A Brief History Of Cold Water Therapy

Cold Water Immersion Therapy (CWI), or Cryotherapy, is a non-invasive treatment, used to treat numerous conditions by the administration of very low temperatures. Although the benefits of CWI are still being researched, using cold water to improve physical health and mental well-being can be traced back as far as the ancient Egyptians, and is also evidenced in Greek and Roman history.

One of the earliest known medical texts is the Edwin Smith Papyrus. Dated from over 3,500 years ago, this ancient Egyptian treatise was assumed to be a record of military surgeries, and details numerous references to cold being used for therapeutic purposes, including to treat inflammation and pain.

Approximately 1000 years later, led by Hippocrates, the ancient Greeks utilised cold water for medicinal practices whilst also recognising its benefits for relaxation and socialisation. Considered to be the ‘father of Western medicine’, the ideas and writings of Hippocrates were thought to have influenced the Romans several centuries later, not just regarding cold water therapies, but also regarding their extensive use of cold baths, or frigidariums.

The Romans and their bathing rituals involving hot and cold baths, were largely responsible for the growth in popularity of using differing water temperatures as a curative and salutary tool, as well as for a means to socialise and relax. For the Romans, bathing was essential for good health and well-being, and this notion soon spread across Europe and parts of North Africa.

The Roman Baths in Bath, Somerset.
I grew up just outside of Bath, which was given it's name due to the fantastic example of Roman baths at the centre of the city. Originally named 'Aqua Sulis' by the Romans in 43BC, the baths are fed with natural thermal water and are still used today.

Although many subsequent cultures explored the concepts of Cold Water Therapy, it wasn’t until the early 19th century that scientific knowledge and experimental procedures supported Cryotherapy as a valid form of medical treatment.

In 1819, English physician, James Arnott began studies into using ice to further progress cold water practices for pain relief and the treatment of tumours. He believed freezing temperatures caused deliberate tissue deconstruction and discovered by mixing ice with salt that temperatures as low as -24℃ could be reached – pioneering a procedure now known as Cryosurgery.

An illustration of the Great Exhibition in London 1851.
The Great Exhibition was an international exhibition that took place in Hyde Park, London, from 1 May to 15 October 1851. It was the first in a series of World's Fairs (exhibitions of culture and industry) that became popular in the 19th century.

However, the method of delivery was crude and unreliable, and despite Arnott winning a medal for his Cryosurgery machine at the Great Exhibition in London in 1851, it wasn’t until the late 1800s that Cryosurgery became more widely known, due in part to the introduction of refrigerants, or ‘liquid air’ by American physician Archibald Campbell White in 1899.

A more efficient method than ice and salt, liquid air could reach temperatures as low as -195℃. Applied in spray form, it was used for a variety of conditions, including skin lesions, inflammation, and cancer. It was replaced by liquid nitrogen in the 1950s, which is still the most used freezing agent today.

Cold water as a therapeutic procedure gained significant traction in the 20th century, with proven methods and scientific research giving credibility to what was rapidly becoming a recognised form of treatment within the medical world.

  • 1900s: William Pusey introduced the use of carbon dioxide snow. Easily available at the time, with a straightforward application, the ‘snow’ was a successful form of cryosurgery.
  • 1920s: Liquid oxygen was popular for a time, with a similar presentation to liquid air, but it’s use was largely confined to acne treatments.
  • 1930s: Dr Miguel Ricardo developed ‘contrast therapy’. This was the practice of alternating between hot and cold treatments, causing blood vessels to open and close rapidly in a pump-like motion, used for sports recovery and injury prevention.
  • 1940s and 1950s: Following WWII, liquid nitrogen became commercially available and was introduced into clinical practice for the treatment and destruction of abnormal skin cells such as warts, verrucae, benign growths, and tumours.
  • 1960s: D H Clarke investigated the benefits of cold water immersion for post exercise recovery.
  • 1970s and 1980s: Cold therapy for therapeutic treatments continued to evolve and become medically recognised.

In 1978-1980, Japanese rheumatologist Toshima Yamaguchi, pioneered research into the treatment of rheumatoid arthritis, inflammation, and general pain, by using a technique known as Whole Body Cryotherapy, or WBC. This procedure uses a special chamber to expose the body to short bursts of air temperatures at around -110℃ and -140℃. The extreme cold induces responses from the circulatory system, the energy meridians, and the nervous system – thus stimulating the body’s natural healing abilities.

A man stood in a whole body cryotheraphy chamber.
An example of a Whole Body Cryotherapy (WBC) chamber.

Originally developed for the treatment of chronic medical conditions, WBC is becoming increasingly popular with athletes due to the healing effects on damaged muscles. However, the process can be costly, reducing the accessibility and prompting people to find alternative DIY methods such as cold showers and ice baths.

In conclusion, history tells us that water immersion in varying temperatures has been used medically, therapeutically, and socially for thousands of years, whether that use is fully, partially, or localised. Although research has stalled at times, significant breakthroughs have been made to elevate Cold Water Therapy to a medically recognised level to treat chronic conditions, skin lesions and tumours, by the discovery of ice and salt mixtures, liquid air, liquid nitrogen, and other notable findings.

Recognising the value of Cryotherapy in the treatment of inflammation, and muscle repair and recovery, the sports industry has heavily employed the use of ice packs, sprays, and baths, together with the installation of WBC chambers in many sports rehabilitation centres across the world.

Advancements within the world of Cold Water Therapy have not just been restricted to physiology. Adopting the practice of social bathing and its positive mental impact, made popular by the Romans, cold water swimming groups such as the Bluetits Chill Swimmers, are becoming more and more commonplace, emphasising the healing properties of water not just on the body but also on the mind.

A woman in a pink beanie hat swimming in the sea.
 Swimming in the Irish Sea in November...

“Water, taken in moderation, cannot hurt anybody.” (‘On Airs, Waters, and Places’ Hippocrates 400 BCE)

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