Mental diseases other than very mild cases of depression should be considered inapplicable. Neurasthenics are sometimes treated at chalybeate or thermal muriated saline spas; but such treatment is entirely secondary to the general management of the case. Neuralgic affections and the later stages of neuritis, especially when dependent on gout or rheumatism, are often relieved or cured. Abdominal venosity (abdominal plethora), a feature of obesity, glycosuria, &c., are extremely well fitted for this form of treatment.
The alkaline sulphated waters, the bitter waters and the common salt waters can all be prescribed, and after a short course can be supplemented with various forms of active and passive exercises. Diseases of the respiratory organs are far more suited for climatic treatment than for treatment by baths. Anemia can usually be better or equally well treated at home, or by seaside residence or a sea voyage, though many physicians prescribe chloride of sodium waters, followed by a course of iron waters at some suitably situated spa. In the anaemia dependent on malarial infection, the muriated or alkaline sulphated waters at spas of considerable elevation and combined with iron and arsenic are often very beneficial. Gravel and stone, if of the uric acid variety, can be treated with the alkaline waters, but the case must be under constant observation lest the urine become too alkaline and a deposition of phosphates take place on the already formed uric acid stone.
Gout is so variable both in cause and effect that much discrimination is required in its treatment. Where the patient is of "full habit," with portal stagnation, the sulphated alkaline or mild bitter waters are indicated, especially those of Karlovy Vary (Carlsbad) and Mariánské Lázně (Marienbad); but the use of these strong waters must be followed by a long rest under strict hygienic conditions. Where this is impossible, a milder course must be advised, as at Homburg, Kissingen, Harrogate, Wiesbaden, Baden-Baden, &c
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