PROPHYLAXIS 343 



waters are, therefore, suitable for drinking at the spring; not, however, for 

 bottling, as carbonic acid readily passes off and the iron is then precipitated. 

 A few springs contain sulphate of iron, and still fewer, chlorid of iron. 



The best-known German iron springs are in Pyrmont in the Duchy of 

 Waldeck, Langenschwalbach at the Taunus, Bochlet (near Kissingen), Cliar- 

 lottenbrunn, Cudoiva and Flinsberg in Silesia, Driburg in the Teutoburger 

 Woods, Elster in Saxony, Franzenslad in Bohemia, Eohlgrub in Bavaria, 900 

 meters above the sea, Muskau in the Lausitz, Liebenstein in Meiningen, Freien- 

 walde on the Oder in Brandenburg, Pulzin in Pomerania, Reinerz, 500 meters 

 high, in the earldom of Glatz, Steben in Upper Franconia. 



Of foreign iron springs there are particularly to be named: Farnbuhl in 

 Luzerne, 8t. Moritz in the Upper Engadine, 1,700 meters above the sea, and 

 Val Sinestra in the Lower Engadine; further, Haarlem in Holland, Szlidcz 

 in Hungary, Spa in Belgium. 



Besides iron, in some cases arsenic is of use as in other anemias; and 

 therefore, besides the preparations of the pharmacopeia, arsenical spring- 

 waters must also be considered; the best known are those of Roncegno and 

 Levico in the Southern Tyrol as well as the Guber Spring in Srebrenica in 

 Bosnia. 



The beneficial effect of all of these iron and iron-arsenic spring cures cer- 

 tainly doefe not consist only in their contents of iron and arsenic, but quite 

 as much in the stimulation to metabolism by change of climate and the con- 

 stant outdoor life, so that, in fact, many extremely chlorotic patients are seen 

 to recover in these regions who show but slight improvement while at home in 

 spite of any iron preparation. 



Of other drugs quinin is chiefly to be mentioned, while remedies such as 

 phosphorus, manganese, and organopreparations, for example, bone-marrow, 

 thymus, etc., are of no importance. 



PROPHYLAXIS 



Although in the direct treatment of the chlorotic symptom-complex a great 

 variety of dietetic, physical and medicinal auxiliary remedies are at our dis- 

 posal, it must nevertheless be repeated that many cases of chlorosis belong to 

 the diseases which are readily preventable, and particularly where the social 

 position of young girls precludes the necessity of their earning their own live- 

 lihood, and the external conditions are favorable for healthy development. 



Since, in spite of this, the disease is observed frequently in well-to-do 

 families, it must be attributed wholly to the utter ignorance even to-day in the 

 most highly cultured families regarding the fundamental principles of hygiene, 

 a deplorable condition which must be combated, on the one hand, by a greater 

 dissemination of the laws of hygiene among the people, and, on the other hand, 

 by the activity of each individual family physician. 



It is sufficient here, to avoid repetition, simply to refer to the deleterious 

 factors which have been previously mentioned as predisposing, and which may 

 be removed in a large measure by hygienic regulation of the mode of life, by 

 bodily exercise, exercise in the open air, etc. 



