Alternate Baths


from Hydrothermic Remedies...

"This treatment is based on the principle that by alternate contraction and dilation of the blood vessels, brought about by contrasting application of heat and cold, the circulation is improved and the removal of waste products is hastened." Hydrotherapy in the Home," p. 12.

Water Temp:-

  • Hot 39.5 - 43.5°C
  • Cold 7 - 21°C



The immersion of an extremity alternately in hot and cold water.

Physiologic Effects

  1. Alternate contraction and dilation of blood vessels
  2. Marked increase of blood flow locally and reflexly
  3. Increased metabolism and healing
  4. Reflex actions
  5. Increased white blood cell activity
  6. Remove waste products from an area.


If very painful, use as a Revulsive i.e. one change, very hot to very short, very cold.

  1. Impaired Venous Circulation
  2. Indolent Ulcers and other Slow-healing cases
  3. Infections especially Lymphangitis
  4. Local Skin Inflammation
  5. Oedema and swelling in
  6. Sprains, Strain, Trauma after 24 hours
  7. Fractures - uncomplicated
  8. Rheumatoid Arthritis and Osteoarthritis
  9. Congestive Headache (treat feet)


  1. Never us water over 43.5°C
  2. Peripheral Vascular Disease and severe Diabetes - not too hot
  3. Sensory Loss or impaired skin sensation
  4. Tendency to Haemorrhage
  5. Over Local Malignancies


  1. Two containers large enough, and the proper shape to allow the part to be treated sufficiently below the surface of the water.
  2. Thermometer
  3. Drape sheet or gown
  4. Turkish towels
  5. Cold Compress for head
  6. Disinfectant if needed
  7. Pitcher to remove or add hot water
  8. Means for heating water
  9. Ice for Cold Compress and Cold Tub Bath if desired.


Important Considerations

  • Usually a Cold Compress should be used for the head or even the neck. Use Ice Bag to the heart if the heart rate is over 80.
  • Hot water should not exceed 43.5°C
  • In PVD and diabetes, do not use water hotter than 40°C. Also avoid very cold in cold bath.
  • Use a suitable disinfectant for open wounds
  • When adding hot water, cause it to touch your immersed skin before that of the patient. Use a thermometer
  • If necessary, warm the patient before treatment with general heat.
  • Never start treatment with cold. Always start with hot.

Preparation for Treatment

  • Assemble the materials
  • Have the room warm and draft-free
  • Explain the treatment to the patient
  • Position the patient and the containers so that the part treated can be easily immersed in either container.


  • Adjust the temperature of the hot bath to 39°C. Immerse part for 3-4 minutes
  • Nest place the part in the cold bath for 30 seconds to 1 minute. Have the temperature between 7-21°C. Add ice to the colder treatments.
  • Each time the part is in cold water, add hot water to the hot bath so that after 6-8 cycles the temperature will have reached the maximum desired (never over 43.5°C.
  • Check the pulse every 5 minutes; apply Cold Compress to neck and Ice Bag to heart if the pulse exceeds 80 bpm.
  • Make 6-8 changes.
  • End with cold

Completion of Treatment

  • Dry thoroughly
  • Have patient rest at least 30 minutes.