What mineral healing baths are there in the world? Hydrotherapy

Baths are water procedures used for hygienic or therapeutic purposes.

General indications to the use of baths
diseases of the CVS without symptoms of NK (heart disease with a completely completed infectious process, operated defects, stage I-II hypertension without pronounced crises and damage to the blood vessels of the brain, kidneys, heart, hypotension), rheumatism in an inactive form after the end of acute phenomena with a completely completed process in heart, diseases (including consequences of injuries) of the central nervous system and peripheral nervous system after the end of the acute period without severe disorders, functional diseases of the nervous system (neuroses), diseases of the digestive system, metabolic diseases, diseases of the musculoskeletal system of non-rheumatic etiology, diseases of the female genital area, skin diseases.

Possible complications
Regardless of the chemical composition, baths are a nonspecific irritant, causing an exacerbation of inflammatory processes in latent foci of infection and activating a chronically ongoing infection, which makes it necessary to preliminary sanitize the lesions and exclude the current infectious process.

General contraindications

• unstable angina in the decompensation phase
• significant impairment of cardiac contractility (decompensation above the first degree),
• for heart defects (significant mitral stenosis, aortic defects)
• heart rhythm disturbances (atrial fibrillation, blockade)
• aneurysms of the heart and blood vessels.
• acute infectious and non-infectious processes
• malignant neoplasms
• active tuberculosis
• clinically significant atherosclerosis with damage to organs
• cirrhosis of the liver
• chronic kidney disease with impaired kidney function
• blood diseases of the acute stage or acute stage
• severe general exhaustion
• progressive glaucoma;
• pregnancy (second half).

Influence of temperature factor

• Cold B- deepening, slowing breathing, slowing and increasing heart rate, increasing the tone of skeletal and smooth muscles, increasing blood pressure.
• Hot, warm B- increased, weakened heart rate, decreased blood pressure, increased breathing, decreased muscle tone.

Features of prescribing baths in children:

• up to 2 years, diffuse reactions even to local irritants, increased hydrophilicity and permeability of the skin - baths are prescribed according to strict indications in non-resort conditions, sodium chloride, mud, sea, coniferous baths can be used (for severe rickets, central nervous system diseases, consequences of hepatitis, injuries).
• Preschool, school age - almost all baths are used, but in lower concentrations.
• At the resort, baths are prescribed after 5-10 days of stay, for a course of 8-12 baths, every other day, a weakened 1 day bath, 2 days rest.
• You can alternate between general and local baths every other day.
• Procedure time 5-7 - 8-12 minutes.
• Baths after 45 minutes. - 1 hour after breakfast. After baths, rest for 15 minutes. , then 1-1.5 hours in the ward.
• Observe the child after 1-2 procedures, after 4-5 procedures (maybe a pathological balneological reaction).

Sodium chloride baths

Sodium chloride waters are the most common. They are also called the waters of ancient seas brought to the surface. One of the largest underground seas is located in the center of the East European Plain - the Moscow artesian basin, with an area of ​​about 360 thousand km2. In the deepest parts of the artesian basin there is a zone of slow water exchange, where highly concentrated salt brines have formed.

Externally, chloride waters of high and medium mineralization are used for baths, irrigation and in therapeutic pools - from 20 to 300-600 g/l.
Composition: sodium, chlorine, magnesium, calcium, potassium ions, etc.
Some natural waters contain bromine and iodine ions.

Mechanism of action
Previously, it was believed that salts do not penetrate the body through the skin, but act only on the stratum corneum of the epidermis and the nerve endings located in it.
In 1988, P.P. Slynko established the phenomenon of post-perspiration permeability of the skin for substances (mineral salts) dissolved in water through sweat glands, which actively “draw” solutions of mineral salts into the deeper layers of the skin - the dermis and subcutaneous fatty tissue, through their excretory ducts after sweating stops.
The chemical effect is due to the direct effect of minerals on skin receptors, cellular elements of the skin, its blood and lymph circulation. The penetration of chlorine and sodium ions through intact skin, as well as the formation of a “salt cloak” has an effect on skin receptors, both during and after the procedure During a long time. This causes reflex changes in the central nervous system and hypothalamus, in the form of increased inhibition processes, with a predominance of parasympathetic activity of the autonomic nervous system.
Baths with a salt concentration of up to 30 g/l reduce, and baths with a concentration of 60 g/l increase the excitability of the brain. The stimulating effect of sodium chloride baths is especially noticeable in patients with low blood pressure, which increases under the influence of baths.

• weak (from 10 to 20 g/l)
• medium (from 20 to 40 g/l) - optimal
• strong (from 40 to 80 g/l).
• more than 80 g/l - damaging effect

Bath water should not be higher than 35-38 °C.
Duration - from 10 to 20 minutes.
Frequency - every other day or two days with a break of two days.
The course is 12-15 baths.
The optimal concentration is predominantly 30 g/l.

Effect of sodium chloride baths

• increases the activity of the endocrine apparatus (pituitary gland, adrenal glands, thyroid gland)
• improves tissue trophism and metabolic processes
• reduces blood viscosity
• reduces platelet aggregation and adhesive activity
• normalizes vascular tone
• increases the tone of peripheral veins
• enhances subcutaneous and muscle blood flow (trace effect).
• improves blood flow from extremities with venous stagnation
• reduces inflammation in joint pathologies
• has a desensitizing effect
• The following is recorded in the skin:
• increase in the number of fibrocytes and elastic fibers
• thickening of the arhydrophilic elements of the skin itself
• formation of cavities between the granular and shiny layers of the epidermis
• vacuolization of epidermal cells and intercellular edema
• increased proliferation of the germinal layer of the epidermis
• the microcirculatory response is significantly improved and prolonged
• the activity of the sweat glands is intensified
• These changes lead to an improvement in the trophism of the skin and its appendages, however, with an increase in the number of baths performed, further proliferation of the germ layer and thinning of the stratum corneum of the skin occurs.

Indications

• hypertension 1.2A (with NC up to 1st degree)
• postthrombotic disease after 2-3 months
• diseases of the central nervous system, PNS.
• pathology of the musculoskeletal system (arthritis, polyarthritis, consequences of injuries)
• chronic inflammatory gynecological diseases
• metabolic disease
• skin diseases (psoriasis, neurodermatitis, seborrhea, hyperkeratosis, some hair diseases).

Sodium chloride baths are indicated for patients with atherosclerosis in its very initial stage with moderate asthenic syndrome, arterial hypotension, and vegetative-vascular disorders. For a long time, the clinical effect of Nauheim's carbonated salt waters was explained by their sodium chloride composition, and not by the presence of carbon dioxide, and mother brine was added to them to enhance the therapeutic effect. Currently, for diseases of the cardiovascular system, sodium chloride baths of low concentration (20-30 g/l) and predominantly indifferent temperature (35-36 ° C) are used.

Contraindications
Common to the use of balneotherapy methods, as well as skin diseases with the presence or tendency to exudative reactions (wetting eczema, etc.).

Occurrence
The waters of the Moscow basin include the springs of Central Russia, on which the resorts Kashin in the Tver region and Staraya Russa in the Novgorod region were built. The waters of the “underground sea” with mineralization from 50 to 270 g/l are predominantly sodium chloride in composition; other cations - potassium, calcium, as well as trace elements are contained in these waters in smaller quantities, but they also determine the therapeutic effect. Thus, the waters of the Staraya Russa resort contain an increased amount of bromine, so the sedative effect is more pronounced.
At the resorts of Usolye-Sibirskoye, Angara in the Irkutsk region, the Obolsunovo and Zeleny Gorodok sanatoriums in the Ivanovo region, Big Salts in the Yaroslavl region, as well as the Zeleny Gorodok sanatoriums near Nizhny Novgorod (Nizhny Novgorod region), etc., salt waters are used underground sources.
At the same time, resorts on salt lakes are popular: “Yarovoye” in the Altai Territory, “Uchum” in the Krasnoyarsk Territory, “Medvezhye” in the Kurgan Region, “Shira” in Khakassia, Sol-Iletsk in the Orenburg Region, Tinaki, Baskunchak, Elton in Volga region.

Sulfide baths

Sulfides in nature are in the form of hydrogen sulfide H2S, in the ionic form hydrosulfide - HS. Their ratio depends on the acidity of the environment. The active ingredient is free hydrogen sulfide, the main active ingredient is sulfide.
It has a predominantly chemical effect.

Mechanism of action
From water, hydrogen sulfide penetrates into the body through the skin, mucous membranes, and respiratory tract in the form of free hydrogen sulfide and hyposulfide ion. As a result, the enrichment of the contents of sulfhydryl and disulfite groups activates glutadione, which stimulates enzyme systems, increases the energy resource of cells and tissues, enhances regenerative processes, and normalizes the processes of excitation and inhibition in the central nervous system. The direct inclusion of hydrogen sulfide and its compounds in biochemical reactions occurring in tissues determines the influence of sulfide waters on the state of metabolic processes and the activity of sulfhydryl groups, which are an integral part of many enzymes.
As a result, redox and enzymatic processes are activated, energy resources in cells and tissues increase, incl. and in the myocardium. Under the influence of hydrogen sulfide entering the blood, the synthesis of atherogenic lipids is reduced. Hydrogen sulfide baths have a pronounced effect on the cardiovascular system: skin hyperemia occurs, which is based on improved microcirculation; the speed of blood flow and the volume of circulating blood increase, the strength of heart contractions also increases against the background of a decrease in their frequency; blood supply to the brain, heart and kidneys improves; breathing slows down and becomes deeper.
When exposed to hydrogen sulfide on the skin, irritation of nerve endings occurs, the amount and activity of histamine, acetylcholine and other substances in it changes. This causes dilation of small vessels and, as a result, intense redness of the skin, improved blood circulation in the skin and underlying tissues: joint capsules, cartilage, internal organs. Also in the mechanism of the therapeutic action of sulfide waters, a large role is given to hormonal changes, changes in the function of the sympathetic-adrenal system, and the state of immunological reactivity.
The duration of circulation of hydrogen sulfide in the blood is very short; the gas is very quickly oxidized in the liver and excreted from the body.

1. Low hydrogen sulfide 0.3-1.5 mmol/l (10-50 mg/l) - Pyatigorsk, Khilovo.
2. Average - 1.5-3 mmol/l (50-100 mg/l) - Menji.
3. Strong - 3-7.5 mmol/l (100-250 mg/l) - Matsesta.
4. Particularly strong - more than 7.5-12 mmol/l (250-400 mg/l) - Matsesta, Talgi, Ust-Kachka.
5. Medicinal - 0.3 mmol/l (10 mg/l) - Kemeri, Ust-Kachka, Klyuchi, Sochi-Matsesta.

Sulfide balneotherapy is used in the form of general baths, half-baths, two and four-chamber baths, irrigation of the head, face, gums, inhalations of sprayed sulfide water, gynecological irrigations, and rising showers.
Water 35-37 degrees.
Duration 8-12 minutes.
Concentration 1.5; 3; 4.5 mmol/l.(50, 100, 150 mg/l).
Frequency: every other day or 2/3.
There are 12-14 baths per course.

Techniques

• Gentle - 5-10 minutes, 1.5-2.25 mmol/l (50-75 mg/l). No. 10-12.
• Intensive - 8-15 minutes, conc. 3-6 mmol/l (100-200 mg/l), No. 12-15.
• Irrigation of gums, vagina - 3-4.5 mmol/l (100-150 mg/l)
• Microclysters up to 3 mmol/l (100 mg/l).
• Local baths - 36-38 degrees, 10-20 minutes, daily/every other day, No. 12-20.

After taking a sulfide bath, the patient should rest (preferably lying down) for at least 20-30 minutes, continuing to rest in the ward or at home for 1-1.5 hours.

The effect of a course of sulfide baths

• normalization of blood pressure
• increase in blood flow speed
• slowing down the heart rate, prolonging its resting period
• improvement of blood supply and innervation of organs and tissues
• changes in various types of metabolic processes
• increased oxygen consumption
• increased pulmonary ventilation
• predominantly inhibitory effect on the central nervous system
• corrective effect for neuroses, autonomic dysfunction
• improvement of blood rheology

Indications

• IHD stage 1, arterial hypertension 75-100 mg/l.
• IHD 2 25-50 mg/l.
• IBS 3 4-chamber baths 75-100 mg/l.
• GB 1.2A,B, 3 tbsp
• Diseases of the liver and biliary tract in remission; diseases and injuries of the PNS and CNS
• polyradiculoneuritis and encephalomyelitis in the late recovery period
• consequences of cerebral and spinal ischemic strokes
• consequences of inflammation and injury to the brain and spinal cord and their membranes
• diseases of the musculoskeletal system of an inflammatory and metabolic-dystrophic nature
• inflammatory diseases of the genital area in women and men
• skin diseases (eczema, psoriasis, neurodermatitis, occupational dermatoses, etc.).
• tubal infertility (and irrigation).

Contraindications:

• IBS 4,
• CH 2, GB 2B, NK B 1 tbsp.
• severe atherosclerosis of cerebral vessels
• diseases of the liver and kidneys with impairment of their functions
• hyperthyroidism
• peptic ulcer in the acute stage
• bronchial asthma
• epilepsy with frequent seizures
• toxic-allergic effect of sulfides on the body when the concentration of hydrogen sulfide in the air exceeds

Sources of sulfide waters in Russia
Krasnousolsk (Bashkiria), Goryachiy Klyuch, Sochi (Krasnodar region), Pyatigorsk (Stavropol region, Caucasian Mineral Waters), Ust-Kachka (Perm region), Khilovo (Pskov region), Chuvashia (Chuvashia).
Balneotherapy with sulfide waters is used in complex spa treatment in the sanatoriums of NP Sankurtur: in the resort of Sochi in the sanatoriums “Im. Ordzhonikidze", "Svetlana"; at the Pyatigorsk resort in the Rodnik sanatorium, at the Ust-Kachka resort

Radon baths

one of the types of α-therapy, the specific active factor of which is the inert radioactive gas radon dissolved in water.
Natural radon waters include mineral waters containing short-lived radioactive substances - radon and its daughter products (radium A, radium B, radium C, radium C1). Natural radon waters, as a rule, have low mineralization (up to 2 g/l) and a complex gas composition (radon, nitrogen or carbon dioxide). Radon concentrations in natural sources range from 1 to 300 nCi/L.
When artificially preparing radon baths, a radon concentration of 40-200 nCi/l (1.5 - 7.5 kBq/l) is most often used.
For medicinal purposes, natural or artificially prepared (physically) radon waters are used, which are used in the form of:

• general and local water radon baths
• “dry” or air-radon baths,
• gynecological irrigation
• microenemas
• inhalation, drinking radon waters, etc.

Mechanism of action
The primary effect of radon baths is based on the ionization of water, which leads to changes in biochemical processes in tissues and an increase in the level of redox reactions. Free radical oxidation reactions and metabolic processes in the protoplasm of cells are activated, the structure of protein molecules changes, and the direction and intensity of biochemical processes changes. Currently, there are two main types of effects of a-radiation of radon and its daughter products on the body: direct and indirect through activation of centers of neuroendocrine and immune regulation. The effect of a-radiation from radon and its daughter products on melanocytes leads to the oxidation of tyrosine and the formation of highly active dioxyphenylalanine (DOPA), DOPA-quinones, and DOPA-amines. These biologically active substances, entering the bloodstream, cause activation of the sympatho-adrenal system.
One of the main mechanisms of action of radon baths is irradiation of the skin receptor apparatus with radon and its daughter products, a change in cellular metabolism in it with the release of biologically active substances. A characteristic feature of baths in their multifaceted effect on the body is their effect on the nervous system at all levels of regulation. Radon baths change the permeability of the blood-brain barrier, block the ascending influence of the reticular formation and enhance inhibition processes in the central nervous system.
In the terminal part of the blood circulation, a two-phase reaction of the capillaries is observed during bathing. In the first minutes of administration - paleness of the skin, spasm of capillaries, decrease in the number of visible capillaries; at the end of the dose and within 1 hour after - a pinkish background, an increase in the number of capillaries and blood flow in them. This two-phase vascular reaction produces a kind of training of peripheral vessels. Therefore, when taking a radon bath, a short-term (within 1-3 minutes) spasm is replaced by a prolonged dilation of arterioles and a slight decrease in venular outflow, which leads to skin hyperemia.
The biological effect of radioactive radiation is determined by the absorbed dose of radiation in various organs and tissues of the body. It is worth focusing on the fact that a course of 15 radon baths with a concentration of 3.0 kBq/l (80 nCi/l) the absorbed dose is about 0.1 mSv (10 mrem), which is comparable to the monthly natural background radiation of a person. Irradiation of other organs and tissues, except fat (4% absorption) and kidneys (30%), is within the limits of daily background fluctuations. However, with radon therapy, significant unevenness of temporal and spatial exposure is recorded. As a result, the radiation dose rate of some organs and tissues in the body is several hundred times higher than the radiation dose rate caused by the natural background radiation. This allows us to understand the reasons for the therapeutic effect of such low absorbed doses of radiation, known as radiation hormesis. According to this theory, only small doses of radiation energy stimulate protective-adaptive mechanisms. Radiation hormesis has been established at the biochemical, cellular and organ levels, in cell cultures, bacteria, plants and animals. Low doses of radiation cause increased immune competence and “overproduction” of adaptive enzymes necessary for DNA repair. The low dose is the value between the background dose from the environment and the threshold dose that causes certain physiological responses. E. Roth proved that with increasing radiation dose, the number of damaged cells increases and reparative processes decrease. When using high concentrations of radon for baths, balneoreactions are often observed. The damaging effects of radiation appear only after exceeding a certain threshold.
When taking a general water radon bath lasting 20 minutes, about 0.5% of the radon contained in the bath penetrates the body through the skin, and about 2% of radon and its decay products settle on the skin. This so-called “active plaque” disintegrates 2-3 hours after the patient leaves the bath. Over 90% of radon that enters the body from a bath accumulates in the skin, where a certain depot of radon and its products is created, which have a specific effect not only during taking a bath, but also after it. From the skin depot, radon enters the blood and spreads to internal environments and organs, but their radiation dose is small compared to the skin. Only about 0.5% of radon that penetrates the body decays, and the resulting decay products of radon (radium A, B and C) completely disintegrate before they are released from the body.
Radon is removed from the body mainly through the lungs (about 60%) and through the skin (about 40%), and this process ends 4-5 hours after the procedure. The deposition and speed of movement in the body of radon and its daughter products are influenced by the temperature of the water and its gas composition. An increase in water temperature accelerates the movement of radon from the skin depot, and carbon dioxide, which settles on the skin in the form of small bubbles, prevents the formation of active plaque on the skin, reduces the entry of radon and its daughter products into the body, and, therefore, reduces the body’s exposure to radiation.

Recommendations
Natural and artificial radon waters are used for radon baths.
According to Russian balneological waters, radon waters include mineral waters, the radon content of which must be at least 185 Bq/l (radon maximum concentration limit for drinking water is 120 Bq/l). This value is quite arbitrary, since the required irradiation intensity can be adjusted by time parameters. Thus, in Poland the minimum therapeutic norm is 375 Bq/l, in France - 370 Bq/l, in the Czech Republic - 1192 Bq/l, in Germany - 6885 Bq/l, in Hungary - 3 Bq/l.

There are:

1. water with low radon concentration - from 5 to 40 nCi/l (0.2-1.5 kBq/l);
2. water with an average radon concentration - from 40 to 200 nCi/l (1.5-7.5 kBq/l);
3. water with a high concentration of radon - above 200 nCi/l (>7.5 kBq/l).

The minimum effective therapeutic concentrations of radon are considered to be: for water baths - 5 nCi/l (200 Bq/l), for drinking - 100 nCi/l (4000 Bq/l). The maximum permissible exposure of a patient (for a course of treatment) is when taking water baths with a concentration of 900 nCi/l (34 kBq/l).
The therapeutic dosages of radon used in baths with a concentration of 1.5 - 3 kBq/l have the greatest therapeutic effectiveness, while at the same time they are several times lower than the established maximum (21 kBq/l). Classically, general radon baths are used with a concentration of 1.5-3.0-4.5 kBq/l (40-80-120 nCi/l) at a water temperature of 35-37 ° C, lasting 10-20 minutes, 4-5 times in Week. Radon baths are prescribed for 2-3 days in a row or every other day, depending on the general condition of the patient, as well as the condition of the cardiovascular system. A total of 12-15 procedures are prescribed per course of treatment.
Children are prescribed radon baths no earlier than 5 years of age; in this case, baths with a radon concentration not higher than 1.5 kBq/l (40 nCi/l) are used.
Radon baths of medium concentration (not higher than 3.0-44 kBq/l) have a positive effect on central hemodynamics, a hypotensive effect, as well as an improvement in coronary circulation and myocardial contractility. For patients with diseases of the cardiovascular system, it is preferable to prescribe radon baths at a temperature of 35-36°C.
Very significant, especially in vascular pathology, is the ability of radon baths to reduce platelet aggregation and reduce the level of hypercholesterolemia in atherosclerosis.
When treating vertebrogenic radiculitis with severe pain and syringomyelia, the radon concentration in the bath can be increased to 7.5 kBq/l (200 nCi/l).
For gynecological diseases, vaginal irrigations lasting 15-20 minutes (temperature 35-40 °C) or microenemas (37-40 °C) are additionally used for 2-3 days in a row and a break day in the amount of 18-20 procedures per course. These procedures are recommended to be carried out before a bath. The radon concentration should be the same as in the bath.
The therapeutic effect of radon baths lasts from 3 to 6 months.

The effect of a course of radon baths

• increased permeability of the blood-brain barrier
• inhibition of the ascending influence of the reticular formation
• predominance of inhibitory processes in the central nervous system
• increasing the speed of excitation propagation along the nerve
• increased reflex excitability of alpha motor neurons
• blocking inhibitory interneurons
• stimulation of tissue lipolytic enzymes
• normalization of basal metabolism, some aspects of carbohydrate, mineral, cholesterol and water metabolism
• increased tolerance to carbohydrates
• improvement of myocardial contractile function
• normalization of heart rate
• equalizes blood pressure
• an increase in the titer of agglutinins, phagocytic activity of leukocytes and a decrease in the titer of antibodies and immunoglobulins against the background of the body’s immune reactivity
• stimulation of glucocorticoid function of the adrenal glands
• slightly reduce thyroid function
• improvement of hemodynamics of the kidneys, liver and brain
• normalization of morphological composition and blood clotting
• stimulation of tissue regeneration processes
• significant analgesic and sedative effect
• normalizing effect on autonomic functions
• anti-inflammatory and desensitizing effects

Indications

• coronary heart disease I-II FC, hypertension I-IIA st.
• obliterating diseases of the vessels of the extremities;
• systemic diseases (scleroderma, rheumatism and rheumatoid arthritis in the phase of remission and minimal activity of the process), ankylosing spondylitis;
• pathology of the digestive (gastritis, peptic ulcer of the stomach and duodenum, diseases of the liver, biliary tract and pancreas), respiratory (rhinitis, sinusitis, COPD, asthma), urinary systems, e
• endocrine pathology, nutritional disorders and metabolic disorders (goiter with mild to moderate hyperthyroidism, diabetes mellitus, obesity, etc.)
• diseases of the skin and subcutaneous tissue (chronic eczema, neurodermatitis, psoriasis, scleroderma, etc.)
• neurological diseases and injuries (radicular and reflex-tonic syndromes of spinal osteochondrosis, mono- and polyneuropathy, plexitis, polyradiculoneuritis in the late recovery period of the disease, neuralgia, ganglionitis, causalgia and phantom pain, syringomyelia, cerebral palsy, consequences of injuries and inflammatory lesions brain and spinal cord and their membranes, hypothalamic syndrome, neurasthenia, etc.).
• pathology of the musculoskeletal system (damages to joints of an inflammatory and dystrophic nature, fractures, chronic inflammatory processes in muscles and tendons).
• gynecological diseases - chronic inflammatory and non-inflammatory processes in the uterus and its appendages, secondary forms of infertility, fibroids, the size of which does not exceed a 12-week pregnancy, bleeding due to fibroids and menopause, endometriosis, infertility, menopausal syndromes, etc.

Contraindications

• general contraindications to balneotherapy.
• contraindications to radon baths and other methods of radon therapy:
• pregnancy
• severe leukopenia (below 3.5 10 9/l)
• all stages of radiation sickness
• hypothyroidism
• hypoestrogenism
• patients who, due to the nature of their profession, remain for a long time in the area of ​​exposure to radioactive radiation or UHF and microwave currents
• acute inflammatory processes, pregnancy at all stages,
• hypofunction of the ovaries of neuroendocrine origin
• hypothyroidism
• epilepsy
• severe forms of neuroses

Sources
There are more than 300 sources of radon water in the world, of which about 30 are in Russia and the CIS countries. Not all of them are used for medicinal purposes. Probably the most unusual radon resort is on the island of Hainan in China, where therapeutic procedures with radon water are not allowed, but the waters of thermal radon springs fill the sectors of the pools and enter the baths of the most expensive rooms of a five-star hotel.
In Russia, the most famous sources of radon water are in the Urals - in the Sverdlovsk, Chelyabinsk regions, the Republic of Bashkiria, the Caucasus, Siberia and the Far East.
In the Urals there are two large deposits of radon waters used for medicinal purposes - Lipovskoye in the Sverdlovsk region and Uvildinskoye in the Chelyabinsk region. A balneotherapy clinic operates on the basis of Lithuanian radon waters (weak radon waters - Rn 5-40 nCi/l). The Uvilda deposit of radon waters (high-radon water - Rn > 120 nCi/l) is used by the Uvilda resort. In Bashkiria, there are sources of radon waters (low radon waters - Rn 20 nCi/l) in the resort of Krasnousolsk. Thermal gases containing radon of the “burning mountain” are used at the Yangan-Tau resort.
The radon clinic at the resort of Pyatigorsk is the largest radon hydrotherapy complex, which can perform 2.5 thousand procedures of seventeen different types per shift. The Pyatigorsk radon water deposit is characterized by a variety of waters in terms of radon content and chemical composition: high-radon (Rn 230-330 nCi/l) waters of the Beshtaugorsk deposit, medium-radon waters (Rn 70-80 nCi/l) of complex ionic composition (radio gallery, well 63, 75) and low-radon (Rn 15-40 nCi/l) warm sulfur sources.
In Western Siberia, there are known sources of radon water: Belokurikha (Rn 10-12 nCi/l) - Belokurikha resort, Altai Territory; Zaeltsovsky (Rn 10-12 nCi/l) (used in sanatoriums of the Novosibirsk region), in Eastern Siberia - Nilova Pustyn (Buryatia), Tumnin (Krasnoyarsk Territory). In the Far East: Kuldur - Jewish Autonomous Region, Nachiki - Kamchatka.
The most famous radon resorts in Russia: Belokurikha (Altai Territory), Kuldur (Jewish Autonomous Region), Pyatigorsk (Caucasian Mineral Waters), Uvildy (Chelyabinsk Region). On the basis of a gas thermal field in Bashkiria, the Yangan-Tau resort operates, where diseases of the musculoskeletal system and peripheral nervous system, as well as some urological diseases, are successfully treated.

Artificial radon waters
Artificial radon waters are becoming increasingly popular along with natural radon waters, which have a multicomponent composition. The first treatment with artificial radioactive waters was carried out in 1905 in Vienna, and the first clinical observation was in Germany in 1907. When treating with artificially prepared radon waters with a level of emanation (radioactivity) similar to natural waters, a therapeutic effect was obtained comparable to the results spa treatment. In 1921 V.I. Spitsyn investigated the transition of radon from minerals to liquid media. In 1949, a book by E.S. was published. Shepotyeva “Artificial radon waters and methods of their use.” Subsequently, methods were developed to enrich water, air and other healing environments with radon obtained from radium preparations, which are stored in a bubbler in a lead container. As a result of the decay of radium, radon is formed, which, using a special technique, is transferred into a bottle of water to prepare a concentrated aqueous solution and subsequent bottling into portioned bottles with a capacity of 100 ml. To prepare a radon bath, a concentrated aqueous solution of radon is poured from a bottle through a siphon onto the bottom of a bath previously filled with water at a given temperature, followed by stirring the water in the bath.
When artificially preparing radon baths, a radon concentration of 40-200 nCi/l (1.5-7.5 kBq/l) is most often used. New radon procedures have appeared (drinking radon water, irrigation, microenemas, suppositories, ointments, applications), and it has become possible to dose radon activity for each patient, taking into account the type of disease and the characteristics of his body.
Currently, safe technology for preparing radon waters and preparations is available in Russia and other CIS countries, Germany, the Czech Republic and Slovakia, as well as Japan. In these countries, along with radon resorts, radon laboratories operate in hospitals and sanatoriums.
There are about 100 such radon clinics in the Russian Federation. The disadvantage of artificially prepared radon water is the inability to recreate the unique natural complex of radon water, characterized by a complex system of connections in the form of interaction of the components of the mineral component of water with radon and its daughter products.

Nitrogen baths

Nitrogen mineral waters - nitrogen-siliceous (nitrogen thermal waters) - natural warm and hot alkaline waters of low mineralization (up to 2.0 g/l), of various ionic compositions, containing free nitrogen up to 20-25 g/cubic dm. and a large amount of silicic acid (50-150 mg/l). Often nitrogenous waters in nature are accompanied by an increased concentration of fluorine and the presence of radon.
Nitrogen baths- medicinal baths, for the preparation of which water containing dissolved nitrogen in high concentrations is used. For baths, either natural nitrogen siliceous thermal waters or artificially prepared nitrogen waters are used, obtained by saturating water with nitrogen under a pressure of 150-250 kPa (1.5-2.5 at) to an average concentration of 0.76-0.82 mmol/ l (21-23 mg/dm3). The use of artificial nitrogen baths was first carried out on the initiative of Professor A.R. Kirichinsky in 1938. The greatest contribution to their study was made by V.Ya. Osipov, L.A. Rutenberg, E.D. Svet-Moldavskaya et al.

Mechanism of action
The main active factor in a nitrogen bath is the inert gas nitrogen, which covers the body in the form of bubbles and causes mechanical and thermal irritation of the skin and its nervous system. Their irritating effect is less pronounced than that of other gas baths, which is the reason for the milder effect of the nitrogen bath on the body. It is also assumed that nitrogen penetrating through the skin will have an effect on various body systems.

Recommendations
To prepare artificial nitrogen baths, fill the bath 1/3 with fresh water at a temperature of at least 60-70 ° C, and then add cold water supersaturated with nitrogen to the required temperature. Cold water is saturated with nitrogen from a cylinder using a saturation apparatus (AN-8, AN-9) under pressure from 150 to 250 kPa (1.5-2.5 at).

Nitrogen baths are carried out at a temperature of 36-34 ° C, and in case of some diseases (thyrotoxicosis) and in the warm season - even at 33-32 ° C, the duration of the bath is 10-15 minutes. They are prescribed daily or every other day, for a course of treatment from 10-12 to 16-20 baths.

Nitrogen water is also used for vaginal irrigation: water temperature 38-39 °C, procedure duration 10-12 minutes, every other day or two days in a row with a break on the third day. The course of treatment consists of 12-14 procedures. If vaginal irrigation is used in combination with general nitrogen baths, then irrigation is done first, and after 15-20 minutes a bath.

Effect of nitrogen baths

• sedative
• hypotensive
• analgesic, anti-inflammatory and desensitizing
• improvement of general and cerebral hemodynamics,
• normalization of the activity of endocrine organs, metabolism, blood coagulation and anticoagulation systems, muscle tone
• improving the reactivity of the central nervous system, normalizing the overall tone of the body, promoting the body’s transition to a more economical level of functioning.

Indications

• Arterial hypertension I-II stage.
• cardiac ischemia
• vegetative-vascular dystonia
• cerebral atherosclerosis
• obliterating vascular diseases
• mild forms of thyrotoxicosis
• neurasthenia
• hypothalamic syndrome
• rheumatoid arthritis
• degenerative-dystrophic lesions of the joints and spine
• skin diseases
• inflammatory diseases of the female genital organs

Contraindications:

• acute inflammatory process
• severe cardiovascular diseases
• chronic renal failure
• malignant and benign neoplasms
• pulmonary tuberculosis in the active phase
• bleeding or tendency to it, blood diseases in the acute stage
• infectious diseases
• some skin diseases (wetting eczema, pemphigus)
• second half of pregnancy

Occurrence
In Russia and the countries of the former USSR, these waters are located in Nalchik, Goryachinsk, Abastumani, Tskaltubo, Kuldur, Severobaikalsk (Dzelinda) and others. In European countries: many in Bulgaria, Pyrenees in France, Wilbad and Wissenbad in Germany, Londek in Poland, Gastein in Austria, Janské Lazne in the Czech Republic.

Oxygen baths.

The effect of oxygen baths
They enhance excitation processes in the central nervous system (which sometimes leads to increased irritability and worsened sleep), cause shifts in the buffer system towards the predominance of hydrogen ions, which enhances lung ventilation, improve bronchial conductivity, deepen respiratory movements due to increased external respiration, increase the level of oxidative processes , reduce the arteriovenous difference in oxygen content.

Application

Basically, as a procedure that calms the nervous system in various diseases accompanied by an increase in its excitability (menopause, Graves' disease, hypertension in the initial symptoms of circulatory failure), in myocardial diseases (myocardiosclerosis, myocardial dystrophy), valvular heart defects with NC no more than the first degree, stage I-II headache in the absence of pronounced crises and damage to the blood vessels of the brain, kidneys, heart, hypotension, neuroses without a predominance of excitation processes, ovarian hypofunction.

Contraindications.

General for baths.
Bath temperature is 34 - 36 degrees, time is 15 minutes, baths are taken daily, the course is 25-30 baths.

• The basis is the water of the Khadyzhensk resort.
• 1 l. Water - 250 g. Potassium bromide, 100 g. sodium iodide (in a dark bottle) - stored for 7 days.
• For 200 l. water 2 kg. table salt
• + 100 ml. solution from a bottle.
• 35-37 degrees, 10-15 minutes, every other day, 2 in a row with a rest on the 3rd. 15-20 procedures.
• Irrigation - 39g, 10l.

Mechanism of action

Balneotherapy uses salty baths from water from bromine-iodine-chloride-sodium sources. Compared to fresh water, the effect of these waters is enhanced by the presence of sodium chloride, bromine and iodine ions. The therapeutic effect is exerted by iodine and bromine ions at a concentration of 10 mg/l and 25 mg/l, respectively. The penetration of bath salts through the skin has not been proven, but salts increase skin irritation caused by temperature and mechanical factors. The effect of salts deposited on the skin continues even after leaving the bath.

Iodine primarily affects the activity of the thyroid gland. Together with the blood flow, it is delivered to the follicles of the organ and stimulates the production of active hormones - thyroxine and triiodothyronine. These substances activate the formation of proteins and the burning of lipids in the body, which leads to increased regenerative processes and normalization of fat metabolism. Thanks to the latter factor, the content of high-density lipoproteins in the blood of patients increases, which prevents the deposition of harmful cholesterol on the walls of blood vessels.

In addition, iodine ions increase blood fluidity, improving its passage through narrow capillaries. As a result, nutrients and oxygen begin to be delivered even to the most secluded corners of the organs. Patients experience pain relief and overall well-being improves.

In the cerebral cortex, iodine inhibits excitation processes, having a sedative effect on patients with neuroses and more serious mental disorders.

Bromine also has pronounced calming properties. Penetrating into the structures of the brain, it enhances inhibition processes. After completing the course, patients note a decrease in irritability, a decrease in headaches and improved sleep.

By blocking the conduction of nerve impulses in the skin, bromine ions cause a weakening of pain and tactile sensitivity. Itching and burning caused by allergic reactions begin to be felt to a lesser extent. Due to the deposition of salts in the dermis, this effect persists for a long time after completion of therapy.

Salt baths have a more pronounced thermal and hydrostatic effect, have an analgesic effect, stimulate metabolic processes, promote the resorption of inflammatory exudate, and cause significant hemodynamic changes in the body, therefore, in case of cardiovascular diseases, they should be prescribed with caution.

Application.

• Salt baths are used for diseases of the musculoskeletal system, peripheral nervous system, metabolic disorders, and gynecological diseases.
• Diseases of the PNS (radiculitis), central nervous system - analgesic effect, normalization of muscle tone, normalization of the ANS.
• Improvement of central hemodynamics.
• Cardiovascular diseases: ischemic heart disease, hypertension 2A, AS.
• Diseases of the musculoskeletal system, with allergic dermatitis.
• Salpingoophoritis (normalization of the anterior lobe of the pituitary gland).
• Obesity, skin diseases (antipruritic effect).

Contraindications.

Everyone who has ever visited Essentuki knows about mineral water baths. But not everyone fully understood their features. What makes mineral baths so popular, what effect do they have on the body, and what indications and contraindications are there for their use? Let's try to look at all this in more detail with photos.

Purpose and features

Let's start with the fact that pearl or carbon dioxide mineral treatment improves blood circulation. Namely, it is one of the main functional features of the body. Poor blood circulation often causes serious diseases not only of the cardiovascular system, but also of internal organs. This is because our blood is a conductor of nutrients to all organs and parts of the body. It is the blood that carries oxygen to all systems, receiving it from the air. Therefore, stimulation of good blood circulation is the very basis on which treatment with mineral baths is based.

A pearl or carbon dioxide mineral bath is a reservoir filled with liquid - mineral water and additional elements that, through this water, carry the necessary substances for a person through his skin.

Indications for mineral baths are as follows:

• endocrine diseases (even a mild form of diabetes, but consultation with a specialist is important);
• some cardiovascular diseases;
• gynecological abnormalities;
• dermatitis;
• diseases of the musculoskeletal system;
• arthrosis;
• varicose veins;
• diseases of the central nervous system;
• ailments of the digestive system.

Attention! Under no circumstances should you start taking mineral baths without a doctor’s advice! Like any health procedures, they must be supervised by specialists and prescribed only when indicated, despite all their beneficial properties!

There are also contraindications for mineral baths. Moreover, despite the large list of indications, there are many reasons to refuse their use (this is confirmed by patient reviews), namely:

• allergic reactions to bath components;
• neuroses, especially of moderate and severe severity;
• arterial hypertension;
• presence of peptic ulcers;
• previous injuries, especially to the head;
• pregnancy;
• some stages and types of cancer;
• renal failure;
• candidiasis;
• acute viral infections (at the peak of the disease);
• eczema and open skin wounds.

Otherwise, taking carbon dioxide or pearl baths helps strengthen the body. Their course can be prescribed even to a healthy person as a means of relieving stress and an auxiliary way to improve overall well-being - their beneficial properties are so good.

Sanatoriums

It is important to note that when heading to Essentuki or Crimea, it is worthwhile to undergo a course of examination and obtain a medical opinion about your state of health. Many specialized institutions require a medical examination of the patient before admission for a preventive period.

Among the health treatments that the Vorovsky Sanatorium offers its patients, mineral baths occupy a special place. They speed up metabolic processes, improve blood circulation, help cleanse the body and remove toxins. In hot water, the pores open as much as possible and blood flow increases, due to which minerals penetrate better into the body and tissues are enriched with oxygen.

Indications for the procedure

Mineral water baths at the Vorovsky Sanatorium are prescribed to patients in the following cases:

• For skin diseases to accelerate regeneration processes. A course of treatment significantly alleviates the symptoms of acute eczema, psoriasis, neurodermatitis, furunculosis, and scleroderma.
• To relieve pain. Thanks to the salts and minerals dissolved in water, tactile sensitivity is reduced, the musculoskeletal system is unloaded, which helps reduce pain in the muscles, spine, and joints due to osteochondrosis, arthritis, and radiculitis.
• For nervous and mental disorders, depression, chronic fatigue syndrome, headaches. Immersion in warm water reduces the level of stress hormones (adrenaline, cortisone, norepinephrine) in the blood.
• For cardiovascular diseases (initial stages of atherosclerosis, stage I and II hypertension, chronic venous insufficiency, etc.). The procedures help improve blood circulation, the outflow of venous blood from the periphery to the heart, and reduce its viscosity.

Contraindications

Taking mineral water baths may not be beneficial for all patients. Procedures are not prescribed if a person has:

• individual intolerance to bath components;
• severe form of diabetes mellitus;
• open wounds;
• fungal infection;
• weeping dermatitis;
• tuberculosis;
• pregnancy;
• renal failure, etc.

After a course of therapeutic mineral baths at the Vorovsky Sanatorium, the immune system is strengthened, sleep improves, and chronic ailments recede for a long time. Returning home, people will feel rested and rejuvenated.

- baths from natural mineral water with a total mineralization of at least 2 g/l, containing various gases, microelements, biologically active substances, etc., as well as from artificially prepared mineral and gas waters. Unlike fresh mineral water baths, in addition to temperature and mechanical effects, they also have a chemical effect on the body, which is perceived by exteroreceptors embedded in the skin, and when some ions, trace elements and other components of mineral water penetrate into the body and on the interoceptors of blood vessels and internal organs.

Sulfide baths

For a long time, sulfide baths were classified as gas baths (A. A. Lozinsky, 1910; V. A. Aleksandrov, 1932; I. A. Valedinsky, 1934, etc.). However, from the point of view of assessing the physiological effect of a gas bath on the body as a kind of two-phase medium - water - gas, this is incorrect.

The high solubility of hydrogen sulfide in water prevents the formation of the applied concentrations of the free gas phase (emission of gas bubbles) in sulfide baths, as occurs in carbon dioxide, oxygen and nitrogen baths. Since there are no gas bubbles in the bath, there is no effect of gas on the skin. In sulfide baths, only the pharmacological effect of sulfides is manifested, and therefore they are more correctly classified as mineral.

Sulfide waters are considered to be those waters that contain sulfides (total hydrogen sulfide) more than 10 mg/l. The healing properties of sulfide waters have been recognized by medical science and practice. The resorts of Sochi—Matsesta, Talgi, Ust-Kachka, Klyuchi, Sergievskie Mineral Waters, Kemeri, etc. are very popular; They are visited annually by a huge number of patients.

Outside resorts, as well as in resorts that do not have natural sulfide waters, artificial sulfide baths, which are prepared chemically, are increasingly being used.

A chemical method for preparing artificial sulfide water was developed at the Central Research Institute of Balneology and Physiotherapy by chemist P. N. Paley (1956). Sochimatsestinsky natural water was taken as a standard for the preparation of such water as it was the most studied.

In subsequent practice, P. N. Paley’s method was somewhat simplified in order to make the preparation of artificial sulfide baths more accessible and feasible in various medical institutions. Below are recipes recommended by Ya. A. Shevtsov and tested by long-term practice for preparing sulfide baths of various concentrations.

Recipe 1. To prepare a bath for 200 liters of sulfide water of the Matsesta type with a total hydrogen sulfide content (free and bound) of 150 mg/l, you need: sodium sulfide (in 100% terms of a chemically pure substance) 71 g, sodium bicarbonate (bicarbonate of soda) 54 g , technical hydrochloric acid (density 1.14) 190 ml, table salt 1520 g.

In this case, sulfide water is obtained with the following properties: alkalinity 8.2 mg-eq/l, total hydrogen sulfide content 150-155 mg/l, pH 6.95.

Recipe 2. To prepare a bath for 200 liters of Matsesta type sulfide water with a total hydrogen sulfide content of 100 mg/l, you need: sulfide/sodium (in 100% chemically pure substance) 47 g/sodium bicarbonate 27 g, technical hydrochloric acid (density 1 ,14) 1 ml, table salt 1020 g.

In this case, sulfide water is obtained with the following properties: alkalinity 6.8 mg-eq/l, total hydrogen sulfide content 100 mg/l, pH 7.

Recipe 3. To prepare a bath for 200 liters of sulfide water of limited mineralization (without the use of soda and salt) with a total hydrogen sulfide content of 150 mg/l, you need: sodium sulfide (in 100% terms of a chemically pure substance) 70.9 g, commercial hydrochloric acid ( density 1.14) 120 ml.

In this case, sulfide water is obtained with the following properties: alkalinity 7 mg-eq/l, total hydrogen sulfide content 153 mg/l, pH 6.8-6.9.

Recipe 4. To prepare a bath for 200 liters of sulfide water of limited mineralization (without the use of soda and salt) with a total hydrogen sulfide content of 100 mg/l, the following is required: sodium sulfide (in 100% terms of a chemically pure substance) 47 g, commercial hydrochloric acid (density 1 ,14) 96 ml.

In this case, sulfide water is obtained with the following properties: alkalinity 5.4 mg-eq/l, total hydrogen sulfide content 102 mg/l, pH 6.8-6.9.

As Ya-A. Shevtsov points out, when preparing artificial sulfide water according to the given recipes, you must be guided by the following.

To prepare sulfide water, you can use any water (tap, river, sea), which is preheated to the required temperature (indicated by your doctor).

Before starting to prepare water (necessarily once a day - at the beginning of work), its alkalinity is determined (the calculation of soda in recipes is given at a water alkalinity of 4.1 mEq/l; for other alkalinities, the amount of soda required is changed, determining it according to the corresponding tables, given below).

To calculate the amount of sodium sulfide solution required to prepare a sulfide bath, determine its percentage in the main solution. The determination is made by iodometric titration or by density; Knowing the percentage of sodium sulfide in the main solution, it is easy to calculate how much sodium sulfide solution in milliliters is required for one bath.

When preparing a sulfide bath with a total hydrogen sulfide content of 100 mg/l, 110 ml of hydrochloric acid with a density of 1.14 is required, and with a total hydrogen sulfide content of 150 mg/l—190 ml; if the density of hydrochloric acid is different, then its quantity per bath should be different.

We present tables developed by Ya. A. Shevtsov (1957) for calculating the amount of raw materials required for a bath (Tables 4-8).

Table 4. Calculation of the required amount of hydrochloric acid per bath

Table 5. Calculation of raw materials for a bath of 200 l of water at a sulfide concentration of 150 mg/l (for recipe 1)

Table 6. Calculation of raw materials for a bath of 20 (C water at a sulfide concentration of 100 mg/l (for recipe 2)

Table 7. Calculation of raw materials for a bath of 200 l of water at a sulfide concentration of 150 mg/l (for recipe 3)

Table 8. Calculation of raw materials for a bath of 200 l of water at a sulfide concentration of 100 mg/l (for recipe 4)

When using the given tables 4-8, it is necessary to take into account that sodium sulfide in solution at a concentration above 19% and a temperature below 15 ° C crystallizes and is released as a precipitate. If a precipitate forms, the concentration of the solution should be slightly reduced by adding a certain amount of water.

The sodium sulfide solution most convenient for preparing sulfide water is a 10-18% solution (the optimal concentration is 15-16%, which corresponds to a density of 1.125-1.134).

Technique for preparing artificial sulfide water. Medicinal sulfide water can be prepared manually (directly in the bath) and mechanized centrally (in special large containers, from where the finished water is supplied through a pipeline to the baths). First, basic (working) solutions of sodium sulfide and hydrochloric acid are prepared; Using these solutions, baths are prepared. It is not necessary to prepare working solutions from soda and table salt, which are relatively easily dissolved.

When preparing a bath manually, they are added in appropriate weight quantities (pre-packaged) directly to the bath water.

Technique for preparing basic solutions (according to Ya. A. Shevtsov). Sodium sulfide solution. Technical sodium sulfide, crushed into small pieces, is weighed out in an amount of 7-8 kg, poured into an iron tank with a capacity of 35-40 liters, and then 20-25 liters of water at a temperature of 70-80 ° C are gradually poured into it and mixed using a stirrer, which is driven powered by a small electric motor. Stir thoroughly until sodium sulfide is completely dissolved (20-30 minutes); The higher the water temperature, the faster and better the sodium sulfide dissolves.

The completely cooled sodium sulfide solution is poured from the tank into a large glass bottle with a capacity of 20-25 liters, in which it settles for 12 hours or more, becoming transparent, as impurities settle to the bottom. You can leave the sodium sulfide solution in the tank in which it was dissolved, if after settling it is possible to organize a careful pumping of the solution from the tank into a clean bottle so that the slag remains at the bottom of the tank untouched and does not get into the solution; This is best done using a siphon.

The settled, clear solution of sodium sulfide is poured into working bottles using a siphon, from which portions of the solution are measured for each bath. It is advisable to have a special tube, which makes it easier to measure dosed portions. When measuring the solution in portions, it is very important to ensure that it remains clean and transparent, since the turbidity of the solution affects the color of the water in the bath and contaminates not only the bath, but also the patient’s skin.

The sediment that has settled to the bottom of the bottle is buried in a special hole, since sodium sulfide waste can cause poisoning in animals and burns in people.

Taking into account that the sodium sulfide solution easily oxidizes, it should not be prepared for more than 6-7 days. Store the solution in well-sealed bottles.

When the preparation of the solution is completed, it is necessary to determine the content of sodium sulfide in it (in percent) or its relative density.

Hydrochloric acid solution. Technical hydrochloric acid is used in practice undiluted. It should be poured into a working bottle with a capacity of 8-10 liters (with a lower tube), from which, as necessary, acid is poured (per bath) into glass jars with a capacity of 0.5 liters.

Strong hydrochloric acid emits suffocating fumes of hydrogen chloride. Therefore, a measured portion of acid per bath should be diluted with a small amount of water. Such portions of acid diluted with water are poured into the bath when preparing it.

Working bottles with concentrated hydrochloric acid are stored in a fume hood, and in its absence, it is necessary to especially carefully ensure that bottles with hydrochloric acid are always hermetically sealed with a stopper and tied with a cap made of oilcloth or plain fabric. The acid is kept well sealed in a fume hood. Hydrochloric acid is also poured into portions in a fume hood.

You can use solutions of hydrochloric acid that are prepared in advance. This somewhat complicates the calculations and is less conducive to the formation of hydrogen sulfide and carbon dioxide in the bath, but it eliminates the release of hydrogen chloride vapor when adding undiluted acid to the bath. A solution of hydrochloric acid is prepared as follows: pour water into a glass bottle with a capacity of 25-30 liters, and then add acid through a funnel in accordance with the recipes and auxiliary tables to them.

It is more convenient to use undiluted hydrochloric acid, as this promotes dosage accuracy, eliminates errors in calculations, saves time, and frees the laboratory from unnecessary bulky glassware.

Technique for preparing sulfide baths. 200 liters of water at the required temperature (35-37°C) are poured into the bath and the appropriate amounts (see calculations) of sodium bicarbonate, sodium sulfide and hydrochloric acid are added in a strictly defined sequence, stirring the water evenly all the time. If you set out to prepare an exact analogue of Matsesta water, then add table salt. In this case, the preparation of the bath begins by placing salt in it in a sieve or canvas bag, through which hot water is passed. Then add the required amount of cold water to the bath (up to 200 l) until the water reaches the specified temperature. After this, all other chemical ingredients are added in the same sequence as indicated above.

In hydrogen sulfide hospitals with a capacity of more than 100 patients per day, the most convenient, reliable and economical method of preparing sulfide water is mechanized, in which the water is prepared centrally. In this case, the chemicals necessary for preparing sulfide water are mixed not in the bath itself, but in large containers. Thus, at the Central Research Institute of Balneology and Physiotherapy, artificial sulfide water is prepared in a special sulfide workshop, in which most of the technological process is automated. The presence of 4 vinyl plastic tanks with a capacity of 6 m3 allows you to have 4 different concentrations of sulfide water - 50, 100, 150 and 200 mg/l. From the tanks, water of the specified concentrations is supplied to the baths through vinyl plastic pipes (which do not corrode, despite the aggressive effect of hydrogen sulfide).

Sulfide waters are used in the form of general and local (hand and foot) baths, irrigations, microenemas, douching, inhalations, etc.

Method of treatment with sulfide baths. The most common treatment method is the following: water temperature 35-37°C, bath duration from A to 12 minutes, sulfide concentration 50-100-150 lg/l; baths are carried out every other day or 2 days in a row with a break on the 3rd day. A total of 12-14 baths per course of treatment.

With a gentle treatment method, the duration of the bath is from 5 to 10 minutes, the concentration of sulfides is 50-75 mg/l; for a course of treatment 10-12 baths. With the intensive method, the bath duration is 8-15 minutes, the sulfide concentration is 100-200 mg/l; for a course of treatment 12-15 baths.

Local baths are carried out at a water temperature of 36-38°C, lasting 10-20 minutes, daily or every other day, for a course of treatment 12-20 baths.

After taking a sulfide bath, the patient must rest (preferably lying in the rest room) for at least 20-30 minutes, continuing to rest in the ward or at home (for outpatient treatment) for 1-172 hours.

Based on the concentration of water, they are divided into: 1) weakly sulfide from 10 to 50 mg/l (Pyatigorsk, Khilovo, etc.); 2) average—from 50 to 100 mg/l (Mendzhi, Psekupsk, etc.); 3) strong - from 100 to 250 mg/l (Matsesta, etc.); 4) especially strong - over 250 mg/l (Matsesta, Talgi, Ust-Kachka, etc.). The main active factor determining the specificity of the effect of sulfide waters on the body is sulfides, which enter the body mainly through the skin, and to a lesser extent through the respiratory tract. Free hydrogen sulfide and hydrosulfide ions pass through the skin. Their entry into the body is greater, the higher the concentration of hydrogen sulfide in water, the area of ​​skin exposed, and the duration of the procedure (S. Ya. Kaplun, 1965; E. G. Kopteva, 1967; A. A. Buyuklyan, 1972, etc. .). Circulating in the blood for some time, hydrogen sulfide overcomes natural and biological barriers (liver, blood-brain barrier) and is found in the cerebrospinal fluid in free and bound form. Hydrogen sulfide, being an active pharmacological agent, has a reflex-resorptive effect on various organs, systems and functions of the body. Central and peripheral nervous structures are especially sensitive to hydrogen sulfide. The normalizing effect of sulfide baths on the functional state of the higher parts of the central nervous system has been established, which is based on changes in the biopotentials of the cerebral cortex, as well as the excitability thresholds of skin receptors and sensory nerves (K. D. Gruzdev, 1956; F. D. Vasilenko, 1957) . Sulfide baths excite carotid chemoreceptors, influencing through them the function of the endocrine glands and the level of metabolism (V. E. Ryzhenkov, 1958, 1959). An important factor in the mechanism of action of sulfide baths are changes in mediator metabolism that occur due to the formation of vasoactive substances in the skin (histamine, acetylcholine, etc.). The nature and severity of the body's responses to the action of sulfide water depend on the amount of sulfides entering the body. Large quantities of them cause toxic effects. Sulfide baths have a pronounced effect on the cardiovascular system, manifested by skin hyperemia, which is based on the expansion of capillaries, subcapillary veins and precapillary arteries. The speed of blood flow and the amount of circulating blood increase, the stroke and minute volume of blood increases, and the pulse slows down. Breathing slows down and becomes deeper. Being an energetic reducing agent by its chemical nature, hydrogen sulfide easily enters into redox reactions in the cells of the body, primarily with the oxidized form of proteins, enzymes and other biosubstrates. As a result, the number of free sulfhydryl groups increases, the physicochemical and biological activity of high molecular weight proteins, enzymes, protein hormones, as well as low molecular weight compounds (glutathione, etc.) increases; all this leads to an increase in energy resources in tissue cells, including the heart muscle. In experimental atherosclerosis, hydrogen sulfide entering the blood from bath water increases the amount of reduced and reduces the amount of oxidized forms of proteins, as a result of which the activity of the pentose cycle decreases and, accordingly, a decrease in the biosynthesis of fatty acids and cholesterol occurs; the activity of cytochrome oxidase, lipase and other enzymes in animal tissues increases; the metabolism of mucopolysaccharides is normalized. This is the inner, deep side of the mechanism of action of sulfide baths on the body of healthy animals and animals with experimental atherosclerosis. Currently, the dependence of phosphorus metabolism, enzymatic processes, osmotic resistance of erythrocytes, etc. in experimental myocarditis has been established and it has been shown that a positive effect is achieved at average concentrations of sulfides in water. The degree of increase in the level of 17-OX in the blood plasma increases as the concentration of sulfides increases (from 50 to 150 mg/l) during the course of treatment. After treatment with baths with a sulfide concentration of 300 mg/l or more, a decrease in this indicator is observed. The latter indicates inhibition of the function of the adrenal cortex - a decrease in the adaptive capabilities of the body, which usually occurs when the action of strong (“extraordinary”) stimuli is combined. These data indicate that baths with sulfide concentrations of 300 mg/L or more should be used with caution. Favorable changes in the level of redox processes, central and peripheral hemodynamics, immunological reactions of the body under the influence of sulfide baths of medium concentration make it possible to widely use these procedures in the treatment of many pathological conditions and, above all, diseases of the cardiovascular and nervous systems, musculoskeletal system, female genitalia, skin diseases, chronic intoxication with salts of heavy metals (lead, mercury), toxic polyneuritis, encephalitis, etc.

In connection with the deepening of knowledge about the mechanism of action of sulfide waters on the body, the indications for prescribing sulfide therapy in recent years have been revised and changed towards expansion in some forms of atherosclerosis of the cerebral and coronary vessels, in particular in the form of local procedures they are prescribed in the near future (1, 5-2 months) after some forms of myocardial infarction, cerebral stroke; for chronic sluggish diseases of the liver, gall bladder and bile ducts (during the interictal period) (V. A. Ivanov, 1952; 3. S. Melnitskaya, 1976; E. I. Sorokin, 1976, etc.).

Contraindications: in addition to general contraindications to hydrotherapy, sulfide therapy is contraindicated in patients with advanced atherosclerosis of the vessels of the heart and brain; after repeated myocardial infarction; patients with a recurrent form of myocardial infarction, as well as an aneurysm complicated in the acute period by a severe course (cardiogenic shock, severe cardiac arrhythmias); patients with hypertension stage BE and above; patients with circulatory insufficiency exceeding degree I, patients with severe frequent attacks of angina pectoris; with chronic diseases of the liver and biliary tract, who have experienced an exacerbation of the disease over the past year, and some others.

It must be taken into account that in the practice of sulfide therapy there are cases of so-called poor tolerance to sulfide baths, associated with the toxic-allergic effect of sulfides on the body. Moreover, they are observed not only when patients receive baths of high concentration, but also when baths containing sulfides of 100-150 mg/l, and occasionally even with a very low concentration of sulfides (50 mg/l). L. 3. Sterninson et al. (1975), when analyzing cases of “poor tolerance” that occurred in Matsesta hospitals, found that pathological abnormalities in the body of patients can be mild, moderate and severe. K.F. Nikitin believes that the main reason for the toxic effects of sulfides is the excess concentration of hydrogen sulfide in the air."

As is known, two phases are distinguished in the mechanisms of the toxic effect of sulfides on the body. The first is the excitation phase. It is caused by reflexogenic influence from the sinocarotid zone. During this phase, shortness of breath, hypertension, erythrocytosis, hyperglycemia, etc. are observed. The second is the phase of paralysis; characterized by depression of the respiratory and vasomotor centers and is the result of the direct effect of sulfides on the centers.

In addition to the sometimes completely undesirable adverse effects on the body, sulfide water, being an aggressive environment, can very quickly render hospital equipment and communications unusable. Hydrogen sulfide released into the air can pollute neighboring rooms.

All of the above must be taken into account when constructing and organizing hydrogen sulfide hospitals. The latter should be placed in a separate building or isolated compartment of the building. All rooms of hydrogen sulfide hospitals must have good supply and exhaust ventilation, ensuring a minimum content of hydrogen sulfide in the air, not exceeding 10 mcg per 1 liter of air.

When studying the composition and physico-chemical properties of hydrogen sulfide waters, especially highly concentrated ones, and the balneotechnical conditions of their operation, measures should be strictly taken to ensure that the concentration of hydrogen sulfide in the air of bathroom buildings when taking such baths is reduced to acceptable harmless values, while ensuring a constant concentration of sulfides in the bath, as well as preserving the natural composition and natural properties of sulfide mineral waters.

The ventilation system and sewage system of hydrogen sulfide hospitals are isolated from other premises. Wall decoration, water and sewer pipes, as well as equipment must be made of materials resistant to hydrogen sulfide. The staff is specially trained; When working, you must follow a number of absolutely mandatory rules.

Slag baths

Slag baths are used for medicinal purposes in some regions of the USSR (Donbass, Dnepropetrovsk, Tula, etc.), where there is metallurgical production. The hot slag formed during cast iron smelting is collected in special containers (granulation basins) to be “quenched” with cold water. In water, sulfur compounds are leached from slag and go into solution, forming so-called slag waters of a pronounced alkaline reaction (pH 8.8-9.6). The chemical composition of slag waters is not constant. It depends on the quantity and quality of the slag, as well as on the quality of the coal poured into the blast furnace, which contains sulfur compounds in larger or smaller quantities.

Dnepropetrovsk slag waters are thiosulfate-calcium sulfate waters, which in other places are called sulfur-slag, blast furnace-slag, granulation waters.

The pronounced alkaline reaction of slag waters excludes the possibility of the presence of free hydrogen sulfide in them in any significant quantities.

The main components of slag water are thiosulfates and calcium ions. They contain hydrogen sulfide only in the form of sulfides, i.e. in a bound state, and therefore the identification of slag waters with sulfide waters and attributing to them the medicinal properties of hydrogen sulfide waters is incorrect. In the action of slag waters on the skin, the main role belongs to the hydrosulfide ions contained in them in large quantities during their alkaline reaction.

Slag baths are prepared by mixing hot (fresh) slag water with pre-cooled water stored in special tanks to obtain water at the required temperature.

Slag waters are used in the form of general and local (hand, foot) baths. General baths at a temperature of 35-37°C, lasting 10-12-15 minutes, are carried out every other day, local baths at a temperature of 36-38°C, lasting 12-15-20 minutes, daily or every other day. In total, the course of treatment includes 10-15 general or 15-20 local baths.

Slag baths are effective for diseases of the musculoskeletal system (joints, muscles, tendons), for damage to the peripheral nervous system (radiculitis, neuritis, neuralgia, polyneuritis, plexitis, etc.), for functional disorders of the nervous system, diseases of the cardiovascular system , diseases and some skin diseases.

Sodium chloride (salt) baths

Sodium chloride waters have been used in balneological practice for a long time. However, the issue of studying the essence of their physiological and therapeutic effects on the body has not been given enough attention.

The categorical assertion of a number of domestic and foreign scientists at one time that intact skin is impenetrable to salts dissolved in water was to some extent the reason for the long-term loss of interest in studying the effect of sodium chloride baths on the body. At the same time, the statement made by V. A. Manassein2, which was very correct, in our opinion, was not taken into account at all: “If the skin does not absorb, then, in any case, by changing the conditions of blood circulation and partly heat in it, increasing or decreasing the secretion of sweat and exposing depending on the special purpose, now this or that thermal or mechanical stimulation, you can produce very significant, closely interconnected changes in the work of the heart, the activity of the nerves, the formation and regulation of heat, the separation and properties of digestive juices and metabolism.”

The range of diseases for which these waters are used was limited to a few nosological units. The hydrogeological reserves of sodium chloride waters and their chemical composition, patterns of formation and distribution have not been sufficiently studied. The need for a wider and more rational, scientifically based use of sodium chloride waters in medical practice was dictated by life itself, since these waters are widespread in nature, their artificial analogues are easily reproduced in any medical institution, the chemical composition of many natural sodium chloride waters is similar (in qualitatively) with the ion-salt composition of organs and tissues of a living organism.

Clinical and experimental studies on this problem were carried out at the Central Research Institute of Culture and Physiotherapy and other institutes (Sverdlovsk Institute of Balneology and Physiotherapy, Tomsk Medical Institute), as well as at a number of resorts in the country (Druskininkai, Ust-Kachka, Staraya Russa, Chartak, etc.).

The study of the distribution, composition and resources of chloride waters of the USSR (G.N. Plotnikova, 1974) based on literature data and stock materials made it possible to strictly document the position known to balneologists that these waters within the Soviet Union have an extremely wide - regional - distribution. They make up the bulk of underground mineral waters and occupy more than 60-70% of the entire territory of the USSR.

Based on the chemical composition of the waters under consideration, the following main groups are distinguished.

Sodium chloride, less often calcium-sodium with mineralization from 2 to 35 g/l.

Sodium chloride and calcium-sodium brines with mineralization from 35 to 350 g/l.

Chloride calcium-sodium, calcium, and less often calcium-magnesium ultra-strong brines with mineralization from 350 to 600 g/l.

The formation of chloride waters with a salinity of up to 35 g/l (and somewhat more) is explained by their formation in sea basins of normal salinity; the origin of brines up to 150 g/l is associated with the dolomite and gypsum stage of halogenesis; strong brines up to 350 g/l - with the halite stage of salt loading; ultra-strong brines with a mineralization of 350-600 g/l, enriched in Ca, Mg, K, Br, Bo, and often Fe, apparently represent the residual brine of ancient salt basins. Some sodium chloride brines (mostly of high concentration) are formed as a result of leaching of halogen deposits by infiltration waters.

In accordance with the general geothermal regime of the subsoil, chloride waters at depths of more than 1000 m are usually thermal (temperature > 35°C).

The statistical reserves of chloride waters and brines on the territory of the USSR are expressed in hundreds of thousands of cubic kilometers and, in practical terms, are inexhaustible. However, in different basins they are characterized by different hydrogeological parameters and are of different value for practical use.

In the USSR, the main areas of distribution of sodium chloride waters have been identified, constituting 4 basins with different flow rates, mineralization, composition, and temperature; self-flowing and without self-flowing. Promising areas for further resort development have been identified. These include Western Siberia, the Kuroarak lowland, abounding in self-flowing thermal iodine-bromine waters, as well as the European part of the Union (Northwestern and Central regions). Currently, 48 resorts and 32 hospitals are already operating using sodium chloride water. There are 11 bottling plants. 16 boreholes have been drilled in Moscow and the Moscow region alone. A number of trade union and departmental sanatoriums in the Moscow region operate wells with sodium chloride water, including “Dorokhovo”, “Zvenigorod”, “Porechye”, “Monino”, “Ereno”, “Istra”, etc. In the courtyard of the Central Scientific Research Institute of Kiev, two types were obtained by drilling natural water - sodium chloride mineralization 120 g/l, used for external use (diluted with tap water to the required concentration for therapeutic use), and sodium-magnesium-calcium sulfate mineralization 4 g/l - for drinking treatment, lavage - intestinal irrigation, inhalation etc.

Analysis of the data obtained in recent years allows us to get a clearer picture of the mechanism of action of sodium chloride waters. The main effect of these waters on the body is the salts dissolved in them. Even earlier, balneologists (L. Bertenson, 1902; A. A. Lozinsky, 1949) noted that in the mechanism of action of sodium chloride waters on the body, a significant role is played by the so-called salt cloak, which forms on the skin during the procedure and determines the reflex reactions of the body not only during it, but also in the aftereffect period.

Work carried out in recent years has established that sodium chloride waters, when applied externally in the form of baths, have a unique, unique effect, which manifests itself in many ways and depends on the concentration and temperature of the water in the bath, as well as on the initial state of the body. It was revealed that, in addition to the general reflex effect of the chemical composition of water that irritates the skin, local changes are also important in the mechanism of action of sodium chloride baths - pronounced functional changes in the receptor apparatus of the skin of humans and animals, as well as in the cellular elements and blood vessels of the skin. Depending on the concentration (10-100 g/l), changes occur in the skin, starting with proliferative processes and ending with necrosis. Baths with a concentration of 60 g/l in intact animals cause an increase in high-energy phosphorus compounds in the tissues of the heart, liver and skeletal muscles, which indicates stimulation of the synthesis of ATP and creatine phosphate and the accumulation of energy resources in the tissues of these organs. Destructive changes in the skin can be a consequence of an overdose not only in terms of the concentration of salts in the water, but also in the frequency of procedures over time. For example, they were found in animals that received treatments daily, and at the same time they were not present in those that received baths for two days in a row with a break on the 3rd day. In animals with initial manifestations of atherosclerosis, a change in the content of norepinephrine in the adrenal glands was found: its increase indicates the influence of baths on the process of catecholamine biosynthesis in the adrenal medulla. Medium concentrations of baths increase the excitability of the central nervous system and endocrine apparatus (pituitary gland, adrenal glands, thyroid gland). The use of the stereotactic method showed that sodium chloride baths at a concentration of 60 g/l cause a generalized reaction in various parts of the brain, enhancing the processes of excitation and inhibition. Baths with a concentration of 30 g/l qualitatively change the relationship between the cerebral cortex and the hypothalamus, with the bioelectrical activity of the anterior part of the latter (parasympathetic) increasing, and the posterior (sympathetic) decreasing. Baths of sodium chloride iodide-bromine water in a course of use in animals with experimental atherosclerosis in the initial stage inhibit the development of the process and lead to a decrease in the concentration of organ-specific antibodies (S.I. Serov et al., 1975). Here, apparently, the influence of the iodine component is also evident, which is confirmed by the activation of the process of adrenaline biosynthesis in the adrenal glands and the inhibition of the oxidative breakdown of catecholamines, identified in animals with experimental atherosclerosis during a course of artificial iodine-bromine baths. In works with age-related endocrine models of atherosclerosis, the interest of neuroendocrine regulation in the mechanism of the inhibitory effect of sodium chloride iodine-bromine waters on the development of the pathological process has been revealed. A study of the effect of sodium chloride baths with a concentration of 50 g/l, temperatures of 42°C, 25-30°C and 36-37°C on the thermal metabolism of healthy people showed that their thermal effect differs significantly from the effect of fresh and other mineral and gas baths. From a hot sodium chloride bath, an average of 11.9 kcal/min enters the body (from a fresh bath 8.3 kcal/min), while blood supply to the skin increases by 6.1 l/min (in a fresh bath by 4.8 l/min ). The study of the physiological and therapeutic effect of sodium chloride baths in the clinic and experiment made it possible to establish that the minimum concentration at which the specific effect of sodium chloride water begins to manifest itself when applied externally is 10 g/l, at a concentration of 20-40 g/l the effect of water becomes completely distinct, and at a concentration of more than 40 g/l, especially at 60-80 g/l, negative reactions on the part of the cardiovascular, nervous and other body systems often begin to appear.

In patients with chronic venous insufficiency, using the method of measuring the tone of venous vessels according to B. E. Votchal (data from E. V. Savelyeva, 1974), under the influence of sodium chloride baths, the most pronounced increase in the elastic-viscous properties of the walls of venous vessels was established in comparison with all other baths (radon, etc. .). Improving the tonic properties of the venous wall promotes better blood outflow from the extremities. The combination of this effect with a moderate increase in arterial blood flow during these baths represents the optimal option for changing peripheral circulation in the affected limbs in patients with chronic venous insufficiency. At the same time, general hemodynamics improves and an increase in the function of the blood anticoagulation system is observed.

The versatile effect of sodium chloride baths on the body made it possible to expand the indications for their use and clarify the method of application (water temperature, duration of the procedure).

Sodium chloride waters, according to their clinical and physiological effects, can be divided into waters of low concentration - from 10 to 20 g/l, medium concentration - from 20 to 40 g/l and high concentration - from 40 to 80 g/l.

It has now been established that sodium chloride baths, with an adequately selected method and dosage, have a regulatory effect on the functional state of the central nervous system, cause immunological changes in the body, significantly change the course of metabolic processes, etc. Analgesic, anti-inflammatory and desensitizing have been identified effect in patients with degenerative and other joint lesions. It should be assumed that these changes in the body of patients are the result of the stimulating effect of sodium chloride baths on the function of various organs and systems, a consequence of their beneficial effect on adaptation and recovery mechanisms and mechanisms of sanogenesis. Clinical observations have shown that sodium chloride baths have a beneficial effect on the functional state of the cardiovascular system in patients with neurocirculatory dystonia of the hypotonic type, hypertension, rheumatic heart disease in adults and children, etc. The positive effect of these baths on a number of indicators of the functional state central nervous system and hemodynamics (REG, oscillography) are much more pronounced compared to carbon dioxide, radon and sulfide baths widely used in such patients (3. S. Melnitskaya et al., 1970, etc.).

In non-resort settings, artificial sodium chloride baths are now much more widely used, which are prepared by dissolving table (lake or sea) salt in fresh water in the amount necessary to obtain the desired concentration (most often from 10 to 40 g/l, rarely more).

Technique for preparing artificial sodium chloride baths. Table salt (lake or sea salt) is poured into a canvas bag, or even better, into a special sieve, which is placed in a bath under running hot water. As the salt dissolves, add cold water to the bath to the required temperature (35-38°C). In this case, the salt dissolves relatively slowly, but insoluble particles mixed with it do not get into the water.

Baths from natural and artificially prepared sodium chloride water at a temperature of 35-38 ° C are carried out for a duration of 10 to 20 minutes, every other day or 2 days in a row with a break on the 3rd day. In total there are 12-15 baths per course.

Indications; diseases of the cardiovascular system - initial manifestations of atherosclerosis, myocardial and atherosclerotic cardiosclerosis, myocardial dystrophy, rheumatic heart disease in adults and children of the 1st degree of process activity with circulatory failure of the 1st and initial 2nd degrees; stage I hypertension and PA, hypotension, initial manifestations of obliterating vascular diseases of the extremities, varicose veins and postthrombophlebitic syndrome; diseases of the musculoskeletal system - arthritis and polyarthritis of non-tuberculous origin (rheumatic, infectious nonspecific, degenerative-dystrophic, brucellosis, dysentery, etc.); diseases of the spine (spondylosis, spondyloarthrosis, spondyloarthritis - ankylosing spondylosis); diseases and consequences of traumatic injuries to bones, muscles, tendons; diseases of the central (consequences of spinal cord injuries, consequences of polio, etc.) and peripheral nervous systems (plexitis, radiculitis, polyradiculitis, etc.); chronic inflammatory diseases of the female genital organs (uterus, appendages, adhesions after surgery), functional ovarian failure; some skin diseases (psoriasis, neurodermatitis) and other diseases.

The contraindications are the same as for hydrotherapy procedures in general (circulatory insufficiency of II-III degree, severe angina with frequently recurring attacks, stage III hypertension, with a tendency to cerebrovascular accidents, etc.). In addition, a period earlier than one year after septic thrombophlebitis from the moment the temperature normalizes, provided there are no changes in the blood; a period earlier than 2-3 months after the end of thrombophlebitis, which occurred with a short-term increase in temperature, without exacerbations; thrombophlebitis with a tendency to recur or accompanied by progressive inflammatory changes; For patients with chronic venous insufficiency of the legs, chamber foot baths should be considered contraindicated due to the position when taking them, which is unfavorable for venous outflow.

Iodine-bromine baths

“Pure” iodine-bromine waters do not exist in nature. Iodine and bromine ions, along with other trace elements, are most often found in sodium chloride waters, which are widespread in large areas of the Soviet Union, especially in oil-bearing areas. The accumulation of bromine and iodine in natural waters, according to E. V. Iosifova et al. (1968), their assimilation by some marine organisms and sorption of silts, especially peats, by organic matter contribute.

Sodium chloride waters containing iodine always contain bromine. Bromine can occur in these waters without iodine. Its quantity varies within very wide limits (from several units to several thousand milligrams per liter). Depending on the predominance of iodine or bromine in the water, sodium chloride water is usually called iodide-bromine or bromiodine.

The criterion for assessing iodine-bromine water in a medicinal sense, according to V.V. Ivanov, G^. A. Nevraev (1964), is that it contains iodine of at least 10 mg/l and bromine of at least 25 mg/l.

Iodine-bromine waters have been used for medicinal purposes for a long time. Literature data indicate that the healing properties of iodine-bromine waters of the Salsonmaggiore resort (Italy) were discovered more than 100 years ago.

Baths from natural sodium chloride waters containing iodine and bromine are used in our country at the resorts of Ust-Kachka, Khodyzhensk, Maikop, Goryachiy Klyuch, Chartak, Tavda, Talitsa, Turinsk, etc. A large amount of bromine is contained in Moscow sodium chloride water (Boenskaya well - 400 mg/l, well TsNIIKiF - more than 300 mg/l).

Iodine and bromine are usually found in natural sodium chloride waters of high mineralization. When using such water for medicinal purposes, it must be diluted (sometimes many times - 1:6, 1:9) with fresh water. Very often, such dilution leads to a sharp decrease in the content of iodine and bromine. The remaining minimum amount of iodine and bromine goes beyond their content in water, which, in accordance with the current classification, is considered to be medicinal iodine-bromine water. Often these trace elements, especially iodine, completely disappear when diluted. This should be taken into account when assessing the effect of the leading medicinal factor in such diluted waters, so as not to attribute their medicinal role to a microelement contained in a minimal amount or completely absent.

The importance of iodine and bromine ions for the body is difficult to overestimate, since they are biologically active substances and play a huge role in the life of the body. They are part of various organs and tissues, but the largest amount of iodine is found in the thyroid gland, bromine - in the pituitary gland.

The current positive solution by the majority of authors to the issue of penetration of iodine and bromine through intact skin from bath water makes it possible to classify iodine-bromine (bromoiodine) baths as active balneotherapeutic procedures that have a biological effect on the body.

In a broad sense, the effect of bromiodine baths is being studied experimentally and clinically at the Sverdlovsk Institute of Balneology and Physiotherapy (works by S. I. Serov, V. E. Tsitsina, L. A. Kozlova, I. G. Balabanova, I. E. Oransky, etc. .). In the collection of works of the institute “Atherosclerosis and its bromiodine balneotherapy” (1974), published under the editorship of. S.I. Serova, summarizes the results of many years of research devoted to the study of the mechanism of action and therapeutic use of sodium chloride bromiodine waters in atherosclerosis. Experimental and clinical evidence has been obtained of the inhibitory effect of bromiodic water on the development of atherosclerosis.

Clinical and experimental studies have established that iodine-bromine (bromoiodine) baths, by their influence on the leading physiological systems of the body - nervous, cardiovascular, sympathetic-adrenal and pituitary-adrenal, can create favorable conditions for the formation of compensatory-adaptive and restorative reactions of the body and thereby promote if not recovery, then a significant change in the pathological process in many diseases, the pathogenesis of which is based on dysfunction of the central nervous system, metabolic processes, thyroid function, etc. In practice, it has been noted that iodine-bromine baths are a mild irritant. Research has established that they have a physiological effect on the activity of the circulatory system in its various parts. Therefore, with appropriate indications, they are prescribed even to elderly people.

Good results were obtained in the treatment of elderly patients with joint diseases (I. Z. Vulfson, 1965), with initial manifestations of atherosclerosis (L. I. Goldenberg, 1962), thyrotoxicosis (V. X. Shogenov, 1967; G. Ya. Gaidash , 1972), for some cardiovascular diseases (N. G. Khoroshavin, 1968; F. L. Barg et al., 1963), skin diseases (P. M. Zorin, I. A. Telishevskaya, 1964), etc. .

Currently, artificial iodine-bromine baths are becoming increasingly widespread, the preparation method of which was developed at the Central Research Institute of Balneology and Physiotherapy. When preparing them, they take as a basis the composition of the natural mineral water of the Khodyzhensk resort (according to the content of chlorine, bromine and iodine in the latter).

100 g of sodium iodide and 250 g of potassium bromide are dissolved in 1 liter of water. The solution is placed in a dark flask. 200 liters of fresh water at the required temperature are poured into the bath. Add 2 kg of table (lake or sea) salt to this water and stir thoroughly until it is completely dissolved; after this, 100 ml of the prepared solution is poured from a dark bottle. It is better to use a freshly prepared solution. The shelf life of the solution should not exceed 7 days.

Baths at a temperature of 35-37°C, lasting 10-12-15 minutes, are carried out every other day or 2 days in a row with rest on the 3rd day. A total of 15-20 baths per course of treatment.

Indications: iodine-bromine waters are used for a wide variety of diseases of the cardiovascular system, diseases of the nervous and endocrine systems (thyrotoxicosis stages I and II, obesity), musculoskeletal system, female genital area, etc.

Contraindications are general for hydrotherapy.

Various aspects of the therapeutic use of iodine-bromine baths are described in more detail in the book by I. Z. Wulfson “Iodine-bromine waters and their therapeutic use for diseases of the joints” (1973).

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Aromatic bathsRadon baths

Since ancient times, in many parts of the world, people have used healing mineral baths to treat their bodies. Nowadays, such healing baths have become used everywhere, because they can cure many diseases. In addition, such therapeutic water procedures not only heal, but also have a huge healing effect.

Today in our country there are quite a lot of resorts, the medical facilities of which offer dozens of medical procedures. The therapeutic complex of such procedures includes both water and warm mineral water, the mechanism of action of which is quite complex and depends on the mineral composition, the presence of microelements in it, as well as on the method of application.

Therapeutic water procedures involve such effects on the human body as chemical, hydrostatic, thermal, electrical and radiation.

In addition to the external use of mineral waters, resorts also use them internally, with low mineralization and concentration.

The balneological treatment includes hydrogen sulfide, iodine-bromine-chloride-sodium, sulfate-sodium-magnesium-calcium, medium sulfide, and local deposits.

Properties of mineral baths

The effect of such hydrotherapy procedures is very effective, as it manifests itself in the very first minutes. The beneficial properties of mineral baths in patients are manifested as follows: the skin turns red and excess heat appears, metabolism is normalized, spasms of blood vessels and bile ducts are relieved, and the anti-inflammatory and analgesic effect is enhanced, and well-being improves.

Each such water treatment procedure is determined by the temperature of the water, its duration and necessarily individual tolerance. Therefore, there are types of healing baths:

• short cold baths up to +20 C 0
• cool baths up to +30 C 0
• indifferent baths +35 C 0
• warm baths up to +38 C 0
• hot baths above +39 C 0

Depending on the temperature in the bath and the substances-preparations added to the water, healing mineral baths can either be beneficial, soothing, relaxing, toning, as well as healing and even healing.

The benefits and harms of mineral baths

Treatment with hot baths suggests that under the influence of temperature, our pores are opened and cleansed, and the skin begins to breathe. Beneficial substances dissolved in water penetrate into the layer of the epidermis, and then into the blood lymph and into our entire body, providing a healing effect. However, such water procedures involve both benefits and harm.

The benefits of a hot bath are already good because various types of carbon dioxide mineral baths (mud, narzan, hydrogen sulfide, pearl, bischofite) in sanatoriums and resorts cure many diseases - these are diseases of the heart and blood vessels; gynecological and urological diseases; respiratory diseases; nervous system disorders; diseases of the digestive system and gastrointestinal tract.

However, there are contraindications and even harm to a hot bath. It consists in the fact that in order to achieve a good therapeutic effect, it is necessary to strictly adhere to the treatment course prescribed by the doctor. Maintain the time spent in the bath, the temperature of the water, the number of procedures, the state of your health.

Even warm water with salt or a hot foot bath, as well as baths with Epsom salts, have a huge healing effect. At the time of exacerbation of a chronic disease, it is strictly forbidden to take such baths. Also, added to a hot bath, it can cause you an allergic reaction, suffocation and dizziness, and as a result, loss of consciousness.

You should also not take a medicinal bath in a drafty environment or immediately after eating. Let 2-3 hours pass. After all, these water procedures have quite a strong effect on the entire human body, just like medication tablets, the effect of which you may not immediately notice.

Here's my recommendation - watch your well-being and remember my golden rule. There should be a sense of proportion in everything, and of course, common sense, and then healing mineral baths will only bring you benefits. Good luck and enjoy your steam!

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