Curing with Water in the Nineteenth Century Hilary Marland

1
Curing with Water in the Nineteenth
CenturyHilary Marland

• Voorjaarsbijeenkomst medische geschiedenis
• Amsterdam
• 28 March 2008

2
Healing Cultures, Medicine and the Therapeutic
Uses of Water in the English Midlands 1840-1948

• Wellcome Trust-funded project, with Dr Jane
  Adams, focusing on
• Mineral spas Buxton, Leamington, Cheltenham,
  Droitwich, Woodhall Spa
• Hydropathic centres Malvern and Matlock
• Isolated hydropathics and minor spas

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Healing Cultures, Medicine and the Therapeutic
Uses of Water in the English Midlands 1840-1948

• Explores
• Healing with mineral waters (spa treatment) and
  pure water (hydropathy)
• Growth in popularity and expansion of treatments
  within water cure centres and beyond
• Association with other physical therapies
• Relationship with orthodox medicine

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Tension between curative power and potential
danger of water

• Expansion in
• Claims for waters curative powers
• Variety of healing approaches
• Numbers of patients
• Widening access
• Tensions
• Powerful agent needing specialised knowledge
• Access to safe water
• Empirical vs. scientific knowledge

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Tension between orthodoxy and alternative practice

• Spa treatments and hydropathy practised by
  trained/qualified doctors e.g. James Gully,
  Edward Johnson and those without formal medical
  qualification e.g. Joseph Constantine, John
  Smedley, as well as female practitioners
• For many practitioners, curing with water enabled
  the patient to develop knowledge of how to treat
  themselves and to prevent illness
• Even within water cure practice much diversity of
  opinion on allopathic practice ranging from
  unqualified opposition of Gully to Johnsons
  eclectic approach

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Spa regime at Buxton mid-19th century

• Drinking water
• Communal Mineral Water Bath
• Passive immersion bathing, 2 or 3 times a week
• Douching with water jets and medical rubbing
• Advice on exercise and diet
• Published advice books on taking Buxton waters
• Drinking water

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Buxton

• the access is free and the bath always open
• When I beheldthe pot-bellied farmer of sixty,
  half-palsied, and the lame artisan with his black
  and callous hands, and the many who suffered from
  cutaneous disorders - all plunging together, or
  one after the other, in quick succession- some of
  whom would set about scrubbing from their
  hardened cuticles the congregated perspiration of
  ages I confess my courage failed me (Granville
  1841)

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Buxton 1854
Natural Baths Gentlemen 2 public 2 private 1
charity Ladies 1 public 2 private 1 charity
Hot Baths Gentlemen I public 4 private 2
charity Ladies I public 4 private 2
charity I cold plunge
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Buxton Access for the poor

• Buxton Bathing Charity
• Devonshire Hospital 1859
• Expanded 1875-81
• Charity hot baths 1876

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Hydropathic centres Malvern and Matlock

• Targeting segmented markets from posh to poor
• Women as clients and practitioners
• Variety of provision

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The water cure at Malvern

• 6am 'Packing' The patient is wrapped in a long
  wet sheet and covered in eiderdowns
• 7am The patient is unwrapped, given a cold
  shower and rubbed down
• A hike up the hills, drinking a glass of water at
  each well or spring. The infirm were allowed to
  ride up on donkeys until well enough to walk
• Further packing, douches and baths
• Strict diet No alcohol or rich foods

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Cold water cure

• George Cruickshank
• The Cold Water Cure

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Sitz bath and wet sheet

• Thomas Onwhyn
• Sitz bath and wet sheet
• 6 oclock winters morng

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The water cure
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Matlock Bank metropolis of hydropathy

• Dominated by John and Caroline Smedley
• Mild cure (warm water)
• Successful publication of Practical Hydropathy in
  numerous editions
• At least 20 hydros in 1880 and 30-40 by 1919
• Smedleys attracting 3,000 patients each year by
  1876
• Trained staff who set up hydros for middle
  classes e.g. the Stevensons who advertised how
  hydropathic establishment was an excellent place
  for acquiring a Knowledge of Hydropathy for HOME
  TREATMENT

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John and Caroline Smedley
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How water works

• Water depicted as a powerful agent, which needed
  careful and subtle management
• Language of water
• Water described as gentle and mild
• natural, refreshing and wholesome and
  simple and pure (Joseph Constantine, A Handy
  Book on Hydropathy, p. 25)
• Everywhere within reach, and presented by nature
  in the greatest purity and profusion, Water was
  probably the first remedy which man opposed to
  the injuries and ailments to which his physical
  frame was liable. To wash his wounds in the
  limpid stream, to allay the pain and to abate the
  heat of bruises and inflammation by immersion in
  its cold, would be the dictate of earliest
  experience and the first essay in the art of
  healing for ages, perhaps, his only resource.
  
• Archibald Hunter, Hydropathy, pp.24-25

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Women and the water cure

• Caroline Smedley and Mary Gove Nichols
• Women and childbirth
• One of the most important and wonderful uses of
  water is to promote health during gestation, and
  to diminish the pains of parturition
• Women as health reformers
• I have also the hope that many women may find
  in sanitary reform, in their families, and the
  wider sphere that may open to them, a kind of
  womans work suited to their desires and
  capacities for usefulness
• Mary Gove Nichols, A Womans Work in Water-Cure
  and Sanitary Education (1868), pp. 64, v.

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Smedleys Health Mission

• One of the principle objects I have in view in
  this work is to teach Hydropathic remedies for
  self-application, and to show the labouring
  classes how to manage many of the processes by
  the simple means within their reach, which, if
  acted upon, would often stay the progress of
  fever, consumption, and inflammation, or prevent
  their proceeding beyond the first symptoms.
  Resolution, and not sparing trouble, alone are
  necessary.
• Smedley, Practical Hydropathy,11th edn
  (1869), p.12

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Domestic advice publications

• Hydropathy is now spreading so rapidly that
  information of its principles and practices is
  required in the cottage as well as the mansion
• (Joseph Constantine, Hydropathy at Home (1869),
  preface).
• almost all the advantages and blessings of the
  water cure may be enjoyed at home, and that far
  cheaper, as a general thing, than any other
  system of medical treatment.
• What was required was air, exercise and proper
  food
• All the rest is water, which can be had
  wherever rain falls, springs bubble, or rivers
  run.
• (Thomas Low Nichols, Nichols Health Manual, p.
  415)

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Appliances for home use

• A tinman, cooper or carpenter could make a bath,
  oil cloth would protect carpets, a gallon of
  water was deemed sufficient for a thorough bath.
• Then there is the sitz-bath, a very important
  water-cure process. And what is a sitz-bath?
  Take a common washtub, fill it half-full of
  water, and sit down in it as you would in a
  chair, with your feet on the outside. There you
  sit from ten minutes to half-an-hour. This is
  the most blessed remedy for constipation as well
  as for diarrhoea and dysentery.
• (Thomas Low Nichols, Nichols Health Manual, pp.
  415-6).

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Smedleys kit form baths

• Instructions for making kit form baths with a
  description of how to use them.
• e.g. Ladies sitz bath- no need to undress.

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Potential risks

• Smedley referred to the superior baths at his
  establishment over the ordinarily-constructed
  baths, which not infrequently cause irreparable
  injury to the body.
• No person can use a plunge bath without risk.
  We could refer to patients who have come to the
  establishment for relief, whose maladies have
  been caused by plunging into a cold bath, or into
  the sea. Many escape injury by such bathing, but
  none practise it without the risk of being
  invalids for the rest of their lives, from
  congestion of the brain, driven on the internal
  organs and certain weak parts which are not able
  to return it. Females, especially, are liable to
  danger from plunge baths (see Mrs Smedleys
  Manual, 1s 6d). (John Smedley, Practical
  Hydropathy, 11th edn, p.12)
• James Wilson described the water cure as an
  artistic process and stressed the role of the
  physician to teach as well as heal, yet the
  douche should be taken only by prescription, and
  never on the responsibility of the patient
• (James Wilson, The Principles and Practice of
  the Water Cure (1854), pp.xiii, 657).

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Tensions Herald of Health Almanac 1877

• Thomas Low Nichols advertises a range of
  appliances for the Home Practice of the
  Water-Cure, baths, brushes, mittens, enemas,
  Sanitary Soap etc.
• Also filters for water, using an illustration of
  London water with its vegetable and animalicular
  organisms.

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Fluid boundaries water and orthodox medicine

• James Gully by 1860s talked of hydrotherapeutic
  system moving into ordinary practice
• we hear of compresses being recommended by
  better orders of the profession we hear of sitz
  baths being ordered as an essential part of
  treatment latterly we even hear of the learned
  Professor of the Practice of Physic in my own
  loved and revered University of Edinburgh packing
  patients suffering from scarlet fever in cold wet
  sheets
• Gully, A Guide to Domestic Hydrotherapeia
  (1863), p.ix.

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Establishing a specialty

• 1895 Royal Medical and Chirurgical Society survey
  of climates and baths
• endorsed British waters, but also referred to
  lack of choice cf. continental spas
• 1896 Society of Balneology and Climatology
  established
• 1900 attempts to get onto medical curriculum

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Diluted principles?

• Auxiliary treatments
• diet and exercise
• massage, medical gymnastics
• electrical treatments, heat, light
• artificial mineral waters, mud
• combination treatments (Weir Mitchell, Buxton
  douche massage)

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Buxton Moor Bath and Buxton Douche
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Malvern Spa, hydropathic centre or climatic
resort?

• Early reputation for springs, air and hills
• 1840s first centre of hydropathy
• 1896 typhoid outbreak at hydro
• Litigation
• Recommended as climatic resort rather than spa

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Englishness

• No involvement of central state
• Increasing involvement of local authority at spas
• Local investment and variety
• Remains empirically based
• Perceived as lagging behind France and Germany
• Popularity and dilution of bathing principles
• Inability to enforce rigorous spa regime

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Lack of discipline of English!

• There also arises here a question of some
  delicacy namely, that of discipline and
  regimen. In the taking of baths and waters more
  has to be regarded than their simple influence,
  and there can be no doubt that the institution of
  strict discipline, in respect of hours of rising
  and of resting, in respect of exercise and of
  dietary, contributes very largely to the
  beneficial effects of a course. To this end the
  cooperation of the medical man and his patient is
  necessary. Very probably our insular freedom is
  chargeable with some neglect in this matter.
  There is perhaps too little general concert of
  opinion and action among the medical men in our
  bath places, and still more a reluctance on the
  part of the patients to submit in England to a
  degree of restraint which they would readily
  accept at Carlsbad or Vicky.
• (1895 Survey)

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Conclusions

• Rich variety of approaches
• Adaptable/innovative systems of treatment
• Emphasis on holistic approach to health
• Importance of institutional and domestic
  treatments
• Inclusive
• Permeated health care regimes more generally

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List of references

• Joseph Constantine, A Handy Book on Hydropathy,
  Practical and Domestic (1860).
• Joseph Constantine, Hydropathy at Home, or a
  Familiar Exposition of the Principles and
  Practice of the Water Cure (1869).
• James Manby Gully, A Guides to Domestic
  Hydrotherapeia (1863).
• Archibald Hunter, Hydropathy Its Principles and
  Practice. For Home Use (1878).
• Mary Gove Nichols, A Womans Work in Water Cure
  and Sanitary Education (1868).
• W. M. Ord and A. E. Garrod, Climates and Baths of
  Great Britain, Vol.1. (1895)
• John Smedley, Practical Hydropathy, 11th edn
  (1869).
• James Wilson, Principles and Practice of the
  Water Cure (1854).