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JUDICIAL DEFERENCE
IN INTERNATIONAL ADJUDICATION
International courts and tribunals are increasingly asked to pass judgment on
matters that are traditionally considered to fall within the domestic jurisdiction
of States. Especially in the fields of human rights, investment, and trade law,
international adjudicators commonly evaluate decisions of national authorities
that have been made in the course of democratic procedures and public delib-
eration. A controversial question is whether international adjudicators should
review such decisions de novo or show deference to domestic authorities. This
book investigates how various international courts and tribunals have responded
to this question. In addition to a comparative analysis, the book provides a
normative argument, discussing whether different forms of deference are justi-
fied in international adjudication. It proposes a distinction between epistemic
deference, which is based on the superior capacity of domestic authorities to
make factual and technical assessments, and constitutional deference, which
is based on the democratic legitimacy of domestic decision-making. The book
concludes that epistemic deference is a prudent acknowledgement of the limited
expertise of international adjudicators, whereas the case for constitutional
deference depends on the relative power of the reviewing court vis-à-vis the
domestic legal order.

Volume 78 in the series Studies in International Law


Studies in International Law
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Protect and Assist: Law and Practice
Christy Shucksmith
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Allocating International Responsibility Between Member States
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Asylum Control and Access to Protection: Admission, Readmission
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Evolutionary Treaty Interpretation
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The Responsibility to Protect and the Failures of the United Nations
Security Council
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The Role of Multilateral Environmental Agreements: A Reconciliatory
Approach to Environmental Protection in Armed Conflict
Britta Sjostedt
Prosecutorial Discretion at the International Criminal Court
Anni Pues
For a complete list of titles in this series, see
www.bloomsburyprofessional.com/uk/series/studies-in-international-law
Judicial Deference
in International
Adjudication
A Comparative Analysis

Johannes Hendrik Fahner


HART PUBLISHING
Bloomsbury Publishing Plc
Kemp House, Chawley Park, Cumnor Hill, Oxford, OX2 9PH, UK
1385 Broadway, New York, NY 10018, USA

HART PUBLISHING, the Hart/Stag logo, BLOOMSBURY and the Diana logo are
trademarks of Bloomsbury Publishing Plc
First published in Great Britain 2020
Copyright © Johannes Hendrik Fahner, 2020
Johannes Hendrik Fahner has asserted his right under the Copyright, Designs and
Patents Act 1988 to be identified as Author of this work.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording, or any information storage
or retrieval system, without prior permission in writing from the publishers.
While every care has been taken to ensure the accuracy of this work, no responsibility for
loss or damage occasioned to any person acting or refraining from action as a result of any
statement in it can be accepted by the authors, editors or publishers.
All UK Government legislation and other public sector information used in the work is
Crown Copyright ©. All House of Lords and House of Commons information used in
the work is Parliamentary Copyright ©. This information is reused under the terms
of the Open Government Licence v3.0 (http://www.nationalarchives.gov.uk/doc/
open-government-licence/version/3) except where otherwise stated.
All Eur-lex material used in the work is © European Union,
http://eur-lex.europa.eu/, 1998–2020.

A catalogue record for this book is available from the British Library.
Library of Congress Cataloging-in-Publication data
Names: Fahner, Johannes Hendrik, 1988- author.
Title: Judicial deference in international adjudication : a comparative analysis / Johannes Hendrik Fahner.
Description: Oxford ; New York : Hart, 2020. | Series: Studies in international law; volume 78 |
Based on author’s thesis (doctoral – Universiteit van Amsterdam, 2018) issued under title:
Intensity of review in international courts and tribunals : a comparative analysis of deference. |
Includes bibliographical references and index.
Identifiers: LCCN 2020009170 (print) | LCCN 2020009171 (ebook) |
ISBN 9781509932283 (hardcover) | ISBN 9781509932290 (Epub)
Subjects: LCSH: International courts. | Judicial process. | Deference (Law)
Classification: LCC KZ6250 .F34 2020 (print) | LCC KZ6250 (ebook) | DDC 341.5/5—dc23
LC record available at https://lccn.loc.gov/2020009170
LC ebook record available at https://lccn.loc.gov/2020009171
ISBN: HB: 978-1-50993-228-3
ePDF: 978-1-50993-230-6
ePub: 978-1-50993-229-0
Typeset by Compuscript Ltd, Shannon
Printed and bound in Great Britain by CPI Group (UK) Ltd, Croydon CR0 4YY

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Foreword

I
AM DELIGHTED to write the foreword for this remarkable thesis of Johannes
Hendrik Fahner. As a trainee in my chambers at the General Court of the
European Union, Johannes showed a profound interest in international
adjudication. On numerous occasions, I had the privilege to discuss with him
issues related to the peaceful settlement of disputes and I have been impressed
by his in-depth knowledge of international law. This erudition has been
nourished by studies at the universities of Utrecht, Paris II, Amsterdam and
Luxembourg, as well as by peer-reviewed publications, most recently in the
prestigious International and Comparative Law Quarterly.
The topic of Johannes’ PhD thesis explores the delicate relationship between
international courts and domestic authorities. Should international judges assess
or even review decisions de novo or should they defer to domestic stakeholders?
And if they assess and review decisions themselves, what should be the scope of
such a review? “Deference” as opposed to “control”, “caution” as opposed “to
bold action”, are increasingly encouraged by States and critical academics. This
tension is of growing importance in international litigation and constitutes,
in the author’s view, a variation on broader debates about the proper balance
between the aims pursued by international law and the prerogatives of sovereign
States.
Johannes Fahner adopts in his analysis a truly comparative approach. He not
only juxtaposes the different permanent institutions, ie, the International Court
of Justice, the European, Inter-American and African human rights courts, the
dispute settlement system of the World Trade Organization and the International
Tribunal for the Law of the Sea; he also embarks upon a meaningful comparison,
highlighting the differences in adjudication techniques in relation to his main
theme by providing concrete examples and proposing alternative solutions to
decided cases. Droit comparé is not simply droit juxtaposé.
The author, in a pedagogical format, takes the reader by the hand to guide
him or her through the difficulties of his topic. His starting point consists of
setting the scene, investigating to what extent international adjudicators have
followed a deference-based approach and whether they should do so when
assessing State conduct against international legal norms. A great variety of
practices justifies the comprehensive comparative study. A useful contribution
of the author is his examination of ‘expressions of deference’ to be found in
the practice of various international adjudicators. Different standards of review,
such as those of reasonableness, good faith and the margin of appreciation, are
vi Foreword

analysed horizontally in order to identify possible common or different mean-


ings across the boundaries of the different fields touched upon by international
disputes.
In addressing the normative aspects, the author raises the question whether or
not courts and tribunals should limit the intensity of their review. An important
distinction is proposed in this context: epistemic deference, based on the supe-
rior capacity of domestic-makers to make factual and technical assessments, and
constitutional deference, based on the legitimacy of domestic decision-making.
The latter, as Johannes rightly points out, relies on a questionable comparison
with domestic judicial review. This is particularly true of those international
courts which do not adjudicate human rights issues, as their review does not
involve a general assessment of the legitimacy of government conduct in the
light of different public and private interests.
As former President of the European Court of Human Rights, I particu-
larly appreciate Johannes’ presentation and appraisal of the theory of the
margin of appreciation. This doctrine may be regarded as being among the
most prominent judge-made legal constructs in European human rights juris-
prudence. As I have highlighted elsewhere, it is an analytical tool that guides
the Strasbourg Court in its examination of the complaints raised under many,
but not all, provisions of the European Convention on Human Rights and its
Protocols. The doctrine accepts pluralism over uniformity as long as the funda-
mental guarantees are effectively observed. It is neither a gift nor a concession,
but more of an incentive to the domestic judge in the member State to conduct
the necessary Convention review, thus giving effect to the principle of subsidi-
arity ((2014) 67 CLP, 49). But as Johannes Fahner points out, the Strasbourg
Court’s deference to domestic authorities results from a variety of reasons: the
flexibility of Convention standards, the subsidiary character of its international
supervision, and the superior legitimacy, proximity and capacity of domestic
decision-making. The establishment of facts, the resolution of technical ques-
tions and the interpretation and application of domestic law might call for a
limited scope of review, which does not of course entail complete deference.
And in any event, assessment of the merits should be distinguished from the
intensity of the review. Admittedly, Johannes is right when he emphasises that
the case-law on the margin of appreciation does not provide a method for the
balancing of factors which are different in nature and pull in different directions.
However, I would submit that it is precisely this flexibility which allows the
Court to deliver judgments which are consonant with its legitimacy and accept-
able to their addressees, ie the member States. Can it be said that there is no
longer any clear boundary between a determination of the width of the margin,
on the one hand, and the final assessment of the merits of the case, on the other,
as Johannes suggests? Or to put it differently, can the Court’s use of the doctrine
be regarded as ‘result-orientated’? This is certainly not my view, and as Johannes
Foreword vii

Fahner himself admits, such a proposition might be an ‘academic construction


that is not necessarily adhered to by the Court’.
The ‘purposeful’ rejection of constitutional deference in the context of inter-
national dispute resolution, save in human rights adjudication, is grounded in
the limited powers of international courts. The author argues that the anal-
ogy with the traditional separation of powers doctrine seems to be flawed.
The impact of decisions by international courts on the domestic legal sphere
is limited. Moreover, Johannes Fahner correctly evokes the conceptual confu-
sion that constitutional deference creates: deference blurs the adjudication
technique. In addition, an adverse ruling by an international court may be frus-
trated by the respondent State by retaining the impugned measure and paying
compensation, ignoring the ruling or withdrawing from the regime altogether.
Practice concerning the (non-)implementation of judgments might occasionally
confirm this rather pessimistic finding, undermining as it does any justification
for constitutional deference.
But again, as Johannes Fahner suggests, the European human rights protec-
tion system is an exception in this respect. Indeed, as highlighted in his work,
the human rights courts are integrated into domestic constitutional frame-
works securing the legitimate exercise of public power, and their judgments are
capable of instigating profound changes in the domestic legal order. Johannes
sees this as an encouragement of ‘the internalization of human rights at differ-
ent levels’. I would call this ‘subsidiarité bien comprise’. The application of
constitutional deference in the context of international human rights adjudi-
cators could raise a question as to the possible overlap between epistemic and
constitutional deference: when judges, in a spirit of constitutional deference,
might appear to lack a mandate to have a final say, especially on controversial
issues, would this not be the result, even partly, of the fact that domestic judges
and agencies are better equipped to make scientific and technical assessments
(epistemic deference)?
For other international judges, it is indeed preferable to determine clearly
the scope and content of international obligations instead of hiding behind
doctrines that leave major questions unanswered. In Johannes Fahner’s opinion,
to provide a conclusive answer to the legal question is better than referring it
back to the respondent State and perpetuating uncertainty about the content of
the international obligation. Besides, he submits, treaty interpretation should be
restrictive, because restrictive interpretation is preferable to constitutional defer-
ence. The principle of restrictive interpretation, detached from any opinion as
to its preference over constitutional deference, nevertheless remains a matter of
debate. Johannes Fahner’s conclusion might not meet with unanimous approval,
but triggering reflection on fundamental, albeit controversial, issues is the
ultimate aim of any academic exploration.
This comparative study demonstrates a profound comprehension of inter-
national adjudication. Posing problems and providing convincing answers are
viii Foreword

undoubtedly the hallmarks of a good PhD thesis. Johannes Hendrik Fahner’s


work will thus surely be of the greatest interest, not only to scholars interested
in public international law and its growing constitutionalisation, but also to
practitioners specialising in international litigation.

Dean Spielmann
Former President of the European Court of Human Rights
Judge of the General Court of the European Union
Acknowledgements

T
HIS BOOK IS the result of a research project executed at the Universities
of Amsterdam and Luxembourg. I thank my PhD supervisors, Matthew
Happold and Pieter Jan Kuijper, for their guidance and mentorship, and
for the good laughs we have shared during these years. I also thank the other
members of my comité d’encadrement de thèse, Herwig Hofmann and Johan
van der Walt, for their supervision, as well as the other members of my PhD
defence jury for their helpful reports and questions: Yvonne Donders, Janneke
Gerards, Hélène Ruiz Fabri, and Stephan Schill.
During my time as a PhD researcher, I have been surrounded by
numerous great colleagues. I would like to thank, in particular, Chrysa
Alexandraki, Fatima Chaouche, Javier Garcia Olmedo, Nijat Hajikhanov,
Stijn Lamberigts, Parvathi Menon, Chukwuma Okoli, Amadou Tidiane Sow,
and Simona Spassova. I thank Moritz Klein for sharing challenging expedi-
tions and Relja Radović for his comradeship and for countless discussions.
I am grateful to the Faculty of Law, Economics and Finance of the University
of Luxembourg and the Amsterdam Center for International Law for
providing extremely pleasant and resourceful environments, as well as to the
World Trade Institute of the University of Berne, where I spent an enjoyable
research stay.
During my PhD project, I have enjoyed a great internship at the General
Court of the European Union. I would like to thank Judge Dean Spielmann
and the members of his Chambers, Anne Colomer, Olivia Davidson, Yves van
Gerven, Susanna Rossow-Schmekel and Panayotis Voyatzis.
This book has benefited from discussions with a great number of schol-
ars who have commented on my written work or presentations. I would like
to thank, in particular, Oddný Arnardóttir, Pierre d’Argent, Marco Bronckers,
Jorge Contesse, Gus van Harten, Nico Krisch, Joanna Mendes, Miguel Moura
e Silva, Matthias Oesch, Pietro Ortolani, Joshua Paine, Martins Paparinskis,
Rodrigo Polanco, Dean Spielmann, Maarten Stremler, Robert Stremler, Ingo
Venzke, Mark Villiger, Panayotis Voyatzis, and Ezgi Yildiz.
I thank my paranymphs, Başak Bağlayan and Jacob van Dijk, for their excel-
lent assistance before and during my defence.
I am grateful to the team of Hart Publishing for their encouragements and
patience, in particular Tom Adams, Richard Cox, Sasha Jawed and Catherine
Minahan.
x Acknowledgements

I thank my late father, my mother, and my extended family, including


Margrete, Johan, Peter, Anneke, Jurrianne, Geert, Gertieme and Bert. Last and
most important, I thank Başak for her love and support throughout these years.

Johannes Hendrik Fahner


Luxembourg, 8th May 2020
Contents
Foreword�������������������������������������������������������������������������������������������������������v
Acknowledgements�������������������������������������������������������������������������������������� ix
Table of Cases���������������������������������������������������������������������������������������������xv
List of Abbreviations����������������������������������������������������������������������������� xxxiii

1. Introduction��������������������������������������������������������������������������������������������1
I. Deference in International Adjudication�����������������������������������������1
II. The Concept of Deference�������������������������������������������������������������5
A. Defining Deference������������������������������������������������������������������5
B. Deference in the Domestic Context������������������������������������������7
C. Deference in the International Context�����������������������������������13
III. Approach: A Comparative Analysis of Deference�������������������������17

2. Judicial Deference in International Practice��������������������������������������������23


I. Introduction��������������������������������������������������������������������������������23
II. The International Court of Justice�����������������������������������������������25
III. The European Court of Human Rights����������������������������������������30
A. Development of the Margin of Appreciation��������������������������31
B. Conceptual Analysis of the Margin of Appreciation���������������36
C. Justifications for the Margin of Appreciation��������������������������41
D. Deference to Domestic Courts Beyond the Margin
of Appreciation���������������������������������������������������������������������43
E. Conclusions on the European Court of Human Rights�����������45
IV. The Inter-American Court of Human Rights��������������������������������47
V. The African Court on Human and Peoples’ Rights�����������������������55
VI. The World Trade Organization����������������������������������������������������58
A. Article 11 of the Dispute Settlement Understanding����������������58
B. Article 17.6 of the Anti-dumping Agreement��������������������������66
C. Conclusions on the WTO�������������������������������������������������������69
VII. Investor-State Arbitration Tribunals���������������������������������������������71
A. Approaches in Favour of (Some) Deference�����������������������������71
B. Approaches Critical of Deference�������������������������������������������79
C. Conclusions on Investment Arbitration����������������������������������82
VIII. The International Tribunal for the Law of the Sea������������������������84
IX. Conclusions���������������������������������������������������������������������������������87
xii Contents

3. A Comparative Analysis of Deference in International Practice���������������89


I. Introduction����������������������������������������������������������������������������������89
II. The Scope of Deference�����������������������������������������������������������������90
A. Deference in the Context of Specific Assessments���������������������91
i. Assessments of Facts��������������������������������������������������������91
ii. Technical Assessments�����������������������������������������������������93
iii. Interpretation and Application of Domestic Law��������������96
iv. Public Policy Choices�������������������������������������������������������99
v. Treaty Interpretation������������������������������������������������������ 100
B. Deference Towards Specific Domestic Actors�������������������������� 106
i. Domestic Parliaments���������������������������������������������������� 107
ii. Domestic Administrative Agencies��������������������������������� 111
iii. Domestic Courts������������������������������������������������������������ 112
C. Deference in the Context of Specific Norms��������������������������� 118
i. Indeterminate Standards������������������������������������������������ 118
ii. Self-Judging Clauses������������������������������������������������������ 121
D. Conclusions on the Scope of Deference���������������������������������� 126
III. The Depth of Deference�������������������������������������������������������������� 126
A. From Treaty Standard to Standard of Review������������������������� 128
B. The Margin of Appreciation�������������������������������������������������� 131
C. Reasonableness���������������������������������������������������������������������� 133
D. Good Faith���������������������������������������������������������������������������� 137
E. Proportionality���������������������������������������������������������������������� 140
F. Procedural Review����������������������������������������������������������������� 142
G. Overlapping Standards of Review������������������������������������������ 146
IV. Conclusions�������������������������������������������������������������������������������� 147

4. A Normative Assessment of Deference in International


Adjudication��������������������������������������������������������������������������������������� 149
I. Introduction�������������������������������������������������������������������������������� 149
II. Epistemic Deference�������������������������������������������������������������������� 151
III. Constitutional Deference������������������������������������������������������������� 154
A. Introduction�������������������������������������������������������������������������� 154
B. Arguments in Favour of Constitutional Deference:
The Domestic Parallel������������������������������������������������������������ 157
i. The Domestic Court Analogy���������������������������������������� 157
ii. The Democratic Argument��������������������������������������������� 161
C. Arguments in Favour of Constitutional Deference:
The International Dimension������������������������������������������������� 171
i. State Sovereignty������������������������������������������������������������ 171
ii. Subsidiarity������������������������������������������������������������������� 174
Contents xiii

D. Arguments against Constitutional Deference�������������������������� 177


i. Deference as an Abdication of the Judicial Task������������� 177
ii. Procedural Fairness�������������������������������������������������������� 181
iii. Universalism and Uniformity������������������������������������������ 185
E. Taking Stock: A Purposeful Rejection of Constitutional
Deference������������������������������������������������������������������������������ 190
i. The Separation of Powers and the Perks
of Sovereignty���������������������������������������������������������������� 192
ii. The Purpose of International Courts and Tribunals�������� 205
iii. The Ambiguities of Deference and the Alternative
of Restrictive Interpretation������������������������������������������� 212
IV. Conclusions�������������������������������������������������������������������������������� 215

5. Final Conclusions�������������������������������������������������������������������������������� 217

Bibliography���������������������������������������������������������������������������������������������� 225
Index��������������������������������������������������������������������������������������������������������� 261
xiv
Other documents randomly have
different content
one very important in the animal economy, and having various relation to
the causes and treatment of disease. Keeping in mind then this reference
to the use of water as an internal remedy, diluents may be viewed under
three conditions of probable usefulness:—First, the mere mechanical
effect of quantity of liquid in diluting and washing away matters,
excrementitious or noxious, from the alimentary canal;—secondly, their
influence in modifying certain morbid conditions of the blood;—and thirdly,
their effect upon various functions of secretion and excretion, and
especially upon those of the kidneys and skin * * * The first is an obvious
benefit in many cases, and not to be disdained from any notion of its
vulgar simplicity. It is certain there are many states of the alimentary canal
in which the free use of water at stated times produces good, which
cannot be attained by other or stronger remedies. I have often known the
action of the bowels to be maintained with regularity for a long period,
simply by a tumbler of water, warm or cold, on an empty stomach, in
cases where medicine had almost lost its effect, or become a source only
of distressing irritation. The advantage of such treatment is still more
strongly attested, where the secretions taking place into the intestines, or
the products formed there during digestion, become vitiated in kind. Here
dilution lessens that irritation to the membranes, which we cannot so
readily obviate by other means, and aids in removing the cause from the
body with less distress than any other remedy. In some cases, where
often and largely used, its effect goes farther in actually altering the state
of the secreting surfaces by direct application to them. I mention these
circumstances upon experience, having often obtained much good from
resorting to them in practice, when stronger medicines and ordinary
methods had proved of little avail. Dilution thus used, for example, so as to
act on the contents of the bowels, is beneficial in many dyspeptic cases,
where it is especially an object to avoid needless irritation to the system.
Half-a-pint or more of water taken when fasting, at the temperature most
agreeable to the patient, will often be found to give singular relief to his
morbid sensations. * * * In reference to the foregoing uses of diluents, it is
to be kept in mind that the lining of the alimentary canal is, to all intents, a
surface, as well as the skin, pretty nearly equal in extent; exercising some
similar functions, with others more appropriate to itself, and capable in
many respects of being acted upon in a similar manner. As respects the
subject before us, it is both expedient and correct in many cases to regard
diluents as acting on this internal surface analogously to liquids on the
skin. And I would apply this remark not only to the mechanical effects of
the remedy, but also to their use as the medium for conveying cold to
internal parts; a point [29]of practice which either the simplicity of the
means, or the false alarms besetting it, have hitherto prevented from being
duly regarded.”

Again he writes:—

“Without reference, however, to these extreme cases, it must be repeated,


that the use of water, simply as a diluent, scarcely receives attention and
discrimination enough in our English practice.”

And again:—

“As I have been treating of this remedy only in its simplest form, I do not
advert to the use of the different mineral waters farther than to state, that
they confirm these general views, separating, as far as can be done, their
effect as diluents from that of the ingredients they contain. The copious
employment of some of them in Continental practice gives room for
observation, which is wanting under our more limited use. I have often
seen five or six pints taken daily for some weeks together (a great part of it
in the morning while fasting), with singular benefit in many cases to the
general health, and most obviously to the state of the secretions. * * *
These courses, however, were always conjoined with ample exercise and
regular habits of life; doubtless influencing much the action of the waters,
and aiding their salutary effect.”

With this quotation we take leave of Sir Henry Holland, merely


observing, that no Hydropathist could say more on the subject than
he has done, and that the Continental practice referred to, of drinking
large quantities of water, conjoined with ample exercise and regular
habits of life, is precisely that practice which Hydropathy enjoins.

Sir John Forbes, a physician already quoted, says, on water drinking


“The water cure is a stomachic, since it invariably increases the appetite.”


Dr. Pereira states—

“It is a vital stimulus, and is more essential to our existence than aliment.”

Liebig, the celebrated physiological chemist, bears similar testimony,


viz.—“It increases the appetite.”

Are these effects consistent with lowering the tone of the stomach?
are they not, on the contrary, the strongest evidence of the tonic
effects of water?

Some objectors say, “water drinking thins the blood.” After


demolishing these objections by arguments which we regret we have
not space to quote, Dr. Gully concludes his observations as follows;

“But the whole assertion regarding thin blood proceeds on grounds that
betray intense ignorance, both of physiology and of the water cure. It
supposes that the whole water imbibed enters into, and remains in the
circulating blood, quasi water, that no chemical transformation of it takes
[30]place in the body at all: this is ignorance of physiology. And it supposes
that all who are treated by water are told to drink the same, and that a
large quantity, without discrimination of the individual cases of disease
presented: this is ignorance of the water cure. So between the horns of
this compound ignorance, and of wilful misrepresentation, we leave the
declaimers about the ‘thinning of the blood.’ ”

It is a curious fact that in all the medical works which treat of


anaemia, or bloodlessness, “allusion is never once made to water-
drinking as a known cause—not even to the possibility of its being a
cause of it.”

In so flagrant a case of thin blood, why has this principal cause been
omitted? It is further curious that this injurious effect of water was
never invented, much less preached, until Hydropathy was found to
be making inconvenient strides in public favour.

Is the reader aware that eighty per cent. of water enters into the
composition of healthy blood, without making any allowance for the
enormous quantity required for the various secretions?

Granting, however, for the sake of argument, that all, and more than
these objectors urge, were true, we still have a kind of feeling that
water is more congenial to the system than prussic acid, or even
iodine. But we may be wrong.

Perhaps there is no disease which would appear, at first sight, so


little suited for Hydropathic treatment as cholera; 15 that disease for
the successful treatment of which we have been hitherto
accustomed to consider stimulants and hot applications of all kinds
as indispensably necessary, and yet there is no disease, in the
treatment of which Hydropathy has been more successful.

The principles of its treatment, by the water system, are so sensibly


and rationally put forward in the pamphlet entitled, “An Address, &c.,”
that, as we think, the greatest sceptic must be convinced of the truth
of the doctrines it propounds, we strongly recommend its perusal to
our readers. Of the many cases treated by the author, all, we are
told, recovered, whilst not a single instance of secondary fever—the
invariable accompaniment of the Allopathic treatment, and only
secondary in danger to the disease itself—occurred. The necessary
prevalence of this secondary fever in the one case, and its
[31]absence in the other, are beautifully explained, on natural
principles, at pages 9 and 10. Though the pamphlet in question is
anonymous, and the author has taken some pains to explain his
reason for concealing his name, yet he has unwittingly betrayed his
identity in the following extract from a letter from Lieut.-Colonel
Cummins, c.m., who, having tried the system as an amateur, in
America, thus writes of it:—

“Tell Barter that his system has lately become the universal practice in the
Southern States, for cholera; and since its adoption, although it is, of
course, but imperfectly carried out, the mortality is not one-fourth.

“I never saw cholera of so frightful a character; that at Quebec, which you


recollect was so near doing for me, was nothing to it; the violence of the
spasms was such that blood oozed out through all the pores of the skin,
especially with the niggers. It did not give the slightest warning; the men
often fell while at work, and before four hours were dead.”

The following statement, extracted from a letter written by Mr. James


Morgan of Cork, and which appeared in the Limerick Chronicle, 4th
April, 1849, affords a remarkable instance of the beneficial effects of
fresh air and cold water, so strongly insisted upon by Dr. Barter, and
corroborating the practice which, on theoretical grounds, he
recommends:

“In a temporary cholera hospital at Gloucester, there were sixteen


patients, one of whom was an interesting young female, between fifteen
and sixteen years of age, for whose recovery the attending physician (Dr.
Shute) was most anxious. On leaving the hospital in the evening, the girl
was in collapse, and quite blue; he called the nursetender, and bade her
be attentive to her, and give her whatever she may call for, as all hopes
had vanished. In the course of the night the nurse went to increase the fire
which was near the girl’s berth in the ward; but she begged the woman not
to do so, as she was almost suffocated, and, at the same time, asked for a
drink. The nurse brought her a bowl of tea, which was rejected, but she
requested water. Remembering the doctor’s directions, the nurse, not
without some reluctance and apprehension, brought her a pint mug full of
water, which she drank with avidity; and continued to call for water about
every five minutes, until she had taken two gallons of it; when she fell into
a profound sleep, in which she was found by the doctor in the morning,
when her natural complexion reappeared, and she was, to his
astonishment, in a state of convalescence. Having with amazement
elevated his eyes, exclaiming, ‘this is something like a miracle!’ he called
the nursetender, who related what had taken place; and perceiving the
window open over the patient’s berth, he asked why it was not shut? and
was told by the attendant, that it was left open at the earnest desire of the
girl. The doctor immediately ordered all the windows of the ward to be
opened, the heavy bed covering on the patients to be removed, and
replaced by light rugs; directed that no drink should be given but cold
water, and the result was, that the whole sixteen persons were cured of
cholera; one, however, died of consecutive fever, produced by eating too
much chicken and drinking too much broth whilst convalescent. The case
[32]was reported to the Government Board of Health, then sitting in
London; and similar treatment was pursued by all the medical men in and
about Gloucester with the most complete success. The report, names of
the doctors, and all the correspondence are minutely detailed in the
columns of the Chronicle in the year 1832.

“Need more be offered upon the subject; and yet with such facts upon
record, ‘hot punch’ is now given to the poor patients in the cholera
hospitals in Limerick. Those pious and angelic Sisters of Mercy, to whom
you have alluded in the Chronicle, never, in all probability, heard or read of
the treatment of cholera as above narrated; but ever attentive and
observant as they are in the performance of their hallowed vocation, they
have not been unmindful of the good effects of cold water. Nature prompts
the sufferer to call for it, and it should be always supplied. In cholera, pure
water is balsamic.

“As to the operation of cold water on the human system in cholera, or the
action of the system on water, I will not presume to pronounce; but I may
say that it is commonly supposed that when the serum (one of the
important constituents of the blood) is exhausted by discharges, collapse
takes place, and the livid hue of the countenance follows; and everybody
has heard of the experimental operation of transfusion of warm water,
combined with albumen and soda, into the veins, to supply the absence of
serum, in order to give the vital current its natural and healthy flow:
whether cold water, from the oxygen it contains, and the necessary heat it
is therefore calculated to impart, is taken up rapidly by the absorbents to
cherish and feed the blood, and fill the channels of circulation, so as to
remove collapse in cholera, I shall leave physiologists to determine; but it
is indisputable that cholera patients have anxiously asked for, and eagerly
swallowed, copious draughts of cold water, till their thirst was allayed,
genial warmth restored, agony banished, and the vital functions vivified
and invigorated.” * * * * *

The following extract is taken from Braithnorth’s “Retrospect of


Medicine,” a standard professional work:—

“I am acquainted with three persons, who, after they had been laid out for
dead, on being washed, previous to interment, in the open court-yard, with
water, to obtain which the ice had been broken, recovered in
consequence, and lived many years. I received from Erycroon, in Turkey,
a letter from our excellent Consul, Mr. Brant, who states that Dr. Dixon, of
that place, was then curing more patients by friction, with ice or snow, than
any other treatment. The same practice is reported to have been the most
effectual in Russia.”

We make no comments on the foregoing, leaving the public to draw


their own conclusions from the facts stated. In setting the facts
before them, we feel we have done our duty; we leave the leaven to
work in their minds, and produce its own result on their future
conduct.

In condemning the mistaken administration of hot stimulants, such


as “hot punch,” &c., Dr. Barter proceeds:—

“I never yet saw a patient that did not cry out for cold water; and the
confirmed dram-drinker can, with difficulty, be persuaded to taste his
[33]favourite beverage; he objects more to brandy or punch than the
temperate do; this I have often remarked. I have seen a patient travel for
miles on an open car, through sleet and rain, without any covering, and
drinking cold water on the way, and remarked that he did better than when
treated with brandy, hot tins, &c. In fact, I often saw such patients beg to
be allowed out again, they used to call loudly for cold water. ‘For the love
and honour of God, sir, get us a drink of cold water,’ was no unfrequent
request amongst them, and that pronounced with an earnestness of
manner most truly impressive; but, alas! in 1832, this appeal was always
refused, though in 1849 a step has been taken in a right direction, and it is
allowed, according to the Sisters of Mercy, ‘in small quantities.’ ”
The truth will ere long be acknowledged, that it is our mode of life
that makes us fit subjects for cholera, and that it is our mode of
treating it alone, which makes the disease so dangerous. The wretch
who is cast uncared for in a ditch, exposed to all the inclemency of
the weather, with water alone to quench his burning thirst, has ten
chances to one in favour of his recovery, compared with the well-
cared patient who is dosed with brandy and the favourite specifics of
the apothecary’s shop. If we look at cholera, and divest our minds of
its accustomed mode of treatment, we will find that every symptom
of the disease points to the presence of some highly irritant poison in
the blood; and in the effort to expel this poison, the serum which
contains it, is drained from the system. What, therefore, can be more
rational than to supply the system with the materials of restoration,
by giving water in large quantities, and to stimulate its chemical
combinations by which the caloric of the system shall be restored, by
the influence of fresh air, water drinking, and cold bathing.

Sir Bulwer Lytton thus sums up his impressions of Hydropathy:—

“Those cases in which the water-cure seems an absolute panacea, and in


which the patient may commence with the most sanguine hopes, are—
first, rheumatism, however prolonged, however complicated. In this the
cure is usually rapid—nearly always permanent. 16 Secondly, gout: here its
efficacy is little less startling to appearance than in the former case; it
seems to take up the disease by the roots; it extracts the peculiar acid
which often appears in discolorations upon the sheets used in the
application, or is ejected in other modes. But here, judging always from
cases [34]subjected to my personal knowledge, I have not seen instances
to justify the assertion that returns of the disease do not occur. The
predisposition—the tendency, has appeared to remain; the patient is liable
to relapses, but I have invariably found them far less frequent, less
lengthened, and readily susceptible of simple and speedy cure, especially
if the habits remain temperate.”
If it be asked why Hydropathy has proved itself so effective a remedy
in curing rheumatism, we would answer, on account of its great
power in strengthening and invigorating the stomach and digestive
organs, in the derangement of which, the cause of that disease is to
be found. Rheumatism proceeds from a sluggish circulation in the
extremities, consequent on a low vitality in the system, arising from a
derangement of the digestive organs and viscera; if these latter were
sound and free from irritation, all the cold and wet, we could possibly
be exposed to, would fail to produce that inflammation of the sheaths
of the muscles in which rheumatism consists. That Hydropathy is
capable of strengthening and invigorating these organs, is well
known to all who have tried it, and is even admitted by its greatest
opponents when they state, “Oh! it is good for the general health,” for
it is utterly impossible for the “general health” to be good without a
sound digestion.

With respect to gout, a permanent cure from it is rarely to be found,


and why?—Because few people have either the time or patience to
continue long enough under treatment for its total eradication,
running away from an “establishment” the moment they get relief
from the pressing fit, and consequently the disease recurs. Now, of
all diseases, gout is perhaps the most tedious of permanent cure,
the visceral irritation which gives rise to it being always inveterate
and of long duration, and nothing short of chronic treatment—
treatment continuing for years instead of months, will remove it. Dr.
Gully observes respecting it:—

“It would be folly, however, to avoid a treatment because it will not for ever
root up your disease in your own convenient time. Look at the destructive
manner in which colchicum reduces a gouty fit, how it approximates the
attacks, and utterly disorganizes the viscera; and then regard what the
water cure is capable of doing, both against individual attacks, and in
reduction of the diathesis, the vital parts meanwhile improving under its
operation; … if it does not utterly cure the gout, at least it does not shorten
the patient’s life as colchicum does.”

On the effects of colchicum he, further on, observes:—

“To the patient, and, indeed, to the physician who knows little of
physiology, all this will appear right: the gout is removed, and that is what
[35]was desired. The physician, however, who is a physiologist, will say,
‘True, that irritation which you call gout, has left the extremities, whither it
had been sent by nature to save her noble internal parts. But look to the
signs exhibited by those parts; are they not those of augmented irritation,
at least of irritation of a degree and kind that did not exist so long as the
limbs were pained and inflamed? The fact is, that your colchicum has set
up in the viscera so intense an irritation as to reconcentrate the mischief
within; and the fit is cured, not by ridding the body of the gouty irritation,
but by driving or drawing it in again,’ (thus baffling nature’s efforts at self
relief). ‘Hence the continuance of the dyspeptic symptoms after the fit;
hence, as you will find, the recurrence of another fit ere long, the intervals
becoming less and less, until gouty pain is incessantly in the limbs, and
gouty irritation always in the viscera.’ ”

When the drugging practitioner drives the inflammation from the


extremities to a more dangerous internal position, he congratulates
himself on having cured the gout; but what in reality has he done?—
By his mischievous interference with nature, he has endangered his
patient’s life and shaken his constitution; whilst the gouty irritation,
which causes the complaint, remains unsubdued, ready to be
transferred at a moment to the head or heart, the practitioner having
cleverly banished it from its original harmless position. It is in this
way also that the Allopathist cures skin diseases, driving in the
irritation which nature is struggling to drive out; this he eventually
succeeds in doing, by weakening the powers of the system, and then
fancies the disease is cured, whilst the patient pays in the long run
for these hostile operations against nature.

But we have interrupted Sir Bulwer Lytton,—he thus proceeds:—


“Thirdly, that wide and grisly family of affliction classed under the common
name of dyspepsia. All derangements of the digestive organs, imperfect
powers of nutrition—the malaise of an injured stomach, appear precisely
the complaints on which the system takes firmest hold, and in which it
effects those cures that convert existence from a burden into a blessing.

“Hence it follows that many nameless and countless complaints,


proceeding from derangement of the digestive organs, cease as that great
machine is restored to order. I have seen disorders of the heart which
have been pronounced organic by no inferior authorities of the profession,
disappear in an incredibly short time; cases of incipient consumption, in
which the seat is in the nutritious powers; hæmorrhages, and various
congestions, shortness of breath, habitual fainting fits, many of what are
called improperly nervous complaints, but which in reality are radiations
from the main ganglionic spring: the disorders produced by the abuse of
powerful medicines, especially mercury and iodine; the loss of appetite,
the dulled sense and the shaking hand of intemperance, skin complaints,
and the dire scourge of scrofula;—all these seem to obtain from
Hydropathy relief,—nay, absolute and unqualified cure, beyond not only
the means of the most skilful practitioner, but the hopes of the most
sanguine patient.”

[36]

Nor will the above results form at all a subject for wonder, when it is
remembered that every natural disease arises either from impurity in
the blood or maldistribution of it, and that all the processes of the
water cure, from the Turkish bath down to the wet sheet, act
powerfully as depurators of the blood and controllers of its
circulation,—attracting it here, and repelling it there, at will.

We know not whether the public will prefer the impartial testimony of
an intelligent observer like Sir Bulwer Lytton, to that of the Allopathic
physician, naturally wedded to his own system and anxious to
sustain it against all intruders; but we may observe, that we never
yet met a physician opposed to Hydropathy, who did not, on
catechising him, exhibit the most absurd ignorance respecting it.
Their chronic idea is that of a person being left to shiver in wet
sheets; and, as a consequence, their chronic note of warning,
accompanied by an ominous shake of the head, consists in, “Don’t
attempt the water cure, or it will kill you.” 17 If medical men would but
see, before they assert, then much value might be attached to their
opinion; but what value can be attached to their opinion about a
system which they will not take the trouble of examining into? How
many orthodox physicians have ever visited Blarney, or any similar
Hydropathic establishment?—The proportion of such visitors (and no
one can form a fair idea of the system without seeing it at work), to
the whole profession would be more than represented by an
infinitesimal fraction.

We wonder how long the public will continue to poison 18 their


systems with mercury, colchicum, iodine, and prussic acid, because
a physician chooses to tell them that a mode of treatment which he
has never investigated “will kill them.”

It may not be uninteresting to observe, that under Hydropathic


treatment, chronic disease frequently becomes acute; for, as the
body improves in strength, the more acutely will any [37]existing
disease develop itself, and for the following reason: pain is caused
by an effort of nature to relieve the system of some morbid influence
residing in it, and the stronger the constitution, the greater efforts will
it make to remove that morbid influence, and therefore the greater
will be the pain; but on the other hand, when the body is enfeebled,
its efforts to relieve itself, though continual, are weak and inefficient,
and the disease remaining in the system, assumes the chronic and
less painful form. Now with these facts before them, we have been
amused at hearing physicians observe, in their efforts to decry the
“Water System,” “Oh it is good for the general health, but nothing
more,” a result albeit, which unfortunately the Allopathic system
cannot lay claim to. When speaking thus they do not however reflect
that they are affording the strongest possible testimony in support of
the system which they seek to decry, inasmuch as every
physiologist, from Cape Clear to the Giant’s Causeway, admits the
principle, that the cure of disease is to be sought for in the powers of
the living organism alone; and it must be evident that the more you
strengthen that organism, the more you increase its powers to cure
itself, and diminish its liability to future disease.

Having trespassed thus far on the attention of our readers, we would


conclude by inviting them and the medical profession, generally, to a
calm and dispassionate investigation, as far as the opportunities of
each allow, of the relative merits of the Allopathic and Hydropathic
systems, approaching the investigation, as far as possible, with a
mind devoid of prejudice and bigotry. Their duty to themselves and to
society demands this inquiry at their hands—two antagonistic (we
use the term advisedly) systems are presented for their acceptance
—which will they lay hold of? To assist them in determining this point
we would recommend for their quiet perusal either or all of the works
alluded to in this article, 19 the study of which will be found interesting
and profitable. If they conclude that drugs are wholesome, let them
by all means be swallowed; but if they are proved to be injurious,
deleterious and unnecessary, then away with them;—if opiates are
innocuous let them be retained, but if they congest the liver, sicken
[38]the stomach, and paralyze the actions of the vital organs, the
sooner they are erased for ever from the Hygienic Pharmacopeia the
better—let them gracefully retire before the improved system of hot
stupes, fomentations, and the abdominal compress.

The very simplicity of the processes of the “water-cure,” which


people cannot believe capable of producing the effects ascribed to
them, combined with a belief, ingrained by long habit, in the absolute
necessity for drugs in curing disease, have chiefly militated against a
more extended reception of Hydropathy by the lay public; but when
they reflect that all the powers of the medical art range themselves
under two great categories, stimulants and sedatives—blistering,
bleeding, drugs, and leeching—acknowledging no other objects, they
cannot but admit the possibility of Hydropathy possessing the
powers attributed to it, since its bracing and soothing properties
cannot be questioned. Were, however, the position of affairs
reversed, and Hydropathy become as old a system as the Allopathic
this belief, in the efficacy of the old school might be securely
entertained; for no one would think for a moment of exchanging a
system, fixed, intelligible, and certain in its action, as based on
scientific principles, and consonant with the laws of physiology, for
the uncertain, groping, empirical, and injurious practice of drug
medication.

We would ask the medical profession of Ireland to reflect on the fact,


that Dr. Barter’s establishment at Blarney, contains at this moment
upwards of 120 patients, with many more frequently seeking for
admission within its walls, most of whom leave the establishment
ardent converts to Hydropathy, determined for the rest of their lives
to “throw physic to the dogs,” fleeing from it as from some poisonous
thing. It will not do for them to “pooh-pooh” the system, and tell their
patients, as many of them do, that it will kill them; 20 [39]such language
only betrays ignorance on their part, and will not put down a system
which daily gives the lie to their predictions by affording ocular
demonstration of its efficacy, in the restored health and blooming
cheek of many a once emaciated friend. Men are too sensible now-
a-days to pin their faith on the dictum of a medical man, who runs
down a system without fairly investigating it, and examining the
principles on which it acts, to say nothing of the prejudice he must
feel in favour of his own particular system; but if a mode of treatment
be rational, producing cures where every other system of treatment
has failed, and recommend itself to the common sense and reason
of mankind, we believe that such a principle will make its way
despite of the opposition of all the physicians that ever lived; and this
very progress the water cure is now making.

We would in conclusion apostrophize Hydropathy, in the words of the


American traveller, who gave vent to his feelings on first beholding
the falls of Niagara, by exclaiming, “Well done, Water!!”

1 1. The Water Cure in Chronic Disease. By James M. Gully, M.D. London:


Churchill.
2. The Water Cure. By James Wilson, M.D. London: Trubner and Co.
3. Hydropathy. By Ed. Wm. Lane, M.D. London: Churchill.
4. Confessions of a Water Patient. By Sir E. Bulwer Lytton, Bart, M.P. London: H.
Baillière.
5. An Address to the Public on the Prevention and Treatment of Cholera on
rational principles. Cork: Geo. Purcell and Co.
6. A few Facts forgotten by the Faculty. By S. B. Birch, M.D. London: H. Baillière. ↑
2 Because either they disapprove of whatever is not practiced by themselves, or
they are ashamed to follow new opinions, and to acknowledge when old, the
errors they had imbibed in youth. ↑
3 The ganglionic nerves are those which cover the stomach, and regulate the
digestive organs: they are also called the “Solar Plexus.” ↑
4 The late melancholy case of Mr. Stafford O’Brien is an instance of this injurious
practice; that gentleman was copiously bled, doubtless that he might be the
better enabled, in his so enfeebled condition, to resist the action of a powerful
poison (opium) afterwards administered with deadly effect. We cast no imputation
whatever on the attendant physician in this case, as we believe the treatment
pursued by him was strictly that enjoined by the orthodox school. Yet, if one
wished to destroy life, could they take a surer means of doing it? ↑
5 “The generality of men are not so much accustomed to pursue this or that
course, in consequence of their previous conviction that it is right, as to believe
that it is right, because they have been accustomed to pursue it.”—Archbishop
Whately. ↑
6 We do not pretend to assert, that consumption is curable when organic
disease of the lungs has actually been established, but we maintain that the
disease is perfectly curable in its incipient stages, though not by drugs nor
banishment to a foreign clime. The latter may somewhat prolong the disease, but
will not cure it, unless by accident, when of a very mild form. ↑
7 The temperature and vitality of our bodies depend upon the continued and rapid
combination of oxygen with the oxidizable products of the blood; if the
necessary supply of oxygen be interfered with, the vitality of the system flags, and
disease results. ↑
8 The very name of scrofula points to the origin of the disease, it being derived
from the Latin Scrofa, a pig (quod sues præcipue hoc morbo vexantur. Cels. 5,
38), in allusion to the condition of the skin in those persons in whom a scrofulous
habit has been engendered. It has been proved beyond contradiction that the
partial closure of the pores, which every one suffers from in some degree, is the
chief source of scrofula in all its hideous forms. ↑
9 When blood is overloaded with carbon, and deprived of its necessary supply of
oxygen, the term “veinous” is applied to it. ↑
10 Where consumption has been relieved by residence abroad, the benefit derived
must be attributed to the action on the skin produced by the hot climates to
which the patient is usually ordered, but recovery in this way has been confined to
very mild forms of the disease, and cannot be looked upon as a scientific mode of
treatment; the improved action of the skin deserving to be considered rather as
induced accidentally than by design; as otherwise more attention would have been
paid to so important a matter, and there would have been no necessity for ordering
the patient abroad, as similar results could have been obtained much more easily
and effectually by keeping him at home; the use of the Turkish bath conferring all
the benefits of increased temperature, followed by the tonic effects of cool air and
water, by which the debilitating effects of continual residence in a warm climate are
obviated. ↑
11Dr. Hufeland remarks—“The more active and open the skin is the more secure
will the people be against obstructions and diseases of the lungs, intestines,
and lower stomach; and the less tendency will they have to gastric (bilious) fevers,
hypochondriasis, gout, asthma, catarrh, and varicose veins.” ↑
12The wearing of flannel close to the skin has a two-fold injurious effect:—First, by
driving the blood from the surface, whereby the activity of the skin is seriously
impaired; and secondly, by shutting out the air, and so preventing it from having
access to the blood, to aerate and purify it. ↑
13 By healthy waste, we mean waste accompanied by corresponding renewal. ↑
We have seen consumptive patients arrive at Blarney shivering with cold though
14
swathed in flannels, who before leaving it were able to wear clothing in winter,
under which they previously would have shivered in the hottest day of summer. ↑
15 The great mortality which has attended the Allopathic treatment of cholera,
ought to make us have little compunction in trying something new. There is no
fear, in this case, of our “jumping from the frying-pan into the fire;” we are already
in it—let us quench it. ↑
16 Dr. Russell, a well-known Homœopathic author, appears to give the palm to
Hydropathy in some rheumatic cases. He thus writes: “In regard to rheumatism,
I am inclined to think that there are some varieties of this complaint which utterly
defy all Homœopathic medicines, from the deeply morbid condition of the blood;
and that in these cases a thorough water course, by effecting a rapid and total
renovation of this fluid, might enable our remedies to act more beneficially.”
Contrast this liberality with that of the Allopathic physician. ↑
17 We were told by our physician that the water system would kill us, as we had
“not sufficient reaction to stand it.” Had he, however, understood anything of its
working, he could not have made this observation, as Hydropathy implies cold
water only in those cases to which cold water is suited; and if he had asked Dr.
Barter, he would have told him that the chief thing he had to guard against in
practice, was excessive reaction, instead of the want of it. We ran the gauntlet,
however, and can truly say we never knew what real health was until we did so,
and forswore the use of drugs. ↑
18 The administering of poison to cure disease, is nothing short of a contradiction
of terms; for the word poison, if it means anything, means something injurious
to bodily health, and therefore incompatible with its welfare. We might as well try to
strengthen a man by bleeding him. ↑
19To those who desire a detailed and scientific account of the water cure in a
popular form, we recommend “The Confessions of a Water Patient,” by Sir
Bulwer Lytton; “The Water Cure,” by Dr. Wilson; and “Hydropathy,” by Dr. Lane;
whilst to those desiring a learned, lucid, and most able scientific treatise, we would
suggest “The Water Cure in Chronic Disease,” by Dr. Gully; and “Domestic
Hydropathy,” by Dr. Johnson. ↑
20 A friend of ours was told by a physician in whom many place confidence, that if
he opted to take the Turkish bath, it would kill him. Having, however, read
something on the subject, he went to Blarney, tried the bath, luxuriated in it, and
derived the greatest benefit from its use. We can tell the reader that this physician
at the time he prophesied, had never visited the Blarney bath, nor could he have
known any thing about it, as no description of it had been published at the time.
Under such circumstances an unsophisticated mind would think it more becoming
for him to have said—“I cannot advise you in this matter, as I have not studied the
subject; what you do must be on your own responsibility.” It is such illiberality of
mind as the above—such a want of pursuing truth for its own sake—which has
brought discredit on the medical profession, and loosened its hold on the public. ↑

[Contents]
THE TURKISH BATH. 1

“Come hither, ye that press your beds of down


And sleep not, see him sweating o’er his bread
Before he eats it.—’Tis the primal curse,
But softened into mercy, made the pledge
Of cheerful days, and nights without a groan.”—Cowper.

“Melancholy is overcome by a free perspiration; and cheerfulness, without


any evident cause, proceeds from it.”—Sanctorius.

What is a Turkish bath? Should this question be asked by any of our


readers, we would answer, that it 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 the bath, are
subjected to an even and equal temperature. 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
[40]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, from want of a sufficient
supply of air to the lungs. And further, there is this difference
between the two baths, that in the case both of the vapour-bath and
the vapour-box 2 the pulse is materially raised, whilst in the Turkish
bath the pulse seldom rises above its normal state, which shows that
the circulation is very little affected by it—an all-important fact, which
is thus accounted for:—The normal temperature of the human body,
when in a state of health, is about 98° Faht., a temperature which
cannot be much augmented or diminished without producing
injurious results in the system; but as it is impossible always to
maintain so low temperature about us, Nature has provided, by
means of perspiration, a safety valve, by which the human body is
protected from the evil consequences which would arise from its
exposure to a high temperature—the principle on which she acts
being as follows:—It is a physical law that whenever evaporation
takes place a considerable amount of latent heat, (i.e. heat not
sensible to the thermometer), is absorbed, by which abstraction of
heat the temperature of the body from which the evaporation
proceeds is greatly lowered; but as evaporation consists in the
absorption of vapour by the surrounding air, it is evident that no
evaporation can take place where that air is already saturated with
moisture, and it is also evident that the amount of evaporation will
depend on the dryness of that air. Accordingly, in the Turkish bath,
the air being almost dry, when perspiration takes place it is followed
by a rapid evaporation which cools the body, and prevents its
temperature from rising above a healthful limit; whereas, in the
vapour-bath and vapour-box, the air being saturated, with moisture,
evaporation cannot take place, and consequently as no means for
reducing the high temperature of the body exist, the heat is thrown in
upon the system, raising the pulse, producing feverish headache,
and other symptoms of a highly deranged circulation; whilst a further
derangement arises from an insufficient supply of air to the surface
of the [41]body. In the Turkish bath, again, the system, feeling that it
has an ample supply of air, is not called upon to quicken the
circulation through the lungs in order to obtain an increased supply,
and thus another source of feverish excitement is obviated. These
and other considerations give the Turkish bath the pre-eminence,
longo intevallo, over all other artificial modes 3 yet invented for acting
on the skin by perspiration.

It may be observed that, cæteris paribus, the strength of each


person’s constitution is directly proportional to the quantity of oxygen
which his system is capable of imbibing, for on this the vitality of his
system and the purity of his blood, and therefore his health,

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