My Water Cure: Kneipp's Hydrotherapy Methods

Table of Contents

1. The Book That Made Wörishofen Famous
2. Before Kneipp: Hahn, Priessnitz and the Horse-Cures
3. Kneipp’s Theory of Disease
4. Dissolve, Evacuate, Strengthen
5. Affusions and Gushes
6. Wraps, Bandages and the Spanish Mantle
7. Baths, Vapours and Washings
8. Hardening: Barefoot in Grass, Stones and Snow
9. Walking in Water
10. How Visiting Physicians Saw the Cure
11. Key Research Papers
12. Connections

1. The Book That Made Wörishofen Famous

Kneipp dated the first preface of Meine Wasser-Kur “Wörishofen … October 1st, 1886”, and the book was published by Jos. Kösel in Kempten, a town in the Allgäu not far from his parish. (One modern historian, Y. Ko, gives the publication year as 1887; the preface date supports 1886.) It was not a slim pamphlet. The text runs to several hundred pages and is arranged in three parts: the first describes the applications of water; the second, which Kneipp called his Apotheca, is a home pharmacy of herbal teas, tinctures, powders and oils; the third lists diseases in alphabetical order with the water and herb treatments he used for each.

Demand outran every printing. By the fifth edition a single run was 6,000 copies, and in 1892 the publisher issued what its title page called “the only authorized and complete English edition”, translated from the 36th German edition. The English title page describes the cure as “tested for more than 35 years and published for the cure of diseases and the preservation of health”, and names its author simply as the “parish priest of Wörishofen (Bavaria)”. According to Ko, Kneipp’s books had sold more than two million copies in many languages by 1921.

The preface is unusually modest. Kneipp wrote that he was a layman and that “only professional men are called upon to publish such things”; that his “earnest wish” had been “that a professional man, a physician, would release me of this heavy burden”; and that “it was by no means my intention to oppose any of the existing medicinal systems, or to attack any individual.”

The book turned a village into a destination. Ko, working from the Wörishofen records, documents 12,107 patients in 1892, the peak year of Kneipp’s lifetime; a Polish history of the cure gives a figure of about 25,000 visitors a year.

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2. Before Kneipp: Hahn, Priessnitz and the Horse-Cures

Kneipp did not invent the cold-water cure, and he said so. As a sick student in the 1840s, by his own account, “an unsightly little book fell into my hands; I opened it; it treated of the water-cure.” He described it as “written by a physician”, and added that “the applications are most of them extremely rugged and rigid.” He does not name the author in My Water-Cure, but historians identify the book as the treatise on the healing power of fresh water by the physician Johann Siegmund Hahn. Ko dates it to 1738, with a reprint of 1833 that Kneipp found in the royal library in Munich; the Neue Deutsche Biographie gives 1743. The story of how he used that book during his own illness is told on the Life and Times page.

The other great name before him was Vincenz Priessnitz (1799–1851), like Kneipp a lay healer, who ran a water-cure establishment at Gräfenberg. The Polish physiotherapy historian Kierzek names Priessnitz and Wilhelm Winternitz (1835–1905) as the creators of hydrotherapy as a world movement. Rohde, a Berlin clinician studying a little-known family water book of Priessnitz from 1847, found that his treatments had been far broader than later memory allowed: more than fifty different applications of water, diet for every patient, a great deal of exercise, air and sun baths and a regular way of life. Rohde calls Priessnitz the first to rediscover and remodel hydrotherapy before Kneipp.

What Kneipp added, in his own telling, was gentleness. He wrote that he remained grateful for what the little book had taught him, “but I soon found out that many applications were too rigid, too strong and discouraging for human nature. For this reason people called at first the water-cures ‘horse-cures’.” He granted that many exercises of the early water cure “were more suited to a muscular and strong-limbed horse than to a human skeleton clothed with soft flesh and stringed with tender nerves.” Of the water-cure hospitals of his own day he wrote that some of their applications appeared to him “too strong, and, pardon the expression, too partial. Too many things are treated exactly alike”, with too little difference made between strong and weak patients.

He named one technique of the Priessnitz school directly. In a footnote in Part III he claimed, from thirty years’ experience, that a “Priessnitz compress” left on for a whole night increased an inflammation rather than reducing it, and that the cause went deeper than poor bandaging. He called ice cloths and ice bags “among the most rugged and violent remedies ever used”. The French medical historian Frexinos places this milder Kneipp cure within the wider rise of natural medicine in nineteenth-century Europe.

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3. Kneipp’s Theory of Disease

Kneipp’s explanation of illness was simple. In the general remarks that open Part I he wrote that all diseases “originate in a disordered circulation of the blood, or in corrupted and heterogeneous ingredients mixed with the blood, and in morbid matters.”

From that theory came the rule that the whole body is treated, not only the part that hurts. A sore throat or an aching knee, in Kneipp’s view, was the local sign of a general disorder of the blood, so his prescriptions nearly always combined a local application with others that reached the whole body — a neck bandage with wet socks, or a knee affusion with an upper-body affusion.

The second rule was that water only assists. The healer’s task, he wrote, “is only this: to help nature struggling for health” — to loosen “the fetters of illness” and let nature “do the work herself again”. Once that is done, “the treatment must cease.” He believed that nothing brought water into such discredit as using it “in an indiscreet way without measure and reason”, and he set his own methods against the long, punishing cold treatments of some institutions: the washings he described were a matter of a minute or two, done quickly, and rubbing or kneading the skin were, in his words, “entirely out of the question”.

A third principle runs through every chapter: warmth after cold. Again and again he described the patient dressing quickly without drying the body and then walking or working until the skin was dry and the body warm again. The cold stimulus was meant to be brief; the reaction of the body, rewarming itself, was the point.

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4. Dissolve, Evacuate, Strengthen

If disease was disordered blood and morbid matter, treatment had three jobs. Kneipp put it in one sentence: the applications of water “tend to the triple aim: To dissolve, to evacuate the morbid matters, and to strengthen the organism.” Each family of applications in the book is assigned to one or more of those aims.

• Dissolving. “In general it may be said that the dissolving is brought about by the vapours and the hot baths of medicinal herbs.” Heat and steam, often from a decoction of hay-flowers, were meant to loosen what had settled in the body.
• Evacuating. The evacuation came “by the water bandages and partly by the shower baths and wet sheets” — the wraps that grow hot against the skin and, in his account, draw matter out through it.
• Strengthening. Strength came “by the cold baths, the shower baths, partly by the ablutions, and finally by the entire system of hardening.”

The order matters in his descriptions. For the weak, the aged and those he called “poor of blood”, he repeatedly substituted warm water or herbal decoctions for cold, or began with warm and moved to cold by degrees; he faulted the water-cure hospitals for treating too many patients “exactly alike”. The same three aims, in his view, had to be reached differently in every person.

The account of how his followers turned these ideas into the “five elements” of water, plants, exercise, nutrition and order is on Kneipp’s Herbs, Diet and the Five Pillars.

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5. Affusions and Gushes

The application most closely tied to Kneipp’s name is the affusion — in the 1892 translation a “shower-bath” or “gush”, in German the Guss. It was not a shower in the modern sense. Cold water was poured from a watering-can in a smooth stream over one part of the body, and the stream was moved along a set path. The book lists eight: the knee-shower, the shower for the thighs, the lower shower, the shower for the back, the whole shower, the upper shower, the arm-gush and the head-gush.

Knee and thigh

The knee affusion poured water over the feet and lower legs up to the knees. Kneipp wrote that the first few were felt as painful, that the feeling passed after eight or ten, and that patients then looked forward to the next with “a kind of longing”, feeling “a remarkably strengthening effect” on the feet. It was usually combined with the upper affusion. The thigh affusion he described as “a continuation of the knee-shower towards the abdomen”, reaching the thighs and lower body; for the lower affusion he noted that the jet fell from no great height, only a few inches.

Back and whole body

The back affusion continued the lower one. The first can wetted the whole back “from the neck to the heels”; the following cans were poured “in an equal stream beginning at the neck and continuing down to the coccyx, and then from the left to the right shoulder-blade.” Kneipp added that with very sensitive and excitable people the spine was spared as far as possible — one of many places where he adjusted the method to the patient. The whole affusion covered the entire body.

Upper body and arms

The upper affusion was given by slowly pouring one or two watering-cans of cold water over the shoulders, back and chest, sparing the hair; the patient then dried face and hair, dressed quickly without drying the rest of the body, and walked or worked until fully dry and warm. The arm-gush, he wrote, does for the arms what the knee and thigh gushes do for the legs: “The gush begins at the hands and is directed upwards to the shoulders; it is always given from both sides.” He gave it as a hardening means for the arms and, in different cases, for dissolving “accumulations of matter”, easing inflammation and pain, and against rheumatism — claims he made from his own observation.

Kierzek’s review of Kneipp’s writings on ear, nose and throat complaints describes how Kneipp applied his water methods to ear disease, colds, sore throats (angina), hoarseness and even diphtheria, as he reported them.

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6. Wraps, Bandages and the Spanish Mantle

Where affusions were brief and cold, Kneipp’s “bandages” were slow and warming. Each was a piece of coarse linen dipped in cold water (sometimes warm), wrung out, laid against the skin, and closed off with a dry covering of linen or wool so that the body heated it. The book describes eight: the head bandage, the neck bandage, the shawl, the foot bandage (with a variant reaching above the knees), the lower bandage, the short bandage, the wet shirt and the Spanish mantle. In his scheme they served mainly to evacuate.

The shawl

The shawl, he wrote, “is a special application for the chest and the upper part of the back.” A square of coarse linen, about a yard or a yard and a half on each side, was folded into a triangle, dipped, wrung out and worn “as an ordinary shawl”, then covered “hermetically” with a dry wrapper. “The patient soon perceives an agreeable warmth, the shawl becomes warm, and by and by even hot.”

The wet shirt

The wet shirt was, in his words, “an often used and much liked application which by its very name sufficiently indicates what is meant by it.” An ordinary linen shirt was dipped and wrung out, put on, and the patient lay wrapped in a blanket under a feather quilt. When he wanted a stronger effect — for example, to bring out the rash of scarlet fever, as he put it — he had the shirt dipped in salt water or in water mixed with vinegar.

The Spanish mantle

The largest wrap had a name he disowned: “This strange appellation is not of my invention but, being now universally in use amongst the water-friends of mine, I have no reason to look for an other name.” Also called “the large bandage”, the Spanish mantle was a wide linen gown, “open in front, and reaching down over the toes” — “a wide, long, linen night-gown”. It was dipped in cold water, wrung out and put on, and the patient was then wrapped closely in blankets on the bed and covered with a feather quilt. For “weaker people, for the aged, for those poor of blood, or afraid of water”, he wrote, the mantle could be dipped in hot water instead. Because it reached the whole body he counted it, like the whole bath, as a complete application in itself, and in serious illnesses he used it only in alternation with other applications.

Wet sheets and the abdominal compress

Closely related were the wet sheets, which open the catalogue of applications in Part I: covering the patient with a wet sheet, laying the patient on one, both together, and a compress on the abdomen. A large piece of coarse linen, of the kind used for straw mattresses, was folded several times lengthwise, dipped, wrung out and laid over the patient in bed, then sealed with a woollen blanket. Instead of plain water he sometimes used vinegar, or decoctions of hay-flowers, shave-grass (field horsetail) or oat-straw.

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7. Baths, Vapours and Washings

Baths

Kneipp’s baths were graded by how much of the body went into the water: cold and warm foot baths; half baths; cold and warm sitting baths; cold and warm whole baths; and part baths for the arm, the head and the eyes. Several were written up twice, once for the healthy and once for the sick. Of the cold whole bath for healthy people he wrote that, whatever was true of others’ “too rugged applications”, that his own short cold baths, taken in summer and winter alike, contributed “in a substantial manner to the maintaining and strengthening of health.”

The warm baths were often herbal. The book describes whole baths of hay-flowers, of oat-straw and of pine sprigs, and baths with salt. “What I call hay-flowers,” he explained, “are all the remains of hay such as stalks, leaves, blossoms and seeds, even the hay itself.” Boiled into a decoction, these hay remains became one of his most used remedies: in foot baths, which he credited with dissolving hardened swellings, gouty deposits and corns on the feet; in whole baths; in vapours; and packed hot into a linen bag as a poultice. The hay-flower sack (Heublumensack) outlived him; in 1975 two German researchers, Fröhlich and Müller-Limmroth, published physical measurements of how it transfers heat, and a centenary article of 1997 took “cold shower and hay flower” as the shorthand for his whole method. The plants of his Apotheca are on the Herbs, Diet and the Five Pillars page.

Vapours

Vapours — steam from a hot decoction directed at one part of the body — were his chief means of dissolving. The book describes a head vapour, a foot vapour, a vapour taken seated over a vessel, and special vapours for particular diseased parts. He usually used decoctions of hay-flowers; for the eyes, he wrote, fennel, eyebright or shave-grass; for the ears, blind-nettle, stinging nettle or yarrow; for phlegm in the throat, yarrow, ribwort or nettles. A head vapour was followed, in his account, by a cold upper affusion — heat to dissolve, then cold to strengthen.

Washings

The ablution, or washing, was the gentlest application of all: a cloth dipped in cold water and passed quickly over the whole body or one part of it. He described a whole-ablution for the healthy, another for the sick, and part-ablutions. The water was to be laid on evenly and fast, with no rubbing, and he pointed to the brevity of these washings as the clearest sign of how his system differed from institutions that kept patients in cold water “for an excessive length of time”. The last item in Part I is the drinking of water.

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8. Hardening: Barefoot in Grass, Stones and Snow

Before he describes a single treatment, Kneipp gives a short list of what he called the “means of hardening” (Abhärtung) — practices meant to make healthy people more resistant to cold and illness, and the sick stronger. The list has seven entries: walking barefoot; walking barefoot in wet grass; on wet stones; in newly fallen snow; in cold water; cold baths for the arms and legs; and the knee affusion, with or without the upper affusion.

“The most natural and most simple means of hardening,” he wrote, “is walking barefooted.” He thought most highly of walking in wet grass, “no matter if it be wet with dew, rain, or watering”, and in a footnote judged it “far preferable to walking on wet stones”; After a walk in the grass, he wrote, the feet were not dried but put, still wet, into dry stockings and shoes, followed by walking on a dry path until the feet were dry and warm; he stressed that damp stockings were never worn after an application.

Walking in snow he regarded as stronger still, but only in a particular kind of snow. He meant “newly fallen, fresh snow, which forms into a ball or clings to the feet like dust, not in old, stiff, frozen snow, which almost freezes the feet and is of no use whatever”, and walks taken not “in cold, cutting winds, but in spring when the snow is being melted by the sun.” He said he knew people who had walked through such snow-water for long periods “with the best result”. He also set a limit: people with open or suppurating chilblains were not allowed into the snow until their feet had healed.

These barefoot practices are among the parts of Kneipp’s teaching most easily recognised today. A related modern interest in cold exposure is covered on the site’s Cold Exposure page.

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9. Walking in Water

The fifth means of hardening became the most famous of all. “As simple as it may appear to walk in water reaching as far as the calf of the leg,” Kneipp wrote, “yet even this application serves as a means of hardening.” This is the origin of what his followers call Wassertreten, water treading: walking through cold water about calf-deep.

He made broad claims for it. In his account it acted on the whole body and “strengthens the whole system”; it worked on the kidneys, so that complaints of the kidneys, bladder and bowels were prevented; it “operates powerfully on the chest, facilitates breathing and carries gases out of the stomach”; and it acted “especially against headache, congestion, and other sufferings of the head.” These are Kneipp’s own claims from his practice, not findings from controlled study.

He described graded forms. The mildest was simply moving the feet in a tub of cold water reaching over the ankles; going in to the shins was stronger, and to the knees strongest of all. Sessions were counted in minutes, beginning very short, and “the colder the water, the better”, in his words; in winter snow might be added to the tub, while weak patients began with warm water that was made colder little by little. As with every cold application, he followed it with exercise — in a warm room in winter, in the open air in summer — “until the body is completely warm.”

The practice outlived much else in the book. Locher and Pforr, in a 2014 review, count more than 60 accredited Kneipp spas and health resorts in Germany today, and in 2015 “Kneipp practice as traditional knowledge and practice according to the teaching of Sebastian Kneipp” was entered in Germany’s national register of intangible cultural heritage, kept under the UNESCO convention — a story told on the Legacy and Modern Research page. For water therapies more generally, see the site’s Hydrotherapy and Contrast Therapy pages.

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10. How Visiting Physicians Saw the Cure

As Wörishofen filled with patients, physicians came too — some to work, some to watch. From 1887, according to Ko, Kneipp held his consultations alongside doctors (Ko names Bernhuber, Kleinschrod, Tacke and Werminghausen), and in August 1892 the physician Alfred Baumgarten joined him and became his principal medical collaborator. On 2 February 1894 the International Society of Kneipp Physicians was founded at Wörishofen with 25 members under Baumgarten. Ko quotes Kneipp telling physicians, “I have never wished to compete with medicine”, and notes that, unlike much of the German nature-cure movement, he did not refuse vaccination or medication and sought the recognition of the medical world.

Foreign doctors wrote up what they saw. Kierzek has described the reports of three nineteenth-century Polish physicians who spent time at the Wörishofen establishment — Władysław Jasiński (1827–1903), Józef Surzycki (1855–1937) and Józef P. Drzewiecki (1860–1907). Their accounts set out the Kneipp methods in detail and describe the physicians working at Wörishofen at the time, and they also record the Polish visitors’ critical view of the treatments they watched. In a companion paper Kierzek himself, writing more than a century later, presents Kneipp as the source of many hydrotherapy methods still in use while calling some of those methods “uncritical”.

What controlled trials have since found is taken up separately: a 2023 systematic review in BMJ Open by Ortiz and colleagues gathered 20 randomised trials of Kneipp hydrotherapy and judged many of them at high or unclear risk of bias, and its findings, with those of other reviews, are set out on Kneipp’s Legacy and Modern Research.

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Key Research Papers

1. Ko Y. Sebastian Kneipp and the Natural Cure Movement of Germany: Between Naturalism and Modern Medicine. Uisahak. 2016;25(3):557-590. PubMed PMID: 28529304
2. Locher C, Pforr C. The legacy of Sebastian Kneipp: linking wellness, naturopathic, and allopathic medicine. J Altern Complement Med. 2014;20(7):521-6. PubMed PMID: 24773138
3. Kierzek A. [Priest Sebastian Kneipp and his hydrotherapeutic method. Point of view after over one hundred years]. Przegl Lek. 2005;62(12):1583-5. PubMed PMID: 16786804
4. Kierzek A. [The reception of Sebastian Kneipp’s hydrotherapeutic method. Its significance in contemporary medicine]. Przegl Lek. 2005;62(12):1586-8. PubMed PMID: 16786805
5. Kierzek A. [The priest Sebastian Kneipp and his outlook on otorhinolaryngology diseases]. Otolaryngol Pol. 2011;65(2):132-8. PubMed PMID: 21735670
6. Frexinos J. [The cold water cure of the parish priest Kneipp and the development of natural medicine in the nineteenth century]. Rev Soc Fr Hist Hop. 2006;(123-124):64-7. PubMed PMID: 17575860
7. Rohde J. [New findings about Priessnitz from the unknown Vinzenz Priessnitz Familien-Wasserbuch from 1847]. Forsch Komplementarmed Klass Naturheilkd. 2002;9(2):85-98. PubMed PMID: 12006726
8. Fröhlich HH, Müller-Limmroth W. [Physical investigations into the thermotherapeutic action of the Kneipp hay flower sack]. MMW Munch Med Wochenschr. 1975;117(11):443-8. PubMed PMID: 804621
9. Klaus J. [Cold shower and hay flower. Sebastian Kneipp died 100 years ago]. Pflege Z. 1997;50(6):312-3. PubMed PMID: 9277252
10. Shampo MA, Kyle RA. Hydrotherapy (Kneippism). Mayo Clin Proc. 1987;62(10):929. PubMed PMID: 3309487
11. Ortiz M, Koch AK, Cramer H, Linde K, Rotter G, Teut M, Brinkhaus B, Haller H. Clinical effects of Kneipp hydrotherapy: a systematic review of randomised controlled trials. BMJ Open. 2023;13(7):e070951. PubMed PMID: 37423627

PubMed Topic Searches

1. https://pubmed.ncbi.nlm.nih.gov/?term=kneipp+hydrotherapy
2. https://pubmed.ncbi.nlm.nih.gov/?term=kneipp%5Bti%5D+history
3. https://pubmed.ncbi.nlm.nih.gov/?term=cold+water+affusion
4. https://pubmed.ncbi.nlm.nih.gov/?term=priessnitz+hydrotherapy
5. https://pubmed.ncbi.nlm.nih.gov/?term=hay+flower+kneipp

Further Reading

• Kneipp S. My Water-Cure. Kempten: Jos. Kösel; 1892 (“the only authorized and complete English edition”, from the 36th German edition; German first edition 1886). https://archive.org/details/39002086176485.med.yale.edu
• Früchte J. “Kneipp, Sebastian.” Neue Deutsche Biographie 12 (1980), 174–175. https://www.deutsche-biographie.de/sfz43187.html
• Ko Y. Sebastian Kneipp and the Natural Cure Movement of Germany (full text). Korean Journal of Medical History 2016;25(3):557–590. http://www.medhist.or.kr/journal/view.php?doi=10.13081/kjmh.2016.25.557

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Connections

• Sebastian Kneipp — The Water-Cure Priest of Wörishofen
• Sebastian Kneipp: Life and Times
• Kneipp’s Herbs, Diet and the Five Pillars
• Kneipp’s Legacy and Modern Research
• Nutrition and Orthomolecular
• Dr. Max Bircher-Benner and the Raw Food Cure
• Hydrotherapy
• Cold Exposure
• Contrast Therapy
• Horsetail (Shave-Grass)
• Fennel
• Stinging Nettle
• Tuberculosis: History and Discovery

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