From Big Medical Encyclopedia

BATHTUBS — the hydrotherapeutic procedures applied with the hygienic, medical and preventive purposes. Distinguish V. general (fig. 1) when all body is shipped in water, local (fig. 2) when in water an underbody of a body (manual, foot etc.); semi-bathtubs, with water immersion only a lower body, to a belt; sedentary V. at which water covers area of a basin, the bottom of a stomach and upper thighs (without immersion in V. of legs).

Fig. 1. Position of the patient at reception of the general bathtub.
Fig. 2. Local bathtubs for hands and legs.

Depending on the water temperature of V. can be cold (to 20 °), cool (20 — 33 °), «indifferent» temperature (34 — 36 °), warm (37 — 39 °), hot (40 — 42 °), usually up to 10 — 15 min. V. of other duration apply the general medical V.' Duration as local, with a hot or cold water more often. Long V. (60 min. and more) with water temperature 36 — 38 ° apply seldom — at some diseases of skin, burns.

On V.'s structure can be fresh, aromatic, medicinal, mineral and gas.

Gigabyte. Century from sweet water apply at t ° waters 36 — 38 ° lasting 20 — 30 min. of Century how to lay down. procedures are as one of techniques a part of complex treatment, and also are an independent technique of treatment (e.g., radonic, hydrosulphuric V.).

The mechanism of action of V. consists of influence of temperature, mechanical and chemical irritants. The body perceiving these irritations is skin, edges is richly supplied with blood vessels, nervous receptors and actively participates in processes of heat exchange in an organism. The thermal factor influences a condition of blood circulation, a nervous system and processes of exchange. Power of temperature irritation depends on a difference between water temperature and skin, on duration, a place of application and the area of influence, and also on a condition of reactivity of an organism, his specific features.

Short cold and cool V. possess all-tonic action, stimulate functions of nervous and cardiovascular systems, raise a metabolism. Warm V. have the calming effect, contribute to normalization of a vascular tone, improve a dream. Hot V. raise a metabolism, strengthen sweating. Influence of a thermal factor on various systems of an organism at reception of hydrotherapeutic procedures — see. Balneotherapy .

For the purpose of strengthening of influence of a thermal factor it is possible to use V. with different water temperature in them — so-called contrast V., or V. with gradually increased temperature — to Gauffa bathtub (see), V. across Valinsky.

Fig. 3. Contrast bathtub. Transition from a bathtub with warm water in a bathtub with a cold water.

For contrast V.' carrying out equip two special bathtubs pools located in one block (fig. 3). One of V. is filled warm, another — a cold water. The difference of temperatures shall make not less than 5 — 10 °, gradually during a course it can be increased to 20 — 30 °. At first the patient plunges on 2 — 3-min. into V. with warm water, then for 1 — 2 min. passes into V. with a cold water. In V. with a cold water it is necessary to do the easy movements. Transition from one V. to another repeats during the procedure 5 — 6 times. Reception of the procedure more often with a cold water comes to an end with stay in V. Apply the general contrast V. for the purpose of a hardening or the training influence on nervous and cardiovascular systems (at hypotension, an idiopathic hypertensia of the I Art., at functional frustration of a nervous system, obesity). Contrast V. local, for hands or legs, use for the purpose of a training of vessels and nervous receptors of extremities, for improvement of blood circulation in them (at initial stages of obliterating diseases of peripheral vessels of extremities). Appoint contrast V. daily or every other day, to a course of treatment of 15 — 25 procedures.

The general V. with gradually increased temperature are offered by the Polish balneologist Walinski. Water temperature in V. gradually raise from 37 to 40 — 42 hail., duration of the procedure is up to 23 min. After V. the patient is stacked on a couch, covered with a sheet and a woolen blanket. This procedure is a strong thermal irritant and causes sharply expressed reactions of an organism: pulse becomes frequent (to 110 — 130 ud. in 1 min.) and breath (to 26 — 30 in 1 min.). Carry out bathtubs through the purpose, on a course 6 — 10, more rare than 20 procedures. Century according to Walinski apply at diseases of a nervous system, Bekhterev's disease, obesity, chronic inflammatory diseases of female generative organs, at bronchial asthma, etc. These V. did not find distribution in the USSR.

Influence of a mechanical factor in V. is defined by pressure of liquid, edges are covered by a body of the patient who is in Century. This pressure usually makes 0,04 — 0:05. The most sensitive to a mechanical factor, except receptors of skin, are veins and limf, vessels.

Intensity of mechanical irritation in V. can be reduced, changing a degree of admission of V. (appointing in necessary cases of a semi-bathtub).

It is possible to strengthen mechanical irritation in V. (V. with grinding, pearl V.), or to weaken (foamy V.); it can also give the special form of influence, creating fluctuations of water (vibration and vortex V.) etc.

Bathtubs with grinding by special brushes will usually see during the filling of a bathtub to a half water t ° 34 — 35 °. The medic, becoming sideways, one hand waters a back of the patient sitting in V. from a ladle, and another vigorously pounds skin a brush, then consistently waters and pounds skin of a breast, a stomach, hands and legs. All procedure is repeated by 2 — 3 times, gradually lowering water temperature in V. it is aware of treatment to 30 — 25 °. At the first feeling of a fever the procedure is stopped. After escaping of V. of the patient vigorously pound a dry rough sheet. Duration of the procedure 10 — 12 min. Apply it at neurosises or as final after thermal hydrotherapeutic procedures. Depending on water temperature in V. and intensity of grinding the procedure can affect as calming (water t ° 34 — 35 ° and grinding of moderate intensity) or tonic, exciting (water t ° 25 — 30 ° and vigorous grinding), a course 10 — 15 bathtubs.

Fig. 4. Pearl bathtub. At the bottom — a lattice for a transmission of air from the compressor, in water air traps are visible.

Pearl bathtubs are prepared, passing air from the compressor under pressure of 0,5 — 1,5 am through a special lattice (fig. 4) at the bottom of V. Postupayushchy under pressure air rages and is poured in water B. as pearls. Air traps cause additional mechanical irritation. Temperature influence of pearl V. is caused by various heat capacity and heat conductivity of water and air.

Are characterized by the calming action century and are effective at functional frustration of c. N of page. Appoint them every other day, at water temperature 35 — 37 °, duration of the procedure 10 — 20 min., to a course 12 — 15 Century.

Foamy bathtubs. For these V.' preparation on a bottom of a bathtub pour hot water a layer of 10 cm, t ° 40 — 45 ° and add frother (powdered soap with impurity of substance like saponins), either special soap liquid, or small planed soap. By means of the air given by the compressor through a special lattice to-ruyu previously put on V.'s bottom, shake up soap liquid to foaming, the filling V. to the edges. Such V. call also air and foamy. If instead of air through a lattice to give carbonic acid to V., it is possible to receive carbonic and foamy V., cover action close to carbonic V.'s action (see below).

The patient shipped in foamy V. appears the large number of small foamy air traps surrounded from all directions which represent a heat-insulating layer since air is a bad conductor of heat. The bubbles bursting on skin make easy mechanical impact whereas hydrostatic pressure almost completely is absent. Pleasant heat, gentle and soft effect of foam on skin receptors exert sedative impact on a nervous system and normalizing — on activity of thermoregulatory mechanisms. Exchange processes amplify, sweating increases. These V. are sparing for heart and vessels. They are applied the patient with neuralgia, a skin itch when there is a danger of the expressed reaction from cardiovascular system. V.'s duration is 15 — 20 min. Course of treatment of 15 — 20 procedures, every other day.

Fig. 5. Vibration bathtubs: the vibrator is directed to area of a stomach (1), a knee joint (2), lumbar area (3), area of a neck (4).

Vibration bathtubs are characterized by additional influence of the vibration strengthening action of a mechanical factor of the water on certain body parts of the patient transmitted through a sheet of water of V. from the special device («Wave-1» or «Wave-2») which is in water B. (fig. 5). The dosed mechanical oscillations of subaudio frequency promote improvement krovo-and lymphokineses, trophicities of fabrics, work analgesic. Apply them at treatment of patients with radiculitis, arthritis, hron, gastritis, hron, cholecystitis, etc., appointing at water temperature 36 — 37 °, lasting 10 — 15 min., to a course of treatment of 12 — 15 procedures, every other day (see. Vibrotherapy ).

Fig. 6. Position of the patient at reception of local vortex bathtubs: 1 — for a hand; 2 — for legs.

Vortex bathtubs are also characterized by the strengthened influence of a mechanical factor that is reached by creation of whirl of water by means of the special devices installed in Century. The arising movement of water is similar to the nek-ry massage movements; vortex V. promote improvement of blood circulation, have the anesthetizing effect. Indications to them the same, as to vibration. They are used in the form of local (fig. 6) and the general V., t ° 36 — 37 °, duration of the procedure 10 — 15 min., on a course of treatment of 12 — 15 V., every other day.

Fresh V.'s influence can be strengthened if in it to dissolve substances which, settling on the surface of skin or adjoining to it, cause inherent to them pharmakol, effect, or exert additional impact on olfactory and visual analyzers. Depending on the chemical and other substances dissolved in water distinguish V. aromatic, medicinal, artificial mineral and gas.

From aromatic V. most often use pine needle baths; train them by addition in water B. of 200 l of 100 ml of liquid spruce extract, either 50 — 70 g of powder, or 1 — 2 tablets containing spruce extract. In these V., except impact of a temperature irritant on skin receptors, the essential oils and terpenes which are contained in extract on visual (color of water) and olfactory (smell) analyzers exert impact that increases quantity of the impulses coming to c. the N of page, also causes sedative action of these procedures. Such V. are shown at functional frustration of c. N of page, idiopathic hypertensia of I and IIA of a stage. Coniferous V. appoint at water temperature 35 — 37 °, lasting 10 — 15 min., every other day or four times a week, to a course 12 — 15 procedures.

Medicinal V. apply as the distracting procedures at respiratory diseases as anesthetizing and antiinflammatory — at diseases of a musculoskeletal system and peripheral nervous system, at diseases of skin, in children's practice (V. with potassium permanganate, starch — see below the section of the Bathtub for children).

For preparation of a mustard bathtub of 100 — 250 g of dry mustard previously part century of 1 l of water t ° 38 — 40 °. Pour in the received solution in the bathtub filled with sweet water of necessary temperature and mix. Carry out at water temperature 36 — 38 °, the general century — lasting 5 — 7, and local t ° 39 — 40 °, lasting up to 10 — 15 min. After V. the patient is washed warm water and wrapped up with a sheet and a blanket for 30 — 60 min. Mustard V. cause vasodilatation of skin, an urezheniye of pulse, an urezheniye and deepening of breath, a lowering of arterial pressure, reduce excitability of a nervous system. The general mustard V. are shown at Qatar of upper respiratory tracts, bronchitis, local — at increase in arterial pressure, at attacks of bronchial asthma (if there is no individual intolerance of a smell of mustard). Mustard V. are contraindicated at skin diseases. These V. more often do before going to bed.

Turpentine bathtubs (use a white emulsion more often) are prepared according to the following recipe offered by A.S. Zalmanov (1966): salicylic to - you are 0,75 g, the crushed baby soap of 30 g, gum spirit of turpentine of 500 g, water of 550 ml. Salicylic to - that and baby soap is filled in with a boiling water, carefully mixing before receiving a homogeneous emulsion. After mix cools down to t ° 40 — 50 °, add turpentine to it. On the first bathtub take from 15 to 20 ml of the emulsion prepared thus and it is consecutive, from the procedure to the procedure, bring its quantity to 60 — 70 ml, more rare it is more. Century of t ° 36 — 37 ° (is more rare than higher), lasting 10 — 15 min. appoint every other day, to a course of treatment 10 — 15.

Turpentine V. have the vasodilating and anesthetizing effect, stimulate sympaticoadrenal system, exchange processes. These V. apply at diseases of peripheral nerves (radiculitises, plexites, etc.), joints (the deforming osteoarthrosis, etc.), at hron. pneumonia. At a number of diseases (an atherosclerotic obliteration of vessels of the lower extremities, a vegetative polyneuritis) it is necessary to be limited to concentration of 35 — 45 ml of an emulsion on 200 l of water. Turpentine V. are contraindicated at individual intolerance of a smell of turpentine and at a number of skin diseases.

The mechanism of action of turpentine V. from a yellow emulsion, a cut is a part, except turpentine, castor oil, caustic soda, etc., is insufficiently studied. These V. possess more expressed vasodilating action, can cause tachycardia, falloff of arterial pressure, sometimes pains in heart. It is not recommended to apply these V.

Sagy bathtubs are prepared by addition to water of the liquid or condensed condensate of a muscat sage. These V. were widely adopted especially in the Moldavian SSR where for their preparation use waste of essential oil-bearing production. In V. pour water, and in seaside resorts — sea water, add to it liquid (at the rate of 4 — 5 l on 100 l of water) or condensed (at the rate of 200 g on 100 l of water) condensate of a sage and carefully mix. Water temperature 35 — 37e, duration of the procedure 8 — 15 min., on a course of treatment of 12 — 18 V. during the carrying out them every other day. These V. work is soothing, apply them at diseases and effects of injuries of a musculoskeletal system (polyarthritises, miozita, contractures, etc.), at diseases and effects of injuries of peripheral nerves with motive and sensitive disturbances, at an initial stage obliterating an endarteritis, at hron, inflammatory processes of a female genital and some diseases of skin.

The general contraindications to listed above the same V., as to to balneotherapy (see).

Century from artificial mineral waters prepare respectively for structure of natural mineral waters; the mechanism of action of artificial mineral V., indications and contraindications to them — see. Balneoterapiya , and also articles devoted to separate types of mineral waters, napr nitric siliceous thermal waters (see), iodine-bromine waters (see), radon waters (see), sulfide waters (see), etc.

Chloride sodium (salt) bathtubs artificial prepare by dissolution in water B. of 200 l 5 — 10 kg cooking (lake or sea) for salt. The salt filled in a special sieve or a bag from a cloth is placed under a stream of hot water and in process of its dissolution add a cold water to V., leading up water temperature to appointed (35 — 36 °). Carry out every other day or two days running with a break on the third, on a course of treatment of 12 — 15 procedures century lasting 12 — 15 min.

Iodine-bromine bathtubs artificial are prepared, using solution of salts of bromine and iodine. B1 of l of water is dissolved 100 and sodium iodide (sodium iodide) and 250 g of potassium bromide (potassium bromide) and this solution are stored in a dark large bottle in order to avoid effect of light. Technology of preparation of V. comes down to dissolution in 200 l of water of 2 kg of sodium chloride and to addition in it 100 ml of the specified solution. V.'s temperature 36 — 37 °, duration of 10 — 15 min., procedures appoint every other day, to a course 12 — 15 Century.

Preparation of artificial hydrosulphuric bathtubs is based on the principle of replacement of free hydrogen sulfide from salts by more strong acids. There are two ways of preparation: manual and centralized (mechanized). At manual medicinal hydrogen-sulfide water prepares directly in V. for what use in advance prepared stock solutions and the hanged-out chemical raw materials. The mechanized method of preparation is carried out in specially equipped room — the sulphidic workshop where medicinal water prepares in the tanks solvents having big capacity (to 5000 — 6000 l). The choice of a method is defined by the capacity of a serolechebnitsa.

Feed chemical stock are sodium sulfide (sodium sulfide), technical salt to - that, hydrosodium carbonate (bicarbonate soda). These chemical products (except soda) and the received free hydrogen sulfide have toxic properties therefore the treatment of them and the organization of work in a serolechebnitsa (see. Balneolechebnitsa ) demand observance of a number of safety regulationss.

Chemical reaction of receiving free hydrogen sulfide happens according to the following equation:

Na 2 S + 2HCl ⇄ H 2 S + 2NaCl.

Course of a chemical change depends on alkalinity of water that is defined by amount of the used bicarbonate soda. Special tables with calculation of amount of solutions and himikaliyev are developed for preparation of hydrogen-sulfide water with various concentration of free hydrogen sulfide (Ya. A. Shevtsov, 1957). Most often apply V. from artificial hydrogen-sulfide waters with concentration of hydrogen sulfide of 100 mg/l. Technology of preparation of V. is as follows: pour in V. 200 l of water t ° 35 — 37 °, pour out in it (at alkalinity 4,1 mekv) 27 g of bicarbonate soda and stir a wooden mixer before dissolution, pour out 355 ml of 12,6% of solution of sodium sulfide, and then 110 ml technical salt to - you ud. the weight 1,14, continuing to stir water a mixer. Century from hydrogen-sulfide artificial water of concentration of 100 — 150 mg/l, at t ° 36 — 37 °, lasting 10 — 15 min. is appointed every other day or two days running with rest to the third day, to a course 12 — 15 procedures. Sometimes use the «sparing» technique: appoint hydrosulphuric general V. of concentration of 50 — 75 mg/l, at t ° 35 — 36 °, lasting 5 — 10 min., every other day, to a course 10 — 12 procedures or local hydrosulphuric V. at t ° 36 — 38 °, lasting 10 — 15 — 20 min., every other day, to a course 12 — 15 — 20 procedures.

Century from artificial radon waters prepare in the special room and with observance of a number of rules according to the accident prevention (see. Balneolechebnitsa ) from solution of the radon received from salts of radium. From the drug which is contained in a special vessel (bubbler) which is placed in a lead container in specially equipped laboratory 1 — 2 times a week prepare strong solution of radon water. This solution also is initial for preparation of small portions (100 — 200 ml) of radon water with the concentration necessary for one radonic bathtub. In the large cities, resort areas radiological laboratories which on a centralized basis provide with strong solution of radon water medical institutions are created.

Fig. 7. The device for pouring out of solution of radon from a special vessel in a bathtub: 1 — the water line in a bathtub; 2 — a curved tube of a siphon; 3 — a vessel with solution of radon; 4 — the level of solution of radon in a vessel; 5 — a tube for an effluence of solution of radon in a bathtub; 6 — a bottom of a bathtub.
Fig. 8. Saturation by gas of water in a bathtub: 1 — a cylinder with gas; 2 — the device of saturation (AH-9); «3 — a hose with a tip.

Technology of preparation of artificial radonic V.: strong solution of radon water of a vessel through a siphon is poured out on a bottom of V. which is previously filled with water t ° 35 — 37 ° (fig. 7), at the same time make careful, but careful hashing of water. Apply V. with concentration of radon 36 — 72 — 109,2 nkyuri/l, at t ° 35-37 °, lasting 10 — 15 min., every other day, on a course 12 — 15 procedures. Gas (carbonic, oxygen, nitric) V. is trained physical and chemical in the ways. At a physical method of preparation saturation of water gas is made under pressure of 1,5 — 3 am by means of special columns mixers or devices of saturation AH-8 or AH-9 (fig. 8). The device or column are connected through a special reducer to a cylinder, in Krom there is the corresponding gas, and water system for supply water in them. The cold water (duration of saturation of 5 — 10 min.) oversaturated in the device by gas through a hose with a tip comes to V. with previously poured in it 1/3 more hotly (t ° 60 — 70 °) water before receiving water of the necessary temperature.

The chemical way with the manual or centralized mechanized preparation is applied for carbonic and oxygen V.

Chashche is used the manual preparation centralized — applied only at the big capacity of a balneary or balneolechebnitsa and demands existence of specially equipped laboratory (workshop).

Serve as feed chemical stock for preparation of a carbonic bathtub: sodium carbonate (sodium carbonate) and acid sodium sulfate (hydrosodium sulfate) or hydrosodium carbonate (bicarbonate soda) and acid potassium sulfate (hydropotassium sulfate). For V.'s preparation from artificial carbonic water with concentration of free carbonic acid of 1 g/l it is necessary to dissolve 400 g of sodium carbonate and 540 g of hydrosodium sulfate in 200 l of water, carefully and slowly mixing for acceleration of course of reaction:

Na 2 CO 3 + 2NaHSO 4 ⇄ CO 2 + H 2 O + 2Na 2 SO 4 .

Carbonic V. can be prepared, having replaced hydrosulphate salt to - that, and sodium carbonate with hydrosodium carbonate. This way more precisely, but it more labor-consuming and dangerous since it is necessary to apply concentrated salt to - that. Pour 600 g of a hydrocarbonate into water B., stir water a mixer before full dissolution and pour out (through a rubber tube on V.'s bottom) 655 ml technical salt to - you ud. the weight 1,14 — 1,15, continuing careful stirring.

The carbonic V. prepared by chemical methods have some shortcomings. The most important of them consist that the carbonic acid which is formed in water B. is emitted unevenly. It in turn promotes useless loss of the gas which is quickly going to air. However correctly executed receptions of the technology of preparation of V. provide quite sufficient efficiency of its action even without the special equipment. These V. appoint every other day, to a course 8 — 12 procedures, t ° 35 — 32 °, V.'s duration from 5 to 12 min.

For preparation of oxygen bathtubs two recipes can be used. First recipe: in 200 l of water pour out 100 g of hydrosodium carbonate, pour out 50 ml of 5% of copper sulfate solution (a copper vitriol) and 200 ml technical pergidrolya, carefully mix also in 10 min., by the time of accumulation of the maximum quantity of vials of oxygen, it is possible to place the patient in V. Second recipe: in 200 l of water pour out 200 ml of 2,5% of solution of potassium permanganate, stir water a mixer and add 40 ml of 20% of solution a chamois to - you and 200 ml technical pergidrolya, again carefully mix water and in 10 min. will prevent the patient in Century.

As any gas, oxygen from water B. gets through skin. Receipt it in an organism favorably influences a condition of cardiovascular system, stimulates exchange, hl. obr. oxidation-reduction, processes. Oxygen V. apply at treatment of patients with an idiopathic hypertensia, atherosclerosis (it is preferential in initial stages), patients with functional disturbances of c. N page and other diseases for the purpose of sedative influence and reduction of manifestations of an anoxemia. Appoint at t ° 35 — 37 °, duration of the procedure 10 century — 15 min., to a course 12 — 15 — 20 V., every other day or every day. The physical way of preparation of nitric bathtubs is similar to a way of preparation carbonic and oxygen. Considering smaller ability of nitrogen to dissolution in water, saturation of water B. by it is made within 10 min.

Bathtubs to children apply the same as to adults, about a gigabyte. and to lay down. purposes. At V.'s carrying out at children it is necessary to consider anatomo-physiological features of a children's organism. The child has a skin surface in comparison with body weight rather big; the nervous system differs in functional immaturity; thermoregulation imperfect. Therefore at children sensitivity to temperature influences is increased that demands extra care and careful control at V. V carrying out children's age cool and the more so cold V. Temperatura warm and hot on about 1 — 2 V. ° below, than do not apply the general to adults, V.'s duration and quantity them on a course of treatment, and also concentration medicinal and chemicals is less.

Hygienic V. positively influence an emotional tone of the child, breath, cardiovascular system, processes of thermoregulation, have the tempering effect. The first hygienic V. to the newborn child by the most part is done after falling away of an umbilical cord and healing of an umbilical wound. Within the first month of life of the child bathe in boiled water t ° 37 — 37,5 °. Hygienic bathtubs do to children up to 10 — 12 months of life daily, then every other day, from 0,5 to 3 one or two years of time a week, is more senior — at least than once a week. Water temperature of V. for children of the first half of the year of life 36,5 — 37 °, and in the second half of the year is also more senior 36 ° — 36,5 °. Duration of bathing for children of the first year of life 5 — 7, on the second year 8 — 10 and after 2 years 10 — 15 min. For the purpose of a hardening, since second month of life, after V. pour over the child water, temperature a cut on 1 — 2 ° lower than the water temperature soap (children's, egg, lanolin) it is necessary to bathe children of early age in V. S two times, and seniors — once a week.

Fig. 9. Bathing of the baby in a bathtub: 1 — water immersion; 2 — washing in a bathtub; 3 — washing after washing in a bathtub.

It is necessary to bathe babies in the tray which is specially intended for this purpose (faience, galvanized) or the enameled basin. During the bathing the head and an upper part of a trunk of the child are placed on a forearm of the left hand bathing, a brush of the right hand fix buttocks and hips (fig. 9). Supporting legs of the child, it is carefully immersed in water. Similar position of the child provides the greatest relaxation of muscles. For bathing it is possible to use also a special support. Children are more senior shall be in V. an easy fit, without tension. At the general V. not to constrain the respiratory movements, water is poured only to the level of nipples of the child, leaving to the breast opened an upper part. It is necessary to carry out century in certain hours not earlier than in an hour after feeding, or in 40 — 45 min. prior to it and for 1 — 1,5 hour to a dream. After V. it is necessary 20 — 30-minute rest.

With the medical purpose widely use for children the general V. from sweet water and medicinal In, Contraindications to them the same, as for adults (see. Balneotherapy ).

The general hot V. apply since the period of a neonatality in complex treatment of acute respiratory diseases, bronchitis, pneumonia, and also scleredemas. The child is immersed in V. with water t ° 37 °, and then add hot water in the foot end of V., leading up V.'s temperature to 39 — 40 °. V.'s duration is 2 — 5 min. (depending on age of the child). In the acute period of a disease they are carried out daily or two days running with a break for the third day, by only 4 — 6 procedures. After V. the child is wrapped in a warm blanket and give warm drink.

The general warm V. from sweet water appoint also as one of methods of complex therapy at spastic paresis and paralyzes, a chorea, bed wetting, pyelonephritis, hron, nephrite. Water temperature of warm V. 37,5 — 38 °, duration from 5 to 10 — 15 min., depending on age of the child and the nature of a disease, on a course of treatment of 10 — 15 V., carry out them daily or every other day. Mustard V. appoint according to the same indications, as the general hot. These V. carry out by the same technique, as for adults, at the rate of 5 — 10 g of dry mustard on a bucket of water (10 l). It is not necessary to apply mustard V. in the presence of an asthmatic component and diseases of skin. Pine needle baths are shown at functional frustration of a nervous system. For preparation use or liquid spruce extract of 2 — 3 ml on a bucket of water, or powder (1 — 2 g on a bucket of water). V.'s duration is 7 — 10 min., t ° 36 — 37 °. Appoint them every other day, to a course of treatment of 15 — 20 procedures.

Century with potassium permanganate have the disinfecting and drying effect, apply them at diseases of skin and an intertrigo. Add 5% to V. solution of potassium permanganate before light pink coloring of water. Duration of the procedure is from 5 (for newborns) up to 8 — 10 min. (for more senior children), water temperature 37 — 37,5 °. On a course of treatment of 6 — 8 bathtubs, every other day.

Chloride sodium (salt) V. possess tonic action, improve a metabolism. Are shown at rickets, hl. obr. in the period of a zatikhaniye of process, since 6 — 8-month age; are contraindicated at diseases of skin. For V.'s preparation for sweet water add cooking (sea, lake) salt at the rate of 100 — 150 g on 10 l (bucket) of water. Water temperature of the first chloride sodium V. for children till 1 year 36 — 36,5 °, then it gradually, through each 3 — 4 procedures, is reduced to 35 — 35,5 °. At the age of 1 — 3 years the original temperature of water 36 ° is reduced to 34 — 35 °. V.'s duration is from 3 to 10 min.; after each 2 — 3 V. duration of the procedure is increased for 1 min. Procedures do .cherez 1 — 2 day, on a course of treatment of 15 — 20 Century. After salt V. pour over children sweet water, temperature a cut on 1 ° is lower than the water temperature in Century.

Starched V. have the antipruritic and drying effect, apply them at skin displays of exudative diathesis and neuroarthritic diathesis, eczema and neurodermatitis. Potato starch (100 g on a bucket of water) is dissolved in a cold water and added in Century. Water temperature 37 — 38 °, V.'s duration of 7 — 10 min., carry out them daily or every other day; on a course of treatment 10 — 12 V.

Krom of the general, in children's practice use also local Century. Manual V. apply during attacks of bronchial asthma, at acute bronchitis, pneumonia, and also in the presence at the child of cardiovascular insufficiency. Hands of the child immerse in water to elbows. Water temperature in V. is gradually increased with 37 to 40 — 42 °, V.'s duration of 10 — 15 min. In the acute period of a disease they will be out daily, on a course of treatment of 4 — 6 Century. Foot V. are shown at acute respiratory diseases (rhinitises, nasopharyngites, laryngitis, etc.). The water line shall reach an upper third of a shin. Water temperature is gradually increased with 37 to 40 — 42 °, duration of the procedure 15 — 20 min. For strengthening of action of foot V. it is possible to add to it 30 — 50 g of dry mustard (on 10 — 15dvo-da).

Contrast foot V. apply for the purpose of a hardening, and also at oznobleniye, vasculomotor frustration at children of preschool and school age. The procedure consists in alternate immersion of legs on 5 — 10 sec. in a basin with water t ° 37,5 — 38,5 ° and in a basin with water, temperature a cut on 3 — 4 ° below. Each 3 — 4 days reduce water temperature in the second basin on 1 — 2 ° and lead up to 18 — 17 °. At the beginning of a course carry out 3 — 4 such immersions, and further 6 — 8 for the procedure. Duration can be extended to 15 — 20 sec.

Indications and contraindications to carbonic, hydrosulphuric and radonic V. for children the same, as for adults (see. Balneoterapiya ). However concentration of chemicals smaller, duration of the procedure 5 — 10 min., carry out them every other day, on a course of treatment of 10 — 12 V. V of carbonic V. concentration of carbonic acid at the beginning of a course of treatment shall be no more than 0,5 g/l, further it can be brought to 0,6 — 0,7 g/l. Water temperature of the first V. 35 — 36 °, then it is gradually reduced to 34 °. In hydrosulphuric V. concentration of hydrogen sulfide from 50 to 100 mg/l, water temperature 36 — 37 °; in radonic — concentration of radon 14,5 — 18,2 nkyuri/l, water temperature 35 — 37 °.

Bibliography: Gromova E. N. Balneotherapy, the Management on a fizioter. and fizioprofilakt. nurseries zabol., under the editorship of A. N. Obrosov and K. V. Lapina, page 101, M., 1968; M at d at with and e in I. P. Balneotherapy, M.,' 1951, bibliogr.; Nev-rayev G. A. A water-thermotherapy, in book: Physical therapy, under the editorship of G. A. Nevrayev, page 199, M., 1955; Syroyechkovskaya M. N. Balneotherapy, M., 1968, bibliogr.; Shevtsov Ya. A. Artificial medicinal waters, M., 195 7; fert H boron. Balneotherapie, Klin. Lehrbuch d. Physikalischen Ther., hrsg. v. J. Grober, S. 508, Jena, 1970, Bibliogr.; Krauss H. Hydrotherapie, B., 1969.

V. T. Olefirenko, H. F. Sokolova; Century of H. Gromova (ped.).