Speaker 1: Welcome to Stuff to Blow Your Mind production of iHeartRadio.
Speaker 1: Hey you welcome to Stuff to Blow Your Mind. My
Speaker 1: name is Robert Lamb and I'm Joe McCormick, and we're
Speaker 1: back with part three of our series on the Healing Waters,
Speaker 1: where we have been focusing on beliefs held by many
Speaker 1: people throughout history that you could heal various diseases by bathing,
Speaker 1: by either immersing yourself in the waters of say warm
Speaker 1: or hot mineral springs, or sometimes maybe by drinking those waters. Also,
Speaker 1: we talked about the medicinal theories on which some of
Speaker 1: these practices were based, especially in the ancient world, such
Speaker 1: as the ancient Greek and Roman beliefs in hute moral theory. Also,
Speaker 1: in the last episode we talked there was a very
Speaker 1: interesting digression you had rob about supposed healing springs that
Speaker 1: have creatures living in them, such as little blood worms
Speaker 1: or fish trapped in the hot waters. Yeah's luck would
Speaker 1: have it. Here in Atlanta, we have a science festival
Speaker 1: here as well, the Atlanta Science Festival, and a very
Speaker 1: cold morning over the weekend, my family went to a
Speaker 1: talk on carnivorous plants about the some of the various
Speaker 1: carnivorous plants that are found internally in the southeastern United States.
Speaker 1: And at the end of it, the children present got
Speaker 1: to feed the carnivorous plants and they were feeding them
Speaker 1: blood worms. So and how it comes comes around. I
Speaker 1: was like, yeah, I know these guys. I was just
Speaker 1: talking about these guys. These would be, of course the
Speaker 1: larval forms of little flies rather than the proper worms
Speaker 1: that we also discussed. But there was no no iye squirting,
Speaker 1: no squirting of the worms in the eyes. Now, nobody
Speaker 1: who was putting these in their eyeballs? Good good, Well,
Speaker 1: today I wanted to take a look actually at the
Speaker 1: paper that first got me interested in this subject, in
Speaker 1: the subject of beliefs about the healing powers of balneotherapy
Speaker 1: or immersion in the water. And this is a medical
Speaker 1: history paper concerning the spa at bath Bath, a location
Speaker 1: in southwest England in Somerset that has been used as
Speaker 1: a spa going way back back back into at least
Speaker 1: as far back as Roman times when it was the
Speaker 1: spa of Minerva Sulus. Remember in the previous episode we
Speaker 1: talked about how often these these spa facilities built out
Speaker 1: by the Romans would kind of be under the heading
Speaker 1: of a sort of composite god made of like a
Speaker 1: Roman god like Minerva, and then the local deity in
Speaker 1: this case it would be some kind of Celtic goddess
Speaker 1: named Sulus. So these are merged together. Minerva Sulus rules
Speaker 1: over the waters of Bath. And yeah, going way back,
Speaker 1: people thought that various illnesses could be healed there. I
Speaker 1: wanted to talk about a paper making a case that
Speaker 1: maybe for one particular disease there actually is is a
Speaker 1: mechanical healing property at the spring. Oh fascinating. You know.
Speaker 1: I visited Bath many years ago, like fifteen plus years ago,
Speaker 1: and I believe my wife and I went as is
Speaker 1: kind of like a day trip out of London by
Speaker 1: train and then we took one of those bus tours
Speaker 1: of the city and then walked around a bit. But
Speaker 1: it was it was really beautiful, and I remember that
Speaker 1: you had this this great layered feeling of history there,
Speaker 1: like the topography of the city, and they like the
Speaker 1: physical building layers of the city revealed, like the deep
Speaker 1: time of the area. I was fascinating totally. I would
Speaker 1: love to go myself, maybe not to get in the water,
Speaker 1: but at least to have a look around. Yeah, I
Speaker 1: don't remember. I mean the tours we were on, the
Speaker 1: tours we could afford at the time. It definitely did
Speaker 1: not have any invitations to get in the water, just
Speaker 1: to like buy a coffee mug at the end, that
Speaker 1: sort of thing. So the paper I want to talk
Speaker 1: about is called a Trial of the Bath Waters the
Speaker 1: Treatment of Lead Poisoning by an author named Audrey Haywood
Speaker 1: in the journal Medical History, published back in nineteen ninety.
Speaker 1: And this paper concerns medical clinical research carried out at
Speaker 1: what was called the Bath General Hospital, which opened in
Speaker 1: seventeen forty one. Now at the time, one of the
Speaker 1: major missions of this hospital facility was to mount what
Speaker 1: the authors of this study called a trial of the waters,
Speaker 1: which was an attempt to record data to test and
Speaker 1: show whether the spa therapy practiced in the pools of Bath,
Speaker 1: whether that therapy was actually effective against disease. Now, as
Speaker 1: we've talked about, people since antiquity have believed all kinds
Speaker 1: of different things that medical complaints could be cured by
Speaker 1: soaking in spas, soaking or bathing in warm mineral springs,
Speaker 1: sometimes drinking the water as well. If you haven't heard
Speaker 1: the last episode yet you should go check that out first.
Speaker 1: We talked about plenty of examples in there. But the
Speaker 1: question is why did people think that the waters of
Speaker 1: these spas were curing their diseases. In modern times, it
Speaker 1: has been commonly assumed that this was entirely due to
Speaker 1: the placebo effect. To the placebo effect is a beneficial
Speaker 1: or healing effect caused by a treatment that has no
Speaker 1: actual direct mechanism on the condition itself, and thus, and
Speaker 1: thus the apparent healing or improvement is believed to be
Speaker 1: caused by the patient's belief that they are being treated
Speaker 1: or by their expectation of improvement. And we've talked about
Speaker 1: placebo effect plenty of times on the show. It has
Speaker 1: a measurable effect. It is a real thing. And so
Speaker 1: if nothing else is doing anything for you, at least
Speaker 1: the placebo effect maybe kicking in right, So that could
Speaker 1: be an explanation for why people maybe would go soak
Speaker 1: in the water and think, oh my, whatever got better now.
Speaker 1: In the ancient world, there were mechanistic theories of why
Speaker 1: the spa would cure you. One example among many is
Speaker 1: again humoral theory, the theory that, oh, your fluids are
Speaker 1: out of balance. You know, maybe you've got too much
Speaker 1: blood or too much yellow bile, not enough flim or something,
Speaker 1: and you could deal with these imbalances by calibrating the
Speaker 1: two sort of like slider knobs on your body, and
Speaker 1: those knobs were wet and dry and hot and cold
Speaker 1: because wet, dry, hot and cold were each correlated with
Speaker 1: one of the humors. So like, oh, I don't have
Speaker 1: it in front of me now, but I think maybe
Speaker 1: like blood was like hot and wet or something, or
Speaker 1: maybe cool and wet. I don't know anyway, So you know,
Speaker 1: if you have too much of one of those things,
Speaker 1: you adjust the hotness or coldness or dryness or wetness
Speaker 1: of the body in order to get yourself back in balance.
Speaker 1: Now we know today that this is not actually how
Speaker 1: the body works. This is an obsolete theory. It does
Speaker 1: not accurately describe where disease comes from. But having the
Speaker 1: belief in it may have led again to placebo effect.
Speaker 1: People are thinking that they've got a correct way of
Speaker 1: addressing disease, so they're at least having an expectation of improvement. Yeah,
Speaker 1: it's like I'm not doing nothing, I'm doing something. I'm
Speaker 1: following the advice or the know or being treated by
Speaker 1: an expert in their field, and you know, it takes
Speaker 1: some of the pressure off, and it puts you in
Speaker 1: a situation where you're expecting some level of healing, you're
Speaker 1: expecting some sort of positive outcome. Haywood explains the common
Speaker 1: modern understanding of this historical practice as quote, the pleasurable
Speaker 1: activity of immersion in warm mineral water has social and
Speaker 1: psychological benefits but no physiological value. And this probably is
Speaker 1: true for the majority of miracle cures people think that
Speaker 1: they received at the SPA. But Haywood records that there
Speaker 1: is at least one condition where there seems to be
Speaker 1: quite strong empirical evidence that the SPA was doing something
Speaker 1: to heal the sick. Now what was that condition? It
Speaker 1: was what was known as plica pictonum, a type of
Speaker 1: paralysis that you get from chronic lead poisoning. M We've
Speaker 1: talked about lead poisoning on the show before, so yeah,
Speaker 1: certainly has been a widespread problem in the past. We
Speaker 1: talked about lead poisoning, I think most recently, most extensively
Speaker 1: in an episode called Cupid's Lead, an arrow from a
Speaker 1: few years back that was about oh, I don't even
Speaker 1: remember what all we got into, and that that was
Speaker 1: one where we did have a digression about lead acetate
Speaker 1: or sugar of lead, known in Roman times for its
Speaker 1: sweet taste. Yeah, you don't want to eat that. But
Speaker 1: colica pictonum paralysis you get from chronic lead poisoning has
Speaker 1: characteristic symptoms. So it starts with what Haywood calls abdominal colic,
Speaker 1: basically meaning abdominal pain. So what a lot of people
Speaker 1: might call stomach pain, but actually your stomach is higher
Speaker 1: up in your torso you know, pain around the guts,
Speaker 1: the intestines, and then also constipation, the inability to move
Speaker 1: the bowels, and then eventually after that loss of ability
Speaker 1: to control the limbs, but not always with concurrent loss
Speaker 1: of sensation. So sometimes you can feel the limbs, but
Speaker 1: you can't move them or can't move them correctly. Now,
Speaker 1: the interesting thing about Bath is that Haywood writes, because
Speaker 1: symptoms were very well documented when patients were admitted to
Speaker 1: the Bath General Hospital, we are able to look back
Speaker 1: at patients who showed up with this particular condition and
Speaker 1: then keep track through the records of whether or not
Speaker 1: they were cured, which could be measured and according to
Speaker 1: local standards was supposed to be measured rigorously by documented
Speaker 1: outcomes like full recovery of limb function. Haywood writes that
Speaker 1: by analyzing the records at this hospital, we can see
Speaker 1: that from seventeen sixty to eighteen seventy nine, the span
Speaker 1: of almost one hundred and twenty years, three thousand, three
Speaker 1: hundred and seventy seven patients presented at Bath with paralysis
Speaker 1: from lead poisoning, and forty five point four percent of
Speaker 1: those patients were documented as cured fully cured, and then
Speaker 1: a further percentage of them were documented as having shown
Speaker 1: some improvement. Now, it would be much more helpful to
Speaker 1: evaluate this in the context of control groups, right. It
Speaker 1: would be great if we had control groups that received
Speaker 1: no treatment or received a placebo, so we could see
Speaker 1: is this actually better? But there are some reasons for
Speaker 1: thinking that this recovery rate is above chance or placebo
Speaker 1: levels for the same condition, and we'll talk about those later.
Speaker 1: So Heywood quotes some seventeenth and eighteenth century physicians on
Speaker 1: this condition Collico picctonum, to see what they knew about it.
Speaker 1: There is a doctor Rice Charlton actually looks like his
Speaker 1: name could be pronounced Charlatan. I don't know if there's
Speaker 1: any connection there, but he's describing collico picctonum in the
Speaker 1: second edition of a book called Three Tracts on Bathwater
Speaker 1: that's bath with a capital B from seventeen seventy four
Speaker 1: and Charlatan rights quote in consequence of a most obstinate costiveness.
Speaker 1: Costiveness means constipation obstinate costiveness attended with exquisite pain in
Speaker 1: the bowels. Upon the constipation being removed and the pain diminished,
Speaker 1: the patient loses the use of his limbs, the arms,
Speaker 1: and hands. Most commonly, rheumatic pains sometimes attack the limbs
Speaker 1: before they become paralytic. Lead we know is remarkably productive
Speaker 1: of this complaint. Now, outbreaks of symptoms like this had
Speaker 1: been common in Europe for centuries, in fact, going way back,
Speaker 1: going back to Roman times, but for the longest time
Speaker 1: there was no agreement about the cause. So somebody might
Speaker 1: get that, you know, you could recognize what this pattern
Speaker 1: of symptoms were. It's like, oh, you've got the thing
Speaker 1: where you have abdominal pain, your gut's really hurt, and
Speaker 1: then you can't poop, and then your wrist fails and
Speaker 1: you can't use your arms. Candidates for the explanation included
Speaker 1: unresolved fevers. Just quote here from the paper over indulgence
Speaker 1: in acid wines. I don't know how much people do
Speaker 1: they want to indulge in acid wines, Like it's your
Speaker 1: wine is spoiled, but you really just want to get
Speaker 1: in there. I mean, sometimes that's all you have around.
Speaker 1: I guess, I guess that's true. No accounting for taste,
Speaker 1: and other explanations were quote high living and passions of
Speaker 1: the mind, so very broad categories, especially on those last two. Yes,
Speaker 1: But actually in the eighteenth century the real cause was identified.
Speaker 1: In seventeen sixty eight, the British physician Sir George Baker
Speaker 1: correctly traced the origin of a particular epidemic of colicopictonum.
Speaker 1: This epidemic was called the Devonshire colic to lead poisoning,
Speaker 1: specifically caused by the widespread consumption of cider tainted with lead.
Speaker 1: He traced it back to where it came from and
Speaker 1: found out, yes, it's from this cider that's got all
Speaker 1: this lead in it. And when the lead was removed
Speaker 1: from the cider, the outbreak of apictonum was alleviated, but Unfortunately,
Speaker 1: cider was not the only place you could get lead.
Speaker 1: In the eighteenth and nineteenth century, people had a vast
Speaker 1: range of options to explore that would end up causing
Speaker 1: overexposure to lead. There was use of lead hardware in
Speaker 1: the preparation, storage, and transport of food and drink. And
Speaker 1: this is everything everything from lead pipes and lead sinks
Speaker 1: to lead cooking pots, lead glazed earthenware, pewter plates, etc.
Speaker 1: There were lead based cosmetics. There was lead as a direct,
Speaker 1: intentional additive to food and drink, maybe as a color
Speaker 1: rent like food coloring, or as a flavor agent. It
Speaker 1: lead in some forms taste sweet, or as a preservative
Speaker 1: and more on this in a second. And then there
Speaker 1: were also lead salts that were used as medicine. In
Speaker 1: less severe cases, lead poisoning would cause a sort of
Speaker 1: like precursor series of symptoms. So lower levels of lead
Speaker 1: poisoning would cause fatigue, weakness, headaches, and what's described as
Speaker 1: a general malaise, just kind of a bad feeling of
Speaker 1: ill health and discomfort that you can't really locate the
Speaker 1: cause of. And while lots of people were dealing with
Speaker 1: minor chronic ill health from these baseline levels of lead exposure.
Speaker 1: Some people got even more vicious doses of lead, often
Speaker 1: from occupational exposure, so you might see referred to colic
Speaker 1: of pictonum referred to as painters palsy. People who were
Speaker 1: dealing with lead based paints a lot in their line
Speaker 1: of work would have higher levels of exposure than everybody else,
Speaker 1: and then they might end up with this form of paralysis.
Speaker 1: But not just that. There was all kinds of manufacturing
Speaker 1: that involved lead at the time. Another major source of
Speaker 1: high exposure to lead came from lead adulterated alcoholic beverages.
Speaker 1: Again coming back to the example of the devonsure colic
Speaker 1: being based insider Haywood Wrights quote, Lead is soluble in
Speaker 1: such weak acids as the acetic acid, that's the acid
Speaker 1: that's in vinegar, formed when alcohol is exposed to the air,
Speaker 1: so alcohol might easily become contaminated. This contamination may occur
Speaker 1: incidentally during distillation when lead is leached out of the
Speaker 1: soldered joints or base metal condensers, or accidentally if sour
Speaker 1: cider or apple must comes into contact with the lead,
Speaker 1: which was often used to repair cracks in the cider press.
Speaker 1: Adulteration could also occur if the cider was stored in
Speaker 1: lead glazed earthenware containers. Poor or acid wines were sometimes
Speaker 1: adulterated deliberately in the Roman tradition of using lead acetate
Speaker 1: as a sweetener improver or fungicide. Got Reading this makes
Speaker 1: me feel so grateful for modern food safety standards and regulations.
Speaker 1: Oh absolutely, it's just unbelievable reading like what went into
Speaker 1: I don't know, Yeah, but this paragraph here from hey
Speaker 1: what also makes me think of the fact that before
Speaker 1: the real cause was known, some people accused those who
Speaker 1: had this paralysis of indulging in quote, acid wines. It's like, oh,
Speaker 1: it's because you drank acidic wine that you have the
Speaker 1: paralyzing colic. Those people actually were probably detecting a real
Speaker 1: correlation but misunderstanding the cause. It wasn't the acidic wine,
Speaker 1: but a heavy metal that, for a couple of different reasons,
Speaker 1: is more likely to end up in sour wines. It
Speaker 1: might be added intentionally to counteract the sourness, or because
Speaker 1: the acetic acid basically the vinegar that forms in a
Speaker 1: sour wine, was a solvent for lead that might come
Speaker 1: from anything. The storage containers or the manufacturing equipment. Okay,
Speaker 1: it makes sense. So people who got more severe lead exposure,
Speaker 1: whatever the source, whether that's from maybe occupational exposure if
Speaker 1: you're a painter working in one of these factories, or
Speaker 1: from drinking alcoholic beverages adulterated with lead. People with these
Speaker 1: types of exposure could end up not just with the fatigue,
Speaker 1: the headaches, and the malaise, but could end up paralyzed
Speaker 1: with the colica pictonum. And then of course if the
Speaker 1: disease progressed beyond that, it could lead to convulsions, coma,
Speaker 1: and death. And so that's the background. This brings us
Speaker 1: back to bath the spa. Though bath had been used
Speaker 1: as a medicinal spa since at least as far back
Speaker 1: as Roman Britain, according to Haywood, the first documentation of
Speaker 1: spa therapy being used to treat what sounds like chronic
Speaker 1: lead poisoning comes in a book from fifteen sixty eight
Speaker 1: by an English doctor, William Turner, with a title that
Speaker 1: really lets you know what the book is all about.
Speaker 1: So it's called a Book of the Natures and Properties
Speaker 1: as well as of the baths in England, as of
Speaker 1: other baths in Germany and Italy. Very necessary for all
Speaker 1: these persons that cannot be healed without the help of
Speaker 1: natural baths. Very mid sixteenth century book title. So in
Speaker 1: this mid sixteenth century book with a paragraph for a title,
Speaker 1: Turner chronicled a long list of conditions that he said,
Speaker 1: we're allegedly cured by spa treatment after having surveyed the
Speaker 1: use of public baths in Germany and Italy. And these
Speaker 1: conditions included quote bruising that cometh by falling or beating,
Speaker 1: for green or new wounds, and for quote old wounds
Speaker 1: falsely healed. But also he said, you know, there's a
Speaker 1: convergence of symptoms that can be healed in these things.
Speaker 1: And it kind of sounds like colic a pictonum. I
Speaker 1: have to say the following sentence from Turner is my new,
Speaker 1: all time favorite description of constipation. You've never heard constipation
Speaker 1: in terms so evocative. So this is what Turner calls it.
Speaker 1: He says, the vain appetite of going to stool when
Speaker 1: a man can do nothing when he cometh there, the
Speaker 1: hardness and binding of the belly when as a man
Speaker 1: cannot go to the stool without capital P physics. I'm sorry,
Speaker 1: I don't mean to laugh at lead poisoning, which is
Speaker 1: no laughing matter, but that is good. This sounds like
Speaker 1: upper class constipation to me, the vain appetite of going
Speaker 1: to the stool. It imagine. It makes me think of um,
Speaker 1: like the Cooleshov effect. Like you're showing that actor just
Speaker 1: gazing at the toilet and you're imagining all of the
Speaker 1: like wheels turning in his head as he yearns. Yeah, well,
Speaker 1: he needs the physics. I should have looked it up.
Speaker 1: I don't know what that word physics refers to. Does
Speaker 1: that mean like the intervention of physicians or maybe some
Speaker 1: kind of like perfect medicine. That's what I take it
Speaker 1: to mean. You need the medical enterprise to intervene. Okay,
Speaker 1: so that's the first part of Turner's description, but the
Speaker 1: text also refers to paralysis of the body and abdominal pain,
Speaker 1: as well as other symptoms that can be caused by
Speaker 1: chronic lead poisoning, such as infertility, spontaneous abortion and pregnancy,
Speaker 1: and even gout. So it's possible that Turner is not
Speaker 1: correct about spot therapy healing these conditions, but it is
Speaker 1: interesting that he lists a large number of symptoms all
Speaker 1: associated with lead toxicity as among the things that can
Speaker 1: be cured by these spas. So by the early fifteen hundreds,
Speaker 1: Bath already had a reputation as a place that could
Speaker 1: cure paralysis, and one of the iconic images associated with
Speaker 1: this place and its healing powers was a big collection
Speaker 1: of discarded crutches. But it was noticed by physicians even
Speaker 1: as far back as the sixteenth century that there was
Speaker 1: one particular type of paralysis which the waters were better
Speaker 1: at curing than other types of paralysis, and this was
Speaker 1: what they called palsy after the colic. Again, this seems
Speaker 1: to be referring to the exact same pattern of symptoms.
Speaker 1: It's colic of pictonum. You have severe abdominal pain, constipation
Speaker 1: followed by weakness and paralysis of the limbs. Just one
Speaker 1: early case study. This is from a report written in
Speaker 1: the early eighteenth century by one doctor Robert Pierce. He
Speaker 1: published accounts of his career in medicine in his memoirs,
Speaker 1: and he wrote of one typical account. He says, a
Speaker 1: guy named a reverend mister Pilkington came to him from
Speaker 1: Lincolnshire in sixteen sixty six, and Pierce described this man's
Speaker 1: arms as quote hanging like flails, and said he was
Speaker 1: unable to dress himself or eat on his own. He writes, quote,
Speaker 1: although he was a clergyman, the disease had made a
Speaker 1: quaker of him. Oh, I don't know. But after he
Speaker 1: bathed and drunk the water at bath for six to
Speaker 1: seven weeks, he finally regained control of his limbs, apparently
Speaker 1: including the ability to doff his hat in greeting, which,
Speaker 1: based on this writing, seems was considered very important, but
Speaker 1: at least by this man. Pilkington and a bunch of
Speaker 1: sources from the eighteen century reports specific patients who saw
Speaker 1: improvement at bath. It was people with paralysis who happened
Speaker 1: to be employed as color grinders, pewterers, and chemists, all
Speaker 1: people who would have had exposure to lead through their jobs.
Speaker 1: So it really seems like a convergence is happening here.
Speaker 1: We're seeing a consistent pattern emerging in the records of
Speaker 1: who's getting healed at bath. It might be worth noting
Speaker 1: what was standard treatment at the time for people with
Speaker 1: colica pictonum other than going to bath. Well, sometimes when
Speaker 1: it was just the colic and constipation stage, so just
Speaker 1: the abdominal pain and constipation. They would prescribe purges and emetics,
Speaker 1: so these would be drugs to help induce defication and
Speaker 1: to induce vomiting. Sometimes opiates would be given for pain.
Speaker 1: For paralysis, additional treatments could include confinement to a bland diet,
Speaker 1: and in cases after the actual cause was known, removal
Speaker 1: of the person from the lead source. That seems pretty important.
Speaker 1: So what was the treatment of bath? How would that
Speaker 1: be different? Well, this treatment involved bathing in the water,
Speaker 1: so you would immerse yourself up to the neck anywhere
Speaker 1: between thirty minutes and several hours, and this would usually
Speaker 1: be done starting in the morning, with people either standing
Speaker 1: or sitting on stone benches or seats in the water
Speaker 1: up to their necks. Starting in the Tudor period, the
Speaker 1: water was changed once a day, so they would remove
Speaker 1: the water after the baths closed around noon, and then
Speaker 1: it would take about nine hours for the pools to refill.
Speaker 1: Heywood notes that getting there early in the morning was
Speaker 1: popular because it meant that you got cleaner water. Just
Speaker 1: think about that. I mean, it's still kind of the deal.
Speaker 1: Right earlier you get to the pool, the less less
Speaker 1: time it's had to absorb certain things. It's had less
Speaker 1: time to stuff on the bottom to get stirred up.
Speaker 1: That's a good point. Oh you're a swimmer, yeah, do
Speaker 1: you try to get there early when you can? I'm
Speaker 1: doing only a morning stone or not for these reasons,
Speaker 1: just for scheduling reasons. But but yeah, there have been
Speaker 1: times where I'm like, oh, they just closed the pool
Speaker 1: for a week and now they're reopening. Everything's nice and clean.
Speaker 1: I want to get in. I want to be Monday morning,
Speaker 1: first thing to get my shot at that clean, clean pool. Nice.
Speaker 1: Do you do you have like a waterproof ear buds
Speaker 1: or something. Do you listen to music when you swim?
Speaker 1: Or I don't even know if that's a thing. Honestly,
Speaker 1: I know it is. I see plenty of people do it,
Speaker 1: and I just I've never done it. Yeah, well they so.
Speaker 1: Heywood says in this paper that sometimes there was music
Speaker 1: or other stuff to entertain people while they were bathing.
Speaker 1: I guess if you're just supposed to sit in the
Speaker 1: warm water for three hours up to your neck and
Speaker 1: there's no music or anything that might get boring, well
Speaker 1: it makes sense. And you know, I see the same
Speaker 1: thing reflected in the YMCA pool that I go to,
Speaker 1: like there's there's often some sort of aquatic aerobics class
Speaker 1: going on, there's music playing. And I was just thinking
Speaker 1: of this when you mentioned earlier, like the social aspect
Speaker 1: of of healing at bats and spas. That's something I
Speaker 1: think I often failed to think about. But yeah, that's
Speaker 1: one of the advantages of going to any kind of
Speaker 1: group exercise scenario is that, yeah, you're doing some level
Speaker 1: of physical exercise, you're being guided in that physical exercise,
Speaker 1: but then you are in the company of other people,
Speaker 1: and you're going to get at least some level of
Speaker 1: social boost That's true, and I'm sure there was a
Speaker 1: lot of socializing going on, especially since I would guess
Speaker 1: a lot of the people bathing together. Probably you know,
Speaker 1: people came there for different reasons, but probably a lot
Speaker 1: of them had similar complaints. It sounds like, and you know,
Speaker 1: you can really have a long conversation if you have
Speaker 1: like the same medical problem as somebody else. That can
Speaker 1: really be a bonding experience. Yeah, And there's also seems
Speaker 1: like a high probability that you would have encountered people
Speaker 1: from your industry, other color grinders, other pewterers and other chemists,
Speaker 1: in addition to people being treated for other maladies. Of
Speaker 1: course exactly so, so that's soaking in the water. What
Speaker 1: about drinking the water? So heywood Wrights quote drinking the
Speaker 1: water became more sceptible after sixteen fifty when a clean
Speaker 1: supply was provided which came directly from the spring. And then,
Speaker 1: referring to that physician from earlier Pierce Pierce claimed that quote,
Speaker 1: advantage has been found by drinking it. Referring to the bathwater,
Speaker 1: especially in the bilious chalks, I think that means colics
Speaker 1: and the usual effect of them loss of limbs. Interesting again,
Speaker 1: I like singling out the people who have the colica
Speaker 1: pictonum as the ones who benefit from drinking the water.
Speaker 1: And Heywood writes one to two pints were consumed each
Speaker 1: morning in divided doses. Sometimes the patients chose to drink
Speaker 1: much larger amounts. But this was frowned upon. Has taken
Speaker 1: us back to Plenty again, who was talking about the
Speaker 1: people who get in the spring and then they just
Speaker 1: want to drink it until you can't see their jewelry anymore.
Speaker 1: The distrust of too much hydration, so bath gained a
Speaker 1: reputation for healing throughout the second half of the seventeenth century,
Speaker 1: though at the time it had not yet been revived
Speaker 1: as a luxurious spa retreat. Haywood says that the journey
Speaker 1: there was kind of treacherous and accommodations were pretty dank.
Speaker 1: It was like, you know, it was not fancy yet.
Speaker 1: But by the eighteenth century, the physicians of Bath were
Speaker 1: convinced that the waters could hear a number of diseases,
Speaker 1: including colic epictonum and that, and word of these cares
Speaker 1: kind of spread around the country, attracting a lot of attention.
Speaker 1: So people were making the journey there in some cases
Speaker 1: like royal people. But there were also some doctors from
Speaker 1: outside Bath that were skeptical, including Richard Meade, a physician
Speaker 1: to King George the Second. So there was impetus to
Speaker 1: put together a sort of large collection of data of
Speaker 1: like a study that would really convince people to come
Speaker 1: there for treatment. And there's a whole section of this
Speaker 1: paper that I'm not going to get into because it
Speaker 1: concerns the medical aspects lost, but it is very interesting.
Speaker 1: It's about the founding of the Bath General Hospital and
Speaker 1: what some of the kind of cold, cruel economic realities
Speaker 1: of that were that, like a lot of this may
Speaker 1: have been driven by locals around Bath wanting their businesses
Speaker 1: to benefit from people coming to the springs for medical treatment,
Speaker 1: but also them having a problem that like, oh, a
Speaker 1: lot of the people who are coming here for healing
Speaker 1: are like poor, and we don't want just poor people,
Speaker 1: so we want to find a way to get the
Speaker 1: poor people out of the city and get rich people coming.
Speaker 1: So some less than savory sort of abuse of the
Speaker 1: concept of charity here. Yeah, but this does lead to
Speaker 1: this large collection of data at the hospital, and Haywood
Speaker 1: notes some very interesting measures that were put in place
Speaker 1: for the evaluation of clinical results at Bath. One thing
Speaker 1: was treatment was regulated, so you're trying to make sure
Speaker 1: that patients were getting basically the same thing. They were
Speaker 1: getting treated in the same way. Also, because to quote
Speaker 1: from Haywood quote, at that time, medical practitioners were notoriously
Speaker 1: over optimists when assessing the results of their own treatments.
Speaker 1: Because of this, they had outcomes of treatment assessed by
Speaker 1: a committee of doctors rather than only by the one
Speaker 1: doctor who had managed the case in question. So you're
Speaker 1: not getting to just like ride up the outcomes on
Speaker 1: your own patients. All right, that's good, spreading it around
Speaker 1: a little bit. Yeah. Yeah. They hoped that this would
Speaker 1: lead to quote irrefutable proof of the efficacy of the
Speaker 1: bath waters for healing. Now I think irrefutable proof is
Speaker 1: a little overenthusiastic there, but these are good measures to
Speaker 1: put in place, certainly compared to the standards of the day.
Speaker 1: So this is not a double blind, randomized controlled trial
Speaker 1: that would really wouldn't become a standard until the twentieth century,
Speaker 1: but pretty good for the time. Another thing was that
Speaker 1: it was agreed that no patient would qualify as quote
Speaker 1: cured if they still had any trace of the original
Speaker 1: symptoms they showed up with, and they enforced pretty high
Speaker 1: standards of record keeping. Okay, so what did the treatment
Speaker 1: at bath consist of? Well, first, and very important to note,
Speaker 1: patients were extracted from their regular environment for their stay
Speaker 1: in bath, which means they were almost certainly cut off
Speaker 1: from the original source of lead toxicity lead exposure, and
Speaker 1: this in itself is important to keep in mind because
Speaker 1: for all we know, this alone could be causing major improvements. Yeah,
Speaker 1: giving them just away from their regular everyday exposure to land,
Speaker 1: and that could be in most cases either occupational or
Speaker 1: from food and drink. And on that last note, they
Speaker 1: were given plenty of fresh food at Bath and this
Speaker 1: included home brewed beer made there. The additional drinking of
Speaker 1: alcohol beyond what was provided by the hospital was forbidden,
Speaker 1: so this was another way to cut off additional lead exposure.
Speaker 1: They were often given purging medication to treat constipation. Bathing
Speaker 1: was generally three days a week in the manner previously described.
Speaker 1: So you know, you go sider stand in the water,
Speaker 1: you keep your head above the water line, but it
Speaker 1: goes up to your neck. And then again, patients would
Speaker 1: often drink one to one and a half pints of
Speaker 1: the spring water a day, maybe divided into two different doses,
Speaker 1: and in some cases they might like sort of pump
Speaker 1: the spring water over the paralyzed limb. So, anyway, what
Speaker 1: are the results if we look back on them historically,
Speaker 1: the results are pretty interesting. By analyzing the records kept
Speaker 1: at Bath General Hospital, it seems there is a pretty
Speaker 1: good reason to think that the spa therapy at Bath
Speaker 1: was doing something to relieve the symptoms of this disease,
Speaker 1: in particular of Colica pictonum. The paper includes a table
Speaker 1: compiling stats on patients admitted to the Bath Hospital from
Speaker 1: seventeen fifty one to seventeen fifty eight. Out of one
Speaker 1: five hundred ninety patients total, one hundred and eight of
Speaker 1: them were admitted with symptoms indicating that they had paralysis
Speaker 1: to to lead toxicity. Those can be further broken down
Speaker 1: into paralyzed patients who had occupational exposure to lead. There
Speaker 1: were thirty seven of those including readmission and patients with
Speaker 1: the Devonshire colic meaning paralysis that was preceded by severe
Speaker 1: abdominal pain and constipation, and there were seventy one of
Speaker 1: these including readmissions. In the cases of patients with occupational exposure,
Speaker 1: fifty nine percent were completely cured and ninety two percent
Speaker 1: were improved. In the case of patients with Devonshire colic,
Speaker 1: forty two percent were completely cured and ninety three percent
Speaker 1: were improved. Now, my initial reaction to this was that's interesting.
Speaker 1: But without a control group receiving no treatment or placebo treatment,
Speaker 1: or without different treatment groups to compare, how can we
Speaker 1: know it was the bathwater in the immersion that was
Speaker 1: actually leading to these CUIs what if simply maybe being
Speaker 1: away from the lead exposure on its own would produce
Speaker 1: the same rates of recovery. Well, that is possible, but
Speaker 1: the author considers that and offers some evidence based on
Speaker 1: their referral letters correlated with each patient's case in hospital
Speaker 1: records that may give us more confidence in the results.
Speaker 1: So talking about the specifically the workers who had occupational
Speaker 1: exposure to lead, most of them came from London or
Speaker 1: the region in the southeast of England, and Heywood writes,
Speaker 1: quote fifteen had already been admitted to one of the
Speaker 1: London hospitals but had not responded to treatment there. They
Speaker 1: were referred to the Bath hospital as quote incurable, but
Speaker 1: after treatment in Bath, eight were cured and the other
Speaker 1: seven were said to be improved. These results support the
Speaker 1: view that the treatment in Bath had something special to offer,
Speaker 1: as in London they would also have been removed from
Speaker 1: exposure to lead and given purges, emetics and a bland diet,
Speaker 1: apparently to no avail. So interesting here, this still doesn't
Speaker 1: prove it. It seems we have a kind of crude
Speaker 1: analog of a control group based in the treatment histories
Speaker 1: from these patients referral letters. So in many cases they
Speaker 1: had already been removed from the lead and received other
Speaker 1: treatments for a long time in different hospitals and shown
Speaker 1: no improvement. So this is still not as good as
Speaker 1: a real control group for a number of reasons. For example,
Speaker 1: one I just thought of is that it's not concurrent.
Speaker 1: So like, you know, the previous treatment that they got
Speaker 1: at the other hospitals happened before and then they came
Speaker 1: to Bath afterwards. So maybe the cumulative time away from
Speaker 1: lead exposure could contribute to better outcomes at Bath and
Speaker 1: so forth. But interesting results nevertheless, Yeah, yeah, and results
Speaker 1: that would seem to some degree to point back two
Speaker 1: questions about the water, like what is it about the
Speaker 1: waters of Bath or what they're doing with the waters
Speaker 1: of Bath that may or may not be having an impact, right,
Speaker 1: that's right. So here's another thing that makes these results interesting.
Speaker 1: The Bath General Hospital records spanned many decades, and they
Speaker 1: seem to indicate a consistently higher rate of cure and
Speaker 1: improvement for palsy from colica pictonum. So again, lead exposure
Speaker 1: paralysis than for other conditions such as paralysis from sources
Speaker 1: other than lead poisoning. So it's possible that you know,
Speaker 1: maybe the Bath General Hospital doctors were using you know,
Speaker 1: they could have been doing all kinds of tricks, consciously
Speaker 1: or unconsciously to make their treatments look more effective than
Speaker 1: they actually were. Maybe they were using selective admission policies
Speaker 1: to improve their outcomes, like picking patients to let into
Speaker 1: the study that seemed more likely to improve, or maybe
Speaker 1: they were just overly positive in assessing outcomes. But if
Speaker 1: any of that were the case, why would the numbers
Speaker 1: be so much better for patients specifically with lead poisoning
Speaker 1: than for all other conditions. Yeah, because it's the numbers
Speaker 1: that really Propoin's interest here, Because if you're just talking
Speaker 1: nottally about like the number of abandoned crutches that they
Speaker 1: have there, it's like, oh, that's not very convincing, because
Speaker 1: there are two majorly compelling reasons that a sick person
Speaker 1: might abandoned their crutch, and only one of them speaks
Speaker 1: to the effectiveness of the treatment. Yes, that's very good
Speaker 1: to point out. So again we get a little bit
Speaker 1: of extra confidence just by looking at the difference comparing
Speaker 1: the different conditions in their outcomes. So again, all this
Speaker 1: like it would not prove it to the standard of
Speaker 1: a modern randomized controlled trial, But I think there's at
Speaker 1: least a solid reason to suspect that SPA therapy at
Speaker 1: Bath did have some healing powers for people who couldn't
Speaker 1: doff their hats because of lead. And so this was
Speaker 1: the paper that initially got me interested in talking about this.
Speaker 1: And the paper finally addresses the question that might be
Speaker 1: burning in all of your minds, like if this is
Speaker 1: the case, if it was actually effective at curing paralysis
Speaker 1: from lead toxicity, how does that work? Well, Heywood's paper
Speaker 1: here speculates the first thing is the immersion. So a
Speaker 1: big component of this treatment at Bath was spending a
Speaker 1: lot of time sitting in warm, mineral spring water up
Speaker 1: to your neck, and Haywood argues that this in itself
Speaker 1: could contribute to the outcomes documented at Bath General Hospital.
Speaker 1: And to back this up, Haywood writes about how in
Speaker 1: the nineteen seventies some researchers were doing experiments for the
Speaker 1: space program for NASA and trying to simulate the effects
Speaker 1: of microgravity, and some of these experiments involved having astronauts
Speaker 1: sit up to their necks in warm water for a
Speaker 1: long time, and Haywood points to a nephrologist named Murray
Speaker 1: Epstein who demonstrated in some papers something kind of interesting.
Speaker 1: When you sit around in water up to your neck,
Speaker 1: it makes you p more. Specifically, not just p more,
Speaker 1: but it increases the rate in which you excrete water,
Speaker 1: but not just water, also sodium and calcium. Now, why
Speaker 1: on earth would that be. This is also not something
Speaker 1: that's one hundred percent clear, but there seems to be
Speaker 1: a reasonable explanation Haywood offers, which has to do with
Speaker 1: water pressure. So like, if your body is sitting down
Speaker 1: below the waterline, you've got water pressing in on your
Speaker 1: skin from all directions. And when that water pressure is
Speaker 1: pressing in on your legs and your abdomen, it causes
Speaker 1: that external flesh to kind of push in some blood
Speaker 1: and interstitial fluid. More fluids are getting pressed into the
Speaker 1: body from the outside, and Haywood writes, quote and this
Speaker 1: extracellular fluid moves into blood vessels in the thorax, meaning
Speaker 1: the trunk of the body, producing an increase in central
Speaker 1: blood volume of about seven hundred milli leads. Now, it's
Speaker 1: interesting that this basically comes back to the idea of
Speaker 1: purging fluids from your body, which is something that was
Speaker 1: long thought or understood to have some sort of roll
Speaker 1: in healing the sick right, and in many cases that
Speaker 1: might not have done anything. But I wonder if this
Speaker 1: means that in the case of lead poisoning, the purges
Speaker 1: would actually be helpful anyway. But to continue here, so
Speaker 1: Heywood rights. The consequent rise in right and left atrial
Speaker 1: pressures is the stimulus that leads to the large increases
Speaker 1: in urinary volume and sodium excretion that are observed during
Speaker 1: immersion up to the neck. This is because sensory receptors
Speaker 1: for blood volume are apparently situated in the right atrium,
Speaker 1: so this relative central hyper volemia, the condition of having
Speaker 1: extra blood volume extra fluid volume in the body deceives
Speaker 1: the body which reacts as though there had been an
Speaker 1: increase in total body fluid volume, not just a reallocation
Speaker 1: of fluid. So does that make sense that I think
Speaker 1: I'm explaining this right? That The simplified version is when
Speaker 1: you immerse your body in water, the water squeezes you
Speaker 1: and essentially squeezes some of your extra body fluid into
Speaker 1: the core of your thorax. It squeezes from the outside,
Speaker 1: so the pressure and the core increases, and because the
Speaker 1: pressure in the core increases, this tricks your body's blood
Speaker 1: volume sensors into thinking the total amount of fluid in
Speaker 1: your body has increased, and thus to compensate for this,
Speaker 1: it kicks off complex chain reactions in the the renal
Speaker 1: system that lead to increased excretion of urine and of
Speaker 1: things that get excreted through urine, sodium, and in this
Speaker 1: case calcium. Okay, that makes sense, Yeah, but why would
Speaker 1: this have anything to do with lead poisoning. Well, Heywood
Speaker 1: notes that the human body typically tends to handle lead
Speaker 1: and calcium in a similar way. So when there's lead
Speaker 1: in your body, the body treats it kind of the
Speaker 1: same way it treats calcium. And so if this is
Speaker 1: causing increased excretion of calcium through urine, it may also
Speaker 1: be causing increased excretion of lead through urine. And in fact,
Speaker 1: Haywood was involved in experiments that were set up at
Speaker 1: the Immersion Laboratory in the Bristol Royal Infirmatory Informatory Infirmary
Speaker 1: to test this hypothesis, and they in fact did find
Speaker 1: that urinary lead excretion goes up when the body is immersed.
Speaker 1: So they tested this out on experiments with modern lead
Speaker 1: workers who were not suffering from symptoms of lead poisoning,
Speaker 1: but still had lead levels much higher than the general
Speaker 1: population in their blood. These workers were subjected to three
Speaker 1: hour sessions of soaking up to their necks in water
Speaker 1: that was thirty five degrees celsius or ninety five degrees fahrenheit,
Speaker 1: and the experiments found that the immersion did indeed cause
Speaker 1: them to pee out higher levels of lead than people
Speaker 1: normally do. Oh wow, okay, haywood Wrights quote. The total
Speaker 1: amounts excreted during one three hour immersion period are small
Speaker 1: compared to the total body lead, which is predominantly tissue bound. Okay,
Speaker 1: so not like free in the blood, but bound up
Speaker 1: in tissues. Hey, what goes on? However, if these immersions
Speaker 1: were continued to the extent described in the bath hospital records, ie,
Speaker 1: three times a week for twenty four weeks, an appreciable
Speaker 1: proportion of the total body lead would be removed. We
Speaker 1: can therefore suggest that this was a mechanism through which
Speaker 1: traditional bath spa therapy could have operated. So that's fascinating.
Speaker 1: Just sitting immersed in the warm water apparently could help
Speaker 1: you get more lead out of the body faster than
Speaker 1: you would doing anything else. Yeah, and this, of course
Speaker 1: working in congress with not having a whole bunch of
Speaker 1: lead flooding into your system through your occupation or other
Speaker 1: environmental causes exactly. So you're removed from the original exposure
Speaker 1: to lead, you'd have less lead coming in, and you're
Speaker 1: increasing the rate at which lead is going out. Okay,
Speaker 1: but there's some other amenities to factor in as well though, right,
Speaker 1: that's right. So, as I mentioned, you know, the patients
Speaker 1: at Bath, in addition to being removed from the source
Speaker 1: of lead and having the immersion, they also got good food,
Speaker 1: so that may have been a factor. They got gentle exercise,
Speaker 1: that may have been a factor as well. So it's
Speaker 1: hard to know for sure with historical cases like this
Speaker 1: because you know, you can't you're not running the test yourself.
Speaker 1: You can't isolate all the variables. You can only deal
Speaker 1: with the data we have from history. But in this case,
Speaker 1: I think you could totally plausibly make the argument that
Speaker 1: the immersion was really doing something for the people with
Speaker 1: lead poisoning. It was doing something more than just getting
Speaker 1: them away from the original lead exposure. Now, there was
Speaker 1: another interesting part of this. That's the immersion, which Haywood
Speaker 1: treats is probably the main explanation, Well, what about drinking
Speaker 1: the mineral water Again, hopefully not two levels described by
Speaker 1: plenty where your rings disappear, but the level generally prescribed
Speaker 1: to drink was like one point five to two pints
Speaker 1: a day. And Haywood notes that water from the mineral
Speaker 1: springs of Bath has elevated levels of calcium and iron,
Speaker 1: and citing a study by Mahafee from nineteen seventy three,
Speaker 1: Haywood observes that calcium and iron deficiency actually increase the
Speaker 1: body's tendency to absorb lead, and calcium and iron deficiency
Speaker 1: increase the toxicity of lead that is already present in
Speaker 1: the body. And this has been shown to the extent
Speaker 1: that calcium and iron supplements have been suggested as partial
Speaker 1: treatment for infants with higher than average levels of lead
Speaker 1: in the blood. So it's possible that the mineral water
Speaker 1: pints that patients at Bath were drinking that was helping
Speaker 1: out as well. Yeah, And I mean, on top of that,
Speaker 1: if they're if you're having to if you're having to
Speaker 1: pe more because of your soakings in the warm waters,
Speaker 1: you need to be drinking more water as well, like
Speaker 1: you need to stay hydrated and This is something I
Speaker 1: saw reflected in some papers. We'll probably discuss in the
Speaker 1: next episode that, like, if nothing else, staying hydrated on
Speaker 1: clean water like that alone is beneficial for the body,
Speaker 1: like you will because if nothing else, you don't want
Speaker 1: whatever's going on with your body to be exasperated by
Speaker 1: also having some sort of dehydration scenario going on as well. Yes, exactly,
Speaker 1: Hydration incredibly important, so that plays a role as well.
Speaker 1: Though I want to be clear this is not should
Speaker 1: not be taken as a general endorsement of drinking mineral
Speaker 1: spring water, which could have all kinds of things in it.
Speaker 1: So it seems like in these cases these people were
Speaker 1: probably doing all right, but you don't want to be
Speaker 1: drinking water from sources you're not sure or safe, right right, right, Yeah,
Speaker 1: But if nothing else, like I say, how much I
Speaker 1: wonder like on a case that case basis, like how
Speaker 1: much of that person's normal liquid intake would have been
Speaker 1: confined to like beers for example, versus you know, they're
Speaker 1: still having beer, they're having good beer when they go
Speaker 1: to bat, but then they're also having a large amount
Speaker 1: of water as well in addition to that beer. So
Speaker 1: it seems like there would be a net positive there. Yeah,
Speaker 1: so I would say in conclusion, while bathing in a
Speaker 1: SPA probably does only work via placebo effect on a
Speaker 1: number of the conditions we've talked about throughout the series
Speaker 1: so far, on the conditions it was used to treat
Speaker 1: throughout history. I think this paper makes a very interesting
Speaker 1: case that when it came to paralysis from lead poisoning,
Speaker 1: spa therapy was genuine medicine. Yeah, it's fascinating, very fascinating.
Speaker 1: All right, Well, we're going to go ahead and close
Speaker 1: out this episode on that note, but we will be
Speaker 1: back in a part four on baths immersion and also
Speaker 1: drinking of naturally occurring spring waters, thermal waters, etc. We
Speaker 1: still have some other important topics to discuss here, so
Speaker 1: come back for that. In the meantime, we'll just remind
Speaker 1: you that our core episodes of Stuffed Toable with Your
Speaker 1: Mind published on two season Thursdays. On Wednesdays we do
Speaker 1: a short form artifact or monster Factor. Mondays would do
Speaker 1: listener mail, and we're already getting some great listener mail
Speaker 1: in about these bad episodes, by the way, And then
Speaker 1: on Fridays we do Weird House Cinema. That's our time
Speaker 1: to set aside most serious concerns and just talk about
Speaker 1: a strange film. Huge thanks to our audio producer JJ Pauseway.
Speaker 1: If you would like to get in touch with us
Speaker 1: with feedback on this episode or any other, to suggest
Speaker 1: a topic for the future, or just to say hello,
Speaker 1: you can email us at contact at stuff to Blow
Speaker 1: your Mind dot com. Stuff to Blow Your Mind is
Speaker 1: production of iHeartRadio. For more podcasts from my heart radio,
Speaker 1: this is the iHeartRadio app, Apple Podcasts, or wherever you're
Speaker 1: listening to your favorite shows the first time time by
Speaker 1: a p