(HT), Balneotherapy (BT),
I - Introductory
Anatomy, Physiology & Pathology, APP
Approximate Duration 6 months
II - Colon
Approximate Duration 12 months
III - Hydropathy
study of the Kneipp Method of Cure and its relationships with the
Health Sate of the body. Approximate Duration 12 months of 100 Hours
of Course Work Study of scientific academic research. 60 Hours
of Classroom Lectures
IV - Clinical Practice Training in
Kneipp Hydrotherapy Method®, 100 hours of Clinical
Practice Training in Kneipp Hydrotherapy Method.
Approximate Duration 20 days (Gaining the required Clinical Skills
for Professional Registration)
Hydrotherapy Course / module, consists on a 12 month study
academic course / module gaining the clinical skills for
is this course for
Students who wish to
study The Kneipp Method of Hydropathy ®
A - History of Medicine
1. History of
2. History of Homeopathy
3. History of Eclectic
4. History of Osteopathic Medicine
5. History of
6. History of Orthopaedics
7. History of
- Clinical Nutrition
C - Materia Medica
- The Kneipp Health Teaching
Order of life
2. Hydrotherapy (water treatment)
5. Medicinal Herbs
therapy: effects and objectives
II. Helps treat a Kneipp
III. Weekly schedule for a Kneipp cure
products and medicinal herbs in the household
- Cold Kneipp Treatments - Grundregeln
The Skin and its Functions
2. Treading Water
To run barefoot
5. Snow Walking
10. The cold washes -
effects, conditions, implementation
11. The cold upper body
12. The cold stomach wash
13. The cold lower body
14. The cold whole ablution
15. The cold wash the sick
16. The cold wash series
- The Hot & Cold Baths - Effects
General Rules for the hot and cold bath
2. The Cold Arm Bath
The Warm Arm Bath
4. The Temperature rising arm bath
6. The Cold Footbath
7. The Warm Footbath
The Temperature rising Footbath
9. The Alternating footbath
The Warm Sitzbath
11. The Change Sitzbad
12. The Cold
half-bath: a "merry Kneipp Bath"
13. The Warm
three-quarter bath (Bath, Kneipp herbal Bath)
14. The Rising
three-quarter Bath (Bath)
15. The Brush Bath
16. The Bath
A - Vapours
The Head & Facial steam
2. The Nose & Throat steam
The Herbal Supplements
A - The Fountains
The Kneipp Showers
2. The Cast: what it is, how it affects
5. Pour life and
6. Cast Rules
7. The Cold Face casting
Warm Face casting
9. The Cold Eyes cast
10. The cold
11. The change-Armguss
12. The cold chest cast
Changing Breast Cast
14. The cold upper cast
15. The cold
16. The cold leg cast
17. The change-leg cast
The change-knee cast
19. The cold solid casting
20. The cold
21. The hot showers
22. The hot neck Cast
A - The Kneipp Winding
The Kneipp winding
2. The cold Kneipp winding
3. Effects and
modes of action
4. The heat-removing cold compresses
heat astonished cold compresses
6. The Perspiration cold
7. Basic Rules when equipped
9. The Cold and wet socks
10. The Cold
11. Cold Neck wrap
12. The cold Chest
13. The cold Lumbar wrap
14. The cold Short winding
A - Dressings & Compresses
1. The Cold
2. Cool Pad with Arnika
3. The Cold Quark Edition
The Cold Lehmauflage
5. The Carbon Edition
6. The Onion
7. The Hot Pad
8. The Small hot pad
9. The Hot
10. The Dampfkompresse
11. The Hot Potato
12. The Heublumensack
13. The Hay Flowers
Accessories and Kräuterabkochung
15. The Hot Roll
Kneipp Treatments for Children
17. Kneipp High Value Medicinal
18. The Right Heilkräutlein
Applications of the High Value Medicinal Plants
20. The Full
List of Kneipp Treatments, with their Clinical Indications &
- Therapeutics (The different Therapeutic Methods and scope of
practice, and when to refer).
(This is the total cost: it covers the
complete course including the required AP&P & GCH®
Academic Classroom Lectures & Clinical Practice & Full Course
Manuals, if the student has already the AP&P & GCH® this
amount will be deducted from the course total, and there is no need
to retake the same.)
Hydropathy, DH Course
Total Hours: Hydropathy, DH® Course
England, Spain, Italy, Mexico, Peru, Chile, South America
Course Fees: £4,000
1. Scientific Study
Hours during a 12 month period
2. Classroom Lecture
Hours: 60 Hours in 80 Lessons (à 45
3. Clinical Training Hours:
100 hours (during 20 days) of Clinical Training in
who attend all class lectures but do not pass the final exam, and or
do not wish to retake the exam will be issued an Award
who complete and successfully pass their exams in all courses are
awarded a Diploma: Kneipp Hydrotherapy® (Ad Modum Kneipp).
Prof. German M. Schleinkofer, Head Instructor of
Hydrotherapy with Rui Alexandre Gabirro at the Kneipp School in Bad
Skills & Knowledge
1. Clinical Practice
Treatment Principle & Therapeutic Techniques
3. Indications &
Prerequisites and co-requisites
Requisites: Courses students need to have taken a Anatomy,
Physiology & Pathology Course.
students will have to do in the course: assignments, exams, projects,
performances, attendance, participation.
In Germany the
Kneipp Method of Cure was applied for many years in Hospitals in the
everyday health care (Study 2015 Charité Universitätsmedizin
Berlin). And this with great success!
Kneipp Method is Quick and effective, help provide relief, provide
the patient with a feel-good experience, both during the day and at
term Kneipp not simply means cold showers, but exciting knowledge
from the single Holistic European Natural Healing Method.
course fee is deliberately kept affordable in order to enable as many
health care professionals in this training.
scientifically verified clinical knowledge, according to practice,
the courses are based.
Fischer, Prof. Sissi Eichhorn-Schleinkofer, Instructor, Prof. German M.
Schleinkofer, Head Instructor of Hydropathy with Rui Alexandre Gabirro at the
Kneipp School in Bad Worishofen, Germany
Evidence-Based Effects of Hydrotherapy on Various Systems of the Body
Am J Med
Sci. 2014 May; 6(5): 199–209.
A Mooventhan and L
Nivethitha1 Ujire, India 1Department of Research and Development,
S-VYASA University, Bangalore, Karnataka, India
use of water for various treatments (hydrotherapy) is probably as old
as mankind. Hydrotherapy is one of the basic methods of treatment
widely used in the system of natural medicine, which is also called
as water therapy, aquatic therapy, pool therapy, and balneotherapy.
Use of water in various forms and in various temperatures can produce
different effects on different system of the body. Many
studies/reviews reported the effects of hydrotherapy only on very few
systems and there is lack of studies/reviews in reporting the
evidence-based effects of hydrotherapy on various systems. We
performed PubMed and PubMed central search to review relevant
articles in English literature based on “effects of
hydrotherapy/balneotherapy” on various systems of the body.
Based on the available literature this review suggests that the
hydrotherapy has a scientific evidence-based effect on various
systems of the body.
Evidence-based effects, Hydrotherapy, Various systems
is the external or internal use of water in any of its forms (water,
ice, steam) for health promotion or treatment of various diseases
with various temperatures, pressure, duration, and site. It is one of
the naturopathic treatment modality used widely in ancient cultures
including India, Egypt, China, etc. Though many countries used
water to produce different physiological/therapeutic effects on
different part of the system for maintaining health, preventing, and
treating the diseases, the scientific evidence-based effects are not
well documented. There are many studies/reviews that reported either
physiological or therapeutic or combination of both the effects of
hydrotherapy on particular system but did not report in all the major
systems of the body, which made us to do this review with the aim and
objective to report scientific evidenced-based effects of
hydrotherapy on various systems of the body. In order to provide a
general overview, we performed PubMed and PubMed central search to
review relevant articles in English literature based on “effects
of hydrotherapy/balneotherapy” on various systems of the body.
Articles published from 1986 to 2012 were included in this review.
cold application may cause physiologic reactions such as decrease in
local metabolic function, local edema, nerve conduction velocity
(NCV), muscle spasm, and increase in local anesthetic effects.
hour head-out water immersions (WI) in various temperatures (32°C,
20°C, and 14°C) produced various effects. Immersion at 32°C
did not change metabolic rate (MR) and rectal temperature (Tre), but
it lowered the heart rate (HR) by 15%, systolic blood pressure (SBP)
and diastolic blood pressure (DBP) by 11% and 12%, respectively,
compared, with controls at ambient air temperature. Along with HR and
blood pressure (BP), the plasma renin activity, plasma cortisol, and
aldosterone concentrations were also lowered by 46%, 34%, and 17%,
respectively, while diuresis was increased by 107%.
at 20°C produced similar decrease in plasma renin activity, HR,
SBP, and DBP, in spite of lowered Tre and increased MR by 93%. Plasma
cortisol concentrations tended to decrease, while plasma aldosterone
concentration was unchanged. Diuresis was increased by 89%. No
significant differences in changes in plasma renin activity,
aldosterone concentration, and diuresis compared with subjects
immersed in 32°C.
at 14°C lowered Tre and increased MR by 350%, HR, SBP, and DBP by
5%, 7%, and 8%, respectively. Plasma noradrenaline and dopamine
concentrations were increased by 530% and by 250%, respectively,
while diuresis increased by 163%, which was more than at 32°C.
Plasma aldosterone concentrations increased by 23%. Plasma renin
activity was reduced. Cortisol concentrations tended to decrease.
Plasma adrenaline concentrations remained unchanged. Changes in
plasma renin activity were not related to changes in aldosterone
in different temperatures did not increase blood concentrations of
cortisol. There was no correlation between changes in Tre and changes
in hormone production. The physiological changes induced by WI are
mediated by humoral control mechanisms, while responses induced by
cold are mainly due to increased activity of the sympathetic nervous
winter swimming significantly decreased tension, fatigue, memory, and
mood negative state points with the duration of swimming period;
significantly increased vigor-activity scores; relieved pain who
suffered from rheumatism, fibromyalgia, or asthma; and improved
general well-being in swimmers.
exposure (CE) to small surface area produced compensatory
vasodilatation in deeper vascular system resulting increased blood
flow to the tissues underlying the site of exposure. This vascular
reaction occurs mainly to maintain constant deep tissue
patient with chronic heart failure (CHF), thermal vasodilatation
following warm-water bathing and low-temperature sauna bathing (LTSB)
at 60°C for 15 min improves cardiac function; repeated
sauna-therapy (ST) increased left ventricular ejection fraction;
increased 6-min walk distance in association with improvement in
flow-mediated dilation and increase in number of circulating CD34 (+)
cells; reduced plasma levels of norepinephrine and brain natriuretic
peptide. These indicates that ST improves exercise tolerance in
association with improvement in endothelial function. LTSB
improves peripheral circulation in cerebral palsy (CP).
ST reduced level of total and low density lipoprotein
(LDL)-cholesterol concentration, while increased level of high
density lipoprotein (HDL)-cholesterol was observed. These changes are
good prognoses for the prevention of ischemic heart disease. ST
increases endothelial nitric oxide synthase (eNOS) activity and
improves cardiac function in heart failure and improve peripheral
blood flow in ischemic limbs. In myocardial infarction (MI)-induced
Wistar rats ST increases myocardial eNOS, vascular endothelial growth
factor mRNA levels. It attenuates cardiac remodeling after MI through
improving coronary vascularity in the noninfarcted myocardium and
thus ST might serve as a novel noninvasive therapy for patients with
Acute MI was thought to result from thrombosis or
plaque rupture because of coronary artery spasm. The vasospasm might
be induced by stimulation of the alpha-adrenergic receptors during
alternating heat exposure during sauna bath followed by rapid cooling
during cold water bath. This effect showed the dangers of rapid
cooling after sauna bathing in patients with coronary risk
factors. Regular ST (either radiant heat or far-infrared units)
appears to be safe and produce multiple health benefits but use of ST
in early pregnancy is a potential concern because evidence suggesting
that hyperthermia might be teratogenic.
water immersion (CWI) induces significant physiological and
biochemical changes in the body such as increase in HR, BP,
metabolism, and peripheral catecholamine concentration; and decrease
in cerebral blood flow.
in HR, and increases in systolic and diastolic biventricular
functions, were observed during acute warm-WI. In contrast,
increase in HR and a decrease in SBP and DBP were observed in 30 min
of head-out WI (38.41 ± 0.04°C).
immersion (HI) produced shortening of activated partial
thromboplastin time. During HI plasminogen activator inhibitor (PAI)
activity was decreased; thrombocyte count was increased; increases in
tissue-type plasminogen activator concentration and leukocytes count
were attributed to hemoconcentration. Immediately after HI,
fibrinogen concentration decreased but increased during recovery.
During thermo-neutral immersion prothrombin time, PAI activity and
granulocyte count ecreased. Warm water bathing leads to
hemoconcentration and minimal activation of coagulation; decrease in
PAI-1 activity. During warm water bathing, marked risk for thrombotic
or bleeding complications in healthy males could not be
ascertained. During contrast baths, longer duration in the second
heating phase was required to produce sufficient fluctuation in blood
up-to shoulder levels at different temperatures (25°C, 34°C,
and 40°C) showed no significant effect on cardiac output in 25°C
compared with 34°C, but in 40°C a considerable increase in
cardiac output was observed.
dioxide (CO2) enriched WI reduced free radical plasma levels, raised
antioxidants levels, and induce peripheral vasodilatation suggests
improvement in microcirculation.[17,18] Decrease in tympanic
temperature; increase in cutaneous blood flow at immersed site was
significantly greater in CO2-WI compared with fresh WI. The three
main effects of CO2 enriched WI are decline in core temperature,
increase in cutaneous blood flow, and elevation of score on thermal
sensation, which were analyzed.
up-to shoulder levels at different temperatures (25°C, 34°C,
and 40°C) showed increased MR, oxygen (O2) consumption (VO2) only
at 25°C. Two main factors affecting O2 transport during immersion
are temperature and hydrostatic pressure. O2 transport was improved
above neutral temperature, because of increase in cardiac output
resulting from the combined actions of hydrostatic counter pressure
and body heating. Below neutral temperature, O2 transport is altered.
At any of the temperatures tested, the pulmonary tissue volume and
arterial blood gases were not significantly affected.
decrease in vital capacity (VC) with bath temperature was observed
(i.e., VC at 40°C >34°C >25°C). Significant
increase in tidal volume (VT) in cold or hot water compared with
thermo neutral water (i.e., VT 40°C >34°C< 25°C).
Alterations in respiratory muscles functioning might produce
variations of the pulmonary volumes as a function of water
was associated with increase in respiratory minute volume and
decrease in end tidal CO2 partial pressure. Repeated cold water
stimulations reduced frequency of infections; increased peak
expiratory flow, lymphocyte counts, and expression of
gamma-interferon; modulated interleukin expression; and improved
quality of life (QOL) in patients with chronic obstructive pulmonary
children suffering from recurrent and asthmatic bronchitis in
remission, a single total air bath, or douche and local (cooling of
the feet with water) exposure to mild cold did not raise noticeable
disorders of the respiratory function. Local cold procedures improve
bronchial patency but heat exposure resulted in its worsening.
hot air while in a sauna produced no significant impact on overall
symptom severity of common cold. A male track and field athlete,
a case of breathing difficulties at rest and during exercise, was
exacerbated in the supine position and during WI.
cold modalities such as ice massage, ice pack, and CWI applied to
right calf region for 15min reduced skin temperature (Tsk) (mean
18.2°C); reduced amplitude and increased latency and duration of
compound action potential. It also reduced sensory NCV by 20.4, 16.7,
and 22.6 m/s and motor NCV by 2.5, 2.1, and 8.3 m/s, respectively.
Even though all three modalities effectively reduced Tsk and sensory
conduction at a physiological level, CWI is the most indicated,
effective modality for inducing therapeutic effects associated with
the reduction of motor nerve conduction.
and pressure of water in aquatic or hydrotherapy can block
nociceptors by acting on thermal receptors and mechanoreceptors and
exert positive effect on spinal segmental mechanisms, which is useful
for painful condition. Forty sessions of Ai Chi aquatic exercise
(AE) program improves pain, spasms, disability, fatigue, depression,
and autonomy in patient with multiple sclerosis.
a study on physiotherapy on land or water in patient with Parkinson's
disease (PD), functional reach test was improved in both therapies,
but Berg Balance Scale (BBS) and Unified Parkinson's Disease Rating
Scale (UPDRS) were improved only in aquatic therapy group. It
indicates improvement in postural stability in PD was significantly
larger after aquatic therapy.
bath on paraplegic (P) group and tetraplegic (T) group, HR increased
significantly during sauna but decreased significantly during
postsauna phase in P group. DBP significantly reduced in T group
during postsauna phase but no significant changes in SBP in both the
a study on CP, LTSB produced increase in HR and cardiac output;
decrease in BP and total peripheral resistance; significant
improvement in skin blood flow, blood flow velocity, pulsatile index,
and resistive index; decrease in numbness and chronic myalgia of the
extremities with no adverse effects.
minutes of immersions in whirlpools produced increases in pulse and
finger temperature with increased feelings of well-being and
decreased state anxiety. CO2-WI activates parasympathetic nerve
activity in humans.
cold shower might have antipsychotic effect similar to that of
electroconvulsive therapy because it could work as mild electroshock
applied to sensory cortex. Additionally, cold shower is example of
stress-induced analgesia and would also be expected to “crowd
out” or suppress psychosis-related neurotransmission within
can activate components of reticular activating system such as locus
ceruleus and raphe nuclei, which can result in activation of behavior
and increased capacity of central nervous system (CNS) to recruit
motoneurons. CE activates SNS; increase blood level of
beta-endorphin and noradrenaline; and increase synaptic release of
noradrenaline in brain. Antidepressive effect of cold shower
attributed to presence of high density of cold receptors in skin
expected to send an overwhelming amount of electrical impulses from
peripheral nerve endings to the brain. It has significant analgesic
effect and it does not cause dependence or noticeable side
effects. Most narcotics administered rectally can cause
intoxication. There is a significant co-morbidity of schizophrenia
with intestinal illnesses and thus colon cleansing can significantly
improve mental state.
in water at umbilical level increases the activity of erector spinae
and activates rectus femoris to levels near to or higher than walking
on dry ground. CWI <15°C is one of the most popular
intervention used after exercise,[11,35] which significantly lowered
ratings of fatigue and potentially improved ratings of physical
recovery immediately after immersion with reduction in delayed onset
muscle soreness at 24, 48, 72, and 96 h follow-ups after exercise
compared with passive interventions involving rest or no
of decrease in plasma lactate concentration over 30 min recovery
period after intense anaerobic exercise was significantly higher in
contrast-WI [hot (36°C) and cold (12°C)] compared with
passive recovery on bed for both genders.
immersion in warm water (44 ± 1°C) for 45 min before
stretch-shortening exercise reduced most of the indirect markers of
exercise-induced muscle damage, including muscle soreness, creatine
kinase activity in the blood, maximal voluntary contraction force,
and jump height. Decreasing muscle damage did not improve voluntary
performance, therefore clinical application of muscle prewarming may
water therapy (CWT) [alternating 1-min hot (38°C) and 1-min cold
(15°C)] for 6/12/18 min lowered subjective measures of thermal
sensation and muscle soreness compared with control (seated rest) but
no consistent differences were observed in whole body fatigue. It
indicates CWT for 6 min assisted acute recovery from high-intensity
running and CWT duration did not have dose-response effect on running
performance recovery. Contrast baths have been suggested for
reducing pain; hand volume; and stiffness in affected extremities but
it had no significant effect on pre- and/or postoperative hand volume
in carpal tunnel syndrome.
water or cold/thermoneutral water did not induce modifications of
inflammatory and hematological markers. The performances of athletes
were not negatively influenced by CWI or CWT. Reduced perception of
fatigue after training session was the principal effect of CWI
because CE increases opioid tone and high MR, which could diminish
fatigue by reducing muscle pain and accelerating recovery of fatigued
muscle, respectively, which can improve training and competitions
in young soccer players.
systematic review on management of fibromyalgia syndrome (FMS)
through hydrotherapy described as “there is strong evidence for
the use of hydrotherapy in the management of FMS” and it showed
positive outcomes for pain; tender point count; and
health-status. Combination of ST (once daily for 3 days/week) and
underwater exercise (once daily for 2 days/week) for 12 weeks
significantly reduced pain and symptoms (both short- and long-term);
and improved QOL in patients with FMS. Pool-based exercise using
deep water running three times/week for 8 weeks is safe and effective
intervention for FMS because it showed significant improvement in
general health and QOL compared with control; and significant
improvement in fibromyalgia impact questionnaire score, incorporating
pain; fatigue; physical function; stiffness; and psychological
may have some short-term benefit to passive range of movement in
rehabilitation after rotator cuff repair. Spa water (37°C)
and tap water heated to 37°C for the duration of 20 min/day for 5
days/week for the period of 2 weeks with home-based exercise program
improved the clinical symptoms and QOL in patient with osteoarthritis
of knee (OAK). However, pain and tenderness statistically improved in
spa water. It may be due to that spa waters are not only
naturally warm, but their mineral content is also significant. Spa
water has mechanical, thermal, and chemical effects.
ankylosing spondilitis (AS) patients, balneotherapy statistically
improved pain; physical activity; tiredness and sleep score; Bath
Ankylosing Spondilitis Disease Activity Index (BASDAI); Nottingham
Health Profile (NHP); patient's global evaluation and physician's
global evaluation at 3 weeks, but only on modified Shober test and
patient's global evaluation parameters at 24 weeks. It indicates the
effect of balneotherapy in improving disease activity and functional
parameters in AS patients. Infrared sauna, a form of total-body
hyperthermia was well tolerated; no adverse effects; and no
exacerbation of disease were reported in patients with rheumatoid
arthritis (RA) and AS in whom pain, stiffness, and fatigue showed
clinical improvements during the 4 weeks treatment period but these
did not reach statistical significance.
without caloric restrictions in obese persons for 6 weeks was
associated with reductions in waist circumference and body fat;
improvement of aerobic fitness and QOL.
may be an excellent alternative to land exercise for individuals who
lack confidence, have high risk of falling, or have joint pain.
Water buoyancy reduces the weight that joints, bones, and muscles
have to bear. Warmth and pressure of water also reduce swelling
and reduces load on painful joints, remotes muscle relaxation. AE
has significant effects on pain relief and related outcome
measurements for locomotor diseases. Patients may become more active
and improve their QOL as a result of AE. Water-based and
land-based exercises reduced pain and improved function in patients
with OAK and that water-based exercise was superior to land-based
exercise for relieving pain before and after walking.
Hydrotherapy is highly valued by RA patients who were treated
with hydrotherapy (30-min session/week) reported feeling much
better/very much better than those treated with land exercises
(similar exercises on land) immediately on completion of the
treatment program (6 weeks). But this benefit was not reflected on 10
m walk times, functional scores, QOL measures, and pain scores by
differences between groups. Hot compress (HC) with surrounding
electro-acupuncture needling was significantly effective on rear
thigh muscles strain and it was superior to conventional needling
method and cupping in improving symptoms and physical signs as well
as recovery of walking function of athletes.
water significantly elevates the resting energy expenditure (REE) in
adults but in overweight children transient decrease in REE was
observed immediately after drinking 10 ml/kg cold water (4°C).
Then a subsequent rise in REE was observed, which was significant
after 24 min and the maximal mean REE values were seen after 57 min,
which was 25% higher than baseline. The recommended daily amount of
water consumption in children could result in energy expenditure
equivalent to additional weight loss of about 1.2 kg/year suggesting
that water drinking could assist overweight children in weight loss
or maintenance. Exposure to cold increases MR, for example,
head-out immersion in cold water of 20°C almost doubles MR, while
at 14°C it is more than quadrupled.
very-HC applied to lumbar region of healthy female for 10-min blood
flow to the back increased to 156% with increased blood flow to upper
arm. Immediately after HC, bowel sounds increased 1.7 times compared
with before application, which suggest that a very HC can be useful
to promote flatus or defecation. Low mineral water intake
normalizes the intestinal permeability of patients with atopic
water is effective for colonic spasm in which significantly less
discomfort was reported compared with control group and this may be
useful as an alternative for glucagon (expensive) and hyoscyamine
(has side effects) because it has no side effects and costs
patients with acute anal pain due to hemorrhoids or anal fissures,
neither cold water (<15°C) nor hot water (>30°C) sitz
bath (SB) did control pain statistically. Similarly, after
sphincterotomy for anal fissure, SB produced no significant
difference in pain but significant relief in anal burning and better
satisfaction score with no adverse effects were observed compared
with control group. Healing and pain relief was not significant
in SB but it improved patient satisfaction in acute anal
there was no strong evidence to support the use of SB for pain relief
and to accelerate fissure or wound healing among adult patients with
anorectal disorders (ARDs), patients were satisfied with using SB and
no severe complications were reported. In contrast, warm-water SB
(40°C, 45°C, and 50°C for 10 min each time) in ARD, pain
relief was more evident and lasted longer at higher bath
Pain relief after SB might attribute to
internal anal-sphincter relaxation, which might be due to
thermosphincteric reflex, resulting in diminution of the rectal neck
pressure. The higher the bath temperature, the greater the drop in
rectal neck pressure and internal sphincter electromyographic
activity, and longer the time needed to return to pretest levels.
posthemorrhoidectomy care, water spray method could provide a safe
and reliable alternative to SB as a more convenient and satisfactory
form of treatment.
treatment with mineral water Nizhneivkinskaya (sulfate calcium)
induced clinical remission of the disease, normalization of the
echoscopic picture of stomach and gallbladder, their motor function,
tesiocrystalloscopic characteristics of saliva suggest its
effectiveness in rehabilitation of patients with gastric and
gallbladder motor-evacuatory dysfunction. Intake of
sulfate-chloride-sodium mineral water activates regulation of
carbohydrate metabolism by insulin and cortisol due to the formation
of adaptive reactions. It promoted trophic effects of insulin and
gastrin in animals with significant reduction in peptic ulcer size
and enhanced resistance to stressful factors.
in Dead Sea water produced significant reduction in blood glucose in
type-2 diabetes mellitus (DM) and no significant differences in
insulin, cortisol, and c-peptide levels were observed between DM
patients and healthy volunteers following immersion.
labor pain scores were significantly higher in control group than
immersion bath (IB) group suggest that use of IB as an alternative
form of pain relief during labor. WI in primipara at any stage of
labor, from 2 cm external opening of the uterine cervix,
significantly decreased parturition duration compared with
traditional delivery. It raised both the amplitude and frequency of
uterine contractions proportional to uterine cervix gaping with no
disturbances in contraction activity of the uterus. A 3-cm gaping of
uterine cervix is the optimal timing for WI in the primipara because
earlier WI at 2-cm uterine cervix gaping also accelerated the labor
but required repetitions of WI or use of oxytocin for correcting
weakened uterine contraction.
contrast, IB did not influence the length of labor and uterine
contractions frequency. However, contractions length was
statistically shorter in IB and it can be an alternative for woman's
comfort during labor, since it provides relief to her without
interfering on labor progression or jeopardizing the baby.
during first stage of labor reduces the use of
epidural/spinal/paracervical analgesia/anesthesia compared with
controls and there is no evidence of increased adverse effects to
fetus/neonate or woman from laboring in water or water birth.
Neonatal swimming can accelerate babies growth in early stage. In
a microbiological study, comparing neonatal bacterial colonization
after water birth to conventional bed deliveries with or without
relaxation bath showed no significant difference between three groups
in neonatal outcome, infant's and maternal infection rate.
but not warm-SB, significantly reduced edema during postepisiotomy
period and perineal pain, which was greatest immediately after
the bath. Bakera, a steam bath prepared with various plants
(commonly the essential oil plants) is traditionally used in Minahasa
(Indonesia) mainly for recuperation after childbirth. It is based
onthermotherapy with aromatherapy which attribute for its therapeutic
effects. Thermotherapy soothes symptoms such as heaviness in limbs,
edema, muscular strain, loss of appetite, and constipation. Essential
oils of the plants used have antiseptic, antiphlogistic, and
immunostimulant effect. Hence it can be an effective and safe method
for recuperation after child birth. In postnatal mothers,
alternate (hot and cold) compress and cold cabbage leaves were
equally effective in reducing breast engorgement, but in relieving
breast engorgement pain, alternate compresses were more effective
than cold cabbage leaves.
(40-45°C) for 10 min, for at least 5 days immediately after the
removal of Foley urethral catheter in patient undergone transurethral
resection of prostate, significantly reduced urethral stricture
compared with no SB group who had 1.13-fold increased risk of
re-hospitalization within 1 month after surgery due to postoperative
complications compared with warm-SB group. Thirty healthy
volunteers and 21 patients with urinary retention after
hemorrhoidectomy underwent SB at 40°C, 45°C, and 50°C
where the number of spontaneous micturitions increased with
higher-temperature baths and it seems to be initiated by reflex
(thermo-sphincter reflex) internal urethral sphincter relaxation. The
urethral pressure both in normal and retention subjects showed
significant reduction, which increased with higher temperature; and
vesical pressure or EMG activity of the external urethral sphincter
did not show significant differences.
CE induced increase of leukocytes, granulocytes, circulating levels
of interleukin (IL)-6, and natural killer (NK) cells and its
activity. Leukocytes, granulocyte, and monocyte responses were
augmented by pretreatment with exercise in water (18°C) and thus
acute-CE has immune-stimulating effects.
brief cold stress can increase both numbers and activity of
peripheral cytotoxic T-lymphocytes and NK cells, the major effectors
of adaptive and innate tumor immunity, respectively. It (for 8 days)
improved survival of intracellular parasite Toxoplasma gondii
infected mice, with consistent enhancement in cell-mediated immunity.
The sustained/longer-term effects of cold stress repeated daily over
the period of 5 days to 6 weeks increased plasma levels of tumor
necrosis factor-α, IL-2, IL-6. A hypothesis describes, daily
brief cold-water stress over many months could enhance antitumor
immunity and improve nonlymphoid cancer survival rate.
possible mechanism of nonspecific stimulation of cellular immunity
might attribute to transient activation of SNS,
hypothalamic-pituitary-adrenal (HPA) and
hypothalamic-pituitary-thyroid axes. Though daily moderate cold
hydrotherapy does not appear to have noticeable adverse effects on
normal subjects, some studies showed that it can cause transient
arrhythmias in patients with heart problems and can also inhibit
humoral immunity. Sudden ice-cold WI can produce transient pulmonary
edema and increase blood-brain barrier permeability, thereby
increasing mortality of neurovirulent infections. Studies are
required to warrant this hypothesis for immunotherapy development for
some (nonlymphoid) cancers, including those caused by viral
water (28°C) treatment could not only cure bacterial cold-water
disease but also immunize against causative agent Flavobacterium
WI (38.41 ± 0.04°C) for 30 min decreased blood viscosity;
red blood cells count; and mean hematocrit without significant
changes in leukocytes and platelets count; mean corpuscular volume;
plasma viscosity; erythrocyte filtration time and red cell
deformability index. Application of hyper-thermic water bath
produced significant reduction of relative B-lymphocyte. Whole-body
hyperthermic water bath reduced relative total T-lymphocyte counts;
increased relative CD8+ lymphocyte; NK cell counts and its activity,
which were probably dependent on increased somatotropic hormone
CE increase levels of circulating norepinephrine was observed and
exercising HPA system by repeated CE could potentially restore its
normal function in chronic fatigue syndrome, or at least increase net
HPA activity (without changing baseline activity). It produces
temporary increase in plasma levels of adrenocorticotropic hormone
(ACTH), beta-endorphin, and cortisol. The sustained/longer-term
effects of cold stress repeated daily produced increase in ACTH,
corticosterone, and decrease in α-1-antitrypsin and
testosterone. Cold stress reduces level of serotonin in most
regions of brain (except brainstem). Cold stress-induced
analgesia might be mediated by increased production of opioid peptide
beta-endorphin (an endogenous pain-killer).[85,86]
to sauna and ice-WI significantly elevated epinephrine levels in
winter swimmer. Steam bath produced increase in blood serum
concentrations of gastric and aldosterone, with decrease in
concentrations of cortisol in athlete-fighters. Whole-body
hyperthermic bath increased STH activity in 8 out of 10
skin, and hair
moist air device seems to be safe and produced improvement in tear
stability and symptomatic relief in ocular fatigue in patients with
meibomian gland dysfunction. Sauna (80°C) produced stable
epidermal barrier function; increase in stratum corneum hydration;
faster recovery of both elevated water loss and skin pH; decrease in
casual skin sebum content on skin surface of forehead; increase in
ionic concentration in sweat and epidermal blood perfusion in
volunteers. It suggests protective effect of ST on skin
Clinical remission of atopic dermatitis has
been reported after intake of low-salt water. Application of
heated mustard compress produced second-degree, partial-thickness
burn followed by hyperpigmentation and hypertrophic scarring.
Persistent use of cold pillow compress could reduce hair follicles
inhibition or damage caused by chemotherapeutic agents. So alopecia
can be decreased or prevented.
applied to lumbar region of healthy female for 10 min increased back
Tsk to 41.1-43.1°C under HC, followed by decreased rapidly but no
changes observed in BT. A case of 20% of 2nd degree burns and
severe heat stroke followed by temperature rose up to 40.5°C and
patient developed severe multiorgan failure and critical
polyneuropathy was reported after exposure to extreme heat in sauna
for unknown period of time.
The most effective method of
reducing body core temperature appears to be immersion in iced water,
main predictor of outcome in exertional heatstroke is the duration
and degree of hyperthermia where possible patients should be cooled
using iced-WI, but if it is not possible, combination of other
techniques may be used to facilitate rapid cooling such as
fan-therapy, CWI, iced-baths, and evaporative cooling.
dry-ice, and cryogen packs applied to skin overlying right triceps
surae muscle for 15 min on 10 females decreased mean Tsk 12°C,
9.9°C, and 7.3°C, respectively. None of the modalities
produced Tsk cooling below 17°C and no cooling was demonstrated 1
cm proximal or distal to any modalities after 15 min of application.
Significant mean Tsk reduction in between pretreatment rest interval
(time 0) and 15 min after removal of modality (time 30) was observed
only in wet-ice. It suggests wet-ice was significantly more efficient
in reducing Tsk than dry-ice and cryogen packs.
exercise at 65% maximal oxygen consumption at ambient temperature of
39°C until Tre increased to 40°C produced no difference in
cooling rate between WI at 8°C, 14°C, and 20°C but
cooling rate was significantly greater during 2°C, which was
almost twice as much as other conditions. It suggests that 2°C WI
is the most effective treatment for exercise-induced
hyperthermia. When hyperthermic individuals are immersed in 2°C
water for approximately 9 min to Tre cooling limit of 38.6°C
negated any risk associated with overcooling.
body immersion in moderately cold water is effective cooling maneuver
for lowering BT and body heat content of approximately 545 kJ at the
end of immersion in absence of severe physiological responses
generally associated with sudden cold stress. Significant less BT
variability and an overall higher BT were observed in late preterm
infants following tub bathing procedure.
on available literature, this review suggests that hydrotherapy was
widely used to improve immunity and for the management of pain, CHF,
MI, chronic obstructive pulmonary diseases, asthma, PD, AS, RA, OAK,
FMS, anorectal disorders, fatigue, anxiety, obesity,
hypercholesterolemia, hyperthermia, labor, etc. It produces different
effects on various systems of the body depending on the temperature
of water and though these effects are scientifically evidence based.
of Support: Nil
of Interest: None declared.
Fleming SA, Gutknecht NC. Gutknecht. Naturopathy and the Primary Care
Practice. Prim Care. 2010;37:119–36. [PMC free article]
Weston M, Taber C, Casagranda L, Cornwall M. Changes in local blood
volume during cold gel pack application to traumatized ankles. J
Orthop Sports Phys Ther. 1994;19:197–9. [PubMed]
Srámek P, Simecková M, Janský L, Savlíková
J, Vybíral S. Human physiological responses to immersion into
water of different temperatures. Eur J Appl Physiol. 2000;81:436–42.
Huttunen P, Kokko L, Ylijukuri V. Winter swimming improves general
well-being. Int J Circumpolar Health. 2004;63:140–4. [PubMed]
Iiyama J, Matsushita K, Tanaka N, Kawahira K. Effects of single
low-temperature sauna bathing in patients with severe motor and
intellectual disabilities. Int J Biometeorol. 2008;52:431–7.
Ohori T, Nozawa T, Ihori H, Shida T, Sobajima M, Matsuki A, et al.
Effect of repeated sauna treatment on exercise tolerance and
endothelial function in patients with chronic heart failure. Am J
Cardiol. 2012;109:100–4. [PubMed]
Pilch W, Szyguła Z, Klimek AT, Pałka T, Cisoń T, Pilch
P, et al. Changes in the lipid profile of blood serum in women taking
sauna baths of various duration. Int J Occup Med Environ Health.
Sobajima M, Nozawa T, Shida T, Ohori T, Suzuki T, Matsuki A, et al.
Repeated sauna therapy attenuates ventricular remodeling after
myocardial infarction in rats by increasing coronary vascularity of
noninfarcted myocardium. Am J Physiol Heart Circ Physiol.
Imai Y, Nobuoka S, Nagashima J, Awaya T, Aono J, Miyake F, et al.
Acute myocardial infarction induced by alternating exposure to heat
in a sauna and rapid cooling in cold water. Cardiology.
Crinnion WJ. Sauna as a valuable clinical tool for cardiovascular,
autoimmune, toxicant- induced and other chronic health problems.
Altern Med Rev. 2011;16:215–25. [PubMed]
Bleakley CM, Davison GW. What is the biochemical and physiological
rationale for using cold-water immersion in sports recovery? A
systematic review. Br J Sports Med. 2010;44:179–87. [PubMed]
Grüner Sveälv B, Cider A, Täng MS, Angwald E,
Kardassis D, Andersson B. Benefit of warm water immersion on
biventricular function in patients with chronic heart failure.
Cardiovasc Ultrasound. 2009;7:33. [PMC free article] [PubMed]
Digiesi V, Cerchiai G, Mannini L, Masi F, Nassi F. Hemorheologic and
blood cell changes in humans during partial immersion with a
therapeutic method, in 38 o C water. Minerva Med. 1986;77:1407–11.
Boldt LH, Fraszl W, Röcker L, Schefold JC, Steinach M, Noack T,
et al. Changes in the haemostatic system after thermoneutral and
hyperthermic water immersion. Eur J Appl Physiol. 2008;102:547–54.
Shih CY, Lee WL, Lee CW, Huang CH, Wu YZ. Effect of time ratio of
heat to cold on brachial artery blood velocity during contrast baths.
Phys Ther. 2012;92:448–53. [PubMed]
Choukroun ML, Varene P. Adjustments in oxygen transport during
head-out immersion in water at different temperatures. J Appl
Physiol. 1990;68:1475–80. [PubMed]
Dogliotti G, Galliera E, Iorio E, De Bernardi Di Valserra M, Solimene
U, Corsi MM. Effect of immersion in CO2-enriched water on free
radical release and total antioxidant status in peripheral arterial
occlusive disease. Int Angiol. 2011;30:12–7. [PubMed]
Sato M, Kanikowska D, Iwase S, Nishimura N, Shimizu Y, Belin de
Chantemele E, et al. Effects of immersion in water containing high
concentrations of CO2 (CO2-water) at thermoneutral on
thermoregulation and heart rate variability in humans. Int J
Biometeorol. 2009;53:25–30. [PubMed]
Pagourelias ED, Zorou PG, Tsaligopoulos M, Athyros VG, Karagiannis A,
Efthimiadis GK. Carbon dioxide balneotherapy and cardiovascular
disease. Int J Biometeorol. 2011;55:657–63. [PubMed]
Choukroun ML, Kays C, Varène P. Effects of water temperature
on pulmonary volumes in immersed human subjects. Respir Physiol.
Goedsche K, Förster M, Kroegel C, Uhlemann C. Repeated cold
water stimulations (hydrotherapy according to Kneipp) in patients
with COPD. Forsch Komplementmed. 2007;14:158–66. [PubMed]
Iarosh AM, Kurch TK. The effect of cold exposure on the respiratory
function in children suffering from inflammatory lung diseases. Vopr
Kurortol Fizioter Lech Fiz Kult. 1995;1:9–11. [PubMed]
Pach D, Knöchel B, Lüdtke R, Wruck K, Willich SN, Witt CM.
Visiting a sauna: Does inhaling hot dry air reduce common cold
symptoms? A randomised controlled trial. Med J Aust. 2010;193:730–4.
Whyte GP, Harries M, Dickinson J, Polkey MI. Breathless in the bath.
Br J Sports Med. 2006;40:554–5. [PMC free article] [PubMed]
Herrera E, Sandoval MC, Camargo DM, Salvini TF. Motor and sensory
nerve conduction are affected differently by ice pack, ice massage,
and cold water immersion. Phys Ther. 2010;90:581–91. [PubMed]
Bender T, Karag¨ulle Z, B´alint GP, Gutenbrunner C, B´alint
PV, Sukenik S. Hydrotherapy, balneotherapy, and spa treatment in pain
management. Rheumatol Int. 2005;25:220–4. [PubMed]
Castro-Sánchez AM, Matarán-Peñarrocha GA,
Lara-Palomo I, Saavedra-Hernández M, Arroyo-Morales M,
Moreno-Lorenzo C. Hydrotherapy for the treatment of pain in people
with multiple sclerosis: A randomized controlled trial. Evid Based
Complement Alternat Med 2012. 2012 473963. [PMC free article]
Vivas J, Arias P, Cudeiro J. Aquatic therapy versus conventional
land-based therapy for Parkinson's disease: An open-label pilot
study. Arch Phys Med Rehabil. 2011;92:1202–10. [PubMed]
Gerner HJ, Engel P, Gass GC, Gass EM, Hannich T, Feldmann G. The
effects of sauna on tetraplegic and paraplegic subjects. Paraplegia.
Robiner WN. Psychological and physical reactions to whirlpool baths.
J Behav Med. 1990;13:157–73. [PubMed]
Shevchuk NA. Hydrotherapy as a possible neuroleptic and sedative
treatment. Med Hypotheses. 2008;70:230–8. [PubMed]
Shevchuk NA. Possible use of repeated cold stress for reducing
fatigue in chronic fatigue syndrome: A hypothesis. Behav Brain Funct.
2007;3:55. [PMC free article] [PubMed]
Shevchuk NA. Adapted cold shower as a potential treatment for
depression. Med Hypotheses. 2008;70:995–1001. [PubMed]
Chevutschi A, Lensel G, Vaast D, Thevenon A. An Electromyographic
Study of Human Gait both in Water and on Dry Ground. J Physiol
Anthropol. 2007;26:467–73. [PubMed]
Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, Davison
GW. Cold-water immersion (cryotherapy) for preventing and treating
muscle soreness after exercise. Cochrane Database Syst Rev.
Morton RH. Contrast water immersion hastens plasma lactate decrease
after intense anaerobic exercise. J Sci Med Sport. 2007;10:467–70.
Skurvydas A, Kamandulis S, Stanislovaitis A, Streckis V, Mamkus G,
Drazdauskas A. Leg immersion in warm water, stretch-shortening
exercise, and exercise-induced muscle damage. J Athl Train.
2008;43:592–9. [PMC free article] [PubMed]
Versey NG, Halson SL, Dawson BT. Effect of contrast water therapy
duration on recovery of running performance. Int J Sports Physiol
Perform. 2012;7:130–40. [PubMed]
Janssen RG, Schwartz DA, Velleman PF. A randomized controlled study
of contrast baths on patients with carpal tunnel syndrome. J Hand
Ther. 2009;22:200–7. [PubMed]
De Nardi M, La Torre A, Barassi A, Ricci C, Banfi G. Effects of
cold-water immersion and contrast-water therapy after training in
young soccer players. J Sports Med Phys Fitness. 2011;51:609–15.
McVeigh JG, McGaughey H, Hall M, Kane P. The effectiveness of
hydrotherapy in the management of fibromyalgia syndrome: A systematic
review. Rheumatol Int. 2008;29:119–30. [PubMed]
Matsumoto S, Shimodozono M, Etoh S, Miyata R, Kawahira K. Effects of
thermal therapy combining sauna therapy and underwater exercise in
patients with fibromyalgia. Complement Ther Clin Pract.
Cuesta-Vargas AI, Adams N. A pragmatic community-based intervention
of multimodal physiotherapy plus deep water running (DWR) for
fibromyalgia syndrome: A pilot study. Clin Rheumatol.
Hay L, Wylie K. Towards evidence-based emergency medicine: Best BETs
from the Manchester Royal Infirmary. BET 4: Hydrotherapy following
rotator cuff repair. Emerg Med J. 2011;28:634–5. [PubMed]
Yurtkuran M, Yurtkuran M, Alp A, Nasircilar A, Bingöl U, Altan
L, et al. Balneotherapy and tap water therapy in the treatment of
knee osteoarthritis. Rheumatol Int. 2006;27:19–27. [PubMed]
Altan L, Bingöl U, Aslan M, Yurtkuran M. The effect of
balneotherapy on patients with ankylosing spondylitis. Scand J
Rheumatol. 2006;35:283–9. [PubMed]
Oosterveld FG, Rasker JJ, Floors M, Landkroon R, van Rennes B,
Zwijnenberg J, et al. Infrared sauna in patients with rheumatoid
arthritis and ankylosing spondylitis. A pilot study showing good
tolerance, short-term improvement of pain and stiffness, and a trend
towards long-term beneficial effects. Clin Rheumatol. 2009;28:29–34.
Wouters EJ, Van Nunen AM, Geenen R, Kolotkin RL, Vingerhoets AJ.
Effects of Aquajogging in Obese Adults: A Pilot Study. J Obes 2010.
2010 231074. [PMC free article] [PubMed]
Arnold CM, Busch AJ, Schachter CL, Harrison EL, Olszynski WP. A
Randomized clinical trial of aquatic versus land exercise to improve
balance, function, and quality of life in older women with
osteoporosis. Physiother Can. 2008;60:296–306. [PMC free
Biscarini A, Cerulli G. Modeling of the knee joint load in
rehabilitative knee extension exercises under water. J Biomech.
Eversden L, Maggs F, Nightingale P, Jobanputra P. A pragmatic
randomised controlled trial of hydrotherapy and land exercises on
overall well being and quality of life in rheumatoid arthritis. BMC
Musculoskelet Disord. 2007;8:23. [PMC free article] [PubMed]
Honda T, Kamioka H. Curative and health enhancement effects of
aquatic exercise: Evidence based on interventional studies. Open
Access J Sports Med. 2012;3:27–34. [PMC free article] [PubMed]
Silva LE, Valim V, Pessanha AP, Oliveira LM, Myamoto S, Jones A, et
al. Hydrotherapy versus conventional land-based exercise for the
management of patients with osteoarthritis of the knee: A randomized
clinical trial. Phys Ther. 2008;88:12–21. [PubMed]
Xu XS, Lin WP, Chen JY, Yu LC, Huang ZH. Efficacy observation on rear
thigh muscles strain of athletes treated with surrounding needling of
electroacupuncture and hot compress of Chinese medicine. Zhongguo
Zhen Jiu. 2012;32:511–4. [PubMed]
Dubnov-Raz G, Constantini NW, Yariv H, Nice S, Shapira N. Influence
of water drinking on resting energy expenditure in overweight
children. Int J Obes (Lond) 2011;35:1295–300. [PubMed]
Hishinuma M, Hiramatsu N, Kasuga M, Ooyoshi M, Kaharu C, Misao H, et
al. The effect on bowel sounds of very hot compresses applied to the
lumbar region. Nihon Kango Kagakkaishi. 1997;17:32–9. [PubMed]
Dupuy P, Cassé M, André F, Dhivert-Donnadieu H, Pinton
J, Hernandez-Pion C. Low-salt water reduces intestinal permeability
in atopic patients. Dermatology. 1999;198:153–5. [PubMed]
Church JM. Warm water irrigation for dealing with spasm during
colonoscopy: Simple, inexpensive, and effective. Gastrointest Endosc.
Maestre Y, Parés D, Salvans S, Ibáñez-Zafón
I, Nve E, Pons MJ, et al. Cold or hot sitz baths in the emergency
treatment of acute anal pain due to anorectal disease? Results of a
randomised clinical trial. Cir Esp. 2010;88:97–102. [PubMed]
Gupta PJ. Effects of warm water sitz bath on symptoms in post-anal
sphincterotomy in chronic anal fissure – a randomized and
controlled study. World J Surg. 2007;31:1480–4. [PubMed]
Gupta P. Randomized, controlled study comparing sitz-bath and
no-sitz-bath treatments in patients with acute anal fissures. ANZ J
Surg. 2006;76:718–21. [PubMed]
Lang DS, Tho PC, Ang EN. Effectiveness of the Sitz bath in managing
adult patients with anorectal disorders. Jpn J Nurs Sci.
Shafik A. Role of warm-water bath in ano-rectal conditions. The
thermo-sphincteric reflex. J Clin Gastroenterol. 1993;16:304–8.
Hsu KF, Chia JS, Jao SW, Wu CC, Yang HY, Mai CM, et al. Comparison of
clinical effects between warm water spray and sitz bath in
post-hemorrhoidectomy period. J Gastrointest Surg. 2009;13:1274–8.
Guliaeva SF, Pomaskina TV, Guliaev PV, Martusevich AK, Aistov VI.
Efficacy of sulfate calcium mineral water in disorders of motor
evacuatory function of the stomach and gallbladder. Vopr Kurortol
Fizioter Lech Fiz Kult. 2004;6:20–2. [PubMed]
Razumov AN, Surkov NV, Frolkov VK, Ziniakov NT. Therapeutic and
preventive effects of sulfate-chloride-sodium mineral water in
experimental peptic ulcer. Vopr Kurortol Fizioter Lech Fiz Kult.
Mizrahi E, Liberty I, Tsedek I, Harari M, Friger M, Sukenik S. The
influence of single immersion in Dead Sea water on glucose, insulin,
cortisol and C-peptide levels in type 2 diabetes mellitus patients.
Harefuah. 2011;150:646–9. 689, 688. [PubMed]
Da Silva FM, de Oliveira SM, Nobre MR. A randomised controlled trial
evaluating the effect of immersion bath on labour pain. Midwifery.
Malarewicz A, Wydrzynski G, Szymkiewicz J, Adamczyk-Gruszka O. The
influence of water immersion on the course of first stage of
parturition in primiparous women. Med Wieku Rozwoj. 2005;9:773–80.
Da Silva FM, de Oliveira SM. The effect of immersion baths on the
length of childbirth labor. Rev Esc Enferm USP. 2006;40:57–63.
Cluett ER, Burns E. Immersion in water in labour and birth. Cochrane
Database Syst Rev. 2009;2:CD000111. [PMC free article] [PubMed]
Zhao S, Xie L, Hu H, Xia J, Zhang W, Ye N, et al. A study of neonatal
swimming (water therapy) applied in clinical obstetrics. J Matern
Fetal Neonatal Med. 2005;17:59–62. [PubMed]
Fehervary P, Lauinger-Lörsch E, Hof H, Melchert F, Bauer L,
Zieger W. Water birth: Microbiological colonisation of the newborn,
neonatal and maternal infection rate in comparison to conventional
bed deliveries. Arch Gynecol Obstet. 2004;270:6–9. [PubMed]
LaFoy J, Geden EA. Post episiotomy pain: Warm versus cold sitz bath.
J Obstet Gynecol Neonatal Nurs. 1989;18:399–403. [PubMed]
Ramler D, Roberts J. A comparison of cold and warm sitz baths for
relief of postpartum perineal pain. J Obstet Gynecol Neonatal Nurs.
Zumsteg IS, Weckerle CS. Bakera, a herbal steam bath for postnatal
care in Minahasa (Indonesia): Documentation of the plants used and
assessment of the method. J Ethnopharmacol. 2007;111:641–50.
Arora S, Vatsa M, Dadhwal V. A Comparison of cabbage leaves vs. hot
and cold compresses in the treatment of breast engorgement. Indian J
Community Med. 2008;33:160–2. [PMC free article] [PubMed]
Park SU, Lee SH, Chung YG, Park KK, Mah SY, Hong SJ, et al. Warm sitz
bath: Are there benefits after transurethral resection of the
prostate? Korean J Urol. 2010;51:763–6. [PMC free article]
Shafik A. Role of warm water bath in inducing micturition in
postoperative urinary retention after anorectal operations. Urol Int.
Brenner IK, Castellani JW, Gabaree C, Young AJ, Zamecnik J, Shephard
RJ, et al. Immune changes in humans during cold exposure: Effects of
prior heating and exercise. J Appl Physiol. 1999;87:699–710.
Shevchuk NA, Radoja S. Possible stimulation of anti-tumor immunity
using repeated cold stress: A hypothesis. Infect Agent Cancer.
2007;2:20. [PMC free article] [PubMed]
Sugahara K, Eguchi M. The use of warmed water treatment to induce
protective immunity against the bacterial cold-water disease pathogen
Flavobacterium psychrophilum in ayu (Plecoglossus altivelis) Fish
Shellfish Immunol. 2012;32:489–93. [PubMed]
Blazícková S, Rovenský J, Koska J, Vigas M.
Effect of hyper thermic water bath on parameters on cellular
immunity. Int J Clin Pharmacol Res. 2000;20:41–6. [PubMed]
Dorfman M, Arancibia S, Fiedler JL, Lara HE. Chronic intermittent
cold stress activates ovarian sympathetic nerves and modifies ovarian
follicular development in the rat. Biol Reprod. 2003;68:2038–43.
Gerra G, Volpi R, Delsignore R, Maninetti L, Caccavari R, Vourna S,
et al. Sex-related responses of beta-endorphin, ACTH, GH and PRL to
cold exposure in humans. Acta Endocrinol (Copenh) 1992;126:24–8.
Glickman-Weiss EL, Nelson AG, Hearon CM, Goss FL, Robertson RJ. Are
beta-endorphins and thermoregulation during coldwater immersion
related? Undersea Hyperb Med. 1993;20:205–13. [PubMed]
Kauppinen K, Pajari-Backas M, Volin P, Vakkuri O. Some endocrine
responses to sauna, shower and ice water immersion. Arctic Med Res.
Panov SF, Pleshakov AA. Effect of steam bath on gastric secretion and
some endocrine changes of athlete-fighters. Fiziol Cheloveka.
Matsumoto Y, Dogru M, Goto E, Ishida R, Kojima T, Onguchi T, et al.
Efficacy of a new warm moist air device on tear functions of patients
with simple meibomian gland dysfunction. Cornea. 2006;25:644–50.
Kowatzki D, Macholdt C, Krull K, Schmidt D, Deufel T, Elsner P, et
al. Effect of regular sauna on epidermal barrier function and stratum
corneum water-holding capacity in vivo in humans: A controlled study.
Dermatology. 2008;217:173–80. [PubMed]
Linder SA, Mele JA, 3rd, Harries T. Chronic hyperpigmentation from a
heated mustard compress burn: A case report. J Burn Care Rehabil.
Li LC, Wang M, Ning XC. Study on preventing alopecia caused by
chemotherapy with cold pillow compresses. Chin J Nurs. 1995;30:643–5.
Rünitz K, Jensen TH. Heat stroke and burns resulting from use of
sauna. Ugeskr Laeger. 2009;171:305–6. [PubMed]
Smith JE. Cooling methods used in the treatment of exertional heat
illness. Br J Sports Med. 2005;39:503–7. [PMC free article]
Harker J, Gibson P. Heat-stroke: A review of rapid cooling
techniques. Intensive Crit Care Nurs. 1995;11:198–202. [PubMed]
Belitsky RB, Odam SJ, Hubley-Kozey C. Evaluation of the effectiveness
of wet ice, dry ice, and cryogen packs in reducing skin temperature.
Phys Ther. 1987;67:1080–4. [PubMed]
Proulx CI, Ducharme MB, Kenny GP. Effect of water temperature on
cooling efficiency during hyperthermia in humans. J Appl Physiol.
Gagnon D, Lemire BB, Casa DJ, Kenny GP. Cold-water immersion and the
treatment of hyperthermia: Using 38.6°C as a safe rectal
temperature cooling limit. J Athl Train. 2010;45:439–44. [PMC
free article] [PubMed]
Marino F, Booth J. Whole body cooling by immersion in water at
moderate temperatures. J Sci Med Sport. 1998;1:73–82. [PubMed]
Loring C, Gregory K, Gargan B, LeBlanc V, Lundgren D, Reilly J, et
al. Tub bathing improves thermoregulation of the late preterm infant.
J Obstet Gynecol Neonatal Nurs. 2012;41:171–9. [PubMed]
Training of Clinical Health Practitioners
Training of Clinical Health Practitioners
Regulating the practice of Clinical Health
Practitioners and preventing
practice by unqualified practitioners requires a proper
system of training, examination and licensing.
for training have to take into consideration the following:
Content of the
Method of the
training is to be provided and by whom;
responsibilities of the future practitioner;
Education required in order to undertake training.
practitioners experts distinguish two types of Health Care
training in function of prior training and clinical
experience of trainees.
Type I training programmes are
aimed at those who have no prior
health-care training or experience. They are designed to
produce Clinical Health Care
are qualified to practise as primary-contact and
primary-care practitioners, independently or as members of a
health-care team. This type of programme consists of a
minimum of two years of full-time study (or its equivalent)
of no fewer than 1500 hours, including no less than 400
hours of supervised clinical training. Acceptable applicants
will typically have completed high school education or
Type II training programmes are aimed at those with health-care training (western and oriental medicine, dentistry,
osteopathy, chiropractor among others) who wish to become
recognized Clinical Health Care Practitioners practitioners. The learning outcomes should be
comparable to those of a Type I programme.
Learning outcomes of Type I
Graduates of the Type I programme have to be able to:
Provide a basic description of the principles and practice of
the various disciplines of traditional, complementary and
Assess the health of their clients of all ages with skill and
accuracy and to communicate this information effectively to
Prescribe appropriate treatments involving naturopathic
modalities used in accordance with naturopathic principles;
Recommend traditional medicines for the purpose of treating and
preventing diseases and promoting health;
Prepare traditional medicines in accordance with pharmacopoeia
requirements and good compounding and dispensing practices;
Monitor, evaluate and adapt, when necessary, the naturopathic
care of each client;
Educate both clients and the public concerning the promotion of
health and the prevention of diseases;
Refer clients to other health-care professionals when necessary
Practise ethically and in compliance with the codes and
guidelines of the relevant professional organizations as well as
the statutes, rules, laws and/or regulations of the licensing or
The Type I programme includes four primary areas of study:
Health sciences, modalities and principles
Clinical training and application.
Since some courses and
disciplines overlap more than one of these areas, this
classification is merely intended to provide a simple
categorization of the breadth of courses that are studied.
Basic sciences include: Anatomy, Physiology, Pathology.
Clinical sciences include: taking a patient history and
clinical assessment; physical examination; first-aid and
emergency medicine; hygiene and public health.
Health sciences, modalities and principles include: natural
health history and practice; nutrition;
hydrotherapy; botanical health; Dr Edward Bach Remedies;
stress management and lifestyle counselling; ethics and
jurisprudence; electrotherapy; soft tissue
Clinical training may include preceptorship and supervised
Kneipp a Practitioner, responsible for the revival of modern
the naturopathy: “Naturopathy
(is) too broad description thus becoming a dumping ground for
anything alternative!” - Dr Jon Wardle on channel 10 News,
Australia July 2016
Sebastian Kneipp was the revival of the Hydrotherapy movement since
Vincent Preissnitz, he improved and developed Hydrotherapy to a more
inclusive integration, of botanical medicines, Exercise, Nutrition,
In 1891, Father Kneipp founded Kneipp Bund in
Germany, and organization that promotes water healing.
Kneipp passed away on the 17 June 1897, the word Naturopathy was
created in 1895 by John Scheel (USA), Benedict Lust around 1900,
purchased the name Naturopathy from John Scheel. In America, Kneipp
Societies were founded, which, under the influence of Benedict
Lust, changed their name to Naturopatic Society of America.
Merriam-Webster Dictionary states that the first known use of the
word "naturopathy" in print is from 1901.
water cure as tested through more than thirty years and described for
the healing of diseases and the preservation of health”.
is no reference to the word Naturopathy:
More than 100 times the
12 times the word: Water Cure
3 times the word:
“Dr Benedict Lust, the father of Naturopathy
and a strong advocate for natural healing methods, requested in 1918
in the Universal Naturopathic Encyclopedia, that some Naturopath
develop bloodless surgery technique, etc. He became very much
interested in bloodless surgery and suggested that the writer do
something about it.
In 1934 and 1935, Dr Lust was a frequent
visitor to the Sanitarium where the writer was assistant director ,
and assisted in performing bloodless surgery operations, which proved
very successful.” - by Dr Paul Wendel in Page 2 of the book
“Bloodless surgery, Technique with treatment” 1945
Hydropathy is not Allophathy medicine
First Letter to
the General Medical Council concerning Medicine & Disease:
Could you please let me
know what is the official accepted definition by the General Medical
Council of the following.
1. The official definition of
2. The official definition of Disease
Reply from the
General Medical Council:
you for your email asking for a definition of the words "medicine"
and also "disease".
The GMC register
medical doctors in the UK that hold an acceptable Primary Medical
Qualification in medicine and surgery. We require our doctors to hold
a degree in "Allopathic medicine".
describes the format of "mainstream medicine which uses
pharmacologically active agents or physical interventions to treat or
supress symptoms or pathophysiologic processes of diseases or
This is the term used for the purpose of
registration in the UK, but the definition of medicine has many
relevant meanings dependent on the context.
For the word
disease, I have used the common dictionary definition: "a
disorder of structure or function in a human, animal, or plant,
especially one that produces specific symptoms or that affects a
specific location and is not simply a direct result of physical
Second Letter to the
General Medical Council concerning Hydrotherapy:
please indicate what is the official position of the General Medical
1. Hydropathy or Hydrotherapy.
Is Hydropathy or Hydrotherapy part of Medicine?
Reply from the
General Medical Council:
"Thank you for
your email about hydrotherapy. I am afraid I cannot help you, as the
matter you raise falls outside our jurisdiction.
help if I explain that the GMC is the statutory regulatory body for
medical doctors in the UK.
Our responsibilities include
setting standards for medical education, granting registration with a
licence to practise to suitably qualified people, promoting good
medical practice, and taking appropriate action where doubts arise
about a doctor's fitness to practise.
In order to be
registered with us, a doctor must hold a primary medical
qualification in allopathic medicine."
First Do No Harm
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