1. HYDRIATIC PRESCRIPTIONMAKING
Dr. Shweta Mishra
drshwetabnys@gmail.com

2. FACTORS OF FORMULATING
A RATIONAL PRESCRIPTION
1. Vital resistance-
The faculty that body
possess of maintaining
a physiological
equilibrium of resisting
encroachment of
microbes, resisting the
disharmony, morbid
state, perturbed vital
activity.
2. Clear concept of nature
of disease
3. Correct searching of
therapeutic indications.

3. REQUIREMENTS FOR
TREATMENT OF DISEASE
1. Removal of cause.
2. Stimulate and regulate the normal
physiological activities

4. NATURAL DEFENCES OF THE
ORGANISM
• Natural methods by
which the body resists
disease are:
 Blood
 Spleen
 Lymphglands
 Cells lining the nasal cavity
and the alimentary canal
 Skin
 Destruction of poisons by
liver
 Destruction of poisons by
Thyroid gland
 Destruction of poisons by
suprarenal gland
 Alkalinity of blood
 Kidney
 Opsonins

5.  Blood-
“The blood is the life.”
• If the blood supply is cut off from a
limb, & even though no injury is
done , death will speedily occur.
• Blood is source of life & a great
healing agent.
• Blood carries oxygen to each and
every part where life is to be
sustained and burns accumulated
poisons (or the poisons are carried
away by the serum).
• Thus through the control
of the general blood
movement and of local
blood supply,
hydrotherapy is capable of
influencing almost every
morbid process.
• Phagocytosis is one of the most
remarkable & useful method by
which body defends itself against
morbid processes/ disease
producing microbes.

6.  Spleen
• Spleen possesses the power of
attenuating parasitic organisms.
 Lymph glands
• On encroachment of microbes
lymph-glands hoard a successful
battle; which gives rise to rapid
enlargement of lymphatic glands in
the vicinity of an infected part.
• (After the removal of spleen same
structural enlargement and increase
of activity occurs.)
 Cells lining the nasal
cavity and the alimentary
canal
• Protect the body from disease by
destroying microbes of many sort.
 Skin
• Skin plays an important part in
defending the body by opposing
the entrance of germs, & by
maintaining various reflex
activities whereby internal
activities are maintained.
• Act as a non-conductor and
regulate the body temperature.

7.  Destruction of poisons by liver
• Liver purifies the blood by removing
the alkaline wastes, & forming urea
from uric acid & other toxic bodies.
• Destruction of poisons by liver
 Destruction of poisons by Thyroid
Gland
• Thyroid and other glands not only
destroy poisons, but act as general
regulators of nutrition through the
internal secretions formed. The
secretions produce physiological
effects, as vasodilatation &
stimulation of spinal cord.
 Destruction of poisons by suprarenal
gland and other gland
( liver, suprarenal gland etc , is most
important and admirable method of
automatic , defence ; which is of
highest value in health & disease, in
acute infections viz: fever it is
indespensable to the saving of life.
 Alkalinity of blood
• Alkalinity of blood plays important
part in the defence of organism, both
in health & disease.
• Lowering of alkalinity of blood
diminishes the activity of the
leucocytes, lessens the energy of the
normal reflexes, diminishes the
promptness & energy of those
manifold reactions upon which so
many of the life processes depend.
• Alkalinity is lowered in various
diseases, especially in fever, in
rheumatism, gout, diabetes & in many
cases of indigestion.
• This lowering of alkalinity is always
accompanied by lowered vital
resistance.

8.  Kidney
• Kidney aid in the defence by
eliminating poisons; especially
those resulting from oxidation of
proteids.
 Opsonins
• Opsonins are certain substances
present in blood which help in
phagocytosis along with leucocytes.
• Opsonins act as exciting agent
• The microbes should absorb these
opsonins in order to enable the
phagocytes to capture them.
• Each species of bacteria has its own
opsonins.
• In experiment Wright has shown
that short cold bath raise the
index of opsonins, thus raising
vital resistance.

9. PROCEDURE FOR INCREASING
VITAL RESISTANCE
• Energy and activity of the cell
must be increased by application
of cold water to cutaneous
surface.
Eg: Brand bath in case of Typhoid
and other infectious disease.
Wet sheet pack, wet girdle pack,
chest pack, rubbing sitz bath,
alternate sponging of the spine,
alternate spinal compress, cold
water drinking, small cold enema.
• As a preparation for the cold
procedure, a short hot application
must be applied
• The hot should be very brief &
cold must be sufficiently
prolonged to produce dominant
effect. Cold is a primary
depressant hence cold application
must be brief and promptly
followed by reaction.
• The lower the temperature, short
duration, more highly tonic the
effect of application.

10. • Eg. Every chronic case requires
cold application twice a day.
• Fever- cold application such as
cold towel rub to be applied every
three or four hours/ cooling wet
sheet pack/ brand bath.

11. PRINCIPLE WAYS IN WHICH THE
BODY RESISTS ENCROACHMENT OF
DISEASE:a) Destruction of toxins:
 All the procedures that
encourage vital resistance, at the
same time encourage the
destruction of toxins by
stimulating the toxin destroying
cells of thyroid gland, liver,
spleen, lymphatics and other
tissues.
 The efficiency of these organs is
increased by the increased rate
of blood movement which
follows tonic cold application.
Eg: hepatic douche, splenic douche
(increase activity of two largest
glands)
general cold douche-
powerfully stimulates all the
bodily activities by which
destruction of toxins is
promoted.
b) Elimination of toxins:
(resulting from bacterial action or
perverted metabolic processes)
kidney, liver, bowels are the most
important outlets for toxic
substances.( liver disposes
alkaline waste, kidney remove
urea, uric acid & other products of
deficient oxidation, various
poisons find their way through
intestines).
 Eliminative baths, electric –light
bath, sweating wetsheet pack,
vapour bath.

12. c) Destruction and
elimination of
bacteria:
• By increasing the alkalinity of
the blood, & especially by
• increasing leucocytosis (it may
be increased by regulation of
local blood movement &
volume, by general cold bath,
frequently renewed heating
compress, alternate compress,
scotch douche, alternate
douche) &
• Increasing activity of
lymphatic glands.
Eg: management of pneumonia,
typhoid fever
• Elimination of bacteria by
skin & kidney is encouraged
by sweating baths, copious
water drinking, vapour bath,
sweating pack, prolonged
neutral bath followed by
cold towel rub/ cold
procedure.

13. PROCEDURE WHICH
INCREASE OXIDATION• Cold bath increases absorption of
oxygen and elimination of CO2.
• Cold should be extensive to lower
body temperature sufficiently (a few
tenth of a degree); in order to develop
reaction necessary to increase heat
production & consequently
consumption of the carbonaceous
elements.
• Eg: prolonged bath like dripping
sheet, rubbing shallow, cold
immersion, plunge & cooling pack
are most effective measures for
stimulating oxidation of fat &
carbohydrates.
• Hot baths to elevate the body
temperature increases the oxidation of
proteid substances.
• Thus; Oxidation of carbon (burning up of
sugar or fat or the oxidation of nitrogen,
perfect combustion and elimination,
through conversion into urea of uric acid,
creatinin, creatin & other proteid waste)
may be affected at will.
• Hot immersion bath, heating pack, dry
pack, vapour, hot-air, turkish bath, sun
bath, electric light bath are most efficient
means of stimulating nitrogen oxidation.
• These measures increase the body
temperature to few tenth degree or even 3-
4 degrees according to duration of bath
• NOTE: To counteract the depressing effect
of hot & to restore the tone of skin the hot
baths shouls be followed by a very short
general cold application.

14. PROCEDURE WHICH EXITE
CENTRAL GANGLIA
Therapeutic procedures-
• Very hot, very cold or alternate
hot & Cold applications
• Alternate general douche
• Percussion or alternate spinal
douche
• Alternate spinal sponging
• Alternate spinal compresses
• Alternate immersion
• All various forms of cold ,
alternate, hot & cold localized
compresses
Indication-
(condition where general or
local excitation of central
ganglia is indicated)
• Adynamic fevers
• Neurasthenic states
• Cardiac failure
• Hypopepsia
• Renal insufficiency
• Visceral congestion

15. MEASURES WHICH
ENCOURAGE GENERAL AND
LOCAL METABOLIC
PROCESSESMeasures which increase Vital
Resistance:
• Brand bath in case of Typhoid
and other infectious disease.
• Wet sheet pack
• Wet girdle pack
• Chest pack
• Rubbing sitz bath
• Alternate sponging of the spine
• Alternate spinal compress
• Cold water drinking
• Small cold enema
• Measures which excite central
ganglia:
• Very hot, very cold or alternate
hot & Cold applications
• Alternate general douche
• Percussion or alternate spinal
douche
• Alternate spinal sponging
• Alternate spinal compresses
• Alternate immersion
• All various forms of cold ,
alternate, hot & cold localized
compresses

16. To produce cutaneous activity-
• General hot bath
• Prolonged hot application followed
by a brief cold application
To increase the visceral activity
• The most effective means is to
apply a short cold douche with
strong pressure
• Alternate douche
• Heating compress
• These measures also increase
blood formation and
glandular activity
• General cold application (very
short general cold bath; the
lower the temperature the
better) to cutaneous surface
promote high degree of blood
formation.( efficiency of cold
bath in combating anemia,
even when all other measures
have failed)
• Cold mitten friction/ cold
towel rub (2-3 times daily)
• Cold douche

17. • NOTE-
• In most of the chronic diseases,
there is either primary or
secondary grave disturbance of
the general nutrition, due to
failure of tissues to maintain
normal metabolism.
• Failure to maintain general
metabolism as in case of
Autointoxication.
• Failure to maintain local
metabolism as in case of
Hypopepsia.
• Hydrotherapy has
measures which
improve the activity of
sluggish organ to
normal ( if activity of
the organ has not been
extensively damaged)

18. PROCEDURES WHICH
INCREASE GENERAL BLOOD
MOVEMENT AND LOCAL
BLOOD SUPPLY• Cold application to surface, excite
the heart, increase the blood
pressure & increase the movement
of blood & lymph throughout ; all
the tonic measures may be applied
here.
• Precordial compress may be applied
where general cold application is
required.
• Precordial compress can be applied
where hot application are required;
antagonize the depressing effect of
heat.
• Cold mitten friction/ cold towel rub
are useful to reinforce the energy of
heart and encourage the circulation
( as in case of fever, cardiac or renal
disease, neurasthenia with general
feebleness, chronic tuberculosis or
other wasting disorders.
• NOTE-
• Cold applications first quicken and
then slow the action of heart , raise
the blood pressure and increase the
movement of the blood and lymph
through their proper channels in all
parts of the body.

19. • General hot application at first
stimulate the heart and increase
the blood pressure , but later
lower the blood pressure,
diminish the energy of heart, and
lessen the rate of movement of
the vital fluids.
• Note-
• hot applications are seldom used
for this purpose; however neutral
baths is useful in quietening
excessive activity.
• If in case hot baths are used in
case of cardiac weakness then
excessive or prolonged general
hot applications may be avoided;
during hot applications a cold
precordial cpompress is applied
to guard against the cardiac
failure.
Eg: vapour bath , electriclight
bath, russian bath, hot immersion
bath , when administered in cases
of cardiac disease.

20. MEASURES WHICH INCREASE
HEAT PRODUCTION
• The process of
thermogenesis occurs by
the impression of cold upon
the thermic nerves of the
skin.
• The more intense and
prolonged this impression
the greater the effect in
increasing heat production.
NOTE-
• The most intense effects are
produced by prolonging the
application until the
temperature of the body has
been slightly lowered.
• If the cold is greatly prolonged
or repeated at short intervals ,
the thermogenic reaction fails
& the depressant effect of cold
appear.

21. MEASURES WHICH INCREASE
THE ELIMINATION OF HEAT
• The measures which maintain
active cutaneous circulation, & at
same time cooling the skin.
Eg: vigorous rubbing in cold
immersion bath (brand bath)
• Rubbing wet sheet
• Wet sheet pack
• Very short hot application followed
by short cold applications to the
surface
• Cold friction bath
• Cold towel rub
• Cold water drinking
• Cold enema
• Cold application to spine
In some cases –
• Hot blanket pack
• Hot evaporating sheet

22. MEASURES WHICH RELIEVE
PAIN & NERVOUS
IRRITABILITY
Measures to relieve pain
And diminish local
irritability (cutaneous or
visceral)
Hot fomentation
Heating compress
Cold compress
Ice compress
Measures which relieve
nervous irritability &
induce sleep
• General neutral bath
• Neutral douche
• Neutral pack
• Moist abdominal
bandage
• Cool head cap
• Heating spinal compress

23. MEASURES WHICH COMBAT
BACTERIAL DEVELOPMENT
• Prolonged application of cold
to the local part infected
• When deeper parts are
affected, growth of parasites
may be combated by
increasing the alkalinity of
blood by means of general
cold applications, and
methods which favour local
leucocytosis ( frequently
renewed heating compress,
alternate compress)
• These measures increase the
movement of blood through
affected parts, and bring fresh
supply of alexins and
antitoxins to the growing
bacteria; thus their growth is
discouraged, at same time the
W.B.C are actively engaged in
capturing and destroying the
parasites.

24. MEANS OF CONTROLLING
BLOOD MOVEMENT AND
VOLUME
Measures which
encourage leucocytosis-
• General cold bath
• Frequently renewed
Heating compress
• Alternate compres
• Scotch douche
• Alternate douche
• Sweating baths
• Copious water drinking
• Vapour bath
• Sweating pack
• Prolonged neutral bath
followed by cold towel
rub/ cold procedure.

25. • Derivative measures
• Cold compress
• Scotch douche
• Revulsive measures

26. NOTE-
• Stagnation of blood and
lymph encourage morbid
processes by favouring
the development and the
accumulation of waste
and toxic substances in
the tissues, leading to
perverted metabolism or
unhealthy tissue
formation; by weakening
the resistance of cells,
which become
asphyxiated by the
accumulation of CO2 &
poisoned by their own
excretions, so that they
get infected by invading
parasites.

27. MEASURES WHICH LESSEN
HEAT PRODUCTION
• Short hot applications to
the surface
• Prolonged or frequently
repeated cold applications
HEATING MEASURES-
• Short hot immersion bath
• Hot blanket pack
• Fomentation to the spine
• Hot evaporating sheet
COLD APPLICATIONS-
• Graduated bath
• Prolonged tepid bath
• Cooling pack

28. MEASURES WHICH LESSEN
HEAT ELIMINATION
(Seldom required)
Heat elimination is to be
decreased in case of
syncope.
Efficient means of preventing
excessive heat loss are-
• Dry pack
• Hot blanket pack
• Hot enema
• Hot water drinking
• Hot application with a
short cold application
with friction
• Vigorous cold wet-hand
rubbing
• Cold mitten friction

29. DIMINISH GENERAL
METABOLIC ACTIVITY
• By absolute rest in bed.
• Neutral bath.
Eg:
• Hypopepsia
• Intestinal catarrh
• Uterine catarrh
• Vesicle catarrh
In above cases
Over-excitation of secreting
glands may be lessened by
withdrawing the blood from
the part by various derivative
measures.

30. HYDRIATIC
INCOMPATIBILITIES
The combination of
treatments must be
decided wisely; so
that one measure
does not undo the
therapeutic effect
generated by the
other.
NOTE-
The combination of hydriatic
processes in such a manner
as to enable one procedure
to intensify or to prolong the
effect of another is perhaps
the best test of a physician’s
experience and skill.

31. 1) Tonic procedures must be
carefully avoided when a
sedative effect is desired.
eg: cold and neutral
procedures.
• Tonic application may be
accidental.
• Contact with pure cold
after a neutral bath, or the
feet with a cold floor, may
destroy the sedative effect
of bath altogether.
2) Sedative measures must be
as carefully suppressed
when tonic procedures are
employed for their specific
effects.
eg: The tonic effect is lost -
• When a hot bath precedes a
cold bath
• If hot is too prolonged.
• If the cold application is too
short.
• If patient is exposed to an
overheated atmosphere after
bath

32. 3) In use of antipyretic
measures, procedure
must be so managed that
heat production will not
be increased so much as
to counterbalance the
increase in heat
elimination;
• Hence, short cold or cool
applications may be
injurious.
• Cool sponging often raises
the temperature by
increasing heat production.

33. References
1. Rational
hydrotherapy,
J.H Kellogg.
2. Principles
and practice
of
hydrotherapy,
George Knapp
Abbott.
3. Baths, Dr.
S.J. Singh.
4. The water
therapy
manual, Vance
Ferrell.