From Big Medical Encyclopedia

PYROTHERAPY (Greek pyr fire + therapeia treatment; synonym pyretotherapy) — a method of treatment by means of artificial fervescence of the patient, i.e. creation of an artificial hyperthermia.

Warming of a body or its parts with the medical purpose was applied in an extreme antiquity (hot bathtubs, heated sand, dirt etc.), but P.'s development as method of creation of artificial feverish reaction began only at the end of 19 century that was promoted considerably by opening in 1876 by the domestic doctor A. S. Rozenblyumom of medical effect of some infectious diseases (malaria, typhinia, etc.) at psychoses of syphilitic genesis. Most widely P. was used in 30 — the 40th there are 20 century. In process of development of ways of causal and pathogenetic treatment P. lost the independent value and is applied usually in a complex with other modern methods of treatment. At the same time also new ranges of application of P., napr were defined, at oncological diseases.

Creation of an artificial hyperthermia is carried out in various ways: introduction to an organism of causative agents of infectious diseases (malaria, typhinia, etc.) and vaccines, the pyrogenic substances (see), in particular foreign proteins (horse serum, inogruppny blood etc.), pyrogenal; use of heated air, water etc., and also influence of electric and magnetic fields of high and ultrahigh frequency (electropyrexia, inductopyrexia). The last methods allow to receive accurately dosed, well managed temperature reaction proceeding without intoxication and by-effects of allergic character.

At all methods the hyperthermia is reached by change of activity of think-tanks of thermal control with disturbance of balance between processes of heat production and a thermolysis. Mechanisms of therapeutic effect of P. are up to the end not clear. Its promoting effect on c is established. N of page, simpa-Tiko-adrenal system, on processes of immunity. Also nonspecific desensibilizing and antiinflammatory influence of G1 is proved. At diseases inf. the nature P. Ustanovlen's effect the lowered resistance of the majority of tumors to overheating (higher than 40 °) in comparison with the normal fabrics surrounding a tumor is not excluded bactericidal (or bacteriostatic). Besides, the high hyperthermia increases sensitivity of a tumor to chemotherapy and beam influence.

The electropyrexia — one of methods P., at Krom fervescence of the patient is reached by the general impact on an organism (on all body of the patient) electric field of the ultrahigh frequency (UVCh) that leads to substantial increase of heat generation in fabrics. The method was offered, developed and implemented in clinical practice in 30 — the 40th there are 20 century V. A. Militsin and G. L. Frenkel.

The electropyrexia is carried out by means of the stationary device UVCh. The naked patient is stacked on the couch covered with a blanket and a sheet close a sheet, and then two woolen blankets, to-rye fix on a wooden framework. Two condenser plates of the size No. 3 establish in one plane under a wooden couch with a gap 8 — 10 cm from its surface; at the same time one plate is located in a projection of a thorax of the patient, and another — in a projection of the lower third of hips. The dose of influence makes 350 — 450 ma. In vrekhmya holding a procedure takes body temperature in an oral cavity or a rectum every 15 min. At temperature increase to 38 — 39 ° the device is switched-off, and in 15 — 30 min. (after decrease in temperature on 0,5 °) included before achievement of the chosen level of a hyperthermia again (38 — 39 °). The general duration of the procedure 2 — 4 hours. From 5 to 12 procedures with a frequency of 1 or 2 times a week are recommended for a course of treatment.

The inductopyrexia is applied to P. as well as an electropyrexia, but unlike the last inductopyrexia in a technique increase in the general body temperature of the patient is reached by action of magnetic field of high frequency from devices of an inductothermy. Use the inductor cable to leading of magnetic field, having it along a couch. The inductor is covered with a blanket and a sheet, creating a gap between a cable and a body of the patient in 1 — 1,5 cm. For the rest a technique of holding a procedure same, as at an electropyrexia.

Immediate effect of procedures electro-and inductopyrexias causes increase of pulse on 20 — 30 blows and respiration rates on 3 — 5 in a minute, strengthening of sweating, decrease in weight by 0,5 — 0,8 kg.

Indications to P.'s use in a complex the sluggish and spastic paralyzes developing at multiple sclerosis and in the outcome of poliomyelitis, early (infectious) forms of syphilis, neurosyphilis, slow gonorrhea, hron, an adnexitis, arthritises with poorly expressed activity of an inflammation, osteoarthroses, nek-ry skin diseases (psoriasis, eczema, streptodermas etc.), nek-ry forms of a keratitis, iridocyclites, and also exceptional cases of malignant new growths at which experience use as the general, and local the Item reckon with other types of treatment. In the latter case fabric of a tumor heats up to 44 — 48 ° and there is a problem of protection against overheating of healthy fabrics. At the same time the hyperthermia to 38 — 39 ° is considered contraindicated in the presence of tumors.

Electro-and an inductopyrexia are shown for treatment of infektsionnoallergichesky bronchial asthma during incomplete remission, infectious nonspecific polyarthritis of moderate and minimum activity, back tabes.

Contraindications for any kind of P. also high-quality new growths, tendency to bleeding, a pneumorrhagia are malignant (with rare exception); cardiovascular insufficiency, idiopathic hypertensia of II and III stages, hron, coronary heart disease, dekompensirovanny diabetes mellitus, thyrotoxicosis, pregnancy.

Bibliography: Alexandrov H. N, etc. Use of a hyperthermia and hyperglycemia at treatment of malignant tumors, M., 1980; Rozenblyum A. S., About the relation of feverish diseases to psychoses, Works of doctors Odessk. mountains. hospitals, century 2, page 72, 1876; The Reference book on physical therapy, under the editorship of A. N. Obrosov, page 71, M., 1976; About that d face downwards ying A. A. About use of the pyrogenic therapy in a dermatovenereology, Vestn, dermas, and veins., No. 4, page 3, 1976; Yanchenko E. H. Changes of nonspecific reactivity of patients under the influence of pyrogens, Owls. medical, No. 7, page 80, 1972.

V. K. Velikov, A. N. Sheyna.