In the middle of the 19th century, the Turkish Bath was introduced into England and its popularity grew with remarkable speed amongst all sections of the population. The new baths not only provided a luxurious and pleasurable experience hut, according to their supporters, they, also offered a powerful therapeutic effect on a wide variety of ailments and conditions. In 1861, Thomas Wakely the founder and editor of The Lancet, acknowledged that the Turkish Bath had "attracted considerable attention in the medical profession" and that:

"many of its leading authorities in, our great metropolitan Schools have made a personal experience of its effects and ... are satisfied that it is likely, to exert a powerful agency on disease. especially when the malady is the result of a suppressed action of the proper functions of the skin, whatever they, may be." (1)

The way in which this ancient Turkish practice was adopted as a serious adjunct to medical practice casts interesting light on medicine and health in Victorian England.

The Turkish Bath or Hammam had, of course, been a regular part of life throughout the Moorish and Ottoman Empires for centuries, before it was so eagerly adopted by the English establishment The procedure in the Turkish Bath varied slightly from Constantinople to Cairo, Bokhara to Damascus, but, essentially, the bather undressed and was led through increasingly hot passages into a "near suffocating vaulted chamber of marble where many-coloured windows tinted the perfumed vapours" in which he "lay on a sheered slab while heat opened his pores." (2) The attendant then started the vigorous "system of kneading and pummelling known as 'shampooing'." (3)

Sir Arthur Clarke, a physician, who had undergone this treatment in various Mediterranean countries, wrote that the "shampooer" caused the joints of the wrist, elbow, shoulders, neck, back, instep, knee and hip to crack "as if he were a perfect anatomist." He described the dorsal articulations cracking "with two distinct explosions nearly 70 similar to the report of a small pop gun" and, although the sensations were "singular and for a moment rather disagreeable," he acknowledged that the massage had been "expertly done." (4) Writing in 1850 about his experiences in Turkey, David Urquart similarly described how an attendant "pulled my, arms through his own and through each other, twisting me about in the most extraordinary, manner and drawing his fingers across the region of the diaphragm so as to make me, a practised bather, shriek . . . the operation concluded by his biting my heel." (5)

Having worked on the joints, the "shampooer" then turned his attention to the skin, as Edward Lane described in his book on the Egyptian customs:

"The operator next kneads the patient's flesh. After this he rubs the soles of the feet with a kind of rasp of baked clay. The next operation is rubbing the bather's flesh with a small coarse woollen bag after which the bather dips himself in one of the tanks . . . (6)

The friction rub was very, effective in removing the bather's "scarf skin loosened by sweat." Urquart wrote that "the dead matter which will accumulate in a week forms, when dry.. a ball of the size of the fist . . . l once collected it and had it dried - it is like a ball of chalk." (7)

The subsequent soaping could be equally, unpleasant, to judge by the novelist William Thackeray's comments on his experience in Egypt in 1844 where his protagonist Titmarch is washed with "something like old Miss MacWhirter's flaxen wig." He writes:

"Just as you are going to remonstrate the thing is . . . dashed into your face, . . . you can't see, the soap is whizzing into your cars, you can't gasp for breath. Miss MacWhirter's wig is down your throat with half a pail full of suds in an instant." (8)

For visitors from the West, the pleasures of the Turkish Bath were largely experienced once it was over. It may, have been the effects of relaxation, accompanied by, coffee and sherbet, or the flights of fancy induced by the narghile (hubble bubble pipe) but, for David Urquart, the after effects of the Turkish Bath were exquisite:

"The body has come forth shining like alabaster, fragrant as the cistus, sleek as satin and soft as velvet . . . The body thus renewed, the spirit wanders abroad . . . There is a sense of life and consciousness that spreads through every member . . . you condense the pleasures of many scenes and enjoy in an hour the existence of years. " (9)

It was this romantic depiction of the Hammam which characterised Urquart's book, The Pillars of Hercules, published in 1850. The book appealed to the Western interest in the Orient, and did much to popularize the Turkish Bath in England. It also gained Urquart two important "followers" each of whom had a key role in the development of the Turkish Bath over the next two decades.

The first of these was Dr. Richard Barter who had built a vapor bath in 1856 at St. Ann's Hydropathic Establishment in Blarney, Ireland. The results were unsatisfactory and he eventually replaced the high humidity with a system of dry air, which was to characterize the English type of Turkish Bath. The advantage of this system was that:

"No one feels the distress which so frequently accompanies other heating appliances, for while perspiration is more fully obtained, the pulse is but rarely unduly excited . . .This is the great feature of the improved Turkish Bath and one on which its perfect safety and curative property will be found mainly to depend." (10)

The other influential figure was Charles Bartholomew who was said to have been seriously ill with gout and given 14 days to live. He survived after shutting himself away in a high temperature chamber for 2 weeks and this convinced him of the therapeutic value of hot baths. Having read The Pillars of Hercules, he contacted Urquart who who was staying at Blarney, and offered to build a Turkish Bath to Urquart 's design. Having done this, he went on to open a string of baths, in major cities, starting in Bristol in 1859 and followed by baths in Manchester, Birmingham, Worcester, Bath, and, finally, in London. The trade journal, The Builder, noted in 1861 that Turkish Bath. establishments "are now springing up everywhere" and a year later the famous and sumptuous Jermyn Street Baths were built at a cost of £6000. (11)

England was by then gripped by Turkish Bath mania, but the popularity of the baths cannot simply be explained by the entrepreneurial actions of these three enthusiasts or by a vague Victorian interest in matters oriental. There were other factors at work, notably, the poor state of health and hygiene of the urban masses, as Croutier points out:

"The absence of plumbing made domestic hygiene impossible. In England, rapid urbanisation bringing with it congestion and slums, contributed to the severity of the cholera epidemic of 1832 and of subsequent outbreaks. An estimated 50,000 people died in the epidemic and as a result the British were motivated to become pioneers in plumbing ... (those) who wished to transplant the oriental bath to England were careful to stress its health giving aspects." (12)

The Turkish Bath was thought to provide an all purpose cure in lands which lacked adequate healthcare, and man, people believed that it could so the same in England:

"The hot bath was what kept smallpox and scrofulous diseases at bay; the foe of gout, sciatica, rheumatism, liver troubles, catarrh, piles and all ailments caused by lack of perspiration; it was cathartic, diuretic, tonic and detersive; it was good for adiposity, baldness and ennui; it rendered many operations unnecessary." (13)

The problem was that the evidence of the health giving properties of Turkish Baths remained anecdotal. The surgeon, Sir John Fife, claimed that the hot bath would cure or alleviate cancer, consumption and leprosy and that it was a cure for barrenness. On this latter point, Bartholomew described how his wife had been unable to perform her domestic duties through "nervous debility," but after working as a bath attendant for 18 months she became the strong and healthy mother of triplets. From this, Bartholomew concluded: "Ladies must only, hope for single births by taking the bath once a week. to make them double or triple will necessitate them and their husbands becoming Turkish Bath attendants." (14)

Not surprisingly, The Lancet became exasperated at the lack of systematic investigation of these claims and. in 1861, the editor wrote:

"It is not important to know how agreeably or how luxuriously two hours may be spent in the bath, few of us who have the work of life before us have time to spare; but we really wish to know how the air bath operates on the human organism . . . We shall have much satisfaction in opening our columns to any properly observed facts." (15)

In spite of this lack of scientific investigation, hospitals began to build Turkish Baths for the use of their patients. There was controversy at St. Thomas's Hospital in London where the medical staff were divided on this course of action although it was reported in The Lancet that the "medical officers as a body are prepared to examine its value as an addition to the ordinary means of treating disease." (16). A letter in the same volume reported other hospitals taking similar action:

"Newcastle and Shrewsbury, have baths in their hospitals St. Mary's Hospital uses a small bath, built in the neighbourhood with good effect; l hear that the Brompton Consumption Hospital, the Reading Hospital and the Radcliffe Infirmary at Oxford, besides many others, are contemplating the addition." (17)

It was not long before the baths began to be introduced into asylums. Doctor Power, resident physician of the Cork District Lunatic Asylum, reported 62 Out Of 124 of his patients to be improved or cured after using the bath, and attributed this to the effects of sweating on the skin and the blood:

"Those who are conversant with the symptoms manifested by the insane are well acquainted with the peculiar odour emanating from their persons and most probably exhaled from the skin, its minute glands and follicles. This must arise from an unhealthy state of the blood which must exercise a deleterious influence on the system generally and on the organs connected with the minds ... any means which effect the removal of the vitiated humours and other secretions must benefit the disordered intellect."

Once again, The Lancet the sceptical:

"It is to be feared that the sanguine observations of Dr. Power will not be fully confirmed." (18)

The editor, Thomas Wakely, never one to mince his words, blamed the British love of "striking novelties" for the excitement which had been at "fever heat in the case of the Turkish Bath," and once again asked the medical profession for evidence:

"Before us lie eight pamphlets by medical authors on the Turkish Bath ... they are, for the most part, either puffs or long descriptions of baths ancient and modern, with a few instances of cures effected ... We can assert with certainty that, in the Turkish Bath, the processes of waste or destruction are carried on with an extraordinary activity, whilst the functions of respiration and skin action are hastened. This is the only fact which can be accepted as provided in relation to the Turkish Bath ... it is very desirable that a fair and scientific trial should be made at a metropolitan hospital, under the direction of the medical officers." (19)

In the absence of any such trial, Bartholomew took it upon himself to challenge the scepticism of the medical profession. Speaking to a medical committee at the Bristol Athenaeum in 1866, he claimed to have discomfited and then converted most of them. l am bound to state that the Turkish Bath gives me complete command over the whole phenomena of human life," he explained. "Nature worked by discharging waste products through the skin and disease resulted when purgation of the skin failed. Unfortunately, doctors failed to realise this and their patients died."

Bartholomew also presented high profile witnesses to convince his listeners. General Sir Abraham Roberts KVB affirmed: "I went to Mr. Bartholomew's bath on crutches and after a few baths I could dance a horn pipe." (20)

It was clear by now that the sole basis of the curative power of the baths rested on the premise of "Nature working her discharges through the skin," and no amount of scientific investigation was going to substantiate the extravagant claims made for the process. There remained, however, considerable interest in increasing the efficacy of the baths, particularly in terms of how high the temperature should be. In a letter to The Lancet, E. J. Tilt, who described himself as someone who had taken baths at Constantinople, Cairo and Damascus, confirmed that Dr. Barter never allowed a temperature higher than 150 degrees, and went on to recount: "Once at an inferior class bath, l looked for the thermometer but there was none; and I explained to the attendant that a coroner's inquest might be very disagreeable."(21)

Another concern was how to induce the maximum perspiration when patients suffer from "inactive skins." The hydropathist, Richard Metcalfe, suggested "giving a slight stimulus to the Surface by rubbing the patient all over with dry bran mustard and then having him bathed well with hot water before entering the hot rooms." (22)

In spite of the extravagant claims for the baths, the general therapeutic effects of relaxation and cleansing of the skin remained. The famous actress Lily Langtree said:

"I attribute my perfect health entirely to the Turkish Bath which l take twice a week regularly. l find it keeps my skin in excellent condition notwithstanding the pigmentation one is unfortunately obliged to use on the stage. " (23)

Of great importance was the impact on the health and hygiene of the poor. The early advocates of the Turkish Bath believed firmly that it should be available to everyone, not only the wealthy. It is recorded that, at the end of the week at Dr. Barter's bath in Blarney, workmen, labourers and afterwards their wives and children were all allowed to use the Turkish Bath. It is even said that he held sessions for the farm animals. Urquart held similar views, stating that "a nation without a bath is deprived of a large portion of the health and inoffensive enjoyment within man's reach." (24)

Thirty years after the publication of The Pillars of Hercules the interest in the baths declined and Bartholomew began to advertise his baths for sale or lease. He blamed the ingratitude and selfishness of doctors and the shortage of good "shampooers," and became disillusioned by patients who did not treat bathing seriously and persisted in talking about politics and religion in his baths.

Alongside this, there was an inevitable reaction when the baths failed to perform the therapeutic wonders attributed to them; and as the number of establishments had increased, the inexperienced "steam doctors" often oversweated their patients, leaving them exhausted instead of rejuvenated. Once the reputation for medical miracles subsided, the rumours of impropriety grew. This had always been an issue, but had been successfully challenged, for example by Henry Kiallmark, a former surgeon of the Ottoman Medical staff: "alarm expressed by some that bathing will lead to effeminacy and degeneracy of race, as it is said to have done with the ancient Roman and the modern Turks, may be looked upon as fallacious." (25)

Now people were less sure about this and, in consequence, they welcomed the development of the new home Turkish Bath which was advertised extensively in magazines in the 1880s and 1890s These were small cubicles, heated by a spirit lamp in which one person sat and sweated, with head exposed. Not surprisingly, these were consigned to the attic or cellar by the start of the 20th century.

The interest in the Turkish Bath in the West was not, of course, confined to England and Ireland. In the 1860s, baths were built in Paris, and in the German towns of Nudersdorff, Friedrischafen and Wittenberg. The Swedish balneologist, Carl Curman, encouraged the construction of two Turkish Baths in Stockholm in 1871 and wrote Om Bad (about baths), one of the first comprehensive studies of bathing habits. (26)

Finally, in 1861, the first Turkish Bath opened in Australia, and the last word on the subject must go to Thomas Wakely, editor of The Lancet, who announced the antipodean venture with customary cynicism:

"The Turkish Bath has just been inaugurated with all the honours at the metropolis of the southern hemisphere . . . and the usual amount of enthusiastic bombast has been employed to celebrate its inauguration. " (27)

References

1. Editorial. Lancet 1861; i: 9 1.
2. Turner E. Taking the Cure. London: Michael Joseph, 1967: 2.18.
3. Ryley Scott G. The Story of Baths and Bathing. London: T. Werner Laurie Ltd, 1939: 113.
4. Clarke A. Essay on warm, cold and vapour bathing. Cited in Turner E. Taking the Cure. London: Michael Joseph, 1967: 219.
5. William L. An account on the manners and customs of the modern Egyptians. Cite in Ryley Scott G. The Story of Baths and Bathing. London: T. Werner Laurie Ltd, 1939: 114.
6. Turner E. Taking the Cure. Michael Joseph, 1967: 221.
7. Thackeray W A journey from Cornhill to Grand Cairo. Cited in Turner E. Taking the Cure. London: Michael Joseph, 1967: 111.
8. Urquart D. The Pillars of Hercules, London: Richard Bentley, 1850: 33-89.
9. Anonymous. Richard Metcalfe Hydropathist. The Man and His Work. London: Bemrose & Sons, 1894: 86.
10. The Builder 1861; 25 May.
11. Croutier A. Taking the Water. London: Abbeville Press, 1992: 94.
12. Turner E. Taking the Cure. London: Michael Joseph, 1967: 2 223
13. Turner E. Taking the Cure. London: Michael Joseph, 1967: 227.
14. Editorial. Lancet 1861; i: 91.
15. Goolden R. Lancet 1861; i: 94.
16. Goolden R. Lancet 1861; i: 95.
17. Medical Annotations. Lancet 1861; i: 491.
18. The Turkish Bath. Lancet 1861; I: 198.
19. Mr. Bartholomew's evidence. Cited in Ryley Scott G. The Story of Baths and Bathing. London: T. Werner Laurie Ltd, 1939: 148.
20. Tilt E. Lancet 1861; i: 47.
21. Anonymous. Richard Metcalfe, Hydropathist. In Ryley Scott G. The Story of Baths and Bathing. London: T. Werner Laurie Ltd, 1939: 148.
22. Testimonial published by Newcastle Turkish Bath Company, 1885.
23. Urquart D. The Pillars of Hercules. London: Richard Bentley, 1850: 33-89.
24. Kiallmark H. Lancet 1861; i: 70.
25. Aaland M. Sweat. Santa Barbara: Capra Press, 1978: 48.
26. Medical Annotations. Lancet 1861; i: 518-512