Turkish baths in hospitals

The Turkish Baths at St Thomas's Hospital

A controversial Turkish bath

We know that this bath was eventually built, but that is all we know about it for certain. There was much controversy about whether it should be built, and we don't know whether the bath that was built was the same as the one that was originally proposed.

And we know that five or six years after it was built the bath was said not to have been used. But we don't know whether it was ever used, nor when it was converted to be usable for other purposes.

The story starts towards the end of 1860, when the hospital was located in Borough High Street. Dr R H Goolden was one of a small group of doctors who had asked for a Turkish bath to be built at St Thomas's' for use in healing disease. Such baths had already been built at the Royal Infirmary, Newcastle-on-Tyne and at the Royal Shrewsbury Infirmary, apparently with good results, and when a committee of hospital doctors had considered the matter, no one had objected.

According to Goolden, in a letter to the editor of The Lancet, three of the committee members had later written privately arguing against the proposal. Accordingly, the Hospital Treasurer—the senior resident member of staff responsible for the running of St Thomas's’ and reporting to the Hospital Governors—wrote to each committee member asking for his views.

Goolden explained that the whole matter had now been put on hold due to the forthcoming relocation of the hospital. Nevertheless, he asked the editor to publish his own reply to the Treasurer because he thought it would be of wider interest. There followed his letter running to more than two pages of dense print.

Goolden began by expressing surprise that three physicians should have such influence when fifteen other physicians and surgeons had requested the bath. They had presented no arguments against it during the committee meeting and he could see no reason to counter the original decision, especially since no one was forced to prescribe the bath until convinced of its value.

Goolden first dismissed the suggestion that the bath was expensive to construct, use and maintain. He then listed all the people he had consulted about the value of the bath, and noted that he had personally visited every London bath open to the public, as well as several private ones. In particular, he described in some detail his visit to the first London bath, that run by Roger Evans in Bell Street, and how beneficial it was to those who were suffering from a variety of medical conditions.

He continued by describing the type of bath which would be suitable for the hospital.

The hospital bath should consist of several chambers: a hot room (150°), a tepid room (100°), and an ante-room with a supply of hot and cold water, so arranged that the bather can have a shower-bath or douche at any temperature. There should also be a tap of cold water supplied to each room. The rooms should be warmed by a flue, not necessarily under the floor. In attending to this matter much saving can be effected without lessening the efficiency. The floor should be of brick, and the walls may be of cement, brick, or Dutch tiles; and the rooms must be so constructed as to admit of perfect ventilation. The estimated cost of fuel is about 1s.6d. a day.

He concluded with a few cautionary notes about the use of the bath, especially when the patient has not used one before and might feel a sensation of faintness.

The faintness is, however, more apparent than real, for the pulse keeps up, and the distress subsides as the skin begins to act. Whenever this distress is felt, the patient should have some cold or warm water thrown over the skin, or even be allowed to go for a minute into the cold air. They never take cold.

Although St Thomas’s Hospital was at this time located in Borough High Street in Southwark, there had for some time been a possibility—soon to be realised—that it was going to have to vacate its premises in order to make room for the enlargement of London Bridge Railway Station.

In the meantime, the hospital’s architect, Henry Currey (1820-1900), soon to design the new hospital in Lambeth opposite the Houses of Parliament, was asked to draw up plans for a Turkish bath. Only two drawings survive, preserved in the hospital’s papers at the London Metropolitan Archives.

The first of the plans shows the ducting underneath the floors of the various rooms of the bath, together with the position of the furnace. The ducts carrying hot air to the rooms is coloured olive green on the original plan, and those removing the vitiated air are coloured black

The second plan dates from September 1860 and shows each of the rooms with its size, purpose, and layout. On the left of the baths, sharing furnace and water supplies, are two private slipper baths, and on the right, a wash-house and drying closet. An examination of the plan shows that the Turkish bath itself is better fitted out, and probably larger, than the one suggested by Goolden in his letter.

A small lobby leads into the cooling-room (frigidarium) which has its own toilet. Leading directly off is the 'intermediate room' (tepidarium) with toilet and shower, and an opening to the 'Hot Chamber' (sudatorium) also with toilet and shower. Unfortunately the plan neither gives any indication of the building materials to be used, nor the internal finish of the walls or seating. Excluding the wash-house, furnace room and slipper baths, this Turkish bath is approximately 47ft.6in. x 24ft.6in., which seems very generous.

The interval between the altercation described in Goolden’s letter to The Lancet and the date on the first of Currey’s plans would seem to indicate that the differences between the two groups were resolved fairly quickly.

But by January 1861, it was known that the hospital would definitely have to move the following year and would need to be in temporary premises for a while. In fact, following the hospital's departure from Southwark in 1862, nine years were to pass in temporary accommodation before it was able to move into its new premises in Lambeth.

In 1863 Dr Goolden published a paper in the British Medical Journal on his use of the bath in the treatment of diabetes. But he makes no mention of whether the bath was in the hospital's temporary accommodation or in an external commercial bath. This is strange since, in his original letter in The Lancet, he drew attention to the fact that St Mary's Hospital in Paddington sent its patients, at a cost of 1s. each, to the commercial baths in nearby Conduit Place. Surely if the bath had been at St Thomas's he would have proudly stated it.

Evidence that it did indeed have a Turkish bath in its temporary accommodation only surfaces nine years later. In the third of his Croonian lectures, Dr John S Bristowe writes that a decade or so earlier, ie, in the early 1860s,

…owing to the fact that special opportunities were afforded to us at the temporary St. Thomas's Hospital, I treated my anasarcus patients largely by the Turkish bath; and I was soon surprised to find how well those even who were seriously ill bore it.

So while there is still nothing conclusive to prove which baths the plans relate to, it seems more likely that they were for those in the temporary accommodation. Further support for this conclusion derives from the appearance of the plans. They seem much less detailed than would have been normal if they had been for part of a major new building complex.

The two articles on successful treatments undertaken in the hospital's temporary accommodation by Drs Goolden and Bristowe are exceptions to a long silence.

But otherwise, apart from a brief indication in 1872 that a Turkish bath existed in the new building, nothing further is heard about it for seventeen years after Currey's two plans, until the publication, in 1877, of Richard Metcalfe's book about Turkish baths called Sanitas sanitatum et omnia sanitas.

 Metcalfe was one of the commissioners appointed to carry out the provisions of the Baths and Washhouses Act in the parish of Paddington. There, too, there had been much controversy as to whether a Turkish bath should be included in the provision they were making for the working classes.

As part of his campaign to persuade the commissioners of the bath's value, Metcalfe sent a letter to a large number of men who were eminent in public life or at different levels of government, in addition to medical officers of health, doctors (including Dr Elizabeth Blackwell), and anyone he knew who ran a commercial Turkish bath.

He asked them whether they were in favour of providing Turkish baths for the poor and whether they thought it valuable 'as a sanitary and cleansing agent'.

The majority of those who replied were in favour, but Metcalfe published all the replies he received (and they make absolutely fascinating reading) in a chapter at the end of his book.

One of these was from James Bryning, proprietor for seven years of the Turkish baths at 191 Blackfriars Road, just a short walk away from the new hospital. He was strong believer in the value of the bath, but emphasized that it would need to be 'ever so cheap' if they were to use it. For the poor, he wrote,

like the rich, have their prejudices, and being uneducated, you cannot persuade them that it is either necessary or beneficial, therefore, it makes it a work of time.

When you find prejudice in educated medical men, you cannot wonder that the masses should be so.

There is a Turkish bath in new St Thomas's Hospital, and they will not avail themselves of its curative powers; therefore it is not used, although Dr Erasmus Wilson, and Dr Goulden [ie, Dr R H Goolden] are both so favourable to its use.

Apart from this letter, nothing more is known about these baths, and further research is needed to discover first, whether the bath that was built differed from Currey's original plans and, second, whether it was ever used, and if so, for how long.

Research into the history of these baths is still continuing.
It was last updated on 12 Feb 2022.