Immersion in water in spas has been practised for centuries and has many proponents. Despite fierce debate about its efficacy there has been little scientific evaluation of the effect of immersion in mineral waters. Eight normal subjects were immersed in Bath spa water for two hours and the renal, haematological, and cardiovascular responses were compared with those in the control periods before and after immersion. Significant, twofold diuresis and natriuresis, 5% haemodilution, and a 50% increase in cardiac index were observed in subjects immersed, sitting, in Bath spa water at 35°C. These changes may constitute part of the scientific rationale for spa treatment in many states of disease.
The Reverend Joseph Glanvill, FRS' was expressing a contemporary view of the aims of the Royal Society when in 1668 he wrote, "We must seek and gather, observe and examine and lay up in bank for the ages to come. This is the business of the experimental philosophers." These words could be applied to the foundation of the Bath General Hospital, which opened in 1741, where it was hoped that by means of a "trial of the waters" it would be possible to show that Bath spa therapy as then practised was effective against many diseases. This was possibly the first extensive trial of any medical therapy. It is commonly assumed that spa therapy has only a placebo effect; that the pleasurable activity of immersion in warm mineral water has social and psychological benefits, but no physiological value. But the records of the Bath Hospital show that Bath spa therapy was an effective treatment for one common and chronic condition, the paralysis that occurs as the result of chronic lead intoxication (colica pictonum). Chronic lead poisoning is a characteristic disorder, presenting with severe abdominal colic and constipation followed by a loss of function of the limbs without loss of sensation. It has been possible, therefore, to use the information collected in the records of the Bath Hospital2 from 1760 to 1879 to identify cases and to show that Bath spa therapy was indeed of value in its treatment.3 During this period of 120 years, 3,377 patients (6.9 per cent of the total admissions) were admitted to the hospital with a diagnosis of paralysis due to lead poisoning; 45.4 per cent of these
The physiological effects of water immersion in man were studied by Epstein' in the 1970s in conjunction with the United States National Aeronautics and Space Administration's research into weightlessness. This showed that immersion up to the neck in water at 35°C produced a profound diuresis, naturesis, and an increased urinary excretion of calcium. These pronounced alterations in renal function brought about by immersion probably occur because the hydrostatic pressure of the water produces a redistribution of extracellular fluid in the body. There is a shift of about 700 ml of blood from the limbs to the thoracicocardiac compartment. This increase in the effective extracellular fluid volume is thought to mediate the renal changes by hormonal mechanisms. A recently discovered hormone, atrial naturetic peptide,2 has been found to have a role in regulating these changes but is unlikely to be the only factor concerned.One study of the treatment of lead poisoning by Bath Spa therapy during the eighteenth century3 has shown that a cure rate of about 49% was achieved in patients who had paralysis due to lead poisoning whereas in hemiplegias or paralyses of unknown aetiology the cure rate was only about 1 % and about 6% when the condition was secondary to spinal deformity.Admission to the Bath Hospital was conditional on the charity patients complying with the prescribed treatments and they were not discharged until a committee of the attending physicians considered that they had obtained the maximum benefit from the spa treatment and had agreed on both diagnosis and outcome. The doctors were to keep good records, an analysis of which was published annually. It was stated that many of the patients had been discharged as incurable from other hospitals before their admission to Bath. Between 1751 and 1758, 15 of the 31 patients with occupational exposure to lead had been referred from London hospitals as incurable; when they were discharged after a stay at the Bath Hospital, seven were cured and eight were much improved.Spa therapy was multifactorial necessitating removal from exposure, a change in diet (probably for Accepted 24 March 1986 the better), increased exercise, and a regimen that required the patient to drink the mineral water daily and to be immersed in the bath three times a week. Knowing that immersion affects the urinary excretion of calcium and that the metabolism of lead and calcium are closely related, we decided to investigate the effects of immersion on the rate of urinary lead excretion to see if this might have contributed to the successful treatment at Bath. MethodsThree lead workers with moderately raised blood lead concentrations volunteered to be immersed and were compared with seven control subjects.4 A 24 hour urine specimen was collected the day before immersion. No food or water was taken after 2230 on the day before the experiment. At 0730 on the day of the immersion a water load of 400 ml was taken but no food. At 0830 the subjects emptied their bladders and drank a further 200 ml of w...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.