I’m not much of a student of history, but I’m intrigued by glimpses into the way medicine was practised a few centuries ago. I guess there would be a few people who would be amused to hear that physicians in Ireland were widely known as ‘leeches‘ – presumably because of their expertise in the ancient Galenic practice of blood letting rather than their avaricious nature! The ancient physician went about on horseback carrying around a ‘fer bolg’ or medicine bag, full of herbal remedies.

Among the few remaining physical traces of the physician’s work are the stone ‘sweating houses’ known in Gaelic as Tigh ‘n alluis [Teenollish]. These small one-man huts were built with small entrance portals that people would have had to crawl through. They were dotted around Ireland, often in quite remote rural areas. Quite a few of them are still to be found in remote fields, but I don’t think any have been used for quite some time!

imageA fire would be lit in the hearth inside the sweating house  – using a cart-load of turf – and allowed to burn out leaving the stones hot for the sweating session the following day.

 

A great fire of turf was kindled inside till the house became heated like an oven; after which the embers were swept out; and vapour was produced by throwing water on the hot stones. Then the person, wrapping himself in a blanket, crept in and sat on a bench of sods, after which the door was closed up. He remained there an hour or so till he was in a profuse sweat; and then creeping out, plunge right into the cold water, after emerging from which he was well rubbed till he became warm. After several baths at intervals of some days he usually got cured of Rheumatism

So apparently this sort of treatment was prescribed for people with rheumatism. Sadly we don’t know if there was a secret therapeutic ingredient (although there has been plenty of speculation). I can’t imagine that many of my patients would agree to trudge up the hill, undress and crawl through a tiny entrance into a very rough sauna before struggling out and jumping in the local pond! My ancestors were clearly made of hardy stuff!

sauna_cabinI got to thinking about whether or not there had been some studies that have looked at sauna treatment for rheumatoid arthritis or AS. I know that there is a strong tradition of spa therapy (Balneotherapy) for arthritis and there may be weak evidence of benefit – but what about dry heat? A small pilot study into the potential benefits of an ‘infrared sauna’ for treating RA and AS was published in 2008 by Oosterveld et al. They used an infrared sauna cabin similar to the one pictured and found that although patients felt less pain and stiffness during the sauna, the benefits in pain and stiffness were not sustained. Of course, the study did not include the post-sauna dip into an ice cold Irish peat bog puddle – which could well have been the secret ingredient! I note, with approval, the authors’ use of stiffness as an outcome and their use of the little used EPM-ROM scale for quantifying range of movement. Sadly, there was no sustained improvement in pain or stiffness or range of movement.

So, do you think that the ancient Irish physicians were right about the benefits of the sweating house – or can you prove them wrong?

Philip Gardiner

Wannabe Irish Leech-Doctor
(in search of a sweating house and some good hungry leeches!)


Further reading: A Social History of Ancient Ireland http://www.libraryireland.com/SocialHistoryAncientIreland/II-XIV-4.php

Isomäki H (1988) The sauna and rheumatic diseases. Ann Clin
Res 20:271–275
Nurmikko T, Hietaharju A (1992) Effect of exposure to sauna heat
on neuropathic and rheumatoid pain. Pain 49:43–51

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