Madness in their Method: Water therapy in Georgian and Regency times

by Lucinda Brant

Using water to treat illness, known today as Hydrotherapy, is a practice dating back to Ancient Egypt. Greek and Roman historians also mention the use of water in the treatment of muscle fatigue, hydrophobia and fever. Using water therapy as a psychiatric tool is attributed to Jean Baptiste Van Helmont’s massive medical tome the Ortus Medicinae published in 1643 and translated into English by John Chandler in 1662. [1]

Van Helmont advocated water immersion therapy in the treatment of mental illness. The patient was fully immersed in cold water until the point of unconsciousness, and thus at the point at which the patient could drown, because he believed near death immersion in cold water could “kill the mad idea” which caused mental derangement. [3]


Naturally, this was a very dangerous technique and never became widespread. However, Van Helmont’s staunch belief in using water as a treatment for mental illness was taken up by various medical institutions and practitioners across Europe so that by the 18th Century the “water-cure” in its various forms became one of a number of standard treatments used by physicians and insane asylums when dealing with all manner of psychiatric conditions.


The two main types of water cure were the douche or cold shower and the balneum or bath. The douche required cold water be poured over the patient’s head or sprayed at the patient’s body to cool the heat of madness if insane, or rouse the depressed if suffering from melancholia. The bath was used to calm overwrought nerves and to encourage sleep. In the early years of this type of therapy, most cures were performed out of doors near a source of water—the sea or a pond. This allowed for public viewing. However, as asylums, both public and private, became more widespread in the 18th Century, water cures were moved indoors. Inside and away from the public eye and an immediate source of water, so institutions and their practitioners developed inventive ways and a wide variety of apparatuses to deliver water therapy to the mad and melancholic. [1]

There were cold shower rooms, bath boxes that shut patients in, shower contraptions that delivered water at intervals via a system of pulleys and levers, dunking devices that immersed patients at regular intervals into small ponds as the device rotated and turned on a giant cogs, and there was the simple ladder and bucket method that involved the patient sitting in a wooden barrel while behind a screen attendants ran up and down ladders with buckets of water that they poured onto the patient’s head from a great height. And then there was “the chair”:

"I have contrived a chair and introduced it to our [Pennsylvania] Hospital to assist in curing madness. It binds and confines every part of the body. By keeping the trunk erect, it lessens the impetus of blood toward the brain. By preventing the muscles from acting, it reduces the force and frequency of the pulse, and by the position of the head and feet favors the easy application of cold water or ice to the former and warm water to the latter. Its effects have been truly delightful to me. It acts as a sedative to the tongue and temper as well as to the blood vessels. In 24, 12, six, and in some cases in four hours, the most refractory patients have been composed. I have called it a Tranquillizer"
(Rush to James Rush, The Letters of Benjamin Rush, Princeton University Press, 1951) [1,3]


By the mid 18th Century water therapy had become a standard treatment in the “mad doctor”’ medical bag. Yet, in this Age of Enlightenment, when many people came to view the shackling of the mad as inhumane, there were those physicians who advocated the use of water therapy not only as a cure but as a more humane means of coercion, thus doing away with the need for physical restraints. Thus water therapy was not only used on the mad and those suffering from depression, it was used by some physicians in the good-natured belief that it would persuade patients who had veered from the path of what society viewed as “normal” behavior to “get back on track”. [2, 3]

Thus water therapy was used by some physicians as a means of treating married women who had become “mildly distracted” and had opted out of their marital responsibilities (i.e. didn’t want to have sex with their husband). One such practitioner who used the method to sadistic effect was Patrick Blair, a physician who is the model for Sir Titus Foley in my novel AUTUMN DUCHESS, a dandified and well-respected physician whose medical forte is treating females for melancholia. When Antonia Dowager Duchess of Roxton is seen to be excessively melancholy and is still wearing mourning three years after the death of the Duke, her loving son is at his wits end and he instructs Sir Titus to treat his mother, little realizing that part of his treatment is the use of water therapy.


Patrick Blair had his female patients blindfolded, stripped and strapped to a bathing chair. The woman was then subjected to 30 minutes of water being sprayed directly into her face. When the woman refused to agree to return to the marital bed, Blair went one step further and repeated the treatment for 60 minutes, then 90 minutes and when she promised obedience Blair allowed her to sleep. Yet, the next day, sensing the woman was “sullen” and probably had only agreed because of the treatment, he again had her strapped to the chair and subjected to the treatment at intervals over the next two days. Finally, exhausted after such physical and mental torture, the woman succumbed and agreed to become a “loving and obedient and dutiful wife forever thereafter”. To make certain she did, Blair visited her at her home a month later and was happy to report “everything was in good order”. [4]

Thankfully Blair’s sadistic treatment of his female patients was not the norm. Yet, most physicians, indeed most people in the 18th and early 19th Centuries viewed water therapy in its various forms as an acceptable means of coercing, treating, and hopefully curing patients with various mental, melancholic and recalcitrant afflictions.


SOURCES

1. Annual Report to the Friends (July 2005 – June 2006) The Institute for the History of Psychiatry, Cornell University, New York.
   
   
2. Porter, Roy. Blood and Guts, A Short History of Medicine, Allen Lane, London 2002.
   
   
3. Scull, Andrew. Social Order/Mental Disorder; Anglo-American Psychiatry in Historical Perspective. Berkeley. University of California Press 1989.
   
   
4. Porter, Dorothy and Porter, Roy. Patient’s Progress: Doctors and Doctoring in Eighteenth-century England. Stanford University Press, Stanford California 1989.

Note: Water treatment images sourced and adapted from [1].