vous
depression and old cases of paralysis are all contra-indicated. Any
trouble, however suited in itself for spa treatment, must be considered
inapplicable if complicated with pregnancy.

In advising balneotherapeutic treatment in any case, all the conditions and
habits of the patient--pecuniary, physical and psychical--must be
considered, as the spa must be fitted to the patient, not the patient to
the spa. Besides the particular disease, the idiosyncrasy of the patient
must be considered, the same morbid condition in different people requiring
very different treatment. Retarded convalescence is a condition often
treated at the spas, although hygienic surroundings, both mental and
physical, are usually all that is necessary to ensure complete recovery.
After rheumatic fever, however, if the joints remain painful and the heart
is dilated, the thermal gaseous saline water of Nauheim, augmented by
Schott's resistance movements, will often appear to work wonders. Chronic
rheumatism, where there is much exudation round a joint or incipient
stiffness of a joint, may be relieved by hot thermal treatment, especially
when combined with various forms of massage and exercises. Simple thermal
waters, hot sulphur springs and hot muriated waters are all successful in
different cases. Chronic muscular rheumatism can also be benefited in a
similar manner. Diseases of the nervous system are on the whole treated by
these means with small success. 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. Anaemia 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 cours