. Only first-class eatables are used, and the kitchen of the establishment can
meet the most complicated dietetic requirements.

Normal rationally mixed meals are prepared as well as half vegetarian, lac o-
vegetable, and strictly vegetable diet, pure milk-cures, diet for diabetics, dry diet and
food poor in fat; furthermore diet for reduction of food, for .seoere anaemia, for gastro-
iiise^rtinal diseases, for renal affections, and for uric acid diathesis. Grape-, fruit-, and
yoghurt cures are also carried out.

Curative factors. The following physical curative factors of the sanatorium are
provided for:

1. Most up-to date hydrotherapeutic appliances, separate for ladies and gentlemen.

2. All modern medicinal baths as radium-, pine-needle extract-, herb-extract,
arsenious, oxygen-, sulphurated-, ferruginous, mud-, sea-salt-, and brine baths. —
Carbonic acid baths prepared by pressure.

3. Electric baths, as faradic, galvanic and alternating current-baths, monopolar-
and four-cell baths.

4. Appliances for photo- and thermo-therapy, as sun-baths, radiation with blue
and ultra-violet rays, furthermore electric hot-air baths, electric light-baths, thermo-
penelrat'on:

5. Electrotherapy; especially Arsonval, Oudin, high fiequency. Franklinization.

6. Mechanotherapy and orthopedics; passive and active Swedish gymnastics,
breathing-gymnastics, Swedish manual massage, vibration massage.

7. Radium and oxygen-inhalation.

8. Air-bath and provisions for open-air resting-cures.

9. Occupation- and sport-therapy.

Indications : The sanatorium is indicated especially for

1. delayed convalescence after severe diseases (especially after tropical diseases),
and after operations;

2. for diseases of the blood and disorders of metabolism, such as diabetes,
anaemia, chlorosis, pernicious anaemia, uric-acid diatiiesis, gout, subnutrition, obesity.
Graves' disease;

3. Cardiac affections, vascular diseases (arterioicleiosis, aneurysm), disorders
of circulation;

4. rheumatism, and its complications;

5. rennl diseases;

6. nervous diseases, especially due to over-exerlion, occupation-neurosis, neu-
rasthenia, neuralgia, neuritis, paralysis, tabes, etc.;

7. gastro-intestinal diseases (constipalion);

8. tardive syphilis and its comphcations.

212

Section II: Meran — Martinsbrunn near Meran — Montreux-Territet

9. Indication is furthermore given, especially in autumn, for all those case*; which
after a mineral cure at Carlsbad, Marienbad, Nauheim, Neuenahr, Kissingen, Homburg,
Tarasp, Levico, Franzensbad, and Gastein, need a dietetic and mechanical after-cure
(grape-cure) in a sanatorium with a dry and sunny sub-alpine climate.

Contra-Indications: Tuberculous and psychically aft'ected patients, morphinists
and alcoholists are absolutely not admitted in the sanatorium, likewise not patients with
cancer, or people suffering from skin-diseases, or other suppurative and offensive maladies.

Prices: The prices in the sanalorium are equivalent to those of lirst-class hotels.
Detailed prospectus and list of prices always at disposal on application.

Outside patients. The curative factors of the sanatorium and the service of the
leading physician are at disposal also for patients outside the sanatorium.

In: R. Binder, Leading physician and proprietor.

Sanatorium Martinsbrunn near Meran

for Internal and Nervous Diseases.

Indications: Constitutional and metabolic diseases, convalescence, cardiac and
circulatory affections, diseases of the kidneys, of the respiratory organs (positively
diagnosed Tuberculosis not admitted!), diseases of the nervous system.

No admittance for patients suffering from alcohohsm, epilepsy, bacillary
consumption, and psychosis fit for asylum.

Detailed prospectus by the manager.

Leading physician and proprietor: Sanitdtsrat Dr. Norbert von Kaan.

Montreux-Territet

Kurhaus Territet and Sanatorium L'Abri.

Dietetic, Hydro- and Electrotherapeutic Institute.

The Kurhaus Territet and Sanatorium L'Abri is located in Territet, i. e. in the
eastern part of the communities of Montreux, protected best of all against winds. It
its chief front, and stands amidst large parks; thus oppor-

faces the south with
tunity is offered to those
looking for recuperation
of taking advantage of
the climatic conditions
of the renowned health-
resort. From the win-
dows, a most wonderful
view of the lake and the
Alps can be enjoyed.
The establishment, re-
cently built as a sana-
torium (190506), is
provided with all the
best hygienic appliances,
such as spring-water

supply, W. C. (English
system), rinsing canali-
zation. It is most
comfortably furnished
(warm - water central
heating, electric light,
hydraulic lift). Concrete
ceilings, flooring of
Terrazzo, and Delmen-
horst cork - carpets,
double-walls with stuf-
fings of material dea-
dening sounds, providing
absolute noiselessness
and silence in the house.

There are in the establishment 50 well furnished rooms for visitors, most of which facing the
south, with roofed separate balconies; in addition, rooms for curative purposes and salons.

Curative factors: Hydrotherapy. Demi-baths and full-baths, running sitz- and
foot-baths with variable temperature, cold and tempered douches of any kind, medicinal
baths, carbonic acid baths, carbonic acid brine-baths for the indications of a Nauheim-
cure. Natural brine and mother-lye from Rheinfelden and Bex are applied for baths in
any desired concentration.

Electrotherapy: Apparatus for constant and induced current and for Franklini-
zation, electric perspiration- and light-baths for the whole body or single limbs.

Air- and sun-baths. — Psychotherapy (Suggestion, Psychanalysis).

For drinking-cures is applied the own mineral spring of the Sanatorium,
(alkaline water, containing lithia), successfully used in gastric, renal, hepatic affections,
and gout.

Section II: Montr eux-TetrUet — Montreux — Munich 213

Furthermore are applied all the scientifically approved mechanical, dietetic and
medicinal cures, such as milk-, whey-, kephir-, and grape-cures; special
dietetic cures for albuminuria, diabetes, gout, gastro-intestinal diseases;
feeding- cures according to Weir-Mitcheil; Banting- cures combined
according to Ebstein and Eichhorst, Oertel-cures; massage, gymnastics.

Most completely equipped laboratory for chemical analysis, and clinical-
examination allowing a permanent control of gastric-juice, faeces, urine, blood etc.,
so that the treatment is strongly individual on the basis of an exact diagnosis and a
permanent superintendence.

Indication is given: For internal and nervous affections, especially for
diseases of the digestive tract (stomach, intestines, liver etc.). diseases of the circu-
latory apparatus (heart, vessels, kidney), disorders of metabolism (anaemia,
clilorosis, rheumatism and gout, obesity, diabetes, emaciation and prostration), affections
of the nervous system (neuralgia, nervous dyspepsia, neurasthenia, general weakness).
Furthermore, convalescents and persons needing rest find here a most-
suitable and pleasant retreat (rational food, not as in hotels, wine not obligatory, house
very quiet.) (At the entrance of the park is a halting-place of the electric tram Vevey —
Montreux— Chillon, connecting the Kurhaus with the centres of social life at Montreux;
conversation-house with renowned concerts etc.)

Insanes and persons with offensive and infectious diseases (pul-
monary tuberculosis) are not admitted.

The establishment is open all the year round.

Prospectus by the administration.

Detailed information most willingly given by Dr. Loy, leading physician.

Hotel Chateau Belmont, Montreux

Celebrated Residence all the year round. — Excellent intermediate Station.

One of the finest and most popular modern first class family Hotels in Switzer-
land. Holding the best position, the most beautiful and quiet, in Montreux; standing
well above the Lake (200 feets) with splendid views; surrounded by its own gardens,
vineyards, terraces and New Tennis Court. 5 minutes from Station and Tramways.

Appartments with Bathrooms. Playroom for Children. English and French Billiards.
Sports of all sorts.

Weekly concerts and soirees dansantes.

Central hot-water heating and electric light throughout. Perfect sanitary arrangements.
Lift. Darkroom. Baths and Douches.

Regular Motor-Bus service to Station, Town and Boats. G.irage-Boxes. Excellent
Cuisine and careful service.

Telegram Address: Belmont Montreux. — Thos.Unger-Donaldson,Propr. and Manager.

Hofrat Dr. Decker's Sanatorium

for Gastro-intestinal and Metabolic Diseases (especially Diabetes),

Munich, Seestrasse 4.

The sanatorium was reestablished in 1905 after its having existed for 9 years
in Tiirkenstrasse. It stands in an ideal and quiet location, close to the "English Garden".
Most of the patients' rooms are facing tiie south, and have spacious balconies for
open-air resting-cures. The house is surrounded by gardens. The institute is open all
the year round. Electric light, central heating, electric lift, top-light.

Treatment for patients with whom chief stress is to be laid on dietetic treat-
ment, per-ons needing recreation after severe diseases, neurasthe nics, patients with
gastro-intestinal diseases (catarrh of the stomach and intestines, ulcers of the stomach
and intestines, dilatation of the stomach, relaxation of the stomach and intestines, car-
cinoma of the stomach and intestines, constipation, diarrhoea, haemorrhoids, nervous
dyspepsia etc.), metabolic diseases (affections of the liver, the bile, the kidneys,
diabetes, anaemia), and patients needing a feeding or a reducing-cure. Owung to
the gieat routine in dietetics, the sanatorium is especially suitable for diabetics, for
whom the daily diet is prescribed on the basis of quantitative examination of urine and
the estimation of calories.

214 Section II: Munich — Nauheim — Nenndorf — Ncrvl — Neuenahr

Baths and hydrolheiapeulic npplicaiions of any kind.

Completely equi] ped laboratory for the examination of metabolism, and all the
necessary physiological and chemical investigations.

Prospectus free of charge on application to Hofrat Prof. Br. Decker.

Formerly Assistant to Prof. Dr. v. Leube at Wiirzburg.

San,-Rat Dr. H. Schmidt's Sanatorium Bad Nauheim

for Heart-Diseases, Gout, Rheumatism etc.

In addition to the baths of Nauheim, especial consideration of the curative factors
offered in this sanatorium, such as hydrotherapeutic applications, massage, gymnastics,
electricity. Dietetic cures. Air-bath. Roentgen-cabinet. Open from March to November.
— For further details see prospectus.

Private-Sanatorium Bad Nenndorf.

Sanitatsrat Dr. Ch. Michelet, Royal Bathing-Physician.

Cures also in the winter: In the house bathing- and drinking-cures with the
sulphurated springs belonging to the fisc, local mud-baths, hot-air baths, rombineJ
Sal V a rs an -Mercury treatment, without by-effects.

Rheumatism, gout, neuralgia (sciatica), skin-diseases (furunculrsis, psoriasis),
diseases of women (exsudates), syphilis (tardive forms with functional disoid-rs).

Telephone No. 8. _

Dr. Ortenau's Family Pension Hygiea at Nervi.

For Pulmonary Diseases.

Open irom October 15'^ to May 1st. Since 1893 under the proprietor's care.

This establishment, formerly "Friedmann's Institute", ha? the character of a
family pension, and is conducted on the well approved lines of modern treatment,
chief stress h-clir^ laid upon a copious nutrition and a strictly sylematic open-air cure
(resting-cure). The country-houses located in the sunniest part of the place are
provided with high, ventilated and well beatable (central heating) rooms facing
the south, large and well-protected gardens, and covered resting-halls. As only a limited
number of patients is admitted, the treatment is strictly individualizing, the control by
the physician most thorough, and the patients have the advantage of an intimate family
life. The house is, therefore, especially recommended for young persons. — Careful cooking,
well trained servants. The proprietor has full command of the English language.

Prospectus by the undersigned. Questions up to Oktober 1st are to be addressed
to Bad Reichenhall.

Dr. Ortenau (during the summer practising in Bad Reichenhall).

Bad Neuenahr, near the Rhine,

Sanatorium Dr. Graul.

The sanatorium of Dr. Graul is located in the most quiet part of the health-resort,
close to the Kurgarten and the springs. It is a special sanatorium for diabetes,
affections of the stomach, intestines, liver, kidney, disorders of
metabolism (gout). All dietetic cures carried out individually. Besides the strictly
individual diet, the following curative factors of the sanatorium are to be mentioned:
electricity, baths and douches, light-baths, massage, fango-treatment,
gymnastics. — Limited number of patients, and consequently most thorough treatment
for each individual patient. First-class equipment in the house. The sanatorium is opea
all the year round.

Prices for boarding and pension from Mks. 9 to 17.

Prospectus on application to Dr. G. Graul

(formerly Assist. Phys. to His Excellency Prof. v. Leube at Wiirzburg.)

6cct:o)i 11: Isrucnahr — UberloschicUz '■21b

Sanatories for Diabetic Patients at Neuenahr.

45 — 49—56 Hauptstrasse.

Diabetic patients who wish to be sure of definite and permanent results ought
to go to a special sanatorium for diabetes.

The three sanatories "Villa Carola", "Belvedere" and "Anna", comfortably furnished
according to the requirements of refined private houses, ai© situated protected against
high- and mountain water.

The sanatories receive: 1. All cases t-f dubious glycosuria for the purpose of a
positive determination of metabolic disorders: 2. all recently noticed cases of diabetes
mellitus for perfect recovery; 3. cases of diabetes that have gone through other cures
without success; 4, inveterate cases complicated by chronic acetonuria.

Not admitted are: lunatic and consumptive patients.

The patient is most carefully examined and methodically observed. His individual
mode of life is regulated according to a thorough investigation of his metabolism. The
cooking of the establishment is perfect as regards quality of material, palatable meals,
varying and reliable food.

Patients are also received in winter. A winter-cure is particularly to be
recommended. Prices for hoard, i. e. living, meals, light, heating, service from Mks. 9 to
27 per day accordit g to size of room and saloons.

Relatives of the patients may have living and boarding in the house at the same
rates, if not otherwise agreed upon. At their request they may have special meals.
Rooms for servants, horses' stable, coach-house, and auto-garage are existing.

Villa Anna can also be rented en bloc. Dr. Kiilz- Neuenahr.

Bad Neuenahr.

Sanatorium of Dr. Ernst Rosenberg

Formerly assistant to Professor Dr. Albu, Berlin, and Professor Dr. Adolf Schmidt,

Dresde-Halle.

Special sanatorium for gastro-intestinal diseases and diabetes. Uric-acid diathesis.
Diseases of the kidney. Neurasthenia. Feeding and reducing cures.

Refined comfort. First class accomodations for dietetic and mechanic treatment.
Quietly located close to the springs and parks of Bad Neuenahr.

Oberloschwitz-Weisser Hirsch near Dresden.

Dr. Teuscher's Sanatorium.

for Nervous-Diseases, Cardiac Affections, Gastro-intestinal
Diseases and for persons needing Recreation.

Epileptics, consumptives, and insanes are not admitteJ.
Scientitically equipped institution for physical and dietetic treatment.
The establishment stands on the woodclad plateau of the right embankment of
the Elbe-river, and is in communication with Dresden by an electric tram (station:
"Weisser Adler").

The situation towards south, at the border of the heath of Dresden (Dresdner
Heide) extending for miles, is the best imaginable.

Price: from Mks. 12 upwards per day all included. Prospectus free of charge.
Open during summer and winter.

Telephone: Loschwitz 913, Cable-address: Teuscher, Weisser-Hirscb.
. 3 Physicians. Leading physician and proprietor

Dr. med. Heinrich Teuscher, Neurologist.

216 Section II: Oeynhausen — Ospedaletti-Ligure — Partenkirchen

Sanatorium Oeynhausen (Westphalia.)

The sanatorium, built in 1891 in the Gothic style, is located in the immediate
neighbourhood of the Kurpark of Bad Oeynhausen; it was enlarged considerably in
1898, 1903 and 1909 by additional buildings. Most modern and comfortable furnishing,
pleasant residence for summer and winter. The winter-baths are given in the liouse
itself, with water from the Kaiser Wilhelmsprudel drilled in 1897. Central heating, water
supply, drainage. Electric lift, electric light. "Physician in the house.

Prices for board and pension from Mks. 50 to 98 per week.

Indications: Diseases of the central and peripheral nervous system, paralysis,
ischias etc. Functional and organic diseases of the heart; diseases of women, all forms
of rheumatic and gouty affections, convalescence after inflammatory and exsudative
processes, complications of traumatism and accidents.

Notification of arrival to one of the physicians is asked for.

Sanitatsrat Dr. K. Reckmann. Sanitatsrat Dr. F. Huchzermeyer.

Villa Dr. Oster. — Ospedaletti-Ligure,
Riviera di Ponente.

Sanatorium for Internal Diseases and Persons needing Recreation,
excluding Tuberculosis, other Infectious Diseases, and Insanes.

The sanatorium is especially equipped for the rational treatment of functional and
organic affections of the heart, vessels, kidneys, of gastro-intestinal and liver-diseases, of
metabolic and nervous disorders (rheumatism, gout, obesity, diabetes, anomalies of blood,
neurasthenia, neuralgia, migraine etc.).

Dietetic cooking wholly adapted to the individual, and under permanent super-
intendence of the leading physician. Hydro- and electrotherapy in all forms, such as
fresh-water, sea-water, sea-salt, pine-needle, carbonic-acid, and carbonic-acid sea-salt baths
(system Fischer-Kiefer) , tempered douches, electric baths. Electrodiagnostic and
therapeutic appliances for all the other approved therapeutical methods. Apparatus for
hot-air treatment. Manual and vibratory massage. Out-door cures, splendidly located,
intensely insolated, large, open, and roofed resting-halls allowing a cure at any weather
and season. Oertel-cures under medical supervision. Drinking-cures in the winter: the
various mineral-waters (Carlsbad, Kissingen, Marienbad, Vichy etc.) always as fresh as
possible, are applied in addition to diet-, resting-, OerLel-, bathing-cures etc. Appliances
for resistance-gymnastics. Laboratory for chemical and bacteriological examination.;.
Roentgen-cabinet.

The establishment built in 1903, and amplified later, stands on the finest spot of
the health-resort, in a large park. All the rooms allow wonderful view of sea and
mountains. Refined comfoi't. Modern hygiene. High and spacious rooms, mostly facing
the south, and drawing rooms for 50 vi-itors with their relatives. Central-water-heating,
inlaid floor, electric light, ventilation, American bathing-outfit, Stigler-lift. Open from
October to May. Prospectus by the proprietor and leading physician Hofrat Dr. Oster,
formerly for many years, Assistant Physician to the Medicinal Clinic and to His Excellency
Professor von Leube, at Wiirzburg.

Dr. Wigger's Kurheim, Partenkirchen.

Par tenkir chen is situated in the idyllic valley of the Loisach and Partnach,
opposite the Zugspitze, protected against rough winds on all sides by mountains rising
to an altitude of 0300 to 10 500 feet.

The climalic conditions are as favourable as they can be imagined. Partenkirchen
is, above all, distinguished by an almost uninterrupted calm, and in winter by an intense
insolation; hence permanent resting-cures in the open-air can he carried out
most conveniently all the year round. On the verandas of the Kurheim temperatures of
30—40'' C (86 — 104*^ F) were observed for weeks in the winter sun. In summer, on
the other hand, there is a permanent change of air, and the heat cannot grow up to
a molesting degree the high mountains getting warm in the morning earlier than the
valley and, on the other hand, cooling off much earlier in the evening. The changing
currents of air carry along fresh ozone from the extensive plateau richly wooded with

Section II: Partenkirchen

21;

pine-forests, and from the spurs of the mountahis densely covered with pine-trees. As a
result of this ventilation, the air is extremely rich in ozone, and the place excells most
of the climatic stations as regards purity and freshness of air.

Kurheini.

Dr. Wigger's Kurheini, huilt in 1905 at the most sheltered and sunny spot ot
Partenkirchen on the slopes of the Riedmountains, was enlarged considerahly in 1906,07
hy an entirely new huiiding, and in 1909 hy the most advantageous acquisition of a
large and shadowy park in front, with several comfortable country-houses. Later on
considerably amplified by a new building.

The establishment is situated som.ewhat above the town, remote from noise and
dust, but still to be reached most conveniently (particularly by means of a lift going
down to the bottom of the valley.)

The large and imposing establishment is furnished throughout with a refined
comfort satisfying those who need recreation. Lift, warm-water central heating, electric

light from own electric works, double
doors, a whole series of decently and
elegantly furnished drawing - rooms,
skittle-ground, roofed and open colon-
nades, large protected verandas for each
room facing the south, large and
shadowy park of about five acres with
air-bath etc., render the residence most
home-like and pleasant. From the
verandas of the Kurheim the most
delicious panorama opens upon the
valley scattered all over with country-
houses, on the Watterstein- mountain
with Dreitorspitze, Alpspitze, Zugspitze,
on the Alps of the Tyrol and Allgau etc.
Indications : The Kurheim is
recommended for convalescents, for
those needing recreation and a change
of air in a refreshing and stimulating
alpine climate, and the treatment is
particularly indicated for:

1. Diseases of the heart and blood-
vessels fdiseases of the cardiac muscle,
of the heart- valves, circulatory disorders, alterations of the vessels, arterio-sclerosis,
vascular neurosis etc.).

2. Affections of the respiratory organs (bronchial catarrh, emphysema,
astlima and allied conditions, with strict exception of any infectious disease).

3. Diseases of the blood and of metabolism (chlorosis, anaemia, gout,
rheumatism, diabetes, obesity etc.).

4. All diseases of the digestive organs (gastro-intestinal affections, chronic
constipation, tendency to diarrhoea etc.),

5. Affections of the liver, bile, kidneys and bladder.

6. All affections of the nervous system of organic as well as functional
nature (paralysis, tabes, neuralgia, sciatica, all forms of neurasthenia and hysteria,
especially nervous disorders of the cardiac function, of the digestive function, of the
sexual sphere etc.), and any kind of prostration.

7. Chronic intoxications (nicotine, alcohol, morphine, cocaine etc.), the latter
under special conditions.

8. Complications of surgical or gynecological interference, and the sequelae
of professional over-exerlion and injurious climatic influences (tropical diseases etc.).

9. Cures after staying at Marienbad, Carlsbad, Nauheim, Kissingen etc., and
transitional station from southern health-resorts to the north or vice versa.

Strictly precluded from admittance are insanes and patients suffering from
infectious diseases. — Five physicians.

Communication via Munich in 2^'.2 hours by railway.

Address questions in business matters to the directory, and questions in medical
matters to the proprietor and leading physician

Dr. Florenz Wigger.

218

Section JI: Pcgli — Pyrmfftit

Kurhaus Pegli.

Only Sanatorium for physical and dietetic therapeutics in the South. Wonderfully
situated on the Mediterranean; quiet and free from dust.
Air-and sun-baths; individual treatment.

Proprietor: Medical Director

H. Ernst. Br. A. R. Ernst.

Sanatorium Bad Pyrmont

of Professor Dr. Schucking, Sanitatsrat.

For diseases of women, cardiac diseases and blood-affections, anomalies of meta-
bolism (gout). 3 refined country houses. Large private park. Frequented by the highest
English Uristocracy.

Dr. Wichmann's Sanatorium Pyrmont Saline.

Patients suffering from anaemia, neurasthenia, chronic internal diseases, and persons
needing a change are admitted all the year round. Cure and treatment by physician.
Mo?t quiet and isolated location near the lower princely brine bathing-house; the total
area of the establishment is about 10 acres..

Electric hght and central heating in all rooms. Water-supply. Drainage. Baths.
Electrotherapy. Massage. Dietetic cures. Berth-halls for open-air cures. Sun- and
air-bath.

Price of pension Mlis. 7 to 10 per day according to choice of room. Family-home
for single ladies. Insanes, coughing patients, and such affected with infectious or skin-
diseases are not admitted.

Detailed prospectus by the proprietor

Sanitatsrat Br. Wichmann, neurologist,
District physician at Pyrmont.

Section II: Schierke — Schomberg 219

Sanatorium Schierke in the Harz.

2250 feet above sea level.

The sanatorium furnished with all modern -omforl, lift, comfortable drawing-
rooms, stands at the southern declivity of the 3997 feet high mountain-crest rad ating
from the Brocken. An old mountain-forest surrounds the place in a semi-circle and protects
it against rough Avinds.

Owing to its favourable and very sunny alpine location and to its stimulating air,
Schierke is known to exert in summer a?; well as in winter a mo<t powerful therapeutic
influence upon physical and nervous alTections. It is specifically suitable for nervous
prostration, asthma, Grave's di-ease, and cardiac affections. Patients and their relatives
are also received for convalescence and recreation. Tuberculous patients and insanes,
however, are not admitted.

There is at Schierke abundance of promenades on smooth and ascending roads
(Oertel- cures). The sanatorium is provided with all kinds of baths (four-cell, mud- and
light-baths), a large air- and sun-bath, an open gallery for resting cures, and the
scienlifically approved physical curative factors (a radium-emanatorium, an apparatus
for thermopenetration, medico - mechanic institute, and a Roentgen-cabinet) are also
at disposal.

Chief stress is laid upon a favourable psychical influence by medical treatment
aided by a laboratory equipped with modern diagnostic appliances.

The diet is prepared under the supervision of the physicians, special care being
devoted to the palatability of the food and to its being adapteil to each individual case,
on scientific principles. Also vegetarian diet, feeding and recuding cures.

Terms. Rooms with one bed including full pension (5 meals), heating, service,
and electric light Mks. 10 to 15 per day, larger rooms with one bed correspondingly more.
Rooms with 2 beds including full pension etc. for two persons Mks. 16 to 35 per day.
Reduction of price during the quiet season, i. e. before and after the winter and summer-
season; the minimum-rate, however, amounts to Mks; 7,50 per day and person.

Entrance-fee Mks. 20, for companions being not under treatment Mks. 10.

In this price is included conveyance from and to the station on the arrival and
departure. For separate carriage or sledge an additional fee of Mks. 2 is to be paid.
For permanent medical treatment up to dismission from treatment at least Mks. 15 per
week are charged. People needing recreation but not constant treatment, are also
received. For baths etc. special tariff.

Railway station from May 1st to October 15 tb at Schierke (Brockenbahn), other-
wise Elend (Harzquerbahn Nordhausen-Wernigerode). The sanatorium is open all the
year round. Detailed information by prospectus.

Physicians: Leading physician Sanitatsrat Dr. Haug, Superintendent physician
Dr. Wichura. House physician.

Schomberg, Oberamt Neuenbiirg, near Wildbad,

in the Black Forest of Wiirtemberg.

Schomberg is situated at a slope of the large plateau of the Northern Black Forest
of Wiirtemberg extending between the Enz- and Nagoldtal, at a height of 2190 to 2450
feet. The place itself is in an altitude of 2275 feet. The height of Schomberg can be
reached on convenient forest-roads by carriage in ° 4 hours from the railway stations
Hofen a. Enz (Enztalbahn: Pforzheim- Wildbad) and Liebenzell (Nagoldtalbahn : Pforz-
heim— Horb.). Regular mail and auto service from Hofen. With auto 15 min.

Tlie place embraced by extensive pine-forests offers the pleasant aspect and the
characteristic scenery of an alpine Black-Forest village. The houses hidden among
orchards are bordering a meadow valley down which a rivulet runs its winding course.

This place offers all the requirements asked for if sanatoria for consumptives
are to be established. The soil is porous and dry (variegated sandstone formation). There
is no considerable incline; everywhere gently ascending forest-paths in all directions. The
place is well-protected against rough winds.

Excellent pure mountain spring-water provided by high-pressure water-system of
the community. The climate of Schomberg shows the characteristics of a south-western
richly wooded medium mountain. It is a stimulating forest-chmate.

According to the registrations of the meteorological station in the "Neue Heil-
anstalt", the following mean figures have been found for the climatic factors: Atmospheric

220

Secti07i 11: Schomberg

pressure 710,5 mm Hg. Temperature 7,4'' C = 44,7'^ F. Mean daily variilion 8,1'^ C =
46,4'^ F. Summer-days (maximum of temperature more tlian 25'^ G = 77" F) 18. Froslv
days (Minimum below 0^ C =- 32,0" F) 108. Ice-days (Maximum below 32" F) 25".
Absolute moisture G,92, relative 86" o. Mean clouding 5,9. Fog in the average on 30 days;
216 clear and 118 cloudy days during the year. Yearly amount of rain 824 mm. in
Ihe average. There were counted in the average: 142 rainy days, 38 days with snow-
fall, 7 days with hail, 12 days with sleet, 41 days with dew, 35 with hoar-frost, further-
more 11 distant and 17 local thunder-storms. — Duration of sunshine in the average
1297,2 hours per year (i. e. daily 3 to 6 hours). The predominant winds are W. and SW.

Schomberg is situated above the fog border-line. In the winter many sunny days
in spite of the long lasting snow.

The location, the property of the soil, the abundance in forests, the
climatic conditions, therefore, offer the most fav ourable ad vantages for the
climatic treatment of chronic pulmonary diseases, especially of chronic
tuberculosis. As Schomberg is in a mean altitude, there is no necessity of
special indications, as for alpine regions.

At Schomberg, the principle of a strict sanatorium-treatment of chronic
pulmonary tuberculosis at favourable climatic places has found ample application;
a principle established in Germany and acknowledged in all cultured countries. Three
large private institutes for patients of better classes and a sanatorium of the
Wiirtembergian-Association for Sanatoria for the not wealthy and not insured patients have
been established on the plateau of Schomberg, during the last 20 years.

Sanatorium Schomberg, Institute for Pulmonary Diseases.

Telephone No. 1. Leading physician Dr. mod. A. Koch.

The establishment was founded in 1888 and amphfied by large new buildings in
1893, 1899, and 1902. The sanatorium is leaning towards north and north-west to a gently
ascending hill offeiing protection against the predominating winds. In front of the

-;!^r^^.

■i4^^

flffc^iS-.

>#

:-^'&

.. ■»-: -S^-

Zj^^'^/:

Sanatorium Schomberg.

establishment is a large park-like garden with a small pond and summer berth-halls,
scattered in the park, numerous beautiful places with dense and high groves offering
cool shadow in the summer. The patients are therefore able, without leaving the
grounds of the establishment, to have short and convenient walks in the quiet and large
parks. Along the chief front of the whole establishment high resting halls are put up
where patients may have a permanent stay in the open-air, just as in the above mentioned
summer berth-halls.

Section II: ScJidmbcrg

221

The eslablishment is furnished in-doors according to all the acquirements of modern
comfort: high rooms, broad corridors, several large conversation Iialls, music-, reading-,
bdliard-, and ladies' room, large dining room 28 feet high with wmter-garden; bath-room
on eacii floor. Electric light in all rooms and berth-halls; central low pressure heating.

Treatment on the lines of the hygienic-dietetic principles of Brehmer and
Deltweiler, with most careful consideration of all the other curative factors approved
by chnical experience (Tuberculin-, inhalation-cures etc); special treatment for diseases
of the throat and nose. Three physicians; nurses of the Red-Gross, and attendants.

The sanatorium is open all the year round, as the good results obtained in winter
fully disprove the still wide-spread prejudice as to the suitablei'iess of a winter-cure in
the Black-Forest.

Meals are served at 7V2 ^-o 8V2 a. m,, first breakfast; at 10 a. m. milk with bread;
at 10 o'clock dinner (4 to 5 courses); at 4 p. m. milk with bread; at 7 p. m. supper
(2 courses); at 9 p. m. milk. Special diet for gastric and other diseases.

Daily price of pension for medical treatment, full pension (milk included, other
drinks excluded), and including rubbings, douches, healing, light and service Mks. 6V0, price
for room from Mks. IV2 to 6 according to position and furnishing. No Kurtaxe.

Detailed information by prospectus free of charge on application.

Questions of any kind and announcement are to be addressed to

Direction des Sanatorium Sch6mbe)~g in Schomhet'g.

Neue Heilanstalt flir Lungenkranke.

(New Sanatorium for Pulmonary Diseases). Leading physician Dr. G. SchrSder.
Schomberg, Oberamt Neuenbiirg near Wildbad.

This establishment is situated at 10—15 minutes' distance from the village of Schom-
berg, clos e to the large pine-forests, which are only at disposal of the patients of the
sanatorium. In the forest spacious forest berth-halls. The establishment consists of a

New Sanatorium Schomberg.

chief building and dependences. Above all, light cases are here received. The appliances
answer all the requirements of hygiene: Central- heating, central warm- water supply.
Electric light, lift, disinfecting-house for laundry, porcelain etc., and sj utum. In front of
the whole establishment, toward the south, there are halls for open-air cure. Most modern
contrivances, such as Roentgen-equipment, incandescent light-bath, electric-medical
apparatus. Treatment of diseases of the upper air-passages by specialists.
Inhalations. Air-bath. Hydrotherapeutic appliances. Cooking supervised by physicians.
Dietetic cooking. 5 meals per day. 3 physicians. 4 Nurses. 2 Attendants.

222

Sectmi II Schomberg — Schonhuc?) (near BbUlngen) — Schdneck

Prices: Pension Mks. 7 per day, medical treatment included. Prices for rooms
varjing between 2 to SVo Mivs. per day, according to position. First consultation Mks. 20.
Extra charge only for baths, medicine, and drinks. Disinfection of the rooms in case of
change or at departure Mks. 7. Carriages of the establishment ready on order at the
railway stations of Hofen a. Enz or Liebenzell. Detailed illustrated prospectus
by the leading pliysician Dr. G. Schroder who is to be addressed for any in-
formation. Cable-address: Dr. Schroder, Schomberg-Neuenburg.

Telephone for distant calls: Schomberg-Neuenburg No. 2,

Sanatorium Schonbuch near Boblingen (WUrttemberg).

1785 feet above sea level.

Sanatorium for Diseases of the Lungs and Larynx
with special department for children.

Leading physician: Dr. med. Th. Briihl.

Summer- and Winter-cures.

Climatically very favourable,
situated very sunny and well-
protected against cold winds,
remote from the dust and noise
of much frequented roads; amidst
a large park of its own exten-
ding for 15 acres, close by the
extensive old timber forests of
Schonbuch. — Most hygienic
and very comfortable. No
rooms facing the north. —
Linoleum and Terrazzo-flooring
in all rooms and corridors, walls
easily washable, rounded corners.
Separate spring- water supply for
the sanatorium. Electric light,

Sch&nbuch bei Bdblingen.

central heating. — Lift. — Roentgen-cabinet. — Excellent isolated berth -hall in
communication with the establishment by a covered walk. — Special berth-
verandas for bed-ridden patients. — Small entirely separate ward for children with
separate berth-halls, and special dining- and playing-rooms.

Only 40 patients are received; thus a permanent supervision and strictly individual
treatment are warranted.

Hygienic dietetic treatment (copious and rational food, strict regulation of rest
and exercise, inurement by precautious hydrotherapy, air- and sun-baths); and specific
treatment according to the case.

Special (also operative) treatment of the nose, larynx and pharynx.

Prices. Pension (including meals, medical treatment and nursing, heating and
light) Mks. 6,50 for adults, Mks. 5,00 for children — Mks. 4,00 for children below
10 years of age. Rooms from Mks. 1,50 to 5,50.

Means of communication: The railway-station is Boblingen, district town,
three quarters of an hour distant, on the line Stuttgart — Freudensladt or Stutt-
gart— H orb— Zurich.

Intending visitors can be met at the station.

Announcement in advance is urgently asked for.

Illustrated prospectus and any other information by the

Directory of the "Sanatorium Schonbuch".

Sanatorium Schoneck

near Beckenried

Lake of Lucerne

Switzerland.

Situated 2467 feet above sea level, about 945 feet above the southern bank of the
lake, with a magnificent view of the lake and the neighbouring mountains. The
sanatorium stands in large parks, which in the north, east and west pass over into

Section II: Schoncck — Semmering 223

forest. The atmosphere is mild, free from dust, moderately moist, slightly stimulating, and
calm. The temperature even in mid-summer very moderate. No hot nii-'hts.

The estabhshment has the advantages of a delicious subalpine climate, and offers
the most possible variety of therapeutic factors on the scale of a sanatorium for
chronic diseases.

Curative Factors: Application of all methods of scientific hydrotherapy (system
of Winternitz), pneumatic cabinet, pneumatotherapy, inhalatorium according to Heyer.
Electrotherapy, electric-light baths, Roentgen-equipment, carbonic acid and oxygen- haths,
galvanic and faradic baths, alternating current baths, hot-air douche, massage, hot-water
massage. Thoroughly specialized dietetic cures.

Indications: Treatment is indicated, above all, for affections of the nervous system,
such as neurasthenia, hysteria, hyjiochondria, organic diseases of the peripheral nerves
and of the cenlral nervous system' (labos). Next to these are treated most of all diseases
of the gastro-intestinal canal, and of the respiratory organs (astlmia), and cardiac
affections. Furthermore, indication is given especially for constitutional diseases, anaem'a,
general disorders of nutrition, muscular and arthritic rheumatism, neuroses of the
uro-genital organs.

Insanes as well as consumptives are not admitted.

Strictly individual treatment.

Leading physician Hofrat Dr. Wunderlich. Two assistants.

Cable-address: Kuranstalt Schoneck, Switzerland,

Season from May 15 1'' to September SQtii.

Prospectus and detailed information by the

Directory.

Kurhaus Semmering.

Physico-dietetic Sanatorium, Summer- and Winter-Cures.

Chief Physicians: Dr. Franz Hansy and Dr. Karl Kraus.

The Semmering situated 3500 feet above sea level, two hours' railway-ride from
Vienna, combines grandeur of scenery and climatic advantages, amidst the most wonderful
forests, with all the comfort of a city. This has established its world-wide repute of an
alpine heath resort.

The Kurhaus, built according to the designs of prominent Viennese architects, and
the annexed Villa Meran, are located in the climatically most advantageous district, in
an absolutely ideal and sunny part, entirely free from winds and fog. The most modern
comfort of a refined hotel is associated here with the hygienic advantages of a first-
class sanatorium.

The medical treatment is carried out by the leading physicians: kaiserlicher Rat
Dr. Franz Hansy, formerly leading hospital physician and Dr. Karl Kraus, formerly assistant
to Hofrat Professor Winternitz at Kaltenleutgeben and substitute to the leading physician
of the sanatorium of Edlach,

The sanatorium is equipped especially for alpine cures, and is uninterruptedly
open all the year round. Indications are given for disorders of metabolism
(diabetes, gout, obesity Sec), diseases of the nervous system (neurasthenia, hysteria), of
the digestive tract and the air-passages, furthermore for Grave's disease, anaemia,
chlorosis, asthmatic disorders, and certain nervous affections of the heart, and particularly
for all those needing recreation, invigoration, and inurement.

Insanes, and persons suffering from incurable and infectious diseases, especially
consumptives, cannot be admitted.

Advice of the house- and consulting physicians of the visitors is considered as far
as possible. Main stress is laid upon a most intimate contact of the patients with the
physicians during the stay at the sanatorium.

Special care is devoted to air-, sun- and bydrotherapeutic cures, furthermore to
the diet adapted to each individual case. In the ordinary dief, food stuffs are selected
most carefully considering particularly the vegetal ian diet. There is opportunity for rational
occupation-therapy. AH appliances are at dispo;al for the application of physico-
Iherapeutic methods, such as general hydrotherapy, carbonic acid and oxygen-baths,
electric two- and four-cell baths, alternating-current baths, contrivances for Arsonvalization,
Zander-institution, inhalatorium, complete Roentgen-equipment &c. Roofed colonnade, forest
berth-hall, sun-bath and forest air-bath for open-air treatment.

2-24 Section II: Semmering — Stambcrg — Sulzhayn

TheKurhaus has 110 rooms, most of them with balconies; electric light, telephone
and noiseless telegraph in all rooms. The chief building has a large hall, free from
smoke, for the reunion of societies, dining-room, breakfast-room, small dining-room,
reading-room, writing-room, smoking- and billiard-room, musik-rooni; hair-dressing-saloon
for ladies and gentlemen, pholoTrraphic dark-room, aQtogarage.

Roads for Oertel-cures, tennis grounds, roads for ski-ing and sledging near the
house. Further information concerning prices and terms is most willingly given at any
time by letter or personally.

Starnberg near Munich.

Dr. Flange's Sanatorium

for nervous and internal diseases, for convalescence and recreation.

(Neurasthenia, hysteria, nervous dyspepsia, ga stro-intestinal diseases.

Feeding and reducing cures. Deprivation cures.

Insanes and patients with infectious disease- are not admitted.

Located 2100 feet above sea level, at the most beautiful of the Bavarian lakes.
Subalpine climate. Abundant vegetation. Sea-air, wholly free from dust. Extensive
promenades in wonderful leafy and pine forest. Opportunity for any kind of sport. Open
in summer and winter. Excellent communication to the Alps and Munich (Festive
performances in the Prinzregenten-theatie). Modern appliances, limited number of patients,
own bathing-house with all the apparatuses for hydrotherapeutic and physical treatment.
Price of pension Mks. 6 to 12 per day. Medical treatment is charged extra.

Detailed informations and prospectus by Br. med. V. Flange.

Sanitatsrat Dr. Kremser's Sanatorium
for Light Pulmonic Diseases

at sulzhayn in SUdharz near Nordhausen.

Open in winter and summer.

The sanatorium is situated 2 km from Sulzhayn, well-protected against ea«t-. north-,
and west-winds, closely embraced by the hills of the Siidharz rising up to 2257 feet,
with magnificent views of the valley open to the south, amidst forests extending for miles
in an atmosphere free from dust and rich in ozone. Own mountain spring water supplies
productively a refreshing drinking- and washing-water.

The rooms of the patients are furnished most conveniently, linoleum flooring, in
part also Torgament, walls with Salubra-hangings, washable paper wall clothing up-to
date ventilation, electric light and low-pressure steam and warm-water heating. Nearly
all the rooms are facing the south. Well-protected berth-halls for out-door cures.

The strictly individual treatment is carried out on the lines of Brehmer-Dettweiler
considering especially gastro-inteslinal disorders, affections of the ear, nose, and throat &c.,
and a variable and acknowledged excellent food; (Hamburg cooking). 2 Physicians.

Most favourable climatic and hygienic conditions. Own park extending for 35 acres,
electric light, Roenlgen-cabinet, rinsing-canalization, setting-pond for sewage, low-pressure
steam heating, warm- water supply, steam disinfecting apparatus Sec; the establishment is,
therefore, a modern model institution for lung-diseases, and has been favoured for many
years as a summer and winter chmatic station.

The sanatorium has only one class for light patients of the educated classes,
and admits but a hmited number of patients. Intimate family-life in spite of strict
observance of the prescribed cure. Absolutely individual treatment of each patient by
the leading physician.

Open in summer and winter.

Price of pension including board, meals, medical treatment kc. Mks. S to 12 per
day according to choice of room. Parlouis, billiard-room, winter-garden, forest berth-hall,
croquet-ground, concerts &c. Telephone: EUrich am Sud-Harz Nr. 35. For further
details see prospectus.

Railway stations: 1. Ellrich, line Nordhausen— Norlheim; 2. Benneckenstein, line
Harzquerbahn from VVernigerode ; 3. Tanne, line Tanne— Blankenburg am Harz.

Sanitatsrat Dr. vied. E. Kremser.

Section II: Tharamdt — Va^-Mont — Wehraiocdd

225

Sanitatsrat Dr. Haupt and Dr. H. Haupt
Tharandt near Dresden,

Sanatorium for Nervous and Internal Diseases, for Disorders of Metabolism and for
Recreation.

Feeding and reducing, and dietetic cures. Laboratory for the investigation of
Metabolism.

Sumnier- and Winter-Cures.

Teleplione: Amt Tliarandt 17.

Val-Mont sur Territet (Switzerland).

2150 feet above sea level — Open all the year.

Medical establishment for special treatment of diseases of the digestive
organs (stomach, intestines, liver elc.) and other troubles affected by diet
(obesity, diabetes, anasmia), also disorders of the kidneys (albuminuria), and of the heart
and circulation. Hydropathy, electropathy, carbonic acid baths, radiopathy. Rest cures.
No cases of tuberculo-is, hysteria, mental or contagious diseases are admitted.
For further details apply to the Direction

Dr. Widmer, Director
3 Assistants.

Sanatorium Wehrawald near Todtmoos.

Most Elevated German Sanatorium for Pulmonary Diseases.

The sanatorium is situated 3013 feot above sea level, in the finest part of the
southern Black Forest of Baden, one quarter of an hour from Todtmoos, and 140 feet

above it, sunny and
protected against
winds, far above the
valley of the Wehra-
river. It is sur-
rounded, on two
sides, by a grand
old pine -forest, but
entirely free in the
south and south-east,
allow'ng abundant
insolation, especially
in tiie winter, and
an unrestrained view
of the picturesque
valley of the Wehra.
The atmosphere is
absolutely pure and
free from dust and

smoke, as the establishment is separated from Todtmoos by a forest, and as in a
wide circuit there is neiliier any industrial establishment nor any large commu-
nity. The sanatorium built upon a rock, stands in a particularly favourable location,

15

226

Section II: Wehrawald — Westmd near Berlin

suitable in all respects, accordinpr to careful metereolocrical observations, for the building;
of a sanatorium for pulmonary diseases.

The Climate is tiie well-lcnown one of elevated yet well-protecled Black Forest
valleys, which in winter are mostly al)ove the foir-hne. This climate offers the advantages
of a forest-place togetlier with the stimulaling effect of an alpine station. The establishment
consists of a chief building facing south, and two wings facing north, one of them
containing looms for the physicians, the other one rooms for management. Bed-rooms
for 100 patients with tent-balconies for bed-ridden patients, to whom thus an out-door
cure is possible throughout the day. Elegant and most modern equipment answering all
hygienic requirements. Low-pressure steam healing, electric light, lifi, baths and douche-,
Roentgen-cabinet, inhalatorium, own water-supply, drainage; berth-halls, aUo in the forest,
colonnade, hne, extensive, and well-lcept promenades, smooth and gently ascending, almost
exclusively in the forest. The physicians' house is connected with the chief building by a
roofed corridor. The machine-house with turbines, laundry and disinfecting station
stands, at a far distance from the Sanatorium, in the valley.

Owing to its elevated location, the sanatorium is particularly suitable as a
transitional station to facilitate acclimatization for those going to or coming from the
mountains.

The treatment is a hygienic dietetic-climatic one and, at the same time, individualizing
according to the principle of Turban.

The sanatorium is open all the year round. Cable-address: Wehrawald-Todtmoos.
Telephone for neighbourhood and long distance. Details by prospectus.

Leading physician: Dr. med. Fr. Lips.

IWeans of communication: Via Sackingen or Basle (Badischer Bahnhofj to Wehr
or Brennet (Rhine).

Westend near Berlin.
Dr. Weiler's Sanatoria

for Persons suffering from Nervous and Psychical Complaints,
from Disorders of Metabolism, and for persons requiring Rest.

11 1 m e 11 Alice 35.

Telephone:

Nussbaumallee 30 and 38.
Cliarloltenlnn-g 506 and 9394.

Section LI: Wt:^iend near Beiiiii — Wiesbaden ±11

1. Kurhaus Westend, Ulmenallee 35. New establishment with finest comfort.
Bed-rooms with hath, small apartments (sitting room, bed-room, bath). Most elegant
drawing-rooms. — Conservatory. Most up-to date appliances for hydro-, photo- and
electro-therapy. High-frequency therapy. — Zander- hall. Winter and
summer gymnastic halls. Dietetic cures.

2. Villa Sibylle, Nussl)aumallee 3U. Small refined home for convalescents.

3. Home for Psychical Affections, Nussbaumallee .38. 4 Physicians, Trained
hospital nurses. Magnificent Park. Berth-halls, large sporting ground; skating rink.

The centre of Berlin can be reached in 20 minutes by convenient
means of communication.

For farther details see prospectus.
Leading physician: Sanitatsrat Dr. Weiler.

Sanatorium
for Gastro-Intestinal Diseases at Wiesbaden.

Parkstrasse 30,

The sanatorium — villa with garden — is located in the finest and most quiet
country-house qm^rter of Wiesbaden, close to the Kurpark, near the Kurhaus, and tiie
royal theatre. It is furnished according to all requirements of modern comfort, and
is open in summer and winter.

Treatment in the sanatorium is indicated for all cases of organic, functional, and
nervous affections of the gastro-intestinal canal, and clironic nutritional disorders in
general, the treatment of these affections being absolutely individual.

Infectious and incurable cases are not admitted.

Greatest care is devited to dietetic cures whicji .are indespensable for restoring
health and can only difficultly be carried out at home, as experience teaches. Special"
stress is laid upon scientifically adapting the diet to the gastro-intestinal disorders, which
is an essential requirement for the cure.

In order to devote medical attendance to tiie patients, in the most profitable way,
only 18 patients are admitted; and it is, therefure, desirable that arrival as well as departure
are noticed some days in advance.

The medical assistant is residing in the clinic.

The daily price for patients is Mks. 40, 35, 30, 25 and 20 on the first or second floor,
Mks. 25, 20 and J 5 on the third floor.

These rates include medical treatment twice a day, full pension, and service, all the
prescribed mineral waters, light and heating.

Excluded are: the first consultation, chemical and microscopical examinations, the
first irrigation of the stomach (if necessary for diagnosis), medicine and wine. (Wine is
only allowed on medical prescription, and may be carried along by the patient or purchased
from local firms at ordinary price.)

Any further information is given by

Dr. Ludicig Abend,
formerly assistant, for many years, to
His Excellency Geheimrat Professor Dr. v. Leube, at Wiirzburg.
Office-hours 10—12 and 2 — 4 o'clock, Grosse Burgstrasse 16 (private residence)

Sanatorium of Dr. Lubowski

Wiesbaden, Gartenstrasse 20.

for Internal, Metabolic and Nervous Diseases
and especialley for persons requiring rest.

Entirely new building, high class in every particular, located in the most quiet
refined part of Wiesbaden. All modem curative factors, thermal-baths, dietetic treatment,
psychotherapy.

Open all year.

Prospectus free of charge on application to the leading physician

Dr. Lubowski.

228 iScdton II: Wleshadm

Wiesbaden.

Dr. med. Amson's Institute for Orthopaedics, Gymnastics, and Massage,

Taunusstrasse 6,

Department for Orthopaedics: Treatment of nialforniatinns of tlie vertebral
column (scoliosis, kyphosis, lordosis), nmlformatiuns of the extremities, fif how-legs and
'knock-knee, club-foot and flat foot, wry-neck, tuberculous inflammation of the vertebrae,
congenital luxatii^ns (especially of the hip-joint), paralysis and contractions, infantile
[)aralysis, congenital stiffness of joints, inflammation of the joints.

Manufacture of splint-apparalus and sup])orting-corsets.

Department for medico-gymnastics and massage: Treatment of disorders of
metabolism, aifeclions of the respiratory, circulatory, and digestive organs, functional and
organic affections of the nervous system, diseases mid 1,r lumalism of the organs of motility
treated by mechanical gymnastics (Docenl Dr. Herz' system Vienna) and manual massage
given exclusively by the physician liimself.

A complete set of electric hot air apparatus (Tyrnauer's system) are supplied
for local treatment of all parts of the bddy.

Roentgen-equipment in the institute.

There is no accommodation for resident-patients in the institute itself, but there is
a good and modern sanatorium in close proximity where all orthopaedic operations are
performed. Patients who are not bed-ridden can reside in the hotels and pensions in
the vicinity. The fact that the baths and springs are close to the institute will be a
great consideration to patients desirous of combining the two treatments.

Prospectus are sent on application to the Director.

Dr. L. Badt's Institute for the Treatment of
Disorders of Locomotion.

Wiesbaden, Taunusstrasse 4.

The institute is located on the groundlloor of the house, close to the Kochbrunnen.
The purpose of this institute is to be lielpful to patients suffering from any kind of
disorders of locomotion, caused either by ataxia or palsy, or by nervous, arthritic or
muscular diseases. As to the treatment, we mention above all the compensation or
exercise-therapy for spinal affections according to Frenkel-Leyden. The
exercise-treatment in a broader sense is applied successfully in hemiplegia, in motor-
neurosis Sec. In such cases the treatment is combined with manual and instrumental
gymnastics. The institute has furthermore provisions for the following therapeutic
factors: electric, sinusoidal (alternating current-) baths, electric-light baths (local and full
light-baths), gymnastic appliances for active and passive motions and for resistance —
Prospectus free of charge.

Wiesbaden. Sanatorium Dr. Schiitz.

Villa Panorama, (at the corner of Fichtestrasse and Panoramaweg), for
Internal Diseases, especially Digestive and Metabolic Diseases, and

Nervous Affections.

Open all the year round. Quiet, beauliiful, and free situation, somewhat elevated,
close by the municipal Kurpark. Garden with fine old groves. Most comfortably
furnished. Large drawing-rooms, verandas and berth-hall, central-heating, electric light,
lift. Complete equipment for hydrotherapy, electric tub-baths, four-cell and
light-baths etc. Thermal-waters of VViesbaden. Laboratory for the examination of
metabolism etc. (Reducing cures under controU of metabolism, investigation of uric acid
tolerance in gout etc,) — Cooking under careful superintendence.

Treatment for patients with disorders of digestion, metabolism and nutrition,
likewise for all kinds of internal diseases — also nervous patients.

Not admitted, however, are insanes, tuberculous patients, and persons
suffering from other infectious diseases. Br. E. SchiUz, ^

Specialist for internal diseases.

Section [I: Wieshaden 229

Wiesbaden, Sanatorium Dr. Paul Guradze.

Mainzer Strasse 3.
Surgical-Orthopaedic Private Clinic.

The sanatorium stands amidst a y:arden in the country-house district of the health-
resoit, the location heing ahsolulely quiet in spite of the vicinity of the Kurhaus and
other points of attraction of the health-resort

The patients' rooms are on the first and second floor, and are furnished according
to the most up-to date requirements of comfort, special attention heing paid to patients
unable to walk.

Telephones all over the house, enabling patients to phone to distant places from
each floor.

Abundance of sunny balconies and ])erth-halls; the garden is at the patients'
disposal, also a roof for berths and suii-l)alhs.

The clinic is in connection with an institute for medico-mechanic treatment,
gymnastics and massage.

The appliances for active and passive mechano-therapy (worked by electricity) are
in two large halls of the groundfloor. There are also the pi-ivate apartment of the
physicians, the waiting and consulting rooms, and the rooms for treatment.

The clinic itself has an operation-room equipped according to the most modern
principles, a room for preparation, rooms for Paris-plaster dressings, and a
Roentgen- cabinet.

In the basement of the house, in a separate wing, are orthopaedic workshops
with electric contrivances. All the required portable apparatus, such as splints for the arm,
foot and leg, supporling-corsels, artificial limbs, bandages etc., are manufactured here
under the direct supervision of the physician.

There is also iu the institute a department for baths and physical
therapy.

Thermal waters of Wiesbaden, and other mediciial baths and douches, electric
baths, electric-light baths, four-cell baths, hot-air treatment, contrivances for Bier's
hyperaemia and suction are applied here.

Newly arranged: Radium-emanatorium for the treatment of gout, rheumatism,
sciatica, and neuralgia.

Treatment of difformities and malformations, as wry-neck, curvatures of
the spine, congenital luxations of the hip-joint. — Knock-knee and bow-legs, club-foot,
flat-foot etc. Recent or inveterate fractures and luxations, affections of the bones and
joints (coxitis and gonitis). All disorders of locomotion and gait, paralysis, gout,
rheumatism, and all the sliffenings resulting from these.

Furthermore, patients needing physico-dietetic treatment, such as medico-mechanic
therapy^ general medico-gymnastics, massage, baths or one of the above mentioned
physical methods.

Price of room Mks. 10 to 25 including full pension, but without medical treatment.
Prospectus by the leading physician.

Dr. Paul Guradze, Specialist for orthopaedics and Surgery,
(formerly Assistant to late Geheimrat Professor Albert Hoffa).

Sanitatsrat Dr. R. Friedlander's

Sanatorium Friedrichshohe (formerly Dr. Cierlich's Kurhaus)

for Nervous and Internal Diseases and for Recreation.

Leberberg 14 Wl'esbaden Schone Aussicht 30

Open and frequented all the year round.

The establishment is located in the finest and most hygienic quarter of Wiesbaden,
on an elevation conveniently to be reached, 5 minutes distant from the Kurhaus,
12 minutes from the forest, free on all sides. As it stands in a large park-like
garden, wdth a wonderful panorama, rural solitude and idyllic silenee may be enjoyed.
But, at the same time, the location allows convenient partaking iu all the enjoyments of
the cosmopolitan health-resort.

1230 Section 11: Wiesbaden

Tlie Kurljaus established in April 1897, is Ijuilt most solidly and ralionally, and
furnished most coiiveiiiently. Elcctri(' light. Central healing. Lift. Reading-, billiard-,
ladies'-, sitting-rooms. On each floor bathing and massage-rooms.

The treatment considers, above all, psychical influence and modern physico-
dietelic methods, such as complete hydrotherapy, thermotherapy, pine-needle-, brine-,
mother-lye-, carbonic -acid baths, thermal- baths of Wiesbaden. Electrotherapy:
faradic and galvanic electricity, Franklinization, electric baths, sinusoidal alternating-
current baths. Massage and medico-gymnastics.

Exercise therapy for ataxia and palsy. — Dietetic cures.

Indications: Nervousness, neurasthenia, hysteria, hypochondria, melancholia,
agoraphobia (dread of open places), sciatica, migraine, impotence etc. Grave's disease,
chorea, peripheral and central paralysis, tabes, neuritis, muscular atrophy,
habituation to morphine, digestive disorders, anaemia, chlorosis, gout, rheumatism, scrofula,
obesity, diabetes.

Also pleasant stay for recreation. Insanes are not admitted at all.

Average number of patients 15 to 20, the highest number are 30.

Prices for room, full pension, service, electric light, and heating from Mks. 8 daily
upwards, according to location and size of room.

Excellent food.

Proprietor and leading physician: Sanitatsrat Dr. R. Friedlaender; formerly
physician to the Sanatorium Dielenmiihle and leading physician of the Augusla-Viktoriabad.

Prospectus sent free of charge.

Sanatorium Dr. Otto Dornbluth, Wiesbaden.

Small retlned institute for individual clinical treatment of internal and nervous
diseases. Price from Mks. 15 per day upwards, including medical treatment, baths, and
medicine.

Detailed information is most willingly given.

Kurhaus Bad Nerotal, Wiesbaden.

Sanatorium for Internal and Nervous Diseases, and Recreation.

Founded in 1851, newly erected in 1906.

Location: The sanatorium, surrounded by a park of its own, is located at the
entrance of the Nerotal, amidst extensive municipal parks, thus enjoying the purest air.
As the establishment is close to the foot of the Taunus-mountains, and near the forest,
it is protected against rough winds. The centre of the town is wi'hin 10 minutes'
distance from the sanatorium. Electric tram in all directions.

Equipment; The sanatorium has high, light, and well-ventilated rooms for about
80 jiersons. Most modern comfort in all rooms and splendid view of all sides. Many
drawing-rooms, large dining room, breakfast room, music-, reading-, smoking-, billiard-
rooms, winter-garden, fine veranda and terrace &c. Electric light and lift, warm-water
heating. Berth-hall.

Curative factors: Application of all therapeutic methods. Complete equipmen*^
for hydrotherapy, massage, gymnastics, electro-therapy in all forms, electric-light baths,
four-cell bath, vibration-massage, and all forms of dietetic treatment.

Hall for gymnastics. — Thermal springs of Wiesbaden. — Medicinal baths of all
kinds. Arsonvalization and Roentgen-cabinet. New: Air- and sun-baths on the tlat loof
of the house.

Indications: The establishment is a sanatorium in the broadest sense of the
Avord, receiving patients with internal nervous diseases.

Prices: Full pension according to location and size of room, from Mks. 10 upwards
per day. Reduced rates for ])hysicians and their families.

The institute is open in summer and winter. Insanes are not admitted.
For further details see the illustrated prospectus. Two physicians.

Br. Fr. J. Hindekmg, Dr. 0. Wappe)ischniitt,
leading physicians.

231

Cure -Establishments, Sanatoria etc.

arranged according to their character.

I. General Sanatoria

for the entire physico-dietetic and other clinically approved therapeutic

methods without limitation to a definite group of diseases, excluding,

however, infectious and mental diseases.

page
Arosa, Sanatorium Villa Gentiana . . 177

Batleu-Badeu, Sanatorium Dr. Burger. 177

,, Sanatorium Dr. Ebers .... 178

Sanatorium Dr. Groddeck . . 178

Pneumatisclie Anstalt (Geheimer

Sanitatsrat Dr. Scliliep^ . . . .180

Bad - Reichenhall, Sanatorium Villa

Romana (Dr. Dre.?dner) .... 180

Sanatorium Bad- Reichenliall (Dr.

V. Heinletli! 180

Eallenstedt (Harz), Sanator. Dr. Rosell 180

Bayerisch-Zell, Sanatorium Tannerhof

(Dr. V. Mengershausen) .... 183

Bendorf (Rhine), Hydrotherapeutic-
Sanatorium "Rheinau" (Geh. San.-
Rat Dr. Erlenmeyer 183

Birken'werder uear Berlin, Sana-
torium Birkenvverder (San. -Rat
Dr. Sperling) 184

Blankenburg (Harz), Sanatorium

Miiller-Rehm 185

Sanatorium "Villa Bergfried" . . 185

St. Blasien, Sanatorium Luisenheim 187
,, Hotel and Kurhaus St. Blasien 188

Champel near Geneva, Etablissement

hydrotherapique 189

Chateau d'Oex, La Soldanelle (Dr. Dela-

chaux) 190

Degersheim, Sanatorium "Sennriiti"

(Dr. V. Segesser) 193

Dresden -Liosehwitz, Dr. Miiller's

Sanatorium 19-i

£lster. Dr. Schmineke's Sanatorium . 195
,, San. -Rat Dr. Kohler's Sanatorium 195

Friedrichroda iThuringia), Sanator. "

Tannenhof (Dr. Bieling") . . . .196
Sanatorium Friedrichroda (Geh.
San. -Rat Dr. Kothe) 197

Hornegg' (Wnrtemlierg), Sanatorium
Schloss Hornegg (San. -Rat Dr.
Roemheld) s^OO

page
Homburg v. d.H., Sanatorium Dr. Baum-

stark 202

Interlaken (S-witzerIand\ Kurhaus

Beaulieu (Dr. Grandjcan) . . . 203

Kaltenlentgeben, Hydrotherapeutic In-
stitute (Hofrat Prof. Dr. VVinternitz) 203

Kissingen, Hofrat Dr. v. Koziczkowsky's

Sanatorium 203

Prof. Dr. Dapper's Sanatorium

"Neues Kurhaus" 204

,, Sanatorium Hofrat Dr. Dietz . . 205
Hofrat Dr. Marquardsen's Kur-

anstalt 205

Hofrat Dr. Leusser's Sanatorium 206

Liiebenstein (Thuringia), Sanatorium
Liebenstein (San. -Rat Dr. Fiilles
and Dr. Meyer) 208

liindenfels, Kurliaus and Sanatorium

Lindenfels (San.-Rat Dr. Sclimitt) 209

Iiueerne,SanatoriumSonnlVlatt(Dr.Hotz) 209

Mammern (SAnritzerland), Hydrothera-
peutic Institute (Dr. UUmann) . . 210
Meran, Sanatorium "Stefanie"(Dr.Binrler) 210
Montreux-Territet, Kurhaus Territet

and Sanatorium L'Abri (Dr. Loy) 212

Oberloschviritz-'Weisser Hirsch, Dr.

Teusclier's Sanatorium .... 215
Ospedaletti-Lignre, Sanatorium Hof-
rat Dr. Oster 216

Partenkirchen, Dr. Wigger's Kurheim 216
Pegli near Genoa, Kurhaus Pegli

(Dr. A. R. Ernst) 218

Pyrmont, Sanatorium Bad Pyrmont

(Prof. Dr. Schiicking) 218

,, Dr. Wichniann's Sanator. Pyrmont

Saline 218

Sehierke (Harz), Sanatorium Scluerke

(San.-Rat Dr. Haug) 219

Schoeneck (Lake of Lucerne , Sana-
torium Schocneck 222

232 Cure-Establishments, Sanatoria etc. arranged according to their character.

page
Semmering (near Vienna), Kurimus

Semiiierinf; 223

Starnlierg (uearMnnich), Dr. Flange's

Sanatorium 224

Tharandt (near Dresden), Sanatorium

Dr. Haupt 225

jiage
Val Mont sur Territet, Sanatorium

Dr. Widmer 225

Westend-Berlin, Dr. Weiler's Sanatoria 22ii
Weisser Hirsch - OberloschTvitz,

Dr. Teuschcr's Sanatorium . . . 21.T
Wiesbaden, Kurliaus Bad Nerotal . . 2;;0

II. Special Sanatoria

a) Sanatoria for Internal and Nervous diseases.

page
. 178
. 178
. 179

Baden-Baden, Sanatorium Dr. Ebe
Sanatorium Dr. Groddeck.
Sanatorium Dr. Lippert .
Bad-Reiciienhall, Sanatorium Villa

Romana (Dr. Dresdner) .... 180
,, Sanatorium Bad-Reichenliall (Dr. v.

Heinleth) 180

Ballenstedt (Harz), Sanator. Dr. Rosell 180
Bendorf (Rhine), Dr. Erlenmeyer's

Sanatoria 182

Blankenbnrg (Thuringia), Sana-
torium V^illa Emilia (Sanitatsrat

Dr. Warda) 185

St. Blasien, Sanatorium Luisenheim 187
,, Hotel and Kurhaus St. Blasien . . 188

Champel near Geneva, Etablissement

hydroth6rapique 189

Endenicb-Bonn, Private Medical Esta-
blishment for mental and nervous
diseases (Dr. v. d. Helm) . . . 196

Friedrichroda (Thuringia), Sanator.

Tannenhof (Dr. Bieling) . . . .196
Sanatorium Friedrichroda (Geh.
San.-Rat Dr. Kothe) 197

Hombnrg V. d. H., Sanat. Dr. Baumstark 202
Hornegg (Wurtemberg), Sanatorium

Schloss Hornegg (San. - Rat Dr.

Roemheld) , . 200

Kaltenlentgeben near Vienna, Hy-

drotherap. Institute (Hofrat Prof.
Dr. Winternitz) 203

Kissingen, Hofrat Dr. v. Koziczkowsky'.s

Sanatorium 203

,, Sanatorium Hofrat Dr. Dietz . . 205

Krenzlingen (S'nritzerland), Sana-
torium Bellevue (Dr. Binswanger) . 206

Kiisnacht onZiirichsee, Dr. Brunner's

Sanatorium 207

liiebenstein (Thuringia), Sanatorium

Liebenstein 208

pat^e
Liindenfels (Hesse-Darmstadt), Sa-
natorium Liiuienfels 209

Lucerne, Sanatorium Sonn-Malt(Dr.Hotz) 209

Mammern (S-witzerland), Hydrothera-

peutic Institute (Dr. UUmann) . . 210

Martinsbrnnn b. Merau, Sanatorium

Martinsbrunn 212

Merau, Sanatorium Stefanie, Dr. Binder 210

Montreux-Territet, Kurhaus Territet

and Sanatorium L'Abri (Dr. Loy) .212

Nauheim, San.-Rat Dr. Schmidt's Sanat. 214

Oberloschwitz -Weisser Hirsch, Sa-
natorium Dr. Teuscher ....

Oeynhansen, Sanatorium Oeynhausen .

Ospedaletti-Ligure, Sanatorium Hof-
rat Dr. Oster

215

216

216

Partenkirchen, Dr. Wigger's Kurheim 216
Pyrmont, Sanatorium Bad Pyrmont . . 218
Dr. Wichmann's Sanatorium Pyr-
mont Saline 218

Schierke (Harz), Sanatorium Schierke 219

Schoeneck (Lake of Lucerne), Sana-
torium Schoeneck 222

Semmering near Vienna, Kurhaus

Semmering 223

Starnberg near Munich, Dr. Plange's

Sanatorium 221

Tharandt near Dresden, Sanatorium

Dr. Haupt 225

Weisser Hirsch-Oberlosch^writz, Sa-
natorium Dr. Teuscher .... 21.")
Westend near Berlin, Dr. Weiler's

Sanatoria 226

Wiesbaden, Sanatorium Dr. Lubowsky 227
,, Sanatorium Dr. Schiitz . . . .228
,, San.-Rat Dr. Friedlaender's Sana-
torium Friedrichshohe .... 229
,, Sanatorium Dr. DornbUitli . . . 2.30
,. Kurhaus Bad Nerotal 230

b) Sanatoria for Mental and severe Nervous Diseases.

page
Bellevue, Sanator., vide Krenzlingen 206
Bendorf (Rhine), Dr. Erlenmeyer's

Sanatoria 182

page

Endenich-Bonn, Private Medical Esta-
blisiiment for Mental and Nervous
diseases l^t*

Cure- Establishments, Sanatoria etc. arranged according to their character. 233

page
Krenzlingen, Sanatorium Bellevue . . i206
Kiisnacht on Ziirichsee, Dr. Brunner's

Sanatorium 207

page
'Westend near Berlin, Dr. Woiler's

Home for Psychical Affections . . 227

c) Sanatoria for Lung-Diseases.

page

Arosa, Sanatorium Villa Gentiana . 177

,, Children's Sanatorium Dr. Pedolin 177

Blankenhain (Tlinringia), Sanatorium

Dr. Silbersteiii 185

St. Blasien, Sanatorium St. Blasien. . 186

Clavadel near Davos, Sanatorium

Clavadel 189

Davos-Pliitz, Sanatorium Davos-Platz . 191

,, Schatzalp-Sanatoiium 192

,, Forest-Sanatorium of Professor Jessen 193
,, Dr. Turban's Sanatorium .... 193

Ebersteinbnrg near Baden-Baden,

Dr. Rumpf's Sanatorium .... 194
Hlgershansen, Dr. Liebe's Sanatorium 194

page
Hohenhonnef (Rhine), Sanatorium for

Lung-Diseases 200

Leysin, Establishments for Chest-Com-
plaints 207

Nervi, Dr. Ortenau's Kurhaus Hygiea . 214

Schomberg (Wnrtemberg), Sanator.

Schombcrg . . 219

,, New Sana(or. for Pulmonary Diseases 221
Schonbuch near Boblingen (Wur-)

temberg), Sanatorium Schonbuch 222
Siilzhayn (Harz), S.-R. Dr. Kremser's

Sanatorium 224

Wehra-nrald nearTodtnioos(Baden),

Sanatorium Wehrawaid .... 225

d) Sanatoria for Gastro-intestinal and Metabolic Diseases

page
Baden-Baden, Sanatorium Dr. Burger 177

,, Sanatorium Dr. Ebers 178

,, Dr. Heinsiieimer's VValdpark-Sanator. 179

,, Sanatorium Dr. Lippeit 179

Bad - Reichenhall, Sanatorium Villa

Romana 180

Ballenstedt (Harz), Sanator. Dr. Rosell 180
Birkemsrerder near Berlin, Sana-
torium Birkenwcrder 184

St. Blasien, Sanatorium Luisenheim . 187

Carlsbad (Bohemia), Dietetic Institute

"VillaRitter" (Med. -Rat Dr. Ritter) 189

Chateau d'Oesc, Dietetic Kurhaus "La

Soldanelle" (Dr. Delachaux) . . .190

Dresden-Losch-witz, Dr. Moller's Sana-
torium 194

£lster. Dr. Schmincke's Sanatorium . . 195

Friedrichroda (Tkuringia), Sana

torium Tannenhof (Dr. Bieling) . . 196
,, Sanatorium Friedrichroda (Geh. San.-

Rat Dr. Kothe) 197

Godesberg (Rhine^, Dr. Schorlcmmer's

Sanatorium 199

Hombnrg v. d. H., Sanatorium Drss.

Pariser-Dammert 201

,, Sanatorium Dr. Baumstark . . 202

Interlaken, Kurhaus Beaulieu

. 203

Kissingen, Hofrat Dr. v. Koziczkowsky's

Sanatorium 203

,, Prof. Dr. Dapper's Sanatorium "Neues

Kurhaus" 204

page

Kissingen, Hofrat Dr. JVIarquardsen's

Neues Diat. Kurhaus 205

, , Hofrat Dr. Leusser's Sanatorium ' ' Villa

Thea" 2O6

Lincerne, Kurhaus Sonn-Matt (Dr. Hot/.) 209

Meran,Dr.Binder'sSanatorium"Stefanie" 210
Martinsbrnnn near Meran, Sana

torium Martinsbrnnn 212

Montreux-Territet, Kurhaus Territet

and Sanatorium L'Abri (Dr. Loy) . 212
Munich, Hofrat Dr. Decker's Sanatorium 213

Nanheim, San. -Rat Dr. Schmidt's Sanat. 214
Nenndorf near Hanover, Private

Sanatorium San. -Rat Dr. iVlichelet. 214
Neuenahr, Sanatorium Dr. Graul . . 214
,, Sanatories for Diabetic Patients

(Dr. Kulz) 215

,, Sanatorium Dr. Rosenberg . . . 215

Oberlosch-writz-Weisser Hirsch, Dr.

Teuscher's Sanatorium .... 216

Partenkirchen Dr. Wigger's K^urheim 216
Pyrmont, Sanator. Prof. br. Schucking 218

Schoneck (Lake of Lucerne), Sana-
torium Schoeneck 222

Semmering near Vienna, Kurhaus

Semmering 223

Val Mont sur Territet, iMedical

Establishment (Dr. Widmer) . . 225

Wiesbaden, Sanatorium for Gastro-
intestinal Diseases (Dr. Abend) . 227
,, Sanatorium Dr. Lubowski .... 227
Dr. Schiitz 228

234 Cure-Establishments, Sanatoria etc. arranged according to their character.

e) Cure-Establishments for Skin-Diseases and Disorders
of the Genito-Urinary Organs.

page

Ballenstedt (Harz), Saiiator. Dr.Rosell 180

Dresden-Iiosch'witz, Dr. MoUcr's Sa-
natorium 194-

page
Lieipzig - Liindenan, Sanatorium for

Diseases of the Skin 207

Neundorf near Hanover, Private

Sanalorium San. -Rat Dr. Michelet 214

f) Cure-Establishments for Orthopaedics and Surgery.

pap;o
Ealleustedt (Ravi,), Saiuilor. Dr. Resell 180

Carlsbad (Bohemia), Dr. Tyrnaiier's

Institute for Swedish Gymnastics 189

Friedrichroda (Thnriugia), Sana-
torium Tanncnhof (Dr. Bieling) . . 196

page
"Wiesbaden, Dr. Amson's Institute for

Orthopaedics etc 228

,, Dr. L. Badt's Institute for the Treat-
ment of Disorders of Locomotion 228
., Sanalorium Dr. Guradze .... 229
,, Kurhaus Bad Ncrotal 230

g) Cure-Establishments for Children.

page I page

Arosa, Children's Saiiator. (Dr. A. Pedolin) 177 Ermatiugen (Switzerland), Medical

I Newscliool "Villa Breitenstein" . 196

Elgershauseu, Dr. Georg Liebe's Sana- : Krenznach, Home of Recreation for

■torium 195 | Cliildren (Dr. Bartenstein) . . . 206

h) Cure-Establishments for Chronic Intoxications
(Drug Habit, Alcoholism etc.)

page
Baden-Baden, Sanatorium Dr. Ebers . 178
Bendorf, Dr. Erienmeyer's Sanatoria . 182

Friedrichroda (Thuringia), Sanator.
Friedrichroda (Geheim. Sanitatsrat
Dr. Kothe) 197

Godesberg (Rhine), Dr. Franz Miiller's

Sanatorium ("Schloss Rlieinblick") 198

page
Kiisnacht on Ziirichsee, Dr. Brunner's

Sanatorium 207

Partenkirchen, Dr. Wigger's Kurheim 21t)

Starnberg near Munich, Dr. Flange's

Sanatorium 22*

Wiesbaden, San. -Hat Dr. Friedlaender's

Sanatorium Friedrichshiihe . . . 229

235

Alphabetical Index

Aaclien (Aix-la-Chapelle . 87

Abbazia 88

Acquarossa (Switzerland) . 89

Aix-la-Chapelle (Aachen) . 87

Alexandersbad (in Bavaria) 89

Altheide (in Silesia) . . 90

Alvaiicii-Bad (Switzerland) 91

Andennatt (Switzerland) . 92

Arosa (Switzerland) . . 92

Ranator. "Villa Gen-

tiana" ... 93. 177

Children's Sanator.

Arosa . . . 93. 177

Axen-Fels (Switzerland) . 94

Axenstein (Switzerland) . 95

B.

Baden-Baden .... 96
,, Sanator. Ur. Burger 98. 177
Dr. Ebers 98. 178
,, Dr. Groddeck98. 178
,, Dr. Heinsiieimer's Sa-
natorium . . .98. 179
.. Sanat. Dr. Lippert 98. 179
,, "PneumatischeAnstalt"
Baden-Baden. . 98. 180
Baden (Switzerland) . . 98

BadCastein 95

Bad-Ischl 95

Bad-Reichenhall ... 99
,, Sanator. Villa Romana

100. 180
,, Bad-Reichenhall

100. 180
Ballenstedt (Harz), Sanat.

Dr. Resell 180

Bayrisch-Zell, Sanatorium

Taiinerhof 183

Beatenberg, St. (Switzer-
land) 100

llellevue. Sanatorium, at

Kreuzlingen .... 206
Bendorf (Rhine), Sanatoria

Dr. Erlenmeyer . . . 182
Bcrchtesgaden .... 101
Berlin- Westend, Dr. Wei-
ler's Sanatoria . . 226

Binz 102

Birkenwerder, Sanatorium,

near Berlin .... 184
Birmenstorfer Bitterwater 102
Blankenberghe (Belgium) . 102
Blankenburg (Harz) Cure-
Establishment Miiller-

Rehm 185

Blankenburg (Harz) Sana-
torium "Villa Bergfried" 185
Blankenburg (Thuringia)

Sanatorium Dr. Warda . 185
Blanketihain (Thuringia)
Sanatorium Dr. Silber-

stoin 185

Blasien, St 103

,, Sanatorium St. Blasien

104. 186

page
Blasien, St., Sanatorium

Luiseniieim . 104. 187
,, Hotel and Kurhaus
St. Blasien . . 104. 188
Boblingen (Wurtcmberg),

Sanatorium Sclionbuch . 222
Bonn - Endenich, Private
Medical Establishment . 196

Bordighera 104

Brunnen (Switzerland). . 106
Biirgenstock (Switzerland) 106
Burtscheid (vide Aachen) 87
Buxton (England) . . .107

c.

Cairo (Egypt) 109

Carlsbad (Bohemia) . . . 122
,, Dietetic Institute Med.

Rat Dr. Ritter. 122. 189
,, Institute Kais. Rat Dr.
Tyrnauer . . 122. 189

Champel (Switzerland),

Etabl. Hydrothdrapique 189

Chateau d'Oex (Switzer-
land), Sanatorium La
Soldanelle 190

Clavadel (near Davos), Sa-
natorium Clavadel . . 189

Colberg 123

D.

Davos-Platz 110

,, Sanator. Davos-Platz

111. 191
, Schatzalp -Sanatorium

111. 192
Forest - Sanatorium
Prof. Jessen . 111. 198
,, Dr. Turban's Sana-
torium . . HI. 193
Degersheim (Switzerland),

Sanatorium Sennriiti. . 193
Dresden - Loschwitz, Dr.

Moller's Sanatorium . . 194
Droitwich (England) . . Ill
Dijrrheim (Baden) . . . Ill

E.

Ebersteinburg (near Baden-
Baden), Dr. Rumpf's
Sanatorium .... 194
Elgershausen (Hesse-Darm-
stadt), Dr. Liebe's Sanat. 194
Elster (Saxony) . . . .112
,, Dr. Schmincke's Sana-
torium 195

,, SanitatsratDr.Kohler's
Sanatorium .... 195
Empfing-Wildbad . . .112

Ems 113

Endenich - Bonn, Private

Medical Establishment . 196
Engelberg (Switzerland). . 112
Ermatingen (Switzerland),

Medical Newschool . . 196
Evian-les-Bains (France) . 112

page

P.

Faido (Switzerland) . .116
Franzensbad (Bohemia) . 116
Friedrichroda (Thuringia) . 117
,, Sanator. "Tannenhof

Dr. Bieling . . 118. 196
,, Sanat. Friedrichroda
Geh. .San. • Rat Dr.
Kolhc . . . 118. 197

G.

Gardone-Riviera. . 118

Gastein-Bad 9ft

Godesberg (Rhine) . . .118
,, Sanat. "SchloB Rhcin-

blick". Dr. Mijllerll9. 198
., Dr. Schorlemmer's Sa-
natorium . . 119. 199

H.

Hall (Upper Austria) . .

Heligoland

Ilelouan (Egypt)

Heringsdorf

Hirsch, Weisser, Dr. Teu-
sciier's Sanator., s. Ober-
loschwitz

Hohenhonnef (Rhine), Sa-
natorium Hohenhonnef .

Homljurg

,, Sanator. Drss. Pariser-

Dammert . . 122.

,, Sanatorium Dr. Bauiii-

stark . . . 122.

Hornegg, Schloss, Sanator.

119

119
120
119

215

200
121

201

202

200

Interlaken, Kurhaus

Beaulieu 203

Ischl, vide Bad-Ischl . . 95

E.

Kaltenleutgeben, Hydro-
therap. Institute, Prof.
Dr. Winternitz . . . 203

Kissingen 122

,, Prof. Dr Dapper's

Sanatorium . 123. 204
,, Sanator. Hofrat Dr.

Dietz . . . 123. 205
,, Sanator. Hofrat Dr.

Koziczkowski . 123. 203
,, Sanatorium Hofrat Dr.

Leusser . . . 123. 206

,, Sanatorium Hofrat Dr.

Marquardsen . 123. 205

Klampenborg (Denmark) . 123

Klosters (Switzerland) . . 123

Kolberg 123

Krankenheil-Tolz . . .167
Krapina-Toplitz .... 123
Kreuzlingen, San. Bellevuc 206

Kreuzna.ch 124

,, Haus Dr. Bartenstein. 206
Kroneiiquelle, Salzbrunn
(Silesia) l.o8

236

Alphabetical Index

page
Kiisnacht (Switzerland)
Sanat. Dr. Brunner . . 207

I.
Landeck (Silesia) . . .126
Langenschwalbacli . . . 126
Leipzig-Lindenau, Sanator.

Dr. Ihle 207

Lenk (Switzerland) . . .127
Levico-Vetriolo .... 129
Leysin 128

,, Sanatoriaof Leysin 128. 207
Liebenstein (Thuringi;\),

Sanatorium Liebenstein. 208
Lindenfels (Hess.-Darnist.)

Sanatorium LindenMs . 209

Locarno 131

Loschwitz - Dresden, Ur.

MoUer's Sanatorium . 194

,, Sanalor. Dr.Teuscbcr 21.5
Lovcre (Italy) . . . .133
Lucerne 133

,, Sanat. Sonn-Matt 133. 209
Luxor (E-ypt.) . . . .133

M.

Mammern (Switzerland),
Hydrotherap. Institute
Dr. Ulliuann .... 210
Marienbad (Bohemia) . . 134
Marthaquelle in Salzbrunn 159
Martinsbrunn near Meran,

Sanator. Dr. v. Kaan 138. 212
Mena House (Eaypt) . . 138

Mentone 138

Meran 136

,, Sanatorium Stefanie
Dr. Binder . . 138. 210

Misdroy 138

Montana (Switzerland) . 138

Monte-Carlo (Monaco) . . 139

Montreux.CliateauBelniont 213

,, -Territet, Kurhaus T.

and Sanator. L'Abri

(Dr. Ley) . . . .212

Moritz, St 140

Munich, Hofrat Dr. Decker's
Sanatorium .... 213

N.

Nauheim 140

,, San. -RatDr. Schmidt's
Sanatorium. . 142. 214
Nenndorf (Hanover) . . 142
,, Private-Sanator. ,San.-
Rat Dr. Michelet 142. 214
Nerotal in Wiesbaden,
Sanatorium .... 230

Nervi (Italy) 142

,, Dr. Ortenau's Family-
Pension Hygiea' 142. 214

Neuenahr 142

,, Sanatorium Dr. Graul

143. 214
,, Sanatories Dr. Kiilz

143. 215
,, Sanator. Dr. Rosenberg

143. 21.5
Nice 143

Oberhof (Tburinpia) . . 144
Oberloscliwitz, Sanatorium

Dr. Teuscher . . . .21,5
Ocynhauscn 144

,, Sanator. Oeynhausen

144. 216
Ospedaletti-Ligurc . . . 141-

,, Sanatorium Dr. Ostcr

144. 216
Ostende (Belgium) . . . 145

P.

Partenkirchen, Dr. VVigger's

Kurheim 216

Passugg 145

Pegli 146

,, KurhausPegli, Dr.Einst

146. 218
Pfaefers-Ragaz . . 146. 1.50
Pierre k Voir .... 147
Pistyan, vide Postyen . . 146

Plombi^res 148

Pontresina 148

Postyen (Hungaria). . . 146

Pyrmont 149

Pyrmont, Sanatorium Bad
Pyrmont Prof. Dr.
Schucking. . . 150. 218
,, Dr. Wichmann's Sana-
torium PyrmontSaline

150. 218

B.

Ragaz-Pfaefers .... 150
Rapallo (Italy) . . . .153

Reichenhall 99

,, Sanator. Dr. Dresdner

100. 180
,, Sanator. Bad-Reichen-
hall Dr. v. Heinleth

100. 180
Reinerz (Silesia) . . . 155

Remo, San 160

Rheinau, vide Bendorf. . 183
Rlieinfelden (Switzerland) 157
Rigi-Scheidegg .... 155

s.

Salsomaggiore (Italy) . . 163

Salzbrunn (Silesia) . . . 157

,, Kronenquelle . . . 158

,. Marthaquelle . . .159

Salzungen (Thuringia) , . 159

San Remo 160

Scheveningen .... 156
Sohierke (Harz), Sana-
torium Schierke . . . 219
Schinznach-les-Bains . . 162
Schlangenbad .... 161
!~^chloss Horneijg, Sanator. 200
Seliomberg, Sanatorium . 219
,, New Sanatorium . . 221
Schoenau, vide Teplitz-

Schoeiiau 167

Schonbuch, Sanatorium . 222
Sclioneck (Switzerland),
Sanatorium .... 222

pago
Semmering (near Vienna),

Kurhaus Semmering . 223
Sirmione (Italy) . . . .163
Soden at the Taunus . . 164
Sender (Switzerland) . . 166
Sonn-Matt, Sanatorium . 209
Spa (Belgium) .... 156
St. Beatenberg .... 100
St. Blasien 103

,, Sanatorium St. Blasien

104. 186

,, Sanatorium Luisen-
heim. . . . 104. 187

,, Hotel and Kurhaus
St. Blasien . . 104. 188

St. Moritz 140

Stachelberg 166

Starnberg (near Munich),

Dr. Plange's Sanatorium 224
Siilzhayii (Harz\ SaniL-Rat

Dr. Kremser's Sanator. 224
Sylt 172

T.

Taormina 167

Tarasp, vide Vulpera . . 170
Teplitz-Schonau . . . .167
Tharandt (near Dresde),
Sanatorium Dr. Haupt . 225

Thusis 168

Tolz-Krankenheil . . . 167
Triberg 169

V.

Val Mont sur Territet, Sa-
natorium Dr. Widmer . 225
Vetriolo, vide Levico . . 129

Vichy 169

Villeneuve (near Montreux) 169
Vulpera 170

W.

Waldhof Elgershausen . . 194
Wehrawald, Sanatorium . 225

Weilbach 171

WeisserHirsch,Sanntorium

Dr. Teuscher . . . .215
Weissenstein (Switzerland) 172
Westend (near Berlin), Dr.

Weiler's Sanatoria . . 226
VVesterland-Sylt . . . .172

Wiesbaden 172

,, Sanatorium Dr. Abend 227
,, Dr. Amson's Institute 228
,, Dr. Badt's Institute . 228
,, Sanator. Dr. Dornbliith 230
,, Sanat. Friedriclishohc,

San.-R.Dr.Friedliindcr 229

,, Sanator. Dr. Guradze 229

Dr. Lubowski 227

Dr. Schiitz . 228

,, Kurhaus Bad Nerotal 230

Wildbad Empfing . . .112

Wildbad in Wurtemberg . 174

Wildungeu 175

Woodiiall Spa (England) . 175

Z.

Zugerberg (Switzerland) . 176