The healing effect of sodium chloride baths. How to take sodium chloride baths? sodium chloride water

Chloride mineral waters- natural waters with a predominance of chlorine (Cl) anions, having a different ionic composition, salinity and temperature. Among the chloride waters, according to the cationic composition, sodium (Na) (the most common), calcium-sodium (Ca-Na), magnesium-calcium-sodium (Mg-Ca-Na), sodium-calcium (Na-Ca), magnesium-calcium (Mg-Ca).

From the history of the use of chloride (salt) waters in the treatment of diseases

Sodium chloride or salt water has been used for salt extraction since ancient times. The discovery of the healing properties of such sources occurred empirically. From ancient times, the inhabitants of Staraya Russa, famous for its salt mines, noted that even during cholera epidemics, there were no cases of illness among the workers of the salt plant. With this water, the local population treated rubella, scrofula, aching bones, and ulcers.

They used the Staraya Russian salt mineral waters haphazardly, and, probably, for a long time the waters would have been known only to local residents, if the disease had not overtaken General Samsonov. During military campaigns, the general visited foreign resorts, had an idea about mineral waters and how to use them. Wounded in battles, he suffered from articular rheumatism and, having learned from local residents about healing springs, he decided to try them on himself. He cleared one of the springs on the outskirts of the city, made a wooden frame and began to bathe in it. Many residents of Staraya Russa began to use Samson's spring to cure many diseases, sometimes on the advice of doctors, sometimes at their own discretion. The idea of ​​​​developing a resort belongs to the life physician Rauh. Having visited Staraya Russa in 1928, he reported this to Emperor Nicholas I, and soon an imperial decree was issued on the arrangement of the resort, and in 1834 a bathroom building for soldiers was built.

Scientific studies of the beneficial effects of salt water were made by the doctors of the Starorussky military hospital. Their reports, dissertations, practical observations remain valuable to this day. They could get such results thanks to hospital treatment that did not exist at other resorts. The health resort helped many sick soldiers to get on their feet, more than a third fully recovered and were able to return to duty. In 1854, the resort was transferred to a civil department. Count Muraviev, who headed the Ministry of State Property at that time, left his name in the history of the health resort: with his assistance, the first stone building was built here and the most powerful self-flowing mineral water fountain in Europe was drilled, which became the symbol and decoration of the health resort. The resort hosted both the Grand Dukes and the Queen of Greece Olga Konstantinovna, writers and artists, musicians and artists. The flourishing of the resort was largely facilitated by the fact that in the homeland of the wife of Alexander I - Elizabeth Alekseevna, nee Princess Louise of Baden-Baden, the resort flourished, and, perhaps, it was this circumstance that prompted the decision to build a luxurious "royal" resort in Staraya Russa.

The opening of the spa resort on the salt springs of Bad Ischl in the Salzkammergut region, which in German means "Pantry of salt", took place at the beginning of the 19th century. At this time, mineral baths were arranged on the sea coast. After examining the composition of the sources, local doctors came to the conclusion that the mineral composition is very similar to sea water, and a higher mineralization will contribute to a greater therapeutic effect. So a small provincial town began to turn into a popular resort. However, it owes its truly universal recognition to the stay and successful treatment of the Habsburg couple, Archduke Charles and Princess Sophie. Before that, a fruitless marriage after medical procedures turned into a joyful opposite: three sons were born, whom popular rumor dubbed “salt princes”.

Some resorts built on salt mines use not only lakes formed after the flooding of salt mines, such as Lake Razval and Tuzluchoe in Sol-Iletsk, but also used salt mines. Underground hospitals were built in salt mines. These are the sanatoriums Soligorsk in Belarus, Solotvino and Salt Symphony (Soledar) in Ukraine, Chon-Tuz in Kyrgyzstan, the Avan-Arinj salt mine in Armenia, Berchtesgaden in Germany, Velichka in Poland, speleological clinics in the salt mines of Praida and Tirgu Okna in Romania. Cm. .

There are also unusual salt spas. In the south of the Altiplano salt desert, in Bolivia, at an altitude of about 3700 m, there is the Uyuni salt marsh (Spanish. Salar de Uyuni), where the hotel was built from salt blocks. These blocks are mined here. Salar de Uyuni is the largest salt lake in the world. Only during the rainy season does it become a lake, and the biggest mirror: when the Salar de Uyuni is covered with water, every cloud is reflected in it. Its area is 10.5 sq. km. The Hotel de Sal Playa in the vicinity of Uyuni was built in 1993. In it, not only the walls are made of salt blocks and fastened together with a solution of salt and water, which the builders used as cement. Everything is made of salt: chairs, tables, beds, walls, floors. The hotel consists of 15 bedrooms, it has a dining room, a lounge-lounge and a restaurant in which everything except food is made from salt.

Deposits of chloride (salt) waters, resorts

Salt waters are often called the waters of ancient seas brought to the surface. One of the largest underground seas is located in the center of the East European Plain - with an area of ​​\u200b\u200babout 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.

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. Opened by deep wells (some over 1000 m), they are used for drinking treatment, baths and other balneological procedures in sanatoriums and rehabilitation centers in Moscow and the Moscow region. Waters of the "underground sea" with mineralization from 50 to 270 g/l are predominantly sodium chloride in composition, other cations - potassium, calcium, as well as trace elements are contained in these waters in smaller quantities, but they also determine the therapeutic effect of waters. For example, the waters of the Staraya Russa resort contain an increased amount of bromine, so the sedative effect is more pronounced.

Salt waters of underground sources are the basis of the resorts Usolye-Sibirskoye, 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) and others

Resorts on salt lakes are very popular: "Lake Yarovoye" in the Altai Territory, "Lake Uchum" in the Krasnoyarsk Territory, "" in the Kurgan Region, "" in, Sol-Iletsk in the Orenburg Region, Tinaki, Baskunchak, Elton in the Volga region. Cm.

Chloride waters of high and medium mineralization are used externally for baths, irrigation, in therapeutic pools. Low-mineralized waters are mainly used as medicinal table waters, less often - medium mineralization.

Drinking treatment with chloride mineral waters

Indications for the use of chloride waters

• Inflammatory diseases in subacute and chronic stages.
• Diseases (neurocirculatory dystonia of cardiac and hypertensive types, stage I-II hypertension, hypotension, chronic venous insufficiency, Raynaud's disease).
• Diseases (polyarthritis, damage to ligaments, tendons, bones, deforming osteoarthritis).
• Peripheral diseases: plexitis, sciatica, neurological manifestations of osteochondrosis, consequences of injuries and injuries of the spinal cord.
• Diseases. The Staraya Russa resort has developed a method for early (7 days after the operation) rehabilitation after surgical treatment for diseases of the digestive system.
• against the background of unchanged hormonal function and hypoestrogenia.
• Diseases: hypothyroidism, obesity of the 1st degree, gout..

Balneotherapy - it is a therapeutic application of mineral waters. It is based on the external use of natural and artificially prepared mineral waters. Balneotherapy also includes the internal use of mineral waters.

^ SODIUM CHLORIDE BATHS - therapeutic effect on a patient immersed in sodium chloride mineral water.

PHYSICAL CHARACTERISTICS. The mineralization of natural sodium chloride waters ranges from 2 to 60 g/l and more. According to the chemical composition and salt content, they are divided into the following types:

1. Sodium chloride, less often calcium-sodium waters with a mineralization of 2-35 g/l.

2. Sodium chloride and calcium-sodium brines with a mineralization of 35-350 g/l.

3. Sodium chloride and calcium-sodium, less often calcium-magnesium ultrastrong brine with a mineralization of 350-600 g/l.

For therapeutic purposes, waters of low (up to 5 g/l), medium (5-15 g/l), high (15-35 g/l) mineralization are used.

DEVICES. Procedures are carried out in a bath or two-, four-chamber baths.

^ THE MECHANISM OF ACTION OF THE FACTOR.Physico-chemical effects. Salts partially penetrate the skin, are deposited on it in the form of a "salt cloak", irritating the skin receptors. The heat flow into the body from a sodium chloride bath is 1.5 times higher than from fresh water.

^ Physiological effects . The “salt coat” is preserved after baths and is a source of long-term influence on the nerve endings in the skin and reflex on the body systems. Sodium chloride penetrates into the internal environment of the body in small quantities, so its biological effect can hardly be taken into account. However, salt baths still indirectly affect the functions of a number of organs and systems.

Salts cause functional disorders in the receptor apparatus of the skin - the primary short-term excitation is replaced by long-term inhibition. Reflex changes in the central nervous system and hypothalamus consist in an increase in the processes of inhibition, in the predominance of the parasympathetic activity of the hypothalamus. In clinical observations, a pronounced analgesic and sedative effect is noted. The formation of a “salt coat” on the skin reduces the evaporation of water from the skin, which leads to a change in the function of the physiological system of thermoregulation. The distinctive effect of sodium baths on heat exchange lies in the greater heating of the body than when taking baths from tap water or gas (carbon dioxide, hydrogen sulfide and radon). An increase in internal body temperature causes a compensatory vasodilating reaction, an increase in oxygen uptake, an increase in the functional activity of the hypothalamus, adrenal cortex and sympathoadrenal system.

Baths with a low salt concentration (10-20 g/l) are characterized by a gradual increase in the stimulating effect on the sympathoadrenal system, starting from the first procedures and reaching a maximum by the end of the course of treatment. At higher concentrations of salts in water, a pronounced stimulating effect is observed. Heat expands the superficial vessels of the skin and increases blood flow by 1.2 times. A significant role in the formation of hyperemia is played by biologically active substances (prostaglandins, bradykinin, etc.) and local neuroreflex reactions. At the same time, after a course of such baths, the content of biologically active substances in patients decreases. Elevated levels of inflammatory markers are reduced.

Sodium chloride water, through its influence on the activity of the sympathoadrenal system and the adrenal cortex, enhances the synthesis of catecholamines, which leads to an increase in oxidative phosphorylation and an increase in the number of macroergs in tissues.

In addition to the general reflex effect due to the chemical composition of water, the mechanism of action of salt baths also has local functional changes in the receptor apparatus of the skin itself, in cellular elements and blood vessels. Medium concentration baths increase the excitability of the central nervous system and the activity of the endocrine apparatus (pituitary gland, adrenal glands, thyroid gland), cause immunocorrection, and change tissue trophism.

The autonomic nervous system reacts to salt baths with an increase in parasympathetic tone, increased blood circulation and diuresis. Thermal and chemical irritation of the skin, activation of thermoregulation mechanisms cause a reflex reaction in the form of expansion of peripheral vessels (compensatory reaction due to an increase in body temperature, a trace effect). An increase in skin circulation is accompanied by the release of deposited blood, an increase in the volume of circulating blood. Sodium chloride baths more significantly than fresh and gas baths increase the tone of peripheral veins and promote the outflow of venous blood from the periphery to the heart, which leads to an increase in venous return, which increases cardiac output (Starling mechanism). An increase in the tone of venous vessels under the action of a sodium chloride bath can be associated with an increase in the activity of sympathetic influences on the cardiovascular system.

^ Healing effects : vasodilating, metabolic, immunostimulating, anti-inflammatory, secretory, antispastic.

INDICATIONS. Sodium chloride baths are indicated for syndromes: hyperergic inflammatory, dysalgic with reduced sensitivity, neurotic on the background of excitement, dyshormonal with a predominance of stress-limiting hormones, immunopathies with allergic or immunodeficiency states), dysplastic, dystrophic by hypotype.

Diseases: inflammatory in the subacute and chronic stages (adnexitis, bronchitis, pancreatitis, etc.), diseases of the cardiovascular system (neurocirculatory dystonia, stage I-II hypertension, chronic venous insufficiency, Raynaud's disease, musculoskeletal system (polyarthritis, damage to ligaments, tendons, bones, deforming osteoarthritis), nervous system (plexitis, sciatica), skin (psoriasis, neurodermatitis, scleroderma), hypothyroidism, stage I-II obesity, gout, vibration disease.

syndromes: infectious, hypoergic inflammatory, dysalgic with increased and inverted sensitivity, neurotic on the background of depression, dyshormonal with a predominance of stress-inducing hormones, as well as organ failure (cardiac, vascular, respiratory, renal, hepatic, gastrointestinal and endocrine dysfunction, encephalomyelopathy, arthropathy, dermopathy) in the stage of decompensation, wound.

Diseases: inflammatory diseases in the acute stage, autonomic polyneuropathy, thrombophlebitis, hypothyroidism.

METHODOLOGY AND TECHNIQUE OF THE PROCEDURE. Artificially prepared baths are used, the content of sodium chloride in which is 10-40 g/l, and the water temperature is from 35-38°C.

DOSAGE. The dosage of baths is carried out by the concentration of dissolved sodium chloride, the temperature of the water, its volume and the duration of the procedure. The duration of the procedures, which are carried out with a break after 1-2 days, is 10-20 minutes.

^ PHYSIOTHERAPEUTIC RECIPE

Diagnosis: Neurocirculatory dystonia of cardiac type.

Rp: Sodium chloride bath, 20 g/l, 35°C, 10 min, every other day, no. 15.

^ BROMONE IODINE BATHS - therapeutic effect on a patient immersed in iodine-bromine mineral water.

PHYSICAL CHARACTERISTICS. In nature, iodine and bromine ions are more common in sodium chloride mineral waters. The content of iodine is not less than 10 mg/l and bromine - 25 mg/l. Iodine-bromine baths contain iodine in ionic form in the form of iodides, the transition of which into a molecular form is accompanied by a significantly greater intake of it from the water into the body of patients, which significantly increases the effectiveness of such procedures. There are various ways of converting iodine into a molecular form, for example, storing water with access to light and air, conducting an electric current through it, and oxidizing it.

DEVICES. The procedure is carried out in the bath.

^ THE MECHANISM OF ACTION OF THE FACTOR.Physico-chemical effects. The penetration of iodine and bromine ions through the skin depends on many circumstances: the mineral composition of water, its temperature, etc. During the procedure (10 minutes), 140-190 μg of iodine and 0.28-0.3 selectively accumulate in the thyroid gland, pituitary gland and hypothalamus. It is known that iodine is an integral part of the thyroid hormone - thyroxine, and bromine is contained in the pituitary tissue. One of the leading factors that affect the penetration of biologically active components of iodine-bromine mineral waters through human skin is kitchen salt.

Among the possible mechanisms of action of sodium chloride on transmembrane ion transport, a decrease in the activity of ions with an increase in the ionic strength of the solution and the formation of ion pairs with different degrees of charge compensation and sizes, and, consequently, with unequal mobility, is of great importance. In a pair of sodium-iodine and sodium-bromine ions, the charges of the ions are compensated to a greater extent, and the size of such pairs is smaller than that of sodium-chlorine ions, since the hydration energy decreases in the series chlorine > bromine > iodine. Therefore, sodium-bromine and sodium-iodine ion pairs, under certain conditions, have an advantage over transmembrane diffusion (but not active transport) compared to a sodium-chlorine pair. Increasing the mineralization of water in the iodine-bromine bath from 6 g/l to 24 g/l doubles the deposition of iodine on the skin. Other things being equal, the movement of water can increase the deposition of iodine on the skin by 5 times, while a 7-fold increase in the volume of water without mixing it by 1.6 times. Established changes in the ability of the thyroid gland to concentrate and fix iodine ions, the direction of which is directly dependent on the concentration of salts in the water: iodine-bromine baths with low mineralization increase the ability of the thyroid gland to concentrate and fix iodine ions. High mineral water baths block the thyroid's ability to store iodine. Fresh water baths have little effect on thyroid function.

^ Physiological effects . Iodine and bromine excite vascular chemoreceptors, reduce muscle tone, blood pressure, heart rate, increase the stroke volume of the heart, the volume of circulating blood, enhance inhibitory processes in the central nervous system, reduce the manifestations of vegetative-trophic disorders.

Entering the structure of thyroxine and triiodothyronine, iodine ions restore the basic metabolism in the body, stimulate protein synthesis and oxidation of carbohydrates and lipids. The lipotropic effect of iodine-bromine baths is more pronounced in contrast to chloride and fresh ones.

The systematic use of iodine-bromine baths with diluted mineral water (mineralization of more than 20 g / l) causes morphological signs of hyperthyroidism, an increase in basophilic cells in the anterior part of the pituitary gland and hypertrophy of the adrenal cortex. There is an improvement in the morphofunctional state of the myocardium and a decrease in the morphological signs of atherosclerosis in the vessels, which indicates a specific inhibitory effect of iodine and bromine on the signs of atherosclerosis. The course application of iodine-bromine baths normalizes the content of 11-OKS in the blood. They increase the fibrinolytic activity of the blood, which is suppressed during atherosclerosis, reduce its coagulation properties and stimulate the formation of antibodies. Under the influence of iodine-bromine water, a decrease in the aggregation ability of platelets is observed, and it is more pronounced than the normalization of indicators of coagulation homeostasis. After a course of baths in the blood, an increase in the content of free heparin is noted.

The presence of iodine and bromine ions in mineral water determines the specific features of the action of baths on the hemostasis system. This is realized through a change in the functional state of endocrine and nervous regulation. The influence of iodine and bromine as biologically active substances on the state of hemostasis through the nervous and endocrine systems is largely antagonistic.

Iodine-bromine baths, increasing blood circulation and changing the function of the endocrine glands, have an anti-inflammatory effect, reduce autoimmune disorders. These aspects of the action served as the basis for the use of iodine-bromine baths in inflammatory diseases. Accumulating in the focus of inflammation in the lungs, iodine ions inhibit alteration and exudation, stimulate the processes of reparative regeneration. The anti-inflammatory effect of iodine-bromine baths is due to the pronounced affinity of iodine to bone and cartilage tissue, as well as the resolving effect, which is achieved due to vasodilation, active redistribution of blood and regulation of local blood circulation.

Penetrating through the blood-brain barrier, iodine ions inhibit excitation processes in the cerebral cortex and weaken pathological temporary connections in patients with psychoses and neurasthenia, accelerate the synthesis of releasing factors of the hypothalamus and tropic hormones of the pituitary gland. The most characteristic property of iodine-bromine baths is the effect on the nervous system, which is expressed by an increase in the threshold of pain sensitivity, increased inhibition processes in the central nervous system, analgesic and sedative clinical effect. By blocking the ion permeability of potential-dependent ion channels of the peripheral nerve conductors of the skin, iodine ions cause a decrease in pain and tactile sensitivity in patients, have a desensitizing, bacteriostatic and bactericidal effect.

Iodine-bromine baths reduce the tone of arterial vessels and increase the tone of veins, increase venous blood flow to the heart and cardiac output.

^ Healing effects : stress-limiting, anti-inflammatory, reparative-regenerative, metabolic, sedative, bacteriostatic, bactericidal, hyposensitizing, immunocorrective, secretory, hypotensive, analgesic.

INDICATIONS. Iodine-bromine baths are indicated for syndromes: hyperergic inflammatory dysalgic with increased and inverted sensitivity, neurotic on the background of excitement, dyshormonal with a predominance of stress-inducing hormones, immunopathies with allergic or immunodeficiency states, dysplastic and dystrophic in hypertype.

Diseases: chronic inflammatory, angina pectoris I and II FC, atherosclerotic and postinfarction cardiosclerosis (10 weeks after myocardial infarction), hypertension stage I-II, polyneuropathy, psychosis, schizophrenia, neurasthenia, eczema, neurodermatitis, cerebral atherosclerosis, Raynaud's disease, endocrine forms of female infertility (with the exception of thyrotoxicosis), osteoarthritis.

CONTRAINDICATIONS. Along with the general syndromes: infectious with a pyretic reaction, hypoergic inflammatory, neurotic on the background of depression, dyshormonal with a predominance of stress-limiting hormones, edematous, as well as organ failure (cardiac, vascular, respiratory, renal, hepatic, gastrointestinal and endocrine dysfunction, encephalomyelopathy, arthropathy, dermopathy ) in the stage of decompensation, dysplastic and dystrophic according to the hypotype, wound.

Diseases: inflammatory in the acute stage, iodine intolerance, severe forms of diabetes mellitus and thyrotoxicosis, pituitary form of obesity, gout, hypothyroidism.

METHODOLOGY AND TECHNIQUE OF THE PROCEDURE. To prepare an artificial bath with a capacity of 200 liters, 2 kg of sea or kitchen salt, 25 g of potassium bromide and 10 g of sodium iodide are added to fresh water. It is advisable to immediately prepare a solution for 10 baths, for this, 250 g of potassium bromide and 100 g of sodium iodide are dissolved in 1 liter of cold water. After the salt is dissolved in fresh water, 100 ml of this solution is added to it. The solution is stored in a dark glass container with a stopper. Before the procedure, a concentrated mother solution is poured into the bath. Then cold fresh water is added until the desired temperature and volume of the bath are obtained. After that, the patient is carefully immersed in the bath to the level of the nipples. After the bath, the patient soaks the body with a towel, wraps himself in a sheet and rests for 20-30 minutes.

DOSAGE. For the procedure, mineral water 35-37 ° C is used, the content of iodine ions, in which is not lower than 10 ml / l, and bromine ions - 25 mg / l. The duration of the procedures with a break every other day or two is 10-15 minutes, the course of treatment is 10-15 baths.

^ PHYSIOTHERAPEUTIC RECIPE

Diagnosis: IHD: atherosclerotic cardiosclerosis, CH 1.

Rp: Iodine-bromine bath, 25 mg/l potassium bromide and 10 mg/l sodium iodide, 35°C, 10 min, every other day, No. 10

^ HYDROGEN SULFIDE BATHS - therapeutic effect on a patient immersed in hydrogen sulfide mineral water.

PHYSICAL CHARACTERISTICS. Hydrogen sulfide waters include waters that contain sulfides in the form of a molecular (H 2 S 2) or hydroxyl ion (HS -). Depending on the content of sulfides (total hydrogen sulfide), natural waters are divided into weak (0.3-1.5 mmol / l, or 10-50 mg / l), medium (1.5-3 mol / l, or 50-100 mg / l), strong (3-7.5 mmol / l, or 100-250 mmol / l) and very strong (7.5-12 mmol / l, or 250-400 mg / l). In clinical practice, water of medium concentration, more than 10 mg/l of total hydrogen sulfide, is more often used. The ionic composition of hydrogen sulfide waters is determined by the hydrogeological features of their deposit and includes hydrosulfite ions, hydrocarbonates, sulfates and chloride. Most natural hydrogen sulfide mineral waters (temperature 35-37°C) have medium and high mineralization (10-40 g/l). Resorts of Ukraine with sulfide waters: Lyuben-Veliky, Nemirov, Sinyak, Cherche.

DEVICES. The procedures are carried out in a bath in a separate room with good ventilation.

^ THE MECHANISM OF ACTION OF THE FACTOR.Physico-chemical effects. Free hydrogen sulfide available in water is split into hydrogen ions, hydrosulfidions and sulfur. Hydrogen sulfide actively penetrates the body through intact skin, mucous membranes and upper respiratory tract. Hydrogen sulfide, as a strong reducing agent, converts the disulfide groups of proteins and enzymes into sulfhydryl groups and acts as a natural antioxidant. As a result, the activity of the pentose cycle and the synthesis of low-density lipoproteins decrease, and glycolysis is activated.

^ Physiological effects . The main active principle of the use of sulfide baths, in addition to their thermal and hydrostatic factors, is free hydrogen sulfide and hydrosulfide ions. Irritating the sensitive nerve endings in the skin and mucous membranes of the respiratory tract, hydrogen sulfide causes reflex reactions of the vasomotor nerves, thereby changing the vascular tone of the skin. At the same time, histamine-like substances are released and participate in this regulation. In addition, penetrating through the skin and mucous membranes of the respiratory tract into the blood, hydrogen sulfide affects the internal environment of the body. Hydrogen sulfide circulating in the blood quickly undergoes oxidation with the participation of the liver. Oxidation products are excreted by the kidneys, therefore, in case of liver and kidney diseases, sulfide balneotherapy is not carried out, since complications from these organs are possible.

Hydrogen sulfide circulating in the blood and its oxidation products, as well as vasoactive substances (histamine, serotonin, etc.) act on the chemoreceptors of the vessels of the sinocarotid and aortic zones (excites), affecting vascular tone, blood pressure and heart regulation.

Sulfide baths contribute to the normalization of the disturbed functional state of the central nervous system, enhancing the processes of inhibition in it and balancing the nervous processes, the functional state of the hypothalamus changes (parasympathetic influence increases) and the vagotonic nature of reactions to the first procedures prevails. Reflexes from carotid chemoreceptors lead to contraction of the spleen and release of erythrocytes into the general circulatory system, activate the secretion of corticosteroids by the adrenal medulla. This leads to hyperglycemia and an increase in the content of immunoglobulins E and G, as well as increased glomerular filtration and diuresis.

Molecules of hydrogen sulfide predominantly penetrate into the body from water, which is further oxidized to sulfates and sulfides. Molecules through the skin enter the bloodstream and cerebrospinal fluid. Oxidized, they form free sulfur and sulfides in the tissues, which, by blocking enzymes containing iron (cytochrome oxidase, lipase, etc.), inhibit the rate of oxidative phosphorylation in tissues. Hydrogen sulfide reduces platelet aggregation and blood viscosity. Due to the activation of polymorphonuclear leukocytes, hydrogen sulfide stimulates reparative regeneration in tissues, streamlines the structure of collagen fibers in scars. The exchange of proteins and amino acids that contain sulfiryl groups is enhanced. Mineral waters containing sulfur have a positive effect on cartilage metabolism. The content of biologically and vasoactive substances in the blood increases, which determine the humoral link in the regulation of the main physiological functions of the body. The number of active capillaries is growing, metabolic processes at the cellular and tissue levels are accelerating, microcirculation is improving.

Expansion of skin vessels with redistribution of blood, a decrease in the tone of arterioles is accompanied by a decrease in peripheral vascular resistance, a decrease in blood pressure and an increase in cardiac output. This is also facilitated by an increase in the flow of venous blood to the right heart due to an increase in the amount of circulating blood (the release of deposited blood due to its movement into the dilated vessels of the skin). Improves filling of the heart. This effect of sulfide baths on the heart, which is regularly repeated during the course of treatment, is considered as training and serves as the basis for their use in the treatment of the initial stage of heart failure (adaptation therapy).

With the hypokinetic variant of blood circulation, hemodynamic recovery occurs due to a decrease in increased peripheral resistance under the influence of baths with a concentration of 75-100-150 mg/l. At the same time, there is an improvement in the contractile function of the myocardium, as evidenced by an improvement in the phase structure of the left ventricular systole.

Restoration of hemodynamics in the hyperkinetic variant occurs due to a decrease in elevated SV, and only under the influence of baths with a low concentration of hydrogen sulfide 25-50-75 mg/l. Sulfide baths with a higher (100-150 mg/l) concentration of hydrogen sulfide either do not reduce the SV or increase it even more.

Hydrogen sulfide baths contribute to the intensification of carbohydrate metabolism, which leads to a decrease in hyperglycemia in patients with diabetes mellitus, activates the reserves of catecholamine biosynthesis and helps to restore the impaired (mainly reduced) functional state of the sympathoadrenal system, glucocorticoid function of the adrenal glands. Sulfide baths (100-150 mg/l) increase the iodine-absorbing function of the thyroid gland, activate the reduced estrogen function of the ovaries, restore the disturbed menstrual cycle.

^ Healing effects : reparative-regenerative, metabolic (glycolytic and lipolytic), immunomodulatory, secretory, stress-inducing, thrombocoagulating (primary), pro-inflammatory (primary), tonic, cardiotonic, analgesic.

INDICATIONS. Hydrogen sulfide baths are shown with the following main syndromes: hypoergic inflammatory, dysalgic with increased, reduced and inverted sensitivity, neurotic on the background of depression, dyskinetic and dystonic, as well as organ failure (cardiac, vascular, arthropathy) in the compensation stage, dysplastic and dystrophic.

Diseases: chronic inflammatory, angina pectoris I-II FC, pathology of the peripheral nervous system and joints with hyporeactivity of the body (neuralgia, polyneuritis, sciatica, myelitis, encephalitis, neurasthenia, cerebroasthenia, polyarthritis, spondylosis, osteochondropathy, osteoarthrosis), Raynaud's disease, obliterating endarteritis, varicose disease, vibration disease, tubal infertility, chronic poisoning with salts of heavy metals.

CONTRAINDICATIONS. Along with the general syndromes: infectious, hyperergic inflammatory, neurotic on the background of excitement, dyshormonal with a predominance of stress-inducing hormones, immunopathies with allergic conditions, organ failure (cardiac, vascular, respiratory, renal, hepatic, gastrointestinal and endocrine dysfunction, encephalomyelopathy, arthropathy, dermopathy) in the stage of decompensation, wound.

Diseases: inflammatory in the acute stage, angina III-IV FC, diseases of the kidneys, liver and biliary tract and bronchopulmonary system, toxic-allergic reactions to hydrogen sulfide, vegetative vascular dysfunction, severe dysfunction of the pelvic organs, arachnoiditis, tendency to thrombosis, gastric ulcer in the acute stage .

DOSAGE. The dosage of baths is carried out by the concentration of hydrogen sulfide, as well as the temperature of the water, its volume and the duration of the procedure. The duration of the procedures, which are carried out with a break every other day or two, is 8-12 minutes, the course of treatment is 12-14 baths.

^ PHYSIOTHERAPEUTIC RECIPE

Diagnosis: Raynaud's disease.

Rp: Hydrogen sulfide bath with a concentration of 75 mg / l, 36 ° C, 15 min, every other day, No. 12.

RADON BATHS - therapeutic effect on a patient immersed in radon mineral water. Recently, other types of radon therapy have also been used: air-radon or "dry radon baths", devoid of the action of water, but retaining the specific effect of alpha radiation. Pararadon procedures ("baths") are natural radon steam from wells, cracks in rocks or mine workings. The features of their action are not only the exclusion of hydrostatic influence, but also a higher accumulation of radon in the internal organs due to the high temperature of the vapor-air medium (44-46 0 C).

PHYSICAL CHARACTERISTICS. The main active factor of the radon bath is the dissolved inert gas radon (Rn), the decay of which is accompanied by alpha radiation (the half-life of radon is 3.823 days). For therapeutic effects, mineral water is used, which contains radon, daughter decay products - polonium (Po), lead (Pb), bismuth (Bi). Moreover, the daughter products of radon (DPR) are an active agent to a much greater extent than radon itself. The part of the DPR accounts for 70% (in water baths) to 97% (in air baths) of the absorbed radiation energy. The half-life of radon radioisotopes ranges from a few to 26 minutes. The volumetric activity of radon in water should exceed 37 Bq/l.

Most natural radon mineral waters have low mineralization (below 2 g/l) and contain, in addition to radon, various gases and minerals. The temperature of radon bath water is 34-36 0 С. The concentration of radon in baths is determined by the unit of activity - curie, corresponding to the activity of any radioactive isotope, in which 37 billion decays occur in 1 s. Today they introduce a new unit of activity according to the international system (SI) - becquerel (BC) 1 nCi = 37 BK. Natural waters are divided into waters with low (0.2-1.5 kBq/l, or 5-40 nCi/l), medium (1.5-7.4 kBq/l, or 40-200 nCi/l) and high (over 7.5 kBq/l, or 200 nCi/l) radon concentration.

DEVICES. The procedures are carried out in a bathtub installed in a separate room with good ventilation.

^ THE MECHANISM OF ACTION OF THE FACTOR.Physico-chemical effects. When the stratum corneum of the skin is irradiated, radiolysis products (radiotoxins) are formed, which can penetrate into the deep layers of the skin (dermis). Radiotoxins disrupt the processes of glycolysis and oxidative phosphorylation and thus affect cell functions. The alpha radiation of radon causes the ionization of protein molecules and water of the dermis and the formation of reactive oxygen species. During the procedure, up to 0.27% of radon penetrates the body through the skin, which creates a high concentration of ionization products in the tissues of internal organs. A so-called radioactive plaque settles on the skin, which continues to act even after the bath. The skin has a kind of barrier layer that prevents the transport of radon. It not only significantly limits the entry of radon into the body, but also slows down its reverse excretion. This layer appears to be composed of phospholipid molecules known to be in liquid crystalline form.

^ Physiological effects . Changes in cellular metabolism are accompanied by the release of biologically active substances, which in turn serve as a source of afferent impulses and many body reactions. Irritation of numerous nerve endings of the skin with alpha radiation reduces the threshold of their sensitivity. Due to internal irradiation, the sensitivity threshold of nerve endings in organs changes. A decrease in alpha- and beta-adrenergic sensitivity was established under the influence of drinking radon water and baths (trace effect).

Radon baths also reduce sensitivity to angiotensin and norepinephrine. The products of protein radiolysis, like the protein products of photodegradation, come into contact with sensitized helper T-lymphocytes and stimulate the release of cytokines. As a result, the synthesis of neutral proteases, biologically active substances and Ig by tissue histiocytes (macrophages) and polymorphonuclear granulocytes is enhanced. The induction of immune processes in the skin is also potentiated by products of lipid peroxidation, which activate the differentiation of T- and B-lymphocytes with the production of immunoglobulins. The primary phase of radon therapy is characterized by a stress-inducing orientation and immunosuppression. In the future, there is a restoration of moderately impaired immune functions. But in the case of deeper breakdowns in the homeostasis of immunoregulatory cells, radon therapy can exacerbate existing disorders and lead to an exacerbation of the disease.

In the hyperkinetic variant, hemodynamic recovery occurs under the influence of baths with a radon concentration of 40-80 nCi/l, in the hypokinetic variant - 40 nCi/l. Restoration of hemodynamics in the hyperkinetic variant (decrease in cardiac output) can be associated with a decrease in sympathetic effects on the cardiovascular system. Confirmation of this position was a decrease in clinical signs of hypersympathicotonia and a decrease in the daily excretion of catecholamines and their precursors, increased before treatment, under the influence of baths with a concentration of 40 and 80 nCi/l.

Restoration of hemodynamics (increase in cardiac output) in the hypokinetic variant of blood circulation occurs due to a decrease in peripheral resistance under the influence of baths with a concentration of 40 and 120 nCi/l (baths of 40 nCi/l work more favorably). An increase in cardiac output is also due to an increase in venous blood flow to the heart, an increase in vein tone only at a given radon concentration. At the same time, an increase in dopamine excretion is observed, which is significant only at a concentration of radon baths of 40 nCi/L.

When applied externally (during bathing - the primary effect), the concentration of catecholamines in various tissues increases. An increase in their level is observed in the adrenal glands with internal use (drinking) of radon water.

One of the main mechanisms of action of alpha radiation from radon baths is the effect on the nervous system of all its levels. After a course of radon baths with a concentration of 40-120 nCi / l, the increased excretion of adrenaline and dopamine decreases with a decrease in the clinical and hemodynamic signs of hypersympathicotonia. Alpha radiation of radon significantly reduces the conductivity of nerve fibers, which leads to a decrease in pain sensitivity of the skin, a decrease in sympathetic tone and an increase in the parasympathetic divisions of the autonomic nervous system.

The effect of alpha radiation on the body is realized both directly on the cells and tissues of organs, and indirectly through the centers of neuroendocrine regulation. There is a stimulating effect of radon baths on the function of the corpus luteum, often reduced in patients with hypertension. In the early period of menopause (menopause lasting up to 1 year), under the influence of treatment with radon baths, a more favorable course is noted than in patients with prolonged (from 2 to 14 years) menopause. It is expressed by a decrease in increased estrone excretion and an increase in estriol due to an accelerated transition of estrone to estriol. This significantly distinguishes the action of radon baths from sulfide and carbonic ones, the action of which leads to favorable changes in estrogen metabolism only in patients in the late period of menopause.

There is a stimulating effect of radon baths on the activity of tissue lipolytic enzymes in atherosclerosis, hypercholesterolemia decreases in patients with coronary artery disease and hypertension during treatment at resorts with radon waters. The use of natural or artificial radon baths in patients with exogenous obesity leads to an increase in carbohydrate tolerance, a decrease in the level of uric acid in the blood and an increase in its excretion in the urine in patients with gout.

^ Healing effects : reparative-regenerative, metabolic (glycolytic and lipolytic), immunostimulating, antispastic, analgesic, stress-inducing.

INDICATIONS. Radon baths are indicated for the following main syndromes: hypoergic inflammatory, dysalgic with increased, inverted sensitivity, neurotic on the background of arousal, dyshormonal with a predominance of stress-limiting hormones, immunopathies with immunodeficiency states, dysplastic and dystrophic.

Diseases: chronic inflammatory, pathology of the cardiovascular (angina pectoris I-III FC, myocardial dystrophy, myocardial, atherosclerotic, postinfarction cardiosclerosis, hypertension stage I-II, varicose veins), musculoskeletal (arthritis, osteomyelitis, bone fractures with delayed consolidation in hyporeactivity of the body, osteoarthritis, spondylitis) and nervous systems (neuralgia, neuritis, radiculitis, plexitis, neurasthenia, sleep disturbance, consequences of brain injuries), skin (neurodermatitis, psoriasis, scleroderma), keloid scars, trophic ulcers, gout, diabetes mellitus, obesity II-III degree, diffuse toxic goiter I-II degree, uterine fibromyoma (up to 12 weeks of pregnancy), endometriosis.

CONTRAINDICATIONS. Along with the general syndromes: infectious with pyretic reaction, hyperergic inflammatory, neurotic on the background of depression, dyshormonal with a predominance of stress-inducing hormones, organ failure (cardiac, vascular, respiratory, renal, hepatic, gastrointestinal and endocrine dysfunction, encephalomyelopathy, arthropathy, dermopathy) in the stage decompensation, wound.

Diseases: inflammatory in the acute stage, poor tolerance to radon mineral water, professional exposure to ionizing radiation, ovarian hypofunction of neuroendocrine origin, pregnancy, uterine fibromyoma (over 12 weeks of pregnancy), lymphopenia, radiation sickness, severe neurosis, autonomic dysfunction, angina pectoris IV FC , hyperthyroidism stage III.

METHODOLOGY AND TECHNIQUE OF THE PROCEDURE. An artificial radon bath is prepared by pouring and stirring a portion (100 ml) of a concentrated radon solution into fresh water of a bath (200 l) of a given temperature. The patient is immersed in the bath to the level of the nipples. After the bath, the patient dries the skin with a towel (without rubbing), which contributes to the preservation of the daughter products of radon decay on the skin, and rests for 30-60 minutes.

DOSAGE. The dosage of baths is determined by the duration of the procedure, the radioactivity of radon, as well as the temperature of the water and its volume. Artificially prepared waters are prescribed for adults at a concentration of 40-80 nCi / l, for children - 20 nCi / l. The duration of the baths, which are carried out daily or every other day, is 12-15 minutes, the course of treatment is 10-15 baths.

^ PHYSIOTHERAPEUTIC RECIPE

Diagnosis: Widespread osteochondrosis.

Rp: Radon bath, 80 nCi/L, 36°C, 10 min, every other day No. 10.

INTESTINAL FLUSHING - irrigation of the walls of the large intestine with liquid.

PHYSICAL CHARACTERISTICS. For intestinal lavage, fresh water with a decoction of herbs (chamomile, etc.), a solution of medicinal substances, mineral water (salt solution of kitchen, English, Karlovy Vary salt, magnesium sulfate) or acidic mineral water with a mineralization of 2-8 g / dm 3 with a temperature 37-39°C.

APPARATUS. A couch for gastrointestinal irrigation with a dosing tank, APKP-760 (underwater intestinal lavage apparatus), AKP (intestinal lavage apparatus) and AMOK (intestine monitor cleaning apparatus), hydrocolon.

^ THE MECHANISM OF ACTION OF THE FACTOR.Physico-chemical effects. The injected fluid penetrates to the ileocecal valve and loosens the intestinal content, which is then excreted with fluid from the colon. The liquid also cleanses the intestinal walls from torn epithelial cells, mucus, waste products, toxins, excreta and putrefactive aerobic bacteria. The washing liquid restores the normal ratio of microorganisms of the intestinal microflora, which break down the nutrients of the chyme, and synthesize vitamins of group B.

^ Physiological effects . An increase in fluid pressure in the rectum to 4-5 kPa causes irritation of the mechanoreceptors of the submucosal layer, leads to the formation of afferent impulse flows that excite the defecation center located in the transverse segments of the spinal cord. The tone of the muscular internal sphincter increases, the tone of the external anal sphincter weakens, and defecation occurs. In this case, there is an increase in respiratory rate, heart rate (by 10-20 beats / min), as well as an increase in blood pressure (systolic by 50-60 mm Hg, diastolic - by 10-20 mm Hg), the volume of circulating blood increases. Due to the absorption of a certain amount of water, diuresis increases. Intestinal lavage enhances the local blood flow of the colon mucosa and restores the absorption of gases and minerals into the blood, which is disturbed during the disease. The flushing liquid reduces inflammation and corrects metabolic disturbances in the interstitium, restores motility and secretion of the intestinal mucosa, and normalizes immunity.

^ Healing effects : defecation, detoxification, metabolic, kinetic, diuretic, hyposensitizing, immunocorrective.

INDICATIONS. Before the appointment of intestinal lavage, clinical and laboratory examinations of the rectum and pelvic organs are carried out (review by a proctologist and gynecologist, sigmoidoscopy, irrigoscopy, fecal occult blood analysis). Intestinal lavage is indicated for the following syndromes : hyper- and hypoergic inflammatory, dysalgic with reduced and inverted sensitivity, immunopathies with allergic or immunodeficiency conditions, dyskinetic and dystonic hyper- or hypotype.

Diseases: chronic colitis, chronic constipation, chronic gastritis, liver and biliary tract disease, gout, diabetes, diathesis, obesity.

CONTRAINDICATIONS. In addition to absolute syndromes: infectious inflammatory, dysalgic with hypersensitivity, edematous, as well as organ failure (cardiac, vascular, respiratory, renal, hepatic, gastrointestinal and endocrine dysfunction) in the stage of decompensation, wound.

METHODOLOGY AND TECHNIQUE OF THE PROCEDURE. Before the procedure, the patient empties the intestines and bladder, it is advisable to give an enema. The flushing liquid is injected into the large intestine under a pressure of 12-15 kPa in portions, which increase from 0.5 to 1.5 liters. The total volume of water is up to 10 liters. The rinsing water is administered through a sterile rectal tube with a Vaseline-lubricated tip and connected to the rinsing reservoir system. The rubber tip is injected to a depth of 15-20 cm. The flushing liquid is injected in portions, using a tap. When urged to defecate, they expel it along with feces into the sewer.

DOSAGE. The dosage is carried out by the pressure of the washing liquid, its volume and the number of washings. Washing is carried out 1-2 times a week. The course of treatment - 6 procedures.

^ PHYSIOTHERAPEUTIC RECIPE

Diagnosis: Chronic non-infectious catarrhal colitis, inactive phase.

Rp: Intestinal lavage with chamomile decoction, water temperature 37 0 C, from 0.5 to 1.5 l, total volume up to 10 l, two days later, No. 5.

^ RECEPTION OF MINERAL WATER INSIDE. The use of drinking mineral waters has become widespread in diseases of the digestive system, urinary, endocrine systems, metabolic pathology.

PHYSICAL CHARACTERISTICS. For drinking treatment, mainly water of low and medium degree of mineralization (2-5 and 5-15 g/l) is used. Waters with a mineralization of less than 2 g/l are therapeutic if they contain any specific components in increased quantities, such as organic substances. The temperature of drinking mineral waters varies widely: cold waters - below 20 0 C, warm (subthermal) - 20-35 0 C, hot (thermal) - 35-42 0 C, very hot (hyperthermal) - above 42 0 C. For ingestion, warm and hot water is more often used. The acidity and alkalinity of the water is important. There are strongly acidic (pH 8.5). More often use weakly alkaline water. The weakly acidic reaction of mineral waters can be converted into slightly alkaline by heating the water, when part of the carbon dioxide is released from it.

Physiological and therapeutic effect depends on the chemical composition of mineral water. It is the ionic composition that determines the type and name of water.

The assessment of the properties of mineral water must begin with a consideration of the geological layers where the water is formed. In this regard, silicic, calcareous, ferruginous, quartz and other waters are of great interest. For example, water deposits in the Zborovsky district of the Ternopil region have unique geological and geophysical properties. During the drilling of the well, rock layers were revealed: loam, calcareous clay, limestone, clay with interlayers of sand and clay, chalk with silicon. These layers are involved in the formation of water containing calcium, silicon, iron, iodine, etc. The lack of these trace elements is observed in patients with vagoinsular type of autonomic dysfunction.

The reserves of sodium and magnesium in the salt deposits of ancient seas create unique waters containing sodium, magnesium, potassium, copper, fluorine, zinc, phosphorus, molybdenum, manganese, vanadium, and chromium. Deficiency of these micro and macro elements is observed in patients with sympathoadrenal dysfunction. The uniqueness of such water deposits makes it possible to introduce a new type into the classification of mineral waters - health-improving (along with medicinal and table waters). For the first time, the concept of "adaptive " water, the action of which is aimed at correcting homeostasis in the patient's body. The intake of this water is determined by the leading syndrome and deficiency of macro- and microelements, their action in conditions of impaired vegetative tone, hormonal balance, immune status and metabolism.

^ THE MECHANISM OF ACTION OF THE FACTOR.Physico-chemical effects. Ions of sodium, potassium, calcium, magnesium, hydrocarbonates, sulfates are involved in the most complex physical and chemical processes, in maintaining acid-base balance. Bicarbonate waters, filling the lack of blood carbonate, increase the body's alkaline reserves, neutralize the acidic secretion of the stomach, reducing the amount of hydrogen ions. Chlorine anions are the initial substrate for the formation of hydrochloric acid in gastric juice. Sulfates inhibit acid formation in the stomach, improve the physicochemical properties of bile. Magnesium salts catalyze the function of a number of enzymes (trypsin, erypsin). Sodium and potassium regulate metabolism and osmotic pressure in tissues.

^ Physiological effects . Drinking mineral water liquefies pathological mucus in the digestive canal, urinary tract, thereby contributing to its removal from these organs. Hydrocarbonate water inhibits the level of acid formation in the stomach. Reacting with gastric juice, bicarbonates form carbonic acid. Neutralization of the acid secretion of the stomach helps to reduce the production of gastrin. ions chlorine are the initial substrate for the formation of hydrochloric acid, increase gastric motility, stimulate pancreatic secretion, the formation of intestinal enzymes. sulfate sodium and magnesium salts, by restoring the function of hepatocytes, have a beneficial effect on the functional state of the liver, increase choleresis, and improve the physicochemical properties of bile. Waters that contain sulfates, irritate the intestinal mucosa, increase its peristalsis and secretion, have a laxative effect. ions sodium, potassium increase the tone and motor function of the stomach and intestines.

In the case of reduced acidity, ingested mineral water of a complex chemical composition irritates the chemoreceptors of the gastric mucosa, reflexively excites the vagus nerve, which is the secretory nerve of the stomach. The release of gastrin, acid formation and gastric motility are enhanced. Gastrin increases protein synthesis of the gastric mucosa, enhances microcirculation, which leads to improved tissue trophism. Stimulation of the activity of glands that form acid is not observed only in patients with deep atrophy of the gastric mucosa, the glandular apparatus of which is not capable of producing hydrochloric acid.

In hyperacid conditions, mineral water stimulates secretin and pancreozymin, which increases the alkalinity of the duodenal cavity, and inhibits gastric secretion of hydrochloric acid.

The functional state of the liver improves, first of all, by improving blood circulation in it. An increase in the intensity of hepatic blood flow, a decrease in tissue hypoxia is associated with the action of gastrin, the release of which is stimulated by mineral water. The function of the pancreas improves, the content of bicarbonates and enzymes in the pancreatic juice increases.

Fluorine normalizes the mineral composition in severe osteoporosis. Patients who constantly receive glucocorticoid hormones (the latter are known to cause magnesium deficiency in the body) should take water with a large amount of magnesium. Against the background of such mineral water, magnesium-calcium and phosphoruresis increase, the secretion of parathyroid hormone decreases, the level of magnesium in the serum increases, which ultimately improves the course of the disease. sulfate anion , which is contained in mineral water, is included in the exchange of connective and cartilage tissue. The process of sulfate assimilation in chondrocytes is observed already an hour after drinking water, and the cation associated with sulfate has a great influence on intracellular fixation and the rate of sulfur absorption.

Mineral waters increase the excretion of uric acid by the kidneys due to the diuretic effect and inhibition of urate reabsorption in the tubules. carbon dioxide bicarbonate and sulfate sodium waters increase the alkalinity of urine and have a diuretic effect, especially waters of low mineralization with a pH above 7.1. Sulphate calcium and magnesium waters also contribute to the removal of urea (by 90%) and chlorine (by 87%).

A risk factor for the formation of calcium oxalate stones is a deficiency in the body of magnesium, therefore, waters with a high magnesium content can be successfully used to eliminate mineral metabolism disorders. Bicarbonate and sulphate waters have litholytic properties, prevent the agglutination of urinary crystals, and stimulate the peristalsis of the urinary tract. With uraturia, the use of bicarbonate sodium waters is more justified, and with oxalaturia - calcium sulfate. Calcium ions form insoluble compounds with oxalic acid, which as a result contributes to the removal of oxalates from the body, preventing relapses of urolithiasis. Sulfate-magnesium waters also suppress oxaluria and normalize mineral metabolism.

The destruction of oxalate and urate stones in the kidneys leads to the use of bicarbonate water, which increases the content of citrates in the urine, causing an increase in alkalinity.

^ In health waters microelements are of great importance, which are important for the correction of water-electrolyte and functional disorders accompanying the leading pathogenetic syndrome.

^ Healing effects : when consumed internally, mineral waters have anti-inflammatory, antispasmodic, analgesic effects, normalize the secretory and motor functions of the stomach and intestines, contribute to the normalization of bile formation and bile secretion, increase diuresis.

INDICATIONS. Ingestion of mineral water is indicated for syndromes: hyper- and hypoergic inflammatory, dyshormonal with a predominance of stress-inducing or stress-limiting hormones, immunopathies with allergic or immunodeficiency conditions, dyskinetic and dystonic hyper- or hypotype.

Diseases: digestive organs (diseases of the esophagus, stomach, peptic ulcer, intestinal diseases without an exacerbation phase; diseases of the liver and biliary tract, chronic pancreatitis without a tendency to frequent exacerbation, diseases of the operated stomach); genitourinary system (chronic pyelonephritis without symptomatic hypertension, chronic cystitis, urolithiasis, condition after surgery for the removal of stones); metabolic diseases (obesity, diabetes mellitus, mineral metabolism disorders).

At dysneurotic syndrome, vagotonics are prescribed healing waters that have a stimulating effect on the central nervous system (for example, Zborovskaya "Tonus"). It contains trace elements of calcium, iron, iodine, selenium, sulfur. Sympathotonics are shown sedative waters containing trace elements - magnesium, potassium, sodium, phosphorus, copper, zinc, manganese, which have an inhibitory effect on the central nervous system (for example, Zborovska "Relax".)

At dishormonal syndrome with a predominance of synthetic processes, tonic water is shown, which activates the sympathoadrenal system and the processes of glucose breakdown (calcium, iron, iodine, sulfur, etc.). In dishormonal syndrome with a predominance of catabolic processes, water is prescribed that contains zinc, molybdenum, vanadium and other trace elements that activate insulin and other synthetic hormones, as well as the processes of glucose uptake.

At disimmune allergic type syndrome shows desensitizing waters (contain calcium, iodine, iron). In case of immunosuppression, immunomodulating waters (magnesium, potassium, etc.)

At dysmetabolic in a syndrome with alkalotic disorders, the use of slightly acidic waters is justified; in case of metabolism with acidosis, alkaline waters are indicated. The slightly acidic reaction of mineral waters can be converted into slightly alkaline by heating the water. Part of the carbon dioxide is released from the water.

CONTRAINDICATIONS. In addition to the general syndromes: infectious with pyretic reaction, dysalgic with hypersensitivity, edematous, organ failure (cardiac, vascular, respiratory, renal, hepatic, gastrointestinal and endocrine dysfunction, encephalomyelopathy, arthropathy, dermopathy) in the stage of decompensation.

Diseases: chronic stomach and intestines, which are accompanied by frequent vomiting, diarrhea, bleeding, severe pain, severe indigestion; diseases with a pronounced violation of the motor-evacuation function of the stomach and intestines, narrowing of the esophagus, adhesions of the abdominal cavity; gastritis rigid; peptic ulcer of the stomach, complicated by stenosis, penetration, all forms of jaundice, cirrhosis of the liver; viral hepatitis; cholelithiasis with frequent attacks; chronic dysentery; urolithiasis disease; urological diseases (cystitis, prostatitis) in the acute stage. Contraindications for the treatment of patients with gout at drinking resorts include frequent renal colic with the discharge of multiple calculi, impaired urine outflow from the kidneys, and an increase in the concentration of urea and creatinine in the blood (respectively above 10 mmol / l and 200 μmol / l).

METHOD AND TECHNIQUE OF HOLIDAY PROCEDURE. There are the following methods of using mineral waters inside:

1. Drinking cure.

2. Transduodenal lavage of the intestine.

3. Tubage (probeless sounding).

4. Lavage and irrigation of the stomach.

5. Rectal method of administration, intestinal lavage, microclysters with mineral water.

Drinking cure technique. Drinking treatment is carried out directly at the source or bottled mineral water is used. It is recommended to drink mineral water directly near the pump room while walking, which contributes to better absorption of mineral water. Water should be drunk slowly, in small sips.

At transduodenal lavage Intestinal mineral water passes through the stomach, directly enters the duodenum, which provides an opportunity to influence the intestinal mucosa with water of the required temperature. The probe inserted into the duodenum is connected to a 3-4-liter vessel with mineral water.

^ Probeless sounding carried out with low- or medium-mineralized waters with the addition of cholekinetic agents (xylitol, sorbitol) to the first portion and using a heating pad.

^ Gastric lavage carried out using a thick gastric tube. For irrigation, a special probe is inserted into the patient's stomach, which consists of two thin probes. The procedure is performed in the supine position on the right side. From one probe, warm mineral water is injected into the stomach and at the same speed through another tube it is poured into the pelvis.

At intestinal lavage mineral water is injected into the intestines and removed simultaneously according to the siphon principle. A rubber tube is inserted into the rectum, one end of which is connected to a funnel. Mineral water is poured up to 1 liter, then the funnel is lowered to the floor and the water is removed. During 1 procedure, 3-5 infusions are carried out.

DOSAGE. The dosage is carried out by the temperature of the mineral water: in the form of heat, water is drunk for diseases of the liver, biliary tract, diarrhea, spastic constipation, hyperacid gastritis; cool mineral water is used in hypoacid conditions. A single dose of mineral water of low and medium mineralization is determined at the rate of 2-3 ml per 1 kg of body weight. During the intake of low-mineralized waters, a single dose is prescribed at the rate of 4-4.5 ml per 1 kg of the patient's body weight. In hyperacid conditions, water is taken 1-1.5 hours before meals, in hypocidic conditions - 10-15 minutes before meals. Water is taken 3 times a day for 30 days. In hyperacid conditions, they take bicarbonate (alkaline), hypoacid - salty (acid), diseases of the biliary tract - sulfate, kidneys - depending on the pH of the urine (with acidic - alkaline, with alkaline - acidic, up to 1000-1200 ml / day).

Health-improving (adaptive) waters are dosed according to the type of disorders and the leading syndrome. Vagotonics should use water in limited quantities due to the tendency to edema. Sympathotonics should increase the amount of prescribed water.

^ PHYSIOTHERAPEUTIC RECIPE

Diagnosis: Chronic superficial gastritis with increased secretory activity.

Rp: Drinking method of using mineral water, 2 ml/kg body weight, water temperature 38°C, one hour before meals, daily, 3 times a day, 30 days.

Salt baths, known as sodium chloride baths, are one of the most accessible mineral hydrotherapy procedures, known for many centuries and actively used in all countries of the world. We invite you to get acquainted with the list of cases in which the adoption of a sodium chloride bath is indicated, and you can take a course of hydrotherapy in a boarding house with treatment Sosnovy Bor.

What is a sodium chloride bath?

Sodium chloride bath- this is the same as a salt bath, that is, a bath in which a large amount (one or two kilograms) of table salt is dissolved. It would seem that the procedure, simple in execution, requires a professional approach (consultation with a doctor is required) and can bring enormous benefits to the body.

Sodium chloride baths are distinguished by the concentration of salt in them, there are baths of low concentration (from 10 to 20 grams of salt per liter of water), medium concentration (from 20 to 40 grams per liter) and high (more than 40 grams per liter).

After taking a salt bath, to achieve the maximum effect, you should not immediately rinse with fresh water - just blot the body with a towel, as the so-called “salt raincoat” forms on the body, which provides a prolonged effect on the skin, subcutaneous receptors and the entire patient's body as a whole. In particular, the body temperature rises slightly, as a result of which the vessels expand, and the rate of oxygen uptake by the tissues increases.

The temperature of the sodium chloride bath is 35-37 degrees Celsius. The duration of the procedure is usually 10 to 20 minutes. The frequency of procedures is once every 2-3 days, the course includes from 7 to 20 baths.

Indications for sodium chloride baths

Taking sodium chloride (salt) baths is recommended in the following cases:

1. Treatment of diseases of the cardiovascular system (cardiosclerosis, ischemic disease, atherosclerosis, cardioneurosis, myocardial dystrophy, thrombophlebitis). In this case, it is recommended to carry out sodium chloride baths with a concentration of 10-30 grams of salt per liter, the course includes from 10 to 14 procedures.
2. Treatment of stage 1-2 hypertension (chronically high blood pressure).
3. Treatment of hypotension (chronically low blood pressure). The concentration of minerals in the salt bath is up to 40 grams per liter.
4. Treatment of vegetative-vascular dystonia.
5. Treatment of disorders of the nervous system (neurosis, sleep disorders, stress conditions, neurasthenia).
6. Treatment of diseases of the musculoskeletal system (arthritis, non-tuberculous polyarthritis, muscle and tendon injuries, various diseases of the spine, including the consequences of a fracture of the spine, osteochondrosis of the spine). Typically, the course includes 10 to 12 salt baths with a mineral concentration of 10-20 grams per liter.
7. Treatment of gynecological diseases of an inflammatory nature.
8. Treatment of skin diseases (psoriasis, neurodermatitis).

Contraindications for taking a sodium chloride bath

There are a number of contraindications to taking saline sodium chloride baths, among them:

1. The period of exacerbation of chronic diseases.
2. Hypertension of the third stage, hypertensive crises.
3. Presence of circulatory failure.
4. Early stages of encephalitis or poliomyelitis.
5. Violation of cerebral circulation.
6. Violations of the functions of the pelvic organs.
7. Violation of motor functions in a pronounced form.
8. The presence of epilepsy or other nervous or mental diseases, accompanied by sudden seizures.
9. Some skin diseases, in particular, pyoderma and weeping eczema.
10. Recent completion of thrombophlebitis treatment.
11. The presence of autonomic polyneuropathy.
12. High concentration sodium chloride salt baths are contraindicated in patients suffering from kidney disease.
13. Hypersensitivity to table or sea salt.

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Methodology (Vagramyan A.G., 1987; Kasyanova I.M., 1993; Vogolyubov V.M. et al., 1997; Klemenkov S.V. et al., 1999; Klemenkov S.V. et al., 2000 )

Mineral waters containing at least 10 mg/dm3 and bromine at least 25 mg/dm3 are iodine-bromine waters.

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.

Iodine-bromine waters are widespread in our country in the Urals and Siberia (Valabanova I.A., 1984). In the waters of the open seas and oceans, the bromine content is determined from 63 to 74 mg/dm3. Sodium chloride waters containing iodine in their composition always contain bromine. At the same time, bromine can be contained in these waters without iodine. Depending on the predominance of iodine or bromine in sodium chloride water, the names iodine-bromine, bromine, bromine waters can be found in the literature (Olefirenko V.T., 1986).

For the preparation of artificial baths, the composition (according to the content of chlorine, bromine and iodine) of the natural mineral water of the Khadyzhensk resort is taken as a basis. 250 g of potassium bromide (sodium) and 100 g of sodium iodide are dissolved in 1 liter of water.

The maximum shelf life of the solution should not exceed 7 days. A freshly prepared solution (100 ml) is poured from a dark vessel into a bath with 200 liters of fresh water of the required temperature, in which 2 kg of common salt (sodium chloride) are first dissolved.

Baths temperature 35-37 °C, duration 810 min. carried out every other day or 2 days in a row with rest on the 3rd day. Total for the course of treatment 12-15 baths. When treating with natural chloride sodium iodine-bromine waters, their mineralization should not exceed 30 g / dm3 (Sorokina E.I., 1989). After the bath, the patient blots the body with a towel (without rubbing), wraps himself in a sheet and rests for 20-30 minutes.

Therapeutic action

During the procedure, 140190 μg of iodine and 0.28-0.3 mg of bromine penetrate the body through the skin, which, entering the bloodstream, selectively accumulate in the thyroid gland (I-), in the pituitary gland and hypothalamus (Br-). Iodine ions, entering the thyroid follicles with the help of active transport, form organic substances (adducts) and physiologically active thyroid hormones - thyroxine and triiodothyronine, restore the basic metabolism in the body. They stimulate the oxidation of carbohydrates and lipids, which leads to an increase in high-density lipoproteins in the blood, and the normalization of its lipid spectrum.

In addition, iodine ions increase the fibrinolytic activity of blood inhibited in atherosclerosis, lower its coagulation properties (Vogolyubov V.M. et al., 1997). M.T. Kudaev et al. (2003) it was proved that balneotherapy with iodine-bromine baths of the sanatorium "Kaspiy" (Republic of Dagestan) had a positive effect on cholesterol metabolism, blood pressure and blood thrombogenic potential in patients with angina pectoris 1-2 FC.

Bromine ions, penetrating into the brain, change the ratio of inhibitory-excitatory processes in the cerebral cortex towards increased inhibition (sedation) and accelerate the synthesis of releasing factors of the hypothalamus and tropic hormones of the pituitary gland. The results of the study by V.F. Kazakova et al. (1994, 1998) showed that the use of baths with sodium chloride bromine water in patients with IVS in the sanatorium "Volzhsky Utes" leads to a decrease in the severity of risk factors for coronary atherosclerosis, multidirectional changes in the level of immunoglobulins and the hormonal spectrum of blood.

In IVS patients, after a course of treatment with sodium chloride iodine-bromine baths, along with an antianginal effect, an effect on systemic hemodynamics is noted - a decrease in blood pressure and PSS is accompanied by a decrease in the tone of arterial vessels and an increase in the tone of venous vessels.

The latter increases venous blood flow to the heart and cardiac output. There is a slight decrease in heart rate. Specific for sodium chloride waters (regardless of the presence of iodine or bromine in them) is their significant positive effect on MC in the form of improving blood rheology, reducing its coagulability, increasing fibrinolytic activity, reducing the adhesive-aggregation activity of platelets, there is a decrease in cholesterol and beta- lipoproteins.

According to A.S. Makarkina (1996), S.V. Klemenkova et al. (2000) and O.B. Davydova et al. (1996) a course of artificial general chloride sodium iodine-bromine baths with a mineralization of 20 g/dm3 in IVS patients with stable angina 1 and 2 FC gives a pronounced antiarrhythmic effect.

At the same time, the average number of ventricular arrhythmias of class 1-4a according to V. Laun decreases per day by 63.0%, supraventricular extrasystoles - by 97.1%. The antiarrhythmic effect of general iodine-bromine baths in patients with coronary heart disease correlates with a decrease in the manifestations of pain and "silent" myocardial ischemia; it is also due to a decrease in parasympathetic influences on the heart.

General iodine-bromine baths give a pronounced training effect in patients with stable angina pectoris 1 and 2 FC with extrasystole, which is manifested by an increase in the level of physical performance and coronary reserve of the heart. With stable angina pectoris 2 FC and ventricular arrhythmias 4B class according to V. Laun, iodine-bromine baths are contraindicated, because they lead to a deterioration in coronary blood supply.

Indications

Sodium chloride iodine-bromine baths are indicated for patients with stable angina pectoris FC 1-2, including those with HB 1-2 degrees, post-infarction cardiosclerosis (1 year or more after the onset of the disease) with extrasystoles and heart failure not higher than 1 degree. in the absence of prognostically unfavorable disturbances of rhythm and conduction of the heart.

Contraindications

Sodium chloride baths

Methodology (Olefirenko V.T., 1986; Sorokina E.I., 1989; Vogolyubov V.M. et al., 1997; Davydova O.V. et al., 1997; Ponomarenko G.G., 1999; Klemenkov S. V. et al., 1999; S. V. Klemenkov et al., 2000; S. V. Klemenkov et al., 2003; O. V. Davydova et al., 2006)

Baths from natural and artificially prepared sodium chloride water at a temperature of 35-37 ° C are carried out for 8-10 minutes, every other day or 2 days in a row with a break on the 3rd day. The total mineralization in the bath should not exceed 30 g/dm3. Total for the course of treatment 10-12 baths.

To prepare artificial CNV, table (lake or sea) salt (3-5 kg) is poured into a canvas bag, or 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 (3537 ° C).

Therapeutic action

The thermal effect of sodium chloride water is more pronounced than fresh water. The heat flux into the body from such a bath is 1.5 times higher than from a fresh bath of the same temperature. The absorbed heat leads to the expansion of the superficial vessels of the skin and increases its blood flow 1.2 times more than fresh water.

A significant role in the formation of hyperemia is played by biologically active substances (prostaglandins, bradykinin, etc.) released under the action of sodium chloride water and local neuroreflective reactions. In such baths, heat transfer by evaporation is significantly reduced.

The high osmotic pressure created by sodium chloride water causes dehydration of the skin, which significantly changes the physicochemical properties of the cellular elements of the skin and the receptors embedded in it. This leads to a decrease in the excitability and conductivity of the nerve conductors of the skin and a decrease in tactile and pain sensitivity and continues after taking a bath, since sodium chloride, crystallizing, leaves the thinnest salt shell (“salt raincoat”) on the skin.

Due to the deformation of heat-sensitive skin structures in sodium chloride water, the action of the thermal factor is enhanced. Dehydration of surface tissues contributes to the release of fluid from the interstitium into the capillary bed, activation of factors of the blood anticoagulation system and a decrease in the adhesive-aggregative activity of platelets.

Despite the decrease in blood pressure and total PVR, the phase structure of the cardiac cycle and the properties of the myocardium do not change significantly, there is no dynamics in terms of heart rate. Under the influence of CNV treatment, the tone of peripheral veins increases and the clinical manifestations of orthostatic hypotension decrease.

Valneotherapy with sodium chloride water in patients with hepatitis B and IVS normalizes the activity of the sympathetic-adrenal system and the adrenal cortex, enhances the synthesis of catecholamines in the adrenal glands and reduces the reabsorption of sodium ions from primary urine, which contributes to an increase in diuresis. With an increase in the concentration of sodium chloride, the vagotonic effect of baths decreases and the activating effect on the sympathetic link of the autonomic nervous system increases.

According to N.V. Lvova et al. (2000) with a combination of HB and IVS, a greater effectiveness of treatment is observed when using baths with a concentration of sodium chloride of 40 g/dm3, and not 20 g/dm3, which was confirmed by their more pronounced effect on pain, 24-hour ECG monitoring, physical performance, parameters central and peripheral hemodynamics.

The limitation of the use of this concentration of baths is, according to the authors, the crisis course of HB, the tendency to hypersympathicotonia, i.e. with this form of combined cardiovascular pathology, the leading factor in determining the indications is the course of HB.

According to N.F. Chashchina (1998), S.V. Klemenkova et al. (1999, 2000, 2003) a course of general sodium chloride baths with a mineralization of 20 g/dm3 in IVS patients with stable angina 1 and 2 FC gives a pronounced antiarrhythmic effect. At the same time, the average number of ventricular arrhythmias of class 1-4a according to V. Laun decreases per day by 49.9%, supraventricular extrasystoles - by 57.5%.

The antiarrhythmic effect of common CNV in patients with coronary heart disease correlates with a decrease in the manifestations of pain and "silent" myocardial ischemia. General sodium chloride baths give a pronounced training effect in patients with stable angina pectoris 1 and 2 FC with extrasystole, which is manifested by an increase in the level of physical performance and coronary reserve of the heart.

With stable angina pectoris FC 2 and ventricular arrhythmias class 4b according to V. Laun, general CNV is contraindicated, because it leads to a deterioration in coronary blood supply. Similar results were obtained by N.N. Shlomov (2003), who successfully used complex therapy using a low-frequency alternating magnetic field in patients with stable angina pectoris with rhythm disturbances.
and HNV.

Indications

Sodium chloride baths are indicated for patients with stable angina pectoris 1-2 FC, including the presence of HB 1-2 degrees, postinfarction cardiosclerosis (1 year or more after the onset of the disease) with extrasystoles and heart failure not higher than 1 degree. in the absence of prognostically unfavorable disturbances of rhythm and conduction of the heart.

Contraindications

Stable angina 3-4 FC. Unstable angina. Circulatory failure 2-3 tbsp. Prognostically unfavorable disturbances of rhythm and conduction of the heart. Paroxysmal cardiac arrhythmias. Atrial fibrillation. cardiac asthma. Aneurysm of the heart.

S.G. Abramovich, N.A. Kholmogorov, A.A. Fedotchenko

SODIUM CHLORIDE WATERS(sodium chloride water) - mineral water with dissolved sodium chloride salts. In addition to the main component - sodium chloride - they contain chlorine in combination with calcium, magnesium, potassium, lithium, iron and other elements. Sodium chloride waters are among the most common types of mineral waters and are one of the main therapeutic factors in many resorts and a number of large balneotherapy institutions.

Depending on the chemical composition, several balneological groups of sodium chloride waters are distinguished. Pure sodium chloride water - water without specific properties and components. Their action is due to the main ionic composition (chlorine and sodium) and depends mainly on the magnitude of the total mineralization. Such waters, as a rule, have a neutral reaction and are characterized by different outlet temperatures. They are found in the resorts of Staraya Russa (see), Druskikinkay (see), Usolye, Kuyalnik, and others. Sodium chloride waters with specific properties include carbonic sodium chloride waters (see Carbonic waters) located near Yerevan, in the Hrazdan River basin ; hydrogen sulfide chloride-sodium waters (see Sulfide waters) found in the resorts of Sochi-Matsesta (see Sochi), Menji, Talgi, Ust-Kachka (see), etc .; sodium chloride waters containing iodine and bromine (see. Iodine-bromine waters)", sodium chloride waters, which include biologically and pharmacologically active trace elements - arsenic, strontium, cobalt (the waters of the Upper Karmadon, Nalachevsky); highly mineralized nitrogen baths of Sakhalin, Kamchatka, Chukotka, Nalchik, etc.

Sodium chloride waters are of different mineralization. Underground sodium chloride waters with a mineralization above 35 g/l are called brines, sodium chloride waters of the same mineralization located in natural open water bodies (lakes, estuaries) are called brine. Hence the terms "brine baths", "brine baths".

Sodium chloride waters with a mineralization of not more than 15 g/l are used for drinking treatment for diseases of the digestive system, accompanied by a decrease in the secretory and motor functions of the stomach or intestines. Such waters are available at the resorts of Druskininkai, Birshto-nas (see), Mirgorod (see), Karmadon and others. used for bottling. Sodium chloride waters are easily prepared outside resorts by dissolving sodium chloride in fresh water.

For detailed indications and contraindications for the internal use of sodium chloride waters, see Mineral Waters.

Outwardly, water with a higher mineralization (but not higher than 80 g / l) is used. The effect of sodium chloride waters on the body when applied externally is mainly due to the degree of mineralization, water temperature; at the same time, the method of application also matters. Intact skin is almost impervious to inorganic salts. Salts only settle on the surface, forming the so-called salt cloak, accumulate in the folds of the skin, in the ducts of the sweat and sebaceous glands, remain there at the end of the procedure and have a local and reflex effect. Balneological procedures with sodium chloride water cause morphofunctional changes in cells, vessels and skin receptors, increase heat transfer. Reflexively, they affect the functional state of the central nervous system, change the course of metabolic processes, affect the sympathoadrenal system, neuroendocrine regulation, vascular tone, have a beneficial effect on the function of the cardiovascular system, have an analgesic, anti-inflammatory, and hyposensitizing effect. The degree of influence of sodium chloride waters on the body depends on their concentration and temperature, the duration of the procedure, which is confirmed by the dynamics of indicators of certain types of metabolism, external respiration function, the state of the sympathoadrenal system, etc. The optimal concentration of sodium chloride waters for baths is 20-40 g / l, the optimum temperature is 35-37 °. The duration of the procedure is 12-15 minutes. Baths (see) appoint every other day or two days in a row with a break for the third; total for the course of 12-15 procedures. Sodium chloride water is also used for irrigation (scalp, oral cavity, vagina), compresses (see Compress), inhalations (see Inhalation), intestinal lavage (see Intestinal lavage), used as a basis for the preparation of radon, pearl, carbonic and other types of baths.

Indications: diseases of the cardiovascular system (initial forms of atherosclerosis, hypertension stage I and II, hypotension, the initial stages of obliterating lesions of the vessels of the extremities, thrombophlebitis and post-thrombophlebitis syndrome), diseases of the musculoskeletal system of inflammatory, dystrophic, traumatic genesis, diseases and consequences of injuries of the central and peripheral nervous system, chronic inflammatory diseases of the female genital organs, some skin diseases (psoriasis, neurodermatitis).

Contraindications - general for hydrotherapy (see), as well as an increased reaction of the skin to the action of sodium chloride waters.

Bibliography: Issues of balneo- and physiotherapy, ed. Yu. E. Danilova et al., M., 1970; Ivanov V. V. and Nev-r and e in G. A. Classification of underground mineral waters, M., 1964; Olefirenko V. T. Water-heat treatment, M., 1978; Syroechkovskaya M. N. Hydrotherapy, M., 1968. N. F. Sokolova.