How often can you take mineral baths. General rules for prescribing and taking baths. Caucasian Mineral Waters

For hydrotherapy, we use in our sanatorium mineral chloride-sodium water with a slight content of radon from the Gdov aquifer. Water is extracted from wells on the territory of the Sestroretsk resort.
Sodium chloride mineral baths have a beneficial effect on the body: they normalize the work of the autonomic nervous system, improve the functional state of the cardiovascular system, increase immunity, strengthen the walls of peripheral vessels, reduce pain, have an anti-inflammatory effect, relieve muscle spasms.

With a wide range of indications and a healing effect on the human body, mineral baths are a medical procedure and in some cases have contraindications, so hydrotherapy is performed only as directed by a doctor.

General rules of application: you should take a bath in a calm state, and we recommend coming to the hydrotherapy room 10 minutes before the start of the procedure in order to “tune in”. After taking a bath, sit for 15 minutes. Bathing suit and rubber slippers are required for hydrotherapy procedures.

Underwater spinal traction

Underwater traction of the spine, or Traction therapy, is one of the methods of treating the spine. The therapeutic effect in underwater traction of the spine is due to a combination of exposure to the patient of warm mineral water and traction (traction). With the help of short-term or long-term traction, muscle spasm is overcome, displacement of the vertebrae and deformation of the spinal column are eliminated.

We recommend horizontal underwater traction of the spine if you have been diagnosed with hernia and protrusion of the intervertebral discs, scoliosis, spondylosis, compression radiculopathy, the initial manifestations of Bechterew's disease. The procedure is indicated for people who lead a sedentary lifestyle and spend a long time in a sitting position.

Pearl baths

In pearl baths, the therapeutic effect on the human body of mineral water enriched with oxygen is used. The pressurized air supplied by the compressor enters the bath, forming bubbles resembling pearls. In combination with water flows, these “pearls” conduct hydromassage, enhancing the penetration of beneficial salts into the skin.
Pearl baths are used for diseases of the nervous system, reducing excitability and providing a calming effect. In addition, pearl baths improve the blood supply to the body by expanding capillaries, while lowering blood pressure and relieving stress from the heart, and are also used for problems with the musculoskeletal system.

Mineral baths

The beneficial properties of mineral baths are due to the effect of minerals on the skin and their penetration into the body through the pores. Mineral bath calms the nervous system, relieving stress and fatigue.

Mineral baths can help in the treatment of the liver, stomach, intestines, gallbladder, biliary dyskinesia and restore health after surgery.

Aromatic baths

In the therapeutic effect of aromatic baths, the leading role belongs to biologically active substances (BAS). BAS - herbal extracts and aromatic oils - are absorbed through the epidermis and carried by lymph and blood throughout the body. In water heated to 36 ° C, their penetrating ability is enhanced.
Our sanatorium offers the following aromatic baths:

• chestnut
• Anti-cold
• Muscle and joint tone
• Khvoynaya and others.

Turpentine baths

Turpentine baths are classified as aromatic baths, in which the effect of water is enhanced by a chemical factor - turpentine. The essential oils contained in turpentine in large quantities actively penetrate the skin under the thermal effect of the water procedure.
The action of turpentine baths is aimed at almost all body systems, so they have a wide range of applications: from the treatment of a large number of diseases to general rejuvenation, they are also used in cosmetology.

Sea baths

While taking sea baths, the patient is exposed to water with sea salt dissolved in it. Sea baths are indicated for a wide range of diseases:

• of cardio-vascular system
• vessels
• central and peripheral nervous system
• traffic organs
• chronic and inflammatory diseases of the genital organs in men and women
• skin diseases

Whirlpool baths

Whirlpool baths are local baths for underwater hydromassage of feet and hands. Depending on the bath, the feet, shins and calves or hands and forearms are massaged with water jets.

Vortex vibrations of water heated up to +36…+37 ºС contribute to the improvement of blood supply to the arms and legs; relieve muscle tension and contractures; suitable for rehabilitation treatment after injuries; reduce swelling and lymphostasis.

Service cost

Whirlpool bath for hands1 percent Aromatic whirlpool bath for hands1 percent Whirlpool foot bath 1 percent Aromatic whirlpool foot bath 1 pt. Bath pearl mineral 1 percent. Mineral bath 1 percent 1 percent 3 percent 6 percent Turpentine bath according to the Zalmanov method 1 percent. Coniferous bath 1 percent 1 percent 3 percent 6 percent Maral bath 1 percent Aromatic bath (chestnut, iodine-bromine, anti-cold, muscle and joint tone, with phyto-collection) 1 percent. Aromatic pearl bath (chestnut, iodine-bromine, anti-cold, muscle and joint tone, with herbal tea) 1 percent. Underwater traction of the spine1 percent.

Service	Qty	Price
250=
300=
250=
300=
450=
300=
Sea bath	300=
	840=
	1 620=
300=
300=
Bath dry carbonic	600=
	1 710=
	3 240=
500=
450=
500=
1 700=

- 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, microelements and other components of mineral water penetrate into the body and on the interoreceptors of blood vessels and internal organs.

Sulphide baths

Sulfide baths have long been attributed to 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 is wrong.

The high solubility of hydrogen sulfide in water prevents the formation in sulfide baths of the applied concentrations of the free gas phase (liberation of gas bubbles), 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 it is more correct to refer to them as mineral.

Sulfide waters are considered to be those waters that contain more than 10 mg/l of sulfides (total hydrogen sulfide). The healing properties of sulfide waters have been recognized by medical science and practice. The resorts of Sochi—Matsesta, Talga, Ust'-Kachka, Klyuchi, Sergievsk mineral waters, Kemeri, and others 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 by a chemical method, are increasingly being used.

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

In subsequent practice, the method of P.N. Paley was somewhat simplified in order to make the preparation of artificial sulfide baths more accessible and feasible in various medical institutions. Below are the recipes recommended by Ya. A. Shevtsov and proven by long practice for the preparation of 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 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 sulfide water of the Matsesta type with a total hydrogen sulfide content of 100 mg / l, you need: sulfide / sodium (in 100% terms of a chemically pure substance) 47 g / sodium bicarbonate 27 g, technical hydrochloric acid (density 1 ,14) PO 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, technical 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, you need: sodium sulfide (in 100% terms of a chemically pure substance) 47 g, technical 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 above recipes, one should 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 a doctor).

Before starting the preparation of water (always once a day - at the beginning of work), its alkalinity is determined (the calculation of soda in the recipes is given at an alkalinity of water of 4.1 mg-eq / l; with a different alkalinity, the amount of soda needed is changed, determining it according to the corresponding tables, below).

To calculate the amount of sodium sulfide solution needed 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 per 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 are required, and with a total hydrogen sulfide content of 150 mg/l, 190 ml; if the density of hydrochloric acid is different, then the amount of it per bath should be different.

Here are the tables developed by Ya. A. Shevtsov (1957) for calculating the raw materials needed per 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 in 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) of water at a sulfide concentration of 100 mg / l (for recipe 2)

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

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

When using the tables 4-8, it must be taken into account that sodium sulfide in solution at a concentration above 19% and a temperature below 15°C crystallizes and precipitates. If a precipitate occurs, the concentration of the solution should be slightly reduced by adding a certain amount of water.

A solution of sodium sulfide, the most convenient for the preparation of 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 the preparation of artificial sulfide water. Medicinal sulfide water can be prepared manually (directly in the bath) and centrally mechanized (in special large containers, from where the finished water is fed into the baths through a pipeline). First, prepare the main (working) solutions of sodium sulfide and hydrochloric acid; baths are prepared using these solutions. From soda and table salt, which are relatively easily soluble, it is not necessary to prepare working solutions.

With the manual method of preparing the bath, they are added in appropriate weight quantities (pre-packaged) directly into the bath water.

Technique for preparing basic solutions (according to Ya. A. Shevtsov). Sodium sulfide solution. Crushed into small pieces, technical sodium sulfide is weighed 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 with a stirrer, which is driven powered by a small electric motor. Stir thoroughly until complete dissolution of sodium sulfide (20-30 min); the higher the temperature of the water, 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 it is possible, after settling, to organize an accurate pumping of the solution from the tank into a clean bottle so that the slag remains intact at the bottom of the tank and does not get into the solution; The best way to do this is with a siphon.

The settled, transparent solution of sodium sulfide is poured into working bottles using a siphon, from where portions of the solution are measured for each bath. It is advisable to have a special tube, which facilitates the measurement of 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 pollutes 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 pit, since sodium sulfide waste can cause poisoning of animals and burns in humans.

Taking into account that the sodium sulfide solution is easily oxidized, it should not be prepared for more than 6-7 days. Store the solution in well-closed 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 (based on one bath) into glass jars with a capacity of 0.5 liters.

Strong hydrochloric acid releases 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 during its preparation.

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

You can use solutions of hydrochloric acid, which 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 undiluted acid is added to the bath. A solution of hydrochloric acid is prepared as follows: water is poured into a glass bottle with a capacity of 25-30 liters, and then acid is added through a funnel in accordance with the recipes and auxiliary tables to them.

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

Technique for the preparation of sulfide baths. 200 liters of water of the required temperature (35-37 ° C) are poured into the bath, and in a strictly defined sequence, the corresponding amounts (see calculations) of sodium bicarbonate, sodium sulfide and hydrochloric acid are added, all the while stirring the water evenly. If the goal is to prepare an exact analogue of Matsesta water, then table salt is added. In this case, the preparation of the bath begins with the fact that salt is placed in it in a sieve or canvas bag, through which hot water is passed. Then the bath is topped up (up to 200 l) with the required amount of cold water until the water of the designated temperature is obtained. After that, all other chemical ingredients are added in the same sequence as above.

In hydrogen sulfide clinics with a capacity of more than 100 patients per day, the most convenient, reliable and economical way to prepare sulfide water is mechanized, in which water is prepared centrally. At the same time, the chemicals necessary for the preparation of sulfide water are not mixed in the bath itself, but in large containers. So, at the Central Research Institute of Balneology and Physiotherapy, artificial sulphide water is prepared in a special sulphide workshop, in which most of the technological process is automated. The presence of 4 tanks made of vinyl plastic with a capacity of 6 m3 each 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 fed through vinyl plastic pipes (not subject to corrosion, despite the aggressive action of hydrogen sulfide) to the baths.

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

The method of treatment with sulfide baths. The most common method of treatment 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. Only 12-14 baths per course of treatment.

With a sparing method of treatment, 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 an intensive method, the duration of the bath is 8-15 minutes, the concentration of sulfides 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 (with outpatient treatment) for 1-172 hours.

According to the concentration of water, they are divided into: 1) weakly sulfide from 10 to 50 mg / l (Pyatigorsk, Khilovo, etc.); 2) medium - from 50 to 100 mg / l (Menji, Psekupsk, etc.); 3) strong — from 100 to 250 mg/l (Matsesta and others); 4) especially strong - over 250 mg / l (Matsesta, Talgi, Ust-Kachka, etc.). The main active factor that determines the specificity of the effect of sulfide waters on the body are sulfides that enter the body mainly through the skin, to a lesser extent through the respiratory tract. Free hydrogen sulfide and hydrosulfide ions pass through the skin. Their entry into the body is the greater, the higher the concentration of hydrogen sulfide in the water, the area of ​​the 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), 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. The 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, which is based on changes in the biopotentials of the cerebral cortex, as well as the excitability thresholds of skin receptors and sensory nerves, has been established (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 (VE Ryzhenkov, 1958, 1959). An important factor in the mechanism of action of sulfide baths are changes in the mediator metabolism that occur in connection with 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 that enter the body. A large number of them cause a toxic effect. Sulfide baths have a pronounced effect on the cardiovascular system, manifested by skin flushing, 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, 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 proteins, enzymes, hormones of protein nature, as well as low-molecular compounds (glutathione, etc.) increases; all this leads to an increase in energy resources in tissue cells, including in the heart muscle. In experimental atherosclerosis, hydrogen sulfide that has penetrated into the blood from the 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; increased activity of cytochrome oxidase, lipase and other enzymes in animal tissues; the exchange of mucopolysaccharides is normalized. Such is the inner, deep side of the mechanism of action of sulfide baths on the body of healthy animals and animals with experimental atherosclerosis. At present, the dependence of phosphorus metabolism, enzymatic processes, osmotic resistance of erythrocytes, etc., has been established in experimental myocarditis, and it has been shown that a positive effect is achieved at moderate concentrations of sulfides in water. The degree of increase in the level of 17-OKS in the blood plasma increases with the increase in the concentration of sulfides (from 50 to 150 mg/l) during the course of treatment. After treatment with baths with a concentration of sulfides of 300 mg/l or more, a decrease in this indicator is observed. The latter testifies to the 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 (“emergency”) stimuli is summed. 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 medium-concentration sulfide baths allow these procedures to be widely used in the treatment of many pathological conditions, primarily diseases of the cardiovascular and nervous systems, musculoskeletal system, female genital area, 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 the appointment of sulfide therapy in recent years have been revised and changed towards expansion in some forms of atherosclerosis lesions 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, stroke of cerebral vessels; with chronic sluggish diseases of the liver, gallbladder and biliary tract (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 infarctions; patients with a recurrent form of myocardial infarction, as well as an aneurysm complicated in the acute period (cardiogenic shock, severe cardiac arrhythmias); patients with hypertension PB stage and above; patients with circulatory insufficiency exceeding I degree, 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 should be borne in mind that in the practice of sulfide therapy there are cases of the so-called poor tolerance of sulfide baths, associated with the toxic-allergic effects of sulfides on the body. Moreover, they are observed not only when patients receive baths of high concentration, but when baths contain sulfides of 100-150 mg/l, and occasionally even at a very low concentration of sulfides (50 mg/l). L. 3. Sterninson et al. (1975) in the analysis of cases of "poor tolerance" that took place in the hospitals of Matsesta, 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.

In the mechanisms of the toxic effect of sulfides on the body, as is known, two phases are distinguished. The first is the excitation phase. It is due to the reflexogenic influence from the carotid sinus zone. In this phase, shortness of breath, hypertension, erythrocytosis, hyperglycemia, etc. are observed. The second is the phase of paralysis; characterized by inhibition of the respiratory and vasomotor centers and is the result of a 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 in the construction and organization of hydrogen sulfide clinics. The latter should be placed "in a separate building or an 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 micrograms per 1 liter of air.

When studying the composition and physico-chemical properties of hydrogen sulfide waters, especially highly concentrated ones, and the balneo-technical 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 the constancy of the concentration of sulfides in the bath, as well as the preservation of the natural composition and natural properties of sulfide mineral waters.

The ventilation system and the sewage system of hydrogen sulfide clinics are isolated from other premises. Wall decoration, water and sewer pipes, as well as equipment must be made of materials that are resistant to hydrogen sulfide. The staff is specially trained; when working, it is necessary to observe a number of absolutely mandatory rules.

Slag baths

Slag baths are used for therapeutic purposes in some regions of the USSR (Donbass, Dnepropetrovsk, Tula, etc.), where there is a metallurgical production. The hot slag formed during the smelting of iron is collected in special containers (granulation pools) to “extinguish” it with cold water. In water, sulfur compounds are leached from slag, which pass into solution, forming the so-called slag water of a pronounced alkaline reaction (pH 8.8–9.6). The chemical composition of slag water 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 large or smaller quantities.

Dnipropetrovsk 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 waters are thiosulfates and calcium ions. They contain hydrogen sulfide only in the form of sulfides, that is, in a bound state, and therefore the identification of slag waters with sulfide waters and the assignment of the healing properties of hydrogen sulfide waters to them is incorrect. In the action of slag waters on the skin, the main role belongs to 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 of the required temperature.

Slag waters are used in the form of general and local (manual, foot) baths. General bath temperature 35-37°C, duration 10-12-15 min, carried out every other day, local - temperature 36-38°C, duration 12-15-20 min, daily or every other day. In total, the course of treatment is 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 sufficient attention.

The categorical statement at one time by a number of domestic and foreign scientists that intact skin is impermeable 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 position expressed by V. A. Manassein2, which, in our opinion, is very correct, was completely ignored: her, depending on the special purpose, then this, then another thermal or mechanical irritation, you can produce very significant, closely related 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 have been carried out at TsNIIKiF and other institutions (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 the chloride waters of the USSR (G.N. Plotnikova, 1974) according to the literature and stock materials made it possible to strictly document the position known to balneologists that these waters within the Soviet Union have an exceptionally 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.

According to the chemical composition, the following main groups are distinguished among the considered waters.

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, less calcium-magnesium ultrastrong brines with mineralization from 350 to 600 g/l.

The formation of chloride waters with salinity 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 stages of halogenesis; strong brines up to 350 g/l - with a halite stage of salt loading; ultrastrong brines with a mineralization of 350-600 g/l, enriched in Ca, Mg, K, Br, Bo, often Fe, apparently represent the residual brine of ancient brine basins. Part of sodium chloride brines (mainly high concentration) is 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 amount to hundreds of thousands of cubic kilometers and are practically 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, salinity, composition, and temperatures; self-draining and without self-draining. Promising areas for their 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 (North-Western and Central regions). Currently, 48 resorts and 32 hospitals are already operating using sodium chloride water. There are 11 bottling plants. 16 wells have been drilled only in Moscow and the Moscow region. A number of trade union and departmental sanatoriums in the Moscow region operate wells with sodium chloride water, including Dorohovo, Zvenigorod, Porechye, Monino, Ereno, Istra, and others. In the courtyard of TsNIIKiF, two types of natural water - sodium chloride mineralization 120 g / l, used for external use (dilute with tap water to the required concentration for therapeutic use), and sulfate sodium-magnesium-calcium mineralization 4 g / l - for drinking treatment, washing - intestinal irrigation, inhalations etc.

An analysis of the data obtained in recent years makes it possible to get a clearer idea of ​​the mechanism of action of sodium chloride waters. The main active principle of these waters on the body are the salts dissolved in them. Even earlier, balneologists (L. Bertenson, 1902; A. A. Lozinsky, 1949) noted that the mechanism of action of sodium chloride waters on the body is played by the so-called salt coat, which forms on the skin during the procedure and causes reflex reactions of the body not only during it, but also in the period of aftereffect.

The works carried out in recent years have established that sodium chloride waters, when applied externally in the form of baths, have a peculiar, inherent only action, 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, the skin irritating effect of the chemical composition of water, local changes are also important in the mechanism of action of sodium chloride baths - pronounced functional shifts 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 the result of an overdose, not only in terms of the concentration of salts in the water, but also in terms of the frequency of arranging procedures over time. For example, they were found in animals that received daily procedures, and at the same time they were not found in those who had baths for two days in a row with a break on the 3rd day. In animals with the initial manifestation of atherosclerosis, a change in the content of norepinephrine in the adrenal glands was found: its increase indicates the effect 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 the endocrine apparatus (pituitary gland, adrenal glands, thyroid gland). The use of the stereotaxic method showed that sodium chloride baths at a concentration of 60 g/l cause a generalized reaction in various parts of the brain, contributing to an increase in 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, and the bioelectrical activity of the anterior part of the latter (parasympathetic) increases, and the posterior (sympathetic) decreases. Baths of chloride sodium iodine-bromine water in the course of application to animals with experimental atherosclerosis in the initial stage inhibit the development of the process, 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 also affects, which is confirmed by the activation of the process of biosynthesis of adrenaline in the adrenal glands and inhibition of the oxidative breakdown of catecholamines, which was detected in animals with experimental atherosclerosis during the course use 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 water on the development of the pathological process was 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 heat exchange 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 fresh 8.3 kcal / min), while blood supply to the skin increases by 6.1 l / min (in fresh water 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 quite distinct, and at a concentration of more than 40 g / l, especially at 60-80 g / l, negative reactions from the cardiovascular, nervous and other systems of the body often begin to appear.

In patients with chronic venous insufficiency, by 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 and others .). Improving the tonic properties of the venous wall contributes to a better outflow of blood from the extremities. The combination of this effect with a moderate increase in arterial blood flow during these baths is the best option for changing the 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 anticoagulant system of blood is observed.

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

According to their clinical and physiological action, sodium chloride waters 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 restructuring in the body, significantly change the course of metabolic processes, etc. An analgesic, anti-inflammatory and desensitizing them 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 favorable effect on the adaptive-restorative 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 hypotonic neurocirculatory dystonia, hypertension, rheumatic heart disease in adults and children, etc. The positive effect of these baths on a number of indicators of the functional state the central nervous system and hemodynamics (REG, oscillography) is much more pronounced compared with carbon dioxide, radon and sulfide baths widely used in such patients (3. S. Melnitskaya et al., 1970, etc.).

In non-resort environments, 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, less often more).

Technique for the preparation of artificial sodium chloride baths. Cooking (lake or sea) salt is poured into a canvas bag, and even better into a special sieve, which is placed in a bath under hot water. As the salt dissolves, cold water is added to the bath to the required temperature (35-38 ° C). In this case, 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. Total for the course 12-15 baths.

Indications; diseases of the cardiovascular system - the initial manifestations of atherosclerosis, myocardial and atherosclerotic cardiosclerosis, myocardial dystrophy, rheumatic heart disease in adults and children of the I degree of activity of the process with circulatory failure I and initial II degree; hypertension stage I and PA, hypotension, initial manifestations of obliterating diseases of the vessels of the extremities, varicose veins and post-thrombophlebitic syndrome; diseases of the organs of movement - arthritis and polyarthritis of non-tuberculous origin (rheumatic, infectious non-specific, degenerative-dystrophic, brucellosis, dysentery, etc.); diseases of the spine (spondylosis, spondylarthrosis, spondyloarthritis - Bechterew's disease); diseases and consequences of traumatic injuries of bones, muscles, tendons; diseases of the central (consequences of spinal cord injuries, consequences of poliomyelitis, etc.) and peripheral nervous system (plexitis, radiculitis, polyradiculitis, etc.); chronic inflammatory diseases of the female genital organs (uterus, appendages, adhesive processes after surgery), functional ovarian failure; some skin (psoriasis, neurodermatitis) and other diseases.

Contraindications are the same as for hydrotherapy procedures in general (circulatory failure II-III degree, severe angina pectoris with frequently recurring attacks, stage III hypertension, with a tendency to cerebrovascular accident, etc.). In addition, the period is 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 proceeded with a short-term increase in temperature, without exacerbations; thrombophlebitis with a tendency to recurrence or accompanied by progressive inflammatory changes; for patients with chronic venous insufficiency of the legs, it is necessary to consider chamber foot baths contraindicated due to the position when taking them, which is unfavorable for venous outflow.

Iodine-bromine baths

In nature, "pure" iodine-bromine water does not exist. 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 regions. The accumulation of bromine and iodine in natural waters, according to E. V. Iosifova et al. (1968), promotes their assimilation by some marine organisms and sorption of silts, especially peat, by organic matter.

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

The criterion for evaluating iodine-bromine water in a therapeutic sense, according to VV Ivanov, G^. A. Nevraeva (1964), is the content of iodine in it is not less than 10 mg/l and bromine is not less than 25 mg/l.

Iodine-bromine waters have been used for medicinal purposes for a long time. Literature data indicate that the healing properties of the 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, Maykop, 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, as a rule, are contained in natural sodium chloride waters of high salinity. Using such water for medicinal purposes, it must be diluted (sometimes many times - 1:6, 1:9) with fresh water. Very often, such a 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 therapeutic iodine-bromine water. Often these trace elements, especially iodine, completely disappear when diluted. This should be taken into account when evaluating the action of the leading therapeutic factor in such diluted waters, so as not to attribute their therapeutic role to a trace element contained in a minimal amount or completely absent.

The importance of iodine and bromine ions for the body can hardly be overestimated, 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 in the thyroid gland, bromine - in the pituitary gland.

The positive decision at present by the majority of authors of the issue of the penetration of iodine and bromine through intact skin from the water of the baths allows us to attribute iodine-bromine (bromine) baths to the category of active balneotherapeutic procedures that have a biological effect on the body.

In a broad sense, the effect of bromide baths - experiment and clinic is studied 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 and others .). In the collection of works of the institute "Atherosclerosis and its bromide balneotherapy" (1974), published under the editorship of. S. I. Serov, the results of many years of research on the mechanism of action and the therapeutic use of sodium chloride bromide water in atherosclerosis are summarized. Experimental and clinical evidence of the inhibitory effect of bromide water on the development of atherosclerosis was obtained.

Clinical and experimental studies have established that iodine-bromine (bromiodic) baths, by their influence on the leading physiological systems of the body - the nervous, cardiovascular, sympathetic-adrenal and pituitary-adrenal systems, can create favorable conditions for the formation of compensatory-adaptive and regenerative reactions of the body and thereby contribute to if not recovery, then a significant change in the pathological process in many diseases, the pathogenesis of which is a violation of the function of the central nervous system, metabolic processes, thyroid function, etc. In practice, it has been noticed 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 older people.

Good results have been obtained in the treatment of elderly patients with diseases of the joints (I. 3. Vulfson, 1965), with the initial manifestations of atherosclerosis (L. I. Goldenberg, 1962), thyrotoxicosis (V. X. Shogenov, 1967; G. Ya. Gaidash , 1972), with some cardiovascular diseases (N. G. Khoroshavin, 1968; F. L. Barg et al., 1963), skin diseases (P. M. Zorin, I. A. Telishevskaya, 1964), etc. .

At present, artificial iodine-bromine baths are becoming more widespread, the method of preparation of which has been 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 bottle. 200 liters of fresh water of the required temperature are poured into the bath. 2 kg of table (lake or sea) salt is added to this water and thoroughly stirred until it is completely dissolved; after that, 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. Total for the course of treatment 15-20 baths.

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

Contraindications are common for hydrotherapy.

In more detail, various aspects of the therapeutic use of iodine-bromine baths are described in the book by I. 3. Vulfson "Iodine-bromine waters and their therapeutic use in diseases of the joints" (1973).

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Aromatic bathsRadon baths

Therapeutic baths are the most important type of balneological treatment. Actually, balneotherapy began at the very moment when a person once decided to cure his ailments by immersing himself in a mineral water bath. Therapeutic baths in the Crimea are a mandatory program for any sanatorium. In the health resort "Yurmino" (Saki), balneological treatment has been practiced since the very beginning of the health resort, respectively, therapeutic baths as a significant component of balneotherapy are included in almost all treatment programs of the sanatorium.

Balneoaroma baths from "Spitzner" (Germany)

Over the thousand-year history of therapeutic baths, the procedure itself has not changed much, but the number of substances that are used as fillers has become simply huge. Modern scientists have also contributed to this impressive list. One of the brightest examples of modern know-how in balneology is the so-called perozons. These fillers are the result of the work of scientists at the intersection of two disciplines: balneology and aromatherapy. The natural essential oils that make up them penetrate the body through the skin, like salts and gases in mineral water, and at the same time, their volatile components have a therapeutic effect, affecting the respiratory system.

In the sanatorium "Yurmino" therapeutic bath concentrates of the company "Spitzner" (Germany) are used. The results of clinical studies in Germany, Russia and Ukraine have shown their high efficacy and excellent tolerability, including in children and the elderly. Aroma baths with perozons are used in the maintenance therapy of acute and chronic diseases and can significantly prolong the period of remission when used in a sanatorium.

	Perozon Valerian, soothing The concentrate contains a large amount of natural valerian essential oil. It is used for stress, overstrain, sleep disorders, increased excitability in children. Soothes, relaxes, relieves nervous tension, facilitates falling asleep and significantly improves the quality of sleep.
	Perozon Rosemary, tonic The concentrate contains a large amount of natural rosemary essential oil. It is used for nervous exhaustion, loss of strength, chronic fatigue syndrome, circulatory disorders and low blood pressure. It tones the central nervous system, improves blood circulation, refreshes, gives vigor and strength, enhances the ability to mental and physical labor, stimulates sexual activity.
	Perozon Chestnut, anti-varicose The concentrate contains a large amount of natural essential oil from horse chestnut seeds. It is used in the treatment and prevention of varicose veins. Strengthens the walls of blood vessels and veins, tones up blood circulation, eliminates swelling of the limbs and a feeling of heaviness in the legs. Favorite type of baths of our patients
	Pinimenthol, anti-cold The concentrate contains a high percentage of a mixture of natural essential oils of camphor, menthol and eucalyptus. It is used in the treatment and prevention of colds, SARS and influenza, as well as infectious diseases of the upper respiratory tract (bronchitis, pharyngitis, tracheitis). It has an anti-inflammatory and anti-edematous effect on the upper respiratory tract, has an expectorant effect, reduces the intensity of coughing, returns nasal breathing and speeds up recovery.
	Dermatological A concentrate is added to the water, which contains a significant percentage of soybean oil, rich in essential fatty acids and ceramides. It is used for various skin diseases, such as dermatitis, dermatosis, psoriasis, allergic eczema. It relieves inflammation, peeling and itching, restores the natural moisture of the skin, its structure, has a regenerating effect, reduces flabbiness of the skin.
	Perozon for muscles and joints, antirheumatic A concentrate is added to the water, which contains a high percentage of pine needle oil and water-soluble salicylates. It is used in the treatment and prevention of diseases of the musculoskeletal system, rheumatic pains, radiculitis, arthritis, joint pain, circulatory disorders, it is recommended to be used for injuries of the musculoskeletal system, in particular muscle strains. Significantly reduces pain in the joints and muscles, stimulates the blood supply to the joints and muscles.

Pearl baths

Pearl bath is considered a classic of balneotherapy, however, to this day it is used along with other methods. In this type of balneotherapy, ordinary atmospheric air is used as an active substance. Heated to +37-38 degrees, the water is saturated with air using a special compressor that supplies air through a grate at the bottom of the bath. The bubbles formed in the water are very similar to small pearls, hence the name of the procedure - a pearl bath. Air bubbles massage the relaxed body of the patient, which is in the bath in a state of weightlessness. The massage effect is enhanced by the temperature difference between the supply air and the water in the bath.

Indications for holiday pearl bath:

• recommended for stress
• nervous system disorders
• early stages of hypertension
• diseases of the musculoskeletal system
• Pearl bath relieves pain
• restores healthy sleep
• normalizes blood pressure
• increases joint mobility
• relaxes muscle tissue.

Rinse baths

In brine baths, water with a high level of mineralization, the so-called brine, is used. This is a solution of complex composition, richly saturated with various mineral and organic substances. In the Yurmino sanatorium, brine baths are made on the basis of the salt of the Yevpatoriya salt industry, which is mined on the Sasyk-Sivash lake and contains almost seven dozen useful mineral and organic substances. We use the same salt for various types of irrigation.

The duration of the procedure is 10-15 minutes in brine with a temperature of +36 to 40 degrees. In our treatment programs, brine baths are usually taken every other day, alternating them with mud therapy.

Rape baths are used for diseases of the cardiovascular system; arthritis and polyarthritis, diseases of the musculoskeletal system and peripheral nervous system, skin diseases (including psoriasis), chronic inflammatory diseases of the female genital organs, as well as for the prevention of colds.

Iodine-bromine baths

Iodine-bromine bath - time-tested balneological procedure. Due to their universal properties, iodine-bromine baths are widely used in spa practice. The action of iodine-bromine baths is based on the ability of iodine and bromine ions, which penetrate the patient's body through the skin, to exert sedative and analgesic effects on him. In addition, iodine-bromine baths help reduce pressure, reduce allergic reactions, improve respiratory function, blood microcirculation and blood supply to internal organs, have a beneficial effect on the skin, improve the condition of the thyroid gland and other organs of the endocrine system.

Iodine-bromine baths are used for functional disorders of the nervous system, diseases of the cardiovascular system (with angina pectoris, post-infarction conditions, hypertension, atherosclerosis), diseases of the musculoskeletal system, endocrine system (especially in mild forms of hyperthyroidism, teriotoxicosis and diabetes mellitus), skin diseases (for dermatoses, psoriasis, etc.), respiratory diseases and diseases of the genitourinary system.

Iodine-bromine baths in the sanatorium are made on the basis of a concentrate purchased from PJSC NPO Yodobrom (Saki), a leading organization in the field in the development and implementation of new technologies for the production of iodine, bromine and their derivatives.

Muscat-sage baths

Clary sage has long enjoyed well-deserved fame in folk medicine. However, in clinical practice, clary sage began to be used after the work of Professor A.P. Obukhov, in whose laboratory in Krasnodar an emulsion based on clary sage essential oil was first prepared. This emulsion was successfully used during the Great Patriotic War and in subsequent years for the treatment of osteomyelitis, varicose veins, felons, burns and some other diseases. In the sanatorium "Yurmino" nutmeg-sage baths are used to treat:

• diseases of the musculoskeletal system
• radiculitis and some other diseases of the peripheral nervous system.

In addition, baths based on clary sage oil reduce nervous tension, improve concentration, memory and stimulate brain activity.

Coniferous baths

Many have noticed that in a coniferous forest it is easier to breathe, nerves calm down, mood improves. This happens due to the essential oils that coniferous trees secrete in the course of their life. Scientists have learned how to obtain these volatile components from various parts of coniferous trees, and studies have shown that subjective sensations do not deceive us - these essential oils are really very useful and can treat a variety of diseases. In balneological practice, coniferous extracts are used in the form of baths. These coniferous baths are also included in the treatment programs of the Yurmino sanatorium.

Benefits of a coniferous bath:

1. Coniferous bath has a bactericidal, antiseptic, tonic and wound-healing effect.
2. It calms the nervous system, heals the respiratory system (indicated, for example, in rhinitis and bronchitis), improves blood circulation in internal organs and skeletal muscles, and acts as an antispasmodic, making it indispensable for relieving pain.
3. Eliminates puffiness, relieves fatigue, increases working capacity, improves mood.
4. Stimulates the immune system.
5. It rejuvenates the skin, smoothes wrinkles, reduces sweating, eliminates heavy foot odor, painful formations disappear from the skin surface, the skin becomes smooth and elastic.

Turpentine baths

The use of turpentine, a product of distillation of the resins of coniferous trees, began to be used for medical purposes as early as the end of the 19th century. However, this technique received its logical conclusion thanks to the well-known physician, Dr. A. S. Zalmanov. He suggested using turpentine baths not for the treatment of a specific disease, but for the general healing of the body. The effectiveness of turpentine baths, according to Zalmanov, is to improve blood microcirculation at the capillary level, which dramatically strengthens the defense mechanisms of the human body.

Essential oils obtained from various parts of coniferous trees are used in turpentine baths. In the treatment programs of the sanatorium "Yurmino" the compositions of the Ukrainian company "Zhivina" are used: white and yellow turpentine emulsions.

During the turpentine bath procedure, the patient is immersed in a previously prepared turpentine solution: turpentine mixture is added to water at a temperature of 37 degrees. Gradually, the temperature of the water in the bath increases to 38-39 degrees when taking a white turpentine bath and up to 40-42 when taking a yellow one. The duration of the procedure starts from 5 minutes, then gradually increases with each procedure, reaching a maximum of 20 minutes. After taking a turpentine bath, bed rest is recommended for 1.5-2 hours.

Turpentine baths are used for diseases:

• cardiovascular and genitourinary systems
• musculoskeletal system, liver, gallbladder
• respiratory organs
• obesity
• diabetes
• neurological diseases
• as well as for the prevention of colds.

Depending on the condition and indications of the patient, white, yellow or mixed baths are prescribed. When taking white baths, the patient's blood pressure rises, so these baths are prescribed for people with low or normal blood pressure. White baths improve blood circulation and tissue nutrition.

Patients whose blood pressure level is higher than 140/90 are shown only yellow baths. They dilate capillaries, helping to reduce pressure. In addition, when taking yellow baths, body temperature rises, sweating is stimulated, which contributes to the removal of metabolic products through the skin.

Mixed bath treatment is a combination of white and yellow emulsions in one bath or alternation of white and yellow bath treatments. The choice of method and dosage of combinations when prescribing mixed baths depends on the level of blood pressure, as well as on the nature of the particular disease of the patient.

General contraindications for taking therapeutic baths are the same as for all balneotherapy procedures:

• all diseases in the acute stage or during the exacerbation of the chronic process
• pregnancy
• bleeding and predisposition to them
• malignant neoplasms, uterine fibroids
• mastopathy
• circulatory failure above stage IIA
• severe heart failure
• as well as individual intolerance to individual components of the aqueous solution.

Baths are water procedures used for hygienic or therapeutic purposes.

General indications to the use of baths
CCC disease without NK manifestations (heart disease with a completely completed infectious process, operated defects, stage I-II GB without severe crises and damage to the vessels of the brain, kidneys, heart, hypotension), rheumatism in an inactive form after acute events with a completely completed process in heart, diseases (including the consequences of injuries) of the central nervous system and peripheral nervous system at the end of an acute period without severe disorders, functional diseases of the nervous system (neurosis), 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 non-specific irritant, causing an exacerbation of inflammatory processes in hidden foci of infection and activating a chronically ongoing infection, which makes it necessary to pre-sanitize foci of lesions and exclude the current infectious process.

General contraindications

• unstable angina in the phase of decompensation
• a significant violation of the contractility of the heart (decompensation above the first degree),
• with 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 organ involvement
• cirrhosis of the liver
• chronic kidney disease with impaired function
• blood diseases of the acute stage or the stage of exacerbation
• severe general exhaustion
• progressive glaucoma;
• pregnancy (second half).

Influence of the temperature factor

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

Features of the appointment of baths in childhood:

• 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, you can use sodium chloride, mud, sea, coniferous (with severe rickets, diseases of the central nervous system, the 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, weakened 1 day bath, 2 days rest.
• You can alternate every other day general and local baths.
• Procedure time 5-7 - 8-12 min.
• Baths after 45 min. - 1 hour after breakfast. After baths rest 15 min. , 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 the 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 salt brines of high concentration have formed.

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

Mechanism of action
It was previously 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 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 the sweat glands, which actively “draw” mineral salt solutions into the deeper layers of the skin - the dermis and subcutaneous fatty tissue, through their excretory ducts after cessation of sweating.
The chemical action is due to the direct effect of minerals on skin receptors, cellular elements of the skin, its blood and lymph circulation. The penetration of chloride and sodium ions through intact skin, as well as the formation of a “salt raincoat”, affects skin receptors, both during and after the procedure. for a long time. This causes reflex changes in the central nervous system and hypothalamus, in the form of an increase in 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 (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 mainly 30 g/l.

The action of sodium chloride baths

• increases the activity of the endocrine apparatus (pituitary gland, adrenal glands, thyroid gland)
• improves tissue trophism and the course of metabolic processes
• reduces blood viscosity
• reduces aggregation and adhesive activity of platelets
• normalizes vascular tone
• increases the tone of peripheral veins
• enhances subcutaneous and muscle blood flow (trace effect).
• improves the outflow of blood from limbs with venous congestion
• reduces inflammation in joint pathology
• has a desensitizing effect
• In the skin is registered:
• increase in the number of fibrocytes and elastic fibers
• thickening of arhydrophilic elements of the skin proper
• formation of cavities between the granular and shiny layers of the epidermis
• vacuolization of epidermal cells and intercellular edema
• increased proliferation of the germ layer of the epidermis
• significantly improves and lengthens the response of the microvasculature
• the activity of the sweat glands is intensified
• These shifts lead to an improvement in the trophism of the skin and its appendages, however, with an increase in the number of baths performed, there is a further proliferation of the germ layer and thinning of the stratum corneum of the skin.

Indications

• hypertension 1.2A (with NC up to 1 tbsp)
• post-thrombotic 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 early stage with moderate asthenic syndrome, arterial hypotension, and vegetative-vascular disorders. For a long time, the clinical effect of Nauheim's carbonic 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, in 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 (weeping eczema, etc.).

Occurrence
The waters of the Moscow Basin include the springs of Central Russia, on which the resorts Kashin in the Tver region, Staraya Russa in the Novgorod region are 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 cause a therapeutic effect. So, 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-Sibirskoe, Angara in the Irkutsk region, the sanatoriums "Obolsunovo" and "Green Town" in the Ivanovo region, "Big Salts" in the Yaroslavl region, as well as the sanatoriums of the Green Town near Nizhny Novgorod (Nizhny Novgorod region), etc., salt water is 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.

Sulphide baths

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

Mechanism of action
From water to the body, hydrogen sulfide penetrates through the skin, mucous membranes, respiratory tract in the form of free hydrogen sulfide and hyposulfide ion. As a result, the enrichment of the content of sulfhydryl and disulfite groups activates glutathione, 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 effect of sulfide waters on the state of metabolic processes, 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 penetrated into the blood, the synthesis of atherogenic lipids decreases. 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; improves blood supply to the brain, heart and kidneys; 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 the expansion of small vessels and, as a result, intense redness of the skin, improved blood circulation in the skin and underlying tissues: joint bags, cartilage, internal organs. Also, in the mechanism of the therapeutic action of sulfide waters, a large role is played by hormonal changes, changes in the function of the sympathetic-adrenal system, and the state of immunological reactivity.
The duration of hydrogen sulfide circulation in the blood is very short, the gas is very quickly oxidized in the liver and excreted from the body.

1. Weak hydrogen sulfide 0.3-1.5 mmol / l (10-50 mg / l) - Pyatigorsk, Khilovo.
2. Medium - 1.5-3 mmol / l (50-100 mg / l) - Menji.
3. Strong - 3-7.5 mmol / l (100-250 mg / l) - Matsesta.
4. Especially strong - more than 7.5-12 mmol / l (250-400 mg / l) - Matsesta, Talgi, Ust-Kachka.
5. Therapeutic - 0.3 mmol / l (10 mg / l) - Kemeri, Ust-Kachka, Keys, Sochi-Matsesta.

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

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 course taking sulfide baths

• normalization of blood pressure
• increase in blood flow
• slowing of the heart rate, prolongation of its rest period
• improvement of blood supply and innervation of organs and tissues
• change various types of metabolic processes
• increased oxygen consumption
• increased pulmonary ventilation
• predominantly inhibitory effect on the central nervous system
• corrective action in case of neuroses, vegetative dysfunction
• improvement of blood rheology

Indications

• IHD 1 stage, arterial hypertension 75-100 mg / l.
• IHD 2 25-50 mg/l.
• IHD 3 4-chamber baths 75-100 mg/l.
• GB 1.2A, B, 3 st
• 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 trauma of 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:

• IHD 4,
• CH 2, GB 2B, NK B 1 st.
• severe atherosclerosis of cerebral vessels
• diseases of the liver and kidneys with a violation 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 is exceeded

Sources of sulfide waters in Russia
Krasnousolsk (Bashkiria), Hot Key, Sochi (Krasnodar Territory), Pyatigorsk (Stavropol Territory, Caucasian Mineralnye Vody), 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"; in the resort of Pyatigorsk in the sanatorium "Rodnik", in the resort of Ust-Kachka

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 decay products (radium A, radium B, radium C, radium C1). Natural radon waters, as a rule, have low salinity (up to 2 g/l) and complex gas composition (radon, nitrogen or carbon dioxide). The concentration of radon in natural sources ranges from 1 to 300 nCi/l.
In the artificial preparation of radon baths, the most commonly used concentration of radon is 40–200 nCi/l (1.5–7.5 kBq/l).
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
• microclysters
• inhalations, drinking radon waters, etc.

Mechanism of action
The primary action of radon baths is based on the ionization of water, which leads to a change in biochemical processes in tissues, 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, the direction and intensity of biochemical processes change. Currently, there are two main types of effects of radon a-radiation and its daughter products on the body: direct and indirect by activating the centers of neuroendocrine and immune regulation. Exposure to a-radiation of radon and its daughter products on melanocytes leads to the oxidation of tyrosine and the formation of highly active dihydroxyphenylalanine (DOPA), DOPA-quinones, DOPA-amines. These biologically active substances, entering the bloodstream, cause the activation of the sympathetic-adrenal system.
One of the main mechanisms of exposure to radon baths is exposure to radon and its daughter products of the receptor apparatus of the skin, a change in cellular metabolism in it with the release of biologically active substances. A characteristic feature of baths in their multilateral influence 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 upward influence of the reticular formation and enhance the processes of inhibition in the central nervous system.
In the terminal link of blood circulation, a two-phase reaction of capillaries is noted during the bath. In the first minutes of admission - blanching of the skin, spasm of capillaries, a decrease in the number of visible capillaries; at the end of the reception and within 1 hour after - pinking of the background, an increase in the number of capillaries and blood flow in them. This biphasic vascular response produces a kind of peripheral vascular training. Therefore, when taking a radon bath, a short-term (within 1-3 minutes) spasm is replaced by a prolonged expansion of arterioles and a slight decrease in venular outflow, which leads to skin hyperemia.
The biological effect of radioactive radiation is determined by the amount of absorbed radiation dose 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) absorbed dose is about 0.1 mSv (10 mrem), which is comparable to the monthly natural background of human exposure. Irradiation of other organs and tissues, except for fat (4% absorption) and kidneys (30%), is within the daily fluctuations of the background. However, with radon therapy, a 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 due to the natural radiation background. This allows us to understand the reasons for the therapeutic effect of such small absorbed doses of radiation, known as radiation hormesis. According to this theory, only small doses of radiation energy stimulate protective and adaptive mechanisms. Radiation hormesis has been established at the biochemical, cellular and organ levels, in cell cultures, bacteria, plants and animals. Small doses of radiation cause an increase in immune competence and "hyperproduction" of adaptive enzymes necessary for DNA repair. A low dose is a value between the background dose from the environment and the threshold dose that causes certain physiological responses. E. Roth proved that with an increase in the radiation dose, the number of damaged cells increases and reparative processes decrease. When using a high concentration of radon for baths, balneo reactions are often observed. The damaging effect of radiation appears 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 into 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 the radon that has entered the body from the bath accumulates in the skin, where a certain depot of radon and its products is created, which have a specific effect not only during the bath, but also after it. From the skin depot, radon enters the bloodstream and spreads through the internal media and organs, but the dose of their exposure is small compared to the skin. Only about 0.5% of the radon that has entered the body decays, and the resulting decay products of radon (radium A, B and C) completely decompose before they are excreted from the body.
Radon is excreted 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 the daughter products of its decay are affected 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 deposited on the skin in the form of small bubbles prevents the formation of active plaque on the skin, reduces the flow of radon and its daughter products into the body, and, consequently, reduces body exposure.

Recommendations
For the release of radon baths, natural and artificial radon waters are used.
According to Russian balneological waters, radon waters include mineral waters, the radon content of which must be at least 185 Bq / l (maximum concentration of radon for drinking water is 120 Bq / l). This value is rather conditional, since the required irradiation intensity can be controlled 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.

Distinguish:

1. water with a low concentration of radon - from 5 to 40 nCi / l (0.2-1.5 kBq / l);
2. water with an average concentration of radon - 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: for water baths - 5 nCi / l (200 Bq / l), for drinking - 100 nCi / l (4000 Bq / l). The maximum allowable 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 applied therapeutic dosages of radon in baths with a concentration of 1.5 - 3 kBq/l have the highest therapeutic efficacy, at the same time they are several times lower than the maximum established (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 2-3 days in a row or every other day, depending on the general condition of the patient, as well as the state of the cardiovascular system. In total, 12-15 procedures are prescribed for the course of treatment.
Radon baths are prescribed for children no earlier than from the age of 5; at the same time, baths with a radon concentration of not more than 1.5 kBq / l (40 nCi / l) are used.
Radon baths of medium concentration (not higher than 3.0-44 kBq/l) showed 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.
In the treatment of vertebrogenic radiculitis with severe pain and syringomyelia, the concentration of radon 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 microclysters (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 before the bath. The concentration of radon 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
• the predominance of inhibitory processes in the central nervous system
• increase the speed of propagation of excitation along the nerve
• increased reflex excitability of alpha motor neurons
• blocking of inhibitory interneurons
• stimulation of tissue lipolytic enzymes
• normalization of basal metabolism, some aspects of carbohydrate, mineral, cholesterol and water metabolism
• increased carbohydrate tolerance
• improvement of myocardial contractility
• normalization of heart rate
• equalize 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 the morphological composition and blood clotting
• stimulation of tissue regeneration processes
• significant analgesic and sedative effect
• normalizing effect on vegetative functions
• anti-inflammatory and desensitizing effects

Indications

• coronary heart disease I-II FC, hypertension I-IIA Art.
• obliterating diseases of the vessels of the extremities;
• systemic diseases (scleroderma, rheumatism and rheumatoid arthritis in remission and minimal process activity), Bechterew's disease;
• pathology of the digestive (gastritis, peptic ulcer of the stomach and duodenum, diseases of the liver, biliary tract and pancreas), respiratory (rhinitis, sinusitis, COPD, BA), urinary systems, e
• endocrine pathology, eating disorders and metabolic disorders (goiter disease 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 osteochondrosis of the spine, 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 (articular lesions 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, fibromyoma, the size of which does not exceed 12 weeks of 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, by the nature of their profession, stay for a long time in the area of ​​​​action of radioactive radiation or UHF and microwave currents
• acute inflammatory processes, pregnancy at all times,
• ovarian hypofunction of neuroendocrine origin
• hypothyroidism
• epilepsy
• severe forms of neurosis

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 medical procedures with radon water are not allowed, but the waters of thermal radon springs fill the pool sectors and enter the baths of the most expensive five-star hotel rooms.
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 water used for medicinal purposes - Lipovskoye in the Sverdlovsk region and Uvildinskoye - in the Chelyabinsk region. On the basis of Lithuanian radon waters (weakly radon - Rn 5-40 nCi / l) there is a balneary. The Uvilda deposit of radon waters (high-radon - Rn > 120 nCi/l) is used by the Uvildy resort. In Bashkiria, there are sources of radon waters (weakly radon - Rn 20 nCi / l) in the Krasnousolsk resort. Thermal gases containing radon from the "burning mountain" are used in the Yangan-Tau resort.
The radon clinic in the resort of Pyatigorsk is the largest radon hydrotherapy complex, in which 2.5 thousand procedures of seventeen different types can be dispensed 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 adit, well 63, 75) and weakly radon (Rn 15-40 nCi/l) Thermal sulfur springs.
In Western Siberia, sources of radon water are known: Belokurikha (Rn 10-12 nCi / l) - Belokurikha resort, Altai Territory; Zaeltsovskie (Rn 10-12 nCi / l) (used in the 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 are: Belokurikha (Altai Territory), Kuldur (Jewish Autonomous Region), Pyatigorsk (Caucasian Mineralnye Vody), Uvildy (Chelyabinsk Region). On the basis of the gas-thermal field in Bashkiria, the Yangan-Tau resort operates, where diseases of the organs of movement and the peripheral nervous system, as well as some urological diseases, are successfully treated.

artificial radon water
Artificial radon water is becoming increasingly popular along with natural radon water, which has 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. In the treatment with artificially prepared radon waters with an emanation (radioactivity) level similar to natural waters, a therapeutic effect was obtained comparable with the results resort treatment. In 1921 V.I. Spitsyn studied the transition of radon from minerals to liquid media. In 1949, a book by E.S. Shepotyeva "Artificial radon waters and methods of their application". Subsequently, methods were developed for enriching water, air and other therapeutic environments with radon obtained from radium preparations, which is stored in a bubbler, in a lead container. As a result of the decay of radium, radon is formed, which, according to a special method, is transferred into a bottle of water for the preparation of 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 the bath, pre-filled with water of a given temperature, followed by mixing the water in the bath.
In the artificial preparation of 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, microclysters, suppositories, ointments, applications), 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, Russia and other CIS countries, Germany, the Czech Republic and Slovakia, as well as Japan own safe technology for the preparation of radon waters and preparations. 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 a unique natural complex of radon water, characterized by a complex system of relationships in the form of the interaction of the components of the mineral component of water with radon and its daughter products.

Nitrogen baths

Nitrogen mineral waters - nitrogen-siliceous (nitrogen thermae) - natural warm and hot alkaline waters of low mineralization (up to 2.0 g / l), of various ionic composition, 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- therapeutic baths, for the preparation of which waters containing dissolved nitrogen in high concentrations are 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 atm) 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. V.Ya. Osipov, L.A. Rutenberg, E.D. Svet-Moldavskaya and others.

Mechanism of action
The main active factor in the nitrogen bath is the inert nitrogen gas, which covers the body in the form of bubbles, causing mechanical and thermal irritation of the skin and its nervous apparatus. 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 influences various body systems.

Recommendations
To prepare artificial nitrogen baths, the bath is filled 1/3 with fresh water at a temperature not lower than 60-70 ° C, and then supplemented with cold water supersaturated with nitrogen to the required temperature. Cold water is saturated with nitrogen from a cylinder by means of a saturation apparatus (AN-8, AN-9) under pressure from 150 to 250 kPa (1.5-2.5 atm).

Nitrogen baths are carried out at a temperature of 36-34 ° C, and for 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.

The 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
• improvement of the reactivity of the central nervous system, normalize the overall tone of the body, contribute to the transition of the body to a more economical level of functioning.

Indications

• arterial hypertension I-II st.
• cardiac ischemia
• vegetovascular dystonia
• cerebral atherosclerosis
• obliterating vascular disease
• mild forms of thyrotoxicosis
• neurasthenia
• hypothalamic syndrome
• rheumatoid arthritis
• degenerative-dystrophic lesions of the joints, spine
• skin diseases
• inflammatory diseases of the female genital organs

Contraindications:

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

Occurrence
In Russia and the countries of the former USSR, these waters are located in Nalchik, Goryachinsk, Abastumani, Tskhaltubo, Kuldur, Severobaikalsk (Dzelinda) and others. In European countries: many in Bulgaria, Pyrenees in France, Vilbad 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 the processes of excitation in the central nervous system (which sometimes leads to increased irritability, worsening sleep), cause shifts in the buffer system towards the predominance of hydrogen ions, which contributes to increased ventilation of the lung, improve bronchial conduction, deepen respiratory movements due to increased external respiration, increase the level of oxidative processes , reduce the arterio-venous difference in oxygen content.

Application

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

Contraindications.

Common baths.
Bath temperature 34 - 36 degrees, time 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. bottle solution.
• 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

In balneotherapy, salty baths from the water of bromine-iodine-chloride-sodium sources are used. 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. 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 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 an increase in regenerative processes and the normalization of fat metabolism. Thanks to the latter factor, the content of high-density lipoproteins in the blood of patients increases, preventing the deposition of harmful cholesterol on the walls of blood vessels.

In addition, iodine ions increase the fluidity of blood, 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 general well-being.

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

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

By blocking the conduction of nerve impulses in the skin, bromine ions cause a weakening of pain and tactile sensitivity. To a lesser extent, itching and burning due to allergic reactions begin to be felt. Due to the deposition of salts in the dermis, this effect persists for a long time after the 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, cause significant hemodynamic changes in the body, therefore, they should be prescribed with caution in CCC diseases.

Application.

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

Contraindications.

1. Being a balneological procedure with a pronounced active effect, carbon dioxide, hydrogen sulfide, radon baths are prescribed only for those diseases that are considered indicated for this type of treatment. These baths should be prescribed to patients only after a thorough and comprehensive examination of them.

2. If the patient is prescribed baths, then in the spa book, along with the diagnosis and the basic information regarding the status of the patient, the attending physician must give the exact recipe for the bath, indicating its size (full, half, to the pubis), the degree of water dilution (if this there is a need), temperature (in degrees C) and duration of administration in minutes. The dates of the bath should also be accurately indicated.

3. If, due to some features and severity of the disease, the patient needs special supervision while taking a bath, then he is sent to a special clinical cabin, which should be at the building of the baths. An appropriate note is made in the patient's resort book or a special referral is issued. A doctor is watching him.

4. When treating with baths, it is necessary to take into account the responses and well-being of the patient, varying the method of treatment depending on this. In particular, the general condition, the reaction of the skin (vasospasm), the pulse and the state of blood pressure deserve attention. If the latter rises towards the end of the bath in a person with normal or high blood pressure, then this indicates one of two things: either treatment with carbon dioxide baths is not allowed for this patient at all, or the carbon dioxide bath was designed incorrectly (temperature, hydrostatic pressure, carbon dioxide content and its duration). ). A restructuring of the treatment methodology is required.

5. Having started treatment with mineral baths, one has to temporarily or completely abandon their use. The indications for this are: a negative reaction to baths, a general breakdown, a violation of compensation, a sharp excitement, a worsening of the main suffering, occasional acute illnesses (flu, tonsillitis, etc.), acute gastrointestinal disorders, etc.

6. Mineral baths are preferably taken in the first half of the day; before taking them, you should rest for 10-15 minutes, and if necessary, even more.

7. If mineral baths are taken in the early morning hours, then this should not be done on an empty stomach, but after a light breakfast (a glass of sweet tea with a bun, a glass of milk, etc.). Baths should not be taken immediately after a heavy meal. An interval of 1.5-2 hours is required between such a meal and a bath.

8. It is necessary to strictly monitor the hygienic condition of the balneological institution where carbonic acid and other baths are dispensed. Cabins, rest rooms should be well ventilated to avoid air pollution, the accumulation of large amounts of carbon dioxide, hydrogen sulfide and significant air humidity. Cabin air temperature should be around 18-20°C; large overheating, as well as a sharp decrease in air temperature, are unacceptable.

9. Arriving in the cabin for taking a bath, the patient must undress and plunge into it. In the bath, he should lie quietly, slightly tilting the body. With a small growth of the patient and large sizes of the bath, a special stand is placed in its foot end to support the legs. After taking a bath, the patient wipes himself with a warm sheet, dresses and goes to rest in a specially prepared room. During rest, many patients doze off and even fall asleep. This is a good indicator. Upon returning to the sanatorium, the patient is entitled to additional rest. Rest in bed after taking a bath, lasting, in general, for an hour, one and a half to two hours (depending on the age of the patient, the severity of suffering, etc.), is necessary for the gradual alignment of those physiological changes that develop as a result of carbon dioxide intake. , hydrogen sulfide, radon baths.

10. On the day of taking a mineral bath, other large loading procedures, both balneological and physiotherapeutic, are unacceptable. So, procedures such as mud therapy, fresh baths, general dry-air bath, general diathermy and other large physiotherapeutic procedures, X-ray therapy, wet wrapping are completely incompatible on the same day with carbonic baths.

11. Not allowed on the day of taking mineral baths of exercise therapy with heavy loads, long excursions and long-distance routes along profiled paths. It is not necessary to assign unloading (hungry) days simultaneously with taking carbonic acid baths.

Large load procedures, including mud therapy, are unacceptable on the same day as taking mineral baths, but can be prescribed on days free from the latter.

12. On the day of taking mineral baths, additional medical procedures may be prescribed only as an exception, provided that these are procedures with low loads. These are: inhalations, vaginal irrigations, intestinal lavages, air baths, medical, including hormonal, therapy, physiotherapy procedures of small strength and scale, such as local D "Arsonval," local galvanization ", local massage, exercise therapy with a small load, etc. The possibility of using procedures with a small load on the same day as taking mineral baths is always allowed, depending on the individual characteristics of the patient.

With a positive solution to this issue, it is unacceptable to prescribe more than two procedures on the same day. One more condition should be observed: between, for example, a carbonic acid bath and additional therapeutic measures, there should be an interval (2-3 hours or more), the more significant, the more energetic the additional procedure. Moreover, it is preferable to prescribe additional procedures before taking carbonic baths.