The medical history of waters and spas, Medical History

In spite of their therapeutic significance for much of human history, mineral waters have been largely ignored by historians of medicine. One suspects that this neglect has to do with the perception that spa medicine has owed more to human credulity than to medical science. This volume of essays suggests that such neglect and dismissal are about to give way to more thoughtful assessment. Although the book exhibits the unevenness characteristic of edited collections, the quality of most contributions is high. It does suffer, however, from an overwhelmingly British focus (with the exception of some essays dealing with waters before the eighteenth century). The result is a distinct impression, becoming explicit statement in several essays, that the waning popularity of spa medicine that has been characteristic of Britain since the late nineteenth century has been universal. Nothing can be further from the truth. In many parts of continental Europe, mineral waters have not merely survived, in spite of changing norms of scientific acceptability, but have actually flourished. The issue of the modern failure of British hydrology is one which haunts the collection. Even the one essay on hydrology in New Zealand is a story of failure; an effort to create a modern scientific spa on the European model was not successful. Some contributors date the decline of British waters (by which they mostly mean Bath) as early as the mid nineteenth century when spas in continental Europe were just beginning their phenomenal expansion. I am not certain whether an absolute decline actually set in this early but it is clear that spa development was mediocre in comparison with the situation on the Continent. The British situation demands some explanation. That other types of resorts competed with spas and that Britons preferred foreign travel and continental waters is certainly true but begs the question, since other nations faced similar problems. David Harley in his essay connects this weakness with the failure of British doctors to eliminate non-medical competition. Presumably this contributed to medical scepticism about the water cure in the twentieth century. Certainly, Janet Browne's essay on Darwin's water cure at Malvern emphasizes both the unorthodox quality of the treatment which was loosely based on Priessnitz's methods and the degree of patient choice and autonomy which it involved. In contrast, water cure in France was thoroughly medicalized and hydropathic sectarianism had little impact. Laurence Brockliss, in an outstanding essay, shows that …