Water

Hydrotherapy is a well-known and ancient form of therapy. Many books have been written on the subject but in my opinion the form of hydrotherapy suggested by Kuhne is simple and effective. Kuhne's book on nature cure is very popular in India. It has been translated in several languages of India. Andhra has the greatest number of Kuhne's followers. He has written a good deal about diet as well, but here I wish to confine myself to his experiments in hydrotherapy.

Hip bath and sitz bath are the most important of Kuhne's contributions to hydrotherapy. He has devised a special tub for use though one can do without it. Any tub thirty to thirty- six inches long according to the patient's height generally serves the purpose. Experience will indicate the proper size. The tub should be filled with fresh cold water so that it does not overflow when the patient sits in it. In summer the water may be iced, if it is not cold enough, to give a gentle shock to the patient. Generally, water kept in earthen jars overnight answers the purpose. Water can also be cooled by putting a piece of cloth on the surface of the water and then fanning it vigorously. The tub should be kept against the bathroom wall and a plank put in the tub to serve as backrest. The patient should sit in the tub keeping his feet outside. Portions of the body outside water should be kept well covered so that the patient does not feel cold. After the patient is comfortably seated in the tub, gentle friction should be applied to his abdomen, with a soft towel. This bath can be taken for five to thirty minutes. When it is over, the body should be rubbed dry and the patient put to bed.

Hip bath brings down the temperature in high fever and given in the manner described above it never does any harm, and may do much good. It relieves constipation and improves digestion. The patient feels fresh and active after it. In cases of constipation, Kuhne advises a brisk walk for half an hour immediately after the bath. It should never be given on a full stomach.

I have tried hip baths on a fairly large scale. They have proved efficacious in more than 75 cases out of 100. In cases of hyperpyrexia, if the patient's condition permits of his being seated in the tub, the temperature immediately invariably falls at least two to three degrees and the onset of delirium is averted.

The rationale of hip bath, according to Kuhne is this. Whatever the apparent cause of fever, the real cause in every case is one and the same, i.e., accumulation of waste matter in the intestines. The heat generated by the putrefaction of this waste matter is manifested in the form of fever and several other ailments. Hip bath brings down this internal fever so that fever and other ailments which are the external manifestations thereof subside automatically. How far this reasoning is correct I cannot say. The specialty of Nature Cure methods lies in the fact that being natural, they can be safely practised by laymen. If a man, suffering from headache, wets a piece of cloth in cold water and wraps it round his head, it can do no harm. The addition of earth to cold water enhances the utility of the cold pack.

Now about the sitz or friction bath. The organ of reproduction is one of the most sensitive parts of the body. There is something illusive about the sensitiveness of the glans penis and the foreskin. Any way, I know not how to describe it. Kuhne has made use of this knowledge for therapeutic purposes. He advises application of gentle friction to the outer end of the external sexual organ by means of a soft wet piece of cloth, while cold water is being poured. In the case of the male the glans penis should be covered with the foreskin before applying friction. The method advised by Kuhne is this: A stool should be placed in a tub of cold water so that the seat is just about the level of the water in the tub. The patient should sit on the stool with his feet outside the tub and apply gentle friction to the sexual organ which just touches the surface of the water in the tub. This friction should never cause pain. On the contrary the patient should find it pleasant and feel rested and peaceful at the end of the bath. Whatever the ailment, the sitz bath makes the patient feel better for the time being. Kuhne places sitz baths higher than hip baths. I have had much less experience of the former than of the latter. The blame, I think, lies mostly with myself. I have been lax. Those whom I advised sitz bath, have not been patient with the experiment, so that I cannot express an opinion on the efficacy of these baths, based on personal experience. It is worth a trial by every one. If there is any difficulty about finding a tub, it is possible to pour water from a jug or a lota and take the friction bath. It is bound to make the patient feel rested and peaceful.

A few words about wet sheet packs will not be out of place. It is very useful in pyrexia and insomnia. The method of giving wet sheet packs is this. Spread three or four thick broad woollen blankets on a cot and on top of them a thick cotton sheet dipped in cold water with the water wrung out. The patient lies flat on the wet sheet with his head resting on a pillow outside the sheet. The wet sheet and the blankets are wrapped round the patient covering the whole body except the head which is covered with a damp towel treated after the manner of the wet sheet. The sheet and the blankets are wrapped round the patient, so that outside air cannot get inside. Though the patient feels a gentle shock when first laid in the wet sheet pack, he finds it pleasant afterwards. In a minute or two he begins to feel warm, unless the fever has become chronic, in about five minutes it begins to come down with sweating. In resistant cases I have kept the patient wrapped in the wet sheet pack up to half an hour. This has finally resulted in sweating. Sometimes, there is no sweating, but the patient goes off to sleep. In that case, he should not be awakened. The sleep indicates that the wet sheet pack has produced a soothing effect and he is quite comfortable. The temperature invariably falls at least by one or two degrees as a result of the wet sheet pack.

Wet sheet packs are also useful in the treatment of prickly heat, urticaria, other forms of skin irritation, measles, smallpox etc. I have tried them on a fairly large scale for these ailments. For smallpox and measles cases, I added enough potassium permanganate to the water to give it a light pink colour. The sheet used for these patients, should afterwards be sterilized by soaking it in boiling water and leaving it in it till it cools down sufficiently and then washed with soap and water.

In cases where circulation has become sluggish, the leg muscles feel sore and there is peculiar ache and feeling of discomfort in the legs, and ice massage does a lot of good. This treatment is more effective in summer months. Massaging a weak patient with ice in winter might prove a risky affair.

Now a few words about the therapeutics of hot water. An intelligent use of hot water gives relief in many cases. Application of iodine is a very popular remedy for all sorts of injuries and the like. Application of hot water will prove equally effective in most of these cases. Tincture of iodine is applied on swollen and bruised areas. Hot water fomentations are likely to give equal relief, if not more. Again, iodine drops are used in cases of earache. Irrigation of the ear with warm water is likely to relieve the pain in most of these cases. The use of iodine is attended with certain risks. The patient may have an idiosyncrasy towards the drug. Iodine mistaken for something else and taken internally might prove disastrous. But there is no risk whatsoever in using hot water Boiling water is as good a disinfectant as tincture of iodine. I do not mean to belittle the usefulness of iodine or suggest that hot water can replace it in all cases. Iodine is one of the few drugs which I regard most useful and necessary, but it is an expensive thing. The poor cannot afford to buy it and moreover its use cannot be safely entrusted to everybody. But water is available everywhere. We may not despise its therapeutic value because it is obtained so easily. Knowledge of common household remedies often proves a godsend in many a crisis.

In cases of scorpion bite where all remedies have failed, immersion of the part in hot water has been found to relieve the pain to a certain extent.

A shivering fit or a rigor can be made to subside by putting buckets of hot boiling water all round the patient who is well wrapped up or by saturating the atmosphere of the room with steam by some other device. A rubber hot water bag is a most useful thing, but it is not to be found in every household. A glass bottle with a well fitting cork, filled with hot water and wrapped in a piece of cloth, serves the same purpose. Care should be taken to choose bottles that would not crack on hot water being poured into them.

Steam is a more valuable therapeutic agent. It can be used to make the patient sweat. Steam baths are most useful in cases of rheumatism and other joint-pains. The easiest as well as the oldest method of taking steam bath is this. Spread a blanket or two on a sparsely but tightly woven cot and put one or two covered vessels full with boiling water under it. Make the patient lie flat on the cot and cover him up in such a way that the ends of the covering blankets touch the ground and thus prevent the steam from escaping and the outside air from getting in. After arranging everything as above, the lid from the vessels containing boiling water is removed and steam soon gets on to the patient lying between the blankets. It may be necessary to change the water once or twice. Usually in India people keep an angithi under the pots to keep the water boiling. This ensures continuous discharge of steam but is attended with risk of accidents. A single spark might set fire to the blankets or to the cot and endanger the patient's life. Therefore, it is advisable to use the method described by me even though it might seem slow and tedious.

Some people add neem leaves or other herbs to the water used for generating steam. I do not know if such an addition increases the efficiency of steam. The object is to induce sweat and that is attained by mere steam.

In cases of cold feet or aching of the the legs, the patient should be made to sit with his feet and legs immersed up to the knees in as hot water as he can bear. A little mustard powder can be added to the water. The foot bath should not last for more than fifteen minutes. This treatment improves the local circulation and gives immediate relief.

In cases of common cold and sore throat a steam kettle which is very much like an ordinary tea kettle with a long nozzle can be used for applying steam to the nose or throat. A rubber tube of required length can be attached to any ordinary kettle for this purpose.

Key to Health, pp. 63 to 75