The therapeutic action and application of the mineral waters of Aix-les-Bains, Savoy : a paper presented to the Section of Medicine of the British Medical Association at Brighton, Aug. 1886 / by Stanley M. Rendall.

  • Rendall, Stanley M.
Date:
1887
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Licence: Public Domain Mark

Credit: The therapeutic action and application of the mineral waters of Aix-les-Bains, Savoy : a paper presented to the Section of Medicine of the British Medical Association at Brighton, Aug. 1886 / by Stanley M. Rendall. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    IO three or four days of repose where nothing is done, or a simple bath or swimming bath is taken, is an average course. The most important point to observe here, though, is the temperature, which should be moderate, from 330 C. to 36° or 37, carefully watching the effect upon the patient’s pulse, tongue, and bowels, and also upon previously affected articulations. A too exciting treatment—that is, one at too high a temperature—in these cases cannot be safely carried out without producing in many patients an intolerance of the waters, as shown by a pulse rising rapidly in number, disordered digestion, headache, sleeplessness, acute pains in the gouty articulations,—a series of symptoms compelling one at once to suspend, or at least alter, the treatment. In patients recovering from a recent attack of gout, especial care has to be taken in the inode of giving the douche, the bath attendants being instructed as to which articulations they may, or may not, touch in the course of massage; in many, mere friction or even contact of the water being exceedingly painful, and impossible without risk of exciting an acute attack ; here the so- called “ revulsive ” treatment has to be followed out, all parts save the affected ones being treated. The exact temperature and duration of treatment vary with the individual case (the patient’s temperament, endurance, &c.). By some of the medical men at Aix, the use of the vapour bath in true gout is doubted; some, however, use it in the form of local baths of short duration to the inflamed joint, and amongst these I class myself, having seen nothing but good follow their careful employment. There is no doubt that there is a greater tolerance of the Aix treatment in a rheumatic than in a gouty patient, and it is often a question, in the case of the markedly gouty, to what extent the treatment, as regards the number and length of the douches with their temperature, can be carried, and a satisfactory conclusion can only be arrived at in the individual case by watching the effect of the treatment, and modifying it to suit that case. Another important question is, Is the treatment suitable in acute gout ? and the answer is, Yes, if a suitable form of douche be