Rubbing

RUBBING, one of the simplest and most widely used hydrotherapy methods for all ages, which consists of wiping and rubbing the naked body over its entire surface or on individual parts with a piece of moistened cloth. Method of application. Rubbing should be performed when the ambient air temperature is not less than 20° and there are no noticeable air currents (drafts, wind). For rubbing, mostly pure water of room temperature is used, but also a 1–2% aqueous solution of NaCl, diluted alcohol, i.e., retail vodka, vodka mixed with water, vodka with salt, cologne, toilet vinegar, table vinegar, in greater or lesser degree diluted with water. Depending on the tolerance to cooling and the ambient air temperature, the whole body is exposed at once or, gradually, the individual parts subject to rubbing at the moment. Then a small piece of crumpled thick and coarser fabric is moistened, for example a short linen towel, a hard sponge, or a glove made of coarse rough fabric; during rubbing it is squeezed so that the liquid does not flow over the surface of the body, and the skin is quickly rubbed and rubbed with greater or lesser force depending on indications. Rubbing is performed sequentially, starting from the neck and shoulders to the hands; then the chest, abdomen, back, lower back, buttocks, thighs, calves, and feet are rubbed and rubbed, and finally the whole body is dried. In the case of general weakness and chilliness, individual parts of the body are rubbed and dried at once with a thick, preferably hairy towel. After drying, these parts of the body are covered. Rubbing can be done without outside help. After finishing rubbing, if the patient does not suffer from general weakness, light gymnastic exercises or a walk can be recommended. Mechanism of action. When using a liquid of indifferent temperature or warmer, rubbing acts as a wash, removing sweat and salts that settle on the skin after its evaporation, as well as dust and dirt; when using liquids containing alcohol, the skin is also cleansed of a fatty deposit, which improves perspiration. When using a liquid of lower temperature, as well as due to its evaporation from the surface of the body, rubbing, like other hydrotherapy procedures, produces cooling of the skin. This causes reflex excitation of the higher nervous centers, especially the centers of respiration and circulation, and the neuromuscular tone increases. Along with this, cooling of the skin causes a local reaction on the part of the skin vessels: rapid constriction followed by dilation. The simultaneous rubbing of the body has essentially important significance as mechanical irritation, which promotes more rapid dilation of the skin vessels and strengthens blood and lymph circulation in the underlying tissues. Thus, visible redness of the skin, a sensation of general warming, and improvement of general well-being are obtained. When using aqueous solutions of salts and alcohol, and especially both together (salted vodka), irritation of the skin, dilation of the skin vessels, and warming are even stronger. According to the teaching of T. Lewis, this local reaction deserves special attention; it serves as an expression of the formation in the skin of a histamine-like substance, which, entering the general circulation, acts on the organism as one of the types of irritant therapy. Indications. Rubbing, like douching, can be applied for hygienic, preventive, and therapeutic purposes. For hygienic purposes, rubbing, insofar as it maintains the cleanliness of the skin, can be recommended to be performed daily. The preventive significance of rubbing lies in the protection against skin diseases associated with its contamination, especially during work in certain industries (e.g., presence in an atmosphere of soot, lime spray, etc.). At the same time, moderate but frequent cooling and moistening of the skin represents one of the softest and most accessible methods of hardening, especially in the tendency to cold diseases. For therapeutic purposes, rubbing is indicated in general in the same pathological states in which other hydrotherapy procedures are applied. Such are general fatigue with suppression of the nervous system, sleep and appetite disorders, etc., vegetative neuroses. Along with this, since rubbing, especially accompanied by rubbing, causes only slight cooling, quickly replaced by warming, it is quite applicable even in weakened patients, even with increased metabolism, for example in feverish, tuberculous patients, especially with excessive sweating. However, in such states, to avoid cooling, only sequential rubbing of individual parts of the body can be done, which, in the case of weakness of the patient, has to be performed in bed; in this case, it is necessary to apply mainly water with alcohol or with toilet vinegar, cologne, or warm water. Contraindications for rubbing: functional neuroses with hyperesthesia of the skin, increased skin irritability, widespread skin diseases with a tendency to desquamation of the epidermis, such as moist eczema, etc. A special form of rubbing is brief moist wrapping, in which the whole body is immediately wrapped in a sheet moistened with water warmed to 20–30°. Such moist wrapping is also usually performed when the ambient air temperature is not less than 20°, and the subject stands on a wooden board or mat. Holding the moistened, squeezed, and unfolded sheet by its upper corners with both hands, it is brought to the patient from behind, and passing the right upper corner of it into his left hand, bent at the elbow, the left edge of the sheet is quickly circled around the body to completely wrap it. Then the wrapper quickly rubs through the sheet the shoulders, the front and back surfaces of the body from top to bottom. After such general rubbing, the sheet is quickly removed, and a dry, preferably hairy sheet is thrown over the patient, and the body is energetically rubbed dry, laid out naked on a comfortable bed for a while and covered. This sudden cooling of the entire surface of the body, replaced by warming under the influence of energetic rubbing, excites the peripheral and central nervous system much more strongly, causes a significantly greater general reaction, and can noticeably increase metabolism. Often the described procedure is performed after a preliminary short stay in a warm bath, thanks to which the reaction to cooling is even stronger. In other cases, after moist wrapping with rubbing, the patient is immediately subjected to the action of Charcot's side shower (see Showers), which has an even stronger effect on the organism. Such a procedure can be applied only in the morning or daytime hours, but never at night. Indications for such a procedure are significantly narrower, mainly the state of depression, lethargy, decreased general tone of the organism and slowed metabolism, especially in obesity. Contraindications for moist wrapping, besides those indicated for rubbing, are rheumatic diseases in an active form, neuritis and neuralgias, not fully resolved pleurisy, and other chronic diseases of the respiratory organs, nephrosis-nephritis, neuroses with an excitation character.