It’s easy to lampoon the spas and their claims that drinking the waters or following the bathing ritual improved health. They were frequently the butt of literary and visual satire in the eighteenth and early nineteenth century when many were at their height. Doctor, patient and novelist Tobias Smollett (1721–71) has a field day in the Expedition of Humphrey Clinker (1771), which author Roger Rolls quotes to good effect in Diseased, Douched and Doctored. This nicely produced book is a reworking and updating of his earlier and out-of-print The Hospital of the Nation (1988).
Like its predecessor Diseased, Douched and Doctored is particularly concerned with the greatest of the English spas, Bath and the hospital opened in 1742 to provide residential care for the worthy poor prescribed a water cure. Rolls covers the earlier history of the Bath waters, but concentrates on the period from the eighteenth century onwards and the hospital set up to make use of the thermal spring. He also explores the other treatments on offer. Since those living in Bath could take the waters while living at home they were excluded from admission. The hospital thus had a wide remit from its inception and this throws up some interesting problems. Funds had to be found to get the patient to Bath (usually paid for by the home parish) and provide the ‘caution money’ demanded by the hospital to ensure the patient could afford to get home after discharge. Neither vagrancy nor unexpected costs to the ratepayers would be popular with the hospital’s potential supporters.
Rolls makes no extravagant claims for the efficacy of the Bath waters, but takes a gentle non-judgmental look at the kinds of conditions thought to be benefited by using the excellent records of the Bath General Hospital and its subsequent incarnations. It is currently the Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and specialises in rehabilitation medicine. The reworking of the rationale for hydrotherapy with an increasing emphasis on water-based physical therapy is an interesting story, concisely told.
Historically the waters do seem to have come into their own, in the treatment of those suffering from chronic lead poisoning or the ‘lead palsy’. This is backed up with some relatively recent research on the effects of immersion in and drinking of the calcium and iron-rich waters. Aware of the pernicious effects of lead and its frequent use in many trades in the eighteenth century, various of the Bath physicians were perhaps right to champion a therapeutic stay in the Bath General Hospital they had helped to establish. As Rolls points out, it was their business to publish good cure rates in the local press as an inducement to would-be subscribers.
He takes nothing away from the placebo effect or the healing power of nature but reminds us that for many who worked long hours in poor conditions the hospital presented a rest of sorts and regular food. He is probably right that the ‘meat, broth, bread, rice and cheese’ must have become very tedious over a stay of several months. Greens and other vegetables were apparently off the menu until 1844 when the Matron tried adding them to the broth ‘by way of experiment’. We don’t learn of the success of this trial by ordeal, but the addition of a refrigerator in 1889 may have improved what was on offer. There is also the familiar complaint of the food being too cold after its journey up to the wards. These and other nice details help paint a picture of what it might have been like to reside there.
Concerned about the behaviour of patients and the debilitating effects of uncontrolled drinking, patients were issued with brass identity tags, which they were required to wear when outside the hospital. Any publicans foolish enough to break the rules and sell booze to the readily identifiable patients were liable to lose their license. Along with the fashionable patients who came for the season and gaming tables these poorer contemporaries were also part of the identity of the city. Their story is less frequently told than that of the grandees.
All classes feature in the book’s excellent illustrations, including some from the author’s own collection. Rolls makes wonderful use of William Hoare’s painting of Dr Oliver and Mr Perice Examining Patients afflicted with Paralysis, Rheumatism and Leprosy (1761), using it as the basis to discuss these illnesses and the contributions of the examining physician and surgeon. It is an earnest canvas that recalls the hopefulness of patients seeking treatment and the power of the admitting medics to turn away those they did not think suitable. He also casts his professional eye over some of the more satirical images, which despite their caricatural excesses provide well-observed records of suffering.
