2: The start of the row: Dr Madden's article

In March 1860, a writer calling himself 'Photophilus' published a pamphlet recounting the beginnings of this sometimes bitter controversy over whether the hot air in a Turkish bath should be dry or wet (or at least humid).

The identity of the author is still unknown, but he might have been connected in some way with St Ann's Hydropathic Establishment or, perhaps, with the Turkish Bath Company of Dublin.

He prefaced his account by likening the progress of a new idea to that of a moving body, suggesting that it is not possible to determine its strength until it meets with resistance; the ease or difficulty with which that resistance is overcome allows us to assess the power of the innovation.

Our new Irish Bath has repelled an attack upon the existence of its early infancy...with a display of inherent vitality which promises a future of appreciated benefit and wide-spread popularity. The circumstances of this attack will be found in the following pages; the results of it must be looked for in the return-sheets of the Turkish Bath Company of Dublin (Limited), which has now found it necessary to prepare additional accommodation for the fast increasing supporters of this National Institution.

As described by 'Photophilus', the controversy erupted with the publication of an attack on Dr Barter's Turkish baths which was published on 16 January in the Dublin Hospital Gazette. The form of the attack was unusual. Dr Corrigan, who was a well-known medical man, generally respected, and the author of a number of successful medical texts, wrote a letter to the editor asking him to publish an important article on the bath written, not by himself, but by a medical colleague, Dr Richard Robert Madden.

Corrigan wrote that he was worried that many of the Turkish baths being built in Ireland had a 'deficiency of a sufficient supply of vapour'. Whether this defect arose by 'accident or ignorance it is a serious and dangerous mistake' which could produce in some bathers an effect 'not only dangerous but positively fatal.'

Accordingly he was now forwarding a paper 'of very great value' by Dr Madden—than whom, perhaps, 'in the kingdom there is no one more competent,...from his long residence in the East and his high scientific attainments, for the task he so kindly undertook at my request.'

Madden had in fact published an account of his travels in Turkey, Egypt, Nubia and Palestine some twenty years before Urquhart, but his own description of hammams in the Middle East had not been as widely noticed by medical practitioners as Urquhart's in The Pillars of Hercules, nor as influential as the latter had, by then, become. In his article for the Dublin Hospital Gazette, Madden praises vapour baths above all other Turkish remedies.

In rheumatic diseases and those of the skin, he 'cannot sufficiently extol the advantages of the Turkish bath.' Unfortunately, he complains,

my own experience of the 'Turkish bath', as it exists in this country, taking the establishment at B*** as the type of all that have been established up to this time, leads me to the conclusion that the use of this bath must be attended with great aggravation of symptoms in several disorders, and with great danger in others...'

Since the only Turkish bath in Ireland which he could have been referring to here was Barter's establishment at Bray, it is odd that he felt the need to be so coy about it.

Continuing, he refers to his own sciatica which had earlier shown signs of improvement but became more aggravated after each visit to the bath.

This result I attribute entirely to the essential difference that exists between the Hammam of the east and the so-called 'Turkish bath' of this country. The former is a hot, humid air bath—a vapour bath, conjoined with a plentiful use of hot water and friction of a particular kind, which can only be employed with it advantageously. The other, or so-called 'Turkish bath' here in use, is a parched air bath, the dry heated air being generated from the combustion of coke in furnaces, which communicate by passages extending under the flooring of the bath-rooms to them in various directions.

Whether intended or accidental, the wording of this last sentence is extremely loose and could be interpreted as suggesting that the hot air and fumes from the burning coke were directly channelled by underfloor ducts into the hot rooms in order to heat them, an extremely dangerous situation, and one without any foundation in fact. The suggestion was made more directly later in the article and would be carefully refuted.

Nevertheless, despite his complaints regarding Dr Barter's establishments, and the dangers which might befall anyone who used them, he was, he maintained, only offering constructive criticism for the public good. He wanted the new baths to succeed. Damning with not a little faint praise, he wrote that it was greatly to the credit of their promoters that they should even attempt to provide hot-air bathing on such a large scale.

But it is only an attempt, or rather an imitation of the outward form, interior arrangement of chambers, of details in the process of manipulation, and attendance in them, of the Oriental Hammam. The main element of the latter, vapour air, that is not only hot, but humid, is wanting in our so-called 'Turkish Baths.' Owing to ignorance, or to false representations, or to foolish economy on the part of projectors, or those who invested their money in a novel and uncertain undertaking, the great mistake was committed of imposing a name and a character on those baths which in reality did not belong to them, calling them 'Turkish', and giving it to be understood that they were identical with the Oriental Hammams, of heated humid air, which they certainly are not.

He warns that the public will not appreciate being fooled and repeats, more directly, his accusation about the origin of the heated air in the hot rooms.

But I am quite sure when the public find out that they have been deceived in their expectations of deriving all the benefit they ought to have received from the use of those new baths had they been in reality what they were represented to be, genuine Turkish baths, the Oriental mode of heating the Hammams with humid air in a state of vapour will be adopted, and the Brummagem idea will be abandoned of generating heat by the combustion of coke in furnaces, and conveying the parched, overpowering, disagreeable smelling and greatly deteriorated air from those furnaces, through numerous channels beneath the floor into a bath room, where the lungs of an unhappy individual...have to breathe it, and to drink it in for a period of half, or even three-quarters of an hour.

As if attacking Barter's Turkish baths was not alone sufficient to convince the public of the dangers that lay within, Madden broadens his attack by drawing attention to part of an untitled (but widely circulated) pamphlet which praised the new bath. The author, he complains, makes a 'variety of statements in regard to it, which he believes to be true, and I know to be false.'

The pamphlet in question, Life in a tub, was a originally a review article which had appeared a year earlier in the Irish Quarterly Review. It dealt in a very positive way with five recently published books on hydropathy, and was later reprinted, with an additional section on the Turkish bath.

Madden focuses on the definition of a Turkish bath given by the pamphlet's pseudonymous author 'Diogenes'.

[The Turkish bath]...is a bath differing from all other hot baths in this important particular, viz.—that the heated medium is air instead of water; and that all parts of the body, when in a bath, are subjected to an even and equal temperature...

Thus far it seems to be such a clear concise definition that one wonders how anyone could possibly take exception to it. But it was the rider to the definition which had upset Madden.

...The result of which is, that inasmuch as man was constituted to breathe air instead of vapour, the Turkish bath may be enjoyed for hours at a time, without inconvenience; whereas in the vapour-bath the patient is unable to remain in it for more than about a quarter of an hour, in consequence of a feeling of suffocation, for want of the necessary supply of air to the lungs.

'Diogenes' then differentiates the Turkish bath from the vapour bath by stating that the former normally has little effect on one's pulse rate. Furthermore, perspiration, being a safety valve designed to maintain a person's body heat at around 98ºF, needs optimum conditions to be effective; heat is lost to the body by the evaporation of sweat caused by its absorption by the surrounding air, so that 'it is evident that no evaporation can take place where the air is saturated with moisture, and it is also evident that the amount of evaporation will vary with the dryness of the air.'

Madden makes no attempt to offer any scientific explanation as to why this should not be so. He sees fit only to contradict 'Diogenes' by relating his own contrary experience while using the baths at B***. Specifically, he claimed that as one entered the ante-room of the bath at 90º or 100º one immediately felt 'a sense of oppression, heaviness, and slight headache', and that this was also felt by other bathers as well. He then claimed that at the end of the main hot room,

there is a bench with a marble slab for bathers not easily made to perspire, and there is a communication beneath the bench with a hot air channel, the mouth of which is in one of the furnaces nearest to it…

This last misstatement, even more specific than the two noted above, was extremely serious. For he was saying that instead of clean air being heated by being passed to the hot rooms through pipes running over (but quite separate from) the furnace, the hot air duct was in effect equivalent to a chimney stack through which all the gases from the coke-fed furnace passed directly into the hot room. The fact that such a suggestion could only have been nonsense in no way lessened its ability to disturb potential patients who might themselves have no understanding of how boilers and furnaces worked.

Madden did go on to admit that in the hot-room (where the temperature was usually 130ºF, but occasionally even higher) the unpleasantness caused was less than in the ante-room because the bather was by this time perspiring. And when he was in the hot room his pulse 'was never under 86 or 90' [sic], and on his first visit was 'upwards of 100.'

Whilst there, Madden took the opportunity to take the pulse of two or three other bathers, one of whom was, in fact, the principal bath attendant. His pulse was 86 although he stated that he had spent seven hours in the bath every day for several months 'and never suffered the slightest inconvenience from his occupation, or had his pulse in the smallest degree quickened or [been] excited by it.'

His statement was treated with contempt by Madden who wrote that,

This man seemed to me not to be aware that he was stating what was not the fact, but merely to have delivered himself up to a reckless tendency to exaggeration which characterizes the statements of the advocates of hydropathy in all its branches…

Furthermore, he continued, the man was 'apparently in full bodily health and strength' seeming to imply that of course this meant that anyone who was not one hundred percent fit was likely to be in a very dangerous situation.

To any unbiased reader, both Corrigan's letter and Madden's enclosed 'paper' seem to lack any substantive basis for their conclusions and it is surprising that, even in the 1860s, a medical journal should print them in such a manner.

This was not, however, to be the last surprise.