Methods of Local Hydro-therapy
In one form or another, douches have for centuries been used for chronic joint affections. Three factors have to be considered—the volume, pressure, and temperature of the impinging water. The size and form of the stream determine its thermic and mechanical effect, and cæteris paribus, the more massive the volume, the more marked the results produced.
The pressure, again, is a most important factor, as the influence on the circulatory and lymph flow in deep-seated tissues is directly proportional to the force of delivery.
We see, therefore, that in douches we have a weapon of great power for good or ill, and the results achieved will be exactly proportional to the judgment displayed in meeting individual requirements in the matter of their temperature, duration, and pressure.
The space at our disposal forbids entering into great detail, and a few general principles are all that can be enunciated. Thus, while extreme pressures are permissible in selected cases, they are contra-indicated when dealing with regions the seat of pain. In such instances we should always begin with mild measures, viz., a tepid fan or spray douche (80° to 92° F.) of low (4 to 8 pounds) pressure. These later may be replaced by a hot (104° to 110° F.) broken jet, or rain douche, of 10 to 15 pounds pressure, and by such graduated procedures pain will often be relieved.
For the relief of stiffness and swelling alternating jets or sprays are most suitable, the hot and cold douches being each of fifteen to thirty seconds duration. The more remote the extremes of temperature, and the more abrupt the transition from hot to cold, the greater the excitant effect.
Simultaneous massage greatly reinforces the stimulating and absorbing action of douches, which latter also may in various ways be advantageously combined with other local procedures, viz., local vapour, hot air, and electric light baths.