PROPERTY OF THE FRENCH REPUBLIC VICHY AND ITS MEDICINAL PROPERTIES As found by the most Prominent Doctors in the 'World “ IVhat are called artificial waters, however admirably prepared, are simply pharmaceutical pro- ducts, and are destitute of a remarkable quality which distinguishes them from the remedies they are intended to imitate— Sir Henry Thompson, F. R. C. S., London. THE VICHY Mineral Waters There are but very few natural mineral waters whose reputations extend very far beyond the countries in which they are produced. Pre-eminent among these are the waters of Vichy. The name is one of world-wide celebrity, and it may safely be said that wherever civilization has penetrated these waters are in use. So great is their reputation that there is no maker of artificial waters who does not, in a more or less crude way, attempt to foist upon the public an imitation of the natural Vichy. Every soda-water fountain keeps on tap something that is labelled Vichy. This immense popularity is based upon the fact that the natural Vichy mineral water enjoys the greatest celebrity ever attained by a mineral water, and has maintained it since times nearly immemorial. The town of Vichy is yearly thronged by the sick who come there for treatment, an average of more than 60,000 having recourse to its therapeutic virtues each season. 2 The employment of imitations of the Natural Vichy Water is, as we have said, very wide-spread, on account of the reputation of this name. Yet there can be but disappointment for those who ex- pect to obtain the same results with these counter- feited waters, as those that are daily observed as a consequence of the employment of the true Vichy Waters. Any water may be analyzed, and with care its mineral ingredients may be placed together in the chemist’s laboratory, mingled with the proper amount of water, which is then charged with gas, and the mixture may then be labelled as one pleases. But does this constitute a true and effective imita- tion? It is in reality but the crudest attempt to deceive, and bears no more true relation to the natural water itself than does a painting to the thing it is supposed to represent. The mysteries of Na- ture’s laboratory are not thus divulged; a true min- eral water is more than a combination of certain chemicals with water. It is something possessed of qualities whose mode of production escapes us, but whose effects are distinctly visible, and cannot be imitated by man. Every investigator who has ever studied the action of true natural mineral waters has always come to this conclusion which, though it is accepted by all scientific observers, has not as yet been thoroughly impressed upon the people at large. The waters of Vichy have clear indications for their use, and may be relied upon with as great a FRASER & CO., Analytical Department, 263 Fifth Avenue, E. E. SMITH, M.D., PH. D., ONE DOOR BELOW 29th STREET. Director. New YORK, November 19th, 1898. Mr. E. de Raimbouville, 220 Broadway, New York City Dear Sir : At your request we have purchased of a well-known firm ten siphons of water labelled “ VICHY,” and have subjected the same to chem- ical analysis. Following are the results obtained : ANALYSIS 7,68 L GRAMMES PER LITRE. Sodium Bicarbonate, - - 0.504 Potassium “ - - 0.004 Magnesium “ - - 0.052 Calcium “ - 0.049 Ferrous “ - - 0.003 Sodium Sulphate, - - - 0.012 Sodium Phosphate, - - Trace Sodium Chloride, - - - 0.410 Alumina, - Trace Silica, ----- 0.006 Total, - - - 1.040 Very respectfully, . , 3 degree of certainty as any tried therapeutic measure. No further proof of this is needed than the fact that it is imported in huge quantities all over the world, and that its long-established popularity is increasing day by day. COMPOSITION There are at Vichy three principal springs, the analysis of which shows a considerable degree of similarity. These springs are known under the name of Celestins, Grande-Grille and Hopital. They are strongly alkaline waters, pleasant to the taste, easily digested, and lose practically none of their properties when bottled and exported. The analysis follows: ANALYSIS ns given by Cyr in Jaccoud's “ Nouveau Dictionnaire de Medecine et Chirurgie Pratiques”. The calculation is made in grammes and per litre. Grande-Grille Celestins Hopital Sodium Bicarbonate .... ... 4,883 5,103 5,029 Potassium “ .... ... 0,352 0,315 o,44o Magnesium “ .. 0,303 0,328 0,200 Strontium “ — 0,005 0,005 ■Calcium “ •• 0,434 0 & to 0,570 Ferrous “ . 0,004 0,004 0,004 Manganous “ — .. T race Trace Trace Sodium Sulphate .. 0,291 0,291 0,291 “ Phosphate .. 0,130 0,09. 0,046 “ Arseniate, .. 0,002 0,002 0,002 “ Borate Trace Trace “ Chloride ■ • 0,534 o,534 0,518 Silica 0,070 0,060 0,050 7,006 7,195 7,i55 Temperature (Fahrenheit). io7°6 57° 86° 4 This analysis shows conclusively that the Vichy Waters have an ideal composition. They are strong enough in alkaline elements to be able to saturate the organism with alkaline salts within a compar- atively short while. They can be taken for a pro- longed period of time, and in this respect are of the highest value, since most of the diseases for which they are prescribed are either of a chronic nature, or, if in the form of an acute attack, depend upon nutritive disorders that have existed for a long time, such as the uric acid diathesis and disturbances of the stomach and liver due to functional disorder. BOTTLING Within the narrow limits of this pamphlet we can- not describe at length the methods employed in bottling the waters. Let it suffice to say that this is done in a splendidly appointed factory, under the direct supervision of experts appointed by the French Government, with the aid of apparatus devised by the engineers of the Government. The water is collected directly from the springs, without having stood in reservoirs, and is put into sterilized bottles stopped with fresh sterilized corks, according to a system that represents the acme of mechanical and scientific precision, thus insuring absolute purity, 5 the minimum loss of the natural carbonic gas, and absolute preservation for an indefinite time in any climate. THERAPEUTIC USES No natural water has ever been made the subject of such exhaustive clinical study as that of the Vichy Springs, and it owes its reputation, not to a simple popularity due to its pleasant taste, but to a fame resulting from the crucial test of centuries of clinical observation. Like other mineral waters, their activity is some- what gi eater at the spring than when taken in bottled form. Yet this is scarcely a disadvantage, since in many cases it allows of a milder, more pro- longed effect which is especially serviceable in chro- nic conditions. It has been noted that the three springs of which we have given the analysis are very similar in their chemical composition. In practice, it is found that the water of Celestins is especially indicated in dis- orders of the kidneys, and such as depend upon the uric acid diathesis; rheumatism, gout, gravel, and cutaneous lesions, such as eczema, etc. The Grande- Grille water is deemed to be especially efficacious in stomach and liver disorders, while the Hopital spring is useful in the same way, but is somewhat milder 6 and slower in its action than either of the others. Practically it may be said that the water of the Celestins spring meets every indication for the em- ployment of Vichy Water. It has a mildly diuretic action of great power, and its action upon the liver and stomach is excellent. By its continuous use the blood is rendered more alkaline, deposits of uric acid in the form of sodic urates no longer take place, since the acid becomes promptly changed into urea, which is rapidly eliminated. The bile becomes diluted, and calculi are no longer formed in the gall- bladder. Those which may be present are desinte- grated through the solution, in a strongly alkaline medium, of the mucus which holds the various parts together, and the fragments are discharged through the common bile duct into the intestinal tract. In chronic hepatic disorders there is secured a greater flow of bile, and the improvement in gastric and intestinal digestion, due to the alkaline treat- ment, relieves the liver of a large part of the work previously given to it. In cases of hepatic sluggish- ness, attended with painful and slow digestion, the effects are often nothing short of marvellous. In gastric and intestinal indigestion the use of Vichy secures a more free action of the bowels, digestion becomes more perfect, and the products of this digestion reach the blood in a better prepared condition. This relieves the liver and kidneys, which no longer have to deal with so many products 7 of imperfect metabolism, and therefore we rapidly see an improvement in the general health which is quite surprising in character. A very large number of the girls and young women for whom we prescribe iron owe the poverty of their blood to gastric and intestinal sluggishness, and the great majority of cases of anaemia and chlorosis are therefore much improved by the Vichy treat- ment. In gastric derangements due to dietetic errors, and in those in which the abuse of alcohol may be in- criminated, the Vichy Waters are of unquestionable efficacy. If dyspepsia is of the decided acid variety, the Vichy Waters naturally act as antacids, and as such are clearly indicated. In this form of dyspepsia we commonly find that those who are content with pre- scribing bicarbonate of soda are disappointed in regard to the permanency of the effects obtained. As has been said by Bartholow: “ While the imme- diate -result is good, the after effect is to increase the production of acid. Those who habitually take sod- ium bicarbonate for acid indigestion suffer severely from acidity.” If the alkaline treatment is limited to the use of Vichy water no such unfortunate result can occur. , Medication by the use of the alkalies themselves must be carefully dosed as to amount and time of administration. Bicarbonate given before meals increases acidity ; given after meals it lessens acidity by the chemical neutralization of a part of the acid of the gastric juice, but while it acts in this manner it fails to afford the multiple results achieved by the Vichy waters, due to the dosage accomplished by Nature itself. These waters so promote oxida- tion in the system, and have such a general effect in improving nutrition, that they finally eliminate the causes themselves of the disturbed digestive pro- cesses. 8 In chronic catarrhal gastritis or enteritis, where there are no very acute symptoms, the use of the Vichy waters is attended with the best results. In cases of atonic dyspepsia, in which there is a defi- ciency in the amount of acid, the Vichy waters given before meals will increase the production of hydro- chloric acid, and by their general effects upon the system will be found to exert a curative influence. We have already pointed out the fact that in the diseases due to the uric acid diathesis the waters of Vichy, and more especially the water from the Ce- lestins spring, have a powerful therapeutic effect. In chronic nephritis it acts as a mild but effective diuretic, whose prolonged use is of the greatest value, and, by improving nutrition, it relieves the kidneys of much of the work they have become unfitted to accomplish properly. In gout we soon obtain a diminution of the produc- tion of acid, the formation of deposits of insoluble urates is checked, and an improved metabolism re- 9 duces the formation of waste products that prove irritating to the whole excretory apparatus. The skin takes on an improved action, the kidneys secrete more urine containing a larger amount of urea, and an increased intestinal action improves di- gestion and nutrition. In chronic emphysema and asthma, as well as in the bronchitis from which so many gouty subjects suffer, it is usually found that the Vichy treatment affords a decided improve- ment simply due to the amelioration of the general condition. In a tendency to the formation of uric acid gravel no treatment is so effective as the long continued use of the Celestins water. It frequently causes the expulsion of calculi from the kidneys, and prevents the formation of gravel. As in the case of biliary calculi, its use may give rise to colics, denot- ing the expulsion of the stones. However disagree- able such occurrences are to the patient, it is evident that they point to an effort, on the part of Nature, to restore a normal condition of affairs, and result finally in an amelioration of the general symptoms. In chronic rheumatism the effect produced is the same that occurs in gout. In acute attacks we ne- cessarily employ means intended to relieve the symptoms with greater rapidity than could be ex- pected from the use of a mineral water alone. But as soon as the acute stages are passed, the employ- ment of Vichy water improves nutrition, prevents the formation of any excess of acid in the system, and forms the best treatment that can be instituted in order to check the rheumatic tendency and pre- vent the occurrence of relapses. In chronic forms of rheumatism the use of Vichy water is so clearly indicated that we need insist no further upon it. In diabetes, both of renal and hepatic origin, Vichy water often has the happiest effects. While we desire generally to reduce the amount of water con- sumed by these patients, they still are compelled to take large quantities, owing to their insatiable thirst. In these cases, if we substitute Vichy water for the ordinary water they drink, we will nearly always find that after a fairly brief lapse of time the poly- dipsia is lessened, owing to the general good effects brought about by the natural mineral water upon digestion and nutrition. While it may not be asserted to possess an actual curative action in such cases, there is no doubt that under the influence of Vichy water many diabetics return to a condition very closely approximating the normal, and can often, at least for many years, live under the pleasant illusion that they are cured, providing they faithfully con- tinue the treatment. In inflammation of the bladder, we have in Vichy water a means of often successfully combating the causes to which it is due. As it brings about a rapid alkalinization of the urine, the latter becomes bland and unirritating. If the cystitis is a gouty symptom, as often occurs, it will rapidly get well, as, for instance, when it is a concomitant of uric acid gravel. Within the limits of this small pamphlet we have only been able to rapidly show how vast a field exists for the careful and well-understood use of this peerless mineral water, which, like all other important therapeutic substances, should be given under the intelligent supervision of the medical man. DOSAGE As to the mode of administration we need say but little. For the purpose of improving nutrition and securing a more efficient intestinal action it is often enough to direct the patient to take a tumblerful in the morning upon arising. We have seen that in gastric disturbances it must be given with a certain attention to details connected with the exact diag- nosis. In acid dyspepsia it should be given on an empty stomach as long as possible before breakfast, in the morning. Then it should be employed during the meals as a table water, directing the patient to take most of the water towards the end of the meal. In atonic dyspepsia it will often be found that a tumblerful before each meal will prove an efficient appetizer, and will make digestion more effective. In rheumatic, gouty and diabetic conditions the water should be drunk during meals as a table water, and the amount is to be increased if a more pronounced effect is desired by the physician. PRODUCTS EXTRACTED from the Vichy Waters Salt The Vichy Co. has erected at Vichy a roomy and splendid factory containing mechanical devices of the most perfect kind and most efficient apparatus for the purpose of evaporating the water, and is thus enabled to extract the mineral salts with every care demanded by that delicate -operation. The saline compound obtained in the manner just related is nearly identical with that which occurs in the natural mineral water of the Government Spring. In dissolving it to the amount of about six grammes to a quart of good spring water, you can obtain an artificial water whose mineralization approaches as nearly as possible that of the natural water. Do we assert that the imitation is a perfect one and that the water prepared with the Vichy Salts is as valuable as the natural bottled water. Evidently not; nature does not thus reveal its secrets. But when the water itself of the springs, Celestins, Grande-Grille and Hopital, cannot be procured, the water prepared with the salt Vichy-Etat is far supe- rior, from the medicinal standpoint, to alkaline solu- tions prepared with common bicarbonate of soda. This water is drunk in the same way and the same doses as the natural imported water. The Vichy-Etat salt is sold by the Vichy Co. in bottles and packages. Each package contains the amount necessary for the preparation of one quart. To avoid substitutions, be careful that each pack- age bears the words : VICHY-ETAT. Comprimes de Vichy effervescing (VICHY COMPRESSED TABLETS.) In the last few years a new and ingenious applica- tion of the salt Vichy=Etat has been devised. The Comprimes de Vichy (Vichy compressed tablets) are prepared with the salt Vichy-Etat. In this preparation the Vichy Salt is not only brought to the smallest possible volume, by power- ful compression, but its chemical composition is such that it gives out, when dissolved in water, an amount of gas equal to that which is in solution in the natural Vichy water. The mineral water thus pre- pared is therefore gaseous, which renders it digest- ible and pleasant. Three of these tablets suffice for a glass of water, and their solution occurs very rapidly. The ease witli which one may always have at hand the ele- ment of an essentially hygienic and digestive water explains the wide popularity that was immediately obtained by the Comprimes de Vichy. Pastilles Vichy=Etat The Vichy-Etat digestive pastilles are bonbons manufactured by the Vichy Co. at the thermal establishment with the salt Vichy-Etat extracted from the spring waters. They aid the action of the water by neutralizing the acidity of the stomach and are thus invaluable in cases of difficult, slow and painful digestion, dys- pepsia, flatulency, and heart-burn. Their immense consumption is quite justified by the convenience and the efificacity of their employ- ment. DOSE.—Four or five should be taken before meals and occasionally as required. They are flavored and scented with peppermint, lemon, vanilla, etc. The particular flavor required should be clearly specified when ordering. Beware of imitations. The genuine pastilles are sold only in sealed metallic boxes bearing the words VICHY-ETAT. E. DE RAIMBOUVILLE GENERAL AGENT 220 Broadway New York. CAUTION Vichy is never imported otherwise than in bottles. Always specify the Name of the Spring: LH3ISMIIi!M Bottled under the direct supervision of the French Government which guarantees genuineness and purity. Xouis THUciea & do. printers . . . . 116 ffulton Street Hew JlJorfe So-called Vichy in syphon or bulk is NOT VICHY.