THE PRESCRIBERS GUIDE 
 
 TO THE 
 
 HARROGATE MINERAL WATERS 
 
 BY 
 
 H. J. JOHNSTO N-LAVIS 
 
 M.D., M.R. C.S., B.esSc, F.G. S. 
 
 HENRY RENSHAW 
 35Q Sti«a.nci, LiONDOlSr 
 
 1892 
 
THE PRESCRIBERS GUIDE 
 
 TO THE 
 
 HARROGATE MINERAL WATERS 
 
i 
 
 i 
 'I 
 
 i 
 
THE PRESCRIBERS GUIDE 
 
 TO THE 
 
 HARRO&ATE MINERAL WATERS 
 
 BY 
 
 H. J. J O H N S T O N - L A V I S 
 
 M.D., M.R.C.S., B.es Sc., F. G. S. 
 
 Honorary, late Acting, Consulting Physician, Surgeon and Sanitary 
 Director to Messrs Sir W. Armstrong, Mittchell and Go's 
 Works at Pozzuoli; Member of the Italian Geological Society, 
 of the Societe Beige de Geologie, Paleontologie et Hydrologie; 
 of the Brit. Association for the Advancement of Science ; 
 Secretary of the Committee nominated by the last, for the 
 Investigation of the Volcanic Phenomena of Vesuvius and its 
 Neighbourhood (from 1884); Corresponding Member of the 
 Accademia di Scienze, Lettere ed Arti di Acireale; Member ot 
 the Societa Italiana dei Microseopisti ; Vice-president of the 
 Societa Americana d' Italia; Honorary Corresponding Member 
 of the Scottish Geographical Society, etc., etc. 
 
 HENRY RENSHAW 
 353 SLreunci, IjONDON" 
 
 1892 
 
TnL GETl Y CENTER 
 LIBRARY 
 
PREFACE 
 
 This little book is intended to place before 
 the busy practitioner the general principles and 
 salient facts to be considered in directing his 
 patients to Harrogate Spa. A spare hour will 
 be sufficient for him to peruse this volume and 
 to glean from it what be is likely to require 
 his attention drawn to. In the endeavour to 
 keep it within such narrow limits, all details 
 and references had to be excluded; where fuller 
 information is desired , larger treatises may 
 be consulted. With one or two exceptions , no 
 originality is claimed, but every effort has been 
 made to keep the argument out of the groove 
 of the romantic hypotheses and superlative 
 statements, often associated with the water cure. 
 
 My best thanks are due to Mrs L. Wolffsohn 
 and Dr. C. Read for looking over the proof- 
 sheets. 
 
 H. J. JOHNSTON-LAVIS 
 
 7. CHIATAMONE. NAPLES, ITALY 
 
 ( In Winter ) 
 
 10. CAMBRIDGE CEESCENT 
 
 HAEROGATE, C. 
 
 ( In Summer ) 
 
CONTENTS 
 
 CHAPTER I. 
 
 Introduction. Neglect of Hydrotherapeutics in Britain. Ad- 
 vantages of British Thermo- mineral stations. Harrogate 
 one the best 7 — lo 
 
 CHAPTER II. 
 
 The principles of Hydrotherapeutics. Drinking and bathing. 
 Physiological action of the different constituents of 
 mineral waters, with their mechanical effect, ii— 14 
 
 CHAPTER III. 
 
 Mineral-water stations and their uses. Difficulties ot em- 
 ploying waters, away from their source. Illustrative 
 cases. A plea for hygiene .... 15 25 
 
 CHAPTER IV. 
 
 Harrogate as a mineral- water station. Situation. Death-rate. 
 Local conditions. Immunity from zymotic deseases. 
 Air spaces. Houses. Gardens. Water. Drainage, Subsoil. 
 Accessibihty. Amusements . , , 26—5 r 
 
 CHAPTER V. 
 
 The Mineral-waters and baths. The springs. Their clas- 
 sification. Superiority of certain Harrogate springs. 
 Analytical table of the principal Harrogate mineral- 
 waters reduced to decimal measures. Table of elemen- 
 tary constituents present in the principal Harrogate 
 waters. Methods of heating. . . , 32 35 
 
 CHAPTER VI. 
 
 Cases for treatment at Harrogate. Sulphur waters. Iron 
 waters. Cases suitable and unfit for such treatment 36—48 
 
CHAPTER I. 
 
 Introduction 
 
 For an Englisli physician, who has travelled 
 through the continent, there is hardly anything 
 more striking than the extreme neglect of hydro- 
 therapeutics by his home colleagues. This assertion 
 not only refers to ordinary cases that are met with 
 in the general run of practice, but to those patients 
 who are obstinate and advanced examples of morbid 
 processes , beyond the reach of routine medical 
 treatment, or where this is inapplicable in con- 
 sequence of some other complication. 
 
 Still more extraordinary is the existence of 
 this state of things in a country that is unique 
 in the production of sufferers from gout and 
 rheumatism. We should naturally expect that the 
 treatment by mineral waters would be universal 
 in great Britain, giving, as it does, by far the best 
 and more permanent results, with least damage to 
 the system, in consequence of its aiding some of 
 the natural physiological processes, whilst removing 
 
8 
 
 JOHNSTOX-LAYIS 
 
 impediment to the full action of, and burdens 
 upon, organs that are at a deadlock. Above all, 
 however, such treatment practically introduces no 
 substances foreign to the animal economy. 
 
 This ignorance of, or often disdain, for such me- 
 thods is principally due to the absolute neglect of 
 any teaching of the subject in our medical schools 
 and in our text books. When I look back and 
 add up what I or my fellow students knew of 
 mineral waters and their uses when we were 
 duly qualified, I feel absolutely shocked at the di- 
 minutive sum total of our acquaintance with the 
 subject. 
 
 That healthy disgust that the British practi- 
 tioner has for any special -pathy ushered forth by 
 speculators, medical or otherwise, with a figura- 
 tive flourish of trumpets little better than the 
 proclamation of the wonderful curative proper- 
 ties of Sequah or S* Jacobs Oil, often leads him 
 to distrust any therapeutic method outside routine 
 practice. 
 
 Another outcome of this state of things, is the 
 idea that the mineral waters of England are of 
 little value and far inferior to those of the con- 
 tinent. 
 
 When some of our British colleagues can do no 
 more for their patients, they send them off to 
 Carlsbad orKissingen,Aix-les-Bains or Spa, without 
 
INTRODUCTION 
 
 9 
 
 sufficiently considering whetlier these places are 
 suited to their cases or not, from a climatic point 
 of Tiew, and absolutely regardless of the sanitary 
 condition of such spas. 
 
 Some years since, I made a tour of the English 
 watering places, almost as a matter of curiosity, 
 when, to my no inconsiderable astonishment , a 
 closer acquaintance with Harrogate showed me 
 that it possessed a collection of mineral waters 
 not approached by any locality in England, and 
 only surpassed by one in Europe, viz: the volcanic 
 district of Naples. 
 
 A combination of circumstances such as a dozen 
 years residence amidst the thousands of thermo- 
 mineral springs of Naples and of Southern Italy 
 and Sicily; some thirty journeys across Europe, 
 taking in many of its great spas, trips to Sara- 
 toga, the solfataras, geysers and hot springs of 
 Iceland, gave me data by which to estimate Har' 
 rogato and its waters. 
 
 Harrogate does not possess everything, or every 
 advantage, for no place ever will, but it certainly 
 has few rivals; and it is therefore the duty of every 
 British medical man to be acquainted with those 
 advantages for the use and benefit of his patients, 
 instead of sending them to inferior foreign resorts, 
 Avhere the hygiene, diet, language, long railway 
 
10 
 
 JOHNSTON-LAVIS 
 
 journies, and many other objections present them- 
 selves. 
 
 This little pamphlet is intended to present to 
 the busy practitioner, in as concise a manner as 
 possible, the main points about a mineral water 
 station, such as the one under consideration, and 
 the principal cases suitable for sending to be 
 treated there. It is not proposed, however, to 
 compete with the other more extensive works 
 treating of that locality, which should be refer- 
 red to where more detail is required. 
 
CHAPTER II. 
 
 The principles op hydrotherapeutics 
 
 Mineral waters may be considered as dilute 
 solutions of different gases, salts, etc. in water. It 
 is this solvent, water, which acts externally as a 
 mechanical agent upon the skin, and a vehicle for 
 the substances dissolved in it, that are thus able, 
 when used as a bath, to penetrate some distance 
 through the epidermis and possibly even into the 
 body. When mineral waters are drunk, the solvent 
 again plays the part as a vehicle for the action 
 of the salts, etc. upon the mucous membrane of 
 the alimentary canal, but, in addition, the water 
 itself is a most valuable therapeutic, or perhaps 
 more correctly, phj'siological agent. This last fact 
 is very frequently overlooked in crediting this or 
 that compound contained in a mineral water, when 
 in reality it is the water itself that did the work. 
 
 Here let me make a remark patent to many of 
 my readers. There are numerous patients who 
 will steadily and patiently consume some mineral 
 water with a nasty taste and an elaborate anal- 
 
12 
 
 JOHNSTON-LAVIS 
 
 ytical table on the ticket of the bottle, who would 
 simply scorn to drink the same amount of distilled 
 water in the twenty four hours, although the 
 latter might be the more beneficial of the two. 
 
 Personally, I look upon the water as the primary 
 and most important therapeutic agent of all mi- 
 neral waters, and the first the action of which must 
 be considered. As water is the most important 
 agent in animal and plant life, as it is the medium 
 in which all the chemical reactions and tissue- 
 changes that take place in the body, are carried 
 on; it is a substance better tolerated than any 
 other, whilst large quantities of it are daily absorb- 
 ed and excreted. It therefore constitutes the best 
 tolerated of all chemical compounds, it is harmless 
 in the largest doses, whilst many other drugs are 
 injurious in the smallest quantities. Some litres of 
 water, more than is requisite, can be driven through 
 the system daily for long periods, without any 
 injury to the health, and very frequently with most 
 beneficial results. In morbid states of the body 
 most marvellous effects can often be brought about 
 by simple water-drinking. The difliculty of applying 
 it in its pure state so as to satisfy the minds of 
 incredulous patients , is one of the many reasons 
 for our resorting to the mineralized waters. 
 
 If to this remarkable action of pure water we 
 can add that of certain sulphides , chlorides, 
 
HYDROTIIERAPFX'TICS 
 
 13 
 
 sulphates and carbonates of alkalies and alkaline 
 earths; with iodides, bromides, and arsenic, we 
 have medicaments of very great value. The use 
 of many of these substances in a concentrated 
 form, such as usually prescribed in ordinary treat- 
 ment, is often attended with serious inconveniences, 
 whereas a large dose, highly diluted, presents no 
 ill effects. The absorption is slower, more con- 
 tinuous and prolonged, and the same vehicle that 
 so favourably introduced the salt or gas into the 
 system, is there ready to remove it if necessary. 
 
 I have frequently found this in patients who 
 have been long under treatment of iodides, intended 
 as an absorbent, but with hardly any effect until it 
 has been combined with large doses of some in- 
 different mineral water, when the action of this 
 same drug has been magical, hard deposits disap- 
 pearing in a remarkably short time, whilst there 
 is less danger of atrophy of healthy organs, and 
 that dreadful, often suicidal, depression is far less 
 marked. The same applies, though I think in a 
 less degree, to mercury. Still more is this the case 
 where the skin is further stimulated to act by 
 douches, hot air, vapour or ordinary baths. 
 
 The same argument holds good when we consider 
 the action of mineral waters as applied externally. 
 Here the solvent plays more a physical than a 
 chemical part. By acting on the vasomotor nerves. 
 
14 
 
 JOHNSTON-LAVIS 
 
 and thus on the capillaries as well as the lym- 
 phatics, by reflex action on the secretery organs 
 of the skin and also its trophic nerves, certain 
 revulsive changes are set up. These changes 
 depend naturally upon temperature, and mechanical 
 action as by bathing, needle, spray, douche baths, 
 etc. and much uponlengthof application. Coincident 
 with the soaking of the skin, the substances dis- 
 solved in the water penetrate to its deeper portions 
 and exert their therapeutic, antiseptic or parasi- 
 ticidal effect in a far more satisfactory and complete 
 manner than by paints, ointments , liniments, 
 and other, often obnoxious, external medicaments. 
 
 Let it be fully understood I do not for one 
 moment deprecate the use of such medicinal agents, 
 which are often most valuable or necessary in 
 the intervals of bathing. 
 
 Over and above the multitudinous methods of 
 using mineral waters for baths or drinking pur- 
 poses, their use as sprays to the throat and nose, 
 as enteroclysms, for washing out the stomach, etc. 
 are, though of less importance, not to be forgotten. 
 Their use in these various ways may often be 
 combined with calomel, arsenic and other mineral 
 vapour baths, with massage, electricity, inunction 
 and so forth, with marked advantage. 
 
CHAPTER 111. 
 
 Mineral water stations and their uses. 
 
 A frequent question, but too well known to all 
 of us, is whether mineral waters may not be 
 taken at home. Our answer must be rather a long 
 and detailed one. So far as drinking goes there 
 is no reason in many cases why the pure thera- 
 peutic effect sliould not be the same at home as 
 at the springs. But a very large number of mineral 
 waters, when withdrawn from tlieir source, rapidly 
 change. There were two such examples at Har- 
 rogate, and although a method has been devised 
 for preventing tiie decomposition of one, numerous 
 essays of all kinds by skilled chemists has failed 
 with the other. This decomposition is particularly 
 marked in the case of sulphur waters, probably 
 from the reaction with metallic bases in the glass; 
 in the same way many iron waters are very 
 unstable. 
 
 Bathing, douching, and any method of using 
 large quantities of mineral waters is of course 
 precluded from being carried out at home by the 
 
16 
 
 JOHNSTON-LAVIS 
 
 question of expense, whilst the same difficulties 
 in the keeping of waters in their normal state 
 applies equally here as in the former case. 
 
 Mineral waters are also not only applied as 
 direct therapeutic agents but they are often em- 
 ployed to bring about a revulsion. This latter 
 object is the real basis of hydropathy as distin- 
 guished from the more wide-reaching hydrothera- 
 peutics of which it is but one important, though, 
 as a system, a lop-sided and unscientific branch 
 of the latter. 
 
 Physiologically we may look upon a revulsion 
 as simply a violent stimulation of all organs of 
 absorption, secretion, and above all of excretion, 
 whilst any chronic strain upon one part of the 
 human mechanism is relieved, and the functions 
 of the organ are put into a state of equilibrium by 
 excessive stimulation of the others. In fact the 
 process is analogous to counter-irritation over a 
 large area. 
 
 But one of the most important factors in the 
 cure is change, which may be well illustrated by 
 the following extreme type case. Mr A. B. is a busy 
 merchant. He was born of parents with a littfe 
 rheumatic and tubercular history. In early life he 
 suffered all the usual routine diseases of childhood, 
 including a little dropsy after scarlet fever, rheu- 
 matic pains brought on by wet feet, and had a few 
 
MINERAL WATER STATIONS 
 
 17 
 
 enlarged glands which under treatment disappeared. 
 As a young man some years were spent in " en- 
 joying himself" with a few " accidents "not of a 
 serious nature. He occasionally was thoroughly 
 overcome by liquor, but more frequently absorbed 
 very considerable quantities without being intox- 
 icated. Since settling in business, trading opera- 
 tions have always been lubricated by nips of beer, 
 port, sherry , champagne or spirits , according 
 to circumstances. He of late years rises at 9 
 a. m. goes straight down to a heavy meat 
 breakfast, served near a roaring fire for 9 months 
 in the year, impedes his digestion by hurrying 
 a little for his train, and later by smoking and 
 reading his newspaper on his journey to town, 
 and finally by a fair share of unpleasant letters ,• 
 and affairs that must occur every day at his 
 office. At 11 -30 he takes upon a still filled stomach 
 " something " to give him an apetite for lunch,, 
 which follows after a cigar or two at 1. p. m. 
 and consists of two or three courses quite sufficient 
 for any ordinary man's dinner. With this is con- 
 sumed half a pint of claret followed by nips of 
 brandy and a cigar. After two hours more of busi- 
 ness and attendant excitement of market changes 
 and other worries, he goes to the railway station, 
 where another nip is taken on his stomach, still 
 un emptied and unrested. 
 
18 
 
 JOHNSTON-LAYIS 
 
 Another train journey , a strol in his garden 
 or a chat indoors and then comes " dinner " of 
 some half dozen or more courses, with several 
 wines, followed by a cigar or two. At 8 p. ni. 
 tea and biscuits are probably poured into the 
 stomach , or perhaps a game or two of billiards 
 in a smoke-choked atmosphere, with brandy hot, 
 is indulged in. In all cases at 11. p. m. a whiskey 
 and water nightcap finishes the day. His stomach, 
 kidneys, skin and lungs have born uncomplaining 
 this tyranny for twenty years. Some two years 
 ago he lost his wife or his favourite son , his 
 daughter wants to marry a " beggar "; Argentine 
 or Portuguese funds have gone down; something 
 went wrong with the drains in the house, he got 
 wet once or twice, and finally a cold brought on 
 an attack of gout; he was drugged with colchicum, 
 iodides , etc. with temporary relief , but a little 
 eczema appeared; he feels his " liver " is out of 
 order, and his cutaneous capillaries are dilated. 
 
 No special organ shows much marked alteration 
 but most are physiologicaly injured , whilst his 
 joints are all a little stiff at times, and this, com- 
 bined with a corpulency, which appeared at 30 
 instead of 40, prevents his taking the small amount 
 of exercise he used to. Finally he " breaks down" 
 and after most heroic, though none the less skillful 
 treatment, which is only in part effectual, he is 
 
MINERAL WATER STATIONS 
 
 19 
 
 dispatched to some mineral water station as a 
 last resource. 
 
 Here he is ordered a rational diet, abstinence from 
 almost all alcoholic liquors and sweets , and the 
 amount of farinaceous food is reduced. He has to 
 rise earlier of a morning, walk to the pump room, 
 and drink several ounces of say saline sulphur 
 water which is absorbed before he gets back to his 
 lodgings or hotel. He then eats a reasonable break- 
 fast, which he is able to digest during a quiet 
 chat or strol in the garden. At 10 or 12 he takes 
 his Turkish or warm sulphur bath, or probably a 
 needle or an Aix douche with a liver pack, followed 
 by another draught of mineral water, and after a 
 short walk returns to his lunch. The afternoon 
 slips on pleasantly in the gardens, at 4 or 5 p. m. 
 another walk to the pump room and back for 
 another draught of mineral water prepares him 
 for his dinner. A few hours pleasant chat, possibly 
 a game of billiards, chess, whist, or a concert whiles 
 away the evening till 10 p. m., when he retires 
 to rest. 
 
 His special symptoms are treated by a practical 
 medical man, and as his limbs get more supple, 
 his exercise is increased by riding, bicycling, walks 
 or lawn tennis, etc. 
 
 During this treatment he is placed in a more 
 healthy atmosphere than that of a crowded town, 
 
20 
 
 JOlINSTON-LaVIS 
 
 dirt)^ and dingy offices, over carpeted, curtained, 
 and lieated rooms Tiie hurry-scurry and worry 
 of every day business life is replaced by calm and 
 pleasant chat with new acquaintances, so that 
 after a few days the feeling of the absolute in- 
 capability for any other living man to look after 
 his business wears off. At the end of from one to 
 three months he regrets leaving his cure, which 
 at first appearing to him a troublesome ceremony, 
 has now assumed the character of a pleasant holi- 
 day. The morbid processes that were destroying 
 him have been arrested, and those overstrained 
 organs have been reposed hy the relief or diversion 
 of the strain upon them. His dyspepsia has gone, his 
 « liver » acts well, his joints have lost their rust, his 
 capillaries have returned as far to their normal 
 state as the permanent tissue change will allow, 
 the brain has been rested, whilst all the tissues are 
 now bathed b}^ a stream of blood no longer charged 
 by abnormal constituents, partly oxidized foods- 
 tuffs, and an excess of excretory substances. 
 
 Let us take one more picture. Miss X. Y. is 
 the daughter of middle class parents ; her father 
 lives rather highly, has a little rheumatism and 
 one or two cases of consumption in his family , 
 whilst her mother , a good but weak-minded 
 woman with an excessive religious turn of mind, 
 is "nervous" or more properly unstable, full 
 
MIXERAL WATER STATION'S 
 
 21 
 
 of prejudices , excessively mock modest , fond 
 of her principal occupation of routine afternoon 
 calls amongst her equally " banal " acquaintances. 
 
 This mother has also one or two tubercular cases 
 in her family, besides a little mental and alcoholic 
 taint. Miss X. Y. was, at a few weeks old, partly fed 
 on some much advertized wonderful baby food, 
 with the result that unrecognized infantile dyspep- 
 sia and intestinal catarrh had taken a chronic 
 hold of her before she was one year old. Most of 
 the food given had been sweetened so that at an 
 early age the child had already developed the 
 perverted appetite for sugar, which, in a more or 
 less refined form during the next 17 years she is 
 allowed to indulge in freely. This has kept up 
 the gastric feebleness, so that her bad appetite is 
 permitted to be stimulated by condiments, vinegar, 
 pickles and other diabolical preparations, which, 
 as age advances, constitute an important part of 
 her meals. 
 
 In earlier years she has been much coddled, 
 fed partly on new (probably tubercular) milk; she 
 has had her " glands swollen ", chronic enlarge- 
 ment of tonsils, frequent attacks of anaemia, which 
 her medical adviser has from time to time treated 
 with quinine and iron or some similar preparations. 
 
 Her studies have been badly directed, so that 
 French, German, Music, drawing and other ac- 
 
22 
 
 ,10HNST0N-LAVIS 
 
 complisliments which she is supposed to have 
 acquired^ but of which she knows very little, and 
 that badly, has prevented her from learning common 
 sense and a little elementary science. The small 
 amount of time left her for recreation is passed 
 in dancing lessons in a dusty room, or at the best 
 a sedate walk, because her loise mother finds that 
 any exercise likely to develope her chest capa- 
 city or bones and muscles, is really too vulgar 
 and tomboyish. In her early years stays have 
 been applied, "but oh! no, never in the least 
 tight, only to fit her well and improve and mould 
 her figure " and to prevent its development! All 
 this with her inactive life, chronic gastro-intestinal 
 catarrh, leads to constipation, which is maintained 
 frequently so as to become a bad habit by that 
 peculiar mock-modesty or false modesty mimicked 
 from, or impressed upon her by her mother. She 
 is constantly sent to Church twice or thrice on 
 Sundays instead of having a day of rest in the open 
 air from the burden of the school room or thestudy. 
 She is catechised until her melancholy gives way 
 under the influence of it, so she flies to her only 
 resources of distraction, that of exciting romance, 
 to which such a girl inevitably resorts. Her interest, 
 intelligence or reasoning power has never been 
 developed, so that as she grows up her sole 
 object in life is to find a husband, whom her 
 
:\IINKRAI; WATER STATIONS 
 
 23 
 
 good mother looks upon as a means of keeping 
 her in idleness for the rest of her life. Her li- 
 terary studies have developed absurd romantic 
 ideas ending in an equally stupid attachment, nipped 
 in its bud by her watchful parents. She frets, 
 takes less exercise , pretends to have a feeble 
 appetite at meals, but constantly nibbles something 
 in the interval. Her chronic anaemia, before hardly 
 distinguishable , now augments at a rapid rate, 
 the resulting feeling of weakness leads her to a 
 still more sedentary life, her already slightly 
 perverted appetite fails, and her diet is always a 
 selection of the most piquant and most unwhole- 
 some dishes on the table. 
 
 Every imaginable preparation of iron and other 
 tonics are given her, only adding to the increasing 
 constipation, so that auto-infection and the degene- 
 ration and non-production of the red blood corpus- 
 cles goes on apace. 
 
 Menstruation has disappeared in consequence of 
 malnutrition of the ovaries and uterus, but the 
 patient's mother and friends take the result for the 
 cause and ill - treat her accordingly. 
 
 As a final resource she is sent to some such 
 watering place as Harrogate. Now a regular course 
 of hygiene, combined with plenty of exercise in the 
 bracing moorland air, aids a course of saline iron 
 waters such as the "Kissingen" or other springs 
 
24 
 
 JOIINSTOX-LAYIS 
 
 that occur there. The patients bowels are gently 
 but regularly cleared out by the salines, and disin- 
 fected and toned by the iron. Any sulphuretted 
 hydrogen and sulpho - organic compounds are 
 decomposed by the iron and prevented from being 
 absorbed into the circulation , so insuring the 
 formation and action of the red corpuscles, 
 whilst the resulting partially individualized pro- 
 toplasm can no longer leak away by the kidneys, 
 producing as it did slight albuminuria. More 
 salines circulate in the blood, helping general 
 metabolism , and the clearing and restoration of 
 gland action, whilst the little iron that is absorbed 
 acts as a tissue food. 
 
 In a few weeks the waxen skin and languid 
 countenance has given place to a healthy pink 
 complexion and an expression of vivacity and 
 beaming smiles. The sufferer is restored to health 
 so far as permanent injuries and defects during 
 her growth will allow. She returns to her home, 
 and follows a more reasonable and regular life, or 
 if not, problably morbid processes act in another 
 direction. 
 
 It has been said that could we write our pre- 
 scriptions on bank notes, we should cure half the 
 deseases that torture humanity ; but if we could 
 write prescriptions — and be obeyed — for more 
 reasonable modes of living, physically, morally and 
 
MINERAL WATER STATIONS 
 
 25 
 
 intellectually, we sliould prevent nine tenths of 
 disease, and should hardly require mineral-water 
 stations. 
 
 Similar pictures could be drawn of the scrofu- 
 lous child, the menorrhagic or neuralgic woman^ 
 the sufferers of all kinds of skin deseases, hy po- 
 chondriacs, the convalescents from grave illnesses, 
 tropical fevers, mental breakdowns, loafers, etc., 
 who often as a last resource are sent off to take 
 the waters. 
 
CHAPTER IV 
 
 Harrogate as a mineral-water station 
 
 Bearing in mind the above observations, it is evi- 
 dent that the locality which can falQl the require- 
 ments of climate, varietj' of springs, ^ood drinking 
 water, drainage and general hj-giene, beauty of sce- 
 nery and locality, to the largest extent, will consti- 
 tute the best spa or mineral water station. No loca- 
 lity can excel in all these factors, but few if any can 
 surpass Harrogate for a remarkable combination of 
 many natural and acquired advantages of this 
 nature. An exile in wiater for many years from 
 England in consequence of hereditary gout and 
 rheumatism, it was after a cool and deliberate 
 examination of numerous mineral-wafcer stations 
 that I selected Harrogate, as in my own judgment 
 one of the most perfect. 
 
 The situation of the town on a moorland plateau 
 with a small portion in a well sheltered valley, and 
 many miles from the sea, renders its climate 
 bracing, exhilarating and remarkably dry during 
 the summer months. Its climate has therefore 
 
HARROGATE AS A SPA 
 
 27 
 
 many of the advantages of mountain regions, but 
 without the disadvantage of the lower barome- 
 tric pressureof high altitudes, which too often upsets 
 people, causing insomnia, headache, etc. The advan- 
 tage of this in rheumatism, gout with dyspepsia, as 
 well as in the different aujEmias, marasmus, debi^ 
 lity from long illnesses, etc. is remarkable and is 
 fully confirmed by the results as seen ia those 
 who resort to it. Where greater stimulation is 
 required, invalids should be sent to central and 
 high Harrogate, where there is always a breeze, 
 whilst the more sensitive, especially convalescents, 
 neuralgics, etc. will be better off in lower Harro- 
 gate, which being in a valley, is protected from the 
 direct action of the wind. Perhaps one of the 
 most striking proofs of the healthful climate , as 
 well also of the good water supply and drainage, 
 is the remarkably low death rate, which for a 
 period of seven years, during the decade 1880-1890 
 averaged 13,7 per thousand, with a maximum of 
 15.5 and a minimum of 11.7. This is all the more 
 remarkable, when we remember that a large pro- 
 portion of the residents have only taken up their 
 abode there late in life, having passed the greater 
 part of their days in unhealthy manufacturing towns 
 and stuffy offices, or tropical climates, whilst not 
 a few are invalids who go there to eke out their 
 remaining existence. 
 
28 
 
 JOHNSTON-LAYIS 
 
 There are no sources of pollution to the air 
 such as factories, chemical works, etc. there being 
 no industries in the town, whilst even the gas 
 works are near upon a mile distant 
 
 Neither do there exist any dirty streets, poor 
 crowded quarters or agglomeration of misery of 
 any kind, to act the part of a hot-bed of infection. 
 This fact, in conjunction with the perfect water 
 and drainage , have acted as impregnable bul- 
 warks against such diseases as typhus , cholera, 
 and above all that scourge of modern civilization — 
 typhoid fever. Strangely, even influenza here assu- 
 mes a very feeble invasive power and benign 
 form. This places the town in a remarkable pre- 
 eminent position for healthiness in comparison 
 with most of our sea-side watering places, and 
 far above all continental health resorts. 
 
 Perhaps no better proof of its healthiness can 
 be found than in the rapid increase of residents 
 which has been within a few years quite phe- 
 nomenal. 
 
 The rapid growth of the town might become 
 injurious, were it not for a large piece of land of 
 200 acres, open to the public, called the Stray, 
 which in the form of a very irregular S, divides the 
 town, embracing the two main parts of it in a 
 broad strip of grass and trees. Avery large pro- 
 portion of the houses are , if not surrounded , 
 
HARROGATE AS A SPA 
 
 29 
 
 backed and faced bj' gardens; the streets are broad 
 and many areas exist which, although not acting 
 as purifiers to the air, add no polluting material 
 to it, whilst aiding the dilution of impure ema- 
 nations, from chimneys and lungs. 
 
 Perhaps above all things it owes its low death 
 rate to the remarkable absence of any poor quar- 
 ters with the dirt and squalor attendant thereon, 
 which constitutes the culture medium for most of 
 the zymotic diseases , and favours infantile mor- 
 tality. 
 
 Next to this, the water supply is undoubtedly 
 of great importance. At Harrogate this is derived 
 from the sandstone rock underlying the neigh- 
 bouring districts of open countrj^ and free from 
 sources of pollution. It is peculiarly soft, as is the 
 case with most sandstone waters, it is carefully 
 stored, aerated, filtered and delivered to the inha- 
 bitants in a highly commendable way. 
 
 In like manner the drainage is well carried out 
 and is conducted down a valley- below the level 
 of, and at some distance from the town, where it 
 is utilized on a sewage farm. 
 
 Finally most of the residents are not natives, 
 but having removed to Harrogate for the sake 
 of their health , are just the class of people 
 whose minds are diverted to the question of 
 hygiene, see with jealousy any attempt to break the 
 
30 
 
 JOHNSTON-LAVIS 
 
 laws of sanitation, and follow up any sacli offence 
 by prompt and energetic action to prevent or 
 remove the danger. 
 
 By far tlie greatest part of the town is situated on 
 sandstone and other highly permeable rocks, so 
 that there is very efficient subterranean drainage, 
 and the gentle slopes allow of a rapid discharge of 
 surface water in heavy storms. These conditions in 
 conjunction with the distance of Harrogate from 
 the west coast with intervening heights that con- 
 dense much ofthe moist winds from the Atlantic, 
 renders its climate much dryer and sunnier than 
 most places to the west. Its elevation likewise 
 relieves it from the mists of more lowly situated 
 towns, such as York, Leeds, etc. In consequence of 
 these special topographical conditions its climate 
 is characterized by having one of the lowest aver- 
 ages of rainfall of Great Britain and more sunny 
 days than most other localities. Of course while 
 this improves it very much as a summer resort, 
 it renders, the climate rather bleak in the winter, 
 but though then cold, it has the advantage of being 
 comparatively dry. 
 
 In so far as distractions and amusements go, 
 Harrogate is well favoured. This is especially the 
 case with regard to pleasant walks as well as 
 longer excursions, which can be made through 
 beautiful country to so many points of picturesque 
 
HARROGATE AS A SPA 
 
 31 
 
 scenery and interesting ruins in the neighbour- 
 hood. These excursions are greatly facilitated 
 by the very frequent trains passing through the 
 station and by the well organized and numerous 
 stage coaches running to the principal points of 
 interest. 
 
 Tennis, and other games, balls, concerts, good 
 theatrical companies and other entertainments, all 
 combine to render the season very lively for those 
 who care for such amusements, whilst there are 
 several good reading rooms and lending libraries 
 for the more studious. 
 
 Such then are the many advantages presented 
 by the climate , town and attractions of Harro- 
 gate. Although other favourable factors may be 
 wanting, still, all the main ones are represented, 
 and above all, the healthy conditions, which are so 
 often practically absent in foreign spas. 
 
CHAPTER V 
 
 The mineral waters and baths. 
 
 In Harrogate and its neighbourhood over 80 
 mineral water springs occur, and only within 
 the last few days others have been brought to 
 light. There are a considerable number of quite 
 distinct chemical types of these waters which 
 often rise quite close together, an association 
 common enough in active volcanic districts but 
 rare elsewhere. These waters may be classified 
 into natural groups, a method very convenient in 
 order to the more precise comprehension of their 
 therapeutic action. I have found this grouping an 
 excedingly useful help for the memory and also in 
 prescribing, for io is then easy to first decide upon 
 the particular group likely to suit the general ill- 
 ness, and after select the variety in that group most 
 applicable to the particular case. Taking for exam- 
 ple thesaline sulphur groups, we can choose a spring 
 that has in one case a predominance of sulphur 
 compounds over the saline, or vice versa, or we 
 
WATERS FOR DRINKIXG & BATHINa 
 
 33 
 
 can choose concentrated or dilute examples of 
 either. To place this classification in a compre- 
 hensive form I have arranged the following table. 
 
 S Strong chloro-saline 
 Mild chloro-saline 
 Sulphate-saline 
 / chloro-ferru- 
 
 S ca?Zo-fer- 
 ^ ■. ' ruffinous 
 
 SULPHUR 
 
 ( Strong chloro-salme 
 ^ \ Mild chloro-saline 
 
 \ Chloro-carbonatcd alkaline 
 f Pure sulphur 
 
 It is thus evident that the 80 or 90 springs of 
 Harrogate fall into eight distinct groups, which 
 may not only again be split up into minor va- 
 rieties by the predominance of one or other solid 
 constituent, but almost into additional groups, 
 dependent on the presence of lithium , barium , 
 strontium, etc. 
 
 Harrogate stands pre-eminent as the possessor 
 of three mineral waters superior to those of any 
 other European spa. The « Old Sulphur Well » 
 water is the strongest sulphurous water known , 
 due no doubt to the low temperature at which it 
 isues from the earth, and to its containing the 
 more stable alkaline sulphides as well as hydro- 
 gen sulphide. In like manner this locality posses- 
 ses both sulphur and iron waters, the richest in 
 
34 
 
 JOHNSTON-LAVIS 
 
 barinin so far known. Finally its «Chloride of Iron» 
 spring is unique. 
 
 All the waters are practically cold, a very great 
 advantage, for the gases are thus more easily 
 retained. For bathing purposes the water is pas- 
 sed through a « Therma » or heating coils devised 
 by Mr Hayton Davis the consulting chemist to the 
 Municipality. This is done at the moment the 
 water flows into the bath, so that the liberation 
 of the gaseous constituents of the waters takes 
 place to a large extent in actual contact with the 
 patients skin. 
 
 For drinking purposes, several of the waters are 
 warmed, when they are ordered to be so taken, 
 and occasionally it is found convenient to mix 
 two varieties together. 
 
 To give as clear an idea as possible, I have re- 
 duced the best analyses of the principal springs 
 to decimal measures, units per thousand or gram- 
 mes per litre, so that at a glance one can form a 
 clear mental conception of any supposed compound 
 in every litre or thousand parts of water. By doing 
 away with our barbarous nineteenth century 
 survival of « Standard Measures » of grains per 
 gallon, an easy comparison is made with conti- 
 nental waters which are always given in decimal 
 proportions. 
 
 We have practically no knowledge whatever of 
 
ANALYTICAL TABLE OF THE PRINCIPAL HARROGATE MINERAL WATERS REDUCED TO DECIMAL MEASURES. 
 
 
 
 Grammes per litre of 
 
 
 Water 
 
 ^ E 
 
 a CO a- 
 
 or fractions per 1000 
 
 Old Sul 
 
 R( 
 Pump 
 (Th 
 
 SULPHUR GROUP. 
 
 a — _ 
 
 E L. 
 
 O 03 
 O — 
 
 h cc E 
 
 5°-E . 
 ^ 5 = < 
 
 a u 
 
 = 2; 
 
 CO 
 
 Organic matter. . . 
 
 Silica 
 
 Ferrous chloride . . 
 Ferrous carbonate . 
 Ferrous sulphate . . 
 Ferric sulphate. . . 
 Aluminium sulphate 
 Manganese chloride 
 Calcium chloride . . 
 Calcium sulphate. . 
 Calcium carbonate . 
 Barium chloride . . 
 Barium sulphate . . 
 Barium carbonate . 
 Strontium chloride. 
 Strontium sulphate. 
 Magnesium chloride 
 Magnesium bromide 
 Magnesium iodide . 
 
 Fluorides 
 
 Magnesium sulphate 
 Magnesium carbonate 
 Lithium chloride . . 
 Ammonium chloride 
 Ammonium sulphate 
 Potassium chloride. 
 Potassium sulphate. 
 Potassium carbonate 
 Sodium nitrate . . . 
 Sodium chloride . . 
 Sodium carbonate . 
 Sodium sulphydrate 
 Sodium sulphide . . 
 
 Total Solids 
 
 Sulphuretted hydrogen 
 Carbon dioxide. . . . 
 Carburetted hydrogen 
 
 Oxygen 
 
 Nitrogen 
 
 0 0 100 1 1 I 0-051 
 
 0-623357 
 
 0-42525 
 0-0938 
 
 trace 
 
 0 6S072S 
 
 0-03257 
 
 0-001011 
 
 0-085042 
 
 0-01075 
 
 0-01472 
 
 0-137028 
 
 12-76671 
 0-0745 
 
 1-141942 
 
 0 125 
 
 0 005071 
 
 0-040228 
 0 007557 
 0-828411 
 
 0-034285 
 
 0 054800 0-022971 
 
 0-238571 0-447085 
 0-238728 
 
 trace 
 
 ~ , 0-008842 
 — i 0-013042 
 0-031142 I 0-304128 
 
 trace 
 0 0 14228 
 
 0-008728 
 
 0-012857 
 11-819571 
 
 0-207142 
 
 trace 
 0-162000 
 
 8-327857 
 0-098428 
 
 0- 0467 14 
 
 — 0 02r)857 
 
 0-009371 
 0-081300 
 
 0-005285 
 5.554285 
 
 0-125385 
 
 0-203942 
 0-017157 
 
 trace 
 
 0-025600 
 trace 
 trace 
 
 0- 182842 
 trace 
 trace 
 
 0-398757 
 
 3 •084-228 
 0-010100 
 
 0-143000 
 trace 
 
 trace 
 trace 
 
 0-050142 
 
 trace 
 trace 
 
 0- 009285 
 
 1- 063428 
 0-200714 
 
 0-019425 
 
 14-905083 
 
 14-322638 
 
 8-895283 
 
 6-932251 i 4-005897 2-165565 
 
 0-056652 
 0. -285665 
 
 Total mineral 
 I constituents by weight 
 
 Gases in cub. centimetres 
 per litre 
 
 Sulphuretted hydrogen 
 Carbon dioxide .... 
 
 Carburetted hydrogen 
 Oxygen ........ 
 
 Nitrogen 
 
 Total gases by volume 
 
 0-4-27430 
 0 006024 
 
 0.008742 
 
 0-023304 
 0-094176 
 
 0-384688 
 0-002096 
 
 0 081926 
 
 0 009096 0-014481 
 
 15-307400 
 
 14-762834 9 021859 
 
 7-333516 
 
 4-0878-23 
 
 2-165565 
 
 IRON GROUP. 
 
 CO j: 
 
 1. eS — s 
 •a 03 V) 
 
 «n ^ 
 
 « a. ca. 
 
 <» 
 
 0-018757 
 
 0-024328 
 0-150014 
 
 0-074212 
 trace 
 taacc 
 
 0-054728 
 0-019242 
 
 trace 
 
 0-008571 
 
 0 00861 4 
 
 0-050185 
 0-219714 
 
 0-050614 
 
 0-051000 
 
 0- 137000 
 
 1- 247671 
 
 0-126542 
 
 0 007271 
 0-030514 
 0-012671 
 
 0-934157 
 trace 
 
 trace 
 
 I trace 
 0-006271 
 
 j 0-020714 
 
 0-020200 1 0-009642 
 
 0-188757 I ~ 
 
 0-157857 I 0-082857 
 
 0 013871 
 1-343071 
 
 0-074342 
 0 003 171 
 
 0 008914 
 
 0-818785 
 
 trace 
 
 trace 
 
 trace 
 0- 005800 
 
 trace 
 
 0-129957 
 0-196600 
 
 — 0-010714 
 0-002914 0-007171 
 
 0-086314 ! 0-019485 
 
 trace 
 
 0-033014 
 0-108928 0-010700 
 0-001871 : 0 021885 
 
 0-187828 
 
 0-306071 0-045785 
 
 9-637114 
 
 3-965157 
 
 0- 067642 
 trace 
 
 trace 
 
 0-082642 
 trace 
 trace 
 
 0-016142 0 002142 
 
 trace 
 
 trace 
 
 0 0-27885 
 trace 
 trace 
 
 0-003742 
 
 2-519571 1 0-166428 0-023214 
 0-015757 
 
 0-679009 
 
 12-496252 
 
 6-845710 3-125767 
 
 0-592439 
 
 0-140553 
 
 36-602 
 144-464 
 
 181-066 
 
 216-156 
 8-280 
 
 13-328 
 
 237-770 
 
 15-059 
 47-626 
 
 7-241 
 
 {)9-926 
 
 194-541 
 2.882 
 
 11-528 
 
 41-430 
 
 208-951 
 
 41-430 
 
 0-042742 
 0 036204 
 
 0-757955 
 
 0-151737 i 0-381481 0-121390 
 
 0-007727 ' — 0-001596 
 0-023533 1 — 0-040638 
 
 0-097880 
 
 0-004221 
 0-036204 
 
 12-679240 
 
 7-227191 
 
 3-289391 
 
 0-592439 
 
 0-278861 
 
 ^ 1 
 5 5 
 
 0-009471 
 0-014871 
 
 0-019400 
 
 trace 
 
 0-009957 
 0-0-20500 
 
 _ (0 
 
 — a. 
 
 trace 
 trace 
 
 0-01815'; 
 
 0 -004385 
 0-032342 
 
 0-046714 
 
 0- 990428 
 
 1- 125142 
 1-278142 
 
 0-8l;{000 
 
 trace 
 
 trace 
 
 0-038100 
 trace 
 trace 
 
 0-018900 
 
 0-015100 
 
 0- 001 000 
 
 0 0434 14 
 trace 
 
 0-014157 
 
 0-022042 
 0-019114 
 
 0-819714 
 
 0-031285 
 0-044857 
 
 0-485142 
 
 0-150299 
 
 0-153611 5-634424 
 
 21 615 I 
 28-821 
 
 76.735 
 
 5-404 
 18-734 
 
 50-436 100-873 
 
 192-919 
 
 
 
 
 0-084418 
 
 0-106502 
 
 
 
 0- 000393 
 
 
 0-002060 
 
 0-003450 
 
 
 0-025025 
 
 0-028736 
 
 
 0-201802 
 
 0-292692 
 
 5-634424 
 
 
 
 
 61-388 
 
 1-116 
 
 32-351 
 
 192-919 94-855 
 
 49-499 I 
 
 2-954 i 
 28-821 ! 
 
 42-691 
 
 1-441 
 19-922 
 
 81-271 
 
 64-054 
 
 53-859 
 0-540 
 2-413 
 
 22-876 
 
 79-688 
 
Back of 
 Foldout 
 Not Imaged 
 
Elementary Constituents Present in the Principal Harrogate Waters. 
 
 SULPHUR GROUP. 
 
 IRON GROUP. 
 
 Parts per 1000, 
 or grammes per litre 
 
 Old Sulphur 
 Well 
 (Thorpe) 
 
 Montpelier 
 Strong Sulphur 
 (Attfield) 
 
 Montpelier 
 MUd Sulphur 
 (Attfield^ 
 
 Mild Sulphur 
 R. Pump Room 
 ^W. A. Miller) 
 
 Magnesia { 
 
 Spa 
 (Muspratt) 
 
 Montpelier 
 
 Kissengen Spa 
 (Attfleid) 
 
 I 
 
 Chloride of ! 
 Iron Spa 
 (Bothamley 
 
 Alexandra 
 Chalybeate 
 (Davis) 
 
 Pure Chalybeate 
 R. Pump Room 
 
 rOavis) 
 
 Potassium . . . 
 
 Sodium .... 
 
 Ammonium . . 
 
 Barium .... 
 
 Strontium . . . 
 
 Calcium .... 
 
 Lithium ..... 
 
 Magnesium . . 
 
 1 ro n 
 
 Manganese. . . 
 r Sulphates . . . 
 o I Nitrates .... 
 72 \ Chlorides . . . 
 
 I Carbonates. . . 
 ^ j Sulphides . . . 
 ^ f Bromides . . . 
 ^ \ Iodides 
 
 Silica 
 
 •0701) 
 f9940 
 •0004 
 •0011 
 trace 
 •3903 
 •0017 
 •2000 
 
 8-6724 
 •3125 
 •0933 
 •0280 
 •0014 
 •0099 
 
 ■0360 
 4-7720 
 -0048 
 -0035 
 -0-258 
 ■4615 
 trace 
 -2093 
 •0028 
 
 •0064 
 •0093 
 8.5823 
 •0780 
 •0849 
 trace 
 trace 
 •0510 
 
 •0425 
 2-2591 
 
 •0031 
 trace 
 
 •0111 
 
 •2566 
 trace 
 
 •1000 
 trace 
 
 •0068 
 •0038 
 4-0000 
 •1430 
 -0514 
 trace 
 trace 
 •0548 
 
 •0827 
 3-3100 
 
 trace 
 
 •2643 
 trace 
 •1400 
 
 5-6200 
 •2410 
 -0562 
 
 -0343 
 
 t 
 
 •2077 
 
 1- 2185 
 trace 
 -0115 1 
 trace 
 •1055 
 trace 
 -0587 
 trace 
 
 2- 1006 
 •2890 
 •0041 
 trace 
 trace 
 •0230 
 
 •1002 
 3,.7889 
 •0021 
 •0255 
 ■0010 
 •5002 
 trace 
 •2360 
 •0661 
 
 •0030 
 
 7^5000 
 •1560 
 
 trace 
 trace 
 •0510 
 
 •0-239 
 
 P5536 
 0019 
 •0506 
 •0040 
 •4817 
 trace 
 •2006 
 •1587 
 •0060 
 •0013 
 
 4^2369 
 •0812 
 
 •0042 
 
 •0201 
 
 •0084 
 •9981 
 trace 
 
 "1 168 
 trace 
 •0374 
 •0400 
 trace 
 -0917 
 
 1-5900 
 2200 
 
 trace 
 trace 
 •0096 
 
 •0028 
 •0072 
 trace 
 
 faint trace 
 •0074 
 •0093 
 
 •0066 
 
 •0128 
 •0524 
 
 •1106 
 
 
 15-0036 
 
 14^3276 
 
 6-9328 
 
 9-7485 
 
 4-0126 
 
 12-4960 
 
 6-8221 
 
 3-1120 
 
 •1-28:} 
 
Back of 
 Foldout 
 Not Imaged 
 
WATERS FOR DRIKING & BATHING 35 
 
 the chemical state of different elements in solu- 
 tion, so that the grouping of the different substances, 
 determined in practical analysis into this or that 
 compound, is based upon purely hypothetical 
 grounds. It is no doubt useful to use such an ar- 
 rangement in prescribing, but it should always be 
 accompained by a table of the percentage of bases 
 and acids , as found by analysis. This has been 
 done in the present instance for the most renowned 
 springs, as shown in the second table. 
 
 In the first table of the hypothetical saline con- 
 stituents , these have been grouped according to 
 their bases, where these latter are the important 
 therapeutic agent in the salt, whereas those in 
 which the radicle is the active substance, the 
 compounds containing such are placed together. 
 
 The gases by weight are added so as to show 
 the total mineralization of the water, and beneath 
 they are again given by volume (*). 
 
 (*) For the preparation of the first table I am much 
 indebted to the help of my wife and my friend Major 
 Warren Frith, R. A., who both kindly relieved me of much of 
 the ver}'^ long and tedious calculations necessary. I must 
 express by deep gratitude to MrHayton Davis for preparing 
 the second table, the labour represented by which is really 
 enormous. 
 
 3 
 
CHAPTER VI. 
 
 Cases for treatment at Harrogate. 
 
 It is a recognized fact that only chronic, or acute 
 diseases extending over a long period , which 
 though not chronic may be looked upon as such, 
 are fit and proper ones to be sent to take the 
 waters. In fact hydrotherapeutic treatment is most 
 applicable to those cases where nutrition, metabol- 
 ism or excretion are at fault. These deranged phy- 
 siological processes constitute the main elements 
 in most chronic deseases and it is in great part 
 by righting these, that baths and drinking the water 
 bring about a cure. 
 
 Of these diseases the gout and rheumatism group 
 stand out pre-eminent. If treatment be adopted as 
 a preventive measure, the milder saline sulphur 
 water acts in a marvellous manner. The alterative 
 action of the sulphur, its marked stimulating effect 
 upon the liver, skin and lungs, clears and restores 
 the deranged functions of these organs, whilst the 
 chloro-alkaline constituents stimulate metabolism 
 
CASES FOR HARROGATE 
 
 37 
 
 generally, improve appetite and digestion, excite 
 the bowels and augment the amount of urine and 
 the elimination of the various forms of uric acid and 
 its salts. In the graver examples of these diseases, 
 the congested or even chronically inflamed state of 
 different organs is removed, molecular uric deposits 
 redissolved and excreted, whilst fibrous tissues 
 are poisoned and irritated by such deposits, regain 
 in part their normal state. Old exudations of joint 
 capsules , thickened ligaments and tendons with 
 their sheaths as well as those of the mascles, 
 facias, aponueroses, gland capsules, fibrous tra- 
 becular frameworks and tubular sheaths, so far 
 return to normal as is compatible with permanent 
 tissue changes , organized new deposits , growth 
 or destruction of tissue. It is absurd to expect 
 an anchylosed joint to regain its normal mobility 
 and use, but much can be done to restore it to an. 
 extent compatible with thevital reparatory powers 
 of Nature, which really execute the work when 
 directed by the phj^sician or more properly the- 
 practical physiologist. 
 
 The sulphur water used as hot plunge, douche,, 
 spray or other baths , combined with massage, 
 excites skin circulation, removing congestion, and 
 stimulating the sweat glands to increase their func- 
 tional activity. 
 
 Not an uncommon result of mineral water treat- 
 
38 
 
 .lOHNSTON-LAVIS 
 
 ment is to set up an acute attack of gout, and a 
 sharp daily look-out should be made to stop tempor- 
 arily the waters and adopt suitable treatment. 
 This phenomenon is not one that should lead to 
 an unfavourable prognosis but quite the contrary; 
 it is, however, a warning to medical advisers not to 
 send their patients to a spa without local advice 
 and supervision. In fact, in a considerable number 
 of cases it is undoubledly due to the patient not 
 being subjected to a graduated treatment advanc- 
 ing from feeble to more active measures as the 
 way clears. 
 
 In the same manner the numerous manifestations 
 of the rheumatic or gouty state are markedly 
 improved by the simple sulphur or chloro-alkaline 
 sulphur water, such as dyspepsia, constipation, uric 
 dysentery or colitis,hepatitis, haemorrhoids, chronic 
 pharyngitis, tonsilitis, laryngitis, bronchial catarrh, 
 bronchitis, pleurisy, chorea, neuralgia, locomotor, 
 ataxy, certain peripheral paralyses, endo- and peri- 
 carditis and arteritis, dilated capillaries especially 
 about the head with symptoms threatening apo- 
 plexy, certain forms of nephritis, eczema, psoriasis, 
 rheumatic nodes, and many others too numerous 
 to mention. 
 
 It would be out of place here to discuss the 
 chemical, biological, and physiological aspects of 
 these two disease groups ; still more is this the 
 
CAS1<:S FOR HARROGATE 
 
 39 
 
 case when we conceive that it is no long time 
 since we passed from the empirical to the hypo- 
 thetical stage of oar knowledge concerning them, 
 and it is but lately that we can say we have ad- 
 vanced to the first steps of the theoretical stage. 
 Speaking generally , both these disease groups 
 depend on defective digestion , assimilation , 
 imperfect oxidation or reduction , or incomplete 
 excretion. In some individuals it appears to be 
 only one of these processes at fault, but far more 
 often, two or even all are performed in a perverted 
 or imperfect manner. 
 
 Our most successful treatment must therefore 
 be in the correct determination of the presence 
 and character of these pathological phenomena 
 and their rational correction. Any method that 
 combines such, correction with an improvement- 
 of the local manifestations and without doing^ 
 injury to the system in general, must necessarily 
 be the most preferable. It is for this reason that- 
 cloro-alkaline sulphur waters offer such great 
 advantages over ordinary drugs when used in a more 
 condensed form. Add to this the climatic and diet- 
 etic advantages that can be fulfilled at a spa, then: 
 we have the obvious explanation of the renown 
 that mineral-water-stations have acquired in the 
 treatment of gout, rheumatism and their allies. 
 
 On the same lines much good can be obtained 
 
40 
 
 JOHXSTON-LAVIS 
 
 in chronic or old serous deposits about the peri- 
 cardium, pleurae, etc. whilst it is most marked in the 
 stages of simple peritoneal exudations or in loca- 
 lized forms such a perimetritis, perityphlitis, etc. 
 Likewise thickenings and chronic congestion or 
 exudative crusts on the cerebro-spinal meninges 
 are greatly ameliorated, and cirrhosis of the liver 
 and kidneys as well as fibroid degeneration of other 
 structures are also benefited by these sulphur 
 waters. 
 
 Chronic metritis, ovaritis, prostatitis, cystitis, etc. 
 are likewise much improved by a course of the 
 sulphur water, and calculous deposits show enor- 
 mous improvement by a course of the "Magnesia 
 spring". 
 
 In old wounds and other traumatic lesions with 
 thickened painful scars, chronic exudations, feeble 
 sloughy ulcers, stiffened points, rigid ligaments 
 and tendons, periostitis, caries and necrosis, the 
 douching, massage and water drinking, by improv- 
 ing the physiological environment and consti- 
 tutional state , rapidly restore the sufferers to 
 health. 
 
 Of some skin deseases we have already spoken. 
 Even where no gouty origin can be found for 
 eczema, much good often acrues , but the results 
 are generally not so brilliant. Impetigo, the first 
 stage of acne rosacea, chronic migratory erisyp- 
 
CASES FOR HAREOGATE 
 
 41 
 
 €las, lichen and most of the parasitic skin diseases 
 are suitable for treatment by the Harrogate sul- 
 phur water. 
 
 After their use in the treatment of gout and 
 rh eumatis m , chloro-alkaline sulphur w aters are most 
 known for the remarkable effect they exert on 
 scrofula and glandular tubercle, with the numerous 
 other lesions depending on that state. Scrofulous 
 or tubercular diseases of glands , viscera , skin, 
 mucous membranes, bones and joints, and especially 
 chronic abcesses are influenced in a remarkable 
 manner at flarrogate. No doubt this is in great 
 part due to the climate and hygiene, but the saline 
 sulphur, water followed, where necessary, by the 
 iron waters, is the main agent in bringing about 
 the remarkable recoveries. Special attention must 
 be drawn to the "Strong Sulphur Well" and the 
 ''Chloride of Iron" water which are, for Barium, 
 the highest mineralized waters known. It is more 
 than a century that the great value the salts of 
 this base have been known to have in the treat- 
 ment of scrofula. 
 
 It has also been said that rickets are benefited 
 by sulphur waters, but I am inclined to refer 
 the result more to the climate and individual hy- 
 giene than the waters. 
 
 Much the same may be said of pthisis. Thera- 
 peutically the sulphides are often of much use, 
 and the chlorides stimulate the apetite, digestion, 
 
42 
 
 JOHNSTON-LAVIS 
 
 and the excretion of the animal poisons absorbed 
 from the tuberculariilcers, but climate and hygiene 
 contribute more to the improvement or recovery. 
 No doubt the dry bracing climate of Harrogate 
 constitutes a useful summer sojourn for such 
 patients, but they should quit it and get settled in 
 their winter quarters not too late in the autumn. 
 
 Syphilis with its innumerable manifestations 
 gives very good results where iodides are being 
 simultaneously prescribed, but the use of sulphur 
 waters during the exhibition of mercury would 
 not be carried out by any physician who recalls 
 his chemistry. 
 
 It is in part for the reason that insoluble sul- 
 phides are formed, that these sulphur waters are 
 so useful in metallic poisoning from mercury, lead 
 arsenic, etc., and in part the improvement of 
 the general health by cleansing the system, that 
 such sufferers are benefited. 
 
 Finally these waters are of great use in a large 
 number of gastro-intestinal and hepatic troubles 
 quite indipendent of gout or rheumatism. In these 
 cases those springs such as the "Old Sulphur 
 Well" that are rich in Barium, and above all. 
 Strontium, ranking as the richest waters containing 
 these substances known, are very valuable. The 
 recent researches on Strontium and its great use 
 in certain diseases of the stomach render some 
 
CASES FOR HARROGATE 
 
 43 
 
 of the Harrogate springs most suitable for the 
 treatment of those disorders. 
 
 The cases that are unfitted for Harrogate Sul- 
 phur waters , are those patients suffering from 
 atheroma, and fatty degeneration in general, aneur- 
 ism, cardiac valvular incompetency with fatty de- 
 generation, not due to gout or rheumatism, all forms 
 of haemorrhage, acute fevers, acute skin diseases 
 and active syphilis. 
 
 Passing on to consider the employment of the 
 iron waters, we have to determine in the different 
 cases whether we choose the saline chalybeate, 
 simple chalybeate, or the chloride of iron and ba- 
 rium water. Each of the first two of these types 
 occur at Harrogate in different grades of dilution, 
 so that in a given patient it is often useful to employ 
 different springs progressively, so as to obtain, if 
 required , tolerance of even large doses of the 
 strongest. 
 
 In the convalescent stage from fevers, other 
 grave illness, or after prolonged treatment with 
 sulphur waters, it is often of great benefit to 
 submit the patient to one or other of these iron 
 waters. 
 
 In simple anaemia dependent on bad hygiene 
 or generalmalnutrition, the simple chalybeate or 
 the Chloride of Iron water should be chosen, and 
 especially the last, where there is any scrofulous 
 
44 
 
 JOHNSTON-LAYIS 
 
 tendency. In anaemia, accompanied by passive 
 haemorrhages in general, much good may be 
 expected from the simple chalybeate and the iron 
 chloride water, whilst the saline chlorides should 
 be avoided as diminishing the coagulating power 
 of the blood at the ends of the bleeding vessels. 
 It is, however, otherwise with chlorosis, which, 
 usually dependent on bad hygienic and moral train- 
 ing, tight-lacing, perverted modesty, etc. has led 
 to imperfectly performed functions in general, com- 
 bined with marked constipation. According to my 
 own views, at the age at which this complaint oc- 
 curs, certain conditions seem to exist, which fa- 
 vour a special kind of fermentation in the retained 
 foeces, in which sulphuretted hydrogen and probab- 
 ly organic compounds of sulphur are formed. The 
 sulphur compounds in the first place precipitate all 
 the iron components in the food and so render 
 them insoluble and incapable of absorption. Besides 
 the iron starvation of the blood, the ferruginous 
 constituents of the red corpuscles likewise enter 
 into composition with the fermentation sulphur 
 compounds that are absorbed from the intestines 
 into the circulation. We have a somewhat similar 
 effect in slow sulphuretted hydrogen poisoning. 
 ]N"ow iron given in this desease performs a two or 
 even three-fold purpose — a chemical precipitant, 
 an antiseptic, and an inorganic food. The excess of 
 
CASES FOR HARROGATE 
 
 45 
 
 iron introduced, goes to decompose and render 
 harmless the sulphur compounds set free in the 
 intestines, and so allows the organic iron consti- 
 tuents of food to be assimilated. It probably acts 
 as an antiseptic, arresting the production of the 
 ansemogenic compounds, and finally a portion is 
 absorbed and goes to regenerate the hsemoglo- 
 bin (*). 
 
 It is a fact well known to the practical physician 
 thai; the administration of even large quantities of 
 iron alone, does but little good in chlorosis, whilst 
 in small doses combined with a purgative, often 
 most marked improvement takes place. This it 
 seems to me can be explained by the large doses 
 impairing digestion, increasing the constipation, 
 and acting as an astringent and irritant to the 
 intestines, whilst certain portions of food, not 
 thoroughly mixed with the iron, still undergoes 
 the ansemogenic fermentation. This fermentation 
 seems only to occur in foeces retained bejond 
 the regular time, so that the stimulation of the 
 bowels by purgatives to evacuate their contents 
 
 (*) The good effect of arsenic in such cases can be 
 explained in the first place by its tonic effect and by the 
 antiseptic action of arseniuretted hydrogen or other arsenical 
 compounds set free in the intestines. 
 
46 
 
 JOHNSTON-LAVIS 
 
 prevents the occurrence of this fermentation. The 
 pernicious effect of purgatives when long continued 
 in, is but too well known, so that when the same 
 effect can he brought about in an equally satisfac- 
 tory manner by the saline constituents of the iron 
 waters, the great advantage is obtained of intro- 
 ducing no abnormal physiological substance into 
 the alimentary canal. The dose also can be so 
 arranged as not to overstep the poison limit of 
 iron; by which I mean the limit at which it 
 begins to do harm. 
 
 As a matter of fact, the effect of the saline 
 chalybeates in the cure of chlorosis is marvellous. 
 No doubt the social, moral, climatic and hygienic 
 change does much to help the medicinal treatment, 
 without which it is far less effectual, but never- 
 theless the waters are the most important element 
 in bringing about the result. 
 
 Convalescence from almost any serious illness 
 will be rendered more speedy and complete if a. 
 course of iron waters be prescribed. Generally in 
 such cases the simple chalybeates will be found 
 most useful, but where morbid products must be 
 absorbed, recourse will be had to the saline chal- 
 ybeates. It is also advisable to prescribe some of 
 these iron waters after a course of the sulphur 
 springs, especially if a little anaemia has beea 
 set up by these latter. 
 
CASES FOR HARROGATE 
 
 47 
 
 In most haemorrhages the astringent iron springs 
 free from salines are the most adapted to this class 
 of cases, but where such discharges are the result 
 of general, or local plethora as in haemorrhoids, all 
 these iron waters are best avoided. 
 
 In menstrual and uterine disturbances, which are 
 so variable in their nature, much good may be done 
 in some cases, whilst harm would accrue in others. 
 To detail such cases would be out of place here 
 in the short space at our disposal. 
 
 A similar remark applies to disturbances or di- 
 seases of the gastro-intestinal canal. 
 
 Such then, in as compact a form as possible, 
 is a general review of those cases fit or unsuitable 
 for treatment at Harrogate, so that the overworked 
 family physician may , without plunging deeply 
 into the therapeutics of the different springs of 
 that town, know what cases to send there. It is 
 for the local medical man to judge of and order 
 the more detailed trea tment and watch its results 
 It is by an almost specialization and constant 
 observation, that one acquires the practical know- 
 ledge of what to do in any given case, which, 
 the ordinary practitioner can hardly hope to 
 obtain. There are one or two points that should 
 be carefully attended to in sending patients to Har- 
 rogate. They should bring a short account of 
 their case and especially of the treatment they have 
 
48 
 
 •TOHNSTON-LAVIS 
 
 been subjected to. They should not be allowed 1o go 
 there without some local advice, and take the « wa- 
 ters » indiscriminately. They should be warntd to 
 attend to diet, exercise, and other advice given ihem 
 by the local physician, and not be allowed t) be- 
 lieve that however much they neglect themsHves 
 the waters will miraculously bring about a com- 
 plete cure in a few days, perhaps of a mslady 
 that has worried them for years. 
 
Works by the same author still on sale 
 
 1883. Notices on the Earthquakes of Ischia of 1881 and 
 
 1883 — In 8°, pp. 56. with I map. Naples, 1883. — 
 Publ. by the author .... Price 2/- 
 
 1884. The Geology of Monte Somina and Vesuvius, being 
 a Study in Vulcanology. — Ext. Quart. Jour. Geol. 
 Soc. Lond. 1884. — Pp. 77, with two woodcuts and 
 one chromolith, plate 2/6 
 
 1885. Monograph of the Earthquakes of Ischia. A Memoir, 
 deahng with the Seismic Disturbances in that 
 Island from the Remotest Times, with Special Ob- 
 servations on those of 1881 and 1883. -— London 
 Dulau & C, and Naples, Furchheim, 1883. — Royal 
 4°., pp. X + 112, with 20 photo-engravings, 2 large 
 maps in colour, 3 hthographic plates, and i chromo- 
 lithographic plate ...... 34/- 
 
 1887. Diario dei fenomeni avvenuti al Vesuvio da Luglio, 
 1882, ad Agosto, 1886. — Lo Spettatore del Vesuvio 
 e dei Campi Flegrei, Napoli, Furchheim, 1887, in 4** 
 pp. 21, with 13 photo-engravings. Entire volume in- 
 cluding other papers . . . . . 17/- 
 
 189 1. Geological Map of Monte Somma and Vesuvius, 
 constructed during the years 1880-1888. Scale i: 10,000 
 or 6,33 inches to the mile. In six sheets with a 
 cloth-bound pamphlet , entitled : A short and Con- 
 cise Account of the Eruptive Phenomena and Geol- 
 ogy of Monte Somma and Vesuvius. English and 
 Italian editions. — London, George Philip and Son, 
 1 89 1 42/- 
 
1 891. The South Italian Volcanoes; Being the Account of 
 an Excursion to them Made by English and other 
 Geologists, in 1889, under the Auspices of the Geol- 
 ogist's Association of London ; with papers on the, 
 differentLocalities by Messrs Johnston-Lavis, Platania, 
 Sambon, Zezi, and Madame Ant. Lavis ; including 
 the Bibliography of the Volcanic Districts and 16 
 plates; edited by H. J. Johnston-Lavis. — Naples 
 Furchheim, 1891, in 8", pp. 343, and 16 photo-en- 
 gravings 1 2/6 
 
 1891. The Thermo-Mineral Water and Gas Springs of Sujo. 
 Naples, Furchheim, 1891 , in 8°, pp. 10, with two 
 photo-engravings ...... 2/- 
 
 4892 Harrogate as seen by an Outsider. Two Letters pub- 
 lished in the «Harrogate Heraldn — Harrogate 1892 -/6