From The Improved Bath Guide 1825
Nature and Qualities of the Hot Waters
THE city of Bath derives not only its name but its celebrity from the medicinal waters which Providence has poured so liberally into its bosom ; and as these may be considered the sources of its prosperity, and even of its existence, we shall endeavour to give as general an account of their chymical properties and salutary virtues, as will satisfy the curiosity of the stranger, and serve to interest the chymist and the philosopher.
We have already stated the most probable conjectures respecting the origin of the city, and consequently all that has been surmised concerning the discovery of the springs. But if the various writers who have treated on this subject are not agreed on this point, still more contradictory are their opinions with regard to their natural source, and the cause or causes which produce so elevated a temperature. Some suggest that their heat may be derived from impregnation of the vapour of pyrites, during the passage of the stream over beds of that substance : while others ascribe it to the agency of subterraneous fires, acting upon their reservoir at some distance below the surface of the earth. In opposition, however, to this latter theory, is the well-attested fact, that vegetable matter, and particularly nuts, have been from time to time brought up by the spring, and found floating in numbers on the surface. Very probable arguments have been urged, and great authorities there are, for each opinion. One fact, at least, is certain — that the hot waters have retained their warmth and virtues through a long course of ages ; and that, whatever may he the cause, there are no just grounds to apprehend that their heat or salubrious qualities will ever fail.
These waters exceed in temperature any in this kingdom by many degrees. Their springs are perfectly distinct, and they arise within a small distance of each other; though Dr. Wilkinson is of opinion that they are all ramifications from one grand unknown source. The supply of water is so copious, that not only the large public baths are daily filled, and a per** petual current through them maintained, but there is also sufficient to fill the private baths with fresh water for each bather, and also for the use of the pump. The appearance of the water, when fresh drawn, is perfectly transparent, and destitute of colour, nor is any air extricated in form ofbubbles. After some hours it affords a small precipitation, and loses its transparency. To the taste it affords a highly chalybeate flavour, but lias no sensible impression on the organs of smelling.
The first analysis of importance was conducted, and the results presented to the public, by Drs. Lucas and Charlton; more recently by Dr. Falconer, Sir Geo. Gibbes, Mr. Phillips, Drs. Wilkinson and Scudamore. Mr. Mansford, Dr. Barlow, and Mr. Spry, have also published scientific and elaborate works on the medical efficacy of the waters. As it is well known that the investigation of the contents of mineral waters is the most difficult of any which comes within the operations of the chymist, it cannot be expected that the relative quantities of every component part of the water should exactly agree in these different analyses, as this depends very much on the quantities used in the operation. It is, however, generally agreed that the Bath Water contains:
- a small quantity of carbonic acid and of azotic gas
- some sulphate and muriate of soda
- selenite
- carbonate of lime
- muriate of magnesia
- silicious earth
- a very small portion of oxy-carbonate of iron
The quantities of any of these contents are certainly extremely small, as the whole of the solid contents, according to the account of some of the most recent experimentalists, do not amount to more than about ten grains in every pint of water. Every medical man must know that none of these materials can have any effect on the human body, in such small doses, with the exception of the iron ; and the amount of this is • so very small, as scarcely to be appreciable by the most minute analysis, it having been estimated at a fractional part of a grain in a gallon of the water. Now it is well known that such a quantity of iron diffused through water by any process which we know, could give no perceptible taste to the waters, and certainly would produce no sensible effects on the most delicate constitution; but it is admitted that the Bath Water has a very manifest chalybeate taste, discovers the presence of that metal by the application of tests, when fresh drawn, and exhibits very decided effects on the human constitution. It has therefore been with much reason supposed, although so little of the iron can be discovered after the evaporation of the water, that it must exist in so volatile and fugacious a combination, as not to be cognizable to our limited powers of analysis. There are various corroborative circumstances which tend to confirm such an opinion.
If the water be subjected to the test for iron immediately on being drawn, it manifests the presence of that metal; but if it be suffered to stand till cold, such existence is not to be perceived : evaporation therefore for the purposes of analysis would dissipate all the iron thus combined, and would retain only the small portion existing in a more palpable form. That iron does evaporate from the surface of the Bath Waters, without the aid of additional heat, and under the common pressure of the atmosphere, has been proved by Dr. Wilkinson, who suspended pieces of calico soaked in a decoction of galls, immediately over one of the baths, so as to receive the steam from the water, and in a short time the cloth became blackened : we must therefore consider that the waters contain this metal in a proportion far beyond what can be collected by analysis ; and that it is to this peculiar form of combination, which is far more subtle than can be imitated in any artificial medical composition, that their particular benefits are to be attributed, and that they so often agree with the constitution, and cure disease in cases wherein all other medicines have failed. We see likewise from this circumstance, how perfectly useless it is to drink these waters after they have once become cold, as they then no longer manifest the presence of iron, which is precipitated on the sides of the vessel, as appears by the glasses in use at the different Pump-Rooms, which are soon tinged by an orange colour that can scarcely be removed.
Many mineral waters, especially those of a saline aperient nature, as likewise the cold chalybeate waters, may be very successfully imitated by artificial combinations, but the Bath Waters, in consequence of this peculiar volatile combination of the iron, will not admit of imitation,
Of Diseases in which the Bath Waters are Internally Used
It is hardly to be expected, in a work of this nature, that we can enter into all the minutiae of diseases in which these waters have proved efficacious ; yet we shall endeavour to state as clearly as possible those diseases which are likely to be benefited by their use, as also those complaints in which they should be avoided, together with the particular symptoms of their agreement or disagreement.
To state an axiom, we should say the BathWaters are of use in all cases arising from debility, and prejudicial in all inflammatory diseases.
To begin with gout, which sends so many of its martyrs to Bath, we shall quote the words of Dr. Saunders, in saying, “ the greatest benefit is derived from this water in those cases where it produces anomalous affections of the head, stomach, and bowels, and it is here a principal advantage to be able to bring by warmth that active local inflammation in any limb, which relieves all the other troublesome and dangerous symptoms. Hence it is that Bath Water is commonly said to produce the gout, by which is only meant, that where persons have a gouty affection shifting from place to place, and thereby much disordering the system, the internal and external use of the Bath Water will soon bring on an increase of action, indicated by a flushing in the face, fullness in the circulating vessels, and relief of the dyspeptic symptoms; and the whole disorder will terminate in a regular fit of the gout in the extremities, which is the crisis always to be wished for.”
During a fit of the gout, or in acute rheumatism, the waters should never be taken, but they are of great service after the inflammatory symptoms have subsided, in removing that debility consequent on these diseases. In all cases where chalybeates are recommended, such as chlorosis, obstructions in the liver, mesenteric glands and spleen, debilitated stomachs, whether arising from intemperate living, dyspepsia, long residence in hot climates, or from whatever cause, the BathWaters are particularly advised ; as well as in all derangements of the alimentary canal not bordering on the inflammatory stage.
The internal use of the waters in paralytic cases appears very doubtful ; at any rate, the greatest caution should be used in their exhibition, under able advice. From their known stimulating effects, wre should infer they would increase that determination of blood to the head, which was the original cause of the disease. In some very debilitated habits they might be used with caution, but at the same time great attention should be paid to the bowels. In cases of paralysis, arising from lead cholic, the waters are of considerable service ; but here also they require the constant aid of purgatives.
In all pulmonary cases the waters do harm, indeed in any diseases that have a tendency to hectic fever.
The Bath Waters, in their effects on the constitution, act not merely as a diluent, but as a general stimulant and tonic ; their stimulant action being of the most diffusible nature, not merely affecting the stomach, or any one organ, but increasing the action of every part. The heart and arterial pulsations are quickened, as can be very clearly ascertained ; the secretions of the gastric fluid, of the saliva, of the urine, and of insensible perspiration, are evidently increased ; and the nervous energies are improved and accelerated, as is evinced by the augmented glow of vivacity which succeeds their exhibition.
The internal exhibition of the waters is a modern practice, compared with their external use. It was a long time before physicians were bold enough to prescribe them, but having once begun, they were determined to pursue the Sangrado principle. Guidot recommended for ordinary constitutions to begin with three pints a day, and increase the quantity in a few days to six pints. But those who were a size stronger in constitution, might increase to a gallon ; and those of the largest size to begin with five pints, and come up to ten !
The present practice of taking the waters is upon a much more moderate scale. Yet Dr. Falconer thinks, that “ if the old practitioners have been mistaken in advising them in so large a quantity, the moderns, on the other hand, have sometimes disappointed their effects by too great a limitation.” He is well satisfied, that “ the waters may, with the utmost safety, in general, be taken in considerably larger quantities than those commonly exhibited at present.”
It is usual for the patient (under a proper preparation from his medical attendant) to begin with the smallest glass, or a quarter of a pint, half an hour or an hour before breakfast ; then take a walk till the breakfast hour, and midway between breakfast and dinner to take another quarter of a pint, and walk for some time afterwards. Should the waters agree, the dose may be gradually increased till the patient takes two full-sized glasses, at an interval of half an hour between each glass, before breakfast, and the same quantity in the middle of the day. It is not, however, every constitution that will bear this quantity : this will be judged of by the medical adviser. In cases of debilitated stomach, dyspepsia, hypochrondriasis, &c. a month or six weeks may be sufficient ; but in more obstinate cases, they should be taken for a month, then left off a few weeks and resumed again.
We have merely alluded here to the general drinking, but it frequently happens that the waters will agree at one pump and disagree at another; these variations must of course be left to the discretion of the professional attendant.
When the waters are likely to prove beneficial, they excite, on being first taken, a pleasing glow in the stomach, to which soon succeeds an increase of appetite and spirits, and a rapid determination to the kidneys.
On the other hand, when they occasion headach, thirst and dryness of the tongue, when they sit heavy on the stomach, and produce sickness, and do not pass off by urine or perspiration, their operation is unfavourable, and their further employment is not to be advised.
To shew the action of the waters on a healthy subject, it may not be amiss to state the effects generally produced. In the sanguineous person, the circulation of the blood is quickened, the face flushes, a sense of heat is perceived over the body, a violent headach is produced, and even in some cases apoplexy may be brought on ; indeed giddiness in many constitutions is a common symptom on first taking them.
We shall close these remarks with the able observations of Dr. Saunders on the Bath Waters : ss The Waters of Bath are certainly among those that require a considerable time to be persevered in, before a full and fair trial can be made. Their operation is very gradual, as indeed might be expected from a medicine which shows so few sensible properties, or immediate effects. Too frequently they are apt to lie heavy upon the stomach, when they have been taken for some weeks ; and when this is the case, they must be intermitted for a time, and afterwards be resumed.
Indeed, it must be owned, that a large proportion of the patients who resort to these springs are afflicted with disorders that are in themselves only to be palliated, or, at least, are always very difficult of cure. Chronic rheumatism, habitual gout, dyspepsia from a long course of high and intemperate living, and the like, are disorders not to be removed by a short course of any mineral waters ; and many of those who have once received benefit at these fountains, find it necessary to make an annual visit to them, to repair the waste in health during the preceding year. However, with well-regulated expectations, and a judicious mode of treatment, the invalid will seldom be here disappointed, and we may fairly consider the Thermal springs of Bath as amongst the most valuable natural waters which our island possesses.
On the External Use of the Bath Waters, Bathing, and Pumping
Dr. Saunders in his work on mineral waters seems very much to doubt whether the Bath Waters, in their external application, can have any different effect from common water heated to the same temperature. He
thinks they certainly possess considerable advantages in the largeness of supply, and their steady uniform temperature, but from the minute quantities of active ingredients detected by chymical investigation, he is led to suppose their properties are too insignificant to be felt by the skin. Whatever may be the cause, we certainly know, from daily experience, that the Bath Water has a decidedly different effect from common water of the same temperature, and no professional man on the spot can for a moment doubt the fact when he sees the number of loathsome diseases relieved and cured, solely by their external application. The hospital reports are a sufficient evidence that numbers of leprous patients, and others suffering under a great variety of cutaneous complaints, are cured, who, before their admission into the Bath Hospital, had tried every means that physicians could devise, and we might almost add, every quack medicine they had seen advertised, without effect.
The above documents cannot be called in question ; and one mode of accounting for the particular efficacy of these waters, when so little is discovered by analysis, is the supposition that we are not yet arrived at that perfection in chymical science which enables us to detect all their active ingredients.
The complaints which are chiefly recommended for the benefit of bathing are principally gout, rheumatism, paralysis, lead cholic, cholorosis, bilious disorders, diseases of the mesenteric glands and spleen. Bathing is also advised in many stomach complaints and derangements of the alimentary canal ; these latter, however, are not such decided cases for the bath as to be resorted to without professional advice. It must always be recollected, that during
die inflammatory stages of any disease, bathing and pumping, as well as drinking, are highly improper. The baths, both public and private, may be resorted to as suits the convenience of the patients or the advice of the physician. The heat is generally directed between the degrees of 92 and 98, and the time from a quarter to half an hour, three times in the week. It is the opinion of many, that the time of remaining; in the water might be extended to a much longer period with great benefit to the patient, particularly in those cases of rigidity of muscles arising from gout, rheumatism, paralysis, or indeed any cases of stiffened joints, whether from casualties or otherwise. Herpetic cases would also bear a much longer continuance in the baths. It is very well known that at Carlsbad, Aix, and other warm baths on the continent, patients remain two and three hours at a time in the water, without the smallest inconvenience ; and that all the old physicians, who have treated of the Bath Waters, recommend a much longer time, and that it be followed up daily.
There are two modes of using the pump : the one, whilst the patient is in the bath ; the other, which is termed dry pumping, is merely applied to the part affected, by exposure of the limb.
The pump is of very great service in most cases where the bath is recommended, and it is also frequently advised for local affections when the bath is not used. For gouty, rheumatic, and palsied limbs, sprains, weakness from fractured or dislocated limbs, bruises, debility of the back or loins, or indeed any local affection without inflammation, the pumping is used with the greatest success. The mode of applying it is to go at any hour most convenient, and begin with one hundred strokes, which may be gradually increased, as the patient is able to bear it, to four or five hundred strokes. This plan may be pursued at first three times in the week, afterwards every day. Confinement, if the weather is fine, is neither necessary with the bath or pump ; still this must be left to the discretion of the medical adviser. As many diseases for which the topical application of the Bath Waters is recommended originate from cold, it must be obvious that care should be taken to avoid it ; still, these applications will be of very little use unless assisted by the patient’s own exertions,
Vapour and Shower Baths
At the Cross-Bath is a Vapour-Bath, recently erected, on the principle recommended by the Hon. Basil Cochrane. It is so adapted as to convey the steam to any particular part of the body, and has been very much recommended, not only for many local pains, but also in restoring generally obstructed circulation. The Vapour-Bath, we think, has not been so much attended to as it deserves ; and the more the principle is investigated, the more consequence will it derive in relieving those suppressed disorders which are often very distressing to professional men. The Shower-Bath is at the same place. Its acknowledged utility in various disorders need not be enlarged upon in this place, and its convenience is generally allowed.General Remarks
It would be impossible to enumerate every disease separately which derives benefit from the use of these waters, either internally or externally. It may be therefore sufficient to observe, that all diseases of debility, in which there is a deficiency of power in the arterial action, decided laxity of fibre, diminished action in the organs subservient to the important processes of digestion and chylification, depressed nervous energy, or defective glandular secretion, in short, all diseases which depend on a want of power in any of the organs, are proper cases for the administration of these waters.
With respect to the baths, there is much necessity for a proper adaptation of the particular bath, and the necessary temperature, as well as the frequency of continuing in it, and of repeating the immersion, according as the circumstances of the case may indicate, and according as the changes in the disease may vender a change in the mode of applying the remedy necessary.
In order to give persons, afflicted with the various diseases which become the subjects of treatment by the Bath Waters, a proper and well-founded ground for hope in their use, we subjoin a list of diseases, taken from the registers of the General Hospital, showing the proportionate numbers of those who have been, within a certain period, cured or relieved of each respective disease. That the list may have a uniform appearance, we have in every instance made the calculation on the number cured or relieved in every hundred admitted, or in the same proportion.
| Idiopathic Palsy | 68 | |
| Palsy from | Cold | 94 |
| External Accident | 73 | |
| distorted Spine | 50 | |
| Lead | 94 | |
| Fever | 76 | |
| Rheumatism | 81 | |
| Chronic Rheumatism | 86 | |
| Hip Cases | 68 | |
| White Swellings of the Knee | 83 | |
| St. Vitus* Dance | 88 | |
| Leprosy | 92 |
It must be observed, that these cases are those of the lower order of people, who come from all parts of the kingdom to the Bath Hospital ; that the cases which come there are of the most inveterate kind, generally those which have resisted all other modes of treatment before they are sent ; and that therefore the proportions of those cured or benefited would in all probability be considerably larger, were the calculation to be made among the higher orders of society. There are likewise several diseases not found in this register (as complaints of the stomach), w7hich are not considered sufficiently urgent to send a poor man from a distance for a cure. Gout likewise is not so often met with in the Hospital ; as it happens comparatively rarely among the poor. Gout is more truly the disease of the rich, and is produced commonly from intemperance in the luxuries of the table and the use of wine : whereas the intemperance of the lower orders in spirituous liquors is productive of diseased liver and its train of diseases.
It may he proper here to notice the season of the year best adapted for the use of the waters. Formerly the summer months were invariably preferred ; latterly, however, the colder seasons are selected, and from what cause this change has taken place it may be right to inquire. Bath from its local situation is very much sheltered by the surrounding hills, and considered warmer in winter than most other situations ; this, in addition to the attraction of a variety of elegant amusements, is the most probable cause wrhy the season at Bath is principally confined to the winter. Still it is the opinion of many eminent physicians that paralytic and rheumatic cases in general derive much more benefit from the warm than the cold weather, and Dr. Falconer particularly enumerates for these complaints the months of June, July, and the beginning of August. At this period the patients are better able to exert, themselves with proper exercise, and to use bathing and pumping without the risk of taking cold, independent of exciting a more regular circulation and perspiratory discharge, very necessary in these complaints.
With regard to diet, few observations are necessary : those wrho have taken too much wine should live abstemious, and those of weak, debilitated frames who require strengthening, may have recourse to a more generous system ; still plethora must at all times be avoided, and the greatest attention paid to the alvine secretions. Exercise to be pursued as much as the patient is able to bear without fatigue.
Although we have given these general instructions respecting the nature and uses of the Bath Waters, we by no means intend that it should preclude the application to proper professional advice by the invalid on his arrival at Bath : the medical adviser at a distance will be enabled to recommend a journey to these springs, but there are many circumstances which require the assistance of a professional opinion on the spot ; the disease may be very well fitted for the use of the waters, but may require the hand of experience to direct it.
As a luxury, the use of the Bath is particularly grateful, and the refreshment experienced after violent fatigue, travelling, or sitting up all night, is most invigorating. When Louis XVIII. was at Bath, his attendants went into the bath every morning ; and they enjoyed it so much, that there was considerable difficulty in inducing them to quit it.
The springs open to the surface at four separate apertures: at each of which baths have been constructed.