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Ablutions and Affusions.

by Sussanna Czeranko, ND

Let us focus on two such uses of water that are familiar to us, even though the words

“ablution” and “affusion” may not be. Ablutions and affusions had specific uses for the early

water cure therapist. The difference between an ablution and an affusion is the manner in which

the water is applied, both of which impart many effects upon the human body. Let us explore

how the ablution and the affusion have been used by naturopathic doctors for over a century.

An ablution is simply a washing that can be done with the hands, a washcloth, a bath mitt or

a sponge that has the benefits of applying friction. An affusion, on the other hand, [no pun

intended] is a washing by pouring water from a vessel, such as a bucket or large pitcher onto

the body. (Baruch, 1920, 41) Both of these procedures were applying water onto the body, one

with hands or cloths, and the other with a container. Knowing how and when to use these

valuable hydropathic tools is what the early NDs meant by the “art” of practice. In this

connection Baumgarten states, “The art, however, is to find out the proper application for each

individual case.” (Baumgarten, 1903, 125) Hoegen reiterates Baumgarten assertions, “A good

Naturopath, as a rule, is a good Hydropath, because he has studied all the fundamentals

necessary to enable him to apply water in diseased conditions of the body in the proper

manner.” (Hoegen, 1917, 312)


Lust wrote about the ablution, lamenting that “nobody has yet realized the full value of a

correct ablution.” (Lust, 1907, 261) Essentially, he explained, all that was needed was a basin of

water “to apply a thorough ablution to the whole body.” (Lust, 1909, 370) To administer an

effective ablution required skill and its application was, as mentioned ealier, an “art”. Baruch

cautioned his readers, “Minute attention to details is the first essential for the successful

application of all hydriatric procedures.” (Baruch, 1920, 38) Lust explained that ablutions could

be “applied to all patients, suffering either from a very slight or a very serious disease; can be

taken standing up, sitting, or lying.” (Lust, 1909, 370) Modern showers have replaced the need

for ablutions, which have essentially been lost as a practice and even as a word in our lexicon.

Back then, the cold ablution was a welcome alternative for those who could not endure the cold

baths. (Lust, 1903, 321)

Linen cloths were often used in the administering of ablutions. Baruch did not condone the use of a

sponge, as an alternative, citing it as ineffective. Schultz also denounced the use of sponges,

writing,“A sponge does not give friction, and should be avoided.” (Schultz, 1914, 535) Baruch noted

that sponging with cloths or the hand in febrile cases could result in a chilling effect by evaporation.

(Baruch, 1920, 39) Lust considered that ablutions performed with the hand had certain advantages over

cloths or sponges. For starters, using just the hand entailed a more conscious awareness of the

pressure applied to another body and a more reliable gauging of the moisture. The temperature of the hand stays constant at 37° C, Lust described, and will not change by stroking equally and uniformly.

(Lust, 1907, 261) Kellogg also weighed in among his abundant contributions to the literature, citing the

benefits: “Wet-hand rubbing is an efficient means of producing strong circulatory reaction with moderate

thermic reaction by the combined influence of cold and friction.” (Kellogg, 1903, 630)

An often cited benefit of the ablution was friction. Many commentators noted that applying the

correct pressure of the hand to create a therapeutic friction needed to be calculated for a patient’s

particular constitution. Lust, for example, noted: “Nervous people have to be touched slightly but

quickly; corpulent people who lack natural warmth, vitality and buoyancy, whose circulation is slow,

have to be washed with a strong pressure that the water permeate the whole system.” (Lust, 1907, 261)

Friction and pressure applied to the body resulted in a range of therapeutic actions such as the

mechanical stimulation upon the nerve and blood supply of the skin. (Schultz, 1914, 349)


Affusions, though, were not as popular among the Naturopaths as they were with others

such as Baruch and the hydropathic therapists. The Kneipp “gushes” or douche showers that

had similar elements of affusions were preferred by the early Naturopaths, partly because the

way the affusion was applied seemed random and did not have any refined methodology. In this

regard, Pope comments, “The ‘affusion’ is a procedure by which a stream of water issuing from

a bucket or pitcher is thrown or falls upon the patient sitting or standing in an empty tub.” (Pope,

1909, 183) The Kneipp gush was meticulously applied, so that the water would form a sheet of

what appeared like glass on the skin surface. Another distinction between the affusion and the

Kneipp gush was the length of time. Weak patients would be limited to a water application of no

more than a minute with a Kneipp gush, whereas the advocates of the affusion directed that it

be longer in duration. For example, Dieffenbach describes an affusion treatment as follows: “In

weak patients it is best to start with 80F [27C] and a mild stream, treatment lasting not over 3-

5 minutes.” (Dieffenbach, 1909, 61) The literature generally indicates that the strength of the

affusion was determined by the temperature of the water used and the height that the water fell.

As well, a number of rules took root and became widely known among the early naturopaths.

With regard to temperature and the height of water, affusions were best utilized in combination with

other hydrotherapies. For instance, Winternitz recommended “cold half baths with affusions of cold

water on the abdomen, pouring same from 3 to 6 feet distances over the abdomen – as an adjunct in

atonic constipation to induce peristalsis.” (Dieffenbach, 1909, 45) These baths were given twice daily.

(Dieffenbach, 1909, 210) Pope rarely employed affusions in his clinical practice, except in conjunction

with the half bath or for some local effect. (Pope, 1909, 183) With regard to the evolving set of rules,

Lust and others established a useful protocol.

Rule # 1

There were many cardinal rules for hydrotherapy which deserve repeating as a way of emphasizing

their importance. Lust says, “Only when the body is entirely warm, a cool ablution or other wetting

should be applied if a benefit is expected.” (Lust, 1909, 370) Ablutions and affusions were

contraindicated for chilled patients and Lust reminds us that to “never apply a cold washing after a

meal, or if the nervous system is excited by fright, terror or annoyance.” (Lust, 1909, 370) The best time

to take an ablution was first thing in “the morning directly on rising, and the patient may retire back to

bed for a few moments or take exercise until the normal bodily warmth is regained.” (Lust, 1903, 321)

Also set out by Lust, another such rule was “exposing of the warm body to the cold application

should be of short duration.” (Lust, 1905, 70) Speed was crucial for ablutions. “If the washing takes too

long, the natural warmth of the body, which must always conquer the cold, will diminish; and it is very

essential that the body should never become cold after an ablution.” (Hartmann, 1905, 178) The length

of time needed to conduct an ablution was no more than 2 minutes. (Lust, 1903, 321) The preparation

of the ablution was important and so was the time after. Hartmann noted that all washes “should be

taken in as short a time as possible. The undressing and dressing must be performed quickly without

any pause at all.” (Hartmann, 1905, 178) Exposure to cold air after an ablution could result in an

aggravation if care was not taken to dress quickly. Hartmann also noted that “anyone who is slow in

dressing and undressing, or who does not wash in the proper way, may feel cold for hours; and even

then the cold must be overcome by exercise.” (Hartmann, 1905, 178)

Unlike our contemporary habits of toweling dry, after an ablution drying with a towel was not done.

For some who suffered with anemia or general weakness, the natural warmth may not last and cold

would set in. According to Hartmann, for these people, exercise that involved all the muscles would

best drive the blood to all parts of the body. (Hartmann, 1905, 178) “The exercise should be practiced

until the body is thoroughly dry and warm.” (Hartmann, 1905, 178)

Hoegen, who was a strong adherent of water therapies, states: “Water applied to the body

should have the purpose of aiding the body to bring back and restore sick parts to health, and also to

bring back proper functions to the organs which are working imperfectly, or it should make abnormal

conditions normal.” (Hoegen, 1917, 312) Panzer cited hardening as one of the benefits of a cold

ablution. He counseled, “If we every morning take an entire ablution, in water at 72F [22C and return

right to straight into bed for a few minutes to warm ourselves again without first drying the body”

(Panzer, 1901, 59) then hardening could help strengthen the body. Lust stated the indications for

ablutions or washings:

1. For cleaning the body;

2. For stimulating the metabolism;

3. For cooling down fever heat;

4. For refrigeration after sweat baths, sweat packings and sun baths.

(Lust, 1909, 370)


Baruch points out that the sponge bath “is usually given to febrile patients in bed. Baruch describes the

procedure of administering a protective water proof sheet is placed on the bed and “covered by a

blanket, and upon this a linen or old cotton sheet or tablecloth is spread, on half reaching over the edge

of the bed, the other rolled upon the other half of the later.” (Baruch, 1920, 38) The temperature of the

water used for “the first ablution is given at 85F [29C].” (Baruch, 1920, 38) For fevers, the ablution

was “repeated every two hours, if patient is awake, reducing the water temperature 5F [or 3C] each

time until 70F [21C] is reached.” (Baruch, 1920, 39) Elsewhere, Pope indicates that the cloth is

dipped into the cold water and the face and neck is sponged. The cloth is then wrung out and re-dipped

into the cold water and the cloth placed on the patient’s forehead. Next, the arms and legs are exposed

so that each can be sponged in a similar manner with a cloth dipped in cold water that contains as

much water without dripping. (Pope, 1909, 116) Pope then goes on to describe the process of ablution:

“The patient then turns over, lying on the belly, and the back is sponged from occiput to coccyx and

over the hips; then turns upon the back, and the chest and abdomen are sponged.” (Pope, 1909, 116)

Schultz preferred colder temperatures for the ablutions. He used “water of 50 to 60F [10 to 16C] …

and a small piece of ice may be placed in the water.” (Schultz, 1914, 535)


Within the literature on this subject, there is frequent reference to the use of friction during an

ablution, most particularly noting its enhancing antipyretic effects. Pope describes its benefits in this

way: “Friction, as we have seen, overcomes the superficial contraction, dilates the blood-vessels, and

by reflex action, as well as by heat abstraction, acts upon the thermogenic and vasomotor centers in

the medulla and cord, limiting heat formation and increasing heat elimination.” (Pope, 1909, 116)

Lust suggests that vinegar added to the water in the ratio of 1:3 [vinegar: water] could also be used as

an ablution. (Lust, 1903, 321) It would follow a wet sheet wrap that was used to treat acute diseases.

Lust adds, “A quick sponge-bath of the unwrapped body with vinegar-water will, in most cases, be felt

as very comforting, as by this method the relaxed skin recovers its former tension.” (Lust, 1923, 739)

Kneipp did not have at his disposal the diagnostic tools that we are familiar with. As did our

naturopathic forebears, he relied completely upon the appearance of his patients and when unsure, the

ablution. Kneipp used the ablution to help determine his patient’s constitution when there were any

doubts. Lust explains:

The ablution and the “cold rubbing [are] … a good diagnostical indicator of the patient’s state of

vitality. In case a collapse is imminent, a superficial washing of the forearm will soon give a hint

which cannot be mistaken. If the skin only slowly begins to take on a reddish color, if the high

temperature falls in a conspicuous and rapid manner, such symptoms are conclusive in proving that

the patient’s vital energies are near the freezing point.

(Lust, 1923, 738)

In other words, if the reddening reaction is slow in coming, the patient’s vitality is very low.

The ablution and the affusion were one of the first interventions that Kneipp would make in cases of

pale and thin individuals. Kneipp concluded in this case “that their blood was poor and of bad quality

and that they lacked natural warmth. His first object then was to stimulate their appetite and circulation

which he accomplished for the post part by partial washings or affusions.” (Bilz, 1901, 212) Likewise,

Hoegen also used ablutions extensively for both acute and chronic diseases. (Hoegen, 1917, 313)

Dieffenbach cited ablutions and affusions for chronic eczema, psoriasis, neurasthenia, and

tuberculosis. (Dieffenbach, 1909, 191, 230, 239) As well, hydrotherpist such as Schultz did not hesitate

to treat spinal meningitis … in fact, every disease using ablutions as the primary intervention. (Schultz,

1914, 535) Dieffenbach used the affusion for meningitis. The patient “is placed in a hot half-bath and

cold affusions are directed over the neck, spine and chest for 2 to 3 minutes, or until reaction takes

place.” (Dieffenbach, 1909, 62) Another protocol for spinal meningitis which incorporated both the

ablution and affusion were cited by Dieffenbach. “To secure relaxation and elimination of the toxins, the

hot, moist blanket or linen cloth pack should be given at once, followed by ablutions with water at 100F

[38C].” (Dieffenbach, 1909, 137) The hot pack was given after a hot enema to clear the bowels.

Dieffenbach continues:

After the hot pack, which lasted 20 minutes and produced marked relaxation, the

patient received sectional hot ablutions and was rested for one hour. We next applied

hot half baths every 3 hours, with cold affusions to the spine and vigorous rubbing of

same, the patient during all these procedures wearing a cold, moist cloth about the

head to relieve cerebral congestion. Each hot half bath lasted 15-20 minutes and was

preceded by hot colon flushings.

(Dieffenbach, 1909, 137)

Although, we rarely prescribe an ablution or an affusion, there is no reason why we shouldn’t. For

our patients who dread cold water, these therapies can have significant results today as they did a

century and more ago.


Baumgarten, A. (1903). Water applications. The Naturopath and Herald of Health, IV(5), 124-126.

Baruch, S. (1920). An epitome of hydrotherapy: for physicians, architects and nurses. W. B. Saunders Company,

Philadelphia, 205 pp.

Bilz, F. E. (1901). The Kneipp cure. The Kneipp Water Cure Monthly, II(8), 210-213.

Dieffenbach, W. H. (1909). Hydrotherapy. Rebman Company, New York.

Hartmann, T. (1905). The cold water treatment. The Naturopath and Herald of Health, VI(7), 178.

Hoegen, J. A. (1917). Hydrotherapy. Herald of Health and Naturopath, XXII(5), 311-316.

Kellogg, J. H. (1903). Rational Hydrotherapy. F. A. Davis Publishing Company, Philadelphia.

Kneipp, S. (1900). Water applications. The Kneipp Water Cure Monthly, I(9), 156-157)

Lust, B. (1907). The importance of ablutions in natural healing. The Naturopath and Herald of Health, XII(8), 261-


Lust, B. (1903). Health incarnate, means of hardening for children and adults. The Naturopath and Herald of

Health, IV(11), 313-322.

Lust, B. (1905). Does hydrotherapy require reform? The Naturopath and Herald of Health, VI(3), 70-71.

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Lust, B. (1909). The natural method of healing. The Naturopath and Herald of Health, XIV(6), 368-373.

Lust, B. (1923). Hydro-therapeutical comments. Herald of Health and Naturopath, XXVIII(12), 736-739.

Panzer, A. (1901). How to harden the system. The Kneipp Water Cure Monthly, II(2), 59.

Pope, C. (1909). Practical hydrotherapy. Cincinnati Medical Book Company, Cincinnati.

Schultz, C. (1914). Hydrotherapy or water cure. The Naturopath and Herald of Health, XIX(6), 345-349.

Schultz, C. (1914). Hydrotherapy or water cure. The Naturopath and Herald of Health, XIX(8), 533-536.

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