Introduction

Immersion bath is also known as the full bath. It is administered in a bath tub made of porcelain or enameled iron or fiberglass. The tub should be properly fitted with hot and cold water connections to administer the bath at cold, neutral, hot, graduated and alternate temperatures.

Cold Immersion Bath

Temperature: 18–24°C.
Duration: 15 minutes
Method: Before entering the bath tub, the patient’s head, neck and chest should be made wet with cold water and the head should be protected preferably with a cold moist towel (compress). The patient should enter the bath tub as quickly as possible so as to generalize the immersion. Vigorous rubbing of the body should be done by the patient himself or by the attendant during the bath. The bath should be terminated if the patient feels chill. Soon after the bath, the patient should be given a quick dry–up and covered with a warm blanket. If the climate is favorable, he should undertake moderate exercise.
Uses: The full cold immersion bath is advantageously employed as a routine hygienic measure. This bath is helpful in reducing high temperature during fever. It is prescribed in cases of obesity and in dyspepsia to improve the appetite. This bath also improves the skin by increasing the blood circulation and stimulating the activities of nerve endings. When used for this purpose, bath should be of short duration 3 to 15 seconds.
Contra–indications: This bath should not be given to young children and very old persons. It should not be given in febrile conditions caused due to acute inflammation as in Acute Peritonitis, Gastritis, Enteritis, Endometritis, Oopheritis etc. and in cases of fever with chills. The cold bath is contra–indicated in Hematuria (blood in urine), because this condition indicates a disease either in the bladder or kidneys (In such conditions a short hot bath, followed by cold friction, wet sheet rubbing and a cold compress should be repeated a number of times). It should be avoided in cases of Asthma and Sinusitis.

Cold Immersion with Friction

Temperature: 18–24°C.
Duration: 2–5 minutes
Procedure: The patient should quickly enter the tub and lie down. The attendant should massage the body with a Turkish towel or Turkish gloves, starting from the legs upwards. The massage should be continued for 2 to 5 minutes or until the skin turns red. Then the patient should take a quick shower for 30 seconds, washing the head at the same time. Thereafter, he should dry himself quickly and cover with a blanket. Hyperemia of the skin continues for 15 to 30 minutes. Until this reaction is completed, the patient should not expose his body to cold water or cold breeze.

Uses: This treatment is helpful in reducing high temperature during fever. When a person is exposed to excess heat or sun he should be given this bath 2 or 3 times to reduce the excess heat absorbed down the blood pressure in hypertensives. As this bath is a powerful stimulant of the skin, it could be prescribed for all types of skin diseases like Psoriasis where there is no inflammation of the skin. Since its effect is tonic in nature it is useful in treating nervous and muscular disorders, including paralysis, muscular degeneration etc.
Contra–indications: This is contra–indicated for very weak patient, cardiac patients and patients suffering from kidney disorders.

Neutral Immersion Bath

Temperature: 32–36°C.
Duration: 10 to 15 minutes. This bath can be given for a longer duration, as the water temperature is close to the body temperature. When this bath is applied for relieving insomnia, the duration should be 15 minutes to 1hour. For fever, this should be administered at 26–28°C.
Procedure: The patient should drink one or two glasses of water before the treatment and lie in the tub after applying a cold compress to the head. After the bath, he should dry himself quickly.
Uses: It is the best sedative among all treatments. Since the neutral bath excites activity of both the skin and kidneys, it is recommended for diseases relating to these organs. In addition, it is helpful in cases of organic diseases of the brain and spinal cord, including paraplegia, locomotor ataxia, chronic inflammation of the brain and the spinal cord (such as meningitis), and in rheumatism, arthritis and other chronic conditions.When the neutral bath is continued at 30–32°C. for 30 to 60 minutes or even longer, it renders great service in general dropsy, caused due to cardiac or renal disease where more vigorous treatments are contra–indicated. Neutral bath is also helpful for multiple neuritis, alcoholism and other narcotic habits, neurasthenia, chronic diarrhea, peritonitis and chronic afflictions of the abdomen, where either hot or cold water is contra–indicated. In such cases, the bath may be given daily for 15 to 30 minutes. This bath is also useful in pruritus without eruption, with or without jaundice. It is useful in toxic conditions caused due to dyspepsia.
Contra–indications: The neutral bath should not be prescribed in conditions of eczema and other skin diseases where water aggravates the symptoms. It is also contra–indicated in extreme cardiac weakness and certain cases of Neurasthenia.

Hot Immersion Bath

Temperature: 40–42°C.(Above 42°C., the bath is termed as very hot).
Duration: 10 minutes. The duration of hot bath varies from 2 to 10 minutes according to the temperature and condition of the patient. It should not be prolonged beyond this, as raising the heat may cause rapid congestion.
Procedure: Generally this bath is started at 37°C. and the temperature is gradually raised to the required by addition of hot water. Before entering the bath tub, the patient should drink sufficient quantity of cold water. A cold compress should be applied to head throughout the treatment.
Uses: At 40 to 44°C. for 10 minutes, followed by a dry pack, it is the most efficient sweating device. This bath also relieves Capillary Bronchitis and Bronchial Pneumonia in children. At 40 to 42°C. for 5–15 minutes, it relieves congestion of the lungs and activates the blood vessels of the skin and the muscles. As soon as the skin turns red, the bath should be terminated.In pneumonia and suppressed menstruation, the bath should be administered at 37.7 to 40°C. and duration from 30 to 45 due and may be repeated for 2 to 3 days in succession. For treating Dysmenorrhea this bath should be given at 38 to 44.4°C. for 15 minutes.In chronic Bronchitis a very hot bath with friction for 5 to 7 minutes should be given. This relieves congestion of the mucous membrane and gives relief immediately. After the bath, the patient should be gradually cooled and, if necessary, oil should be applied to the skin.The hot bath at 38.8–41°C. is a valuable treatment in chronic rheumatism and obesity. It can be administered for 10 to 15 minutes daily. Hot bath taken daily relieves the intolerable itching caused due to jaundice and in urticaria. When there is pain due to the formation of stone in the gall bladder and the kidneys, hot bath gives relief immediately. The pain in cystitis is relieved by a very hot bath for 10 minutes.
Contra–indications: The hot bath is contra–indicated in organic diseases of the brain or spinal cord, such as Sclerosis and Myelitis. This should not be administered in cases of high blood pressure and heart diseases.

Neutral Half Bath

This bath can be conveniently taken in an immersion bath tub.
Temperature: 32–36°C.
Duration: 15 minutes.
Procedure: The tub is filled with water up to a height of 6” to 8”. The patient should drink one or two glasses of water and apply cold compress over the head. Then he should sit in the tub by stretching his legs in the water and keeping his arms and hands away from the water, on the sides of the tub.
Uses: When employed in case of high blood pressure, a cold compress to the chest is advised. This bath helps to relax the heart muscles and blood circulation is diverted to the lower extremities. It also gives soothing effect to the heart, lungs and cerebral vessels by acting on the reflex zones present in the feet. This bath is useful in cases of hypertension, varicose veins, leg cramps, insomnia, bronchial asthma, arthritis of lower limbs, lumbago etc.

Graduated Immersion Bath with Epsom Salt

Water Temperature: 40°C.
Duration: 30 minutes.
Procedure: The immersion bath tub should be filled up to 4” to 6” with water. A pound of Epsom salt is dissolved in the water. After drinking a glass of cold water and covering the head with a cold compress the patient lies down in the tub. The attendant quickly gives massage starting from the legs upwards for 2 minutes, then the hot water tap is opened and the water level is raised to 8” to 10” at 40°C and another pound of Epsom salt is dissolved in the water. The patient is again given massage for 3 to 5 minutes starting from the legs. The patient relaxes in the tub while the cold water tap is opened, which cools the water gradually. When the tub gets filled with water the temperature will be around 30°C and the patient continues to relax in the tub for 10 to 20 minutes. Later he comes out of the tub and quickly dries himself.
Uses: This bath is helpful in treatment of all types of arthritic conditions when not associated with fever. This bath is also helpful as a diuretic and hence useful to the patients suffering from kidney disorders, dropsy, edema etc. Since this bath relaxes the whole system it is very useful in Insomnia also.
Contra–indications: To be avoided in High Blood Pressure, Heart Diseases, Weakness, Fever etc.

Asthma Bath

Procedure: The patient should lie down in the immersion tub which is half filled with water at a temperature of 37 to 38°C. The hot water tap is then opened and temperature is raised to 40 to 42°C. The duration is 4 minutes. Then the body is rubbed, beginning with the left leg, then the left arm, abdomen, chest, right leg, back and the spine. The spine is rubbed till the skin turns red. After rubbing the spine, the chest and the abdomen are rubbed for 3 or 4 minutes. When rubbing is over, the flow if hot water is stopped. Then the patient is asked to sit in an upright position and exhale for an instant and a bucketful of cold water is dashed over his back. Immediately the patient is asked to inhale and half a bucket of cold water is poured on his chest. He is asked to lie in the tub again for 2 to 4 minutes.
This process has to be repeated 2 to 3 times. The water in the tub has to be brought back always to 37–38°C. Finally, a short cold shower for 2 minutes and 30 to 40 minutes of relaxation is advised.
Uses: This treatment helps to improve the depth of respiration and relieves congestion from the lungs. Hence it is helpful in asthma, bronchitis, and emphysema etc.

Whirlpool Bath

Water Temperature: Cold 18–24°C, Neutral 32–36°C.
Duration: 15 minutes
Procedure: The water revolves in a big well–type tub. When the patient enters the tub he gets a gentle massage by the whirling water. A normal adult with good physique can take this bath with cold water.
Uses: This bath is a powerful stimulant for muscular and circulatory activities. When given with cold water it reduces the temperature of the body, but stimulates perspiration, heart’s activity and other vital functions. Since the cold bath increases the blood pressure, it is not advisable for high blood pressure patients. Because of the increased respiratory movement there will be rigorous fluxion through the brain thereby making the brain more alert and active. The sudden contact of cold water stimulates the activity of the kidneys, liver and peristalsis of the intestines, hence is useful in chronic constipation and disorders of the kidney and liver. Persons emaciated due to deficient absorption of nutrition will benefit as this increases the appetite as well as the digestion and assimilation of food. It may be given after giving hot applications like steam bath, sun bath, sauna bath etc. for a short duration.

Underwater Pressure Bath

This is the latest addition to hydrotherapeutics. By this application, the body gets influenced not only with the temperature of the water, but also by the percussion movement, which is made on the periphery with a strong water jet. In fact this is the combination of two treatments, viz., general immersion bath and massage.
Water temperature: Cold 18–24°C. or Neutral 32–36°C.
Duration: 15 minutes.
Procedure: This treatment is given in a specially fabricated tub with an attached jet pipe. In case of neutral underwater massage, the patient drinks one or two glasses of cold water before the treatment. The patient is subjected to gentle vibration of the water and later a jet spray is directed over his back and front. A short cold shower is given to the head after the neutral underwater massage. The patient is advised to relax for 30–40 minutes.
Uses: Cold underwater massage is helpful in stimulating the activity of the skin by diversion of circulation to the peripheral blood vessels. The excess heat in the muscles is absorbed and the muscles are toned up. Hence, it is useful in strengthening muscles whenever there is atony.

In cases of Paralysis, Poliomyelitis and Paraplegia cold underwater massage is a valuable treatment. It not only stimulates the activity of the skin, but also the entire nervous system (because of its strong reaction on the nerve ends). Hence, this is useful in all types of neuralgias. The cold underwater massage stimulates the digestive activity and increases the production of gastric juices. Hence, it is useful for patients suffering from loss of appetite due to deficient secretion of gastric juices.

The neutral underwater massage at 32 to 36°C is a relaxing treatment, especially after rigorous physical activity such as exercises, walking etc. After participation in sports and games, this treatment relaxes the tired muscles. It is also useful in cases of Insomnia and helps to tone up muscular and nervous systems. In cases of Spondylosis, Sciatica, Arthritis, Scoliosis and other disorders of the bones and joints, neutral underwater massage is useful.