From Big Medical Encyclopedia

HARDENING — a complex of methods of purposeful increase in functional reserves of an organism and its resistance to adverse action of physical environmental factors (lowered or the elevated temperature of air, water, the lowered atmospheric pressure, etc.) by the systematic training dosed influence by these factors.

3. — one of the most important sections of prevention, a component of actions for strengthening of health in sanatoria, rest houses, boarding houses, on recreational bases of the enterprises, in sanatoria dispensaries. Modern comfortable conditions of the dwelling, clothes, transport etc. reduce impact of the changing conditions of weather on a human body and reduce stability in relation to meteorol. to factors. Being an important part physical. education, 3. recovers this stability. Major factors 3. — air, water, solar radiation; combination to physical. exercises increases efficiency of the tempering influences.

The physiological mechanism of the tempering impact on an organism

3. it is possible to consider as adaptation (see), the edge is reached by systematic repeated influence of this or that physical. a factor on an organism that causes reorganization of metabolism and a row fiziol, functions, aimed at providing homeostasis (see); neurohumoral and exchange processes in various bodies and systems are improved. So, under the influence of systematic action of a cold air in a parenchyma of lungs there is more intensive combustion of high-energy products of exchange — lipids, including and cholesterol. The general adaptation opportunities of an organism improve, nonspecific immunity, ability to quickly mobilize protective resources at action of adverse factors increases. At repeated, repeated action of cold, thermal irritants or the lowered atmospheric pressure functional and morfol, changes of adaptive character gradually develop; the general body resistance increases.

The hardening is specific, i.e. it is defined by gradual decrease in sensitivity of an organism only to action certain physical. factor. So, the systematic dosed cold influences increase stability of hl. obr. to action of low temperatures, and thermal — to action high. 3. by cold does not predetermine development of resistance to heat or to low atmospheric pressure.

The hardening by cold

the Most almost important is 3. by cold, since overcooling — the most frequent reason of acute respiratory diseases. The complex system of thermal control of an organism allowing to maintain constancy of temperature of its internal environment irrespective of changes of ambient temperature consists of two mechanisms — physical. and chemical. thermal controls (see). Physical. thermal control is connected with regulation of heat output by means of vascular reactions of skin and internals therefore depending on ambient temperature decreases, «transportation» of heat with blood to the surface of skin increases, skin turns pink, turns pale. However when cooling continues to accrue and opportunities physical. thermal controls become insufficient, chemical thermal control joins, edges it is connected with metabolic rate, the strengthened combustion of products of exchange. Thus, big heat output is compensated by the strengthened heat generation, and temperature of internals remains to a constant. 3. provides a training of processes as physical., and chemical thermal controls, improves and provides them more accurate and energetically more hard work.

It is established that heat generation at the person tempered by cold is, more, than at not tempered owing to what at strong cooling balance of a heat balance at it remains longer, than at not tempered. At identical cooling at tempered by cold temperature of skin is higher and skin seems to the touch more warmly, than at not tempered; it is caused by the best blood supply of skin at the people tempered by cold. More high temperature of skin causes big heat waste from its surface, but at the person tempered by cold the strengthened heatloss becomes covered by the increased heat generation; but bigger blood supply of skin and its more high temperature provide high resistance of the tempered person to freezing injuries since the crucial role in developing of freezing injuries belongs to considerable reduction of blood supply of the cooled parts of a body (see. Freezing injury ). Decrease in sensitivity to Cold irritants is characteristic of the people tempered by cold a nek-swarm that clearly is shown at local and general cooling. In stability against overcooling the big role belongs to vascular reactions as that body part which is exposed to cooling, and all body. Cooling of any site of a body surface of the person causes reaction not only in the place of cooling, but also in uncooled sites. Not tempered people during the cooling have a stop less than on 5 ° (in comparison with initial temperature, edges it is usually equal 28 — 29 °) there is a reaction of a mucous membrane of a nose — expansion of its vessels, swelling and allocation of a plentiful secret, i.e. development of a catarral state. At the upper respiratory tracts tempered such reaction from a mucous membrane does not arise that is defined by various nature of reflex vascular reactions at the people who are not tempered and tempered by cold.

Along with funkts, the changes occurring in the course of 3. an organism by cold, changes in skin are noted and morfol. Repeated systematic cooling of skin involves a thickening of its corneous layer that increases heat-insulating properties of skin.

The hardening to high temperature of air

At high temperature of the environment owing to difficulty of a thermolysis arises danger of disturbance of thermal balance and fervescence (see. Overheating of an organism ). As a result of repeated and systematic action of heat resistance of an organism to it increases that the hl is reached. obr. improvement of a thermolysis. The main role in adaptation belongs to action of heat physical. thermoregulations. At long 3. to heat efficiency of sweating increases, i.e. the amount of the evaporating sweat increases (plentiful profuse sweat is rather ineffective since its most part flows down in the form of drops and practically does not influence the size of warm loss). Increase in heatloss happens only at the expense of the evaporating sweat. Amount of the evaporating sweat and, therefore, a thermolysis evaporation at permanent residents of tropical countries much more, than at newcomers from the countries with a frigid or temperate climate.

At long stay of inhabitants of a temperate climate in the conditions of high temperature of the environment efficiency of sweating at them gradually increases. This results from the fact that in process of 3. an organism to high temperature of air the players of sweat are changed, in it the content of fatty substances generally due to increase in release of skin fat increases. Thanks to increase in content of fatty substances in sweat its surface intention therefore sweat is more evenly distributed on skin decreases and the general evaporating surface increases. There are instructions on the fact that in process of 3. to high temperature of air concentration of chlorides in sweat decreases. Thanks to it there is rather smaller loss of salts at intensive sweating (see) that provides big stability of salt balance. Thanks to improvement of a thermolysis at the people tempered to influence of high temperature ability to preservation of constancy of body temperature increases; increase of pulse in operating time happens moderate, working capacity increases. One of indicators of hardness to high temperature — increase in a zone of optimum heatfeeling (a zone of comfort).

A hardening to low atmospheric pressure

It is carried out by hl. obr. in the conditions of gradual, «step», ascensions to mountains that increases resistance of an organism to a lack of air of oxygen. At decrease in atmospheric pressure the partial pressure of oxygen in an arterial blood decreases; at repeated repeated action of the lowered atmospheric pressure develop funkts, changes of adaptive character and resistance of an organism to these conditions of the environment increases (see. Adaptation to height ). The increase in ventilation of the lungs observed with the lowered atmospheric pressure involves build-up of pressure of oxygen in an alveolar air and an arterial blood. Increase in saturation rate of an arterial blood is oxygen a consequence of it. Through chemoceptors of carotid and aortal zones decrease in partial pressure of oxygen in an arterial blood causes also changes in activity of cardiovascular system. The lowered atmospheric pressure causes increase in minute volume of blood and speed of a blood-groove. It promotes bigger oxygen absorption in lungs and to transition of bigger amount of oxygen from blood in fabric. Increase in resistance of an organism to a lack of oxygen is to a certain extent reached by an exit of erythrocytes from blood depots — strengthening of an erythrogenesis and increase in a hemoglobin content in erythrocytes, as a result of it the oxygen capacity of blood increases. Along with it in the course of 3. an organism to the lowered atmospheric pressure efficiency of oxidizing processes in fabrics increases that promotes increase in resistance of fabrics to the low partial pressure of oxygen.

Forms and methods of a hardening

Main methodical principles 3. the following is: systematic use of the tempering procedures; continuous increase this or that physical tempering influences. factor; adequacy of a dosage to functionality of an organism. At the termination of use of the tempering procedures degree of hardness weakens and usually in 2 — 3 months resistance to these or that physical. to factors disappears.

For receiving a certain degree of hardness by cold and heat widely use stay in the open air — in the beginning the dosed air bathtubs, and further a day and night dream, and also the round-the-clock stay in the open air (see. Air-cure ). Apply also zharovozdushny bathtubs in a bath sauna; hydrotherapeutic procedures — rubdowns partial and full, douches partial and full, douches and bathtubs of contrast temperatures (see. Balneotherapy ), bathings in the closed and outdoor pools and reservoirs, the rivers, lakes, the sea (see. Bathing ); the highest degree 3., available to only very trained and almost healthy people — bathing in ice water — so-called winter swimming. One of the efficient tempering factors is solar radiation as means of increase in the general stability of an organism to adverse physical. to environmental factors.

At the systematic dosed solar radiations the provitamin D which is contained in skin turns into vitamin D 3 . Resistance of skin to UV rays increases, the xanthopathy (suntan) accrues, penetration of UV rays into fabrics decreases, barrier and protective properties of skin increase. Exchange, fermental and immune responses are normalized that in turn can influence activity of a row fiziol, systems of an organism, in particular phosphorus-calcium and cholesteric exchange is normalized. Resilience to various infections and catarrhal diseases increases (see. Heliation ).

For 3. to the lowered atmospheric pressure use ascension to mountains, stay in mountains and a training in pressures chamber.

The most common and available form 3. in life — use of fresh air. At the same time it is necessary to consider seasonal features. In warm season for 3. long walks in the fresh air, a dream indoors with an open window are used at air temperature not lower than 16 °. Air bathtubs should be begun indoors at air temperature not lower than 14 — 15 °. At the beginning of a course no more than 3 — 5 min., further, adding duration of daily procedures 1 min. every day, lead up duration of the procedure up to 15 — 20 min. It is useful in house conditions to go daily on a floor barefoot, since 1 min., adding every 5 — 7 days 1 min., lead up duration of walking up to 10 — 15 min. The specified recommendations belong to the faces which are not tempered at all and only starting carrying out 3. In cold season 3. carry out in the form of the dosed walks on foot, walking on skis, the «slow», so-called tempering run in the facilitated clothes, skating, etc.

Use for 3. hydrotherapeutic procedures has the features; water — more vigorous tempering factor, than air. Heat conductivity of water in 28 times more heat conductivity of air. Except temperature, water has mechanical effect on the receptor device of skin that is a peculiar massage which improves microcirculation and a lymph flow. The most common forms 3. water in house conditions — rubdowns and douches. To begin 3. water follows at a temperature it not lower than 34 — 35 °, further, at daily reception of procedures, through everyone — 7 days reduce water temperature on 1 °. According to such scheme lead up temperature to 22 — 24 ° and further continue rubdowns and douches by water of the specified temperature of 2 — 3 months. At a favorable current 3., i.e. in the absence of negative reactions in the form of Qatar of upper respiratory tracts, weakness, weakness or irritability, a hyperexcitability, frustration of a dream, appetite, it is possible to pass to 3. water of lower temperature — with 22 °, reducing every 10 days on 1 °; at daily reception of procedures bring rubdowns and douches to water temperature 10 — 12 ° (usual temperature of mains water).

Occupations physical. exercises, in particular carrying out morning gigabyte. gymnastics in the facilitated clothes, whenever possible in the open air or in carefully aired rooms, 3 also promote. to low air temperatures. In order to avoid overcooling classes in cold weather are given at more vigorous speed and less long time in the open air. In hot weather, in particular at the increased humidity, it is necessary to take measures against overheating (see. Thermal shock ). After each exercises reception of a shower is recommended.

The vapor bath has the great tempering value; the combined influence of heat, steam, water and mechanical irritation (washing by means of a bast or a broom) strengthens exchange processes, breath and blood circulation. The vapor bath promotes the best course of processes of recovery at athletes, especially after the intense trainings and competitions. It is not necessary to use, however, excessively long bathing procedures, especially at advanced age (duration of stay in a bath and is not more often no more than 10 — 15 min. 1 — 2 weekly, in days, free from trainings).

Methods 3. apply in the conditions of stay in rest house and treatment in sanatoria and sanatoria dispensaries. Most widely, as well as in life, use the Hardening air. On the basis of dependence of formation of size of deficit of heat which is formed in an organism during the cooling with air or water, the equivalent and effective air temperature or water (see. Climatotherapy ) tables of dosages at 3 are developed. air and water. Because the speed of increase of deficit of heat in time as is of great importance for a hardening by cold (air and water) at reception of the separate procedure, and all course, four extents of cold influence — «poorly training» from 3,0 to 18,0 kcal/m are developed 2 , «moderately training» from 4,5 to 36 kcal/m 2 , «strongly training» from 4,5 to 52 kcal/m 2 , «extremely training tempering influence» from 6,0 to 72 kcal/m 2 body surfaces of the person (see. Air-cure ).

Depending on degree of hardness of the person also the corresponding, complex mode 3 is selected.

The vigorous tempering action bathings in open reservoirs since at them the thermal irritation is combined by water with influence of air, solar radiation and movements (swimming) possess. Usually begin to bathe at water temperature and air not lower than 18 — 20 °, stop at water temperature 10 — 12 °, air — 14 — 15 °. Duration of bathing at the beginning of 4 — 5 min., gradually time it is led up up to 15 — 20 min. It is not recommended to bathe earlier than in an hour after food.

Winter bathings («winter swimming») are characterized by very intensive influence on cardiovascular and nervous systems connected with action of a strong cold irritant, high tension of thermoregulatory mechanisms, profound changes of a metabolism etc. Use of winter bathings by healthy people with observance of rules of gradual adaptation of an organism to action of strong cold irritants increases resistance to action of low temperatures. However only almost healthy people can be engaged in «winter swimming» and before it careful gradual preparation of an organism (not less than a year) for action of cold is necessary. Stay in ice water shall last no more than 20 — 30 sec. and be followed by the movement. The people who are engaged in winter bathing shall be under systematic medical observation.

3. by solar radiation it is used in the form of reception of the general solar bathtubs, local — on certain body parts; apply also scattered solar and air bathtubs under the tent which is partially passing UV rays (see. Heliation ).

For 3. to low atmospheric pressure most widely use stay in the mountain camps located at various heights (so-called step acclimatization). In process of passing of a certain stage of acclimatization pass into the following, more highly located camp (see. Mountaineering ). Such gradual rise to mountains should be combined with active muscular work (training ascensions). More rare for 3. to low atmospheric pressure use a training in special pressures chamber (see).

Important condition of efficiency of procedures 3. the regular medical control and self-checking which are carried out by overseeing by health, change ve sa, functions of a number of internals and a nervous system are. During the use of the strong tempering factors (solar radiation, a cold water) there can be frustration (sleep disorders, appetite, etc.); in this case dosages of the separate tempering procedures limit. Choice of the optimum mode 3. for various age groups of the population it is necessary to carry out differentially taking into account specific features of an organism, initial degree of hardness, a profession etc.

The hardening at advanced and senile age is carried out with care and in the conditions of careful systematic medical control. At this age during the carrying out 3. deterioration in adaptation to action physical shall be considered. irritants and slower recovery fiziol. functions after the procedures. Different types 3 are most preferable to these contingents. air — air bathtubs in rooms, on verandahs, balconies, in a shadow of trees or under a tent (summer), gradual schooling to walks in the facilitated clothes. It is better to use solar radiation in the form of scattered solar and air bathtubs of Occupation physical. exercises it is necessary to complete receptions of a hydrotherapeutic procedure in the form of rubdown, douche or a shower, and in warm season — bathings in water at water temperature and air not lower than 20 — 22 °, however duration of bathings shall be limited.

Features of a hardening of children

Features of a hardening of children are caused by the nature of morfofunktsionalny development of an organism of the child. Than the child is younger, especially incompleteness of development of its c is expressed morfol, and funkts. N of page, hemadens, respiratory organs and blood circulation. In the first months of life considerable thermolability is inherent to children; they keep the standard temperature of a body only at insignificant temperature variations of the environment, easily overheat and overcool. At babies thermal control is carried out by hl. obr. by means of change of chemical thermoregulation. Physical. thermoregulation is developed poorly owing to incompleteness of formation of the exteroceptors, conduction paths and all other components of a reflex arc providing responses from respiratory, circulatory and endocrine systems.

The external irritations adequate on the force to the level of development of system of thermal control of the child, promote its further improvement, improvement of perception of irritations and acceleration of response. On this fiziol, patterns are based the principles 3. children.

1. Gradualness of increase in force of an irritant, since the least perceived (indifferent); restriction or cancellation of an irritant (air, water, solar radiation) at the first signs of the beginning cooling or overheating.

2. Systematic daily repetition 3. at combination about a gigabyte. procedures and various motive activity of children.

3. The accounting of specific features of an organism of the child at the choice of means and ways 3., since irregularity of development of children within the same age causes considerable variability of responses.

Begin 3. from air bathtubs indoors, optimum air temperature: for children aged till 1 year 22 — 21 °; from 1 year to 2 years — 21 — 20 °; from 2 to 4 years — 20 — 19 °; from 4 to 7 years — 19 — 16 s. These procedures are carried out usually during the change of clothes after a night and day dream. Duration of an air bathtub from 3 — 4 min. is gradually increased up to 10 min. It is reasonable to combine 3. with massage and gymnastics. Children receive a partial air bathtub also during the outdoor games and sports occupations when they are in the facilitated clothes. Stay has the tempering effect during walks and a day dream on the planted trees and shrubs site or an open verandah in the open air. In total children shall be out of the room in cold season on 2 — 5 hours, depending on age, and in the summer on 10 — 12 hours daily. In summertime walk is combined with air and svetovozdushny bathtubs, after to-rymi children years are more senior shall receive d solar bathtubs. Children aged till 1 year under direct sunshine are not taken out, they should be held in the treatment of light and shade formed by krone of trees or canopies. It is necessary to alternate periodically stay of children years in a shadow and on the site lit with the sun are more senior. Gradual increase in the area of a naked body surface and an obligatory light headdress prevent excess radiation and overheating. Essential value for 3. air both in the summer, and rationally picked up clothes have in the winter: it shall provide thermal comfort to the child in the room and out of it, it is necessary to consider that overheating is not less harmful, than cooling.

The hardening with water is begun after preliminary carrying out during 1 — 2 week of air bathtubs indoors. Gradual increase in force of effect of water is reached by uniform decrease in water temperature, increase in the area of the moistened integuments, replacement of local hydrotherapeutic procedures with the general which are also given as the increasing intensity: wet rubdown, douche, a bathtub, a shower, bathing in an open reservoir. In total gigabyte. hydrotherapeutic procedures shall be combined with 3. Local use of water in a gigabyte. the purposes (washing or wet rubdown of the person, neck, washing of hands, pog) comes to an end with use of more cool water. Widely apply douche of feet and the lower third of shins. Begin these procedures at water temperature 30 °, in a week reduce on 1 — 2 ° each 1 — 2 day, leading up to 22 ° for children of the first year of life, to 18 — 16 ° for children from 1 year to 3 years and to 16 — 14 ° for children of 4 — 7 years. For the general short-term hydrotherapeutic procedures (rubdown, douche) water temperature with 35 ° in a week begins to be reduced on 1 — 2 ° each 1 — 2 day and leave at the level of 28 ° for children at the age of 1 — 2 years and 24 — 22 ° for preschool children. For the general a gigabyte. bathtubs water temperature remains to a constant (36 °). For 3. gigabyte. the bathtub is completed the general douche by water t ° 34 °. 3. carry out by water indoors at the usual room temperature of air and an obligatory exception of a draft. The hydrotherapeutic procedure comes to an end with the wipe of skin dry accompanied with light massage for strengthening of peripheric circulation. Then the child puts on usual clothes. In all cases of the forced termination 3. it should be renewed perhaps quicker, however after 3 — a 5-day break water on 2 — 3 ° more warmly than that is used, to-ruyu applied in the last day 3. If hydrotherapeutic procedures were not carried out more long term, begin them with the recommended initial temperature again.

As a result of correctly carried out 3. considerably incidence decreases, physical improves. and psychological development of children. To some extent 3. influences specific features of century of N of of children. In process of long repetition of correctly picked up procedures force, mobility and steadiness of processes of excitement and braking in c improves. N of page.

The children weakened by a hypotrophy, rickets, repeated or hron diseases, especially need the tempering procedures increasing body resistance. However use of means 3. for improvement of patients and the weakened children demands special approach. The fresh pure air has salutary effect at any diseases; it is widely used during a day dream. Stay in the open air both in the summer, and is especially useful for children with diseases of bodies of blood circulation and breath in the winter (inborn heart diseases, rheumatism, hron. pneumonia, bronchial asthma) since at these diseases first of all function of gas exchange is broken. The general air bathtubs indoors depending on a condition of the child reduce and limit to a partial short-term exposure of a body during change of clothes. Svetovozdushny and solar bathtubs are strictly dosed, children accept them in a prone position, turning through certain time slices. Hydrotherapeutic procedures at the weakened and sick children apply hl. obr. slabodeystvuyushchy: cost washing, wet rubdown, douche. Water temperature with initial (35 — 36 °) decreases much more slowly and only at improvement of the general condition of the child it is carried to the level recommended for healthy. To the children having exudative diathesis with the expressed phenomena of dermatitis, water rub off only not affected areas of skin.

At the acute diseases which are followed by fervescence, all tempering procedures are excluded. In process of recovery and taking into account specific features of an organism of the child order of implementation of the tempering procedures recommended for healthy children is restored.

The hardening of staff of Armed Forces

the Hardening of staff of Armed Forces aims to increase resistance of an organism of the military personnel to various jumps physical. environmental factors, to the conditions connected with features of service (e.g., noise, vibration, etc.).

Activity of the military personnel can proceed in difficult climatic conditions and is accompanied by impact on an organism of the maximum loads connected with service and control of the new equipment. Fighting capacity of troops in considerable degree - depends on the state of health of the military personnel, from their physical. fitness and hardness, therefore physical. preparation and 3. are an important component of combat training of troops and are carried out during all endurance at all seasons of the year. 3. is result of a combination physical. preparation and sport with the mode regulated by the relevant charters and manuals (charters of Armed Forces, orders MO USSR, instructions of commanders-in-chief of different types of Armed Forces, and also instructions of the commander of a part). The chief of a health service together with the chief physical. preparation makes the plan of measures on 3. the military personnel also submits it for the approval to the commander of a part.

Great value in system 3. the military personnel systematic carrying out morning has a gigabyte. gymnastics in the open air, with washing after it a cold water to a belt (water temperature with 25 — 18 ° gradually reduce to 12 — 10 ° below). Important action in 3. rinsing of a throat is a cold water, and also washing of legs a cold water before a release, a dream with the transoms which are slightly opened for the night at a temperature of the sleeping room of 16 — 15 °C gradual decrease it to 13 — 12 ° in the beginning. During the winter period ski trainings and transition from one room to another without overcoats, performance of some types of work and occupations in the facilitated clothes are used. In the early spring in sunny windless days classes are given in ski preparation with a naked torso. Very effective measure 3. rubdown serves as snow to a belt, at the same time the military personnel shall be almost healthy, trained (a contraindication pustulous diseases of skin are).

During the summer period some types of works, occupations and sporting events are also held in the facilitated clothes. In time, free from occupations, and on the weekend acceptance of air and solar bathtubs will be organized. Bathing in open reservoirs is begun at water temperature not lower than 15 and air temperature not lower than 18 — 20 °; duration of bathing depending on water temperature in the beginning 1 — 2 min., and then happens up to 15 — 20 min.

The hardening to high temperatures of air provides the corresponding exercises with intensive physical. loading in hot season. Stay in the sun is begun from 15 — 20 min. with gradual finishing till 1,5 — 2 o'clock.

Control of the correct use of means 3. it is carried out by medical structure and it is provided in the plan of work of medical service of a part. The chief of medical service will organize acquaintance of staff of a part with rules 3. by holding lectures, conversations with wide use of visual aids (stands, photoshow-windows etc.). After carrying out medical inspections the doctor recommends appropriate means 3. to certain groups of the servicemen, monitors respect for systematicity and a continuity in holding the tempering procedures, gradual building of their dosage. The medical service watches also what impact is exerted by 3. on the state of health of staff, paying at the same time special attention to the military personnel needing systematic medical observation; controls implementation of requirements 3. in relation to climatic conditions in which a part is located, and makes the corresponding temperature corrections of air and hydrotherapeutic procedures, a dress code, duration of procedures 3. etc.

Bibliography: Marshak M. E. Physiological bases of a hardening of a human body, L., 1965, bibliogr.; Minkh A. A. Sketches on hygiene of physical exercises and sport, M., 1976; Sarkizov-Serazini I. M. Bases of a hardening, M., 1953; Smirnova E. T. Hygienic bases of education in preschool institutions, M., 1973, bibliogr.; Speransky G. N. Hardening of a children's organism, M., 1934; Spirina V. P. Hardening of children, M., 1972; H and about in with to and I am A. P. Gigiyena of children of early and preschool age, page 49, M., 1971; Egolinsky Ya. A. Physical endurance of the person and way of its development, M., 1966.

V. Ya. Kramsky, I. A. Kryachko, M. E. Marshak; V. A. Zhuravsky (soldier.), V. P. Spirina, G. P. Yurko (ped.).