Sussanna Czeranko, ND
Today, the almost fabled carbon dioxide bath is not known by many in North America, yet there was a time that a simulated Nauheim bath of German fame was central to the treatment
of many conditions and especially cardiovascular diseases on American soil.
The carbon dioxide bath originated from Nauheim, Germany, the site of a mineral water spring with a high
concentration of carbon dioxide, “varying from 1.8 to as high as 3.9%”. (Bovaird, 1909, p. 75)
It was discovered that this carbon dioxide rich water was quite efficacious for several
conditions. The Nauheim bath became synonymous with carbon dioxide bathing and had
many names such as ‘effervescent bath’ and ‘carbonic acid bath’. The Nauheim or carbon
dioxide bath continues to be utilized in several European countries as part of a flourishing
network of medical balneotherapy clinics. Here in North America, this remarkable modality
has simply vanished in thin air.
Since 1835, the Nauheim mineral spring has attracted many, drawn by the therapeutic
benefits that this water offers. One famous visitor, U.S. President Roosevelt when a young
boy, came to Nauheim with his father who was suffering from heart disease. He and
thousands of others have benefited from the effervescent carbonic acid baths which were
used in the treatment of neurasthenic conditions and insomnia, (Hoegen, 1916, p. 61) as well
as anemia, loss of appetite, impotence, old age, circulatory disturbances, hemorrhoids,
inflammation of the female reproductive system (menstrual irregularities), functional and
organic heart diseases, rheumatism, gout, and skin diseases. (Kellogg, 1903, pp 564-566;
Hoegen, 1916, p. 267; Baruch, 1920, pp. 104-106)
Diseases traditionally treated with the Nauheim Baths
Arteriosclerosis
Hypertension
Angina
Chronic nephritis
Cardiac weakness (Endocarditis, Mitral insufficiency, Cardiac Hypertrophy,
Aortic and Mitral Stenosis)
Rheumatism
The term ‘Nauheim bath’ meant “a cold brine bath in which free carbon dioxide gas is
liberated.” (Swan, 1911, p. 30) The utilization and specifications of such a water therapy
were not well known even among naturopaths these days. The temperature of “the Nauheim
bath was rarely given higher than 95 F, nor lower than 86 F”(Baruch, 1917, p. 182) which
may have felt to the patient a bit chilly initially. However this chilliness was quickly replaced
by “warmth and well-being” (Harveian, 1903, p. 6) as soon as the bubbles of CO2 gas began
to accumulate upon the skin. As Hoegen pointed out, “The skin shows decided hyperemia
wherever it is in contact with the gas bubbles.” (Hoegen, 1916, p. 534) Dr. Swan, who studied
the Nauheim bath literature in 1911, concluded that “the most important effect is the
equalization of the distribution of the blood in the skin and the viscera by the vasodilation
produced in the vessels of the former organ, the skin (Swan, 1911, p. 31), a contention also
supported by his colleagues Colebeck, Hare, Bishop, Anders and Merklen and explicated
variously among doctors in the first decade of the last century. [Colebeck, 1904; Hare, 1907;
Bishop, 1909; Anders, 1905; Merklen, 1908]
Having personally experienced these baths, the sensation is like bathing in ‘a tub of
champagne’. The body becomes covered with a film of tiny bubbles and despite the
coolness of the water, the body feels very warm due to vasodilation of the capillaries.
Whatever the patient’s experience of the waters, the Nauheim bath became famous for the
treatment of heart disease and was considered by some as the panacea for all cardiac
ailments. Swan, though, cautioned against the “promiscuous use of these carbogaseous
baths”. In his view, the therapeutic indications of the different cardiopathies needed to be
considered and the Nauheim practitioner needed to be prudent in their prescription. “The
best cases for the Nauheim treatment are those with myocardial weakness from whatever
cause. For vulvular heart disease in the stage of broken compensation with dropsy, it is not
suitable.” (Swan, 1911, p. 44) A
Harveian reported that physiological effects included “heart sounds [that became] clearer and
stronger” and “respiration [that became] easy and slower and deeper”. (Harveian, 1903, p. 6)
The physicians who worked at Nauheim “ascribe[d] the effects of the baths to mechanical
stimulation to the skin, with a reflex effect upon the heart or upon the circulatory system.”
(Bovaird, 1907, p. 76) The Nauheim physicians found the baths to “raise a low blood
pressure and lower a high blood pressure.” (Swan, 1911, p. 29) In fact, Beneke’s very early
18 month study published in 1859 of patients utilizing these rich carbon dioxide waters,
concluded:
The cases of organic cardiac disease which have resulted from
rheumatism or endocarditis furnish no contra-indication to the use of
the saline bath… I should not hesitate an instant to bathe persons
who in consequence of rheumatism have become afflicted with
cardiac disorder. (Harveian, 1903, pp 1-2)
Dr. Brown found the “the cases peculiarly fitted for Nauheim treatment are cases in which the
heart muscle acts insufficiently, either from dilation, poor blood supply from anemias or
arteriosclerosis with changes in the muscle, poisoning, acute or chronic and notably tobacco
poisoning and fatty changes of moderate degree.” (Brown, 1906, p. 92). Baruch later
reported, “The principal guide to a prescription of the Nauheim method, whether natural or
artificial, is adaptation of the bath in duration, temperature and gas and mineral contents to
each case, and a careful watching of the response of the heart.” (Baruch, 1917, p. 182)
Doctors who use this therapeutic tool then and now recommend rest as essential before and
after the Nauheim bath. Patients would “not leave the bath house without resting at least an
hour.” (Baruch, 1917, p. 180) Indeed, the carbon dioxide baths were sometimes augmented
by exercise that was introduced by the Schott brothers and subsequently used by many.
“These baths are given methodically, according to the indications of each case and the effect
of each bath, and they are accompanied or followed by certain passive or resisting
movements, which offer a systematic but mild exercise of the principal voluntary muscles of
the body. “ (Hoegen, 1916, p. 532)
Treatment Protocol
In Nauheim, the standard protocol for Nauheim baths consisted of a series of 18 baths and
did not exceed 24. Doctors, such as Baruch and Hoegen, counseled their fellow colleagues
in North America who were in the habit of prescribing fewer baths, to abide by the standards
and protocols established at Nauheim. However, not only the fewer number of treatments
came under criticism in America, but also the way in which the baths were delivered.
In Europe, volcanic mountains were abundantly available and necessary for carbon dioxide
rich mineral waters. In America, this was not the case and the number of hot springs rich
with carbon dioxide was limited to a very few such as Saratoga, NY and some in California.
To make the Nauheim bath available in America, doctors devised formulas to simulate the
carbonated waters. To create the carbon dioxide found naturally, doctors would create
formulas such as the one used by Kellogg at his Battle Creek Sanitarium: sodium carb,
sodium bicarb, calcium chloride, sodium chloride and sodium bisulphate. (Kellogg, 1903, pp.
562-3) Although, the effect was similar to naturally occurring carbon dioxide, discussions and
debates pursued as to whether these simulated treatments deviated too far from the original
Nauheim bath.
Replicating the medicinal properties of the Nauheim baths were also attempted at Saratoga,
NY. Baruch calculated that adding sodium chloride and calcium chloride to each bath would
enhance the effects of carbon dioxide. It was agreed that the waters at Nauheim also had a
distinct mineral composition which also enhanced carbonic acid delivery into the body. The
formulas that were created tried to replicate the minerals at Nauheim.
Natural vs. Artificial
The natural carbonated waters were considered to contain finer bubbles and more dissolved
CO2 than artificial waters. “The artificial, on the contrary, contains more free CO2 gas which
escapes more easily.” (Baruch, 1917, p. 599)
Here in America, Dr. Simon Baruch was determined to understand the effects of CO2 baths.
In a scientific manner he investigated whether there was difference between the artificial
baths and those baths found naturally. There was little choice for American doctors who
wanted to include carbon dioxide baths. The naturally occurring CO2 springs also had the
therapeutic addition of minerals or ‘salines’. The early doctors were engaged in determining
the actions of the minerals versus the carbon dioxide on the body. Studies initiated by
Baruch found that “absorption of CO2 is furthered by [minerals] and escape of CO2 [were]
prevented by [minerals]” (Baruch, 1917, p. 111) when minerals were added to a CO2 bath.
Today, there is renewed research interest in the merits of carbon dioxide baths. (Falagas et
al., 2009; Delahaye, R., et al, 1993; Fabry et al., 1992) The carbonated waters of the
Nauheim are among the rich heritage of modalities and nature-cure resources in our tradition.
It behooves us to know these roots and to sustain them in our eclectic repertoire.
References
Anders, JM, (1905). Proceedings of the Philadelphia County Medical Society, January 31.
1905.
Baruch, S, (1917). The Nauheim Bath, Herald of Health and the Naturopath, Benedict Lust
Publishing, New York, Vol XXII, #1, pp 599-600.
Baruch, S, (1917). The Nauheim Bath, Herald of Health and the Naturopath, Benedict Lust
Publishing, New York, Vol XXII, #2, pp 110 – 112.
Baruch, S, (1917). The Nauheim Bath, Herald of Health and the Naturopath, Benedict Lust
Publishing, New York, Vol XXII, #3, pp 179 – 182.
Baruch, S, (1920). An Epitome of Hydrotherapy: For Physicians, Architects and Nurses, W.
B. Saunders Company, Philadelphia.
Bishop, LF, (1909). Heart Disease, Blood Pressure and the Nauheim Schott Treatment, E. B.
Treat Company, New York, 3 rd Edition.
Bovaird, D, (1907). The Nauheim Treatment, Medical Times, A Monthly Journal of Medicine,
Surgery and the Collateral Sciences, Alfred Kimball Hills, editor, Volume XXXVII, March, New
York.
Brown, PK, (1906). Artificial Nauheim Baths in Chronic Heart Cases, Trans Am Climatolog
Clin Assoc. Vol. 22, pp108–116.
Colebeck, EH, (1905). Diseases of the Heart, W. T. Keener & Co., Chicago, Second Edition
Delahaye, R et al. (1993). Place de la Crénotherapie dans la prise en charge et la
reeducation des artériopathes, Pathologie Vasculaire de Membres, Editoris Masson.
Fabry, R., et al., (1992). The Effects of CO2 Gas Therapy in stage 3 artherosclerosis
obliterans of lower limbs. European J. of Physical Medicine. 1992:1.
Falagas, ME, (2009). Meta-Analysis, The therapeutic effect of balneotherapy: evaluation of
the evidence from randomized controlled trials, The International Journal of Clinical Practice,
Blackwell Publishing, 63, 7, 1068-1084.
Hare, HA, (1907). A Text-book of the Practice of Medicine for Students and Practitioners.
Lea Brothers & Co., Philadelphia, Second Edition.
Hoegen, J A, (1916). Nauheim Treatment, Herald of Health and the Naturopath, Benedict
Lust Publishing, New York, Vol XXI, #1, pp 61-62.
Hoegen, J A, (1916). The Nauheim Bath, Herald of Health and the Naturopath, Benedict Lust
Publishing, New York, Vol XXI, #8, pp 532-536.
Kellogg, J H, (1903). Rational Hydrotherapy, 2 nd Edition, F. A. Davis Company Publishers,
Philadelphia.
Merklen, P, (1908). Lecons sur les Troubles Fonctionnels du Coeur,
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Swan, JM, (1911). A Résumé of the Opinions upon the Nauheim Treatment of Chronic
Disease of the Heart, Trans Am Climatolog Clin Assoc. Vol. 27, pp 28–59.
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