From Big Medical Encyclopedia

MUD CURE (synonym pelotherapy) — a method of thermal treatment, at Krom influence an organism of the patient therapeutic muds of various types (peat, sapropelic, sulphidic silt, clay Ils, etc.).

It is, as a rule, applied as a part of complex therapy, but can sometimes be an independent method of treatment.

History. With to lay down. the purpose of dirt applied in Ancient Egypt, Ancient Rome, India what instructions of ancient historians and doctors confirm (Herodotus, Pliny, K. Galen, etc.). Since the end 18 and at the beginning of 19 century treatment by dirt began to be carried out in many countries of Western Europe (Sweden, France, Germany, Austria); in Russia to lay down. dirt was used in 14 — 16 centuries (on the Crimean peninsula, in Saky and in the former Astrakhan province — Tinaki). Originally G. had empirical character and remained property of traditional medicine, only since the beginning of 19 century it began to be carried out under control of physicians. N. A. Auger was the first doctor who was working in Saky (1828) and left the description of G. which was carried out there. The glory about curative properties of therapeutic muds quickly grows, they begin to be applied on the first balneol. resorts (Caucasus Mineralnye Vody region, Lipetsk, Kemeri, Sergiyevsky Mineralnye Vody, Sloviansk, etc.).

After Great October socialist revolution works on research new and to studying of already known mud resources, the organization of zones a dignity were developed. protection of mud fields, ways of preservation and regeneration of dirt, and also concerning scientific justification of the mechanism to lay down. effects of dirt and to improvement to lay down. G. Sozdannye's techniques in the first years of existence of the Soviet power Balneal in-t on Caucasus Mineralnye Vody region, Central in-t of balneology and physical therapy in Moscow, Ukrainian of in-t of balneology in Odessa were the organizational and methodical centers for statement and carrying out scientific research in the area. The big role in G.'s development in Russia was played V. A. Alexandrov, by E. M. Brusilovsky, I. A. Valedinsky, A. A. Verigo, O. O. Mochutkovsky, etc. They evidence-based and entered into practice new techniques of G. — use of dirt of generally low temperature and preferential application way; band G. (intra vulval, intra rectal); combined G. (galvanogryazelecheniye, electrophoresis of mud solution, diathermomudtherapy, diatermogalvanogryazelecheniye, induktotermogryazelecheniye); use of mud drugs and contrast mud applications. Since the beginning of the 30th of 20 century it began to be applied extra resort G. Boley widely began to use with Lech. the purpose fresh-water peat (see. Torfolecheniye ) and sapropels. The big role in studying to lay down. values of dirt of these types belonged Moscow regional in-that physical therapy and physioprevention (nowadays Moscow regional physiotherapeutic-tsa) and Sverdlovsk in-that to balneology and physical therapy. Especially it should be noted value of positive experiment on G. of wounded in days of the Great Patriotic War. G.'s use at a number of surgical diseases was evidence-based, in particular at fire osteomyelites, injuries of peripheral nerves, a spinal cord and horse tail, injuries of joints (T. S. Zatsepin, X. M. Freydin, 1944; B. V. Ognev, 1948, etc.). For the purpose of increase in reactive opportunities of an organism, for the best current of the postoperative period of G. at these diseases began to apply to preparation for surgical intervention. The big contribution to studying of comparative effect of dirt of various types and a technique of their use is brought by central research institute of balneology and physical therapy.

Mechanism of action of mud cure

Physiological reactions of separate bodies and systems. Lech. influence of dirt consists of action thermal, mechanical and chemical factors. Expressiveness of this influence depends not only on a reference state of an organism of the patient, but also on physical. - chemical properties of dirt of various types. However data on reactions of all organism and separate bodies and systems at G. depending on type of the applied dirt are studied not enough. The data of researches of certain authors given below have mostly non-systematic character.

Thermal influence of therapeutic muds is defined by the general for all types of properties — dirt high heat capacity and heat-retaining ability, small heat conductivity (see. therapeutic muds ). However thermal effect of various dirt on an organism is unequal. Physical. properties of dirt, in particular heat conductivity, are defined by properties of the chemical substances which are contained in it, a ratio of organic and inorganic compounds, etc. So, heat conductivity of sulphidic silt mud is almost twice more, than peat that is explained by high content in sulphidic silt mud of mineral substances. Thereof at the same temperature of dirt the procedure from sulphidic silt mud is more load on an organism, than the procedure from peat or sapropelic.

Reactions are differently shown and developing at the same time fiziol. So, at comparative study of influence of sulphidic silt and peat dirt in an experiment at animals it is revealed that in identical conditions of holding a procedure sulphidic silt mud caused stimulation of adrenomedullary function, and peat — oppressed her. According to A.I. Zolnikova et al. (1968), against the background of an experimental hypothyroidism these changes were more expressed. Distinctions in expressiveness fiziol, shifts at G. are established also depending on degree of a mineralization of dirt (the salts dissolved in it) and an indicator of the mud environment (pH).

Researches of some authors showed that during the heating to the same temperature of dirt, the environments having higher mineralization and characterized by sharply acid indicator, contribute to the excitability of the neuromuscular device and skin thermoreceptors which was more expressed to normalization, and also more increase conductivity of skin, accelerate some enzymatic processes, stimulate neurohumoral system, etc.

At experimental hepatitis dirt of a high mineralization caused more expressed stimulation of exchange ascorbic to - you in an organism and normalization of functions of a liver.

Taking into account physical. - chemical properties of dirt of various types various maximum limits of temperature of heating of dirt recommended at G. are set: for sulphidic silt mud 44 °, for sapropelic 46 °, for peat 48 °. Under the influence of a thermal factor in the field of the appendix of dirt the vasodilatation corresponding to force of a temperature irritant, acceleration of a blood-groove in them, temperature increase in the subject fabrics, normalization of permeability, acceleration of exchange processes is observed.

Mechanical factor at G. is essential during the carrying out the general mud baths and band. At an application method its value decreases. However the used amount of dirt in various techniques of G. is strictly considered. Thickness of mud weight at application shall be not less than 4 — 5 cm ^ Amount of dirt for vaginal or rectal tampons of 350 — 400 g. Believe that unsharply expressed prelum of the subject fabrics promotes distribution of heat in fabrics deeply.

Volumetric factor at G. is defined by influence of the organic and inorganic compounds which are contained in dirt, a mineralization of biologically active agents, microelements, gases, etc.

Experiences with an exception of thermal and mechanical factors in the mechanism of action of G. (use of mud applications and mud solutions of low temperature) confirmed existence of a chemical component in operation to lay down. dirt. During the imposing of mud application not directly on skin of the patient, and on a polyethylene film (an exception of influence of chemical components on skin receptors and their absorptions through skin) G.'s effect was considerably reduced. Inorganic chemical components are generally absorbed by skin, causing irritation of numerous receptors of skin and skin vessels. Particles of some organic matters get through skin, circulate in blood and can make immediate effect on various bodies and systems of an organism. Treat them first of all various organic to - you (valerian, ant, humic, etc.), volatile components of dirt (the amine bases, hydrogen sulfide), hydrocarbons, nitrogenous substances, etc. The possibility of penetration into skin and concerning some ions of inorganic matters is proved, to hl. obr. sulfurs and gland. The chemical factor of G. is caused to some extent by the content in dirt of biologically active agents of the organic nature (enzymes, vitamins, substances like mediators — a histamine, acetylcholine, etc.).

The important role in fiziol, effect of dirt belongs to gormonopodobny connections like folliculin and other oestrogenic substances. One of proofs of their passing through skin and specificity of action is development in an experiment of a sharp hyperemia of the ovary replaced in an anterior chamber of an eye of a doe-rabbit after influence by several mud applications. These substances, apparently, possess the known role in efficiency of therapeutic action of G. at a row ginekol, diseases.

Among organic fractions to lay down. dirt the connections like antioxidants which are characterized by ability to stabilize and regulate enzymatic processes in fabrics are found. During the imposing of mud applications there is an increase in activity of a catalase, oxidase, proteinase, cholinesterase and other enzymes therefore oxidation-reduction processes accelerate, gas exchange, tissue respiration improves. Stimulation of oxidizing phosphorylation in fabrics is an indicator of influence of G. on biopower processes. Presence of connections like antioxidants is proved by the suppression of intensity of free radical oxidation observed in an experiment in fabrics at influence of radio and aqueous extracts from different type to lay down. dirt.

With anti-oxidizing (or anti-radical) effect connect beneficial effect of mud cure on processes of an angenesis, and also reduction of toxic influence on an organism of products of free radical oxidation.

Mechanism of action mud drugs is explained by influence present at dirt and their solutions of the biogenic stimulators activating cellular metabolism and regenerative processes.

To dirt, especially sulphidic silt, the bactericidal action caused by presence at them of some agents like bacteriophages and substances like antibiotics (e.g., penitsillinopodobny) which are developed and allocated in dirt with microbes antagonists, different types of bacteria, actinomycetes, mold fungi is inherent. Bactericidal action to lay down. dirt causes a possibility of use them for treatment of contaminated wounds, etc.

During the carrying out gryazelech. procedures all three factors (thermal, mechanical and chemical) work annoyingly on numerous thermo - chemo - osmo-and mechanioreceptors of skin, exerting reflektornogumoralny impact on various bodies and systems of an organism. At intra vulval and rectal G. there is an irritation of receptors of mucous membranes.

The mechanism of action to lay down. dirt on an organism it consists of reactions of separate bodies and systems. On condition of an adequate technique of G. makes generally stimulating impact.

G.'s role in change immunol, reactivity of an organism is essential. Products of antibodies are normalized, development of allergic reactions of the immediate and slowed-down type is late that reduces an allergic mood of an organism; indicators of nonspecific immunity are normalized. Exerts impact on the microcirculating processes in fabrics which are closely connected with «enzymatic and trophic» system of an organism; permeability of capillaries and connective tissue structures is normalized that promotes reparative processes.

One of the main parties of the mechanism to lay down. effects of dirt influence on local inflammatory process is. Causing a hyperemia of fabrics, improvement of a trophicity, blood circulations, processes of exchange, G. promotes a rassasyvaniye patol, products of an inflammation. The decomposition products of proteins coming to blood work as «autoproteinoterapiya» that causes increase in protective forces of an organism. In antiinflammatory action of G. activation of system a hypothalamus — a hypophysis — adrenal glands owing to increase in reserve opportunities of sympathoadrenal system is of great importance. Antiinflammatory action of G. is most shown in a stage of proliferation and involution of inflammatory process when elements of connecting fabric are still insufficiently condensed. At yet not permanent fibrous changes of G. can promote the maximum rassasyvaniye of the connective tissue educations which arose in the inflammatory center.

Mud procedures, improving food of fabrics, promote a softening of hems, a rassasyvaniye of commissures, stimulate regenerative processes, accelerate calcification of a bone callosity, reduce a tutopodvizhnost and increase the volume of movements in joints.

The reactions of an organism caused by use to lay down. dirt, proceeds also after the end of a mud procedure (a phase of an after-effect). Repeated use of dirt strengthens and will mobilize adaptation properties of an organism. Manifestation of reactions of an organism is closely connected not only with temperature and physical. - chemical properties of dirt, but also with an area of mud application and the place of its appendix. Mud applications, extensive on the area, in comparison with small exert more intensive impact on an organism. The applications imposed on so-called reflexogenic zones (humeral and pelvic belts, some sites of top and bottom extremities) cause owing to irritation of these skin zones a number of changes in the bodies which are metamericly connected with the corresponding segments of a spinal cord y spinal vegetative ganglions (shifts in some types of exchange and hemodynamic indicators, in a functional condition of these bodies). Taking into account this situation in the practician G. apply techniques of so-called mud collars, trousers, gloves, etc. (see below, the section «Technique»).

In response of an organism the special role belongs to cardiovascular system. Under influence gryazelech. procedures increase in number of the functioning capillaries is noted, emission of blood from depot increases owing to what the blood stream accelerates and exchange of the circulating blood increases in an organism. The coming hemodynamic shifts depend on intensity of influence of the mud procedure and a reference state of cardiovascular system. Under the influence of the mud procedure with a temperature of dirt of 40 — 42 ° at most of patients increase of pulse is observed (10 — 15 min. later this indicator is normalized). The ABP at patients with hypotension during the procedure raises, and at patients with an idiopathic hypertensia goes down (fluctuations of pressure make 5 — 15 mm of mercury.). Upon termination of the ABP procedure also quickly is returned to initial figures. Also moderately expressed negative changes of electrocardiographic indicators which are characterized by increase in teeth of P, R and T, sometimes lengthening of atrioventricular conductivity, with an insignificant shift of interval S — T from the isoelectric line are observed. 15 — 20 min. later after the end of a procedure these changes are normalized.

Influence of mud procedures of high temperatures (44 — 48 °) on cardiovascular system is more expressed. These procedures quite often cause tachycardia, increase in the ABP, emergence of unpleasant feelings and pain in heart, deterioration in overall health, negative shifts in indicators of an ECG.

Especially sharply negative shifts are shown at patients who in addition to the disease shown for G. have accompanying disturbances from cardiovascular system. In this regard at patients with associated diseases of cardiovascular system G. it is necessary to carry out with extra care; it concerns temperature of dirt, the area of mud applications and the number of procedures on a course.

In the course of carrying out a course G. the so-called balneoreaktion is observed (see. Balneoterapiya ). At fiziol. balneoreaktion of change in a functional condition of bodies and systems — in limits fiziol, the fluctuations which are not causing disturbance of a dynamic equilibrium. Patol. the balneoreaktion and reaction of an aggravation at G. which are expressed in strengthening of the main a wedge, symptoms of a disease shall be considered as result of disturbance of a dynamic equilibrium of internal environment of an organism and consequently as the harmful, undesirable phenomenon. They can be warned by the correct assessment of a reference state of the patient at purpose of mud procedures and use in the necessary cases of the sparing technique of G. providing rather good to lay down. effect.


Indications (are stated in the sequence depending on the frequency of use of G. at this or that disease).

Diseases of the musculoskeletal device. Arthritis and polyarthritis traumatic, infectious (brucellous, etc.) and dystrophic character in hron, stages and stages of the calming-down aggravation; rhematoid polyarthritis, rheumatism (a joint form) in an inactive stage (not earlier than in 8 — 9 months after an aggravation), diseases of a backbone and joints (osteochondrosis, an osteochondropathy, the Spondylarthrosis and a spondylarthritis in hron, stages, Bekhterev's disease at the minimum degree of activity of process); diseases and traumatic injuries of bones, muscles and sinews — changes with the slowed-down consolidation, an osteitis and a periostitis, a miositis, a fibromyositis, a bursitis, the Tendovaginitis, a contracture dermatogenny (after burns, phlegmons etc.). myogenetic and artrogenny character (because of traumatic damages), osteomyelitis without signs of activity of inflammatory process, trophic ulcers, it is long not healing wounds.

Diseases and effects of injuries of the central nervous system. Infectious and toxic diseases of c. N of page: the encephalomeningitis, an arachnoiditis, encephalitis (including diencephalitis), encephalomyelitis, toxic encephalopathies, meningomiyeloradikulit, a myelitis, including epidemic poliomyelitis (all diseases upon termination of the acute period); back tabes without the expressed ataxy and a cachexia; effects of wounds and other injuries of a spinal cord, its covers, a horse tail, including in the presence of unsharply expressed dysfunctions of pelvic bodies; effects of hematomyelias (hematomyelia) not earlier than in 2 months after an injury; effects of brain injuries in the absence of epileptic seizures and mental disorders.

Diseases and effects of injuries of a peripheral nervous system. Radiculitis primary (infektsionnotoksicheskiya), secondary various localization, connected with diseases of a backbone (osteochondrosis, etc.), with ginekol, diseases in hron, stages and stages of the calming-down aggravation; states after operations on intervertebral disks: a polyradiculoneuritis, a polyneuritis, a plexitis, neuritis of infectious, infectious and allergic and toxic character in subacute and hron, stages, a vegetative polyneuritis, a solar plexitis, a ganglionitis, a truncitis, a vibration disease (a form with preferential defeat of a peripheral vegetative innervation) in subacute and hron, stages; effects of wounds and other injuries of peripheral parts of the nervous system (traumatic radiculitis, a plexitis, neuritis) which is not demanding an operative measure including with unsharply expressed syndrome of a kauzalgiya and stump neuralgias.

Diseases of female generative organs. Diseases of a uterus and its appendages of inflammatory character; an erosion of a neck of uterus (at an exception of a zlokachestvennost); infertility because of inflammatory diseases of ovaries, unsharply expressed functional insufficiency of ovaries.

Diseases of men's generative organs. Hron, prostatitis, epididymite, orchitis, vesiculitis.

Diseases of digestive organs. Peptic ulcer of a stomach and duodenum out of the period of an aggravation, especially in the presence of inflammatory infiltrates and spasms, insufficiency of motor function of a stomach, a perigastritis, a periduodenitis, hron, colitis, hepatitis, cholecystitis, a cholangitis (not calculous), a pericholecystitis.

Diseases of an ear, throat, nose. Hron, atrophic and subatrophic processes in a nasopharynx. Hron, inflammatory diseases of adnexal bosoms of a nose, hron, tonsillitis in a stage of compensation, hron, inflammatory diseases of an ear.

Diseases of eyes. Neurogenic keratitis, ulcer and cataract of a cornea; traumatic defeats of an eyeglobe, the compensated forms of glaucoma, a pigmental degeneration of a retina, an atrophy of an optic nerve, etc.

Diseases of skin. Hron, forms of eczemas; neurodermatitis and psoriasis out of a stage of an aggravation.

Diseases of peripheral vessels. Phlebitis, effects of thrombophlebitis (infiltrate, an ulcer) not earlier than in 3 months after an aggravation.

The residual phenomena after burns and freezing injuries (hems, trophic ulcers, etc.).

The main contraindications

Acute inflammatory processes, high-quality and malignant new growths, diseases of blood, the hemopoietic bodies, bleedings and bent to them, tuberculosis of any localization, a circulatory unefficiency of II and III stages, an idiopathic hypertensia of the II B and the III stage, the expressed forms of atherosclerosis, endocrine diseases and diseases of a metabolism (obesity of III and IV degrees, severe forms of a thyrotoxicosis, a myxedema, a diabetes mellitus, etc.), diseases of kidneys and urinary tract; all durations of gestation; mental diseases, including general paralysis and drug addiction; severe forms of neurosises, genuinical epilepsy, cirrhosis, all forms of jaundices in an acute stage; polyarthritis with the progressing current, with heavy deformations, ankiloza; osteomyelitis in the presence of the large sequester or a large foreign metal body in the osteomiyelitichesky center.

A technique

At the choice of methodical receptions of G. and its options it is necessary to proceed from the accounting of a form of a disease, localization, a phase and a stage patol, process, existence of associated diseases, the general reactivity of an organism of the patient. Distinguish the general and local mud procedures.

The general mud baths from dense dirt (a consistence of dense sour cream) found distribution generally abroad, in the USSR used them till 1930. In a number of resorts use the general adjustable mud baths (so-called mud talkers) who prepare by cultivation of dirt by a brine or less concentrated mineral water in various ratios (e.g., 2/3 brines and 1/3 dirt). Apply these procedures preferential at generalized forms of defeat (e.g., polyarthritis) and the accompanying functional disturbances of cardiovascular system.

Fig. 1. Mud (peat) application on the lower extremities (before wrapping).

The application technique of G. in the form of the general and local mud applications has the greatest distribution. For carrying out mud applications display a flannelette or cloth blanket on a procedural couch, over it put an oilcloth or a polyethylene film, and on it a sheet from a scrim. On a sheet according to the part of a body which is subject to influence impose a layer of dirt of the appointed temperature, 5 — 6 cm thick for sapropelic and sulphidic silt mud and 6 — 8 cm for peat. The patient lays down on mud flat cake, on it quickly impose dirt (fig. 1) and wrap up. Upon termination of the procedure remove dirt from the patient, and it is washed under warm (t ° 36 — 37 °) a rain shower. After washing of the patient it is dry wiped and passes into the restroom where shall lie down on a couch of 30 — 40 min.

At the general mud applications cover with dirt all body of the patient, except for the head, a front surface of a thorax. Put a cold compress or a bubble with ice on a forehead. Such technique of G. is used preferential for treatment of patients with common forms of defeat (at polyarthritis, a polyradiculoneuritis, etc.) without frustration from cardiovascular system.

Fig. 2. Mud (sulphidic silt mud) application on «collar area».

At local mud applications dirt is imposed on the site or a part of a body (fig. 2): area of a stomach, back, waist, joints, etc. The place of imposing of mud application is defined by localization patol, process, degree of its activity. In practice of G. some local mud applications received certain names: mud «stockings», «socks», «gloves» (during the imposing of dirt on extremities and joints) for treatment of patients with neuritis, arthritis, etc.; mud «trousers» (on a basin and on legs) at radiculitis, effects of injuries of a spinal cord, etc.; «pants» (on a basin and upper thighs) at diseases of bodies of a small pelvis; «collar» (on a back surface of a neck, an upper back and supraclavicular areas — «collar area») at diseases of a brain, an eye, cervical department of a backbone, upper extremities, etc.; «bras» — on mammary glands (at ginekol. diseases).

Mud compresses also belong to local mud procedures. They are applied at diseases of joints, it is preferential in a subacute stage. On a gauze napkin, skintight to skin, impose a layer of dirt 1 — 2 cm thick and cover it with an oilcloth, then a quilted jacket and strengthen all this bandage or a towel. Such compress of the patient can hold 5 — 6 hour.

For strengthening of effect of dirt by M. S. Belenky (1946) it is offered to combine mechanical irritation of the skin site special brushes with the subsequent imposing on this site of mud application (brush mud baths). The purpose of such combination — the irritation of skin receptors leading to education in skin of histamine and atsetilkholinopodobny substances. It increases permeability of skin and facilitates absorption of biologically active agents which are contained in dirt.

Allocate the following options of application G.: intensive and sparing (mitigirovanny). At intensive G.'s technique of the procedure with rather high temperature of dirt (44 — 46 — 48 °) is appointed 2 — 3 days in a row with one day of rest, duration of the procedure 15 — 20 min., a course of treatment of 14 — 15 procedures. By an intensive technique it is shown for treatment of the residual phenomena of a disease or in a stage of permanent remission without signs of disturbance from cardiovascular system. At the sparing G. procedures appoint every other day and even more rare, duration of the procedure 10 — 15 min., temperature of dirt 38 — 40 °, to a course 10 — 12 procedures. Such technique finds broad application for treatment of diseases of inflammatory character with moderate activity of process or in the presence of the accompanying disturbances from cardiovascular system. Feature of sparing G.'s technique is what mud applications preferential impose on the corresponding reflexogenic zones. The sparing G.'s reception found especially broad application in treatment of diseases of c. the N of page, at the progressing muscular dystrophy, the residual phenomena of a tick-borne encephalitis, a diencephalic syndrome, cervical osteochondrosis with a syndrome of a vertebral artery, etc.

Polostnoye G. consists in introduction of mud tampons to a vagina or a rectum at treatment of diseases of bodies of a small pelvis. Dirt for tampons is carefully processed, wiping it through a dense metal sieve. The vulval mud pad of t ° 46 — 48 ° most often is entered by means of a soft rubber tube 30 cm long and left for 30 — 40 min. (sometimes longer) then dirt from a vagina is deleted with vigorous irrigation by water t ° 40 — 42 ° on ginekol, a chair. Procedures are carried out every other day, on a course of treatment of 10 — 15 procedures. The rectal tampon is slowly entered into a rectum by means of the special syringe. The dirt entered into a gut remains before defecation. Temperature of dirt 38 — 46 °, procedures are carried out every other day, on a course of treatment of 10 — 15 procedures. «the unified syringe» with tips of different diameter, suitable for introduction of both vulval, and rectal tampons is offered. Polostnoye

G. often combine with local applications on «a trusikovy zone».

There are techniques of treatment by mud applications of contrast temperatures. So, at a vibration disease impose sapropelic dirt t ° 46 — 50 ° on area of brushes in the form of «short gloves» and t ° 26 — 28 ° — on «a collar zone». Procedures lasting 15 — 20 min. are appointed every other day, to a course of treatment of 10 — 12 procedures. Much more rare (generally at ginekol. diseases in a subacute stage) use mud applications of lower temperatures — to 4 °.

Wide spread occurance techniques of use of mud solution and drugs from therapeutic muds, especially convenient for treatment in extra resort conditions — Peloidinum, gumizolya got, a pelobiol, etc. Mud solution is received by an extraction, by filterings, centrifuging of dirt; drugs from mud solution are used for compresses, irrigations, rinsings, injections and in techniques of an electrophoresis. Drug Peloidinum (see) received by extraction is applied by per os, in enemas, and also outwardly to compresses.

Drugs is peloidodistillit (see), FIBS (see) received from condensate of steam distillation of silt mud and also Torfotum (see) — from distillation of peat, use for subcutaneous injections. Gumisolum (see) — drug from the dirt extracted from the Haapsalu gulf of the Baltic Sea represents the mud solution containing according to chemical structure of this type of dirt a large number of fractions humic to - t. Pelobiol — the drug received from a liquid phase of sapropelic and peat dirt. Contains preferential organic compounds. It is used in the form of solutions for injections and an aerosoltherapy, and also in the form of ointment. Drugs from to lay down. dirt find application for treatment of diseases of inflammatory character in a subacute stage when influence of a thermal factor because of danger to cause an aggravation is undesirable.

Carry out also G.'s techniques, combined with electrotreatment; at the same time simultaneous influence takes place to lay down. dirt and a direct current (galvanogryazelecheniye) or the electromagnetic field of high frequency (induktogryazelecheniye) that increases antiinflammatory influence of dirt. Lack of the expressed thermal influence of dirt (at this technique dirt of lower temperature is used) causes a possibility of use of such technique of G. at an average degree of activity of inflammatory process, and also in the presence of disturbances from cardiovascular system.

At, it is possible to appoint also general mineral bathtubs (hydrosulphuric, chloride sodium, radonic, etc.) or one of methods of hardware physical therapy (ultrasound, diadynamic currents, an electrophoresis of medicinal substances, etc.), consistently alternating (preferential every other day) mud procedures to procedures of bathtubs or electrotreatments. E.g., for treatment of rhematoid polyarthritis the technique of use of mud applications developed Central in-volume of balneology and physical therapy on joints in alternation with an inductothermy on area of adrenal glands is offered. Alternation gryazelech. procedures and procedures of electrotreatment or reception of the general mineral bathtubs increases efficiency of influence. However such method of complex treatment is possible only at patients with the minimum activity of process and satisfactory condition of cardiovascular system.

It is possible to combine with to lay down. physical culture, massage, mechanotherapy, extension of a backbone, drug treatment.

It is impossible to combine with G. in the same day the general mineral bathtubs and other thermal procedures, UF-radiations in erythema doses, cold and cool souls, sea bathings, an aerogeliotherapy at the lowered air temperatures. Usually a course G. is conducted once a year. Sometimes, according to indications, a thicket. An interval between courses not less than 6 months

Mud cure at children

the Main indications for G. at children: cerebral paralyzes, poliomyelitis, cerebral arachnoiditis, encephalitis, traumatic neuritis, infectious arthritis, hron, tonsillitis, cholecystitis, cholangitis (not calculous), viral hepatitis, hron, pneumonia.

Contraindications, compatible and same incompatible procedures that at adults, and, besides, a hypotrophy of the III degree, bent to convulsive states.

At children it is carried out by the same general principles, as at adults, however to lay down. techniques are differentiated taking into account age features of an organism of the child.

At children apply an application technique at a temperature of dirt of 38 — 42 °, duration of the procedure at children of younger age of 5 — 15 min., and the senior has 10 — 20 min. The course of treatment consists on average of 15 procedures which are carried out every other day. After the mud procedure of the child put for rest to bed for 30 — 60 min. In autumn and winter season of the child it is not necessary to release from the room earlier than in 2 hours after the procedure. Air temperature indoors, is carried out to Krom by G. to children, shall be not lower than 20 — 22 °. Children can see off in a complex with massage, to lay down. gymnastics (usually in one day with the mud procedure, however till their beginning), and also with the general bathtubs (radonic, sulphidic, chloride sodium, etc.) or methods of hardware physical therapy, appointing them in days, free of. If necessary also medicamentous therapy is carried out.

Private techniques and. At various forms of a cerebral palsy, including and with hyperkinesias, to children is aged more senior than 1 — 1,5 years G. apply in the form of applications on «a collar zone», and in the presence of reflex contractures — on an extremity, alternating these procedures. Temperature of dirt 38 — 39 °. Procedures are carried out every other day, on a course of treatment of 10 — 12 procedures. Apply in a complex with pine, radonic, sea needle baths, electroprocedures (an electroanesthesia by Semenova's technique, novocaine electrophoresis).

At G.'s poliomyelitis appoint not earlier than in 2 — 3 months after the acute period. G.'s use in a recovery stage, i.e. from 4 — 6 months, from the beginning of a disease is the most effective, however favorable results can be received and patients with prescription have diseases more than 3 — 4 years. Mud applications impose on area of the struck department of a backbone and the paralyzed extremities, temperature of dirt 38 — 42 °, 12 — 20 procedures on a course of treatment. At 3-month stay in the resort to children with easy and moderate severity of defeat of motive function appoint 12 — 16 mud procedures and 10 — 14 mineral bathtubs (on condition of reception no more than 3 balneol. procedures in a week).

At a cerebral arachnoiditis of, carry out in a phase of full or incomplete remission. At poorly expressed disturbances of circulation of cerebrospinal liquid mud applications apply on «a collar zone», alternating them to pine or radonic needle baths. In the first half of a course of treatment within a week appoint one mud procedure and two bathtubs, in the following half — two mud procedures and one bathtub a week. On a course 6 — 10 mud procedures and 10 — 12 bathtubs. G. at a diffusion form of an arachnoiditis is more effective or with preferential localization of process in the field of the basis of a brain, is less successful at localization of process in a back cranial pole.

A technique of use of G. at effects of encephalitis the same, as at an arachnoiditis. It is more effective at effects of a tick-borne encephalitis, less — at effects of postvaccinal encephalitis.

At rheumatism (a joint and cardial form) G. in the resort is carried out not earlier than in 10 — 12 months after subsiding of an active phase of process. Existence of valve heart disease is not a contraindication, however at the combined heart diseases, a stenosis and insufficiency of the mitral valve of the indication to G. are limited. In local sanatoria (which are in a zone of full-time residence of the child) G.'s use is possible in 3 — 5 months after the acute period on condition of a top general condition, the standard temperature of a body which is not accelerated by ROE in the absence of other changes in indicators of a picture of blood and full compensation of cordial activity. The same requirements remain for G.'s carrying out at sanatorium country boarding school, a cut appoint after full adaptation of the child to new conditions (in 1 — 1,5 month after receipt in country boarding school).

At rheumatism carry out at a temperature of dirt of 38 — 40 ° in a look «сапожек» or «gloves», and also in the form of «a mud collar». Duration of the procedure 8 — 12 min., on a course prior to 15 procedures.

At rhematoid polyarthritis of G. it is shown in a phase of remission, and also in a subacute stage — at ROE it is not higher than 30 mm in an hour. Mud applications appoint to the affected joints, temperature of dirt 39 — 42 °, duration of influence of 10 — 15 min., to a course of treatment of 15 — 20 procedures. It is possible to combine with chloride sodium, carbonic, sulphidic bathtubs, to lay down. physical culture, massage, by the same technique, as at paralysis.

At hron, tonsillitis mud applications impose on submaxillary area, temperature of dirt 38 — 40 °, duration of the procedure 10 — 15 min., carry out procedures every other day, on a course of treatment of 10 — 12 procedures. More expressed effect is reached at G.'s combination to washing of lacunas, UF-radiation of almonds, impact on area of almonds by electric field of UVCh.

At cholecystitis and a cholangitis (not calculous) carry out in subacute and hron, stages of a disease. Mud applications impose on area of the right hypochondrium, temperature of dirt 39 — 40 °, duration of the procedure 6 — 10 min., procedures are carried out every other day, on a course of treatment of 7 — 10 procedures.

At the children sick with a viral hepatitis, considerably increases efficiency of complex therapy of this disease. The sick viral hepatitis (at easy and medium-weight forms of a disease) even in the presence of significant increase in a liver and its dense consistence recommends. Mud applications impose on area of a liver and segments of a backbone (With 3-4 and Th 6-10 ), temperature of dirt 38 — 40 °, duration of the procedure 10 — 20 min., on a course 6 —-15 procedures. The patients who had a viral hepatitis can see off not earlier than in 3 — 6 months after the beginning of a disease.

With success apply in complex therapy hron, nonspecific pneumonia in a stage of remission of a disease. Mud applications of t ° 38 — 39 ° impose on interscapular area. Procedures are carried out every other day, on a course of treatment of 10 — 15 procedures. At this G. it is reasonable to combine with inhalation therapy by antibiotics, an aero ionotherapy, to lay down. physical culture and others to lay down. actions.

Bibliography: White M. S. Metodika of resort mud cure, Kiev, 1963, bibliogr.; And in r and l about in N. A. Balneo-tekhnik, M., 1959; Mud cure in the resorts of Caucasus Mineralnye Vody region, under the editorship of A.S. Vishnevsky, M., 1969; Dick V. G. Mud cure of gynecologic patients, M., 1958, bibliogr.; V. P. treasurers and Dzizinskiya. A. Pathophysiological bases of a balneoterapiya, Vopr, kurortol., fizioter., century 4, with * 319, 1969; Lozinsky A. A. Lectures on the general balneology, M., 1949; Magazanik G. L. Torfolecheniye, M., 1949, bibliogr.; M and and A. M c. Treatment of gynecologic patients in resorts, L., 1957, bibliogr.; Mal-ch e of N to about L. V. Long-term results of extra resort mud cure of the children sick with rheumatism, Vopr. kurortol., fizioter., No. 3, page 202, 1968; About l of e f and-r e of N to about V. G. Vodo-teplolecheniye, M., 1970, bibliogr.; The guide to physical therapy and physioprevention of children's diseases, under the editorship of. And. N. Obrosov and T. V. Karachevtseva, page 129, M., 1976; With e-menova K. A., Mai of bales of an E. M ismuglinm. V. Klinika and rehabilitation therapy of cerebral palsies, M., 1972; Tatevoso in S. R. Mud cure, M., 1958, bibliogr;; Works of the 6th All-Union congress of physiotherapists and balneologists, M., 1973; Sh at x the island and E. V. and Babin L. M. A resort therapy of children with effects of encephalitis, poliomyelitis and a cerebral arachnoiditis, M. i 1968.

M. S. Belenky, Ts. F. Sokolova; N. A. Vladimirova (ped.).