50 



important branch of thermal practice is at this moment 

 a subject of serious consideration at Carlsbad. The 

 want of good douches is the more surprizing that 

 the following quotation, from Wenzel Payer's work, 

 seems to prove that Carlsbad was the first place in 

 Germany, where that powerful remedy was intro- 

 duced: Et miror saepe me cum quod nullus medicorum 

 pet* Germaniam dull a (douche from gutta , gocchie) 

 utatur , quia in nulld putrid , magis necessaria esset. 

 It is at least probable that Payer, having learned the 

 utility of the douche y did not neglect to establish it 

 at Carlsbad. 



Our medical institutions can be therefore divided 

 into three distinct periods. During the first, bathing 

 alone was usual. The second period, and certainly 

 the most important, dates from Wenzel Payer, on 

 whose suggestion, in 1521, the internal use of the 

 waters was added to bathing. The third began so 

 late as 1827 , when the application of steam was 

 joined to drinking and bathing. The junction of 

 these three curative means has manifestly increased 

 the fame of Carlsbad, and, although often prescribed 

 to the same patient, drinking remains in general the 

 most essential part of the cure. A great number 

 accomplish it without water or vapour -baths 5 but 

 bathing without drinking is rare. 



Formerly, when the purgative effect of the waters 

 was deemed the most important, physicians encou- 

 raged plentiful drinking 5 but, since their alterative 

 and slowly desobslruent action has been better under- 



