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= Hydrotherapy =
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Introduction
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Hydrotherapy, formerly called hydropathy and also called water cure,
is a branch of alternative medicine (particularly naturopathy),
occupational therapy, and physiotherapy, that involves the use of
water for pain relief and treatment. The term encompasses a broad
range of approaches and therapeutic methods that take advantage of the
physical properties of water, such as temperature and pressure, to
stimulate blood circulation and treat the symptoms of certain
diseases.
Various therapies used in the present-day hydrotherapy employ water
jets, underwater massage and mineral baths (e.g. balneotherapy,
Iodine-Grine therapy, Kneipp treatments, Scotch hose, Swiss shower,
thalassotherapy) or whirlpool bath, hot Roman bath, hot tub, Jacuzzi,
and cold plunge.
Hydrotherapy lacks robust evidence supporting its efficacy beyond
placebo effects. Systematic reviews of randomized controlled trials
have constitently found no clear evidence of curative effects, citing
methodological flaws and insufficient data. Overall, the scientific
consensus indicates that hydrotherapy's benefits are not conclusively
greater than those of placebo treatments.
Uses
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Water therapy may be restricted to use as aquatic therapy, a form of
physical therapy, and a cleansing agent. However, it is also used as a
medium for delivering heat and cold to the body, which has long been
the basis for its application. Hydrotherapy involves a range of
methods and techniques, many of which use water as a medium to
facilitate thermoregulatory reactions for therapeutic benefit.
Shower-based hydrotherapy techniques have been increasingly used in
preference to full-immersion methods, partly for the ease of cleaning
the equipment and reducing infections due to contamination. When
removal of tissue is necessary for the treatment of wounds,
hydrotherapy, which performs selective mechanical debridement can be
used. Examples of this include directed wound irrigation and
therapeutic irrigation with suction.
Technique
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The following methods are used for their hydrotherapeutic effects:
* Packings, general and local;
* Hot air and steam baths;
* General baths;
* Treadmills
* Sitz (sitting), spinal, head, and foot baths;
* Bandages or compresses, wet and dry; also;
* Fomentations and poultices, sinapisms, stupes, rubbings, and water
potations.
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".
In some cases, baths with whirlpool water flow are not used to manage
wounds, as a whirlpool will not selectively target the tissue to be
removed, and can damage all tissue. Whirlpools also create an unwanted
risk of bacterial infection, can damage fragile body tissue, and in
the case of treating arms and legs, bring risk of complications from
edema.
History
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The therapeutic use of water has been recorded in ancient Egyptian,
Greek and Roman civilizations. Egyptian royalty bathed with essential
oils and flowers. Romans had communal public baths for their citizens.
Hippocrates prescribed bathing in spring water for sickness. Other
cultures noted for a long history of hydrotherapy include China and
Japan, the latter being centred primarily around Japanese hot springs.
Many such histories predate the Roman thermae.
Modern revival
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Hydrotherapy became more prominent following the growth and
development of modern medical practices in the 18th and 19th
centuries. As traditional medical practice became increasingly
professional, it was felt that medical treatment became increasingly
less personalized. The development of hydrotherapy was believed to be
a more personal form of medical treatment that did not necessarily
present to patients the alienating scientific language that modern
developments of medical treatment entailed.
1700–1810
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Two English works on the medical uses of water were published in the
18th century that inaugurated the new fashion for hydrotherapy. One of
these was by Sir John Floyer, a physician of Lichfield, who, struck by
the remedial use of certain springs by the neighbouring peasantry,
investigated the history of cold bathing and published a book on the
subject in 1702. The book ran through six editions within a few years,
and the translation of this book into German was largely drawn upon by
J. S. Hahn of Silesia as the basis for his book called 'On the Healing
Virtues of Cold Water, Inwardly and Outwardly Applied, as Proved by
Experience', published in 1738.
The other work was a 1797 publication by James Currie of Liverpool on
the use of hot and cold water in the treatment of fever and other
illnesses, with a fourth edition published in 1805, not long before
his death. It was also 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 formed
everywhere to promote the medicinal and dietetic use of water; and in
1804 Professor E.F.C. Oertel of Anspach republished them and quickened
the popular movement by unqualified commendation of water drinking as
a remedy for all diseases.
The general idea behind hydropathy during the 1800s was to be able to
induce something called a crisis. The thinking was that water invaded
any cracks, wounds, or imperfections in the skin, which were filled
with impure fluids. Health was considered to be the body's natural
state, and filling these spaces with pure water would flush the
impurities out, which would rise to the skin's surface, producing pus.
The event of this pus emerging was called a crisis, and was achieved
through a multitude of methods. These methods included techniques such
as sweating, the plunging bath, the half bath, the head bath, the
sitting bath, and the douche bath. All of these were ways to gently
expose the patient to cold water in different ways.
Vincenz Priessnitz (1799–1851)
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Vincenz Priessnitz was the son of a peasant farmer who, as a young
child, observed a wounded deer bathing a wound in a pond near his
home. Over several days, he would see this deer return, and eventually
the wound was healed. Later, as a teenager, Priessnitz was attending
to a horse cart, when the cart ran him over, breaking three of his
ribs. A physician told him that they would never heal. Priessnitz
decided to try his hand at healing himself and wrapped his wounds with
damp bandages. By daily changing his bandages and drinking large
quantities of water, after about a year, his broken ribs had healed.
Priessnitz quickly gained fame in his hometown and became the
consulting physician.
Later in life, Priessnitz became the head of a hydropathy clinic in
Gräfenberg in 1826. He was extremely successful and by 1840, he had
1600 patients in his clinic, including many fellow physicians, and
important political figures such as nobles and prominent military
officials. Treatment length at Priessnitz's clinic varied. Much of his
theory was about inducing the aforementioned crisis, which could
happen quickly or could occur after three to four years. Under the
simplistic nature of hydropathy, a large part of the treatment was
based on living a simple lifestyle. These lifestyle adjustments
included dietary changes such as eating only very coarse food, such as
jerky and bread, and of course, drinking large quantities of water.
Priessnitz's treatments also included a great deal of less strenuous
exercise, mostly including walking. Ultimately, Priessnitz's clinic
was extremely successful, and he gained fame across the western world.
His practice even influenced the hydropathy that took root overseas in
America.
Sebastian Kneipp (1821–1897)
==============================
Sebastian Kneipp was born in Germany, and he considered his role in
hydropathy to be that of continuing Priessnitz's work. Kneipp's
practice of hydropathy was even gentler than the norm. He believed
that typical hydropathic practices deployed were "too violent or too
frequent," and he expressed concern that such techniques would cause
emotional or physical trauma to the patient. Kneipp's practice was
more all-encompassing than Priessnitz's, and his practice involved not
only curing the patients' physical woes, but also emotional and mental
as well.
Kneipp introduced four additional principles to the therapy: medicinal
herbs, massages, balanced nutrition, and "regulative therapy to seek
inner balance". Kneipp had a very simple view of an already simple
practice. For him, hydropathy's primary goals were strengthening the
constitution and removing poisons and toxins in the body. These basic
interpretations of how hydropathy worked hinted at his complete lack
of medical training. Kneipp did have, however, a very successful
medical practice despite, perhaps even because of, his lack of medical
training. As mentioned above, some patients were beginning to feel
uncomfortable with traditional doctors because of the elitism of the
medical profession. The new terms and techniques that doctors were
using were difficult for the average person to understand. Having no
formal training, all of his instructions and published works are
described in easy-to-understand language and would have seemed very
appealing to a patient who was displeased with the direction
traditional medicine was taking.
A significant factor in the popular revival of hydrotherapy was that
it could be practised relatively cheaply at home. The growth of
hydrotherapy (or 'hydropathy' to use the name of the time) was thus
partly derived from two interacting spheres: "the hydro and the home".
Hydrotherapy as a formal medical tool dates from about 1829 when
Vincenz Priessnitz (1799-1851), a farmer of Gräfenberg in Silesia,
then part of the 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.
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.
Spread of hydrotherapy
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Captain R. T. Claridge was responsible for introducing and promoting
hydropathy in Britain, first in London in 1842, then with lecture
tours in Ireland and Scotland in 1843. His 10-week tour in Ireland
included Limerick, Cork, Wexford, Dublin and Belfast, over June, July
and August 1843, with two subsequent lectures in Glasgow.
Some other Englishmen preceded Claridge to Graefenberg, although not
many. One of these was James Wilson, who himself, along with James
Manby Gully, established and operated a water cure establishment at
Malvern in 1842. In 1843, Wilson and Gully published a comparison of
the efficacy of the water-cure with drug treatments, including
accounts of some cases treated at Malvern, combined with a prospectus
of their Water Cure Establishment. Then in 1846 Gully published 'The
Water Cure in Chronic Disease', further describing the treatments
available at the clinic.
The fame of the water-cure establishment grew, and Gully and Wilson
became well-known national figures. Two more clinics were opened at
Malvern. Famous patients included Charles Darwin, Charles Dickens,
Thomas Carlyle, Florence Nightingale, Lord Tennyson and Samuel
Wilberforce. With his fame he also attracted criticism:
Sir Charles Hastings, a physician and founder of the British Medical
Association, was a forthright critic of hydropathy, and Gully in
particular.
From the 1840s, hydropathics were established across Britain.
Initially, many of these were small institutions, catering to at most
dozens of patients. By the later nineteenth century, the typical
hydropathic establishment had evolved into a more substantial
undertaking, with thousands of patients treated annually for weeks at
a time in a large purpose-built building with lavish facilities -
baths, recreation rooms and the like - under the supervision of fully
trained and qualified medical practitioners and staff.
In Germany, France, America, and the UK (especially in Scotland), the
number of hydropathic establishments rapidly increased. 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 about whether the new
method would help minor ailments and benefit the more seriously
injured. Hydropathists 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 (1827-1897) of Berlin, Raljen and Theodor von Jürgensen 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 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.
Hot-air baths
===============
Hydrotherapy, especially as promoted during the height of its
Victorian revival, has often been associated with cold water, as
evidenced by many titles from that era. However, not all therapists
limited their practice of hydrotherapy to cold water, even during the
height of this popular revival.
The specific use of heat was often associated with Victorian Turkish
baths. Inspired by David Urquhart's travel book, 'The Pillars of
Hercules', and with Urquhart’s help, Dr Richard Barter built the first
such bath at his hydropathic establishment near Blarney, Co. Cork,
Ireland in 1856. Urquhart built the first bath open to the general
public in Manchester the following year, and soon baths were being
opened around the whole of the then UK and British Empire. Over 800
such baths were opened in the British Isles between 1856 and the
1970s. Today, only 11 remain open. The Turkish bath 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.
Spread to the United States
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The first U.S. hydropathic facilities were established by Joel Shew
and Russell Thacher Trall in the 1840s. Charles Munde also established
early hydrotherapy facilities in the 1850s. Trall also co-edited the
'Water Cure Journal'.
By 1850, it was said that "there are probably more than one hundred"
facilities, along with numerous books and periodicals, including the
New York 'Water Cure Journal', which had "attained an extent of
circulation equalled by few monthlies in the world". By 1855, there
were attempts by some to weigh the evidence of treatments in vogue at
that time.
By October 1863, Dr Charles Shepard had added a Victorian Turkish
bath, the first in the United States, to his hydropathic Sanitorium in
Brooklyn
Heights. Two years later, Dr Martin L Holbrook opened the first in
Manhattan. They then spread across the country as fast as they did in
the British Isles, making a similar impact on hydropathic practice.
Following the introduction of hydrotherapy to the U.S., John Harvey
Kellogg employed it at Battle Creek Sanitarium, which opened in 1866,
where he strove to improve the scientific foundation for hydrotherapy.
Other notable hydropathic centers of the era included the Cleveland
Water Cure Establishment, founded in 1848, which operated successfully
for two decades, before being sold to an organization which
transformed it into an orphanage.
At its height, there were over 200 water-cure establishments in the
United States, most located in the northeast. Few of these lasted into
the postbellum years, although some survived into the 20th century,
including institutions in Scott (Cortland County), Elmira, Clifton
Springs and Dansville. While none were in Jefferson County, the Oswego
Water Cure operated in the city of Oswego.
Subsequent developments
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In November 1881, the 'British Medical Journal' noted that hydropathy
was a specific instance, or "particular case", of general principles
of thermodynamics. That is, "the application of heat and cold in
general", as it applies to physiology, mediated by hydropathy. In
1883, another writer stated "Not, be it observed, that hydropathy is a
water treatment after all, but that water is the medium for the
application of heat and cold to the body".
Hydrotherapy was used to treat people with mental illness in the 19th
and 20th centuries and before World War II, various forms of
hydrotherapy were used to treat alcoholism. The basic text of the
Alcoholics Anonymous fellowship, 'Alcoholics Anonymous', reports that
A.A. co-founder Bill Wilson was treated by hydrotherapy for his
alcoholism in the early 1930s.
Recent techniques
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A subset of cryotherapy involves cold water immersion or ice baths,
used by physical therapists, sports medicine facilities, and rehab
clinics. Proponents assert that it results in improved return of blood
flow and byproducts of cellular breakdown to the lymphatic system and
more efficient recycling.
Alternating the temperatures, either in a shower or complementary
tanks, combines hot and cold in the same session. Proponents claim
improvement in the circulatory system and lymphatic drainage.
Experimental evidence suggests that contrast hydrotherapy helps to
reduce injury in the acute stages by stimulating blood flow and
reducing swelling.
Society and culture
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The growth of hydrotherapy and various forms of hydropathic
establishments resulted in a form of tourism, both in the UK, and in
Europe. At least one book listed English, Scottish, Irish and European
establishments suitable for each specific malady, while another
focused primarily on German spas and hydropathic establishments, but
including other areas. While many bathing establishments were open all
year round, doctors advised patients not to go before May, "nor to
remain after October. English visitors rather prefer cold weather, and
they often arrive for the baths in May and return in September.
Americans come during the whole season, but prefer summer. The most
fashionable and crowded time is during July and August". In Europe,
interest in various forms of hydrotherapy and spa tourism continued
unabated through the 19th century and into the 20th century, where "in
France, Italy and Germany, several million people spend time each year
at a spa." In 1891, when Mark Twain toured Europe and discovered that
a bath of spring water at Aix-les-Bains soothed his rheumatism, he
described the experience as "so enjoyable that if I hadn't had a
disease I would have borrowed one just to have a pretext for going
on".
This was not the first time such forms of spa tourism had been popular
in Europe and the U.K. Indeed,
in Europe, the application of water in the treatment of fevers and
other maladies had, since the seventeenth century, been consistently
promoted by a number of medical writers. In the eighteenth century,
taking to the waters became a fashionable pastime for the wealthy
classes who decamped to resorts around Britain and Europe to cure the
ills of over-consumption. In the main, treatment in the heyday of the
British spa consisted of sense and sociability: promenading, bathing,
and the repetitive quaffing of foul-tasting mineral waters.
A hydropathic establishment is a place where people receive
hydropathic treatment. They are commonly built in spa towns, where
mineral-rich or hot water occurs naturally.
Several hydropathic institutions wholly transferred their operations
away from therapeutic purposes to become tourist hotels in the late
20th century while retaining the name 'Hydro'. There are several
prominent examples in Scotland at Crieff, Peebles and Seamill amongst
others.
Animal hydrotherapy
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Canine hydrotherapy is a form of hydrotherapy directed at the
treatment of chronic conditions, post-operative recovery, and
pre-operative or general fitness in dogs.
See also
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* Balneotherapy or "bath therapy"
* Colon cleansing
* Destination spa
* Enema
* Finnish sauna
* Halliwick
* Hot spring
* Hot tub
* Mineral spring
* Sebastian Kneipp
* Kneipp facility
* Spa
* Spa bath
* Spa town
* Steam shower
* Thalassotherapy
* Water aerobics
Notes
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a. While the second sense, of water as a form of torture is
documented back to at least the 15th century, the first use of the
term 'water cure' as a torture is indirectly dated to around 1898, by
U.S. soldiers in the Spanish-American War, after the term had been
introduced to America in the mid-19th century in the therapeutic
sense, which was in widespread use. Indeed, while the torture sense of
'water cure' was by 1900-1902 established in the American army, with a
conscious sense of irony, this sense was not in widespread use.
'Webster's' 1913 dictionary cited only the therapeutic sense, 'water
cure' being synonymous with 'hydropathy', the term by which
hydrotherapy was known in the 19th century and early 20th century.
The late 19th century expropriation of the term 'water cure', already
in use in the therapeutic sense, to denote the polar opposite of
therapy, namely torture, has the hallmark of arising in the sense of
irony. This would be in keeping with some of the reactions to water
cure therapy and its promotion, which included not only criticism, but
also parody and satire.
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http://en.wikipedia.org/wiki/Hydrotherapy
