External Applications in Anthroposophic Nursing

Tinkling Wash with Lemon

Kind of substance

Water with lemon

Guiding principle for the application

This tinkling wash, as a therapeutic wash, extends to hands and forearms, feet and lower legs, whereby the addition of fresh lemon in warm water is just as important. It does not serve to cleanse the body, it enables a process of letting go, re-immersing and once again taking hold of the diseased body in critical situations that occur, especially in cases of congested fluid in the legs. Together with the lemon, the tinkling wash can serve as a cautious help if body contact and substance effects seem too oppressive to the patient and a stagnating situation needs to be brought back into flow. It is particularly suitable for patients who are very weakened and severely restricted in self-care.
The tinkling wash takes its name from the splashing sound of the water, which is produced when water is poured over the hands and feet. The sound of the tinkling water reminds us of “the water of life”, and hopeful images can emerge within, reminiscent of the “eternal stream of life”. The quality of touch and attention in connection with lemon water and warmth is of particular importance in this application.
Partial baths as tinkling washes (hand or foot baths) can be used as a variation of this, if required, when a further reduction of the application appears sensible.

Guiding Principle for the substance

Indications

  • Leg edemas
  • The dying process
  • Severe exhaustion

All indications: see example case

Instructions

Materials

  • Washing glove
  • Low basin with warm water
  • 2 terrycloth towels to protect the bed and dry the patient


Instructions
  • Ensure quiet during treatment
  • Position the patient with a semi-erect upper body


To wash the patient's hands and feet, the caregiver places the bowl with warm water at hip or calf level on the bed, laying a terrycloth towel underneath in each case. 
The caregiver stands next to the bed (facing the patient’s face) and holds the patient’s forearm with his nearest hand so that her fingertips are immersed in water.
With his free hand he lets the water flow very slowly and rhythmically with a tinkling sound 3–5 times over her hand and forearm. Afterwards, place the squeezed out washing glove into the palm of the patient's hand for a moment. After removing the bowl, place the patient’s hand and forearm on the towel and gently dry them. The caregiver then changes sides and treats the patient’s left hand and forearm in the same way.
For the footbath, the caregiver stands on one side of the bed next to the patient (looking towards the patient’s feet) and places his nearest hand from outside under the hollow of the patient’s knee and calf and lifts the foot into the basin. If the knee cannot be bent, place cushions under the leg so that the foot can be placed over the bowl at the foot end. Then hold the leg with your hand and forearm, and with your other hand scoop water over the foot and calf, as described above. When you are finished, place the foot on the terrycloth towel underneath and gently dry it off.

Evidence
Well-proven in many patients
Dosage
As needed
Onset of effect
Immediate
Length of therapy
As needed
Other recommended therapies
An aurum-lavender heart compress

Case example

Example case
A Japanese colleague from Munich was called to Tokyo by her family to assist her 70-year-old sister, because she was very ill after an aneurysm operation that had lasted 12 hours. She was hardly recovering from the operation, so that she was expected to die.
The colleague visited her sister in the hospital. The patient was very weakened and did not speak, her legs were thickly swollen. She barely noticed her own sister. Our colleague immediately washed her sister’s hands and feet with lemon (Demeter quality), the way she had learned. The room smelled so good that all the other patients happily asked what they were doing. Every day she repeated these washes and already on the 3rd day the leg edema had decreased so much that even the doctor asked: “What did you do?” The patient opened her eyes, could speak and the two sisters spent the rest of the week talking together. The patient thanked her very much for these beneficial treatments, as did the family. Two weeks later the patient died, after she had been able to talk to her family for a long time more and express her gratitude to them.
US

Author

Red., US

Bibliography

  • Heine R. Variationen zur Ganzkörperwaschung, in:  Anthroposophische Pflegepraxis, Salumed Verlag, Berlin, 2017, p. 313–324
  • Heine R. Tinkling washing, in: Dimensionen therapeutischer Prozesse in der Integrativen Medizin. Springer, Wiesbaden, 2016, p. 123–144.
  • Kierey B. Die «Klingende Waschung» in der ambulanten Pflege. Schweizerische Zeitschrift für Ganzheitsmedizin/Swiss Journal of Integrative Medicine 29.2 (2017): 103–104.