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J. H. KELLOGG, M.D., LL.D., F.A.C.S.
Fellow of Royal Society of Medicine; the Societe
d' Hygiene of France; the British and American
Association of the Advancement of Science; Medical
Director of the Battle Creek (Michigan) Sanitarium.

Water is without doubt the most ancient of all remedial agents for disease. This fact is evidenced by the frequent reference to its use in the earliest medical literature, as well as by the habits and customs of the most ancient peoples as brought to light more fully within recent years by the study of the old Assyrian and Egyptian records. The reason for this is clearly to be found in the fact that water is a means not only usually found ready at hand, but one which adapts itself to almost every imaginable pathological condition in a remarkable manner, thus approaching more nearly to a panacea than any other known remedy. No other agent is capable of producing so great a variety of physiological effects, no other is so universally present, and hence none is so readily adaptabled for meeting the various exigencies and indications arising from accident and disease. The ancient Egyptians, Hebrews, Greeks, Persians, and Hindus all employed water in the treatment of disease, as do the representatives of these peoples at the present time.

According to a Chinese record dating back several centuries before Christ, a physician prescribed for a woman of that country one hundred affusions of ice-water, each followed by wrapping in a linen sheet, - a treatment in principle resembling the wet-sheet pack.

The Tokio Medical Journal (1881) states that the cold bath has been in use in Japan for nearly eight hundred years, especially among the native country physician, and that especially among the native country physicians, and that nearly three hundred years ago a small treatise on the medical use of the cold bath was published by Dr. Nakagami, in which it was especially recommended for acute mania, hysteria, asthma, and convulsions in children.

Among the Spartans of ancient Greece cold bathing was made obligatory by law. The bath in various forms is also frequently referred to in Grecian mythology.

Hippocrates evidently had an excellent understanding of the physiological properties of water, both hot and cold, which he employed in the treatment of fevers, ulcers, hemorrhages, and a variety of maladies both medical and surgical, giving many directions for its use which the experience of two thousand years has not improved upon. For instance, he directed that cold baths should be of short duration, and should be preceded and followed by friction; and he evidently understood the phenomena of reaction, since he records the observation that after a cold bath the body quickly recuperates its heat and remains warm, while a hot bath produces the opposite effect.

Under the Romans the bath attained a very high degree of development. Emperors vied with one another in erecting magnificent public baths, capable of accomodating thousands of persons daily. In studying the interesting ruins of some of these structures at Rome and Pompeii, the author was astonished to find the perfection attained in every detail of the equipment of these ancient bathing establishmens. Hot or cold water baths, hot-air and vapor baths, might be enjoyed at will.

Asclepiades employed water in nearly every form,- hot and cold baths, douches, compresses, etc. One of his disciples, Antonius Musa, attained great fame by curing the Emperor Augustus of a chronic catarrh by means of the cold bath, as a reward for which his statue was ordered to be erected in the temple of Esculapius; but a lack of discrimination in the use of this powerful agent led to his downfall. Being called upon to treat the emperor's nephew, Marcellus, a popular favorite, he adopted the measures which had resulted so admirably in the cure of the athletic old soldier, but they proved too powerful for the effeminate youth, and he was prostrated to such a degree that he died soon after at Naples, where he had gone to receive treatment at the hot baths of Baiae. This enthusiastic apostle of hydrotherapy succeeded later in redeeming his reputation by the cure of the poet Horace.

Pastor Kneipp, the Bavarian water-cure empiric, a few years ago had a similar experience. Being called upon to visit the pope, who was suffering from chronic rheumatism, he was received with great honors; but the first cold bath given the aged prelate, entirely unaccustomed to such heroic treatment, occasioned such an exacerbation of his sufferings that the poor priest was peremptorily dismissed in disgrace. Had the patient been a sturdy young German peasant instead of a feeble Italian gentleman, the prescription might have succeeded better. A similar lack of discrimination, whether by a charlatan or a legally qualified practitioner, is always attended by disastrous results. The untoward effects thus produced should not, however, be attributed to scientific hydrotherapy, but must be charged to the stupid audacity of quackery, or to the lack of information or experience of the otherwise competent physician.

According to Pliny, the bath was almost the exclusive method of treatment employed in Rome during five centuries. Celsus and other prominent Roman physicians highly extolled the bath in their works, Celsus later making it one of the three essentials of what he called a perfect therapeutic system, termed "apotheraphia," the other two being exercise and friction. During the middle ages the Arabic physicians, the most learned men of their time, were enthusiastic advocates of the bath, especially in fevers, and their directions for the treatment of smallpox and measles could scarely be improved upon at the present time. Rhazes recommended drinking ice-water to the extent of two or three pints within half an hour, as a means of reducing the temperature in fevers. Avicenna recommended cold water for the relief of constipation.

M. Barra, of Lyons, published in 1675 an interesting little volume entitled "L'Usage de la Glace, de la Neige, et duFroid" (The Use of Ice, of Snow, and of Cold). In this work the author anticipated many of the therapeutic uses of cold which have, by scientific experiments within the last half century, been placed upon a sound therapeutic basis. He calls attention to the fact that the Hebrews made use of melted snow for drink, and cooled water by exposing it to the action of the wind, afterward keeping it in vessels covered with straw. He pronounced cold water to be the best of all remedies for continuous fever, and especially recommended it for "erysipelas, pestilential fevers, contagious boils, frost bite, dysentery, pleurisy, the plague, inflammation of the throat, and tightness of the stomach."

Lanzani, an Italian physician, wrote an elaborate thesis on the internal use of water for the treatment of fevers, in the early part of the 18th century. Fra Bernardino, about the same time, acquired the name of "the cold-water doctor" by the use of iced water in the treatment of indigestion, nervous disorders, hemorrhages, etc. He required his patients to drink from three to six glasses of ice-water daily. He avoided sweating, and aimed to stimulate the bowels and kidneys.

We quote below a few interesting extracts from a small work entitled "Primitive Physick," by John Wesley, M.A., the founder of the Methodist Church, published in 1747, which afford ample evidence of the existence at that period among the common people of a very considerable amount of knowledge respecting the use of water in a variety of ailments, as well as for the preservation of health, since the remedies recommended in Wesley's work were all such as he found in successful use among the people.

For ague or intemittent fever, "go into the cold bath just before the cold fit" (this method is still in use in Germany and France"; or, "drink a quart of cold water just before the cold fit, and then go to bed and sweat."

For a tertian ague, it is recommended to "use light and sparing diet on the day between," "or use the cold bath (unless you are of advanced age or extremely weak [a wise precaution, showing no little experience]). But when you use this, on any account whatever, it is proper to go in cool; to immerge at once, but not head foremost; to stay in only two or three minutes (or less at first); never to bathe on a full somach; to bathe twice or thrice a week at least, until you have bathed nine or ten times; to sweat immediately after it )going to bed), in palsies, rickets, etc.

"Before the cold fit begins, go to bed, and continue a large sweat by [drinking] lemonade for six or eight hours. This usually cures in three or four times. If it does not, use the cold bath between the fits." The writer found this method in use among the laity of the middle part of the United States nearly forty years ago, 1868, and with success in cases in which quinine and other antiperiodics had failed to effect a cure. For apoplexy, "to prevent, use the cold bath, and drink only water." For asthma, "take a pint of cold water every morning, wash the head therein immediately after, and using the cold bath once a fortnight." "For present relief, vomit with a quart or more of warm water. The more you drink of it the better." For dry or convulsive asthma, "use the cold bath thrice a week." "To prevent swelling from a bruise, immediately apply a cloth five or six times doubled, dipped in cold water, and new dip when it grows warm." "To cure a swelling from a bruise, foment it half an hour, morning and evening, with cloths dipped in water as hot as you can bear." For a burn or a scald, "immediately plunge the part into cold water. Keep it in an hour; or if not well before, perhaps four or five hours." "To prevent the rickets, tenderness, and weakness [in children], dip them in cold water every morning, at least until they are eight or nine months old." For whooping cough, "use the cold bath daily." For cholera morbus, "drink two to three quarts of cold water, if strong, or of warm water, if weak." For a cold, "drink a pint of cold water lying down in bed." For colic, "drink a pint of cold water, or a quart of warm water, or [apply] hot water in a bladder, or steep the legs in hot water, a quarter of an hour." For hysteric colic, "use the cold bath. Using the cold bath two and twenty times a month has entirely cured hysteric colic fits and convulsive motions." For chronic headache, "keep your feet in warm water, a quarter of an hour before you go to bed, for two or three weeks." For headache from heat, "apply to the forehead cloths dipped in cold water, for an hour." For one seemingly killed by lightning or suffocation, "plunge him immediately into cold water." For mania, "apply to the head, cloths dipped in cold water, or pour cold water on the head out of a teakettle, or let the patient eat nothing but apples for a month." For rheumatism, "use the cold bath, with rubbing and sweating." For rickets, "wash the child every morning in cold water." For sciatica, "use cold bathing and sweat, together with flesh-brush twice a day; or drink half a pint of cold water daily in the morning and at four in the afternoon." For stone, to prevent its occurrence, "drink a pint of warm water daily just before dinner." "It is also useful to use the hot bath a few days before you use the cold." Wesley recommended cool bathing for the cure of nearly all the affections of childhood, all chronic diseases, and many surgical cases.

Although Wesley was not a physician, but simply described in his work such successful remedies as he found in common use, one cannot but note the sagacity and wisdom displayed in many of these recommendations, which in many instances could scarcely be improved upon at the present day, and certainly evince extended and accurate observation of the efects of hydriatic applications.

Cullen made some very practical observations respecting the therapeutic uses of water. In his treatise on fever he commended water as a sedative when used in such a manner as to "moderate the violence of reaction," and as a tonic when used for "supporting and increasing the action of the heart and arteries." The action of cold he described as follows:
1. Diminished temperature and pallor of the skin
2. Weakened action of the heart and arteries, observing that in cold countries the pulse in uniformly slow.
3. Weakness and inactivity, effects observable in the inhabitants of cold countries.
4. Prolonged and very cold applications "are capable of entirely extinguishing the vital powers," cold combined with moisture chilling the body much faster than dry cold.
5. Cold applications prepare the body for applications of heat, "producing accumulation of sensibility to the stimulus of heat."

Cullen used water according to Dr. Darwin's rule- "warm the patient in the cold fit, and to cool him in the hot one."

HYDROTHERAPY IN EUROPE: It is very interesting to observe how few of our modern methods of employing water are really new. The moist compress was well known to the ancient Greeks under the name of "epithem." According to Sir John Floyer, who wrote in the latter part of the seventeenth century, the wet-sheet pack was employed in his time by sportsmen who wished to diminish the wright of their jockies. The method is thus described: "Dip the rider's shirt in cold water; and after it is put on very wet, lay the person in warm blankets to sweat him violently, and he will after lose a considerable weight, a pound or two."

The same method was used in the treatment of various maladies, particularly rickets in children. The child, being prepared for bed with a gown and nightcap, was quickly immersed in cold water, then put to bed closely wrapped in warm blankets, and left in this condition all night, sweating profusely, a portion of the clothing being removed toward morning so that the body might be gradually cooled. That it was the custom to employ this method with great perseverance is evidenced by the following suggestion made by the learned author: "If one year's dipping proves not successful, it is repeated the next year, which generally answers expectation."

Floyer also mentions that in Staffordshire and other parts of England it was a custom with the people "to go into the water in their shirts, and when they come out, they dress themselves in their wet linen, which they wear all day, and much commend that for closing the pores and keeping themselves cool; and that they do not commonly receive any injury or catch any cold thereby, I am fully convinced from the experiments I have seen made of it."

The leading features of the so-called "Kneippism" are simply a revival of these rude practices of ignorant English peasants a century and a half ago.

Sir John Sinclair, in his "Code of Health and Longevity," gives an account of an English nobleman, born in the year 1700, who for a great part of his life was accustomed, immediately on arising in the morning, to wrap himself in a sheet just dipped in cold water- a wet-sheet pack.

In the fifteenth century, Savonarola, an Italian physician, made a systematic use of the cold bath, and Barizzi employed the cold vaginal douche in uterine affections. Cold affusions and general couches were employed by Baccio in Italy, while leading Spanish and German physicians recommended cold applications for insomnia.

Septala, in the seventeenth century, employed the cold douche for the relief of headache and sunstroke.

Herman, a Belgic physician, resorted to the use of cold water at the same period for the relief of constipation, migraine, paralysis, and mania,- maladies in the treatment of which cold water still holds its own against all other single remedies.

HYDROTHERAPY IN ENGLAND: Sir John Floyer, in 1697, published a history of cold bathing, in which he directed that the patient should be made to sweat before taking the cold bath, by wrapping him in a wet sheet with blankets, precisely the same method employed more than a century later by Priessnitz, and now known as the wet-sheet pack. Floyer also erected a water-cure establishment at Litchfield, England, in the latter part of the seventeenth century. Two rooms were provided, one of which was used for hot baths and dry packs to produce sweating, while cold baths were administered in the adjoining room.

John Hancock published a work entitled " Febrifugum Magnum, " in 1723, in which he demonstrated the value of water-drinking as a means of treatment in scarlet fever, smallpox, and measles. He cured ague by having the patient drink large quantities of cold water while wrapped in blankets, thus inducing profuse sweating.

Sir John Chardin, a celebrated English traveler of the 18th century, had bilious remittent fever when in Persia. His companion, a French surgeon, thinking his case hopeless, a native physician was called in, who made the patient fast five days, and drink large quantities of water previously cooled with snow, causing him to lie meanwhile upon a mat wet with water, and keeping the skin constantly wet with water. Water was also poured at intervals over the patient while two men supported him. In two days the fever disappeared.

This Persian physician evidently had a knowledge of the value of water-drinking, of the evaporating bath, and of the affusion as a means of combating fever,- invaluable measures, of which Western physicians are scarcely yet making any considerable practical use.

The native physicians of Mohammedan countries still generally follow Galen, and so make use of water in many maladies in a very effective and practical way.

THE WORK OF CURRIE AND JACKSON: Two English physicians, Currie and Jackson, in the latter part of the 18th century, made a most intelligent and scientific study of the use of water in fevers, and with results which for a time commanded much attention from the profession in England. Currie discovered many important principles relating to hydrotherapy, some of which have not always been kept in mind by his successors in the use of water. For example, he says that the indications for the use of water in fevers, especially intermittent, are as follows:
1. To diminish cold in cold stages.
2. To diminish heat in heat stages.
3. To diminish spasm of blood-vessels.
4. To support the powers of life till the diseased association die away from the ceasing of their causes.
5. To unload the bowels.

He also advised cold water drinking in large quantities, immersion instead of affusion in warm countries, where the water is seldom at a lower temperature than 70 F., and suggested that after immersion the patient should be exposed to the air, so that the body might be cooled by evaporation. He recommended as a principle of the utmost importance for regulating the use of water, that it might be safely used "when there is no sense of chilliness present, when the heat of the surface is steadily above what is natural, and when there is no general or profuse perspiration." he observed that a cold pour could be used more safely than cold sponging, for the reason that it is "an energetic remedy," and "the system often accommodates itself to a cold which is general and stimulating, but shrinks from a cold which is slow and successive."

He also warned against fatigue occasioned by too much bathing, and recommended that after the bath the patient should be dried "hastily with towels," and recommended that when too severe effects had been obtained, causing too great depression, the extremities should be rubbed, and "a bladder of hot water applied to the stomach."

Currie also noted the evil effects of reaction in fever, and taught that short cold applications should not be made in cases of high fever, on account of their tendency to increase the fever. he also taught that great mischief might result from the use of hot applications immediately after cold in such cases. He made use of the "wet blanket," or pack, in fevers, and observed that it relieved delirium. He also applied cold to the feet in hemorrhage of the lungs, and in a case of pulmonary hemorrhage suddenly plunged the patient up to the hips in cold water, a method previously successfully used by Dr. Darwin for relief of hemorrhage from the kidneys.

Even before the time of Currie, Crawford, in 1781, had recognized as one of the physiological effects of cold, its influence upon oxidation, observing that cold "increases the difference in color between arterial and venous blood, while heat lessens this difference in color."

For some reason not easily understood, the work of Currie and Jackson, the ablest of the early pioneers of a truly scientific method of inestimable value in febrile disorders, was lost sight of, and it was not until the attention of the whole civilized world was attracted by the fame of an uneducated and blundering, but still successful, cold-water empiric, that the profession began to give this agent the serious attention that was its due; for the modern popularity of water as a remedy must without doubt be largely credited to the enterprise and ingenuity of a Silesian peasant, Vincent Priessnitz, born in the little village of Graefenburg, in Austrian Silesia, in 1790.

HYDROTHERAPY IN AMERICA: At a very early period, Dr. Benjamin Rush, of Philadelphia, used cold water with success in the treatment of rheumatism, gout, smallpox, measles, and many other maladies, including yellow fever. Currie declares that he found cold water "a most agreeable and powerful remedy... applied by means of napkins to the head, and to be injected into the bowels by means of the clyster, also washing the face and hands, and sometimes the feet, with cold water." In 1794 Rush introduced the use of broken ice in a bladder applied to the head in fevers, and claimed great advantage from the employment of this remedy.

Drs. Bard and Hosack, of the New York Hospital, began the use of cold water in fevers about the year 1795, three or four years before Currie's book on the medical uses of water appeared in America.

In 1799, Peter Edes, of Augusta, Me., published an interesting little work on the use of water, summarizing Currie's volume, and adding observations of his own.

Another American writer ingeniously suggested, in 1808, the employment of moistened clay as a cooling application for inflamed and congested parts. He used cold in the early stages of fever, but forbade its use in the latter stages.

Among the earliest scientific observations respecting the effects of the bath as regards both the physiological and the therapeutic effects of water, must be noted the careful experiments conducted by Henry Wilson Lockette, of Virginia. These experiments were published by him in the year 1801 in "An Inaugural Dissertation of the Warm Bath, presented to the Trustees of the Medical Faculty of the University of Pennsylvania for the Degree of Doctor of Medicine." In this treatise, a copy of which the author is so fortunate as to have in his library, Dr. Lockette details with great perspicacity the effects upon the pulse and general functions, of baths of different duration at varying temperatures. Among the observations that he made, were the following:
1. That a foot bath at 110 F. increased the pulse from 76 to 92 beats a minute, the redness of the legs and the enlargement of the veins of the feet and legs and the slight but temporary pain in the head showing clearly the exciting effect of this treatment.
2. That a full bath at 107 F. raised the pulse from 72 to 114 pulse, producing congestion of the veins, drowsiness, and profuse perspiration. The excitation continued for more than a quarter of an hour after the bath.
3. That a bath at 96 F diminished the pulse from 79 to 64 beats in ten minutes, whereas an elevation of temperature to 100 raised the pulse to 80 beats, and a greater increase of temperature (to 105) increased the pulse in fifteen minutes more to 92 beats. "The patient sweat freely and yawned after dressing, and was much debilitated, complaining of weakness in the legs, "- a very good description of the depressing effects of the hot bath.
4. That a bath at 90 F. lowered the pulse, in five minutes, from 80 to 64 beats. An elevation of temperature to 100 raised the pulse in ten minutes to 73 beats; and raising the temperature to 105 in twenty minutes more raised the pulse to 118 beats, with difficulty of breathing and profuse perspiration.

He noticed , among other effects, that a bath in which the temperature was gradually raised to 110 raised the pulse from 83 to 153 beats, producing intolerable pain in the head, partial delirium, confusion of thought, inability to speak, dimness of sight, vesical tenesmus, and "sensations which are commonly present in a violent state of fever." On leaving the bath, the experimenter nearly fainted, and sweat profusely for some time.

During the middle decades of the present century hydropathy flourished to a considerable extent. Many institutions devoted to the carrying out of these measures were established in different parts of the United States, and scientific hydrotherapy was ably advocated by Dr. John Bell, of Philadelphia, whose work on "Baths" has, up to recent times, remained the most complete and able treatise on the subject in the English language.

THE HYDROPATHY OF PRIESSNITZ. When seventeen years of age, Priessnitz met with an accident whereby he received numerous bruises and other injuries, including the fracture of two of his ribs. Local physicians gave him no hope of recovery; but having been accustomed to use water in the treatment of the domestic animals for which he cared, it occurred to him to try the same remedy for himself. He covered the affected parts with cloths kept wet with cold water, and was in a short time completely cured. Hearing of this remarkable cure without the use of drugs or the application of any of the ordinary salves or lotions, many wounded persons, and later people suffering from chronic diseases, came to Priessnitz for relief, and soon his whole time was occupied with their care. Priessnitz was not a quack, for he made no great pretensions. He did not claim special knowledge or skill. He made no pretensions to the possession of any secret method or process. His work was done frankly, honestly, and openly. He was a man of few words, of serious, dignified character, an enthusiastic student of nature. He labored patiently and earnestly for the development of the great principles which he recognized. He commanded the respect of his countrymen, even of members of the profession. He was granted a diploma by the Austrian government after an official investigation of his work and methods. The French government sent the head of the medical department of the army to study his methods, and by this means hydrotherapy was introduced into the military service of France nearly a century ago. The government of other countries did likewise. Thus the principles and methods developed by this nature-taught physician were rapidly diffused.

The basis of the system of Priessnitz was perspiration, followed by cold applications. His methods were exceedingly crude and were administered with comparatively little discrimination, the natural result of his total lack of medical knowledge. However, his native tact and sagacity soon led him to recognize a difference in the ability of his patients to react to cold applications, and he accordingly made it a practice to observe in each case the effects of the first application, the readiness with which the patient yielded to the means adopted to induce perspiration, and the promptness with which reaction took place on the application of cold water.

Priessnitz discovered little, perhaps, but he succeeded in calling general attention to the efficacy of various simple methods of applying water as a remedial agent which had previously been little appreciated. And he accomplished more than this. He aided to recovery a vast number of chronic invalids whose maladies were practically incurable by the measures in common use by the medical profession of that time; and though at first denounced and opposed by scientific physicians because of his empiricism, the more sagacious among them, after a time, became convinced of the genuineness of the cures effected, and many visited him for the purpose of studying his system, such as it was.

Priessnitz found nearly all the methods of employing water which entered into his system, in use among the peasantry of his country, by whom they were commonly employed, at least as early as 1737, and probably even before that time. Priessnitz, however, was one of the first to organize the use of these various measures into a system, for which he deserves much credit. Crude and empirical though his system was, his success was sufficient to compel attention, and he commanded an extensive following.

The attention thus attracted led to a careful study of the physiological effects of water in its various modes of application, for the purpose of finding a scientific foundation for its therapeutic use. Among the first to undertake this study was Fleury, who published in 1852, the first extended scientific treatise upon hydrotherapy, under the title, "Traite Pratique et Raisonne d' Hydrotherapie."

SCIENTIFIC HYDROTHERAPY. Liebermeister, Brand, and Ziemssen in Germany, and above all, Winternitz, of Vienna, revising, and his pupils greatly extending the work of Fleury and other pioneers, have within the last half century built up a scientific hydrotherapy which is based upon definite and accurate data. Before Fleury, the use of water was for the most part empirical; at the present time, however, thanks to the labors of the eminent investigator whose names have been mentioned, supplemented by those of Jurgensen, Rosbach, Bouchard, Delmas, Robin, BeniBarde, Strasser, D' Arsonval, and others, it may be fairly stated that there is no therapeutic agent whose use rests upon a more thoroughly rational and scientific basis than water. It has thus been rescued from the hands of empirics and charlatans, and is now recognized by eminent medical men as one of the most potent of all remedial agents.

Hartshorne, of Philadelphia, published in 1847 a suggestive and thoughtful treatise on the use of water. In 1850, Bell, of the same city, published the best and most comprehensive work on the subject which had appeared in English before the translation and publication of the masterly treatise by Winternitz as a part of Ziemssen's therapeutics in 1883.

The work of Winternitz in establishing hydrotherapy upon a sound scientific basis so greatly exceeds that of all other investigators in modern times that we have given, at the close of this work, a complete list of the contributions to hydrotherapeutics made by this eminent pioneer in this line of medical research, which Dr. Winternitz, at the author's request, has kindly furnished him.

It is but just also to call attention to the indefatigable labors of Dr. Baruch, of New York, in calling the attention of the profession to the great value of water in the treatment of both chronic and acute disorders.