British Spas

Oun British spas are steadily improving their treatments and amenities so as to compete in every way with those on the Continent, but they are handicapped in so far as they do not receive State subsidies as is the common custom abroad. Nevertheless for many reasons those in search of restored health, who need either a nerve sedative or a " tonic" spa, will be wise to keep at home. If they seek sedative treatment, Bath, Cheltenham, Droitwich, and Leamington are the least "tonic." Then follow Llandrindod Wells, Woodhull Spa, and Strathpeffer, while the most stimulating spas are Harro- gate, the summer temperature of which is six degrees below that of Central France, and Buxton, which is 1,000 feet above sea-level.

These nine spas belong to the British Spa Federation, the lion. Secretary of which is Mr. John IIatton, the able and popular director of the baths at Bath. The aim of the Federa- tion is to encourage research work into hydrological treatment, to improve spa administration, to provide better entertain- inents and amenities, and in every possible way to help British spas to hold their own against the State-aided spas of the Continent.

Of special interest at the present time are the plans being prepared in co-operation with the Ministry of Health and the principal National Insurance Societies to provide spa treat- ment for all insured persons suffering from rheumatic diseases. Rheumatism in its varied forms is a matter of serious conse- quence to the nation, for, according to the report of the Royal Commission on National Health Insurance, no less than 872,600 insured persons seek advice for rheumatic diseases every year. Annually the country loses from insured persons alone "over 3,000,000 weeks of work from rheumatism, and this disease costs the Approved Societies nearly £2,000,000 a year in sickness benefit."

The organization for sending approved patients to British spas will, it is hoped, in time include all insured persons, but in its initial stages it will probably be only those Approved Societies with a surplus that will be able to give their members the advantages of spa treatment as "an additional benefit." The spa will be selected on a regional basis, and patients will therefore be sent to the nearest one to their homes, and Probably at the quieter periods of the year out of the season, When the baths are not crowded by the normal visitor. It is calculated that as a start an average of approximately 2,000 insurance patients could undergo treatment at the British Spas at one time. If the average duration of a course is taken as three to four weeks, it will be possible for at least 30,000 insured persons to be treated every year. It is hoped that an inclusive capitation fee, possibly 18s. per week, will be charged for spa treatment given under prescription by experienced Physicians.

The other development in our British spas is the greater encouragement of research work. The mineral springs of Britain are being subjected to a careful chemical and physical examination, and a uniform notation is being adopted whereby one water may be compared with another, and with the corresponding Continental springs. Harrogate has achieved aluable results by such scientific work, while Bath, through he work of Sir William Ramsay and other investigators, has a_itade useful discoveries as to the radioactivity of her waters.. A Buxton, too, helpful work is being done, but generally speaking, we have far too little research work in Great Britain to compare with the scientific investigations made no the Continent.

However, we learnt much during the war, when thousands of disabled men were treated, and the special case record cards

have been preserved. We gained from 1914 to 1919 special

experience in the work of re-education of injured, paralysed, and arthritic limbs, a sphere of study that is being followed, notably at Bath, Droitwich, and Cheltenham. In the hot swimming bath at Bath I have seen persons exercising their partially paralysed limbs in water that supports their bodies and reduces spasms. Even helpless patients are carried in slings and taught to execute movements until they can swim by themselves.

There are, of course, other spas besides the nine belonginl to the British Federation. There are spas at Llanwrtyd and the Bridge of Allan, where the " tonic" influence predomi- nates, while at Trefriw in North Wales there arc powerful iron waters. The town of Searbormigh owed its reputation originally as a holiday resort to the medicinal wells discovered

there in 1620. The waters arc still sold in the pump room and

are taken as a tonic. At Torquay, too, the Corporation baths, reconstructed in 1922, are among the finest for any seaside resort in Europe. Both British and Continental methods are employed in giving treatment fir gout, rheumatism and nervous troubles, and the patients sitting in the spacious cooling lounge can enjoy the magnificent view over Torbay.

Although a decided forward movement is visible in most British spas many visitors and observers regret the lack of attention given in some cases to town-planning. In many Continental spas special care has been taken to provide open spaces, to encourage civic architecture, and to protect the surrounding countryside from desecration by the speculative builder. The Spectator has several times described the ideals of the Council for the Preservation of Rural England. This

body has plenty of scope for its work in the neighbourhood or

British spas, where only too often invalids drive out into the country along roads fringed with ugly bungalows and tawdry villas. The dignity of good architecture and the beauty of landscape have their influence upon patients. This was wisely recognized by the Canadian Government, who called in Mr. T. H. Mawson, a Past President of the Town Planning Institute, to plan at Banff in the Canadian Rockies a beautiful and stately spa city. Some of our British spas have not even started-on a town plan, and are allowing the speculative builder to spoil their surrounding country.

Another weakness is that the publicity of many of our spas is not as attractive or as effective as that of Continental ,Ints. Bath is a notable exception, for the advertising of this city :tad the baths is skilful and literary, but some of the ',tilers still cling to out-of-date methods.

It is hoped that this brief sketch may (la something to show that our British spas, although they do not proclaim their virtues sufficiently, are probably the best administered in the world. They should attract and arc attracting more and more patients, not only from Britain, but also invalids from the Continent and tropical countries. " skew thee the best springs," wrote Shakespeare, and the Vine has come to pay more attention to the worth of our British