March 16, 2024 • 48 mins
The idea of healing via immersion in sacred or special waters dates back to prehistory, and it’s still alive and well in the modern world. In this classic episode of Stuff to Blow Your Mind, Robert and Joe consider the myth, history and reality and healing waters. (originally published 03/21/2023)
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Speaker 1 (00:06):
Hey, welcome to Stuff to Blow Your Mind. My name
is Robert Lamb.
Speaker 2 (00:09):
And I am Joe McCormick, and it's Saturday. Going into
the Old Vault for an episode of the show from
last year. This one originally published March twenty first, twenty
twenty three, and it's part three of our series called
The Washing of the Waters.
Speaker 1 (00:22):
Enjoy Welcome to Stuff to Blow Your Mind, production of iHeartRadio. Hey,
welcome to Stuff to Blow your Mind. My name is
Robert Lamb.
Speaker 2 (00:39):
And I'm Joe McCormick, and we're back with part three
of our series on the Healing Waters, where we have
been focusing on beliefs held by many people throughout history
that you could heal various diseases by bathing, by either
immersing yourself in the waters of say warm or hot
mineral spring, or sometimes maybe by drinking those waters. Also,
(01:03):
we talked about the medicinal theories on which some of
these practices were based, especially in the ancient world, such
as the ancient Greek and Roman beliefs in humoral theory. Also,
in the last episode we talked there was a very
interesting digression you had rob about supposed healing springs that
have creatures living in them, such as little blood worms
(01:26):
or fish trapped in the hot waters.
Speaker 1 (01:28):
Yeah, as luck would have it. Here in Atlanta, we
have a science festival here as well, the Atlanta Science Festival,
And a very cold morning over the weekend, my family
went to a talk on carnivorous plants, about some of
the various carnivorous plants that are found internally in the
southeastern United States. And at the end of it, the
(01:50):
children present got to feed the carnivorous plants and they
were feeding them bloodworms. So wow, it comes around. I
was like, yeah, I know these guys. I was just
talking about these guys. These would be, of course, the
larval forms of the little flies, rather than the proper
worms that we also discussed.
Speaker 2 (02:08):
But there was no eye squirting, no squirting of the
worms in the eyes.
Speaker 1 (02:12):
Now, nobody was putting these in their eyeballs.
Speaker 2 (02:14):
Good good, Well, today I wanted to take a look
actually at the paper that first got me interested in
this subject, in the subject of beliefs about the healing
powers of balneotherapy or immersion in the water. And this
is a medical history paper concerning the spa at Bath Bath,
(02:35):
a location in southwest England in Somerset that has been
used as a spa going way back back back into
at least as far back as Roman times when it
was the spa of Minerva Sulas. Remember in the previous
episode we talked about how often these these spa facilities
built out by the Romans would kind of be under
the heading of a sort of composite god made of
(02:58):
like a Roman god like Minerve, and then the local
deity in this case it would be some kind of
Celtic goddess named Sulus. So these are merged together. Minervasulus
rules over the waters of Bath, And yeah, going way back,
people thought that various illnesses could be healed there. I
wanted to talk about a paper making a case that
(03:19):
maybe for one particular disease there actually is a mechanical
healing property at the spring.
Speaker 1 (03:27):
Oh fascinating. You know, I visited Bath many years ago,
like fifteen plus years ago, and I believe my wife
and I went as is kind of like a day
trip out of London by train and then we took
one of those bus tours of the city and then
walked around a bit. But it was really beautiful and
I remember that you had this great layered feeling of
(03:48):
history there, like the topography of the city, and like
the physical building layers of the city revealed, like the
deep time of the area. I was fascinating totally.
Speaker 2 (03:58):
I would love to go myself, maybe not to get
in the water, but at least to have a look around.
Speaker 1 (04:03):
Yeah, I don't remember. I mean the tours we were on,
the tours we could afford at the time. It definitely
did not have any invitations to get in the water,
just to like buy coffee mug at the end, that
sort of thing.
Speaker 2 (04:13):
So the paper I want to talk about is called
a Trial of the Bath Waters the Treatment of Lead
Poisoning by an author named Audrey Haywood in the journal
Medical History, published back in nineteen ninety and this paper
concerns medical clinical research carried out at what was called
(04:33):
the Bath General Hospital, which opened in seventeen forty one.
Now at the time, one of the major missions of
this hospital facility was to mount what the authors of
this study called a trial of the waters, which was
an attempt to record data to test and show whether
(04:55):
the spa therapy practiced in the pools of Bath, whether
therapy was actually effective against disease now, as we've talked about,
people since antiquity have believed all kinds of different things
that medical complaints could be cured by soaking in spas,
soaking or bathing in warm mineral springs, sometimes drinking the
water as well. If you haven't heard the last episode yet,
(05:17):
you should go check that out first. We talked about
plenty of examples in there. But the question is why
did people think that the waters of the spas were
curing their diseases. In modern times, it has been commonly
assumed that this was entirely due to the placebo effect.
To the placebo effect is a beneficial or healing effect
(05:38):
caused by a treatment that has no actual direct mechanism
on the condition itself, and thus, and thus the apparent
healing or improvement is believed to be caused by the
patient's belief that they are being treated or by their
expectation of improvement.
Speaker 1 (05:56):
And we've talked about the cebo effect plenty of times
on the show is and has a measurable effect. It
is a real thing. And so if nothing else is
doing anything for you, at least the blacebo effect maybe
kicking in.
Speaker 2 (06:09):
Right, So that could be an explanation for why people
maybe would go soak in the water and think, oh my,
whatever got better.
Speaker 1 (06:16):
Now.
Speaker 2 (06:16):
In the ancient world, there were mechanistic theories of why
the spa would cure you. One example among many is
again humoral theory, the theory that, oh, your fluids are
out of balance. You know, maybe you've got too much
blood or too much yellow bile, not enough phlim or something,
and you could deal with these imbalances by calibrating the
(06:37):
two sort of like slider knobs on your body, and
those knobs were wet and dry and hot and cold
because wet, dry, hot, and cold were each correlated with
one of the humors.
Speaker 3 (06:49):
So like, oh, I don't have it in front of
me now, but I think maybe like blood was like
hot and wet or something, or maybe cool and wet.
I don't know anyway, So you know, if you have
too much of one of those things, you adjust the
hotness or coldness or dryness or wetness of the body
in order to get yourself back in balance. Now we
know today that this is not actually how the body works.
(07:11):
This is an obsolete theory. It does not accurately describe
where disease comes from. But having the belief in it
may have led again to placebo effect. People are thinking
that they've got a correct way of addressing disease, so
they're at least having an expectation of improvement.
Speaker 1 (07:27):
Yeah, it's like I'm not doing nothing. I'm doing something.
I'm following the advice or the you know, or I'm
being treated by an expert in their field, and you know,
it takes some of the pressure off, and it puts
you in a situation where you're expecting some level of healing,
You're expecting some sort of positive outcome.
Speaker 2 (07:46):
Hey, what explains that The common modern understanding of this
historical practice, as quote the pleasurable activity of immersion in
more mineral water has social and psychological benefits but no
physiological vests. And this probably is true for the majority
of miracle cures people think that they received at the SPA.
(08:09):
But Haywood records that there is at least one condition
where there seems to be quite strong empirical evidence that
the SPA was doing something to heal the sick. Now,
what was that condition? It was what was known as
colica pictonum, a type of paralysis that you get from
chronic lead poisoning.
Speaker 1 (08:30):
Hmmm. We've talked about lead poisoning on the show before,
so that certainly has been a widespread problem in the past.
Speaker 2 (08:38):
We talked about lead poisoning, I think most recently, most
extensively in an episode called Cupid's Lead and Arrow from
a few years back that was about Oh, I don't
even remember what all we got into in that. That
was one where we did have a digression about lead
acetate or sugar of lead, known in Roman times for
its sweet taste. Yeah, you don't want to eat that.
(08:59):
But Kalica pi tonem paralysis you get from chronic lead
poisoning has characteristic symptoms. So it starts with what Heywood
calls abdominal colic, basically meaning abdominal pain, so what a
lot of people might call stomach pain, but actually your
stomach is higher up in your torso you pain around
the guts, the intestines, and then also constipation, the inability
(09:23):
to move the bowels, and then eventually after that loss
of ability to control the limbs, but not always with
concurrent loss of sensation, so sometimes you can feel the limbs,
but you can't move them or can't move them correctly. Now,
the interesting thing about Bath is that Heywood writes, because
symptoms were very well documented when patients were admitted to
(09:44):
the Bath General Hospital, we are able to look back
at patients who showed up with this particular condition and
then keep track through the records of whether or not
they were cured, which could be measured according to local standards.
Was supposed to be measured rigorously by documented outcomes like
full recovery of limb function. Haywood writes that by analyzing
(10:08):
the records at this hospital, we can see that from
seventeen sixty to eighteen seventy nine, a span of almost
one hundred and twenty years, three three hundred and seventy
seven patients presented at Bath with paralysis from lead poisoning,
and forty five point four percent of those patients were
documented as cured fully cured, and then a further percentage
(10:30):
of them were documented as having shown some improvement. Now,
it would be much more helpful to evaluate this in
the context of control groups, right. It would be great
if we had control groups that received no treatment or
received a placebo, so we could see is this actually better?
But there are some reasons for thinking that this recovery
rate is above chance or placebo levels for the same condition,
(10:54):
and we'll talk about those later. So Heywood quotes some
seventeenth and eighteenth century physicians on this condition, colicapictonum, to
see what they knew about it. There is a doctor
Rice Charlton. Actually it looks like his name could be
pronounced Charlatan. I don't know if there's any connection there,
(11:15):
but he's describing colicapictonum in the second edition of a
book called Three Tracts on Bathwater that's bath with the
capital B from seventeen seventy four, and Charlatan writes, quote,
in consequence of a most obstinate costiveness. Costiveness means constipation
obstinate costiveness attended with exquisite pain in the bowels. Upon
(11:37):
the constipation being removed and the pain diminished, the patient
loses the use of his limbs, the arms, and hands.
Most commonly, rheumatic pains sometimes attack the limbs before they
become paralytic. Lead we know is remarkably productive of this complaint. Now,
outbreaks of symptoms like this had been common in Europe
(11:58):
for centuries, in fact, going way back, going back to
Roman times, but for the longest time there was no
agreement about the cause, so somebody might get that, you know,
you could recognize what this pattern of symptoms were. It's like, oh,
you've got the thing where you have abdominal pain, your
gut's really hurt, and then you can't poop, and then
your wrist fails and you can't use your arms. Candidates
(12:19):
for the explanation included unresolved fevers. Just quoting here from
the paper, over indulgence in acid wines. I don't know
how much people do they want to indulge in acid wines,
Like your wine is spoiled, but you really just want
to get in there.
Speaker 1 (12:34):
I mean, sometimes that's all you have around. I guess,
I guess that's true.
Speaker 2 (12:37):
No accounting for taste, and other explanations were quote high
living and passions of the mind.
Speaker 1 (12:46):
So very broad categories, especially on those last two.
Speaker 2 (12:48):
Yes, But actually in the eighteenth century the real cause
was identified. In seventeen sixty eight, the British physician Sir
George Baker correctly traced the origin of a particular epidemic
of colicapictonum. This epidemic was called the Devonshire colic to
lead poisoning, specifically caused by the widespread consumption of cider
(13:12):
tainted with lead. He traced it back to where it
came from and found out, yes, it's from this cider
that's got all this lead. And when the lead was
removed from the cider, the outbreak of colicapictonum was alleviated.
But unfortunately cider was not the only place you could
get lead. In the eighteenth and nineteenth century, people had
a vast range of options to explore that would end
(13:33):
up causing over exposure to lead. There was use of
lead hardware in the preparation, storage, and transport of food
and drink. And this is everything from lead pipes and
lead sinks to lead cooking pots, lead glazed earthenware, pewter plates,
et cetera. There were lead based cosmetics. There was lead
as a direct, intentional additive to food and drink, maybe
(13:57):
as a color rent like food coloring, or as a
flavor agent. It lead can in some forms taste sweet
or as a preservative and more on this in a second.
And then there were also lead salts that were used
as medicine. In less severe cases, lead poisoning would cause
a sort of like precursor series of symptoms. So lower
(14:18):
levels of lead poisoning would cause fatigue, weakness, headaches, and
what's described as a general malay is just kind of
a bad feeling of ill health and discomfort that you
can't really locate the cause of. And while lots of
people were dealing with minor chronic ill health from these
(14:38):
baseline levels of lead exposure, some people got even more
vicious doses of lead, often from occupational exposure, so you
might see refer to colica pictonum referred to as painters palsy.
People who were dealing with lead based paints a lot
in their line of work would have higher levels of
exposure than everybody else, and then they might end up
(14:58):
with this form of para. But not just that, there
was all kinds of manufacturing that involved lead at the time.
Another major source of high exposure to lead came from
lead adulterated alcoholic beverages. Again coming back to the example
of the devonsri colic being based in cider, Heywood writes, quote,
(15:19):
lead is soluble in such weak acids as the acetic
acid that's the acid that's in vinegar, formed when alcohol
is exposed to the air. So alcohol might easily become contaminated.
This contamination may occur incidentally during distillation when lead is
leached out of the soldered joints or base metal condensers,
or accidentally if sour cider or apple must comes into
(15:42):
contact with the lead, which was often used to repair
cracks in the cider press. Adulteration could also occur if
the cider was stored in lead glazed earthenware containers. Poor
or acid wines were sometimes adulterated deliberately in the Roman
tradition of using lead acetate as a sweetener improver or fungicide.
(16:06):
Reading this makes me feel so grateful for modern food
safety standards and regulations. Oh absolutely, it's just unbelievable reading
like what went into I don't know, Yeah, but this
paragraph here from hey what also makes me think of
the fact that before the real cause was known, some
people accused those who had this paralysis of indulging in
(16:29):
quote acid wines. It's like, oh, it's because you drank
acidic wine that you have the paralyzing colic. Those people
actually were probably detecting a real correlation but misunderstanding the cause.
It wasn't the acidic wine but a heavy metal that,
for a couple of different reasons, is more likely to
end up in sour wines. It might be added intentionally
(16:52):
to counteract the sourness, or because the acetic acid basically
the vinegar that forms in a sour wine was a
solvent four lead that might come from anything the storage
containers or the manufacturing equipment.
Speaker 1 (17:07):
Okay, it makes sense.
Speaker 2 (17:08):
So people who got more severe lead exposure, whatever the source,
whether that's from maybe occupational exposure if you're a painter
working in one of these factories, or from drinking alcoholic
beverages adulterated with lead. People with these types of exposure
could end up not just with the fatigue, the headaches,
and the malaise, but could end up paralyzed with the
(17:29):
colica pictonum. And then of course, if the disease progressed
beyond that, it could lead to convulsions, coma, and death.
And so that's the background. This brings us back to
bath the spa. Though bath had been used as a
medicinal spa since at least as far back as Roman Britain.
According to Haywood, the first documentation of spa therapy being
(17:49):
used to treat what sounds like chronic lead poisoning comes
in a book from fifteen sixty eight by an English doctor,
William Turner, with a title that really lets you know
what the book is all about. So it's called a
book of the natures and properties as well as of
the baths in England, as of other baths in Germany
(18:10):
and Italy. Very necessary for all these persons that cannot
be healed without the help of natural baths. Very mid
sixteenth century book title. So in this mid sixteenth century
book with a paragraph for a title, Turner chronicled a
long list of conditions that he said were allegedly cured
by spa treatment after having surveyed of the use of
(18:33):
public baths in Germany and Italy. And these conditions included
quote bruising that cometh by falling or beating, for green
or new wounds, and for quote old wounds falsely healed.
But also he said, you know, there's a convergence of
symptoms that can be healed in these things, and it
(18:55):
kind of sounds like colica pictonum. I have to say
the following sentence from Turner is my new all time
favorite description of constipation. You've never heard constipation in terms
so evocative. So this is what Turner calls it. He says,
the vain appetite of going to stool when a man
can do nothing when he cometh there, the hardness and
(19:18):
binding of the belly when as a man cannot go
to the stool without capital p physics. I'm sorry. I
don't mean to laugh at lead poisoning, which is no
laughing matter.
Speaker 1 (19:31):
But that that is good. This sounds like upper class
constipation to me.
Speaker 2 (19:37):
The vain appetite of going to the stool it imagined.
It makes me think of like the the koles Shov effect,
Like you're showing that actor just gazing at the toilet
and you're imagining all of the like wheels turning in
his head as he yearns.
Speaker 1 (19:52):
Yeah, well he needs the physics.
Speaker 2 (19:53):
I should have looked it up. I don't know what
that word physics refers to. Does that mean like the
intervention of physicians or maybe some kinds like pergetive medicine.
Speaker 1 (20:02):
That's what I take it to mean, like you need
the medical enterprise to intervene.
Speaker 2 (20:07):
Okay, so that's the first part of Turner's description, but
the text also refers to paralysis of the body and
abdominal pain, as well as other symptoms that can be
caused by chronic lead poisonings, such as infertility, spontaneous abortion
and pregnancy, and even gout. So it's possible that Turner
is not correct about SPA therapy healing these conditions, but
(20:28):
it is interesting that he lists a large number of
symptoms all associated with lead toxicity as among the things
that can be cured by these spas. So by the
early fifteen hundred's bath already had a reputation as a
(20:52):
place that could cure paralysis, and one of the iconic
images associated with this place and its healing powers was
a big collection of discarded crutches. But it was noticed
by physicians even as far back as the sixteenth century
that there was one particular type of paralysis which the
waters were better at curing than other types of paralysis,
(21:14):
and this was what they called palsy after the colic. Again,
this seems to be referring to the exact same pattern
of symptoms. It's colic of pictonum. You have severe abdominal pain, constipation,
followed by weakness and paralysis of the limbs. Just one
early case study. This is from a report written in
the early eighteenth century by one doctor Robert Pierce. He
(21:36):
published accounts of his career in medicine in his memoirs,
and he wrote of one typical account. He says a
guy named a reverend mister Pilkington came to him from
Lincolnshire in sixteen sixty six, and Pierce described this man's
arms as quote hanging like flails, and said he was
unable to dress himself or eat on his own. He writes, quote,
(21:58):
although he was a clergyman, the disease had made a
quaker of him.
Speaker 1 (22:02):
Oh, I don't know.
Speaker 2 (22:04):
But after he bathed and drunk the water at bath
for six to seven weeks, he finally regained control of
his limbs, apparently including the ability to doff his hat
in greeting, which, based on this writing, seems like was
considered very important, but at least by this man Pilkington,
and a bunch of sources from the eighteenth century report
(22:24):
specific patients who saw improvement at bath. It was people
with paralysis who happened to be employed as color grinders, pewterers,
and chemists, all people who would have had exposure to
lead through their jobs. So it really seems like a
convergence is happening here, we're seeing a consistent pattern emerging
in the records of who is getting healed at bath.
(22:47):
It might be worth noting what was standard treatment at
the time for people with colic of pictonem other than
going to bath. Well, sometimes when it was just the
colic and constipation stage, so just the abdominal pain and
constant pay, they would prescribe purges and emetics, so these
would be drugs to help induce stefecation and to induce vomiting.
(23:08):
Sometimes opiates would be given for pain for paralysis. Additional
treatments could include confinement to a bland diet and in
cases after the actual cause was known, removal of the
person from the lead source. That seems pretty important. So
what was the treatment at bath? How would that be different? Well,
this treatment involved bathing in the water, so you would
(23:28):
immerse yourself up to the neck anywhere between thirty minutes
and several hours, and this would usually be done starting
in the morning, with people either standing or sitting on
stone benches or seats in the water up to their necks.
Starting in the Tudor period, the water was changed once
a day, so they would remove the water after the
(23:48):
baths closed around noon, and then it would take about
nine hours for the pools to refill. Heywood notes that
getting there early in the morning was popular because it
meant that you got cleaner water.
Speaker 1 (24:04):
Just think about that. I mean, it's still kind of
the deal. Right. The earlier you get to the pool,
the less less time it's had to absorb certain things,
it's had, less time for stuff on the bottom to
get stirred up.
Speaker 2 (24:17):
That's a good point. Oh you're a swimmer, yeah, do
you try to get there early when you can.
Speaker 1 (24:21):
I'm generally a morning swimmer, not for these reasons, just
for scheduling reasons. But yeah, there have been times where
I'm like, oh, they just closed the pool for a
week and now they're reopening. Everything's nice and clean. I
want to get in. I'm going to be Monday morning,
first thing to get my shot at that clean, clean pool. Nice.
Speaker 2 (24:40):
Do you have like waterproof earbuds or something. Do you
listen to music when you swim or I don't even
know if that's the thing.
Speaker 1 (24:45):
Honestly, no, it is. I see plenty of people do it.
I just I've never done it.
Speaker 2 (24:49):
Yeah, well they so, Heywood says in this paper that
sometimes there was music or other stuff to entertain people
while they were bathing. I guess if you're just supposed
to sit in the warm water for three hours up
to your and there's no music or anything that might
get boring.
Speaker 1 (25:03):
Well it makes sense. And you know, I see the
same thing reflected in the YMCA pool that I go to,
Like there's there's often some sort of aquatic aerobics class
going on, there's music playing. And I was just thinking
of this when you mentioned earlier, like the social aspect
of of of healing at baths and spas. That's something
(25:24):
I think I often fail failed to think about. But yeah,
that's one of the advantages of going to any kind
of group exercise scenario is that, yeah, you're doing some
level of physical exercise, you're being guided in that physical exercise,
but then you are in the company of other people,
and you're going to get at least some level of
social boost.
Speaker 2 (25:41):
That's true, and I'm sure there was a lot of
socializing going on, especially since I would guess a lot
of the people bathing together. Probably you know, people came
there for different reasons, but probably a lot of them
had similar complaints. It sounds like and you know, you
can really have a long conversation if you have like
the same medical problem as somebody else. That can that
can really be a bonding experience.
Speaker 1 (26:01):
Yeah. And there's also seems like a high probability that
you would have encountered people from your industry, other color grinders,
other pewterers, and other chemists, in addition to people being
treated for other maladies. Of course.
Speaker 2 (26:15):
Exactly, so, so that's soaking in the water. What about
drinking the water? So Heywood rites quote drinking the water
became more acceptable after sixteen fifty when a clean supply
was provided which came directly from the spring. And then,
referring to that physician from earlier Pierce, Pierce claimed that
quote advantage has been found by drinking it, referring to
(26:38):
the bathwater, especially in the bilious chalicks. I think that
means collis and the usual effect of them loss of limbs.
Interesting again, I like singling out the people who have
the colic of pictonum as the ones who benefit from
drinking the water, and Heywood rights. One to two pints
were consumed each morning in divided doses. The patients chose
(27:00):
to drink much larger amounts, but this was frowned upon.
This taking us back to Plenty again, who was talking
about the people who get in the spring and then
they just want to drink it until you can't see
their jewelry anymore.
Speaker 1 (27:14):
The distrust of too much hydration.
Speaker 2 (27:17):
So Bath gained a reputation for healing throughout the second
half of the seventeenth century, though at the time it
had not yet been revived as a luxurious spa retreat.
Haywood says that the journey there was kind of treacherous
and accommodations were pretty dank. It was like, you know,
it was not fancy yet. But by the eighteenth century,
(27:37):
the physicians of Bath were convinced that the waters could
cure a number of diseases, including colicapictonem that and word
of these cures kind of spread around the country, attracting
a lot of attention. So people were making the journey there,
in some cases like royal people, but there were also
some doctors from outside Bath that were skeptical, including Richard Meade,
a physician to King George the Second. So well, there
(28:00):
was impetus to put together a sort of large collection
of data of like a study that would really convince
people to come there for treatment. And there's a whole
section of this paper that I'm not going to get
into because it concerns the medical aspects less, but it
is very interesting. It's about the founding of the Bath
(28:21):
General Hospital and what some of the kind of cold,
cruel economic realities of that were. That like, a lot
of this may have been driven by locals around Bath
wanting their businesses to benefit from people coming to the
springs for medical treatment, but also them having a problem
that like a lot of the people who are coming
(28:42):
here for healing are poor, and we don't want just
poor people, so we want to find a way to
get the poor people out of the city and get
rich people coming. So some less than savory sort of
abuse of the concept of charity here, But this does
lead to this large collection of data at the hospital,
and Heywood notes some very interesting measures that were put
(29:04):
in place for the evaluation of clinical results at Bath.
One thing was treatment was regulated, so you're trying to
make sure that patients were getting basically the same thing,
they were getting treated in the same way. Also, because
to quote from Haywood quote, at that time, medical practitioners
were notoriously over optimistic when assessing the results of their
(29:25):
own treatments. Because of this, they had outcomes of treatment
assessed by a committee of doctors rather than only by
the one doctor who had managed the case in question.
So you're not getting to just like ride up the
outcomes on your own patients.
Speaker 1 (29:39):
All right, that's good, spreading it around a little bit. Yeah.
Speaker 2 (29:42):
Yeah. They hoped that this would lead to quote, irrefutable
proof of the efficacy of the bath waters for healing.
Now I think irrefutable proof is a little over enthusiastic there,
but these are good measures to put in place, certainly
compared to the standards of the day. So this is
not a double blind, randomized controlled trial that would really
(30:02):
wouldn't become a standard until the twentieth century, but pretty
good for the time. Another thing was that it was
agreed that no patient would qualify as quote cured if
they still had any trace of the original symptoms they
showed up with, and they enforced pretty high standards of
record keeping. Okay, so what did the treatment at bath
(30:22):
consist of? Well, First, and very important to note, patients
were extracted from their regular environment for their stay in Bath,
which means they were almost certainly cut off from the
original source of lead toxicity lead exposure, and this in
itself is important to keep in mind because for all
we know, this alone could be causing major improvements.
Speaker 1 (30:46):
Yeah, getting them just away from their regular everyday exposure
to land.
Speaker 2 (30:51):
And that could be in most cases either occupational or
from food and drink. And on that last note, they
were given plenty of fresh food at bath and this
included home brewed beer made there. The additional drinking of
alcohol beyond what was provided by the hospital was forbidden,
so this was another way to cut off additional lead exposure.
(31:12):
They were often given a purging medication to treat constipation.
Bathing was generally three days a week in the manner
previously described. So you know, you go sit or stand
in the water. You keep your head above the water line,
but it goes up to your neck and then again,
patients would often drink one to one and a half
pints of the spring water a day, maybe divided into
(31:34):
two different doses, and in some cases they might like
sort of pump the spring water over the paralyzed limb. So, anyway,
what are the results if we look back on them historically.
The results are pretty interesting. By analyzing the records kept
at Bath General Hospital, it seems there is a pretty
good reason to think that the SPA therapy at Bath
(31:56):
was doing something to relieve the symptoms of this disease,
in particular of Colica pictonum. The paper includes a table
compiling stats on patients admitted to the Bath Hospital from
seventeen fifty one to seventeen fifty eight. Out of one thousand,
five hundred and ninety patients total, one hundred and eight
of them were admitted with symptoms indicating that they had
(32:17):
paralysis due to lead toxicity. Those can be further broken
down into paralyzed patients who had occupational exposure to lead.
There were thirty seven of those including readmission, and patients
with the Devonshire colic meaning paralysis that was preceded by
severe abdominal pain and constipation, and there were seventy one
(32:39):
of these including readmissions. In the cases of patients with
occupational exposure, fifty nine percent were completely cured and ninety
two percent were improved. In the case of patients with
Devonshire colic, forty two percent were completely cured and ninety
three percent were improved. Now, my initial action to this
(33:00):
was that's interesting. But without a control group receiving no
treatment or placebo treatment, or without different treatment groups to compare,
how can we know it was the bathwater and the
immersion that was actually leading to these cures. So what
if simply maybe being away from the lead exposure on
its own would produce the same rates of recovery. Well,
(33:21):
that is possible, But the author considers that and offers
some evidence based on their referral letters correlated with each
patient's case in hospital records that may give us more
confidence than the results. So talking about the specifically the
workers who had occupational exposure to lead, most of them
(33:43):
came from London or the region in the southeast of England,
and Heywood writes, quote, fifteen had already been admitted to
one of the London hospitals but had not responded to
treatment there. They were referred to the Bath hospital as
quote incurable treatment. In Bath, eight were cured and the
other seven were said to be improved. These results support
(34:06):
the view that the treatment in Bath had something special
to offer, as in London they would also have been
removed from exposure to lead and given purges emetics and
a bland diet apparently to no avail. So interesting here.
This still doesn't prove it, but it seems we have
a kind of crude analog of a control group based
(34:27):
in the treatment histories from these patients' referral letters. So
in many cases they had already been removed from the
lead and received other treatments for a long time in
different hospitals and shown no improvement. So this is still
not as good as a real control group for a
number of reasons. For example, one I just thought of
is that it's not concurrent, so like, you know, the
(34:49):
previous treatment that they got the other hospitals happened before
and then they came to Bath afterwards, So maybe the
cumulative time away from lead exposure could contribute to be
outcomes at Bath and so forth. But interesting results nevertheless.
Speaker 1 (35:05):
Yeah, Yeah, and results that would seem to some degree
to point back to questions about the water, like what
is it about the waters of Bath or what they're
doing with the waters of Bath that may or may
not be having an impact, right.
Speaker 2 (35:19):
That's right. So here's another thing that makes these results interesting.
The Bath General Hospital records spanned many decades and they
seem to indicate a consistently higher rate of cure and
improvement for palsy from Colica pictonum. So again, let exposure
paralysis than for other conditions such as paralysis from sources
(35:41):
other than lead poisoning. So it's possible that, you know,
maybe the Bath General Hospital doctors were using you know,
they could have been doing all kinds of tricks consciously
or unconsciously to make their treatments look more effective than
they actually were. Maybe they were using selective admission policies
to improve their outcomes, like patients to let into the
(36:01):
study that seemed more likely to improve, or maybe they
were just overly positive in assessing outcomes. But if any
of that were the case, why would the numbers be
so much better for patients specifically with lead poisoning than
for all other conditions.
Speaker 1 (36:17):
Yeah, because it's the numbers that really perk one's interests here,
Because if you're just talking anecdotally about like the number
of abandoned crutches that they have there, it's like, oh,
that's not very convincing, because there are two majorly compelling
reasons that a sick person might abandon their crutch, and
only one of them speaks to the effectiveness of the treatment.
Speaker 2 (36:39):
Yes, that's very good to point out. So again we
get a little bit of extra confidence just by looking
at the difference comparing the different conditions in their outcomes.
So again, all this like it would not prove it
to the standard of a modern randomized controlled trial, but
I think there's at least a solid reason to suspect
that SPA therapy at Bath did have some healing powers
(37:00):
for people who couldn't doff their hats because of lead.
And so this was the paper that initially got me
interested in talking about this. And the paper finally addresses
the question that might be burning in all of your minds,
like if this is the case, if it was actually
effective at curing paralysis from lead toxicity, how does that work? Well,
(37:21):
Heywood's paper here speculates the first thing is the immersion.
So a big component of this treatment at Bath was
spending a lot of time sitting in warm, mineral spring
water up to your neck, and Heywood argues that this
in itself could contribute to the outcomes documented at Bath
General Hospital. And to back this up, Heywood writes about
(37:43):
how in the nineteen seventies some researchers were doing experiments
for the Space program for NASA and trying to simulate
the effects of microgravity, and some of these experiments involved
having astronauts sit up to their necks in warm water
for a long time. And Heywood points to a nephrologist
to named Murray Epstein, who demonstrated in some papers something
(38:05):
kind of interesting. When you sit around in water up
to your neck, it makes you pee more. Specifically, not
just pea more, but it increases the rate at which
you excrete water, but not just water, also sodium and calcium. Now,
why on Earth would that be. This is also not
something that's one hundred percent clear, but there seems to
(38:26):
be a reasonable explanation, Heywood offers, which has to do
with water pressure. So like, if your body is sitting
down below the waterline, you've got water pressing in on
your skin from all directions. And when that water pressure
is pressing in on your legs and your abdomen, it
causes that external flesh to kind of push in some
(38:48):
blood and interstitial fluid. More fluids are getting pressed into
the body from the outside, and Heywood writes, quote this
extracellular fluid moves into blood vessels in the thorax, meaning
the trunk of the body, producing an increase in central
blood volume of about seven hundred milli liters.
Speaker 1 (39:08):
Now, it's interesting that this basically comes back to the
idea of purging fluids from your body, which is something
that was long thought or understood to have some sort
of roll in healing the sick.
Speaker 2 (39:21):
Right, and in many cases that might not have done anything.
But I wonder if this means that in the case
of lead poisoning, the purges would actually be helpful anyway.
(39:42):
But to continue here, so Heywood writes, the consequent rise
in right and left atrial pressures is the stimulus that
leads to the large increases in urinary volume and sodium
excretion that are observed during immersion up to the neck.
This is because sensory receptors for blood volume are apparently
situated in the right atrium. So this relative central hypervolemia,
(40:07):
the condition of having extra blood volume extra fluid volume
in the body deceives the body which reacts as though
there had been an increase in total body fluid volume,
not just a reallocation of fluid. So does that make
sense that I think I'm explaining this right that the
simplified version is when you immerse your body in water,
(40:29):
the water squeezes you and essentially squeezes some of your
extra body fluid into the core of your thorax. It
squeezes from the outside, so the pressure in the core increases,
and because the pressure in the core increases, this tricks
your body's blood volume sensors into thinking the total amount
of fluid in your body has increased, and thus to
(40:49):
compensate for this, it kicks off complex chain reactions in
the the renal system that lead to increased excretion of
urine and of things that get excreted through urine, sodium,
and in this case calcium.
Speaker 1 (41:02):
Okay, that makes sense, Yeah, but.
Speaker 2 (41:04):
Why would this have anything to do with lead poisoning. Well,
Heywood notes that the human body typically tends to handle
lead and calcium in a similar way. So when there's
lead in your body, the body treats it kind of
the same way it treats calcium. And so if this
is causing increased excretion of calcium through urine, it may
(41:27):
also be causing increased excretion of lead through urine. And
in fact, Heywood was involved in experiments that were set
up at the Immersion Laboratory in the Bristol Royal Infirma
Infirmatory Infirmary to test this hypothesis, and they in fact
did find that urinary lead excretion goes up when the
(41:49):
body is immersed. So they tested this out on experiments
with modern lead workers who were not suffering from symptoms
of lead poisoning, but still had lead levels much higher
than the mineral population in their blood. These workers were
subjected to three hour sessions of soaking up to their
necks in water that was thirty five degrees celsius or
ninety five degrees fahrenheit, and the experiments found that the
(42:13):
immersion did indeed cause them to pee out higher levels
of lead than people normally do. Oh wow, okay, Heywood
writes quote. The total amounts excreted during one three hour
immersion period are small compared to the total body lead,
which is predominantly tissue bound. Okay, so not like free
in the blood, but bound up in tissues. Heywood goes on. However,
(42:35):
if these immersions were continued to the extent described in
the Bath hospital records i e. Three Times a week
for twenty four weeks, an appreciable proportion of the total
body lead would be removed. We can therefore suggest that
this was a mechanism through which traditional bath spa therapy
could have operated. So that's fascinating. Just sitting immersed in
(42:58):
the warm water currently could help you get more lead
out of the body faster than you would doing anything else.
Speaker 1 (43:06):
Yeah, and this of course working in congress with not
having a whole bunch of lead flooding into your system
through your occupation or other environmental causes exactly.
Speaker 2 (43:16):
So you're removed from the original exposure to lead, you'd
have less lead coming in, and you're increasing the rate
at which lead is going out.
Speaker 1 (43:26):
Okay, but there's some other amenities to factor in as
well though, right.
Speaker 2 (43:29):
That's right. So, as I mentioned, you know, the patients
at bath in addition to being removed from the source
of lead and having the immersion, they also got good food,
so that may have been a factor. They got gentle
exercise that may have been a factor as well. So
it's hard to know for sure with historical cases like this,
because you know, you can't you're not running the test yourself.
You can't isolate all the variables. You can only deal
(43:52):
with the data we have from history. But in this case,
I think you could totally plausibly make the argument that
that the immersion was really doing something for the people
with lead poisoning. It was doing something more than just
getting them away from the original lead exposure. Now there
was another interesting part of this, that's the immersion, which
(44:13):
Heywood treats as probably the main explanation. But what about
drinking the mineral water. Again, hopefully not two levels described
by plenty where your rings disappear, but the level generally
prescribed to drink was like one point five to two
pints a day. And Heywood notes that water from the
mineral springs of bath has elevated levels of calcium and iron,
(44:36):
and citing a study by Mahaffe from nineteen seventy three,
Heywood observes that calcium and iron deficiency actually increase the
body's tendency to absorb lead, and calcium and iron deficiency
increase the toxicity of lead that is already present in
the body. And this has been shown to the extent
that calcium and iron supplements have been suggested as partial
(44:57):
treatment for infants with higher than average level of lead
in the blood. So it's possible that the mineral water
pints that patients at bath were drinking. That was helping
out as well.
Speaker 1 (45:09):
Yeah, And I mean on top of that, if they're
if you're having to if you're having to pee more
because of your soakings in the warm waters, you need
to be drinking more water as well, Like you need
to stay hydrated, right, And this is something I saw
reflected in some papers. Will probably discuss in the next
episode that, like, if nothing else, staying hydrated on clean
(45:31):
water like that alone is beneficial for the body, like
because if nothing else, you don't want whatever is going
on with your body to be exasperated by also having
some sort of dehydration scenario going on as well.
Speaker 2 (45:45):
Yes, exactly. Hydration incredibly important, so that plays a role
as well. Though I want to be clear this is
not should not be taken as a general endorsement of
drinking mineral spring water, which could have all kinds of
things in it. So it seems like in these these
people were probably doing all right, but you don't want
to be drinking water from sources you're not sure.
Speaker 1 (46:05):
Or safe, right right, right, Yeah, but nothing else, like
iuld say how much I wonder on a case that
case basis, like how much of that person's normal liquid
intake would have been confined to like beers for example,
versus you know, they're still having beer. They're having good
beer when they go to bath, but then they're also
having a large amount of water as well in addition
(46:27):
to that beer. So it seems like there would be
a net positive there.
Speaker 2 (46:31):
Yeah. So I would say in conclusion, while bathing in
a SPA probably does only work via placebo effect on
a number of the conditions we've talked about throughout the
series so far, on the conditions it was used to
treat throughout history. I think this paper makes a very
interesting case that when it came to paralysis from lead poisoning,
(46:51):
SPA therapy was genuine medicine.
Speaker 1 (46:54):
Yeah, it's fascinating, very fascinating. All right, Well, we're going
to go ahead and close out this episode on that note,
but we will be back in a part four on
baths immersion and also drinking of naturally occurring spring waters,
thermal waters, et cetera. We still have some other important
(47:15):
topics to discuss here, so come back for that. In
the meantime, we'll just remind you that our core episodes
of stuff to blow your mind publish on Tuesdays and Thursdays.
On Wednesdays we do a short form artifact or monster fact.
On Mondays we do listener mail, and we're already getting
some great listener mail about the Bath episodes, by the way.
And then on Fridays we do Weird House Cinema. That's
our time to set aside most serious concerns and just
(47:38):
talk about a strange film.
Speaker 2 (47:39):
Huge thanks to our audio producer JJ Posway. If you
would like to get in touch with us with feedback
on this episode or any other, to suggest a topic
for the future, or just to say hello, you can
email us at contact at stuff to blow your Mind
dot com.
Speaker 3 (47:57):
Stuff to Blow Your Mind is production of iHeartRadio.
Speaker 1 (48:04):
For more podcasts from iHeartRadio, visit the iHeartRadio app, Apple Podcasts,
or wherever you're listening to your favorite shows.
Hey, welcome to Stuff to Blow Your Mind. My name
is Robert Lamb.
Speaker 2 (00:09):
And I am Joe McCormick, and it's Saturday. Going into
the Old Vault for an episode of the show from
last year. This one originally published March twenty first, twenty
twenty three, and it's part three of our series called
The Washing of the Waters.
Speaker 1 (00:22):
Enjoy Welcome to Stuff to Blow Your Mind, production of iHeartRadio. Hey,
welcome to Stuff to Blow your Mind. My name is
Robert Lamb.
Speaker 2 (00:39):
And I'm Joe McCormick, and we're back with part three
of our series on the Healing Waters, where we have
been focusing on beliefs held by many people throughout history
that you could heal various diseases by bathing, by either
immersing yourself in the waters of say warm or hot
mineral spring, or sometimes maybe by drinking those waters. Also,
(01:03):
we talked about the medicinal theories on which some of
these practices were based, especially in the ancient world, such
as the ancient Greek and Roman beliefs in humoral theory. Also,
in the last episode we talked there was a very
interesting digression you had rob about supposed healing springs that
have creatures living in them, such as little blood worms
(01:26):
or fish trapped in the hot waters.
Speaker 1 (01:28):
Yeah, as luck would have it. Here in Atlanta, we
have a science festival here as well, the Atlanta Science Festival,
And a very cold morning over the weekend, my family
went to a talk on carnivorous plants, about some of
the various carnivorous plants that are found internally in the
southeastern United States. And at the end of it, the
(01:50):
children present got to feed the carnivorous plants and they
were feeding them bloodworms. So wow, it comes around. I
was like, yeah, I know these guys. I was just
talking about these guys. These would be, of course, the
larval forms of the little flies, rather than the proper
worms that we also discussed.
Speaker 2 (02:08):
But there was no eye squirting, no squirting of the
worms in the eyes.
Speaker 1 (02:12):
Now, nobody was putting these in their eyeballs.
Speaker 2 (02:14):
Good good, Well, today I wanted to take a look
actually at the paper that first got me interested in
this subject, in the subject of beliefs about the healing
powers of balneotherapy or immersion in the water. And this
is a medical history paper concerning the spa at Bath Bath,
(02:35):
a location in southwest England in Somerset that has been
used as a spa going way back back back into
at least as far back as Roman times when it
was the spa of Minerva Sulas. Remember in the previous
episode we talked about how often these these spa facilities
built out by the Romans would kind of be under
the heading of a sort of composite god made of
(02:58):
like a Roman god like Minerve, and then the local
deity in this case it would be some kind of
Celtic goddess named Sulus. So these are merged together. Minervasulus
rules over the waters of Bath, And yeah, going way back,
people thought that various illnesses could be healed there. I
wanted to talk about a paper making a case that
(03:19):
maybe for one particular disease there actually is a mechanical
healing property at the spring.
Speaker 1 (03:27):
Oh fascinating. You know, I visited Bath many years ago,
like fifteen plus years ago, and I believe my wife
and I went as is kind of like a day
trip out of London by train and then we took
one of those bus tours of the city and then
walked around a bit. But it was really beautiful and
I remember that you had this great layered feeling of
(03:48):
history there, like the topography of the city, and like
the physical building layers of the city revealed, like the
deep time of the area. I was fascinating totally.
Speaker 2 (03:58):
I would love to go myself, maybe not to get
in the water, but at least to have a look around.
Speaker 1 (04:03):
Yeah, I don't remember. I mean the tours we were on,
the tours we could afford at the time. It definitely
did not have any invitations to get in the water,
just to like buy coffee mug at the end, that
sort of thing.
Speaker 2 (04:13):
So the paper I want to talk about is called
a Trial of the Bath Waters the Treatment of Lead
Poisoning by an author named Audrey Haywood in the journal
Medical History, published back in nineteen ninety and this paper
concerns medical clinical research carried out at what was called
(04:33):
the Bath General Hospital, which opened in seventeen forty one.
Now at the time, one of the major missions of
this hospital facility was to mount what the authors of
this study called a trial of the waters, which was
an attempt to record data to test and show whether
(04:55):
the spa therapy practiced in the pools of Bath, whether
therapy was actually effective against disease now, as we've talked about,
people since antiquity have believed all kinds of different things
that medical complaints could be cured by soaking in spas,
soaking or bathing in warm mineral springs, sometimes drinking the
water as well. If you haven't heard the last episode yet,
(05:17):
you should go check that out first. We talked about
plenty of examples in there. But the question is why
did people think that the waters of the spas were
curing their diseases. In modern times, it has been commonly
assumed that this was entirely due to the placebo effect.
To the placebo effect is a beneficial or healing effect
(05:38):
caused by a treatment that has no actual direct mechanism
on the condition itself, and thus, and thus the apparent
healing or improvement is believed to be caused by the
patient's belief that they are being treated or by their
expectation of improvement.
Speaker 1 (05:56):
And we've talked about the cebo effect plenty of times
on the show is and has a measurable effect. It
is a real thing. And so if nothing else is
doing anything for you, at least the blacebo effect maybe
kicking in.
Speaker 2 (06:09):
Right, So that could be an explanation for why people
maybe would go soak in the water and think, oh my,
whatever got better.
Speaker 1 (06:16):
Now.
Speaker 2 (06:16):
In the ancient world, there were mechanistic theories of why
the spa would cure you. One example among many is
again humoral theory, the theory that, oh, your fluids are
out of balance. You know, maybe you've got too much
blood or too much yellow bile, not enough phlim or something,
and you could deal with these imbalances by calibrating the
(06:37):
two sort of like slider knobs on your body, and
those knobs were wet and dry and hot and cold
because wet, dry, hot, and cold were each correlated with
one of the humors.
Speaker 3 (06:49):
So like, oh, I don't have it in front of
me now, but I think maybe like blood was like
hot and wet or something, or maybe cool and wet.
I don't know anyway, So you know, if you have
too much of one of those things, you adjust the
hotness or coldness or dryness or wetness of the body
in order to get yourself back in balance. Now we
know today that this is not actually how the body works.
(07:11):
This is an obsolete theory. It does not accurately describe
where disease comes from. But having the belief in it
may have led again to placebo effect. People are thinking
that they've got a correct way of addressing disease, so
they're at least having an expectation of improvement.
Speaker 1 (07:27):
Yeah, it's like I'm not doing nothing. I'm doing something.
I'm following the advice or the you know, or I'm
being treated by an expert in their field, and you know,
it takes some of the pressure off, and it puts
you in a situation where you're expecting some level of healing,
You're expecting some sort of positive outcome.
Speaker 2 (07:46):
Hey, what explains that The common modern understanding of this
historical practice, as quote the pleasurable activity of immersion in
more mineral water has social and psychological benefits but no
physiological vests. And this probably is true for the majority
of miracle cures people think that they received at the SPA.
(08:09):
But Haywood records that there is at least one condition
where there seems to be quite strong empirical evidence that
the SPA was doing something to heal the sick. Now,
what was that condition? It was what was known as
colica pictonum, a type of paralysis that you get from
chronic lead poisoning.
Speaker 1 (08:30):
Hmmm. We've talked about lead poisoning on the show before,
so that certainly has been a widespread problem in the past.
Speaker 2 (08:38):
We talked about lead poisoning, I think most recently, most
extensively in an episode called Cupid's Lead and Arrow from
a few years back that was about Oh, I don't
even remember what all we got into in that. That
was one where we did have a digression about lead
acetate or sugar of lead, known in Roman times for
its sweet taste. Yeah, you don't want to eat that.
(08:59):
But Kalica pi tonem paralysis you get from chronic lead
poisoning has characteristic symptoms. So it starts with what Heywood
calls abdominal colic, basically meaning abdominal pain, so what a
lot of people might call stomach pain, but actually your
stomach is higher up in your torso you pain around
the guts, the intestines, and then also constipation, the inability
(09:23):
to move the bowels, and then eventually after that loss
of ability to control the limbs, but not always with
concurrent loss of sensation, so sometimes you can feel the limbs,
but you can't move them or can't move them correctly. Now,
the interesting thing about Bath is that Heywood writes, because
symptoms were very well documented when patients were admitted to
(09:44):
the Bath General Hospital, we are able to look back
at patients who showed up with this particular condition and
then keep track through the records of whether or not
they were cured, which could be measured according to local standards.
Was supposed to be measured rigorously by documented outcomes like
full recovery of limb function. Haywood writes that by analyzing
(10:08):
the records at this hospital, we can see that from
seventeen sixty to eighteen seventy nine, a span of almost
one hundred and twenty years, three three hundred and seventy
seven patients presented at Bath with paralysis from lead poisoning,
and forty five point four percent of those patients were
documented as cured fully cured, and then a further percentage
(10:30):
of them were documented as having shown some improvement. Now,
it would be much more helpful to evaluate this in
the context of control groups, right. It would be great
if we had control groups that received no treatment or
received a placebo, so we could see is this actually better?
But there are some reasons for thinking that this recovery
rate is above chance or placebo levels for the same condition,
(10:54):
and we'll talk about those later. So Heywood quotes some
seventeenth and eighteenth century physicians on this condition, colicapictonum, to
see what they knew about it. There is a doctor
Rice Charlton. Actually it looks like his name could be
pronounced Charlatan. I don't know if there's any connection there,
(11:15):
but he's describing colicapictonum in the second edition of a
book called Three Tracts on Bathwater that's bath with the
capital B from seventeen seventy four, and Charlatan writes, quote,
in consequence of a most obstinate costiveness. Costiveness means constipation
obstinate costiveness attended with exquisite pain in the bowels. Upon
(11:37):
the constipation being removed and the pain diminished, the patient
loses the use of his limbs, the arms, and hands.
Most commonly, rheumatic pains sometimes attack the limbs before they
become paralytic. Lead we know is remarkably productive of this complaint. Now,
outbreaks of symptoms like this had been common in Europe
(11:58):
for centuries, in fact, going way back, going back to
Roman times, but for the longest time there was no
agreement about the cause, so somebody might get that, you know,
you could recognize what this pattern of symptoms were. It's like, oh,
you've got the thing where you have abdominal pain, your
gut's really hurt, and then you can't poop, and then
your wrist fails and you can't use your arms. Candidates
(12:19):
for the explanation included unresolved fevers. Just quoting here from
the paper, over indulgence in acid wines. I don't know
how much people do they want to indulge in acid wines,
Like your wine is spoiled, but you really just want
to get in there.
Speaker 1 (12:34):
I mean, sometimes that's all you have around. I guess,
I guess that's true.
Speaker 2 (12:37):
No accounting for taste, and other explanations were quote high
living and passions of the mind.
Speaker 1 (12:46):
So very broad categories, especially on those last two.
Speaker 2 (12:48):
Yes, But actually in the eighteenth century the real cause
was identified. In seventeen sixty eight, the British physician Sir
George Baker correctly traced the origin of a particular epidemic
of colicapictonum. This epidemic was called the Devonshire colic to
lead poisoning, specifically caused by the widespread consumption of cider
(13:12):
tainted with lead. He traced it back to where it
came from and found out, yes, it's from this cider
that's got all this lead. And when the lead was
removed from the cider, the outbreak of colicapictonum was alleviated.
But unfortunately cider was not the only place you could
get lead. In the eighteenth and nineteenth century, people had
a vast range of options to explore that would end
(13:33):
up causing over exposure to lead. There was use of
lead hardware in the preparation, storage, and transport of food
and drink. And this is everything from lead pipes and
lead sinks to lead cooking pots, lead glazed earthenware, pewter plates,
et cetera. There were lead based cosmetics. There was lead
as a direct, intentional additive to food and drink, maybe
(13:57):
as a color rent like food coloring, or as a
flavor agent. It lead can in some forms taste sweet
or as a preservative and more on this in a second.
And then there were also lead salts that were used
as medicine. In less severe cases, lead poisoning would cause
a sort of like precursor series of symptoms. So lower
(14:18):
levels of lead poisoning would cause fatigue, weakness, headaches, and
what's described as a general malay is just kind of
a bad feeling of ill health and discomfort that you
can't really locate the cause of. And while lots of
people were dealing with minor chronic ill health from these
(14:38):
baseline levels of lead exposure, some people got even more
vicious doses of lead, often from occupational exposure, so you
might see refer to colica pictonum referred to as painters palsy.
People who were dealing with lead based paints a lot
in their line of work would have higher levels of
exposure than everybody else, and then they might end up
(14:58):
with this form of para. But not just that, there
was all kinds of manufacturing that involved lead at the time.
Another major source of high exposure to lead came from
lead adulterated alcoholic beverages. Again coming back to the example
of the devonsri colic being based in cider, Heywood writes, quote,
(15:19):
lead is soluble in such weak acids as the acetic
acid that's the acid that's in vinegar, formed when alcohol
is exposed to the air. So alcohol might easily become contaminated.
This contamination may occur incidentally during distillation when lead is
leached out of the soldered joints or base metal condensers,
or accidentally if sour cider or apple must comes into
(15:42):
contact with the lead, which was often used to repair
cracks in the cider press. Adulteration could also occur if
the cider was stored in lead glazed earthenware containers. Poor
or acid wines were sometimes adulterated deliberately in the Roman
tradition of using lead acetate as a sweetener improver or fungicide.
(16:06):
Reading this makes me feel so grateful for modern food
safety standards and regulations. Oh absolutely, it's just unbelievable reading
like what went into I don't know, Yeah, but this
paragraph here from hey what also makes me think of
the fact that before the real cause was known, some
people accused those who had this paralysis of indulging in
(16:29):
quote acid wines. It's like, oh, it's because you drank
acidic wine that you have the paralyzing colic. Those people
actually were probably detecting a real correlation but misunderstanding the cause.
It wasn't the acidic wine but a heavy metal that,
for a couple of different reasons, is more likely to
end up in sour wines. It might be added intentionally
(16:52):
to counteract the sourness, or because the acetic acid basically
the vinegar that forms in a sour wine was a
solvent four lead that might come from anything the storage
containers or the manufacturing equipment.
Speaker 1 (17:07):
Okay, it makes sense.
Speaker 2 (17:08):
So people who got more severe lead exposure, whatever the source,
whether that's from maybe occupational exposure if you're a painter
working in one of these factories, or from drinking alcoholic
beverages adulterated with lead. People with these types of exposure
could end up not just with the fatigue, the headaches,
and the malaise, but could end up paralyzed with the
(17:29):
colica pictonum. And then of course, if the disease progressed
beyond that, it could lead to convulsions, coma, and death.
And so that's the background. This brings us back to
bath the spa. Though bath had been used as a
medicinal spa since at least as far back as Roman Britain.
According to Haywood, the first documentation of spa therapy being
(17:49):
used to treat what sounds like chronic lead poisoning comes
in a book from fifteen sixty eight by an English doctor,
William Turner, with a title that really lets you know
what the book is all about. So it's called a
book of the natures and properties as well as of
the baths in England, as of other baths in Germany
(18:10):
and Italy. Very necessary for all these persons that cannot
be healed without the help of natural baths. Very mid
sixteenth century book title. So in this mid sixteenth century
book with a paragraph for a title, Turner chronicled a
long list of conditions that he said were allegedly cured
by spa treatment after having surveyed of the use of
(18:33):
public baths in Germany and Italy. And these conditions included
quote bruising that cometh by falling or beating, for green
or new wounds, and for quote old wounds falsely healed.
But also he said, you know, there's a convergence of
symptoms that can be healed in these things, and it
(18:55):
kind of sounds like colica pictonum. I have to say
the following sentence from Turner is my new all time
favorite description of constipation. You've never heard constipation in terms
so evocative. So this is what Turner calls it. He says,
the vain appetite of going to stool when a man
can do nothing when he cometh there, the hardness and
(19:18):
binding of the belly when as a man cannot go
to the stool without capital p physics. I'm sorry. I
don't mean to laugh at lead poisoning, which is no
laughing matter.
Speaker 1 (19:31):
But that that is good. This sounds like upper class
constipation to me.
Speaker 2 (19:37):
The vain appetite of going to the stool it imagined.
It makes me think of like the the koles Shov effect,
Like you're showing that actor just gazing at the toilet
and you're imagining all of the like wheels turning in
his head as he yearns.
Speaker 1 (19:52):
Yeah, well he needs the physics.
Speaker 2 (19:53):
I should have looked it up. I don't know what
that word physics refers to. Does that mean like the
intervention of physicians or maybe some kinds like pergetive medicine.
Speaker 1 (20:02):
That's what I take it to mean, like you need
the medical enterprise to intervene.
Speaker 2 (20:07):
Okay, so that's the first part of Turner's description, but
the text also refers to paralysis of the body and
abdominal pain, as well as other symptoms that can be
caused by chronic lead poisonings, such as infertility, spontaneous abortion
and pregnancy, and even gout. So it's possible that Turner
is not correct about SPA therapy healing these conditions, but
(20:28):
it is interesting that he lists a large number of
symptoms all associated with lead toxicity as among the things
that can be cured by these spas. So by the
early fifteen hundred's bath already had a reputation as a
(20:52):
place that could cure paralysis, and one of the iconic
images associated with this place and its healing powers was
a big collection of discarded crutches. But it was noticed
by physicians even as far back as the sixteenth century
that there was one particular type of paralysis which the
waters were better at curing than other types of paralysis,
(21:14):
and this was what they called palsy after the colic. Again,
this seems to be referring to the exact same pattern
of symptoms. It's colic of pictonum. You have severe abdominal pain, constipation,
followed by weakness and paralysis of the limbs. Just one
early case study. This is from a report written in
the early eighteenth century by one doctor Robert Pierce. He
(21:36):
published accounts of his career in medicine in his memoirs,
and he wrote of one typical account. He says a
guy named a reverend mister Pilkington came to him from
Lincolnshire in sixteen sixty six, and Pierce described this man's
arms as quote hanging like flails, and said he was
unable to dress himself or eat on his own. He writes, quote,
(21:58):
although he was a clergyman, the disease had made a
quaker of him.
Speaker 1 (22:02):
Oh, I don't know.
Speaker 2 (22:04):
But after he bathed and drunk the water at bath
for six to seven weeks, he finally regained control of
his limbs, apparently including the ability to doff his hat
in greeting, which, based on this writing, seems like was
considered very important, but at least by this man Pilkington,
and a bunch of sources from the eighteenth century report
(22:24):
specific patients who saw improvement at bath. It was people
with paralysis who happened to be employed as color grinders, pewterers,
and chemists, all people who would have had exposure to
lead through their jobs. So it really seems like a
convergence is happening here, we're seeing a consistent pattern emerging
in the records of who is getting healed at bath.
(22:47):
It might be worth noting what was standard treatment at
the time for people with colic of pictonem other than
going to bath. Well, sometimes when it was just the
colic and constipation stage, so just the abdominal pain and
constant pay, they would prescribe purges and emetics, so these
would be drugs to help induce stefecation and to induce vomiting.
(23:08):
Sometimes opiates would be given for pain for paralysis. Additional
treatments could include confinement to a bland diet and in
cases after the actual cause was known, removal of the
person from the lead source. That seems pretty important. So
what was the treatment at bath? How would that be different? Well,
this treatment involved bathing in the water, so you would
(23:28):
immerse yourself up to the neck anywhere between thirty minutes
and several hours, and this would usually be done starting
in the morning, with people either standing or sitting on
stone benches or seats in the water up to their necks.
Starting in the Tudor period, the water was changed once
a day, so they would remove the water after the
(23:48):
baths closed around noon, and then it would take about
nine hours for the pools to refill. Heywood notes that
getting there early in the morning was popular because it
meant that you got cleaner water.
Speaker 1 (24:04):
Just think about that. I mean, it's still kind of
the deal. Right. The earlier you get to the pool,
the less less time it's had to absorb certain things,
it's had, less time for stuff on the bottom to
get stirred up.
Speaker 2 (24:17):
That's a good point. Oh you're a swimmer, yeah, do
you try to get there early when you can.
Speaker 1 (24:21):
I'm generally a morning swimmer, not for these reasons, just
for scheduling reasons. But yeah, there have been times where
I'm like, oh, they just closed the pool for a
week and now they're reopening. Everything's nice and clean. I
want to get in. I'm going to be Monday morning,
first thing to get my shot at that clean, clean pool. Nice.
Speaker 2 (24:40):
Do you have like waterproof earbuds or something. Do you
listen to music when you swim or I don't even
know if that's the thing.
Speaker 1 (24:45):
Honestly, no, it is. I see plenty of people do it.
I just I've never done it.
Speaker 2 (24:49):
Yeah, well they so, Heywood says in this paper that
sometimes there was music or other stuff to entertain people
while they were bathing. I guess if you're just supposed
to sit in the warm water for three hours up
to your and there's no music or anything that might
get boring.
Speaker 1 (25:03):
Well it makes sense. And you know, I see the
same thing reflected in the YMCA pool that I go to,
Like there's there's often some sort of aquatic aerobics class
going on, there's music playing. And I was just thinking
of this when you mentioned earlier, like the social aspect
of of of healing at baths and spas. That's something
(25:24):
I think I often fail failed to think about. But yeah,
that's one of the advantages of going to any kind
of group exercise scenario is that, yeah, you're doing some
level of physical exercise, you're being guided in that physical exercise,
but then you are in the company of other people,
and you're going to get at least some level of
social boost.
Speaker 2 (25:41):
That's true, and I'm sure there was a lot of
socializing going on, especially since I would guess a lot
of the people bathing together. Probably you know, people came
there for different reasons, but probably a lot of them
had similar complaints. It sounds like and you know, you
can really have a long conversation if you have like
the same medical problem as somebody else. That can that
can really be a bonding experience.
Speaker 1 (26:01):
Yeah. And there's also seems like a high probability that
you would have encountered people from your industry, other color grinders,
other pewterers, and other chemists, in addition to people being
treated for other maladies. Of course.
Speaker 2 (26:15):
Exactly, so, so that's soaking in the water. What about
drinking the water? So Heywood rites quote drinking the water
became more acceptable after sixteen fifty when a clean supply
was provided which came directly from the spring. And then,
referring to that physician from earlier Pierce, Pierce claimed that
quote advantage has been found by drinking it, referring to
(26:38):
the bathwater, especially in the bilious chalicks. I think that
means collis and the usual effect of them loss of limbs.
Interesting again, I like singling out the people who have
the colic of pictonum as the ones who benefit from
drinking the water, and Heywood rights. One to two pints
were consumed each morning in divided doses. The patients chose
(27:00):
to drink much larger amounts, but this was frowned upon.
This taking us back to Plenty again, who was talking
about the people who get in the spring and then
they just want to drink it until you can't see
their jewelry anymore.
Speaker 1 (27:14):
The distrust of too much hydration.
Speaker 2 (27:17):
So Bath gained a reputation for healing throughout the second
half of the seventeenth century, though at the time it
had not yet been revived as a luxurious spa retreat.
Haywood says that the journey there was kind of treacherous
and accommodations were pretty dank. It was like, you know,
it was not fancy yet. But by the eighteenth century,
(27:37):
the physicians of Bath were convinced that the waters could
cure a number of diseases, including colicapictonem that and word
of these cures kind of spread around the country, attracting
a lot of attention. So people were making the journey there,
in some cases like royal people, but there were also
some doctors from outside Bath that were skeptical, including Richard Meade,
a physician to King George the Second. So well, there
(28:00):
was impetus to put together a sort of large collection
of data of like a study that would really convince
people to come there for treatment. And there's a whole
section of this paper that I'm not going to get
into because it concerns the medical aspects less, but it
is very interesting. It's about the founding of the Bath
(28:21):
General Hospital and what some of the kind of cold,
cruel economic realities of that were. That like, a lot
of this may have been driven by locals around Bath
wanting their businesses to benefit from people coming to the
springs for medical treatment, but also them having a problem
that like a lot of the people who are coming
(28:42):
here for healing are poor, and we don't want just
poor people, so we want to find a way to
get the poor people out of the city and get
rich people coming. So some less than savory sort of
abuse of the concept of charity here, But this does
lead to this large collection of data at the hospital,
and Heywood notes some very interesting measures that were put
(29:04):
in place for the evaluation of clinical results at Bath.
One thing was treatment was regulated, so you're trying to
make sure that patients were getting basically the same thing,
they were getting treated in the same way. Also, because
to quote from Haywood quote, at that time, medical practitioners
were notoriously over optimistic when assessing the results of their
(29:25):
own treatments. Because of this, they had outcomes of treatment
assessed by a committee of doctors rather than only by
the one doctor who had managed the case in question.
So you're not getting to just like ride up the
outcomes on your own patients.
Speaker 1 (29:39):
All right, that's good, spreading it around a little bit. Yeah.
Speaker 2 (29:42):
Yeah. They hoped that this would lead to quote, irrefutable
proof of the efficacy of the bath waters for healing.
Now I think irrefutable proof is a little over enthusiastic there,
but these are good measures to put in place, certainly
compared to the standards of the day. So this is
not a double blind, randomized controlled trial that would really
(30:02):
wouldn't become a standard until the twentieth century, but pretty
good for the time. Another thing was that it was
agreed that no patient would qualify as quote cured if
they still had any trace of the original symptoms they
showed up with, and they enforced pretty high standards of
record keeping. Okay, so what did the treatment at bath
(30:22):
consist of? Well, First, and very important to note, patients
were extracted from their regular environment for their stay in Bath,
which means they were almost certainly cut off from the
original source of lead toxicity lead exposure, and this in
itself is important to keep in mind because for all
we know, this alone could be causing major improvements.
Speaker 1 (30:46):
Yeah, getting them just away from their regular everyday exposure
to land.
Speaker 2 (30:51):
And that could be in most cases either occupational or
from food and drink. And on that last note, they
were given plenty of fresh food at bath and this
included home brewed beer made there. The additional drinking of
alcohol beyond what was provided by the hospital was forbidden,
so this was another way to cut off additional lead exposure.
(31:12):
They were often given a purging medication to treat constipation.
Bathing was generally three days a week in the manner
previously described. So you know, you go sit or stand
in the water. You keep your head above the water line,
but it goes up to your neck and then again,
patients would often drink one to one and a half
pints of the spring water a day, maybe divided into
(31:34):
two different doses, and in some cases they might like
sort of pump the spring water over the paralyzed limb. So, anyway,
what are the results if we look back on them historically.
The results are pretty interesting. By analyzing the records kept
at Bath General Hospital, it seems there is a pretty
good reason to think that the SPA therapy at Bath
(31:56):
was doing something to relieve the symptoms of this disease,
in particular of Colica pictonum. The paper includes a table
compiling stats on patients admitted to the Bath Hospital from
seventeen fifty one to seventeen fifty eight. Out of one thousand,
five hundred and ninety patients total, one hundred and eight
of them were admitted with symptoms indicating that they had
(32:17):
paralysis due to lead toxicity. Those can be further broken
down into paralyzed patients who had occupational exposure to lead.
There were thirty seven of those including readmission, and patients
with the Devonshire colic meaning paralysis that was preceded by
severe abdominal pain and constipation, and there were seventy one
(32:39):
of these including readmissions. In the cases of patients with
occupational exposure, fifty nine percent were completely cured and ninety
two percent were improved. In the case of patients with
Devonshire colic, forty two percent were completely cured and ninety
three percent were improved. Now, my initial action to this
(33:00):
was that's interesting. But without a control group receiving no
treatment or placebo treatment, or without different treatment groups to compare,
how can we know it was the bathwater and the
immersion that was actually leading to these cures. So what
if simply maybe being away from the lead exposure on
its own would produce the same rates of recovery. Well,
(33:21):
that is possible, But the author considers that and offers
some evidence based on their referral letters correlated with each
patient's case in hospital records that may give us more
confidence than the results. So talking about the specifically the
workers who had occupational exposure to lead, most of them
(33:43):
came from London or the region in the southeast of England,
and Heywood writes, quote, fifteen had already been admitted to
one of the London hospitals but had not responded to
treatment there. They were referred to the Bath hospital as
quote incurable treatment. In Bath, eight were cured and the
other seven were said to be improved. These results support
(34:06):
the view that the treatment in Bath had something special
to offer, as in London they would also have been
removed from exposure to lead and given purges emetics and
a bland diet apparently to no avail. So interesting here.
This still doesn't prove it, but it seems we have
a kind of crude analog of a control group based
(34:27):
in the treatment histories from these patients' referral letters. So
in many cases they had already been removed from the
lead and received other treatments for a long time in
different hospitals and shown no improvement. So this is still
not as good as a real control group for a
number of reasons. For example, one I just thought of
is that it's not concurrent, so like, you know, the
(34:49):
previous treatment that they got the other hospitals happened before
and then they came to Bath afterwards, So maybe the
cumulative time away from lead exposure could contribute to be
outcomes at Bath and so forth. But interesting results nevertheless.
Speaker 1 (35:05):
Yeah, Yeah, and results that would seem to some degree
to point back to questions about the water, like what
is it about the waters of Bath or what they're
doing with the waters of Bath that may or may
not be having an impact, right.
Speaker 2 (35:19):
That's right. So here's another thing that makes these results interesting.
The Bath General Hospital records spanned many decades and they
seem to indicate a consistently higher rate of cure and
improvement for palsy from Colica pictonum. So again, let exposure
paralysis than for other conditions such as paralysis from sources
(35:41):
other than lead poisoning. So it's possible that, you know,
maybe the Bath General Hospital doctors were using you know,
they could have been doing all kinds of tricks consciously
or unconsciously to make their treatments look more effective than
they actually were. Maybe they were using selective admission policies
to improve their outcomes, like patients to let into the
(36:01):
study that seemed more likely to improve, or maybe they
were just overly positive in assessing outcomes. But if any
of that were the case, why would the numbers be
so much better for patients specifically with lead poisoning than
for all other conditions.
Speaker 1 (36:17):
Yeah, because it's the numbers that really perk one's interests here,
Because if you're just talking anecdotally about like the number
of abandoned crutches that they have there, it's like, oh,
that's not very convincing, because there are two majorly compelling
reasons that a sick person might abandon their crutch, and
only one of them speaks to the effectiveness of the treatment.
Speaker 2 (36:39):
Yes, that's very good to point out. So again we
get a little bit of extra confidence just by looking
at the difference comparing the different conditions in their outcomes.
So again, all this like it would not prove it
to the standard of a modern randomized controlled trial, but
I think there's at least a solid reason to suspect
that SPA therapy at Bath did have some healing powers
(37:00):
for people who couldn't doff their hats because of lead.
And so this was the paper that initially got me
interested in talking about this. And the paper finally addresses
the question that might be burning in all of your minds,
like if this is the case, if it was actually
effective at curing paralysis from lead toxicity, how does that work? Well,
(37:21):
Heywood's paper here speculates the first thing is the immersion.
So a big component of this treatment at Bath was
spending a lot of time sitting in warm, mineral spring
water up to your neck, and Heywood argues that this
in itself could contribute to the outcomes documented at Bath
General Hospital. And to back this up, Heywood writes about
(37:43):
how in the nineteen seventies some researchers were doing experiments
for the Space program for NASA and trying to simulate
the effects of microgravity, and some of these experiments involved
having astronauts sit up to their necks in warm water
for a long time. And Heywood points to a nephrologist
to named Murray Epstein, who demonstrated in some papers something
(38:05):
kind of interesting. When you sit around in water up
to your neck, it makes you pee more. Specifically, not
just pea more, but it increases the rate at which
you excrete water, but not just water, also sodium and calcium. Now,
why on Earth would that be. This is also not
something that's one hundred percent clear, but there seems to
(38:26):
be a reasonable explanation, Heywood offers, which has to do
with water pressure. So like, if your body is sitting
down below the waterline, you've got water pressing in on
your skin from all directions. And when that water pressure
is pressing in on your legs and your abdomen, it
causes that external flesh to kind of push in some
(38:48):
blood and interstitial fluid. More fluids are getting pressed into
the body from the outside, and Heywood writes, quote this
extracellular fluid moves into blood vessels in the thorax, meaning
the trunk of the body, producing an increase in central
blood volume of about seven hundred milli liters.
Speaker 1 (39:08):
Now, it's interesting that this basically comes back to the
idea of purging fluids from your body, which is something
that was long thought or understood to have some sort
of roll in healing the sick.
Speaker 2 (39:21):
Right, and in many cases that might not have done anything.
But I wonder if this means that in the case
of lead poisoning, the purges would actually be helpful anyway.
(39:42):
But to continue here, so Heywood writes, the consequent rise
in right and left atrial pressures is the stimulus that
leads to the large increases in urinary volume and sodium
excretion that are observed during immersion up to the neck.
This is because sensory receptors for blood volume are apparently
situated in the right atrium. So this relative central hypervolemia,
(40:07):
the condition of having extra blood volume extra fluid volume
in the body deceives the body which reacts as though
there had been an increase in total body fluid volume,
not just a reallocation of fluid. So does that make
sense that I think I'm explaining this right that the
simplified version is when you immerse your body in water,
(40:29):
the water squeezes you and essentially squeezes some of your
extra body fluid into the core of your thorax. It
squeezes from the outside, so the pressure in the core increases,
and because the pressure in the core increases, this tricks
your body's blood volume sensors into thinking the total amount
of fluid in your body has increased, and thus to
(40:49):
compensate for this, it kicks off complex chain reactions in
the the renal system that lead to increased excretion of
urine and of things that get excreted through urine, sodium,
and in this case calcium.
Speaker 1 (41:02):
Okay, that makes sense, Yeah, but.
Speaker 2 (41:04):
Why would this have anything to do with lead poisoning. Well,
Heywood notes that the human body typically tends to handle
lead and calcium in a similar way. So when there's
lead in your body, the body treats it kind of
the same way it treats calcium. And so if this
is causing increased excretion of calcium through urine, it may
(41:27):
also be causing increased excretion of lead through urine. And
in fact, Heywood was involved in experiments that were set
up at the Immersion Laboratory in the Bristol Royal Infirma
Infirmatory Infirmary to test this hypothesis, and they in fact
did find that urinary lead excretion goes up when the
(41:49):
body is immersed. So they tested this out on experiments
with modern lead workers who were not suffering from symptoms
of lead poisoning, but still had lead levels much higher
than the mineral population in their blood. These workers were
subjected to three hour sessions of soaking up to their
necks in water that was thirty five degrees celsius or
ninety five degrees fahrenheit, and the experiments found that the
(42:13):
immersion did indeed cause them to pee out higher levels
of lead than people normally do. Oh wow, okay, Heywood
writes quote. The total amounts excreted during one three hour
immersion period are small compared to the total body lead,
which is predominantly tissue bound. Okay, so not like free
in the blood, but bound up in tissues. Heywood goes on. However,
(42:35):
if these immersions were continued to the extent described in
the Bath hospital records i e. Three Times a week
for twenty four weeks, an appreciable proportion of the total
body lead would be removed. We can therefore suggest that
this was a mechanism through which traditional bath spa therapy
could have operated. So that's fascinating. Just sitting immersed in
(42:58):
the warm water currently could help you get more lead
out of the body faster than you would doing anything else.
Speaker 1 (43:06):
Yeah, and this of course working in congress with not
having a whole bunch of lead flooding into your system
through your occupation or other environmental causes exactly.
Speaker 2 (43:16):
So you're removed from the original exposure to lead, you'd
have less lead coming in, and you're increasing the rate
at which lead is going out.
Speaker 1 (43:26):
Okay, but there's some other amenities to factor in as
well though, right.
Speaker 2 (43:29):
That's right. So, as I mentioned, you know, the patients
at bath in addition to being removed from the source
of lead and having the immersion, they also got good food,
so that may have been a factor. They got gentle
exercise that may have been a factor as well. So
it's hard to know for sure with historical cases like this,
because you know, you can't you're not running the test yourself.
You can't isolate all the variables. You can only deal
(43:52):
with the data we have from history. But in this case,
I think you could totally plausibly make the argument that
that the immersion was really doing something for the people
with lead poisoning. It was doing something more than just
getting them away from the original lead exposure. Now there
was another interesting part of this, that's the immersion, which
(44:13):
Heywood treats as probably the main explanation. But what about
drinking the mineral water. Again, hopefully not two levels described
by plenty where your rings disappear, but the level generally
prescribed to drink was like one point five to two
pints a day. And Heywood notes that water from the
mineral springs of bath has elevated levels of calcium and iron,
(44:36):
and citing a study by Mahaffe from nineteen seventy three,
Heywood observes that calcium and iron deficiency actually increase the
body's tendency to absorb lead, and calcium and iron deficiency
increase the toxicity of lead that is already present in
the body. And this has been shown to the extent
that calcium and iron supplements have been suggested as partial
(44:57):
treatment for infants with higher than average level of lead
in the blood. So it's possible that the mineral water
pints that patients at bath were drinking. That was helping
out as well.
Speaker 1 (45:09):
Yeah, And I mean on top of that, if they're
if you're having to if you're having to pee more
because of your soakings in the warm waters, you need
to be drinking more water as well, Like you need
to stay hydrated, right, And this is something I saw
reflected in some papers. Will probably discuss in the next
episode that, like, if nothing else, staying hydrated on clean
(45:31):
water like that alone is beneficial for the body, like
because if nothing else, you don't want whatever is going
on with your body to be exasperated by also having
some sort of dehydration scenario going on as well.
Speaker 2 (45:45):
Yes, exactly. Hydration incredibly important, so that plays a role
as well. Though I want to be clear this is
not should not be taken as a general endorsement of
drinking mineral spring water, which could have all kinds of
things in it. So it seems like in these these
people were probably doing all right, but you don't want
to be drinking water from sources you're not sure.
Speaker 1 (46:05):
Or safe, right right, right, Yeah, but nothing else, like
iuld say how much I wonder on a case that
case basis, like how much of that person's normal liquid
intake would have been confined to like beers for example,
versus you know, they're still having beer. They're having good
beer when they go to bath, but then they're also
having a large amount of water as well in addition
(46:27):
to that beer. So it seems like there would be
a net positive there.
Speaker 2 (46:31):
Yeah. So I would say in conclusion, while bathing in
a SPA probably does only work via placebo effect on
a number of the conditions we've talked about throughout the
series so far, on the conditions it was used to
treat throughout history. I think this paper makes a very
interesting case that when it came to paralysis from lead poisoning,
(46:51):
SPA therapy was genuine medicine.
Speaker 1 (46:54):
Yeah, it's fascinating, very fascinating. All right, Well, we're going
to go ahead and close out this episode on that note,
but we will be back in a part four on
baths immersion and also drinking of naturally occurring spring waters,
thermal waters, et cetera. We still have some other important
(47:15):
topics to discuss here, so come back for that. In
the meantime, we'll just remind you that our core episodes
of stuff to blow your mind publish on Tuesdays and Thursdays.
On Wednesdays we do a short form artifact or monster fact.
On Mondays we do listener mail, and we're already getting
some great listener mail about the Bath episodes, by the way.
And then on Fridays we do Weird House Cinema. That's
our time to set aside most serious concerns and just
(47:38):
talk about a strange film.
Speaker 2 (47:39):
Huge thanks to our audio producer JJ Posway. If you
would like to get in touch with us with feedback
on this episode or any other, to suggest a topic
for the future, or just to say hello, you can
email us at contact at stuff to blow your Mind
dot com.
Speaker 3 (47:57):
Stuff to Blow Your Mind is production of iHeartRadio.
Speaker 1 (48:04):
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