HYPERJEMIA AND CATARRH. H 



salts) has an unmistakable influence upon the course of many cases of 

 chronic laryngeal catarrh, which, unfortunately, cannot as yet be distin- 

 guished from cases in which it fails. For this mode of cure, it is best 

 to send the patient to such places as Ems, Obersaltzbrunnen, or Gleichen- 

 berg, and only when his means will not permit him to do otherwise, to 

 allow hiLi to use seltzer-water, or one of the so-called mineral waters as 

 a cure, at home. We may let him drink the Ems or Kesselbrunnen 

 water, or the Krahnchen of Ems, on the spot, as they have, respectively, 

 a temperature of 117 F. and 90 F., without the addition of warm 

 milk or warm whey. In order to warm them, it is better to mix the 

 Obersaltzbrunnen, or the imported Ems-water, with equal parts of hot 

 milk. That the far more customary addition of whey should have any 

 real advantage over that of milk, is, at least, doubtful. The " well-pre- 

 pared whey," at celebrated watering-places, furnished generally by a 

 " Swiss," and, if possible, by an Appenzeller, in his national costume, so 

 much lauded in the newspapers and bath-journals, and to which often 

 more credit is given than to the springs themselves, is merely milk, 

 minus cheese, and can hardly effect more than the milk from which the 

 cheese has not been eliminated. It is only in the somewhat rare cases, 

 in which milk is not well borne by the patient, while the whey is borne 

 well or better, that I allow the latter to be added to the mineral water 

 instead. 



Several hypotheses have been advanced as to the action of the alka- 

 line-muriatic mineral waters. The fact that the ashes of the mucus are 

 richer in salt (chloride of sodium) than the ashes of the blood, and that 

 mucus becomes less tenacious upon the addition of salt, seems certainly 

 to indicate that salt plays an important role in the formation of mucus, 

 but it by no means justifies the conclusion that the use of salt effects a 

 cure, or more rapid resolution of a catarrhal process. 



In other quarters (Sprengler) the principal importance has been 

 attributed to the amount of alkaline carbonates contained in these 

 mineral waters, and, depending upon an observation of Virchoufs, ac- 

 cording to which very dilute solutions of alkalies are capable of exciting 

 the ciliary movements in epithelium, they assert, in explanation of the 

 beneficial action of the waters in question, that their use reestablishes 

 the extinguished or repressed ciliary vibrations. Grave objections may 

 be brought against this explanation of the action of the saline waters, 

 which is not merely palliative, but in many cases absolutely curative, 

 and we must be content with the empirical fact, that the springs of 

 Ems, Obersaltzbrunnen, and Selters, have often alleviated or cured chronic 

 laryngeal catarrh. The cold sulphur springs, too (such as those of 

 Weilbach, in the dukedom of Nassau, of Eilsen, in the principality of 

 Schaumburg-Lippe, of Langenbrlicken, in the grand-dukedom of Ba- 



