History of Medicine

 THE ROYAL MINERAL WATER

HOSPITAL AT BATH

 

Romans loved bathing, and shortly after 50 AD they founded a bathing city, “Aquae Solis” (waters of the sun), on the river Avon in west England. Sumptuous baths, fed by hot springs emitting warm mineral waters, cleansed their bodies. When the Roman empire crumbled, 

Roman bath, restored    (by author)

the structures decayed, but the Anglo-Saxons who followed the Romans saw something else in the water: curative properties. Over time, a large number of the poor with various medical problems and disabilities sought relief from the sulfurous waters. Begging became widespread in the city and the well-heeled avoided it.

 Its reputation rose rapidly after a visit by Charles II in 1662 to allow his wife, Queen Catherine, to try the waters as a cure for her sterility. From then on, especially in the 18^th century, Bath developed into a major attraction, bringing the fashionable as well as the lame seeking the curative properties of the water. The splendid buildings of the architect John Woods and his son and the social activities organized by the dandy Richard (“Beau”) Nash transformed Bath into an elegant and wealthy city, offering sophisticated entertainment as well as relief of ailments. Alongside the socially prominent clientele, though, the lame and indigent remained fixtures in the city.

Pump Room, adjacent to Hospital, where the lame drink spring water, 1798. Now a restaurant and tea room. (Wikipedia)

The new combination of illness and wealth in Bath naturally attracted physicians. One of the earliest to arrive was Dr. William Oliver, educated in medicine at Cambridge and Leyden. He, Richard Nash, and Ralph Allen, another early organizer, seeing the number of  ill and lame arriving with meager resources, sought public subscription to found the General Hospital, later called the Royal Mineral Water Hospital. The hospital, designed by John Woods in Georgean style, opened in 1742 with Oliver as chief physician. The banker, Henry Hoare II, handled finances. Hospital treatments included bathing in the warm waters, drinking the waters, and a number of other remedies. Patients paid a modest entrance fee to cover clean clothing and travel home at discharge, but otherwise they received free care.

Painting of Dr. William Oliver (rt), Mr. Pierce, surgeon (cntr) examining a boy with leprosy, man 
with wrist drop (palsy), and woman with arthritis, Royal Mineral Water Hospital. By William
Hoare. (Courtesy ArtUK and NHS Foundation Trust)

Before long, disputes broke out between members of the medical staff over policies, fees, treatments, etc. Pamphlets were written, accusations made. Eventually, a triumvirate of Drs. Oliver, Abel Moysey, and Rice Charleton held power over the appointment of physicians to the hospital staff and other medical matters. Physicians who were denied appointments often retaliated with bitter articles or pamphlets against the triumvirate, but to little effect. The physician turned writer, Tobias Smollett, in Peregrine Pickle, satirized the situation, saying that the Bath physicians are “a class of animals who live in this place, like so many ravens hovering about a carcase” (sic). 

Dr. Moysey, the second of the triumvirate, had received his BM (bachelor of medicine) and MD (doctor of medicine) at Oxford, practiced briefly in Sherbourne, then moved to Bath, was appointed to the General Hospital in 1747, and enjoyed a successful practice. 

Dr. Rice Charleton, the third leader of the medical staff, also received his medical degrees at Oxford and was an enthusiastic

Dr. Rice Charleton by Gainsborough
(Photo by author)

believer in the healing power of the waters. He analyzed the water chemically, utilizing techniques published by the famous Anglo-Irish experimenter, Robert Boyle, and the prominent continental physician and professor of medicine and chemistry at the University of Leiden, Herman Boerhaave. Boerhaave was one of the first to emphasize chemistry in medical education.  

A few results of Charleton’s work indicate the level of analysis. The waters are alkaline, reacting with acids. Fine particles are attracted to loadstone, suggesting iron, and other particles give a blue flame on a red-hot poker (as sulfur does). Adding powdered oak gall to the water yields a deep purple color, suggesting iron (tannic acid in gall reacts with iron to produce the coloring). This mixture was an old way of making ink. The temperature of the main bath varied between 100-103 degrees utilizing “Fahrenheit’s mercurial thermometer.” Charleton attributes the heat in the waters to the presence of fire, a substance he considered an element, dissolved in water.

Charleton also recorded the restorative powers of the baths. For people with “apoplexy” (strokes) there was little improvement and patients with injuries and other disabilities showed variable results. The patients that showed most improvement were heavy cider drinkers, painters, and plumbers with upper limb peripheral nerve palsies and abdominal pain. Charleton correctly diagnosed them as victims of lead poisoning, generally related to their occupations. They improved when away from lead. Apple juice leached lead from the cider presses, sickening the cider drinkers.

Thomas Gainsborough, self-portrait
(Wikipedia)

One of Dr. Charleton’s patients was the painter, Thomas Gainsborough. What Gainsborough suffered from is unclear, but one illness seems to have been a prolonged fever and another an extended anxiety attack provoked by a visit to London, during which he, according to a letter, committed “a foolish act.” Gainsborough and his family also sought the services of Abel Moseley, known for his high fees and probably the person mentioned in a satirical book, Bath Characters, as “Dr. Fleecem.” Gainsborough painted full-length portraits of both doctors.

Dr. Abel Moysey by Gainsborough
(Wikimedia)

At the Hospital, finances were a constant problem. Because of budget restraints in early years, the number of patients under its roof varied roughly between 40 and 112, and donations were constantly sought. With more subscriptions, a second story was built, in place by the time Jane Austin arrived in Bath in 1797. Gradually the hospital became a center for treatment of rheumatic diseases and rehabilitation. In 2019, the aging building was vacated and services moved to a new building on the outskirts of Bath, the Royal National Hospital for Rheumatic Diseases. There are plans to install a hotel at the original site, but, as yet, the old building remains unchanged.

 

Royal Mineral Water Hospital, Bath, today (by author)

SOURCES:

Foster, F, “Bath: Physicians and Literature.” Bull Med Libr Assoc 1944; 32: 2-22.

Jenkins, J, “Thomas Gainsborough’s Doctors.” J Med Biog 2005; 13: 58-63.

Van Opstal, M T, et al, “Physicians as the Firat Analytical Chemists: Gall Nut Extract Determination of Iron Ion (Fe²⁺) Concentration.”  J Chem Educat 2018; 95: 456-62.

Heywood, A, “A Trial of the Waters: The Treatment of Lead Poisoning.” Med History, 1990; Suppl No. 10, 82-101.

Hamilton, James, Gainsborough: A Portrait. 2017; Orion Books, U. K.

Powers, John C, Inventing Chemistry: Herman Boerhaave and the Reform of the Chemical Arts. 2012, Univ of Chicago Press.

Charleton, R, Three Tracts on Bath Water. 1774; R. Cruttwell, Printer.

Christopher, “The Royal National Hospital for Rheumatic Diseasses: History and Bath Medical Museum.” Available at: https://thephysiologist.org/2016/10/31/the-royal-national-hospital-for-rheumatic-diseases-history-and-bath-medical-museum/

 

Falconer, R W and Brabazon, A B, History of the Royal Mineral Water Hospital Bath, 3^rd ed., 1888, Charles Hallett.

A full index of past essays is available at: 

https://museumofmedicalhistory.org/j-gordon-frierson%2C-md