MINERAL WATERS 847 



(Bickel(a) ) and the stimulating effect of water alone (King and Hanford; 

 Sutherland; Hawk(e)) first shown by Pawlow probably plays an impor- 

 tant role. In this connection may also be mentioned v. Noorden's opinion 

 that experimental results of value in therapeutics cannot be obtained in the 

 normal organism but must be secured in one that is deranged by disease. 



On pancreatic secretion saline waters have a stimulating effect 

 (Bickel(c) ) as shown in experiment on dogs with pancreatic fistula. The 

 question as to the influence of these waters on the utilization of food has 

 long been of interest and the monograph of v. Noorden summarizes his 

 own results and those of others on persons in health and in disease. Fats 

 especially had customarily been contra-indicated during the cures because 

 of their supposedly defective absorption and this idea is completely refuted, 

 for the changes in fat excretion were within normal limits, during the 

 mineral water periods sometifnes above and sometimes below the original 

 values. This was found true even when unusual amounts of fat were in- 

 gested ; no marked decrease in its assimilation occurred despite the simul- 

 taneous administration of maximum quantities of fat and mineral water 

 together. Even small supplements of (Kissingen) bitter waters (SO 4 ) 

 did not always increase the fecal content of fat and of nitrogen though 

 their laxative action was noted. 



In their long series of cases the stimulation of protein metabolism, a 

 phrase which appears ad nauseam, in so much of the balneological litera- 

 ture, was not observed. The excretion of uric acid was generally increased 

 by drinking weak saline waters, especially in gouty patients (v. Noorden 

 and Dapper(a) ; Leber) a statement for which v. Noorden has no explana- 

 tion, but which must be accepted on the basis of the figures given ; opposite 

 findings on well persons are reported by Bain and Edgecombe and v. 

 Noorden also observed the opposite in nephrolithiasis. 



A diuretic property has also been the marvelous possession of all min- 

 eral waters. Water is the best diuretic, said Osier, and mineral waters are 

 seldom properly compared with ordinary water nor are the relations of 

 diet, muscular activity and external temperature and humidity ever con- 

 sidered. A transient diuresis (15-30 min.) is indeed often observed after 

 drinking mineral water and the increased rapidity with which some min- 

 eral waters leave the stomach as compared with ordinary water may in 

 part account for this ; some of the salts they contain do also act as stimu- 

 lants to the renal epithelium but no one has addressed himself properly to 

 the task of determining the behavior of the kidney under the prolonged and 

 immediate influence of mineral waters, and to the temporary and perma- 

 nent effects on the body of such behavior. The ingestion of larger amounts 

 of water (1200 c.c. in 1 hr.) with consequent enormous diuresis has very 

 little effect on the blood according to Haldane and Priestley. Its conduc- 

 tance is slightly diminished whereas when salt solution is ingested its, 

 conductance is increased but hemoglobin percentage is lowered. It has 



