Basic Techniques in Hydrotherapy
Hydrotherapy is an ancient healing approach with roots in Greek, Egyptian, and
Roman Civilizations. This powerful tool is still used today to revitalize,
maintain, and restore health.
 Introductory Principles of Hydrotherapy
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Many variables in hydrotherapy:
o Those that the practitioner can control
 Temperature
 Duration
 Extent of Treatment
o Those determined by the client’s health picture
 Client’s Disease
 Client’s Vitality
 Client’s ability to tolerate hydrotherapy
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It is the job of a successful hydrotherapist to manipulate the variables that
are under his/her control in response to the variables that are not under
his/her control to create optimum response.
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Temperature:
o The greater the difference between applied temperature and the client’s
body temperature, the greater the intensity of the treatment
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
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Timing:
o Duration of Application
 When temperatures are extreme the duration is inversely
proportional to the overall intensity of the treatment
o For example: A sitz bath at 55ºF for one minute will be a stronger
treatment than a sitz bath at the same temperature for 10 minutes.
While this can be counterintuitive, you must take into
consideration that the body will accommodate to
changes/conditions in an attempt to create homeostasis.
 Now, to confuse even further, treatment at moderate temperatures
(closer to normal body temperatures), are directly proportional to
the duration of the treatment.
o For example, a neutral bath at 94 ºF for an hour is a stronger
treatment than a half hour at the same temperature.
o The body does not respond quickly to create the opposite reaction
in order to re-establish homeostasis, but instead reacts slowly;
therefore the longer the treatment, the more of a reaction.
o Hour of the Day
 If hydrotherapy treatment is performed at the client’s “strong” time
of day, the treatment will be more effective
o For Example: The client feels like a million bucks at 8 am, but
feels horrible at 3 pm. Treatment will be most effective at 8 am
and least effective at 3 pm, when their body is already exhausted
and you’re pushing it to respond.
Location or site of application:
 Extent of application: The greater the treatment area, the greater the
intensity of treatment.
Application of Pressure or Friction:
o Pressure: A steady stream of water sprayed at the body externally is
considered pressure
o Friction: A cold friction massage (or ablution-meaning washing) given
with a mitt at 55 ºF will be a stronger treatment than a massage given with
the bare hand at the same temp of water. Heavy friction will feel warmer
than light friction.
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
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Pressure and friction send nervous stimuli that compete with the
incoming stimuli of cold perception, so heavy friction will more
strongly compete
 Also pressure and friction will also increase local circulation, bring
more blood to the area, and warm the cutaneous tissue, which helps
quiet the cold receptors
For compresses: The material that covers the compress will make a
difference. Is it porous or not porous?
For compresses and fomentations: Wetness of the application-the more wet
the application, the stronger the impact on the body.
o Example: A towel loosely wrung out with hot water carries more heat
than a towel that is tightly wrung out (i.e. less water left in it)
 Modern history1
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1697-John Floyer, English physician published The History of Hot and Cold
Bathing. It was translated into German in 1749, and is presumed to have
influenced Johann S. Hahn.
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Johann S. Hahn (1696-1773), along with his father and brother (medical
doctors), established the principles of modern hydrotherapy in Germany.
o The Hahn’s lived and practiced in Silesia, Austria
1
Lectures in Naturopathic Hydrotherapy; Boyle, Wade, N.D. and Saine, Andre, N.D. Eclectic Medical
Publications, 1988
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND

Vincent Priessnitz (1799-1852, Silesia, Austria) was a peasant who grew up
on a farm. The story states that his elderly neighbor, who treated the cattle
with water, taught young Priessnitz how to utilize this therapy. Priessnitz, in
turn, treated the farm animals with this water therapy. In 1816, he was
injured in a farm accident and broke two ribs. When the surgeon was
consulted, Priessnitz was told by the surgeon that he could not do anything
for him. Priessnitz reduced his own fractures by pressing his rib cage
against a chair, then wrapped his chest in cold towels and drank lots of
water. He regained his health and began treated his neighbors with cold
water. Through further practice he discovered that combining sweating
treatments and cold water treatments worked even better in some chronic
conditions. He was said to be so successful with these therapies, that people
travelled to seek his therapy and his house became too small for all the people.
In 1830, the Austrian government gave him special authorization to treat
patients with his water therapies, despite the fact that he had no formal
medical training. The story further states that demand was so high for his
services that the government was forced to build new roads to facilitate access
to his clinic. Physicians from many countries made pilgrimages to
Priessnitz’ to study under him and open their own “water cure” clinics.
One of his best students was J.H. Rausse (1805-1848).
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J.H. Rausse wrote The Water Cure Applied to Every Known Disease and later
published Errors of Physicians and others in the Practice of Water Cure
under the pseudoname Francke
o Many others, less well known, followed, including: Louis Kuhne, who
wrote Neo-Naturopathy and articulated the “Unity of Disease” theory;
Adolph Just who wrote Return to Nature, F.E. Bilz who wrote The
Natural Healing Method. The most successful to follow was Father
Kneipp
Sebastian Kneipp (1821-1897) applied for the priesthood, but was initially
rejected due to having tuberculosis. After curing himself of his disease by
the use of water treatments and diet, he was admitted to the priesthood. As a
priest, he began to treat his parishioners with the same treatments that he had
utilized to cure himself. He wrote, My Water Cure, in which he detailed his
water and herb treatments. This had a very strong and direct influence on
the practice of hydrotherapy today.
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Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
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Also disbursed throughout these definitive early years, were many other
practitioners, texts, and developments. James Curry was the first to insist on
thermometric monitoring of fever patients as a guide to water treatment.
A Viennese water physician, Wilhelm Winternitz (1834-1912) wrote over
200 articles and books on hydrotherapy, trained hundreds of doctors and
nurses, and treated thousand of patients in his Kaltenleutgeben institutes. He
was also the first to discover that hydrotherapy has a marked
physiological impact on the nervous system. He was a mentor to Drs.
Simon Baruch and John Harvey Kellogg, who brought hydrotherapeutics
to the United States.
John Harvey Kellogg (1852-1943) helped establish and run the famous
Battle Creek Sanitorium in Michigan. His book Rational Hydrotherapy
was published in 1901 and is still considered the definitive textbook for
hydrotherapy, even today.
Simon Baruch practiced hydrotherapy successfully on a hospital-wide scale
throughout New York state and wrote two important texts among the world
of hydrotherapeutics, The Principles and Practice of Hydrotherapy (1898)
and An Eptitome of Hydrotherapy (1920).
o In reality, hydrotherapy had already begun to bubble in the U.S. before
Kellogg and Baruch presented their teachings, as early as 1725 with John
Smith, 1845 with Benjamin Rosh, and several more.
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND

Benedict Lust (1872-1943) was born in Germany and contracted TB in his
youth. As a last resort he went to Father Kneipp, and was cured. In 1892
he was “commissioned” by Father Kneipp to introduce the Kneipp water cure
to the U.S. Lust added his studies in chiropractic, massage, and other
emerging natural therapies and brought this to the U.S. .

Henry Lindlahr (1852-1925) was a real estate tycoon, mayor, and banker in
Montana. At 41 years old, he weighed over 250 pounds and was diagnosed
with diabetes. He was told by his doctor to “settle his affairs”. He then
journeyed to Vienna to consult with doctors there and was told the same thing.
In a last attempt, he went to Father Kneipp who told him “You have the
sugar disease. You are a pig. You will take sitz baths, live on fruits and
greens and vegetables alone. You shall have no breads, no cereals, no
meats.”. By spring of the next year, his diabetes was gone and he had lost 40
pounds. He returned to the U.S., studied medicine and eventually
established a sanitarium in Chicago (he was also the father of
Naturopathic Medicine).
http://www.soilandhealth.org/02/0201hyglibcat/020123lindlahr/020123toc.html

Dr. O.G. Carroll (1879-1962) created constitutional hydrotherapy and is
considered a central character in the history of hydrotherapy. As a child
had rheumatic fever and juvenile arthritis and was cured by a student of
Father Kneipp (Dr. LeDoux), he went on to study at Cleveland Chiropractic
College in Chicago and proceeded to further studies with Lindlahr, and
eventually became the doctor to Lindlahr, Lust, Kellogg’s family and was
a mentor to Dr. John Bastyr (one of the greatest Naturopathic physicians in
history, founded Bastyr college of Naturopathic Medicine), and Dr. Harold
Dick.
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
 Terminology2 3
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Hydrotherapy: The application of water for the purpose of treating disease
and maintenance of health (externally or internally).
Hydropathy: refers to the “water cure” which arose from empirical tradition
and is professed to cure all diseases by the use of water (especially cold)
Balneology or Balneotherapy: The use of baths for therapy
Ablution: Application of water by a hand covered in a mitt or towel
Affusion: The pouring of water in a stream on the body or a localized
segment of the body (usually used to lower body temp in fever).
Poultice: A soft, moist substance spread between layers of cloth, heated, then
applied to a local area (ex. Onion, carrot poultice to neck, Mustard plaster)
Compress: A moist pad of folded material (linen) applied to an area with
pressure; sometimes medicated.
Heating compress: Cold compress is applied to part of the body and then
covered by dry flannel. The body responds by increasing circulation to warm
the area.
Fomentation: A VERY hot, moist application (usually wool)
Derivation: The drawing of blood or lymph from one part of the body, by
increasing circulation to another part of the body.
Retrostasis: The driving of blood or lymph from one part of the body to
another.
Alternate: A series of alternating hot and cold applications to the same area
of the body, with at least 3 applications of each (called 3 cycles). The cold
applications should be 1/4th to ½ the length of the hot applications.
o For instance: 3 minutes hot, 45 seconds cold (which is often rounded to 30
seconds of cold for ease).
Revulsive: A single prolonged application of heat followed by a single brief
application of cold (the difference with alternate being the amount of time
each temperature is utilized, therefore manipulating the effect)
Fluxion: A large increase of the circulation in a particular part of the body
Depletion: Reduction of blood in a congested area (often by cold
applications)
Other Hydrotherapy Terms (For Your Information, but not terms that we will
utilize today):
o Crenology or Crenotherapy: Therapeutic use of water from mineral
springs
o Douche: A stream of water directed against a part of the body or into a
body cavity
o Clyster: a fluid injection into the rectum (i.e. an enema)
2
Lectures in Naturopathic Hydrotherapy; Boyle, Wade, N.D. and Saine, Andre, N.D. Eclectic Medical
Publications, 1988
3
The Princtiples and Practice of Hydrotherapy; A Guide to the Application of Water in Disease for
Students and Practitioners of Medicine, Baruch, Simon , M.D. William Wood and Company, 1908.
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
 Properties of water
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Andre Saine, ND and Wade Boyle, ND in Lectures in Naturopathic
Hydrotherapy state: “If you are going to be hydrotherapists, it is only fair that
we let you in on the secret of hydrotherapy from the outset which is that, aside
from its universal solvent action, water possesses no innate healing
qualities. If it did, there would not be so many sick people in the world. In
fact, the term “hydrotherapy” is, in some ways, a misnomer and should
more properly be called “thermotherapy,” i.e., the treatment of disease
by the application of hot and cold.
On the other hand, the point is made that heat and water are two of the most
therapeutic agents available to any healer. “If water were not of central
importance to health, the body would not be made of such a large percentage
of it; if heat were not vitally important to health, the body would not be
equipped to maintain such a narrow thermic range…We want to impress upon
you that water treatments belong in the same category (powerful modalities
which must be used with accuracy and precision). “
 Properties of hot and cold
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Definitions of temperatures/temperature ranges:
o Temperatures above 110˚ F are painful (110-124˚ F), and
temperatures around and above 124 are dangerously hot and may
cause damage.
o Very Hot: 105-110˚ F, short periods
o Hot: usually refers to temperatures between 98-104˚ F, part applied to
will turn red
o Neutral: 93-97˚ F
o Tepid: 81-92˚ F, i.e. slightly below skin temp.
o Cool: 66-80˚ F, results in goose bumps
o Cold: 55-65˚ F, usually uncomfortable but tolerable
o Very Cold: 32-54˚ F, painfully cold
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Circulatory Effects of Hot and Cold:
o Short hot (< 5 mins) stimulates circulation
o Long hot (> 5 mins) depresses circulation
o Short cold (<1 min) stimulates circulation
o Long cold (>1 min) depresses circulation
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The Body’s reaction to hot and cold
o Cold is a much greater threat to the body (being further away from the
body’s natural temperature), therefore the body acts more quickly to
address the threat. If the cold continues long enough after the body has
already reacted, a depressive effect will take over.
 To explore this effect in more depth, a cold application will have an
immediate (momentary) vasoconstrictive affect, immediately followed
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
by a vasodilating compensation. If enough time elapses, the body will
again begin to vasoconstrict.
o Since the body is less threatened by heat, it reacts more slowly to
application of same.
 Hot application will cause vasodilation, then vasostasis (blood will
pool in area)
o When considering the terms long and short, temperature should remain
more or less the same over that time. Otherwise, a longer duration of a
temperature that is decreasing over time may actually equal a short
duration. This concept can be very confusing. The following examples
demonstrate these concepts: A bath is considered a relatively maintained
temperature, as the body will not greatly influence a change in the
temperature of water within the tub. On the other hand, consider a hot
towel applied to the chest, following by the individual being covered by
wool blankets for 10 minutes. Even with the covering of wool blankets,
the towel will continue to decrease in temperature over time (perhaps
losing 15 or so degrees in a few minutes). Thus it would be more
accurately described as a short application, as it maintained its hot
temperature for less than five minutes before reducing to a point of being
neutral. The same concept would apply for a cold towel applied in same
manner, in that the body would warm the towel to a cool state in less than
a minute (and a neutral state within a few minutes). Thus, this would also
be considered a short application, regardless of the towel being applied a
longer period of time.
o When using the term stimulation, this means increased blood flow,
increased nutrient delivery to the cells, increased oxygen absorption,
increasing metabolism, and increased waste products being taken way
from cells. Tissue tonicity will depend on the temperature causing
stimulation, i.e. hot will decrease tissue tone and cold will increase.
 Blood
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It is impossible to discuss circulation, without visiting blood and its
constituents to understand on a deeper level that when we mechanically
manipulate circulation, we are thus manipulating the components that are
circulating.
Everyone remember their Anatomy and Physiology courses????
Blood consists of RBCs (approx. 45% of blood volume), WBCs (approx. 1%
of blood volume), Platelets (< 1% of blood volume), and the aforementioned
components are suspended in a fluid called Plasma (approx. 55% of blood
volume)
o It is important to also note that although plasma is mostly H2O, it contains
a large number of substances-many of which are essential to life
(including a mixture of proteins, fats, minerals, etc.)
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
 Manipulation of circulation by hot and cold (some of these concepts have
already been discussed)4
 Direct Method (reliable, will happen every time): Applying a direct hot or
cold application, causing direct local stimulation or depressive effects in the
superficial tissue as a result.
 Alternate: Alternate application of hot and cold. By alternating, you
magnify the effects of the following application, thus acting synergistically.
 Derivation or Retrostasis (drawing of blood/lymph from one part of the
body, or driving blood/lymph to a part).
o Derivation is accomplished by heat, while retrostasis is accomplished by
cold. For example: Feet placed in a hot foot bath will cause local
vasodilation and thus draw the blood and lymph to the feet. While cold
application to the feet will vasoconstriction and push/drive blood away
from the feet.
o Retrostasis and Derivation can be further applied together. For
example, if an individual has a congestive headache, a hot foot bath and
cold application to the head or back of the neck will work synergistically
to drive the blood away from the head and pull towards the feet.
o Collateral Circulation (more advanced concept): Modification of blood
flow at a superficial artery will create the opposite reaction in a deeper
artery distal to a bifurcation.
-To elaborate: Consider where a large artery bifurcates (splits) into a
superficial branch and a deep branch. If you apply cold over the
superficial branch, it will result in constriction, forcing the blood flow
from the large artery to redirect to the deeper branch (which would dilate
to accomodate). If hot were applied over the superficial branch, it would
dilate and thus the blood would be diverted to the superficial branch and
the deep branch would constrict.
4
Lectures in Naturopathic Hydrotherapy; Boyle, Wade, N.D. and Saine, Andre, N.D. Eclectic Medical
Publications, 1988
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
o Arterial Trunk Reflex: By affecting the arterial trunk, the affect is
passed on to the smaller vessels fed by that trunk. For example, if an
individual has a cut on their hand or foot, applying cold proximal to the
cut at the trunk would cause better control of bleeding.
o Spinal Cord Reflex: Refers to the nerve registering stimulation, i.e.
relaying impulse, to the brain and the brain creating a response. This is
useful because if you have an injury to one foot, you can actually treat the
other foot, which will register the input to the brain and cause some bilateral response. Therefore causing a response in the injured foot, without
having to treat that foot.
 Hydrotherapy Techniques:
o Hot Foot Baths: Local immersion of the feet and ankles in water at a
temperature of 102-112 degrees F for 10-30 minutes
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
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Effects:
1.Derivative effect:
-Draws congestion from upper body and internal organs inferiorly
2. General warming of body:
-to prepare for other modalities/cold treatments
-Diaphoresis (encourage sweating)
3. Sedative
4. Increase WBC count and acitivity
Note: You must be careful and take into consideration the individual. If
their vasculature cannot support increased metabolism, then this
treatment should not be performed as it may cause damage.
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Indications
 Congestion of upper body
 Head, chest, sinuses, pelvis
 Infections
 Plantar warts
 Suppressed menstruation
 Detoxification: increased cellular metabolism
 Insomnia
 Epistaxis (combined with cold compress on nose)
 Preparation for cold treatments
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Contraindications
 Active inflammation/edema in lower extremities
 Neuropathy
 Peripheral Vascular Disease: ateriosclerosis, Buerger’s disease
(necrosis on tips of extremities…found a lot in smokers), deep vein
thrombosis (Heat Increased metabolism that the body may be
unable to support due to impaired vasculature)
 Diabetes Mellitus (DM)
 Bruising
 Malignancy
 Open wound/ active bleeding
 Elderly and children do not have optimal thermo-regulation-Use
with caution
 Loss of consciousness
 Loss of sensation
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Procedure
1. Fill basin with hot water
2. Start with warm and end with hot
3. Client’s feet in basin, cover with hot towel
4. End footbath with cold!
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
 cold mitten friction rub
 pour cool water over the feet
 pour cold water in the basin
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Combine with cool compress to head for congestive headache,
epsitaxis
o Heating Compresses: A cold compress applied to the body and covered
with wool that the body then actively heats
 Heating Compress
mechanism:
First stage – cold
1. Vasoconstriction
2. Decreased metabolism
3. Increased heart/respiratory rate
Second stage – heat
1. Vasodilation
2. Increased cellular metabolism
3. Diaphoresis
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Effects:
 Derivative: Draws blood from an area of congestion to another
area of the body
 Increases blood flow locally increasing diffusion of nutrients
 Immune system
 Increases circulation/ metabolism/ WBC activity
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Indications:
 Chest compress: Mastitis, chronic bronchitis, pneumonia, chest
cold, flu, cough
 Abdominal compress: diarrhea, ulcerative colitis, Crohn’s
disease, IBS
 Throat Compress: pharyngitis, laryngitis, tonsillitis,
lymphadenopathy
 Joint compress: Non-rheumatoid arthritis
 Wet sock
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Contraindications
 Debilitated client that cannot heat the compress
 Chilly client/ low body temperature
 Skin conditions aggravated by prolonged moist application
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
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Procedures:
1. Wet T-shirt-chest applications :
-apply a cold wet, wrung T-shirt (relative to client’s vitality)
-cover with wool sweater (make sure that its tight enough)
2. Wet scarf-throat/ear applications:
-Consider adding essential oils or botanical infusion to compress
water
-Wet a very thin cotton towel with cold water, wring out, and wrap
that around the neck or head and ears & then cover that with the
wool scarf
3. Wet socks:
-Cotton socks are soaked in cold water, covered fully by wool
socks, then the person jumps into bed immediately and sleeps until
morning.
-Socks must be completely dry by morning, or can be detrimental
to the system
-Can do a footbath for five minutes before
*Important that socks are warm and dry by morning otherwise
the process is depleting*
o Steam Inhalation: A hot moist air bath to the respiratory tract
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Effects:
 Relieves irritation of the upper respiratory tract
 Relieves spasmodic breathing, antispasmodic
 Moistens mucus membranes
 Loosens secretions
 Heat increases WBC activity in the upper respiratory tract
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
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Moist heat increases circulation and metabolism
Use as a solvent to introduce other botanicals or essential oils
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Indications:
 Cough
 Laryngitis
 Respiratory tract infection
 Sore throat
 Spasmodic breathing
 Dry, thick secretions
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Contraindications:
 Congestive heart failure
 Asthmatics (especially with botanicals)
Caution: Children (consider humidifier instead, or run shower and
allow bathroom fill up with steam)
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Procedure:
 Boil hot water in pot
 Place pot on a hot pad on table
 Sitting in chair, make tent with towel over head and pot
 Inhale through nose and mouth for 10 – 15 minutes as needed
 Add botanicals (a few Tablespoons) or essential oils (up to 5
drops) as indicated.
o Sitz Bath: Immersion bath with the patient seated in a tub, or tub-like
apparatus, so that water is able to cover the hips, buttocks, and lower
abdomen (this is generally a treatment that the client will do in their own
home, not in your office)
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Effects
 Derivation from head and lungs
 Tonifying to pelvic and abdominal organs
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
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 Can use with a hot foot bath
Indications
 Hot: -Painful spasms (colon, uterine, vaginal, kidney, etc.)
-Nerve pain (ovarian, testicular, intestinal, sciatic)
-Insomnia
-Irregular menses, painful menses, amenorrhea,
Hemorrhoids
-Headaches
 Cold: -Prolapse of the uterus, bladder or rectum
-Constipation
-BPH
-Heavy menses
-Incontinence
 Alternate:
-Vaginal Infection
-Chronic UTI
-Pelvic Congestion
-Constipation
-Post partum to facilitate healing
-BPH
-Hemorrhoids, Fissures
 Neutral:
-Bladder infection
-Itching of the vulva/penis/anus
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Contra-Indications
 Hot: -Hemorrhage
-Heavy menses
-Pelvic congestion
 Cold: -Painful conditions/Spasms
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-Heart problems, Congestive lung problems
 Alternate:
-Includes all conditions listed under hot and cold
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Procedure:
 Place a towel on the bottom of washtub and drape towels over the
front and back of tub (this is to protect the client’s back and knees)
 Fill tub with water of appropriate temp. and instruct client to get in
(water should reach approximately ½ inch above navel)
 Client can also use hot foot bath
 For Hot Sitz: Temp. 106-110˚F
Foot temp: 110-112˚F
Duration: 3-8 mins
 For Cold Sitz: Temp: 55-75˚F
Foot temp: 105-110˚F
Duration: 3-8 mins
 Neutral Sitz: Temp: 92-97˚F
Duration: 15 mins-2 hours
 Alternate Hot and Cold Sitz: Temps are same as above
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
2-5 mins hot, 20-60 seconds cold
o Fomentations: local applications of moist heat directly to the body
 Effects
 For stimulating effects- apply for 5 min., followed by cold
 For sedative effects-8-10 minutes
 Increases WBCs
 Muscle relaxant
 Increased Elimination via diaphoresis (sweating)
 Increased Metabolism
 Relieves internal congestion by increasing peripheral circulation
 analgesic
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Indications:
 Before physical medicine modalities
 Prepare for a cold procedure
 Constitutional hydrotherapy
 Hypertonicity
 Pain
 Bring out local infections
 Insomnia
 Chest congestion
 Bronchitis, pleuracy
 Chest Colds
 Sciatica
 Lung Algia
 Intercostal neuralgia
 Dysmenorrhea, painful bleeding
 Renal Colic (heat will relax smooth muscle when passing a stone)
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Contraindications:
 Edema / varicose veins /advanced vascular disease in lower
extremities
 Neuropathy
 Diabetes Mellitus
 Malignancy
 Elderly and children-caution due to thermoregulatory variance
 Hemorrhage / bleeding tendency / open wound
 Gastric clients
 Unconscious clients
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Procedure
1. Wearing rubber gloves, roll towels and put under hot tap water
2. Wring directly before applying to client
3. Test before applying to client to avoid burns
4. Change fomentation every 3-10 minutes
•Do not microwave – causes hot spots that may scald a client
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
o Salt Glow: Friction application of wet salt rubbed on skin

Effects
 Friction portion increase vasodilation increases circulation
(without having to incorporation an external temperature change)
 Chemical irritation creates dilation increases circulation
(again, without having to externally incorporate temperature
change)
 Tonifying
 Note: Epsom salt is rich in Magnesium

Indications
 Chronic conditions (DM, indigestion, Muscle pain)
 Stagnant circulatory conditions
 Low Vital Force
 Frequent illness
 Weakness, Nerve pain

Contra-Indications
 Broken skin
 Same as for hot foot bath
Note: Too frequent of treatment may cause irritation to skin

Procedure
 Have client partially disrobe and sit on stool or lay down
 Drape client with sheet, then blanket
 Can incorporate a hot foot bath if client is sitting
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND

Add water to salt to create a sticky consistency, but enough not to
dissolve it

Wet skin, apply a handful of moistened salt to skin and create back
and forth movements (friction) until skin is pink or to tolerance (do
not rub so hard as to break skin or to point of bleeding
o Can start at fingers, then hands, then legs and toes, followed by
chest, abdomen, back, hips and buttocks
o Can remove salt by spray, shower, bath, or affusion with cool
water
o Rub skin during rinse, then dry using friction, have client rest
for 30 mins after treatment if able
o Alternate Baths: Series of immersions of a body part/body parts in hot
and cold water


Effects
 Short hotdilation, short coldconstriction,
alternatingpumping action, thus increasing circlation
 Increased circulation increased nutrients to cells, increased
removal of toxic products (great for infection)increased healing
Indications
 Infections
 Sprains/Strains/Bruises/Fractures
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND


 Arthritis
 Venous Stasis Ulcers
 Edema
Contra-Indications
 Cancer
 Diminished sensation
 Hemorrhage
Procedure
 Fill basin with hot water (103˚F)
 Fill a second basin with cold water (40-70˚F)
 Place part to be treated in this hot water for 3 minutes
 Then take treated part out of the hot and put in cold for 30 seconds
 Repeat this series of hot and cold baths for 3-8 cycles
o With each alternation the intensity of the reaction will
decrease, so doing more than 8 cycles will lose
effectiveness
 Always finish with a cold
Note: the greater the contrast of water temperature, the more intense
the treatment. Alter temperatures based on client’s vital force.
Also Note: This can be done as alternating hot and cold showers,
same time durations.
o Wet Sheet Wrap: A heating compress to the entire body, i.e. a cold, wet
sheet wrapping the entire body, covered with wool blankets
 4 Stages
–Cold
–Neutral
–Heating
–Sweating

Wet Sheet Wrap Mechanism
•Stage 1: Cooling
–Short cold (depending on client’s constitution)
-Start off with client hot or warm (hyperthermia bath, sitz bath, hot
foot bath, etc.)
–vasoconstriction and subsequent dilation
–tonic
•Stage 2: Neutral
–vasodilation increases heat (encourages more circulation)
–sedative
•Stage 3: Heating
–vasodilation increases circulation and derivation
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
–simulating-more
intensely stimulating circulation and cellular
metabolism
•Stage 4: Sweating
–sweating increases elimination
–hence detoxifying

Indications:
 Cooling
-Fever
-Tonifying
 Neutral
-Insomnia, Anxiety, Thyrotoxicosis
-Fever
-Intractable itching/pain. Toxemia of pregnancy,
-Peripheral Edema
-Drug withdrawal, cleansing or healing
 Heating/Sweating
-detoxification, infection

Contraindications:
 Chilled client
 Extreme debility or severe colds and flu
 Acute Asthma (cover chest with a dry cloth)
 Skin conditions worse by moisture
 Weak heart
 Diabetes or circulatory problems
 Claustrophobia

Procedure:
 Warm client: hot footbath /shower/ hyperthermia bath/ exercise
 Prepare sheet: fold, immerse in cold/ice water, wring (and optional
freeze)
 Lay wool blanket on table
 Lay sheet on table
 Client lays supine on sheet, sheet at shoulder level
 Client raises arms above head; wrap sheet around torso, up under
arms and around one leg – leave no air pockets
 Bring arms down, tuck sheet snugly around body
 Mummy client in wool blanket
 Put towel at neck to prevent wool irritation from wool blanket
 Renew as needed, depending on phase. If heating/sweating phase,
end with a cool application
o Cold Mitten Friction

Mechanism:
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND

Short cold:
initial vasoconstriction vasodilation
increases circulation superficially, eliminating heat, decreasing
visceral (organ) congestion
increases activity of RBC and WBC
increased tissue tone
increased metabolism, increasing toxin processing

Indications:
 Cold water application with friction from mittens, washcloths, or
loofah
 To complete hot treatments
 Tonification: immune, circulation
 Anemia (theoretically it will help bring more blood to the tissues,
and oxygen to the cells)
 Low energy (because it is tonifying and invigorating)
 Nervous exhaustion
 Fever
 Depression (because it is stimulating and invigorating)

Contraindications
 Be able to name two c/I
 Chilled client
 Skin lesions
 Intolerance to Treatment

Full Body Treatment Procedure (start distally, work proximally)
 Have nude client lie supine on a blanket and cover
 Client must be warm first
 Expose and friction only one part at a time starting at the arm
 Dip mitt or washcloth in cold water and wring out
 If using a washcloth, fold it in half and wrap around fingers and
hold in place with thumb to stimulate
 Start at the fingers and work up to the shoulders and back to the
fingers until skin becomes pink
 Dry arm with friction and cover arm
 Expose chest and abdomen keeping arms covered, perform rub
 Do legs in the same manner
 Have client turn prone
 Place pillow under chest and arms raised to head level
 Expose back and hips, and apply friction as done in other areas.
 Rest client ½ hour after drying and covering
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND
o Poultices: A hot, soft, moist mass of material applied directly to skin and
covered with cotton (sometimes followed by plastic wrap, then wool, or
applied in between layers of cloth)


Effects
 Reduce irritation
 Osmotic pull (useful to pull out infection)
 Toxin absorption
 Astringent (shrink or constrict body tissues)
 Emollient (soften, sooth)
Indications
 Pain
 Congestion
 Inflammation/Swelling/Abscesses
 Bee stings, Insect Bites
 Antiseptic
 Wound Healing

Contra-Indications
 Allergy to poultice material
 Cellulitis and/or Lymphangitis (not necessarily contra-indicated,
but more aggressive treatment is needed by a physician)

Procedure
 Moisten poultice material with enough hot water to make a thick
paste
 Apply paste directly to skin (or can apply to cloth, then place on
skin, alternately can apply in between layers of cloth and then cloth
to skin)
 Place cotton cloth over poultice material and area
 Can cover with plastic if choose
 Can add another level, by placing wool over plastic (which is lying
over the cloth, which is lying over the poultice material)
 Fasten wrapping securely, so that it will not spill contents or move
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND

Can leave on anywhere from 30 mins to several hours
Cortiva Institute, School of Massage Therapy
MaryK Geyer, ND