Dr. Lewis describes the following
hydrotherapy procedures most of which are best used
in conjunction with other treatments to enhance recovery, while some
may be used alone. Please use discretion and consult your physician
if you have questions about your condition or the appropriateness of
these treatments for you.
Cold Compresses
Description
An application that is
applied cold and restored as it warms. It is generally applied as a
cold cloth wrung from ice water (not usually as cold as an ice pack).
Purpose
Cold compresses are
commonly used where it is beneficial to force blood from an area or
to prevent its accumulation. (Such an accumulation might cause
congestion which might then cause pain or discomfort.) They may also
be applied to relieve heat in an affected part.
Uses
To reduce a minor
inflammatory reaction, to relieve or prevent headache accompanying
fever, following a hot application to stimulate blood flow.
Materials
A cloth of appropriate
size to cover the area to be treated (terry cloth face, hand, or
bath towel) and a basin of ice water.
Procedure
Wring a cloth of
appropriate size from ice water and apply to the area to be treated.
Restore as necessary to keep the cloth cold or for the comfort of
the person treated.
Cold Friction Rub
Description
A cold application
with friction.
Purpose
The cold friction rub
is very stimulating and increases the function of the various
organs.
Uses
Immune stimulation (very
useful in chronic
fatigue syndrome, upper respiratory infections, pneumonia, etc.); to
stimulate blood flow into an area to enhance healing.
Materials
Ice water bath; terry
cloth towel or mitten.
Procedure
The patient is prepared
with a heating process (see also Hot Packs, Immersion Baths, Steam/Sauna,
Hot Blanket Packs, and Sprays/Showers sections of this chapter).
Briskly rub the area to be treated with the cold, wet cloth until
the skin turns pink. Wrap up and stay warm.
Variations
This treatment may be
applied to the trunk (front and back) when treating general
conditions or it may be applied to a small area or extremity when
treating specific conditions.
Constitutional Hydrotherapy
Description
An application of
first hot then cold to the trunk, front and back.
Purpose
The treatment is useful
to balance body functions, strengthen the immune system, and promote
healing.
Uses
Constitutional hydrotherapy
is useful in the treatment of, or as an adjunct to, the treatment of
any condition. It is perhaps most useful in the treatment of acute
conditions such as upper respiratory infections, bronchitis, asthma,
the stomach flu, and in chronic
conditions such as irritable bowel, ulcerative colitis, premenstrual
syndrome, and arthritis. (When in doubt, try constitutional
hydrotherapy.)
Materials
A bed or treatment
table, one double sheet folded end to end (or two twin sheets), two
wool blankets (or acrylic), three bath towels (a small bath towel is
best, one that when folded in half reaches side to side across the
patient and from shoulders to hips), one hand towel, and a source of
hot and cold water.
Procedure
This is a version of
the constitutional hydrotherapy treatment used by naturopathic
physicians. It has been simplified for use at home.
Have the patient undress to the waist and
lie face up between the sheets, under one blanket.
Place two hot, folded bath towels (four
layers) on the patient's trunk, shoulders to hips, side to
side.
Cover with sheet and one blanket, and leave
on five minutes.
Return with one hot bath towel and one cold
hand towel.
Place the new hot towel on top of two old
towels and flip all three towels. Remove the two old hot
towels leaving the new hot towel in place. Place the cold
towel on top of the new hot towel and flip again. Remove the
hot towel leaving the cold in place.
Cover the patient and add an extra layer of
blanket. Leave ten minutes or until the cold towel is well
warmed.
Remove the towel.
Have the patient roll over, face down.
Repeat steps applying the towels to the
patient's back.
Variations
The contrast may be
narrowed (not as hot or cold) for the very ill or weak patient or
may be pushed to the hot for sedation or to cold to tonify and
strengthen.
If using the patient's bed, take care not to get it wet.
Hot water from the tap is usually hot enough. The hot towel
should be hot enough that it's just possible to wring it out.
The cold towel should be quite cold (use ice water), but wring
it out thoroughly and use only one layer.
If the patient has trouble warming the cold towel, massage the
back (through the blankets and towel) and feet.
Patients with asthma often react negatively to cold
applications on the chest. For these persons, begin with a
smaller cold towel applied to the abdomen only. With later
treatments, gradually increase the size of the cold towel until
you're able to cover the entire chest and abdomen without any
negative reaction.
Contrast Applications
Description
An application of
alternating hot and cold generally applied as three to four minutes
hot followed by thirty to sixty seconds cold, repeated three to five
times. It may be applied with hot and cold compresses or with
immersion.
Purpose
Contrast applications are
the most effective for increasing blood flow through an area. This
aids in removing wastes that accumulate in areas of inflammation
and helps bring nutrients and oxygen into those areas. It is also
known to increase the functional activity of the organs that are in
reflex relationship to the areas of skin being treated (e.g.,
contrast applied to the skin over the liver will increase the
functional activity of the liver itself). Whole body contrast
treatments have been shown to be effective in stimulating immune
function.
Uses
Contrast hydrotherapy is the
appropriate treatment to follow ice in acute
injuries. Once the acute phase is over (usually twenty-four to
thirty-six hours), ice should be discontinued and contrast begun.
Contrast is useful in postacute, subacute, and chronic
cases of tendinitis, bursitis, arthritis, as well as local
infections such as otitis, mastitis, urethritis, or even many
infected wounds.
Materials
Hot and cold compresses
(terry cloth hand, face, or bath towel), or basin of hot and cold
water for immersion.
Procedure
Apply hot compress to,
or immerse the affected part in hot water (approximately 110 degrees
Fahrenheit) for three to four minutes. Follow with cold (ice water)
for thirty to sixty seconds (not longer, the effects of short cold
are desirable here). Repeat three to five times; always end with
cold.
Variations
Chemical hot packs and
gel cold packs may be used if desired, but wet hot and cold
applications are more effective and more readily available. Hand
towels and face cloths are readily available and may be adequately
heated from hot tap water and cooled from a basin of ice water.
Enema/Colon Irrigation
Description
An irrigation of the
large bowel using a small amount of water or solution.
Purpose
To aid in, and encourage,
elimination from the bowel.
Uses
Used in detoxification
from chemical exposure or abuse, to relieve constipation.
Materials
Enema bag (fountain
syringe) available at most pharmacies, sea salt, baking soda, and
lubricant (hand lotion, surgical lubricant, vegetable oil).
Procedure
Prepare enema solution
of one tablespoonful of sea salt and one tablespoonful of baking
soda per quart of water, at about 98 degrees Fahrenheit. Place
solution in enema bag and place bag about three feet above the
patient. Lubricate the anus and the enema tubing. Insert the tubing
just past the inner sphincter (about one and a half to two inches),
and hold in place. Release the valve to allow the solution to enter
the colon. Introduce the solution slowly and don't try to take too
much (about one pint is usually adequate at one time). Hold the
solution for a few minutes before releasing into the toilet. Repeat
the procedure several times during each enema.
Variations
It is possible to take
the enema while lying on the floor or sitting on the toilet. Choose
which is most comfortable for you.
Often it is useful to stand and walk or massage the abdomen
after taking a small amount of solution and before releasing
into the toilet.
If there is spasm and tension in the bowel, warmer water (about
102 degrees Fahrenheit) will often help relax the bowel.
If the bowel is weak and flaccid, colder water may help to
strengthen it. (Use water at about 75 to 80 degrees Fahrenheit.)
The use of large amounts of solution introduced at once into
the bowel during frequent enemas may cause the bowel to become
stretched. To avoid this, remember to introduce the smallest
amount of solution necessary to produce results.
It is possible to use water without salt and baking soda. It
is also possible to use other solutions for other effects.
Heating Compresses
Description
A heating compress is
a cold application that is left in place for a long period of time.
It is heated by the body and so becomes a hot application.
Purpose
The heating compress
requires an active response from the body and therefore stimulates
increased metabolic and healing activity in its vicinity.
Uses
Because it encourages blood flow
into an area, it can be used to reduce congestion in another
area. (Wet socks may be used to reduce congestion headaches,
sinus congestion, and lung congestion.) Its tendency to bring
blood into an area makes it useful for chronic
joint pain or chronic bronchitis. It may be used in acute
and chronic sore throats, tonsillitis, and ear infections. A
whole body treatment may be achieved by the use of the wet sheet
pack.
Materials
One pair light cotton
socks, one pair heavy wool or acrylic socks, or a light-weight
cotton fabric cut in width and length to wrap around the area to be
treated (joint, neck). You will also need a wool cloth, cotton tee
shirt, or wool sweater to cover the body.
Procedure
The wet sock treatment
is especially useful in treating children with upper respiratory
infections. Before bedtime, wring a pair of cotton socks in ice
water, pull over feet, and cover with wool socks; leave in place
overnight. By morning the socks should be warm and dry.
Variations
Knees, ankles, elbows,
and wrists may easily be treated by wrapping the area with a cotton
cloth wrung from cold water. (One or two layers are adequate.) Then
cover with wool and leave several hours until quite warm (overnight
is easiest). Throat conditions may be treated the same way.
Shoulders and hips may also be treated this way but will require
more creative wrapping techniques.
You can also use a chest pack. By far the
easiest way to make one is to use a cotton tee shirt. Wring the
shirt in ice water, pull it on, and cover yourself with a wool
sweater. Leave in place overnight.
Hot Blanket Packs
Description
A hot blanket pack
with a hot water bottle or electric heating pad.
Purpose
To produce a mild increase
in body temperature.
Uses
The hot blanket pack may be
used to produce hyperthermia
for immune stimulation or detox. It may also be used to prepare for
cold applications (see also Wet Sheet Packs, Cold Friction Rub, and
Sprays/Showers sections of this chapter).
Materials
A dry sheet, two wool or
acrylic blankets, two hot water bottles (or an electric heating pad),
and a cold compress.
Procedure
Lay out two blankets
with a dry sheet covering them. Have the patient undress and wrap in
the sheet. Place one hot water bottle on the abdomen and one at the
feet. (Or place the electric heating pad on the abdomen.) Mop the
face with the cold compress as needed. Leave the patient in the pack
for twenty to sixty minutes depending on the amount of heating
desired.
Variations
A hot half-pack may be
used where it is desirable to heat only the lower half of the body.
In this case wrap only from the waist to the feet with a hot water
bottle or heating pad between the legs. This treatment is milder
than the hot foot bath and may be used with people who have
peripheral vascular diseases or loss of peripheral sensations.
Consult your physician.
Hot Packs
Description
A hot application
used to warm a local area.
Purpose
To relieve muscle spasms,
produce local hyperthermia, encourage local blood flow, or relieve
pain.
Uses
To relieve muscle spasms from
various causes, to bring out local infections, or to prepare for
cold applications.
Materials
Commercially available
chemical hot packs or towels soaked in hot water from the tap (or
heated in the microwave).
Procedure
Prepare hot packs to
about 120 degrees Fahrenheit. Place two to three layers of toweling
over the area to be treated. Place the hot pack on the toweling and
cover. If the pack gets too hot for comfort, add additional layers
of toweling as needed. Leave the pack in place five to twenty
minutes depending on the time needed to obtain the desired effect.
Packs may need to be restored if they cool too much. Follow with a
short cold application when done (thirty seconds). Local redness and
perspiration will occur.
Variations
Towels may be wrung
from tap water at a temperature that will allow them to be placed
directly on the skin. If the desired effect requires that they stay
in place for more than five minutes, they should be renewed
frequently so that they stay warm.
Never apply toweling that has been heated in a
microwave directly to the skin. Microwave heating often creates hot
and cold spots, so you may not be aware of an area that is too hot.
In general, hot packs wrung from hot tap water are the safest. If
you can wring them out with your hands, they're not likely to be hot
enough to cause burns.
Hyperthermia
Description
A local or whole body
treatment intended to raise the temperature of the tissues (also
called artificial fever).
Purpose
To destroy heat sensitive
organisms (viruses, bacteria, etc. that are sensitive to increases
in body temperature), to enhance immune function and to encourage
elimination of toxic material from the body.
Uses
Hyperthermia
may be very useful in the adjunct treatment of various infectious
diseases ranging from upper respiratory infections to pneumonia,
from influenza to AIDS. It is also very useful in helping to
eliminate toxic material from the body by encouraging sweating. In
addition, it has been used in the treatment of many different types
of cancer.
Materials
A hot tub or deep hot
bath at 103 to 104 degrees Fahrenheit, or a hot blanket pack, or
steam/sauna bath; a basin of ice water and terry cloth towel; and
drinking water.
Procedure
Hyperthermia treatments
may safely be done by immersing the body in hot water (103 to 104
degrees Fahrenheit) for up to sixty minutes at a time. Maintain the
bath temperature for the entire time. To prevent a headache, apply
cold to the head during treatment. Liberal use of cold water is
advised. Begin early in the treatment and a headache can be
prevented. (It is much more difficult to get rid of a headache than
to prevent one.) Check the oral temperature every ten to fifteen
minutes. If the oral temperature exceeds 104 degrees Fahrenheit,
cool the bath and apply more cold to the head. Following the
treatment, rinse in a cool shower. Then wrap up and stay warm.
Variations
If a bath or hot tub is
not available, it is possible to heat the body in a steam or sauna
bath. The hot blanket pack may also be used to raise body
temperature. Local hyperthermia
may be achieved by the use of hot packs or through the inhalation of
steam. When inhaling steam for upper respiratory illness, avoid
inhaling the steam deeply into the lungs.
Hotter water can generally be tolerated for short periods, but
it may cause an increase in body temperature that occurs too
quickly. This may cause the treatment to be ended soon and leave
the patient feeling uncomfortable.
Consult your physician before doing this treatment if you have
any of the following: high or low blood pressure, serious
illness, diabetes mellitus, multiple or muscular sclerosis.
Do not use this treatment if you are or may be pregnant.
Watch for signs of hyperventilation. These include numbness
and tingling in the lips, hands, or feet. If hyperventilation
occurs, reduce the bath temperature; breathe from the abdomen,
not the chest; or breathe into a paper bag until the tingling
passes.
Stand slowly after finishing the treatment and be careful in
the shower for the cool rinse.
Having an attendant near or at hand may be a good idea for the
first few times the treatment is done.
Ice Packs
Description
A very cold
application using ice or gel packs.
Purpose
To reduce
swelling, inflammation, pain, or reduce congestion.
Uses
To relieve swelling and inflammation
from acute
injuries and conditions such as sprained ankles, blows, crushing
injuries, tendinitis, and bursitis. To reduce congestion from
vasodilation.
Materials
Commercially available
cold pack, crushed ice in bag, bag of frozen vegetables, ice cubes,
frozen paper cup of water, or ice water bath.
Procedure
Apply a cold pack to the
affected part twenty minutes out of every hour for the first
twenty-four to thirty-six hours after acute injury, depending on the
severity.
Variations
An immersion bath may
be used if more convenient (e.g., an ankle sprain). Add ice to a
basin of water and immerse the affected part as in one above. (The
disadvantage with immersion is that it is difficult to elevate a
part that is immersed in a water bath.)
In the case of an acute tendinitis or muscle
spasm, it may be useful to rub the area with an ice cube or frozen
cup. Rub vigorously over the painful area until a feeling of burning
occurs and the area begins to feel numb (usually about ten to twelve
minutes). This may be repeated hourly in acute cases.
Immersion Baths
Description
A bath in which all or
part of the body is immersed in water. It may be used for contrast
or for the effects of hot or cold alone.
Purpose
Immersion may be the easiest way to
apply hydrotherapy to the body either because of the irregularity of
a part like a hand or foot or if a large area is to be covered. It
may be useful in cases of edema
to provide pressure to force fluid back into circulation. Water is
also a powerful solvent and may dissolve and remove "toxic"
materials from the body through the skin.
Uses
Extremities may be treated in
the immersion bath for any of the various effects of hot, cold, or
contrast. Chemicals may be added for various effects such as Epsom
salt for its anti-inflammatory
and "drawing" effects. Full immersion baths may be given
to produce a hyperthermia
response (artificial fever), for the relaxing and sedative effects
of a neutral bath, to relieve sore muscles, to "detoxify,"
or for the stimulation of a cold plunge.
Materials
A basin (or two for contrast) large enough to accommodate the part to be
immersed,
filled with hot or cold water (or one of each), plastic wastebaskets
are often the best for a foot, leg, or arm. A double-bowl kitchen
sink may also serve. A hot tub, whirlpool bath, or bathtub may serve
for full immersion when needed.
Procedure
For a local application,
cover the part entirely. The hot bath may be approximately 110
degrees Fahrenheit. The cold should be ice water. Most conditions
respond best to contrast unless within the first twenty-four to
thirty-six hours of an acute
inflammatory condition (see also Contrast Applications section of
this chapter). Epsom salt may be added to the hot bath if desired,
generally one-quarter to one-half pound per gallon, for its
anti-inflammatory action.
Variations
A full immersion bath
may be useful in promoting a fever (see also Hyperthermia
section of this chapter), for the relief of sore, aching muscles, or
to aid in "detoxification." For the latter two, soak in a
tub (102 to 104 degrees Fahrenheit) fifteen to twenty minutes and
follow with short cold plunge or shower. (Epsom salt may be added,
one-quarter to one-half pound per gallon.)
In cases of insomnia, anxiety, or
nervousness, a
neutral bath (97 degrees Fahrenheit) may be taken for anywhere from
thirty minutes to several hours. Do not follow with cold.
A cold plunge may be useful after exercise or
after any whole body hot application.
Sitz Baths
Description
A bath in which the
pelvis is immersed in hot and/or cold water.
Purpose
To provide the benefits of
hot, cold, or contrast to the pelvic organs.
Uses
May be used in infections of the
bladder, prostate, or vagina; hemorrhoids; menstrual problems; or bowel
problems such as anal fissures, colitis, diverticulitis, or other
inflammatory bowel diseases. Cold sitz alone may be used to tonify
the pelvic musculature in cases of bladder or bowel incontinence or
prolapse.
Materials
One (or two) basins
adequate to sit in such that water will cover up to the level of the
navel, or bathtub of water filled to reach the level of the navel
and a basin of ice water and bath towel if needed for contrast
treatment.
Procedure
Warm soaks alone may be
useful for the treatment of local anal or vaginal irritation.
Hemorrhoids and anal fissures may be treated by soaking in a warm
bath for ten to fifteen minutes. Other conditions will respond
better to contrast. Use one tub of hot water (about 110 degrees
Fahrenheit) and one tub of ice water. Follow directions as for
contrast applications; three to four minutes hot, thirty to sixty
seconds cold, repeated three to five times. Always end with cold.
Variations
If two tubs are not
available, the following is very effective. Sit three to four
minutes in a hot half-bath (water up to the level of the navel in a
bath tub), then stand in the hot water and pull a cold towel between
the legs and over the pelvis in the front and back. Hold in place
thirty to sixty seconds, then sit back into the hot bath. Repeat as
with contrast three to five times. End with cold
Sprays/Showers
Description
A hot or cold spray of
water from a hose or shower.
Purpose
Hot-to prepare for cold;
cold-to stimulate and increase function.
Uses
Contrast showers-to improve
immune function; cold sprays-to increase organ function or stimulate
the nervous system.
Materials
A household
shower, and
a hose attached to a faucet or bathtub filler spout.
Procedure
For general immune
stimulation follow a hot cleansing shower with a two-minute cold
rinse.
Variations
Following a hot shower
(or other heating application), a cold spray on each side of the
spine is very stimulating and invigorating. A gentle cold spray over
mild varicose veins
(without preheating) may help to tone the veins.
Precautions/Special
Considerations
Don't use a strong spray over varicose veins. Cold showers and
sprays may be approached gradually, starting with cool and working
gradually to all cold.
Steam/Sauna
Description
A full-body
application of heat in a humid environment.
Purpose
To increase body
temperature and/or promote sweating.
Uses
May be used to prepare for
cold applications (see also Contrast Applications, Wet Sheet Packs,
and Sprays/Showers sections of this chapter), to produce an
artificial fever, or to encourage the breakdown and elimination of
"toxic" material.
Materials
Steam room, steam cabinet, sauna.
Procedure
No more than fifteen to
twenty minutes should be spent in a steam room or sauna where it is
necessary to breathe hot air or steam. This is due to the fact that
hot air, moist or dry, reduces the ability of the lungs to exchange
oxygen and carbon dioxide. It may be preferable to work your way up
to the longer times. Begin with three to four minutes in the hot
environment then exit and do a cool rinse. Gradually increase your
time in the heat and increase the degree of cold water for the rinse.
It may be useful to take a basin of ice water and a cloth into the
steam room to apply cold to the head and face. This may reduce the
tendency to headache that can occur with whole-body heating.
Variations
Where available, a
Russian steam room or steam cabinet is preferable. This is a room or
cabinet that allows the head to be outside the hot environment. This
allows the patient to breathe room temperature air and an attendant
may easily apply cold compresses to the face and head. It is
possible for a person to remain in this environment for a much
longer period of time. Treatment times of up to sixty minutes may be
achieved depending on the tolerance and response of the patient.
Prolonged applications of heat may encourage
hyperventilation. If there is any evidence of tingling in the lips,
fingers, or toes treatment should be discontinued and a cold rinse
applied.
A headache is a common side effect to prolonged
heating that may occur immediately or some time following the
treatment. Most headaches can be avoided by applying cold to the
head and face during treatment. It is probably not possible to
overdo the use of cold in this way.
Wet Sheet Packs
Description
A full-body wrap in a
cold wet sheet. The treatment progresses in three phases: cold or
cooling, neutral, and heating.
Purpose
To stimulate, relax, or
detoxify depending on phase.
Uses
The treatment is stimulating
and tonifying if it is stopped before the sheet is warmed (first
phase). There are easier ways to achieve this stimulation and
therefore it is rarely used this way. However, the cold application
is useful to control a fever that is rising too rapidly or is too
high.
The neutral phase is useful to relax and sedate.
The final phase of heating is commonly used to
aid in cleansing through the skin. It promotes sweating and
elimination and is therefore useful in detoxifying from
environmental or chemical exposure or from drug, alcohol, or tobacco
use.
Materials
A bed or treatment table,
wool blankets (one to three may be needed), pillows (two-one for the
head, one for under the knees), a cotton (poly/cotton) sheet soaked
in ice water, a terry cloth bath towel, and a terry cloth hand towel.
Procedure
Lay out one
blanket with a pillow for the head and one to support the knees.
The blanket should be high enough to fold over the shoulders of
the patient.
Thoroughly wring the sheet from ice water and lay it out over
the blanket.
Have the patient undress and lie down on the center of the wet
sheet and pull the far half over themselves.
Return and arrange the sheet by pulling the far half under the
arms and around the far leg. Have the patient place the arms in
a comfortable position across the abdomen. (If the patient is
claustrophobic, one arm may be left out.) Wrap the near half of
the sheet over the shoulders, arms, and around the near leg.
Next, bring the blanket across the patient, draping it over the
shoulders. Any extra length of wet sheet should be folded up
over the blanket.
Add extra layers of blanket to hold in heat produced by the
patient to warm the sheet. (If the treatment is used to reduce
fever, extra blankets are not needed.)
If general detoxification
is desired, leave the patient in the wet sheet until profuse
sweating has occurred and as long as he or she tolerates. This
may require two to four hours or more. The heating/detoxifying
stage will be reached sooner if the patient has undergone some
sort of heating before getting into the wet sheet pack (exercise,
hot shower, hot tub, etc.).
Variations
If the relaxing effects
of the neutral phase are desired, the patient should be removed from
the pack before he or she begins to perspire. A warm (not hot)
shower following is acceptable.
If the tonifying, fever-reducing effects are
sought, remove the patient as soon as he or she begins to heat the
sheet. It may be appropriate and necessary to restore the cold wet
sheet one or more times to reach the desired effect of the cold.
Hot drinks such as hot ginger tea will promote sweating.
However, don't burn the patient (test the temperature of the
drinks first) and don't give too much fluid. The need to urinate
could end the treatment too soon if too much fluid is given.
Water to drink may be necessary during the elimination phase.
The bath towel may be used to cover the patient's head and
eyes to enhance the heating phase and shade the eyes.
The hand towel may be used as a cold compress and to mop the
patient's face once perspiration begins in the elimination phase.
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