hydrotherapy

hydrotherapy, use of water in the treatment of illness or injury. Although the medicinal and hygienic value of water was recognized by the early Greeks, hydrotherapy attained its widest use in the 18th and 19th cent. through the practice of the British physician Sir John Floyer and an Austrian peasant, Vincenz Priessnitz. Priessnitz is credited with a number of inventions still in use including the sponge bath, the douche, and the wet sheet pack, and he is acknowledged as an important contributor to the rise of the health spa movement in Europe. Scientific hydrotherapy is based on the conduction of heat to or from the body by means of a water medium. Heated water is used for its sedative effect, and hot water vapor is used in controlled situations to relieve pain. Patients who have suffered extensive burns are often immersed in water for long periods. Maintained at skin temperature, i.e., approximately 93°F; (34°C;), the water prevents loss of body heat. Fevers are reduced by cold sponge baths taken on rubber sheets. Whirlpool baths are used to relieve painful muscle and joint conditions, and underwater exercise has proved a useful physical therapy in cases of paralysis and stiffness of the extremities.

External use of water for medical treatment. Wet heat helps relieve pain, improves circulation, and promotes relaxation. Wet cold causes blood vessels to close, reducing swelling and pain after injury. Underwater exercise helps strengthen weak muscles, restore joint motion after injury, clean and heal burned flesh, aid muscle function after stroke, and treat arthritic deformity and pain. Whirlpool baths and showers are also used. Hydrotherapy is usually employed by specialists in physical medicine and rehabilitation.

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Hydrotherapy, formerly called hydropathy involves the use of water for soothing pains and treating diseases.

Its use has been recorded in ancient Egyptian, Greek and Roman civilizations. Egyptian royalty bathed with essential oils and flowers, while Romans had communal public baths for their citizens. Hippocrates prescribed bathing in spring water for sickness. A Dominican monk, Sebastian Kneipp, again revived it during the 19th century. His book My Water Cure in 1886 was published and translated into many languages. The use of water to treat rheumatic diseases has a long history. Today, hydrotherapy is used to treat musculoskeletal disorders such as arthritis, ankylosing spondylitis, or spinal cord injuries and in patients suffering burns, spasticity, stroke or paralysis. It is also used to treat orthopedic and neurological conditions in dogs and horses and to improve fitness.

Historical background

Hydrotherapy in general dates back to ancient cultures from China, Japan (Onsen, Japanese Hot Springs), and most recently to the Thermae (Roman Hot Springs). After an oblivion during the Middle Ages, hydrotherapy was rediscovered during the 18th and 19th century by J.S.Hahn (1696-1773), MD, Vincent Priessnitz, Oertel (1764-1850), and Rausse (1805-1848). In Woerrishofen (south Germany) Sebastian Kneipp developed the systematic and controlled application of hydrotherapy for the support of medical treatment which was delivered only by doctors at that time.

Cold water bathing and drinking

Hydrotherapy as a formal medical tool dates from about 1829 when Vincent Priessnitz, a farmer of Gräfenberg in Silesia, Austrian Empire, began his public career in the paternal homestead, extended so as to accommodate the increasing numbers attracted by the fame of his cures. Two English works, however, on the medical uses of water had been translated into German in the century preceding the rise of the movement under Priessnitz. One of these was by Sir John Floyer, a physician of Lichfield, who, struck by the remedial use of certain springs by the neighboring peasantry, investigated the history of cold bathing and published in 1702 his IvxpoXovoLa, or the History of Cold Bathing, both Ancient and Modern. The book ran through six editions within a few years and the translation was largely drawn upon by Dr J. S. Hahn of Silesia in a work published in 1738 On the Healing Virtues of Cold Water, Inwardly and Outwardly applied, as proved by Experience. The other work was that of Dr James Currie of Liverpool entitled Medical Reports on the Effects of Water, Cold and Warm, as a remedy in Fevers and other Diseases published in 1797 and soon after translated into German by Michaelis (1801) and Hegewisch (1807). It was highly popular and first placed the subject on a scientific basis. Hahn's writings had meanwhile created much enthusiasm among his countrymen, societies having been everywhere formed to promote the medicinal and dietetic use of water; and in 1804 Professor Ortel of Ansbach republished them and quickened the popular movement by unqualified commendation of water drinking as a remedy for all diseases. In him the rising Priessnitz found a zealous advocate, and doubtless an instructor also.

At Gräfenberg, to which the fame of Priessnitz drew people of every rank and many countries, medical men were conspicuous by their numbers, some being attracted by curiosity, others by the desire of knowledge, but the majority by the hope of cure for ailments which had as yet proved incurable. Many records of experiences at Gräfenberg were published, all more or less favorable to the claims of Priessnitz, and some enthusiastic in their estimate of his genius and penetration; Captain Claridge introduced hydropathy into England in 1840, his writings and lectures, and later those of Sir W. Erasmus Wilson (1809 – 1884), James Manby Gully and Edward Johnson, making numerous converts, and filling the establishments opened soon after at Islalvern and elsewhere. In Germany, France and America hydropathic establishments multiplied with great rapidity. Antagonism ran high between the old practice and the new. Unsparing condemnation was heaped by each on the other; and a legal prosecution, leading to a royal commission of inquiry, served but to make Priessnitz and his system stand higher in public estimation.

Increasing popularity soon diminished caution whether the new method would help minor ailments and be of benefit to the more seriously injured. Hydropathists to occupied themselves mainly with studying chronic invalids well able to bear a rigorous regimen and the severities of unrestricted crisis. The need of a radical adaptation to the former class was first adequately recognized by John Smedley, a manufacturer of Derbyshire, who, impressed in his own person with the severities as well as the benefits of the cold water cure, practised among his workpeople a milder form of hydropathy, and began about 1852 a new era in its history, founding at Matlock a counterpart of the establishment at Gräfenberg.

Ernst Brand (1826 – 1897) of Berlin, Raljen and Theodor von Jurgensen of Kiel, and Karl Liebermeister of Basel, between 1860 and 1870, employed the cooling bath in abdominal typhus with striking results, and led to its introduction to England by Dr Wilson Fox. In the Franco-German War the cooling bath was largely employed, in conjunction frequently with quinine; and it was used in the treatment of hyperpyrexia.

The use of heat

The Turkish bath, introduced by David Urquhart into England on his return from the East, and ardently adopted by Richard Barter, became a public institution, and, with the morning tub and the general practice of water drinking, is the most noteworthy of the many contributions by hydropathy to public health.

Until around 1840, hydropathy was not common in the United States although it was popular in Europe in the 19th century. But in "Nature's Cures", Michael Castleman wrote that hundreds of 'water-cures' were located on the countryside during the Civil War.

State of the field at the beginning of the 1900s

The following material is from the 1911 Encyclopedia Britannica and thus represents the state of the field at the beginning of the 1900s.

Forms of hydrotherapy

Packings

The full pack consists of a wet sheet enveloping the body, with a number of dry blankets packed tightly over it, including a macintosh covering or not. In an hour or less these are removed and a general bath administered. The pack is a derivative, sedative, sudorific and stimulator of cutaneous excretion. The trapped body heat causes the patient to be warmed. There are numerous modifications of it, notably the cooling pack, where the wrappings are loose and scanty, permitting evaporation, and the application of indefinite duration, the sheet being rewetted as it dries; this was used to deal with fever. There are also local packs, to trunk, limbs or head separately, which are derivative, soothing or stimulating, according to circumstance and detail.

Hot air baths

Hot air baths or saunas, the chief of which is the Turkish (properly, the Roman) bath, consisting of two or more chambers ranging in temperature from 50°C to 100°C or higher, but mainly used at 66°C for curative purposes. Exposure is from twenty minutes up to two hours according to the effect sought, and is followed by a general bath, and occasionally by soaping and shampooing. It is stimulating, derivative, depurative, sudorific and alternative, powerfully promoting tissue change by increase of the natural waste and repair. It determines the blood to the surface, reducing internal congestions, is a potent diaphoretic, and, through the extremes of heat and cold, is an effective nervous and vascular stimulant and tonic. Morbid growths and secretions, as also the uraemic, gouty and rheumatic diathesis, were believed to be beneficially influenced by it. The full pack and Turkish bath for a while seemed to be replacing the once familiar hot bath. The Russian or steam bath and the lamp bath are primitive and inferior varieties of the modern Turkish bath, the atmosphere of which cannot be too dry and pure.

General baths

General baths comprise the rain (or needle), spray (or rose), shower, shallow, plunge, douche, wave and common morning sponge baths, with the dripping sheet, and hot and cold spongings, and are combinations, as a rule, of hot and cold water.

Local baths

Local baths comprise the sitz, douche (or spouting), spinal, foot and head baths, of hot or cold water, singly or in combination, successive or alternate. The sitz, head and foot baths are used flowing on occasion. The application of cold by Leiters tubes was believed to be effective for reducing inflammation (e.g. in meningitis and in sunstroke); in these a network of metal or indiarubber tubing is fitted to the part affected, and cold water kept continuously flowing through them. Rapid alternations of hot and cold water was believed to have a powerful effect in vascular stasis and lethargy of the nervous system and absorbents, benefitting local congestions and chronic inflammations.

Compresses

Bandages (or compresses) are of two kinds,cooling, of wet material left exposed for evaporation, used in local infiammations and fevers; and heating, of the same, covered with waterproof material, used in congestion, external or internal, for short or long periods. Poultices, warm, of bread, linseed, bran, &c., changed but twice in twenty-four hours, are identical in action with the heating bandage, and superior only in the greater warmth and consequent vital activity their closer application to the skin ensures.

Other

Fomentations and poultices, hot or cold, sinapisms, stupes, rubefacients, irritants, frictions, kneadings, calisthenics, gymnastics, electricity, &c., are adjuncts largely employed.

Effects of modern medicine

Modern medicine's successes, particularly with drug therapy, removed or replaced many water-related therapies during the mid-20th century. Water is now used mostly in physical therapy, as a cleansing agent, and a medium for delivery of heat and cold to the body.

The appliances and arrangements by means of which heat and cold are brought to bear are (a) packings, hot and cold, general and local, sweating and cooling; (b) hot air and steam baths; (c) general baths, of hot water and cold; (d) sitz, spinal, head and foot baths; (e) bandages (or compresses), wet and dry; also (f) fomentations and poultices, hot and cold, sinapism, stupe, rubbings and water potations, hot and cold.

Submersive hydrotherapy

Hydrotherapy which involves submerging all or part of the body in water can involve several types of equipment:

• Full body immersion tanks (a "Hubbard tank" is a large size)
• Arm, hip, and leg whirlpool

Whirling water movement, provided by mechanical pumps, has been used in water tanks since at least the 1940s. Similar technologies have been marketed for recreational use under the terms "hot tub" or "spa".

References

See also

• Finnish sauna
• BullFrog Spa
• Hot tub
• Spa
• Balneotherapy or "Bath Therapy"
• Hydropathic establishment
• Spa bath
• Steam shower
• Thalassotherapy
• Water therapy

External links

• No difference in effectiveness measured between treatment in a thermal bath and in an exercise bath in patients with rheumatoid arthritis
• The effect of hydrotherapy on the incidence of common cold episodes in children: a randomised clinical trial