From Big Medical Encyclopedia

BALNEARY — the treatment and prevention facility for holding hydropathic procedures, is preferential with use of sweet water. In a balneary are held as well procedures using artificial mineral and gas-works liquors. Are located in the bathing building century. There are also hydropathic departments which are a part of hospitals, policlinics, medical medical units, etc. V. are available in suburban sanatoria and in the resorts which do not have natural mineral waters. Quite often in V. there are departments for a thermotherapy (paraffin, ozokerite, etc.) or mud cures (silt mud, peat); in such cases they are called water mud baths or water mud-medical department. Often as a part of V. there is also department to lay down. massage.

Fig. 1. The scheme of a design of a balneary of sanatorium on 250 — 400 beds: I \ozhidalnya;;;;;;;;; II \bathing rooms; III \the room for service personnel; IV \the room for wet wrappings; V \razdevalnya;;;;;;;;; VI \shower hall; VII \the room for massage; VIII \linen: 1 — couches; 2 — a case for heating of blankets; 3 — toilets; 4 — bathtubs; 5 — tables; 6 — linen cases; 7 — a medical case; 8 — a water protecting screen; 9 — shower department; 10 — stall showers.

The following main rooms (fig. 1) are V.'s part: the shower hall, bathing department, the room for wet wrappings, band irrigations, utility rooms (including for storage of chemicals), rooms for rest of patients after the procedures, the room for an undressing with individual open cabins, rooms for personnel, for storage and drying of linen, etc. In nek-ry V. are provided to lay down. pools, the device for contrast bathtubs.

The equipment and the device of rooms for V. shall meet technical standards of a waterproofing and a dignity. - a gigabyte. to rules for rooms with the increased air humidity (see. Bathing building ). In general the room and the equipment B. shall satisfy to the «Rules of the device, operation and the accident prevention of physiotherapeutic departments» approved by M3 of the USSR.

Hot water service is carried out by connection to a heating plant or heating of water in boiler rooms using boiler rooms of installations. Water is brought to shower devices under supertension for what the compressor sets consisting of the force pump and a tank with a capacity of 500 l maintaining pressure apprx. 5 am are used. Two water handling — one for hot, another — for a cold water are arranged. At impossibility of use of compressors use the tanks installed in garrets on water towers. At rising of water its pressure increases by 10 m on 1 at. Pressure of the pumped hot and cold water in to shower department (see) shall be constant (not lower than 2 — 2,5 at). Placement hydropathic (and mud-medical) departments in basement and semibasement rooms according to safety regulationss in the USSR is forbidden.

Walls in V. revet with a glazed tile, a floor — a rough metlakhsky tile. Independent positive-pressure ventilation with exchange of air in rooms where hydropathic procedures are carried out, on inflow not less than 3 volumes an hour and on an extract — not less than 5 volumes an hour, in mud-medical department on inflow 4, on an extract 5 with heating of air is provided; air temperature 25 °, relative humidity — to 70 — 75%. It is necessary to put bathtubs and shower installations so that on the person adopting procedures daylight fell. Walls of cabins for bathtubs shall be 2 high., from the thick opaque glass or concrete revetted with a tile and not to reach a floor on 10 — 15 cm.

Fig. 2. Option of a design of the shower hall of hydropathic department for hospital on 250 — 300 beds: I \shower department; 2 — a water protecting screen; 3 and 5 — escapings of the shower hall in razdevaln; 4 — stall showers.

In the shower hall (fig. 2) the shower department with struyevy souls and installations for the rain, circular, needle, ascending shower and a bathtub for reception of sedentary bathtubs is placed. In balnearies of nurseries to lay down. - professional, institutions sometimes in the shower hall the bathtub is put and there is escaping of the shower hall to the shallow-water medical pool. where the gymnastics in water is carried out.

A floor in V. needs to be done with heating from below and with a bias not less than 1 cm by 1 m in the direction of drain ladders.

Approximate consumption rates of water at hydropathic procedures for an hour: a bathtub the general (2,5 procedures) — 500 l, a shower rain (10 procedures) — 1200 l, the shower ascending (8 procedures) — 400 l, circular (8 procedures) — 1200 l, struyevy (12 procedures) — 3000 l, a bathtub sedentary (2,5 procedures) — 160 l.

The area of a cabin for reception of usual bathtubs of 6 m 2  ; in large V. more spacious cabins (the area of 18 m 2 ) are taken away for an underwater shower massage and bathtubs, in to-rykh underwater extension of a backbone (capacity of bathtubs of 400 — 500 l) is made. The area of the room for wet wrappings shall be defined at the rate of 6 m 2 on one place (but not less than 12 m 2 ). For underwater intestinal washings the certain room not less than 18 m is allocated 2 . Room of the lechebnoplavatelny pool of 180 m 2 on 10 people (see. Pools medical ) includes the pool (5X12 m), razdevalnyu with shower (25 m 2 ).

Fig. 3. Option of a design of an office for hydrosulphuric (sulphidic) bathtubs: 1 — razdevalnya with a lock; 2 — one of bathrooms: 3 — the room for storage of reactants; 4 — laboratory.

The standard equipment is provided in a balneary, in Krom the basic are: devices for saturation of water gas — carbonic acid, nitrogen and oxygen, the device for underwater intestinal washings, shower department with a set of flourishes, a lattice for carrying out gas bathtubs, etc. Chemicals and medicinal substances for preparation of medicinal bathtubs and bathtubs from artificial mineral water are stored in the special rooms equipped with cases. The additional rooms isolated from other departments (fig. 3) are necessary for carrying out sulphidic and radonic bathtubs, in to-rykh shall be observance of special rules on operation and the accident prevention is provided.

Installation and operation of cylinders with carbonic acid, oxygen and nitrogen (for carrying out the corresponding bathtubs) are regulated by special rules on to the accident prevention (see). Cylinders are established out of bathing department.

During the use of artificial radon and sulfide waters the isolated rooms are provided in V. for each type of bathtubs not only for carrying out to lay down. procedures, but also for laboratories where the bubbler with radium is stored, prepare and spill solution of radon, chemicals and their solutions for preparation of sulfide water are stored. These rooms shall be equipped with independent system of the positive-pressure ventilation operating during all working day with frequency rate of air exchange on inflow not less than 4 air volumes an hour and on an extract not less than 5 volumes an hour. Concentration of radon and its affiliated products in air of workrooms shall not exceed 3×10 - 11 curie/l, in adjacent — 10 - 11 curie/l.

A marginal hydrogen sulfide content in air of rooms where prepare and carry out procedures with artificial sulfide water, there have to be not higher than 10 mg/m 3 . In big V. and where carry out radonic and sulphidic bathtubs, the stall shower is necessary for personnel.

The list to lay down. the procedures which are carried out in V., the mechanism of their action, the equipment and a technique of carrying out, the indication and a contraindication — see. Balneoterapiya , Bathtubs , Balneotherapy , Shower .

See also Balneolechebnitsa , Mud baths .

Bibliography: Questions of technology and the accident prevention during the holding fizio-balneoterapevtichesky procedures, under the editorship of A. P. Speransky and G. A. Nevrayev. M, 19 70: About l of e f and p e of N to about V. T. Vodo-teplolecheniye, M., 1970, bibliogr.; Portnyagin F. G. Methodical recommendations for doctors organizers of the physiotherapeutic help, Tomsk, 1972, bibliogr.; Tamazov A. A. The organization of physical therapy in hospitals and policlinics, M., 1961, bibliogr.; F and N of au genes S. N. Organization, technician and technique of the physiotherapeutic help, Kiev, 1963, bibliogr.

A. P. Speransky.