In search of a cure: a history of pharmaceutical discovery

The support of doctors and public authorities was not just a necessity for public acceptance and popularity; it was a prerequisite for the development of hydrological science. Several contributors make the point that much writing on waters was a form of publicity for a specific water and the relative lack of hydrological research in Britain until late in the nineteenth century is quite striking. There was nothing like the Parisian Academy of Medicine which imposed some outside guidelines on research and which, while committed to the system as a whole, had no particular stake in any specific spa. Nevertheless, several contributors make the point that hydrological research cannot be simply dismissed as propaganda. In describing the development of chemical analysis from the eighteenth century, Noel Coley emphasizes its importance in legitimating spa therapy and also makes clear how real the achievements were, particularly in the nineteenth century. Christopher Hamlin tries to distance himself from an exclusively internalist approach to chemical analysis and stresses its legitimating function. But he does suggest that chemists eventually brought "much more of the ethos of pure scientific research into mineral water analysis.. ." (p. 80). Clinical medicine also had its forms of research. Audrey Heywood analyses the patient records of the Bath General Hospital which opened in 1741 with specific reference to the treatment of lead poisoning. Her essay is eye-opening on at least two counts. It makes clear that research whose explicit purpose was to demonstrate the efficacy of the local product could still be of reasonably high quality. If Bath doctors actually followed the stated protocols in determining the effects of therapy, their data is uniquely rigorous for hydrological research of the period. Secondly, she makes a good case that treatment was in fact effective for lead poisoning and uses recent research (in which she herself participated) to explain this effectiveness which applies to only one of many conditions treated with waters. Her explanation centres on the physiological effects of submergence in water rather than on specific chemical properties or other treatment modalities, so it is hardly a rehabilitation of the principles of traditional water therapy. Nevertheless, it does suggest that if we want to understand the popularity of the waters over the centuries, we need to take seriously their clinical effects.