Archives of the Balkan Medical Union Copyright © 2015 CELSIUS. HISTORY OF MEDICINE HYDROTHERAPY: HISTORICAL LANDMARKS OF A Cl ALL REMEDY G. TsoucaLas', M. SGANTZOS™, MARIANNA KARAMANOU!', K. GRITZALIS', G. ANDROUTSOS' 'History of Medicine Department, Medical School, University of Athens, Greece ‘Department of History of Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece "Department of Anatomy, Faculty of Medicine, University of Thessaly; Larissa, Greece Summary In Hippocratic Corpus we may find fragments mentioning hydrotherapy as a remedy for several diseases. During the 18th century the English physicians John Floyer and James Currie proved the efficacy of hydrotherapy inaugurating a new era. In early 20th century, the Greek physician Angeliki Panagiota- tou, strongly supported hydrotherapy, publishing several treatises in Greek and French languages. Currently in several countries hydrotherapy is still used as a complementary treat- ‘ment in various diseases. Key words: Hippocrates, water, hydrotherapy, medicine INTRODUCTION ater is considered the most basic element of linked with divine powers and healing properties [1]. Hydrotherapy, derived from the Greek words “hydro” meaning water and “therapy” meaning treatment has been part of the healing tradition of nearly every civilization from ancient Greece and Egypt to Rome. During the time of Hippocrates, baths were used for cleansing and ‘medicinal purposes and a combination of hot/cold water was, used to bring harmony in human body [2]. Moreover, ancient Greece, water was important for the maintenance of personal and environmental hygiene so, at the beginning, hydrotherapy was introduced as a purification method, remedy to clean both body and soul and later on it was used for various therapeutic purposes, becoming thus a panacea Bh. Correspondence address: Marianna Karamanow, MD, Ph.D 4 sir Themidos, 14564, Kifissia, Athens, Greece REsuME L'hydrothérapie: Repéres historiques d'une panacée Dans Corpus Hippocratique on peut trouver des citant 'hydrothérapie comme une véritable panacée. Au du 18eme sigcle, les médecins anglais John Floyer et Currie ont prouvé I'efficacté de I'hydrothérapie et leur 4 inauguré une nouvelle ére. Au début du 20eme sitce, premigre femme médecin en Gréce, Angeliki Panagiotatou, fortement soutenu I'hydrothérapie et elle a publié plus traités en langue grecque et francaise. Mots clés: Hippocrate, eau, hydrothérapie, médecine Water: a remedy over the centuries In ancient Greece, private hot baths flourished as an | integral part of everyday life. According to the beliefs of the fra, a warm or hot spring bath could enhance the physical and mental health, purify the soul and revive the spirit Ancient Greeks gave a great importance in water and constructed public baths. These public bathing places were devoted to particular deities, while they were considered as sacred ground. The goddess Artemis was the patroness of the sources which were controlled by the nymphs [4,5]. In many cases, Artemis co-worshiped within Asclepieia along with Apollo and Asclepius, a proof of water's healing powers [6] In 5th century BC, the distinguished Greek medical theorist and philosopher Alemaeon of Croton was the first to state that the quality of water may influence the health of people while Hippocrates (460-377 BC) was the first to deal with the topic of water, its use, its effects on e-mail: mariannakaramanou@ yahoo.comArchives ofthe Batkan Medical Union HIPPOCRATE,, Tir he to Malone hau fr pats fen ne Figure 1 - Marble bust of Hippocrates (Source: Welleome Library, London) fhuman body and its correlation with disease. In his ‘On Airs, Waters, and Places", water yields a gificant role [7]. In most cases, more than a purifying bath needed for a complete therapeutic cycle and salt water in minerals had been also used. Hippocrates realized the ince of clima, as well as of elements of nature for the tenance of life [7,8]. The following statement: "the fet can cure everything", is written within Hippocratic pus, while its therapeutic value is highlighted in several ages [7]. Moreover, Hippocrates recommended cold or Bt water in the treatment of pneumonia, pleurisy, hepati and skin infections such as empyema and herpes. [9]. However, ancient Rome became the “mother of spa iments”, Etruscans were using the water to preserve Ith and treat diseases and in Ist century AD, piades (124-40B C) introduced water in Rome ical therapy. The Roman encyclopaedist Celsus IBC. .50 AD) pointed out the importance of bathing for Penonal hygiene and recommended drinking water could accompany a therapeutic bath, favouring geis and eliminating “bad humours’, In his turn Pliny provided an exhaustive account on hydrotherapy ming among others its positive therapeutic effect on. ia and insanity {10}. les the accounts of ancient medical writers on the ffcial role of water, several religious cultures have September 2018, 431 Figure 2 -A man taking a shower as pant of a hydrotherapeutic cure. Wood engraving by Thomas Onwhyn, 1860 (Source: Wellcome Library, London) Figure 3 - Angeliki Panagiotatou (1878-1954), the first woman that graduated from Athens Medical School regarded water as sacred and profane. In Old Testament water is a major symbol. It was created on the first day, it brings life and joy. It is a powerful element that can destroy evil and enemies as it is mentioned in the Hood and the flight of Israel from Egypt while John the Baptist used the water of the Jordan to cleanse people's sins. Water's healing, properties are also reported as Naaman the Syrian was cured from leprosy. In New Testament, water was more symbolic and was considered a symbol of spiritual grace, purification and salvation [11]. Centuries later, in medicine, the leading renaissanceHYDROTHERAPY: HISTORICAL LANDMARKS OF A CURE ALL REMEDY - TSOUCALAS eta physician, botanist and alchemist Paracelsus (1493-1541) viewed nature as a balsam which could heal all wounds while water was the fundamental matter, prima materia from which everything else emerged. Paracelsus was prescribing hot mineral baths instead of herbal medicines to restore the balance of elements in the body {12} In 18th century a new era in hydrotherapy inaugurated thanks to the works of the English physicians John Hoyer (1649-1734) and James Currie (1756-1808). In his treatise on cold bathing Flyer pointed out the benefits on hydrotherapy Flyer also built a water cure establishment at Litchfield, UK. “The treatment was performed in two rooms, one of which was used for hot baths and dry packs while cold bath was done in the adjoining room. In his tum Currie suggested the use of ‘water in the treatment of intermittent fever, he used the “wet blanket” in fevers and advised cold water drinking in large quantities. Furthermore, Currie carried out experimental and thermometric studies to proof for the value of hydrotherapy, creating thus a scientific school [13]. In 1832 the French pioneer of experimental physiology Francois Magendie (1783-1855) denied that cholera was a contagious infection, attributing it to bad hygiene provoked by dirt, damp, and the lack of air and light. According t0 hhim, none of the five epidemic diseases such as typhus, leprosy, yellow fever, cholera, and plague, was contagious. Hydrotherapy, balneotherapy in this case, became once again a cure all remedy. Magendie boosted the movement of hygienists and thermal waters and inhalations became in vogue in therapeutics [14] ‘In Greece, at the beginning of 20th century, Angeliki Panagiotatou (1878-1954), the first woman that graduated from Athens Medical School, wrote a historical review on hydrotherapy in Ancient Greece while her masterpiece "Hygiene in ancient Greece" published in 1924, received the prize of the French Academy of Sciences. Panagiotatou introduced the water cure in Greece pointing out water's curative abilities (15]. During the same period, another physician, Emmanuel Mandalakis contributed significantly in the development of hydrotherapy and thermal medical tourism. Mandalakis revealed the curative virtues and physico-chemical and biological properties of Greek thermal springs, suggested several of treatment methods and provided important epidemiological informations on thermal springs and treated diseases [16] ‘Throughout centuries, water had an emblematic the maintenance of health and body equilibrium, hydrotherapy or hydropathy is part of alternative and is applied in several conditions such as skin dis chronic fatigue, mild depression, stress, poor circulation Its application in orthopaedic and sports med rehabilitation is very popular. Hydrotherapy may true panacea, but surely has a multifaceted mechanism. CONCLUSION REFERENCES “Mandyla‘Kousouni M. Water asthe fundamental a philesophical approach in therapeutics on che easter ranean region. Medical Archives ofthe Northwest Gree 671-75. 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Waters and spas in the classical wold Suppl. 1990; (10): L=1. Fahbusch E et al. The Encyclopedia of Christianity: Le Eercimans, 1998. Pagel W. Paracelsus: An Introduction to Philoso Medicine in the Era of the Renaissance. Basel, Kage, 19 Kellogg JH. Rational hydrotherapy. Batele Creek, ) Modemn Medicine, 1918. Fleury L. Traité pratique et raisonné hydrothérapic. Labé, 1856. Panayotatou A. Baths and bathing in Ancient Greece, Soc Med. 1919; 12(Supp\): 107-121. Gritalis K. e¢ al. La contribution de éminent Emmanuel Mandalakis au développement de de la climatothérapie en Grece modeme. Archives of Balkan Medical Union 2013 548 (2) :225-228