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Naturopathic Hydrotherapy: The Constitutional Treatment

by David Goddard ND(more info)

listed in water, originally published in issue 101 - July 2004

Naturopathic Hydrotherapy

Hydrotherapy uses water to gain therapeutic benefits; these can be exploited to achieve a range of responses which can relieve symptoms and improve the way the body works. Water can be used in a number of ways. It can be applied to areas of the body, or the body (or parts of it) can be immersed in water, and various substances such as essential oils, clay, Epsom salts can be used in water to alter its effects. Water can be used hot, warm, or neutral (body temperature), cold, or as ice or even steam. Water can be applied at an even temperature directly or via material, such as a cotton towel, and then alternated with either hotter or colder water in order to stimulate a response from the body. With careful application, and using scientifically applied principles, we can direct blood or withdraw blood to any part of the body. This can be a very useful tool to accelerate the body's own healing potential.

A working hypothesis of Naturopathy is that health, and therefore healing, is proportional to the normal flow of healthy blood.

Specifically, this refers to the quantity and quality of blood flowing through a given tissue. Through the application of hot and cold compresses, we can regulate and in fact increase or decrease the circulation in any part of the body. We employ this mechanism through the use of Hydrotherapy (thermal therapy).

The Constitutional Treatment

Constitutional Hydrotherapy is a very effective treatment in which hot and cold towels are applied to the trunk of a patient in order to help boost the immune system, improve circulation and detoxify the body of unwanted waste matter.

This treatment is particularly beneficial to the liver, which has the potential to regenerate and is considered to be the body's laboratory, physiologically speaking.

The timing of these applications is crucial and needs to be carried out by an efficient operative who understands the body's reaction to circulatory manipulation. Electrical apparatus that gives a sine wave, or Tens machine (Transcutaneous Electrical Nerve Stimulator) is attached to the dorsal area of the back (T5), also the umbilicus (navel) to help control and regulate heart beat. (Speeds it up).

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. We know that therapeutic heat may be applied to the body by various methods, e.g., the heating pad or the infrared lamp, but one of the most efficacious ways is by water.

By convention we use the term 'Hydrotherapy' to describe these applications of hot (and cold) via water. But it should be remembered that the primary value of water in healing is its ability to carry heat.

In hydrotherapeutics, water is the 'medium' and heat (or cold) is the 'message'. To summarize this in strictly Naturopathic terms, neither water nor heat nor cold water heals; only the body heals; but hot and cold via water can enhance the capacity of the body to heal. Dr OJ Carroll brought about and perfected this treatment as a result of mastering other hydrotherapeutic treatments and used this same system for about 60 years. He used variations of this routine and modified it to suit the patient and the particular disorder.

There are very few contra-indications to this treatment, which is extremely useful in treating the following conditions:

• Digestive tract problems such as dyspepsia, Crohn's disease, irritable bowel syndrome, ulcerative colitis;
• Respiratory problems such as chronic asthma, bronchitis, pleurisy, emphysema;
• Infectious diseases such as colds, influenza, lymphangitis, hepatitis;
• Female reproductive problems such as premenstrual syndrome; dysmenorrhea, infertility, endometriosis;
• Immune deficiency problems such as Aids, cancer, environmental hypersensitivity, ME and MS;
• Circulatory problems such as varicose veins, haemorrhoids, Raynaud's disease, hypertension (high blood pressure);
• Other ailments such as arthritis, cirrhosis of the liver, diabetes, depression, obesity, psoriasis, rheumatism, sprains, strains.

A good time to start is about late March. The liver is far more responsive to tonification during the months of spring.


• Fear of treatment (this is true of any modality) but can be counteracted with the Bach Flower Remedy 'Mimulus';
• Acute bladder infection;
• Acute asthma;
• Malignant fever;
• Patient with oral temperature of less than 97 degrees F.

Please note that adequate manual lymphatic drainage must always be carried out to ensure that there is no passive congestion. Manual lymphatic drainage or MLD, is a form of very light rhythmical massage that encourages stimulation of the lymphatic system. It is a very specific technique of manual body massage therapy.

The lymphatic system has a vital role in the body by regulating the immune system, which protects the body against infection. It transports nutrients to cells and eliminates metabolic wastes, toxins and excess fluids from the body. MLD is also a very effective way of detoxing the body plus stimulating vital immune defences. This is a powerful, deep cleansing treatment. Using a light touch, the therapist helps to clear areas of congestion and stagnation. MLD is a great addition to other detox measures.

How it Works

If Hydrotherapy is really Thermotherapy, i.e., the treatment of disease by hot and cold, then to learn about Hydrotherapy we must understand the physiological effects of hot and cold.

Let's begin by defining hot and cold in terms of temperature. For Hydrotherapeutic purposes, hot is considered to be between 98-104 degrees F, and cold is considered to be between 51-65 degrees F. The chart below defines the full range of temperature possibilities:

In this chart we have drawn special attention to hot and cold by italicizing them. For right now these two are the most important concepts to understand.

Having defined hot and cold in terms of temperature, let's now define them in terms of their effects upon the body's circulation. To do this we must define them in terms of duration because their effects change depending on the length of the application.

The circulatory effects of a short hot application are not the same as the effects of a long hot application; in fact, their effects are opposite. A short hot application, defined as one lasting less than five minutes, is stimulating to the circulation. We consider this to be an 'intrinsic' effect, meaning it is the direct result of the heat which is transferred to the body. A long hot application, defined as one lasting more than five minutes, is depressing to the circulation. We consider this to be a 'reactive' effect, meaning it is the result of the body's protective reaction to the heat applied to it.

As we might expect, the circulatory effects of a short cold application are the opposite of the effects of a long cold application, but the scheme for understanding the effects of cold is not identical to the one just outlined for hot. While a short cold application is stimulating to the circulation, it is defined by duration as lasting less than one minute instead of five. And this stimulating effect is considered to be reactive. The effect of a long cold application, i.e., one lasting longer than one minute, is depressing to the circulation and is considered to be an intrinsic or a direct mechanical effect. The chart above lays out these differences in summary form:

A close look at the chart reveals that duration is more predictive of the effects than temperature. Short applications are stimulative regardless of whether they are hot or cold. But how can hot and cold, which are opposites, have similar effects on the body? Because the body reacts to hot and cold at different speeds. The body perceives cold, which is much further away from normal human body temperature than hot, as a greater threat and reacts quickly to it. If the cold is prolonged, the body's reaction is eventually spent and the intrinsic or depressive effect of cold takes over. The body is less threatened by hot and reacts more slowly. Thus the intrinsic or stimulative effect of hot on the circulation is allowed to express itself before the reaction takes place, but if the heat is prolonged, the reactive, depressive effect overrules.

Note: it is easy to become confused about the actual use of these terms 'short hot', 'long cold', etc. When we refer to a 'long' application, we are talking about an application which does not significantly change temperature over time, e.g., a bath where the quantity of water is sufficient to not be influenced by the temperature of the body parts immersed in it or the ambient air surrounding it. Therefore, an application which changes temperature over time, e.g., a compress which is more easily influenced by the temperatures of the body parts and air with which it comes in contact, is by definition 'short'. A 115 degree F towel applied to the chest and abdomen for ten minutes, even if it is amply covered by wool blankets, will be reduced in temperature to about 95 degrees F in just five minutes. This means it is a short application even if it lasts ten minutes. A cold towel applied similarly at 55 degrees F may achieve a temperature of 70 degrees F or more after one minute and of 80 degrees F or more after ten minutes. Even though it was applied for ten minutes, its practical effect was that of a short cold application.

Let's take our understanding a step further and define specifically what we mean by the stimulative and depressive effects that hot and cold have on circulation. A cold application has an immediate, momentary and insignificant vasodilatory effect (reactive) which, if the application is continued long enough, is followed by another vasoconstrictive effect (intrinsic). A hot application has an immediate vasodilatory effect (intrinsic) followed by a vasostatic effect (reactive).

Having looked at the effects of varying lengths of hot and cold applications on circulation, let's look at their effects on the metabolism of the tissues over which they are applied. A short cold application stimulates the metabolism; a long cold application depresses the metabolism. Some of the metabolic and other physiological effects of short cold are depicted below:

Short cold

• Oxygen absorption;
• Carbon dioxide excretion;
• Nitrogen absorption and excretion;
• Tissue tone;
• Peripheral white blood cell count;
• Peripheral red blood cell count;
• Blood glucose.

These effects are the body's reaction to short cold. A short hot application stimulates the metabolism, as does a long hot application, but neither stimulates it quite so much as a short cold application.

While the body has sophisticated means for regulating its temperature, it cannot overcome the biological fact that metabolism is increased by heat, regardless of its duration, so long as it is within a range compatible with life. Therefore, there is no true reactive phase in the metabolic response to a hot application. Some of these metabolic and other physiological effects of hot are depicted below:


• O2 absorption;
• CO2 excretion;
• Tissue tone;
• Peripheral white blood cell count;
• Peripheral red blood cell count;
• Blood glucose.

For future reference, note some of the significant differences between the physiological consequences of cold and hot application, e.g., their contrasting effects on blood glucose, tissue tone and red and white blood cell counts.

Also for future reference, let's briefly collate the effects we've discussed on the circulation and the metabolism.

The italicized entry in the above chart is to draw your attention to the potentially dangerous incompatibility between the circulatory and metabolic effects of long hot. Increased metabolism requires a corresponding increase in circulation to support it, i.e., to bring in the necessary nutritional ingredients and carry off the resultant waste products. If circulation is depressed in an area of increased metabolism, serious consequences, such as tissue infarction, can result. Hence manual lymphatic drainage must be carried out before treatment.

I have been using this protocol now for eight years especially on my ME and MS patients and women who have difficulty in conceiving. Alongside new dietary and stress management protocols, the constitutional treatment is by far the most powerful treatment in my armoury of modalities.

Timing of Treatments to Enhance Detoxification

From observations over the years, I have found that by using this protocol when the moon is waning, it seems to enhance detoxification and allows my clients improved access to their vitality, whilst at the same time minimizing any healing crisis.

It does seem that during the waxing phase of the moon (new < full) our bodies at cell level are in an assimilation cycle. This is a good time to get those cell building nutrients in as they are more readily absorbed. However, from a full moon to a new moon our energy levels and vitality usually go up, and the waste products from our cells are dumped into the lymphatic system. Bearing in mind that, in terms of our chemical composition, we are about 75 per cent water, then I think it's reasonable to take into account the effect that the moon will have on our body fluids, just as it does on the tides of our planet.

The Benefits of Cold Showering

Next time you take a shower why not be brave! After your usual washing ritual, divert the shower head away from your body, set the thermostat to cold, take a deep breath and then direct the jet of cold water down the outside of your right leg, from the right knee to the right foot, then slowly up the inside of the right leg, up to the groin. Now, in a continuous movement proceed up the right side of the trunk, under the right armpit, over the top of the right shoulder, down the outside of the right arm to hand, then up the inside of the arm to the armpit. Now a figure eight around the chest then down the left side of trunk to left foot, then up the inside of the left leg to the groin, continue up the left trunk to shoulder, then directly down the outside of the left arm to the back of the hand, proceed up over the palm and inner arm to armpit, then figure eight around chest and finally, play the water down the backbone for a couple of seconds.

This whole protocol should take only twenty five seconds, but could add years to your life.

Skin brushing could be done just before bathing or showering to stimulate the lymphatic system. You start at the point furthest from the heart and work your way towards it, brushing towards the lymph nodes. Bear in mind that the skin is the body's largest elimination organ.

These protocols don't take long and help to improve circulation and aid elimination of toxins. You will certainly feel more alert and energized.

Case Studies

Case One

I hadn't long qualified as a naturopath when I was asked if I could help regarding a case of compromized immune system. The patient was a dental technician. He was taken ill with glandular fever some fifteen years before and felt that his energy levels, and general resistance to any colds or flu had suffered since then. He booked in for seven sessions of constitutional hydrotherapy over four weeks and expressed his gratitude as his energy levels started to rise. Over the last eight years he has requested and received this treatment twice since, as a top up so to speak. He informs me that he is about to book in again this year.

Case Two

Parcel Force Worker, Sorter, late fifties, stumbled at work one night. Fell awkwardly onto barrier. Felt nauseous after bruising lower ribcage on her right side. Incident recorded in accident book.

Happened beginning December 2003. Checked out at GP: doctor felt it was just bruised ribs, wrote a sick note, advised rest for two weeks. She did not respond; liver area painful when lying down. Felt as if she was 'going to die' after drinking two glasses of red wine one evening a few days before Christmas, so decided to contact me. On palpation, liver tender, swollen. I advised her to drink no alcohol until further notice and I worked on her lymphatics. This lady was usually fit, strong and active, but unable to do anything too strenuous because of her discomfort. Her GP had signed her off for another two weeks. I advised her that her liver was swollen and compromized. I felt that the constitutional would help her. She made rapid progress and was able to return to work within two weeks.

Case Three

A holistic therapist first attended my clinic in June 2000, suffering from thrush. Lacked confidence and motivation, complained of feeling tired all the time. In fact, since entering puberty, she just seemed to lack energy compared to her contemporaries. She started to take an active interest in her diet, which she drastically improved. She then went on to train as a therapist before coming to my surgery. With the help of supplementation, and being on a strict diet, her energy levels rose. However, she did have gynaecological problems, including endometriosis and pre-cancerous cells. I saw her periodically, perhaps twice a year, until two years ago when she informed me that she and her long time partner wished to start a family. She had quite a lot of scar tissue internally and had been trying to conceive for twelve months. I recommended a programme of Constitutional Hydrotherapy which she underwent and in between I showed her how to apply a topical castor oil pack. She was pregnant within three months. I am pleased to say she has a beautiful son and, due to our combined efforts, is seriously considering undergoing training to become a naturopath.


Wade Boyle ND and Andre Saine ND. Lectures in Naturopathic Hydrotherapy. Buckeye Naturopathic Press. ISBN 0-9623518. p1-4.1998.

Further Information

David Goddard ND RMANM runs various workshops for interested parties. There is an introductory talk and demonstration of constitutional treatment being given on 7 July 2004 at the London College of Naturopathic Medicine (LCNM). They have a clinic at Kings Norton in Birmingham. Details of LCNM's workshops and courses can be found on


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About David Goddard ND

David Goddard ND RMANM has had a natural healing ability for over twenty five years. Due to a debilitating illness he set about finding a cure in complementary medicine, as the conventional route offered very little help. He was introduced to naturopathic principles and relaxation techniques, which helped him to cope with today's stressful society. David initially trained in Reflexology in 1977, Shiatsu in 1986 and graduated in Naturopathy with the Association of Natural Medicine in 1997. He incorporates a variety of treatments including gentle postural re-alignment, magnet therapy, kinesiology, hydrotherapy and uses Bush and Bach flower essences to neutralize stresses and traumas. David is on the faculty of the London College of Naturopathic Medicine and Food Science and on the governing counsel of The Association of Natural Medicine. He has been in remission from multiple sclerosis for twelve years now. He subscribes to constitutional hydrotherapy himself and is testament to its effectiveness. He can be contacted on Tel: 01621 816089;

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