Hydrotherapy

Hydrotherapy has been used as a form of healing since the early 1800s.

The main contributors to hydrotherapy include:

Vincent Priessnitz (1799-1851) is considered the founder of the hydrotherapy-nature cure movement. Priessnitz relied on nothing except cold water, air, a simple diet, and physical activity to heal his patients. Johann Schroth (1798-1856) disagreed with, what he preceived to be, Priessnitz’s extreme use of the cold water and he prescribed long-lasting warm moist packs and hot baths. Both Vincent Priessnitz and Schroth enjoy much success, even though their treatments were diametrically opposed.
J.H. Rausse was the first person to lay down the scientific principles of water cure. In 1837 he spent ten weeks receiving treatments from Priessnitz and he began to ponder the principles underlying water cure. wrote The Spirit of the Graefenburg Water Cure in 1838. His writings increased Priessnitz’s fame. His cousin, Theodor Hahn (1824-1883), a chemist and a contemporary of Vincent Priessnitz, advocated using water cure along with a vegetarian diet. Hahn promoted the belief that the nature doctor should educate people on how to live a healthy life, how to use natural treatments, and to realize personal responsibility for their own health. He wrote a system of water cure known as “Enforced water cure” and he wrote the book Hahn’s Water Doctor.
Of greatest and lasting influence was the work of Father Sebastian Kneipp. Using an eclectic and integrated approach, Kneipp combined hydrotherapeutic baths with heliotherapy (sunshine), exercise, vegetarian and fruit diets, and the indigenous European herbs so well known to him. Father Kneipp provided the link between the European nature cure and American Naturopathy.
Johann Schroth (1798 – 1856) was a layman, not a practitioner. When he smashed his knee in an accident with a horse he was advised to use the Priessnitz method of cure. In order to avoid the frequent changing of the packs, as prescribed by the Priessnitz method, he placed several packs on top of one other and wrapped his whole knee with a woolen cloth which he left on for several hours. The moist heat worked and he was cured. What he theorized was that the moist heat caused the poisonous toxins to dissolve and be swept away. Over time he developed the famous Schroth cure in which dry food and little else is taken, in conjunction with the use of damp packs. The Schroth cure was renamed by Bilz to “the regenerative treatment” and it was used for chronic diseases through the use of an extreme diet following total fasting by withdrawing of all food and drink and then the use of totally dry grain products and the eventual reintroduction of fluids. F.E. Bilz, was also a lay practitioner who established a Nature Cure sanitarium in Germany and he is the author of the first Naturopathic encyclopedia, The Natural Method of Healing, which has been translated into a dozen languages, and in German alone has run into 150 editions. Both Vincent Priessnitz and Schroth enjoy much success, even though their treatments were diametrically opposed.
In the early 1900s Dr. Otis G. Carroll, a naturopathic doctor from Illinois, modernized hydrotherapy techniques by introducing constitutional hydrotherapy, a series of hot and cold compresses applied to the chest, abdomen and back during which the patient is wrapped in blankets. The concepts of constitutional hydrotherapy were furthered by NDs Leo Scott and Harold Dick and then in the 1980s by Dr. Andre Saine, ND.
German healers continue to be the active proponents of hydrotherapy as a signification means of treating disease.

Physiological Effects

The unique properties of water contribute to its effectiveness as a therapeutic agent. The main physiological effects of hydrotherapy can be classed as thermal, mechanical, and chemical.

Thermal:
Mechanical:
Chemical:

DBM Protocols – Adjunct Therapies – Hydrotherapy in Practice

Constitutional Hydrotherapy

Constitutional Hydrotherapy originated with Dr. Otis G. Carroll in 1908. Involves the use of alternating hot and cold water directly on the skin.
Conditions that may benefit include as cancer, arthritis, fibromyalgia, heart disease, migraines, environmental toxicity, and many others.

Foot Baths

Hot foot baths

In this method, the patient should keep his or her legs in a tub or bucket filled with hot water at a temperature of 400c to 450c. Before taking this bath, a glass of water should be taken and the body should be covered with a blanket so that no heat or vapour escapes from the foot bath. The head should be protected with a cold compress. The duration of the bath is generally from 5 to 20 minutes. The patient should take a cold shower immediately after the bath. The hot foot bath stimulates the involuntary muscles of the uterus, intestines, bladder and other pelvic and abdominal organs. It also relieves sprains and ankle joint pains, headaches caused by cerebral congestion and colds. In women, it helps restore menstruation, if suspended, by increasing supply of blood especially to the uterus and ovaries.

Cold foot bath/hot foot baths

Cold foot bath

Three to four inches of cold water at a temperature of 7.20c to 12.70c should be placed in a small tub or bucket. The feet should be completely immersed in the water for one to five minutes. Friction should be continuously applied to the feet during the bath, either by an attendant or by the patient by rubbing one foot against the other. A cold foot bath, taken for one or two minutes, relieves cerebral congestion and uterine haemorrhage. It also helps in the treatment of sprains, strains and inflamed bunions when taken for longer periods. It should not be taken in cases of inflammatory conditions of the Genito-urinary organs, liver and kidneys.

Compresses

A cold compress is prepared by soaking a cloth or cotton pad in cold water and then applying it to the area of injury or distress. When the cloth reaches room temperature, it should be resoaked and reapplied. Applying gentle pressure to the compress with the hand may be useful.
Cold compresses are generally used to reduce swelling, minimize bruising, and to treat headaches and sprains. Warm or hot compresses are used to treat abscesses and muscle aches.
A warm compress is prepared in the same manner as a cold compress, except steaming water is used to wet the cloth instead of cold water. Warm compresses should be refreshed and reapplied after they cool to room temperature.
Essential oils may be added to moist compresses to increase the therapeutic value of the treatment. Peppermint, a cooling oil, is especially effective when added to cold compresses.
To add oils to compresses, place five drops of the oil into the bowl of water the compress is to be soaked in. Never apply essential oils directly to a cloth, as they may irritate the skin in undiluted form.
Using either hot water, cold water or alternating between hot and cold. Moist compresses – Cold, moist compresses can reduce swelling and inflammation of an injury. They can also be used to cool a fever and treat a headache. Hot or warm compresses are useful for soothing muscle aches and treating abscesses.

Cold Compress

This is a local application using a cloth which has been wrung out in cold water. The cloth should be folded into a broad strip and dipped in cold water or ice water. The compress is generally applied to the head, neck, chest, abdomen and back. The cold compress is an effective means of controlling inflammatory conditions of the liver, spleen, stomach, kidneys, intestines, lungs, brain, pelvic organs and so on. It is also advantageous in cases of fever and heart disease. The cold compress soothes dermities and inflammations of external portions of the eye. When the eyeball is affected, the cold compress should follow a short fomentation.

To make in bulk: purchase some towelling sheets – cut into strips. Dip in water, place in a bag and freeze. They will be ready for use as you need them. There are of course the more modern cold compresses available, but these tend to be too cold and if not administered correctly can damage the skin.

Heating Compress

This is similar to a cold compress covered in such a manner as to bring warmth. A heating compress consists of three or four folds of linen cloth wrung out in cold water which is then covered completely with dry flannel or blanket to prevent the circulation of air and help accumulation of body heat. It is sometimes applied for several hours. The duration of the application is determined by the extent and location of the surface involved, the nature and thickness of the coverings and the water temperature. After removing the compress, the area should be rubbed with a wet cloth and then dried with a towel. A heating compress can be applied to the throat, chest, abdomen, and joints. A throat compress relieves sore throat, hoarseness, tonsillitis, pharyngitis and laryngitis. An abdominal compress helps those suffering from gastritis, hyperacidity, indigestion, jaundice, constipation, diarrhoea, dysentery and other ailments relating to the abdominal organs. The chest compress also known as chest pack, relieves cold, bronchitis, pleurisy, pneumonia, fever, cough and so on, while compress is helpful for inflamed joints, rheumatism, rheumatic fever and sprains.

For more information on the various types of compresses see: General Therapies: Poultices & Compresses

Steam Baths / Saunas (Conventional)

Steam Treatments and Saunas.

Steam rooms and saunas are recommended to open the skin pores and cleanse the body of toxins. Steam inhalation is prescribed to treat respiratory infections. Adding botanicals to the steam bath can increase its therapeutic value. A Steam bath is one of the most important time-tested water treatments which induces perspiration in a most natural way. The patient, clad in minimum loin cloth or underwear, is made to sit on a stool inside a specially designed cabinet. Before entering the cabinet, the patient should drink one or two glasses of cold water and protect the head with a cold towel. The duration of the steam bath is generally 10 to 20 minutes or until perspiration takes place. A cold shower should be taken immediately after the bath.

Very weak patients, pregnant women, cardiac patients and those suffering from high blood pressure should avoid this bath. If the patient feels giddy or uneasy during the steam bath, he or she should be immediately taken out and given a glass of cold water and the face washed with cold water.

The steam bath helps to eliminate morbid matter from the surface of the skin. It also improves circulation of the blood and tissue activity. It relieves rheumatism, gout, uric acid problems, and obesity. The steam bath is helpful in all forms of chronic toxaemias. It also relieves neuralgias, chronic nephritis, infections, tetanus and migraine.

Infrared Sauna (FIR Sauna)

Involves the use of emissions of light in the infrared wavelength to create a heat source that goes beyond the surface of the skin to the lymphatic tissue and organs beneath. As you sit in the sauna, the infrared wavelengths emitted meet the skin surface and heat up the skin and underlying tissues to a depth of 3.5-4 inches. This creates an increase in lymphatic drainage via sweating, as the majority of the lymphatic system is located underneath the skin’s surface. As you begin to sweat, the lymphatic system eliminates any toxins via the skin pores, greatly enhancing the circulation of lymphatic fluid and furthering the toxin elimination.

Cold-Wet Sheet Packs

Applied to the trunk of patients suffering from chronic cardiac, rheumatic and metabolic diseases was found to be beneficial both physically and mentally.

Full wet sheet pack

This is a procedure in which the whole body is wrapped in a wet sheet, which in turn is wrapped in a dry blanket for regulating evaporation. The blanket should be spread on the bed with its edges hanging over the edge of the bed. The upper end should be about eight inches from the head of the bed. Then spread a linen sheet wrung out in cold water over the blanket so that its end is slightly below the upper end of the blanket. The patient should lie on the bedsheet with his shoulders about three inches below the upper age. The wet sheet should be weekly wrapped around the body of the patient, drawn in, tightly tucked between the legs and also between the body and the arms. The sheet should be folded over the shoulders and across the neck. Now the blanket should be drawn tightly around the body and tucked in along the side in a similar manner, pulling it tightly. The ends should be doubled up at the feet. A Turkish towel should be placed below the chin to protect the face and neck from coming into contact with the blanket and to exclude outside air more effectively. The head should be covered with a wet cloth so that the scalp remains cold. The feet should be kept warm during the entire treatment. If the patient’s feet are cold, place hot water bottles near them to hasten reaction. The pack is administered for half an hour to one hour till the patient begins to perspire profusely. He may be given cold or hot water to drink.

This pack is useful in cases of fever and benefits those suffering from insomnia, epilepsy and infantile convulsions. It is useful in relieving chronic cold and bronchitis and helps in the treatment of rheumatism and obesity.

Baths.

Tepid baths are prescribed to reduce a fever. Baths are also one of the oldest forms of relaxation therapy. Aromatherapists often recommend adding essential oils of lavender (Lavandula angustifolia) to a warm to hot bath to promote relaxation and stress reduction. Adding Epsom salts (magnesium sulphate) or Dead Sea salts to a bath can also promote relaxation and soothe rheumatism and arthritis.

Hip baths

The hip bath is one of the most useful forms of hydrotherapy. As the name suggests, this mode of treatment involves only the hips and the abdominal region below the navel. A special type of Tub is used for the purpose. The tub is filled with water in such a way that it covers the hips and reaches up to the navel when the patient sits in it. Generally, four to six gallons of water are required. If the special tub is not available, a common tub may be used. A support may be placed under one edge to elevate it by two or three inches. Hip bath is given in cold, hot, neutral or alternate temperatures. Also known as a Sitz Bath.

Cold hip bath

The water temperature should be 100c to 180c. The duration of the bath is usually 10 minutes, but in specific conditions it may vary from one minute to 30 minutes. If the patient feels cold or is very weak, a hot foot immersion should be given with the cold hip bath. The patient should rub the abdomen briskly from the navel downwards and across the body with a moderately coarse wet cloth. The legs, feet and upper part of the body should remain completely dry during and after the bath. The patient should undertake moderate exercise like Yogasanas, after the cold hip bath, to warm the body. A cold hip bath is a routine treatment in most diseases. It relieves constipation, indigestion, obesity and helps the eliminative organs to function properly. It is also helpful in uterine Problems like irregular menstruation, chronic uterine infections, pelvic inflammation, piles, Hepatic congestion, chronic congestion of the prostate gland, seminal weakness, impotency, Sterility, uterine and ovarian displacements, dilation of the stomach and colon, diarrhoea, dysentery, haemorrhage of the bladder and so on. The cold hip bath should not be employed in acute inflammations of the pelvic and abdominal organs, ovaries and in painful contractions of the bladder, rectum or vagina.

Hot hip bath

This bath is generally taken for eight to 10 minutes at a water temperature of 400c to 450c. The bath should start at 400c. The temperature should be gradually increased to 450c. No friction should be applied to the abdomen. Before entering the tub, the patient should drink one glass of cold water. A cold compress should be placed on the head. A hot hip bath helps to relieve painful menstruation, pain in the pelvic organs, painful urination, inflamed rectum or bladder and painful piles. It also benefits enlarged prostatic gland, painful contractions or spasm of the bladder, sciatica, neuralgia of the ovaries and bladder. A cold shower bath should be taken immediately after the hot hip bath. Care should be taken to prevent the patient from catching a chill after the bath. The bath should be terminated if the patient feels giddy or complains of excessive pain.

Neutral hip bath

The temperature of the water should be 320c to 360c. Here too, friction to the abdomen should be avoided. This bath is generally taken for 20 minutes to an hour. The neutral hip bath helps to relieve all acute and sub-acute inflammatory conditions such as acute catarrh of the bladder and urethra and subacute inflammations in the uterus, ovaries and tubes. It also relieves neuralgia of the fallopian tubes or testicles, painful spasms of the vagina and prorates of the anus and vulva. It is a sedative treatment for erotomanias in both sexes.

Alternate hip bath

This is also known as revulsive hip bath. The temperature in the hot tub should be 400c to 450c and in the cold tub 100c to 180c. The patient should alternately sit in the hot tub for five minutes and then in the cold tub for three minutes. The duration of the bath is generally 10 to 20 minutes. The head and neck should be kept cold with a cold compress. The treatment should end with a Dash of cold water to the hips. This bath relieves chronic inflammatory conditions of the pelvic viscera such as salpingitis, ovaritis, cellulitis and various neuralgias of the genito-urinary organs, sciatica and lumbago.

Spinal bath

The spinal bath is another important form of hydrotherapic treatment. This bath provides a soothing effect to the spinal column and thereby influences the central nervous system. It is given in a specially designed tub with its back raised so as to provide proper support to the head. The bath can be administered at cold, neutral and hot temperatures. The water level in the tub should be an inch and a half to two inches and the patient should lie in it for three to 10 Minutes. The cold spinal bath relieves irritation, fatigue, hypertension and excitement. It is beneficial in almost all nervous disorders such as hysteria, fits, mental disorders, loss of memory and tension. The neutral spinal bath is a soothing and sedative treatment, especially for the highly strung and irritable patient. It is the ideal treatment for insomnia and also relieves tension of the vertebral column. The duration of this bath is 20 to 30 minutes. The hot spinal bath, on the other hand, helps to stimulate the nervous, especially when they are in a depressed state. It also relieves vertebral pain in spondylitis and muscular backache. It relieves sciatic pain and gastrointestinal disturbances of gastric origin.

Immersion baths

This is also known as full bath. It is administered in a bath tub which should be properly fitted with hot and cold water connections. The bath can be taken at cold, neutral, hot, graduated and alternate temperatures.

Cold immersion bath

This may be taken for four seconds to 20 minutes at a temperature ranging from 100c to 23.80c. Before entering the bath, cold water should be poured on the patient’s head, chest and neck and the head should be protected with a cold moist towel. During the bath, the patient should vigorously rub his or her body. After the bath the body should be quickly dried and wrapped up in a blanket. If the climate is favourable, moderate exercise should be undertaken. This bath helps to bring down fever. It also improves the skin when taken for five to 15 seconds after a prolonged hot bath, by exhilarating circulation and stimulating the nervous system. This bath should not be given to young children or very elderly persons, nor be taken in cases of acute inflammation of some internal organs such as acute peritonitis, gastritis, enteritis and Inflammatory conditions of uterus and ovaries.

Graduated bath

The patient should enter the bath at a temperature of 310c. The water temperature should be lowered gradually at the rate of 10c per minute until it reaches 250c. The bath should continue until the patient starts shivering. The graduated bath is intended to avoid nervous shock by sudden plunge into the cold water. This bath is often administered every three hours in cases of fever. It effectively brings down the temperature except in malarial fever. Besides, it also produces a general tonic effect, increases vital resistances and energises the heart.

Neutral immersion bath

This bath can be given from 15 to 60 minutes at a temperature ranging from 260c to 280c. It can be given for long duration, without any ill-effects, as the water temperature is akin to the body temperature. The neutral bath diminishes the pulse rate without modifying respiration. This treatment is the best sedative. Since the neutral bath excites activity of both the skin and the kidneys, it is recommended in cases relating to these organs. It is also beneficial for cases of organic diseases of the brain and spinal cord, including chronic inflammatory conditions such as meningitis, rheumatism and arthritis.

A neutral immersion bath taken for 30 to 60 minutes is highly beneficial in general dropsy, due to cardiac or renal diseases. It also helps those suffering from multiple neuritis, alcoholism and other narcotic habits, chronic diarrhoea, peritonitis and chronic affections of the abdomen. In such cases the bath may be given daily for 15 to 30 minutes. This bath is also useful in the toxaemic conditions caused by dyspepsia and pruritus. The neutral bath should not be prescribed in certain cases of eczema and other forms of skin diseases where water aggravates the symptoms, nor in cases of extreme cardiac weakness.

Hot immersion bath

This bath can be taken from two to 15 minutes at a temperature from 36.60c to 400c. Generally, this bath is started at 370c and the temperature is then gradually raised to the required level by adding hot water. Before entering the bath, the patient should drink cold water and also wet the head, neck and shoulders with cold water. A cold compress should be applied throughout the treatment. This bath can be advantageously employed in dropsy when there is excessive loss of tone of the heart and blood. This bath also relieves capillary bronchitis and bronchial pneumonia in children. It relieves congestion of the lungs and activates the blood vessels of the skin and muscles. The bath should be terminated as soon as the skin becomes red.

In pneumonia and suppressed menstruation, the bath should be administered at 37.70c to 400c for about 30 to 45 minutes. This bath should be given when the menstruation is due and may be repeated for two to three days in succession. In dysmenorrhoea, this bath should be given at 380c to 44.40c for 15 minutes.

In chronic bronchitis a very hot bath taken for 5 to 7 minutes should be accompanied with rubbing and friction. This relieves congestion of the mucous membrane and provides immediate relief after the bath, oil should be applied to the skin if necessary. The hot bath is a valuable treatment in chronic rheumatism and obesity. It gives immediate relief when there is pain due to stones in the gall bladder and the kidneys. The hot bath should not be taken in cases of organic diseases of the brain or spinal cord, nor in cases of cardiac weakness and cardiac hypertrophy.

Internal Hydrotherapy.

Colonic irrigation

An enema that is designed to cleanse the entire bowel. Proponents of the therapy say it can cure a number of digestive problems.

Preparations

Because of the expense of the equipment and the expertise required to administer effective treatment, hydrotherapy with pools, whirlpools, Hubbard tanks, and saunas is best taken in a professional healthcare facility, and/or under the supervision of a healthcare profession- al. However, baths, steam inhalation treatments, and compresses can be easily administered at home.

Warm to hot bath water should be used for relaxation purposes, and a tepid bath is recommended for reducing fevers. Herbs can greatly enhance the therapeutic value of the bath for a variety of illnesses and minor discomforts.

Herbs for the bath can be added to the bath in two ways as whole herbs and flowers or essential oils.

Whole herbs and flowers

These can be placed in a muslin or cheesecloth bag that is tied at the top to make an herbal bath bag. The herbal bath bag is then soaked in the warm tub, and can remain there throughout the bath.

Essential Oils

When using essential oils, add five to 10 drops of oil to a full tub. Oils can be combined to enhance their therapeutic value. Marjoram (Origanum marjorana) is good for relieving sore muscles; juniper (Juniperus communis) is recommended as a detoxifying agent for the treatment of arthritis; lavender, ylang ylang (Conanga odorata), and chamomile (Chamaemelum nobilis) are recommended for stress relief; cypress (Cupressus sempervirens), yarrow (Achillea millefolium), geranium (Pelargonium graveolens), clary sage (Salvia sclaria), and myrtle (Myrtus communis) can promote healing of haemorrhoids; and spike lavender and juniper (Juniperus communis) are recommended for rheumatism.

Make sure that you receive guidance from an accredited aromatherapist before you self-medicate.

Salts

To prepare salts for the bath, add one or two handfuls of Epsom salts, Dead Sea salts or Magnesium Chloride to boiling water until they are dissolved, and then add them to the tub.

A sitz bath, or hip bath, can also be taken at home to treat haemorrhoids and promote healing of an episiotomy. There is a special apparatus available for taking a seated sitz bath, but it can also be taken in a regular tub partially filled with warm water.

DBM prefers the use of enemas to colonic irrigation. For more information visit: Liver Cleanse – Coffee Enema as well as General Therapies: Enemas

Steam Inhalation

Steam inhalation treatments can be easily administered with a bowl of steaming water and a large towel. For colds and other conditions with nasal congestion, aromatherapists recommend adding five drops of an essential oil that has decongestant properties, such as peppermint (Mentha piperita) and eucalyptus blue gum (Eucalyptus globulus). Oils that act as expectorants, such as myrtle (Myrtus communis) or rosemary (Rosmarinus officinalis), can also be used. After the oil is added, the individual should lean over the bowl of water and place the towel over the head to trap the steam. After approximately three minutes of inhaling the steam with eyes closed, the towel can be removed.

For information on UNA3 Protocols for steaming go to: IMMUNOClean™: steaming

Other herbs and essential oils that can be beneficial in steam inhalation include:

Tea tree oil (Melaleuca alternifolia) for bronchitis and sinus infections.
Sandalwood (Santalum album), virginian cedarwood (Juniperus virginiana), and frankincense (Boswellia carterii) for sore throat.
Lavender (Lavandula angustifolia) and thyme (Thymus vulgaris) for cough.

Precautions

Individuals with paralysis, frostbite, or other conditions that impair the nerve endings and cause reduced sensation should take hydrotherapy treatments only under the guidance of a trained hydrotherapist, physical therapist, or other appropriate healthcare professional.

Because these individuals cannot accurately sense temperature changes in the water, they run the risk of being seriously burned without proper supervision. Diabetics and people with hypertension should also consult their healthcare professional before using hot tubs or other heat hydrotherapies.

Hot tubs, Jacuzzis, and pools can become breeding grounds for bacteria and other infectious organisms if they are not cleaned regularly, maintained properly, kept at the appropriate temperatures, and treated with the proper chemicals. Individuals should check with their healthcare provider to ensure that the hydrotherapy equipment they are using is sanitary. Those who are using hot tubs and other hydrotherapy equipment in their homes should follow the directions for use and maintenance provided by the original equipment manufacturer.

Certain essential oils should not be used by pregnant or nursing women or by people with specific illnesses or physical conditions. Individuals suffering from any chronic or acute health condition should be carefully screened by the physician before starting treatment with any essential oil.

Such essential oils as cinnamon leaf, juniper, lemon, eucalyptus blue gum, peppermint, and thyme can be extremely irritating to the skin if applied in full concentration. Oils used in hydrotherapy should always be diluted in water before they are applied to the skin. Individuals should never apply essential oils directly to the skin unless directed to do so by a trained healthcare professional and/or aromatherapist.

Colonic irrigation should be performed only by a healthcare professional. Patients should be sent for colonic irrigation ONLY in cases where faeces are highly impacted and then a program for restoring the natural flora should be implemented.

Side effects

Most forms of hydrotherapy are well tolerated. There is a risk of allergic reaction (also known as contact dermatitis) for some patients using essential oils and herbs in their bath water. These individuals may want to test for allergic sensitization to herbs by performing a skin patch test (i.e., rubbing a small amount of diluted herb on the inside of their elbow and observing the spot for redness and irritation). People who experience an allergic reaction to an essential oil should discontinue its use and contact their healthcare professional for further guidance.

The most serious possible side effect of hydrotherapy is overheating, which may occur when an individual spends too much time in a hot tub or Jacuzzi. However, when properly supervised, this is a minimal risk.