An enema involves the injection of fluid into the rectum thereby cleaning the bowels. An enema-can is required for this purpose. This can should be filled with water at 98oF temperature and placed on a suitable hook at a height of four to six feet from the ground. The patient is made to lie on his right side extending his right leg and folding the left leg at right angle. The enema nozzle, lubricated with oil or vaseline, is inserted into rectum. Generally, one to two litres of water is injected. The patient may either lie down on his back or walk a little while, retaining the water. After five to ten minutes, the water can be ejected along with the accumulated morbid matter. A warm water enema has to clean the rectum of accumulated faecal matter. This is not only the safest system for cleaning the bowels , but it also improves the peristaltic movement of the bowels and therby relieves constipation.
(2) The Dry Friction
Dry friction bath is an excellent method of keeping the skin in order. It increases the activity of all the functional processes lying at or near the surface of the body. This bath can be taken with a rough dry towel or with a moderately soft bristle brush. If a brush is used, the procedure is as follows : Take the brush in one hand and begin with the face, neck and chest. Then brush one arm, begining at the wrist and brushing towards the shoulder. Now brush one foot, then the ankle and leg. Then do the other foot and leg, and next the hips and central portion of the body. Continue burshing each part until the skin is pink. Use the brush quickly in a backward and forward motion on every part of the body. If a towel is used it should be fairly rough, and the same process gone through as for the use of brush.
(3) Sponge Bath
For giving sponge bath, water should be taken at the required temperture in a basin. The sponge bath may be given either with a turkish towel or with gloves prepared with the turkish cloth. Generally the sponge bath is given to bed-riden patients who are very weak and to those suffering from prolonged fever / illness. The patient should be covered with a bedsheet and the limbs rubbed one after the other with the turkish towel dipped frequently in water. Soon after the friction, the legs should be dried. The patient should then again be covered with the bed sheet. Sponge one part at a time in the following order : arms, chest,abdoment, legs, feet and back. For the arm or leg, spread the towel under the whole length of the arm or leg while it is being sponged. Rub skin briefly with the face towel to draw blood on the surface. Dry each part after the sponge to avoid chilling. Be sure the patient is dry before replacing clothing and covers. In case of very weak patients warm water should be used and for other persons cold water can be used.
(4) Cold Compress
This is a local application using a cloth which has been wrung out in cold water. The cloth should be folded into a broad strip and dipped in cold water or ice water. The compress is generally applied to the head,neck, chest, abdomen and back. The cold compress is an effective indirect means of controlling inflammatory conditions of the liver, spleen, stomach, kidneys, intestines, lungs, brain pelvic organs and so on.
(5) Wet Pack or Heating Compress
This is a cold compress covered in such a manner as to bring warms to the body. A heating compress consists of three or four folds of linen cloth wrung out in cold water which is then covered completed with dry flannel or blanket to prevent the circulation of air and help accumulation of body heat. It is sometimes applied for several hours. The duration of the application is determined by the extent and the location of the surface involved, the nature and thickness of the coverings and the water temperature. After removing the compress, the area should be rubbed with a wet cloth and dried with a towel. A heat compress can be applied to the throat, chest abdomen and joints. A throat compress relieves sore throat, hoarseness, tonsillitis, pharyngitis and laryngitis. An abdominal compress helps those suffering from gastritis, hyperacidity, indigestion, jaundice, constipatin, diarrhoea, dysentery and other ailments relating to the abdominal organs. The chest compress, also known as chest pack, relieves cold, bronchitis, pleurisy, pneumonia, fever, cough and so on, while the joints compress is helpful for inflammed joints, rheumatism, rheumatic fever and sprains.
(6) Hip Baths
The hip bath is one of the most useful forms of hydrotherapy. As the name suggests, this mode of treatment involves only the hips and the abdominal region below the navel. A special type of tub is used for the purpose. The tub is filled with water in a way that it covers the hips and reaches upto the navel when the patient sits in it. Generally four to six gallons of water is required. If the special tub is not available, a common tub may be used. A support may be placed under one edge to elevate it by two or three inches. Hip bath is given in cold, hot, neutral or alternate temperatures.
(I) Cold Hip Bath
The water temperature should be 10oC to 18oC. The duration of the bath is usually 10 minutes. If the patient fells cold or is very weak, a hot foot immersion should be given with the cold hip bath. The legs should be so adjusted that there is no pressure upon the muscles, ligaments and blood vessels of the knee region.
The patient should rub the abdomen briskly from the naval downwards and across the body with a moderately coarse wet cloth. The legs, feet and upper part ofthe body should remain completely dry during and after the bath. The patient should undertake moderate exercise after the cold hip bath to warm the body. A cold hip bath is a routine treatment in most diseases. It relieves constipation, indigestion, obesity and helps the eliminative organs to function properly.
(ii) Hot Hip Bath
This bath is generally taken for eight to 10 minutes at a water temperture of 40oC to 45oC. The bath should start at 40oC. The temperature should gradually increase to 45o C. No friction should be applied to the abdomen. Before entering the tub, the patient should drink one glass of cold water. A cold compress should be placed on the head. Care should be taken to prevent the patient from catching a chill. After the bath the patient should be given a cold shower. A hot hip bath helps to relieve pain in the pelvic organs, painful urination and inflammed rectum or bladder.
(iii) Neutral Hip Bath
The temperature of the water should be 32oC to 36oC. Here too, friction to the abdomen should be avoided. This bath is generally taken for 20 minutes to an hour. The neutral hip bath helps to relieve all acute and sub-acute infalmmatory conditions.
(iv) Alternate Hip Bath
This is also known as revulsive hip bath. The temperature in the hot tub should be 40oC to 45oC and in the cold tub 10oC to 18oC. The patient should alternately sit in the hot tub for five minutes and then in the cold tub for three minutes. The duration of the bath is generally 10 to 20 minutes. The head and neck should be kept cold with a cold compress. The treatment should end with a dash of cold water to the hips. The bath relieves chronic inflammatory conditions of the pelvic viscera.
(7) Full Wet Sheet Pack
This is a procedure in which the whole body is wrapped in a wet sheet, which in turn is wrapped in a dry blanket for regulating evaporation. The blanket should be spread on the bed with its edges hanging over the edge of the bed. The uppet end should be about eight inches from the head of the bed. Then spread a linen sheet wrung out in cold water over the blanket so that its end is slightly below the upper end of the blanket. The patient should lie on the bedsheet with his shoulders placed about three inches below the upper edge. The wet sheet should be quickly wrapped round the body of the patient, drawn in, tightly tucked between the legs and also between the body and the arms. The sheet should be folded over the shoulders and across the neck. Now the blanket should be drawn tightly around the body and tucked in along the side in a similar manner, pulling it tightly. The ends should be doubled up at the feet. A turkish towel should be placed below the chin to protect the face and neck from coming into contact with the blanket and to exclude outside air more effectively. The head should be covered with a wet cloth so that the scalp remains cold. The feet should be kept warm during the entire treatment. If the patientís feet are cold, place hot water bottles near them to hasten reaction. The pack is administered for half an hour to one hour till the patient begins to perspire profusely. He may be given cold or hot water to drink.
This pack is useful in cases of fever, especially in typhoid and continued fevers, and benefits those suffering from isominia, epilepsy and infantile convulsion. It is useful in relieving chronic cold and bronchitis.
(8) Hot Foot Bath
In this method, the patient should place his or her legs in a tub or bucket filled with hot water at a temperature of 40oC to 45oC.
Before taking this bath, a glass of water should be taken and the body should be covered with a blanket so that no heat or vapour escapes from the foot bath. The head shouold be protected with a cold compress. The duration of the bath is generally from five to 20 minutes. The patient should take a cold shower immediately after the bath. The hot foot bath stimulates the involuntary muscles of the uterus, intestine, bladder and other pelvic and abdominal organs.
(9) Steam Bath
Steam bath is one of the most important time-tested water treatments which induces perspiration in a most natural way. The patient, clad in minimum loin cloth or underwear, is made to sit on a stool inside a specially designed cabinet. Before entering the cabinet, the patient should drink one or two glasses of cold water and protect the head with a cold towel. The duration of the steam bath is generally 10 to 20 minutes or until profuse perspiration takes place. A cold shower should be taken immediately after the bath.
If the patient feels giddy or uneasy during the steam bath, he or she should immediately be fitted out and given a glass of cold water and the face should be washed with cold water.
The steam bath helps to eliminate morbid matter from the surface of the skin. It also improves circulation of blood and tissue activity. It relieves rheumatism, gout, uric acid problems, jaundice and obesity. The steam bath is helpful in all forms of chronic toxemias. It also relieves neuralgias, chronic nephritis, infections, tetanus and migraine.
(10) Neutral Immersion Bath
This is also known as full bath. It is administered in a bath tub which should be properly fitted with hot and cold water connections. This bath can be given from 15 to 60 minutes at a temperature ranging from 26oC to 28oC. It can be given for longer duration, without any ill-effects, as the water temperature is akin to the body temperature. The neutral bath diminishes the pulse rate without modifying respiration. This treatment is the best sedative, since the neutral bath excites activity of both the skin and the kidneys.
(11) Mud Packs
The use of mud packs has been found highly beneficial and effective in the treatment of chronic inflammations caused by internal diseases, bruises, sprains, boils and wounds. A mud pack is prepared with clay obtained from about ten cms. below the surface of the earth, after ensuring that it does not contain any impurities such as composit or pebbles. The clay is then made into a smooth paste with warm water. This is allowed to cool and then spread on a strip or cloth, the size of which may vary according to requirements. The dimensions of the pack meant for application on the abdomen are generally 20 cm. X 10 cm. X 2.5 c.m. for adults. As the abdomen is the seat of most diseases, mud pack applied to this part of the body can cure many disorders including all forms of indigestion affecting the stomach and bowels. It is most effective in decreasing the external heat and breaking up the morbid matter.
Massage is an excellent form of passive exercise. It involves the scientific manipulation of the soft tissues of the body. If correctly done on a bare body, it can be highly stimulating and invigorating. The general massage, dealing with all parts of the body, tones up the nervous system, influences respiration and quickens the elimination of poisons and waste material from the body through the various eliminative organs such as the lungs, skin, kidneys and bowels. It also boosts blood circulation and metabolic processes.
Cotton seed oil is most commonly used for massaging. If the patient is averse to oil, talcum powder may be used. General body massage may be done for 40 to 45 minutes and local body massage for 10 to 15 minutes. The oil should be washed off completely after massage.
(I) Abdominal Massage
This form of massage is beneficial in constipation. It stimulates the peristalisis of the small intestines, tones up the muscles of the abdomen walls and mechanically eliminates the contents of both large and small intestines. Abdominal massage should not be done after a heavy meal, but after two hours or so. The bladder should be emptied before the massage. The patient is made to lie on his back with his knees drawn up. This enables the abdomen wall to relax. The masseur should stand at the right side of the patient and use finger tips for friction round the umbilical region from right to left. He should likewise alternatively knead the walls and roll with both hands, making deep and firm pressure. He should knead with heal of the hand and finger tips and later take up massaging the larger intestines. The manipulation of the large intestine should begin on the right side. Keep it going upwards and across the transverse colon and move right down on the left side to the sigmoid flexure and rectum. Circular kneading should be done with the help of the three middle fingers. At the same time, press into the contents of the abdomen, following the course of the larger colon with a crawling motion. Keep kneading by means of a few circular movements in one spot with the help of finger tips. Keep moving the finger a little further along. Knead repeatedly. Use knuckles of the hand to make keep pressures along the large colon,moving the hands along after each pressure.
(ii) Chest Massage
Chest massage strenghens the chest muscles, increases circulation and tones up the nervous system of the chest, heart and lungs. It is especially recommended in weakness of the lungs, palpitation and organic heart disorders.
The patient is made to lie on the back with the arms at the sides. The masseur starts manipulating the chest by means of strokes with both hands on each side of the breast bone. A circular motion is formed by the movement made up and down on the chest. Next the muscle kneading is done by picking up the skin and muscles with both hands. Treatment is given to both the sides of the chest likewise. Circular kneading is done next by placing one hand on each side of the breast bone and making the circular motions outward towards the sides.
(iii) Massage of the Throat
This helps to overcome headache, sore throat and catarrh of the throat. The patient is made to throw his head back. The masseur places palms of both hands on sides of the neck with thumbs under the chin, and fingers under the ears. A downward stroke is made towards the chest over the jugular veins. Do not exert heavily on the jugular veins. Repeat several times.
(13) Yogic Practices
(For Older Childern)
Yogic kriyas, asanas and pranayama constitute the physical basis of yoga. The practice of kriyas and asanas leads to excellent blood circulation. It also energises and stimulates major endocrine glands of the body. Yogic exercises promote inner health and harmony, and their regular practice helps prevent and cure many common ailments. They also help eliminate tensions, be they physical , mental or emotional. Pranayama slows down the ageing process.
All yogic exercises should be performed on a clean mat, carpet or blanket covered with a cotton sheet. Clothing should be light and loose-fitting to allow free movement of the limbs. The mind should be kept off all disturbances and tensions. Regularity and punctuality in practicising yogic exercises is essential.
A disease-free system should be the starting ground for yogasana and pranayama. There are six specific cleansing techniques, known as Shat Kriyas, which eliminate impurities and help cure many ailments. Of these, the following three can be practised by older children safely.
Jalaneti is a process of cleansing the air passage of the nostrils and the throat by washing them with tepid saline water. Take a clean jalaneti pot. Put half a teaspoonful of salt in the pot and fill it with lukewarm drinking water. Stand up and tilt your head slightly to the right. Insert the nozzle of the pot in the left nostril and let the water flow into it. Inhale and exhale through the mouth, allowing the water to flow out through the right nostril. Reverse this process by tilting your head to the left and letting the water flow from the right to the left nostril.
Jalaneti should be practised only in the morning. It will relieve sore throat, cold, cough, sinusitis, migraine, headache and cases of inflammation of the nasal membranes. It keeps the head cool and improves vision.
(ii) Kunjal or Vamana Dhouti
This is a process of cleansing the interior of the stomach. Drink four to six glasses of tepid water with a salt added to it early in the morning on an empty stomach. Then stand up, bend forward, insert the middle and index fingers of the right hand into the mouth until they touch the uvula. Tickle it until you feel a vomiting sensation. The saline water thus ejected will bring up bile and other toxic matter with it. Repeat the process till all the water is vomited out. This should be done once a week or as and when necessary. It is beneficial for cleansing the stomach in cases of excessive bile, constipation and gastric troubles.
This is a respiratory exercise for the abdomen and diaphragm. The channels inside the nose and other parts of the respiratory system are purified by this exercise. In the process, the brain is also cleared. Sit in a comfortable position, preferably in padmasana. Exercise the diaphragm by exhaling suddenly and quickly through both nostrils , producing a hissing sound. Inhaling will be automatic and passive. The air should be exhaled from the lungs with a sudden, vigorous inward stroke of the front abdominal muscles. The abdominal stroke should be complete and the breath should be expelled fully. While inhaling, no wilful expansion is necessary and the abdominal muscles should be relaxed. This exercise should be done in three phases, each consisting of 20 to 30 strokes a minute. A little rest can be taken in between. Throughout the exercise throacic muscles should be kept contracted. Kapalbhati enables the inhalation of a good amount of oxygen which purifies the blood and strengthens the nerve and brain centres. This kriya provides relief in many lung, throat and chest disease like chronic bronchitis, asthma,pleurisy and tuberculosis.
(I) Shavasana (Dead body pose)
Lie flat on your back, feet comfortable apart, arms and hands extended about six inches from the body, palms upwards and fingers half-folded. Close your eyes. Begin by consciously and gradually relaxing every part and each muscle of the body : feet, legs, calves, knees, thighs, abdomen, hips, back, hands, arms, chest, shoulders, neck head and face. Relax yourself completely feeling as if your whole body is lifeless. Now concentrate your mind on breathing rhythmically as slowly and effortlessly as possible. This creates a state of complete relaxation. Remain motionless in this position, relinquishing all responsibilities and worries for 10 to 15 minutes. Discontinue the exercise when your legs go numb.
(ii) Padmasana (Lotus pose)
Sit erect and stretch your legs out in front of you. Bend one leg to place the foot on the thigh of the other, the sole facing upwards. Similarly, bend the other leg too, so that they press down on other side of the groin. Keep your neck, head and spine straight. Place your palsm one upon the other, both turned upward and cupped, and rest them on the upturned hells a little below the navel. Padmasan is a good pose for doing pranayama and meditation. It helps in the treatment of many heart and lung disease and digestive disorders. It also calms and refreshes the mind.
Sit erect in padmasan. Fold your hands behind your back, holding your left wrist with the right hand. Take a deep breath. While exhaling, bend forward slowly keeping your hands on your back. Bring your face downwards until your nose and forehead touch the floor. While inhaling, slowly rise back to the upright position. The practice of this asana tones up the nervous system, builds up powerful abdominal muscles and strengthens the pelvic organs. It helps pep up digestion, boosts the appetite and removes constipation.
(iv) Vajrasna (Pelvic pose)
Sit erect and stretch out your legs. Fold your legs back, placing the feet on the sides of the buttocks with the soles facing back and upwards. Rest your buttocks on the floor between your heels. The toes of both feet should touch. Now, place your hands on your knees and keep the spine, neck and head straight. Vajrasana can be performed even after meals. It improves the digestion and is beneficial in case of dyspepsia, constipation and colitis. It strengthens the hips, thighs, knees, calves, ankles and toes.
(v) Viparitakarani (Inverted action pose)
Lie flat on your back, with your feet together and arms by your side. Press your palms down, raising your legs to a perpendicular poisition without bending the knees. Your palms should touch the waist. Then streaighten your legs. The trunk should not make a right angle with the ground but simply an upward slanting position. The chest should not press against the chin but be kept a little away. To return to the ground, bring your legs down slowly, even balancing your weight. Through this asana, the muscles of the neck becomes stronger and blood circulation is improved.
(vi) Sarvangasana ( Shoulder stand pose )
Almost all parts of the body are involved and benefit from this asana. Lie flat on your back with your arms by the side, palms turned down. Bring your legs up slowly to a 90 o C angle and then raise the rest of the bodby by pushing the legs up and resting their weight on the arms. Fix your chin in Jugular Notch, and use your arms and hands to support the body at the hip region. The weight of the body should rest on your head, back and shoulders, your arms being used merely for balance. The trunk and legs should be in a straight line. The body, legs, hips and trunk should be kept as vertical as possible. Focus your eyes on your big toes. Press your chin against your chest. Hold the pose for one to three minutes. Return to the starting position slowly reversing the procedure. Sarvangasana helps relieve bronchitis, dyspepsia, and peps up the digestion. It stimulates the thyroid and para-throid glands, influences the brain, heart and lungs.
(vii) Uttanapadasana ( Leg-lifting pose)
Lie on your back with leg and arms straight, feet together, palms facing downwards, on the floor close to the body. Raise your legs about two feet from the floor without bending your knees. Maintain this pose for some time. Then, lower your legs slowly without bending the knees. This asana is helpful for those suffering from constipation. It strengthens the abdominal muscles and intestinal organs.
(viii) Halasana ( Plough pose)
Lie flat on your back with legs and feet together, arms by your side with fists near your thigh keeping your legs straight, slowly raise them to angles of 30 o , 60 o and 90 o, pausing slightly at each point. Gradually, raise your legs above your head without bending your knees and then move them behind until they touch the floor. Stretch your legs as far as possible so that your chin presses tightly against the chest while your arms remain on the floor as in the original position. Hold the pose from between 10 seconds to three minutes, brathing normally. To return to the starting position, slowly reverse the procedure. This asana relieves tension in the back, neck, and legs and is beneficial in the treatment of many diseases, including arthritis and asthma.
(ix) Bhyjangasana ( Cobra pose)
Lie on your stomach with your legs straight and feet together, toes pointing backwards. Rest your forehead and nose on the ground. Place your palms below the shoulders and your arms by the side of the chest. Inhale and slowly raise your head, neck, chest and upper abdomen from the naval up. Bend your spine back and arch your back as far as you can, looking upwards. Maintain this position and hold your breath for a few seconds. Exhale, and slowly return to the original position. This asana has great therapeutic value in the treatment of diseases like bronchitis, and asthma.
(x) Shalabhasana ( Locust pose)
Lie flat on your stomach, with your legs stretched out straight, feet together, chin and nose resting on the ground, looking straight ahead. Move your arms under the body, keeping them straight, fold palms into fists and place them close to the thighs. Now, raise your legs up, keeping them straight together and stretching them as far back as possible without bending your knees and toes. Hold this position for a few seconds and repeat four or five times. The whole body is strengthened by this asana especially the waist, chest, back and neck.
(xi) Dhanurasana ( Bow pose )
Lie on your stomach with your chin resting on the round, arms extended alongside the body with the legs straight. Bend your legs back towards the hips, bring them forward and grasp your ankles. Inhale and raise your thighs, chest and head at the same time. Keep your hands straight. The weight of the body should rest mainly on the navel region. Therefore, arch your spine as much as possible. Exhale and return slowly to the starting position, by reversing the procedure. Dhanurasana provides good exercise for the arms, shoulders, legs, ankles, back and neck. It also strengthens the spine. It relieves flatulance and constipation and improves the functioning of the pancreas and the intestines.
(xii) Paschimottanasana ( Posterior stretching pose )
Sit erect, stretch your legs out in front of you, keeping them close to each other. Bend your trunk and head forward from the waist without bending your knees and grasp the big toes with your fingers. Holding your toes, and without bending your knees, rest your forehead on your knees. With practice, the tense muscles become supple enough for this exercise. Old persons and persons whose spine is stiff should do this asana slowly in the initial stages. The final pose need be maintained only for a few seconds. Return to the starting position gradually. Paschi-mottanasana is a good stretching exercise in which the posterior muscles get stretched and relaxed.
(xiii) Pavanmuktasana ( Gas releasing pose )
Lie flat on your back, hands on your side. Fold your legs back, placing your feet on the floor. Make a fingerlock with your hands and place them a little below the knees. Bring your thighs up near your chest. Exhale and raise your head and shoulders and bring your nose between your knees. This is the final position.
Maintain this pose for a few seconds and repeat three to five times. Reverse the procedure to get back to the original position. This asana strengthens the abdominal muscles and internal abdominal organs like the liver, spleen, pancreas and stomach. It helps release excessive gas from the abdomen and relieves flatulence.
(xiv) Chakrasana( Lateral bending pose )
Stand straight with your feet and toes together and arms by your sides, palms facing and touching the thighs. Raise one arm laterally above the head with the palm inwards up to shoulder level and palm upwards, when the arm rises above the level of your head. Then, bend your trunk and head sideways with the raised arm touching the ear, and sliding the palm of the other hand downards the knee. Keep your knees and elbows straight throughout. Maintain the final pose for a few seconds. Then gradually bring your hand back to the normal position. Repeat the exercise on the other side. This asana induces maximum stretching of the lateral muscles of the body, especially the abdomen. It strengthens the knees, arms and shoulders and increases lung capacity.
(xv) Trikonasana ( Triangle pose )
Stand erect, with your legs apart, stretch your arms up to shoulder level. Bend your trunk forward and twist to the left, looking upwards and keeping your left arm raised at an angle of 90o. Place your right palm on your left foot without bending the knees. Maintain this pose for a few seconds. Then straighten up and return to the normal position. Repeat the procedure on the other side. Trikonasan is an all-round stretching exercise. It keeps the spinal column flexible and reduces the fat on the lateral sides of the body. Besides, it stimulates the adrenal glands and tones up the abdominal and pelvic organs.
Sit in any comfortable meditative pose, keeping your head, neck and spine erect. Rest your left hand on your left knee. Close your right nostril by pressing the tip of your right thumb against it. Breath out slowly through the left nostril. Inhale slowly and deeply through the left nostril, keeping the right nostril closed. Close your left nostril with the little finger and ring finger of your right hand and exhale through the right nostril. Then inhale through the right nostril, keeping the left nostril closed and, lastly, exhale through the left nostril, keepng the right nostril closed. This completes one round of anuloma-viloma. Repeat the entire process. Inhaling and exhaling should be done very slowly, without making any sound. This pranayama is a process of purification. It strengthens the lungs and calms the nerves. It helps cure cough and cold, insomnia, chronic headache and asthma.
Sit in any comfortable meditative pose. Inhale slowly, deeply and steadily through both nostrils with a low uniform sound through the glottis. Hold your breath for a second or two after inhaling and then exhale noisily only through the left nostril, keeping the right nostril closed. Do this as often as required. This pranayama clears the nasal passage and helps the functioning of the thyroid gland and benefits respiratory disorders, especially bronchitis and asthma.