Soap Lake: A Spa for Thrombo-angiitis Obliterans *

A spa treatment for thrombo-angiitis obliterans was brought to my attention first by a patient who was planning to "take the cure" after reading an article entitled "Some Won't Die," featured in a veterans' journal.2 I had never heard about this spa, but my interest was sufficiently aroused by the name, "Soap Lake," and the brief description of the water given in the artide, to visit the lake during the following summer ( 1940). At that time a special study was being made of thrombo-angiitis obliterans and the phlebitic type of ulcer. The working theory was that these diseases are due to a fungus infection of the skin which progresses, chiefly because of personal neglect, to cause deep-seated disease. The treatment adopted to combat the mycosis was, first, a foot soak in a solution of sodium hypochlorite to soften keratin and incidentally to kill fungi, and second, a pedicure, after the skin was softened, to remove the excessive keratin and to trim away diseased areas of nails. This treatment, combined with simple surgical measures for the relief of pain and the dressing of open lesions, usually resulted after a time in a remission as the fungus allergy subsided. This concept of these circulatory disorders had much in its favor, but it had not been established as a fact. However, surgeons have agreed that dermatomycosis has an adverse effect in these cases. The following account of my observations will therefore dwell particularly on the effect the spa treatment may have on the skin disease.