Dermatology in Bath

Dermatology in Bath.

By Dr. C.R. Lovell

According to legend, Bladud, an ancient British swineherd, observed that the blemishes on his pigs were cured by Bath’s thermal springs and the healing properties of the waters achieved international repute in Roman times. The Royal National Hospital for Rheumatic Diseases (Mineral Water Hospital) was founded in 1738.

A fine painting on its main staircase shows a boy with a skin eruption on his hand (possibly Still’s disease) being examined by a physician (Dr Oliver) and a surgeon (Mr Peirce), an early example of a combined clinic. Patients with skin diseases accounted for 10-15% of admissions to the hospital between 1752-1764; 241 “lepers” were admitted, of whom 122 were “perfectly cleared” and 85 “much benefitted” (Rolls, 1988). Doubtless many of these had psoriasis, known as “lepra alphos”, and the results seem comparable to many current therapies! Dr Oliver himself described one such patient who improved with a combination of immersion in the waters, purgation and an ointment concocted from tar and neat’s foot oil.

Two physicians, John Cottle Spender and his son John Kent Spender, were early advocates of compression bandaging for venous leg ulcers (Spender 1856). Dr Richard Bayliss, resident Medical Officer at the hospital, noted that disorders such as psoriasis responded to the waters (Bayliss 1902).

The Royal United Hospital was founded in 1826 and moved to its current site at Combe Park in 1926. Dr Harry Green was appointed Consultant Dermatologist in 1946. His knowledge of antiques was unsurpassed and many patients gained from his expert horse racing tips (subsequent post-holders have proved sadly lacking in this respect).

Dr Robert Tan was appointed in 1975, and was responsible for setting the department on a sound footing. He established strong clinical links with rheumatology, an association which flourishes to this day. Despite a large clinical workload, he maintained his research interest in cutaneous lymphoma. After retiring from Edinburgh, Professor Paddy Hare worked briefly as Bob’s Clinical Assistant. The author was appointed in 1985. A generous bequest from the late Sheila Kinghorn enabled the creation of an active nurse-led treatment area led by Kay Dawkes.

When Bob Tan retired in 2001 he was replaced, not surprisingly, by two people, Dr Bill Phillips from the Royal Free, and Dr Amrit Darvay from St John’s. Subsequently Dr Cari Aplin has joined the consultant staff. Bath now participates in the Bristol Specialist Registrar rotation.

References Bayliss RA (1902) The Bath mineral Water in the Treatment of Diseases of Skin. J Balneol Clin 6:108.

Rolls, Roger, (1988). The Hospital of the Nation. The story of Spa Medicine and the Mineral Water Hospital at Bath. BIRD Publications, Bath. ISBN 0 951321900.

Spender JC (1856) Notes on pathology and treatment of ulcers of the leg. Association Medical Journal 205, quoted in Evans, CD (1972) A history of Dermatology in Bristol and the West of England. Br J Dermatol. 86:180 – 191.