The therapeutic utilisation The therapeutic utilisation of the thermal water of the thermal water

Dr. Zoltán Muraközi (Director-General)Dr. Zoltán Muraközi (Director-General)Dr. Enikő Simkovics (Chief Medical Officer)Dr. Enikő Simkovics (Chief Medical Officer)

A A magyar (energiafajták szerinti) felosztásmagyar (energiafajták szerinti) felosztás szerint a szerint a tisztán fizikaitisztán fizikai energiát alkalmazó kezelések (fizikoterápia) közé soroljuk az elektroterápiát, energiát alkalmazó kezelések (fizikoterápia) közé soroljuk az elektroterápiát, a fototerápiát, a termo-kryoterápiát, a hidroterápiát és a mechanoterápiáta fototerápiát, a termo-kryoterápiát, a hidroterápiát és a mechanoterápiát

A A fizikai és kémiai energiákat egyaránt felhasználófizikai és kémiai energiákat egyaránt felhasználó fizioterápiás gyógymódok fizioterápiás gyógymódok közé tartozik az ásvány- és gyógyvizet felhasználó közé tartozik az ásvány- és gyógyvizet felhasználó balneoterápia,balneoterápia, az az inhalációs kezelések, a klímaterápia és az étrendi kezelésinhalációs kezelések, a klímaterápia és az étrendi kezelés

Balneoterápia

Elektroth. Hidroth.

Termoth.Fototh.

KlímaterápiaDiéta

Inhaláció

Mechanoth.

Fizikoterápia

Fizioterápia

FiziotherapyFiziotherapy

Hydro-,balenotherapyHydro-,balenotherapy The hydrotherapy (balneotherapy) healing with water, The hydrotherapy (balneotherapy) healing with water,

through bath treatments, packings, hydromechanics through bath treatments, packings, hydromechanics procedures the (thermal)water reports his systematic use procedures the (thermal)water reports his systematic use

Physical characteristicsPhysical characteristics : : bouyancy (felhajtóerő)bouyancy (felhajtóerő) hydrostatics pressure (hidrosztatikai nyomás)hydrostatics pressure (hidrosztatikai nyomás) temperature (hőmérséklet)temperature (hőmérséklet) medicinal water physiological, his salutary effects medicinal water physiological, his salutary effects

The formation of the medicinal watersThe formation of the medicinal waters

Sources stemming from 20 m of depth or from deeper Sources stemming from 20 m of depth or from deeper one with a constant temperature one with a constant temperature

Geothermal gradiensGeothermal gradiens: the layer thickness in which the : the layer thickness in which the earth's crust is temperature 1ºC is growing. Hungary: earth's crust is temperature 1ºC is growing. Hungary: 20 m, Europe: 30-33 m 20 m, Europe: 30-33 m

The quantity of the substances relieved in the water: The quantity of the substances relieved in the water: depends on the peculiarities of the water, the depends on the peculiarities of the water, the combination of the rockscombination of the rocks

Thermal water,mineral water, medicinal Thermal water,mineral water, medicinal waterwater I.I.

Thermal waterThermal water: in Hungary:eater above 30 degrees, in : in Hungary:eater above 30 degrees, in Europe: 20 Europe: 20 ººC C

Mineral waterMineral water: natural water like that, that litre contains at : natural water like that, that litre contains at least 1000 mg of mineral, you are some kind of special least 1000 mg of mineral, you are some kind of special biological one activity the quantity of an interpretive biological one activity the quantity of an interpretive microelement exceeds the prescribed limit value: microelement exceeds the prescribed limit value:

iodine és sulfid: 1 mg/liodine és sulfid: 1 mg/lfluorid:1,5 mg/lfluorid:1,5 mg/lbromine: 5 mg/lbromine: 5 mg/lradon: 37 Bq/lradon: 37 Bq/l

Thermal water,mineral water, Thermal water,mineral water, medicinal water IImedicinal water II..

Medicinal waterMedicinal water:: mineral water that has a curative :: mineral water that has a curative effect effect

It is necessary to justify the curative effect with It is necessary to justify the curative effect with objective examination methods objective examination methods

The medicinal water the condition of manifestation The medicinal water the condition of manifestation the symptomatic parameters being subject of the the symptomatic parameters being subject of the examination at least 51 %-the improvement of os .examination at least 51 %-the improvement of os .

We have We have 164164 acknowledged medicinal waters acknowledged medicinal waters currently ( in Hungarycurrently ( in Hungary))

The balneotherapy indicationsThe balneotherapy indications

Chronic joint illnessesChronic joint illnesses The abrasion illnesses of the spineThe abrasion illnesses of the spine

Osteoporosis, fibromyalgia, reumatizmusOsteoporosis, fibromyalgia, reumatizmusIschias, neuralgiasIschias, neuralgiasProtruded intervertebral disk postoperative stateProtruded intervertebral disk postoperative stateParalyses of the nervous systemParalyses of the nervous system

Took shape after injuries, accidents organ of Took shape after injuries, accidents organ of locomotion changeslocomotion changesOrthopaedics illnessesOrthopaedics illnessesDermatological illnessesDermatological illnessesGynaecological illnessesGynaecological illnessesChronic respiratory illnessesChronic respiratory illnessesGastrointestinális illnesses Gastrointestinális illnesses

Balneothyerapy contraindicationsBalneothyerapy contraindications

Acute inflammatory diseasesAcute inflammatory diseasesManifest cardiac insufficiencyManifest cardiac insufficiencySerious hypertoniaSerious hypertoniaInfectious diseasesInfectious diseasesFeverish statesFeverish statesPhlebitisPhlebitisAlcohol in case of an effectAlcohol in case of an effectMalignus tumours Malignus tumours

The partition of the mineral waters and The partition of the mineral waters and medicinal watersmedicinal waters

kloridos (konyhasós, NaCl, ) kloridos (konyhasós, NaCl, ) Földes-meszes (Ca-Mg-HFöldes-meszes (Ca-Mg-HCOCO33 )) Szénsavas (Szénsavas (COCO22 )) Szulfidos (kénes, S)Szulfidos (kénes, S) Jódos-brómos (I, Br)Jódos-brómos (I, Br) Szulfátos (keserűsós, glaubersós, Szulfátos (keserűsós, glaubersós, MgSOMgSO44 NaSONaSO44)) Alkáli-hidrogénkarbonátos (lúgos, alkalikus, Alkáli-hidrogénkarbonátos (lúgos, alkalikus, NaHCONaHCO33 )) Vasas (Fe)Vasas (Fe) Radioaktív, radonos (Rn)Radioaktív, radonos (Rn)

Iodised-bromine bathsIodised-bromine baths Jodine: 1 mg/l, Jodine: 1 mg/l, Bromine: 5 mg/l (limit value)Bromine: 5 mg/l (limit value) in salty mineral waters can be found in salty mineral waters can be found Sóshartyán, Cserkeszőlő, Hajduszoboszló, Sóshartyán, Cserkeszőlő, Hajduszoboszló,

BerettyóújfaluBerettyóújfalu the iodine uptake taller through the lung, than the iodine uptake taller through the lung, than

through the leather through the leather Jodised bath:iodide implies an ion, in complex Jodised bath:iodide implies an ion, in complex

bandage bandage

The biological effects of the iodineThe biological effects of the iodine Jodine:dissolves the proteins, inflammatory Jodine:dissolves the proteins, inflammatory

products products Increases the permeable ability of the border Increases the permeable ability of the border

membranes, the absorption of liquid oedemata membranes, the absorption of liquid oedemata furthers it furthers it

Increases the peripheral circulation Increases the peripheral circulation the uric acid and blood sugar reduce it level the uric acid and blood sugar reduce it level Encourages the function of the ovary Encourages the function of the ovary

His iodised indications taking a bathHis iodised indications taking a bath Ovary inflammation Ovary inflammation Chronic gynaecological inflammations Chronic gynaecological inflammations Chronic urology inflammations Chronic urology inflammations PsoriasisPsoriasis Chronic inflammatory one and degeneratív Chronic inflammatory one and degeneratív

rheumatology illnesses rheumatology illnesses Operative after treatmentsOperative after treatments HypertoniaHypertonia Peripheral arterial and venous circulatory Peripheral arterial and venous circulatory

disturbances disturbances Special contraindicationSpecial contraindication: iodine allergy, : iodine allergy,

hyperthyreosis hyperthyreosis

Alkaline medicinal water, Na-K- hydrogen Alkaline medicinal water, Na-K- hydrogen carbonate mineral waterscarbonate mineral waters

Litre 1g more relieved substances, in which the majority Litre 1g more relieved substances, in which the majority of the cations is of the cations is sodiumsodium and and potassium,potassium, are implied ion, are implied ion, the majority of the anions though the majority of the anions though hydrogen carbonatehydrogen carbonate

Balf, Bükkszéki Salvus víz, Fonyód, parádi Csevice, Balf, Bükkszéki Salvus víz, Fonyód, parádi Csevice, Békés, Gyopárosfürdő, Gyula, Békés, Gyopárosfürdő, Gyula, Berettyóújfalu.Berettyóújfalu.

The effects of medicinal water The effects of medicinal water Chronic inflammatory one and degeneratív Chronic inflammatory one and degeneratív

rheumatology illnessesrheumatology illnesses mucolytics and cholagogue effect (drinking cure) mucolytics and cholagogue effect (drinking cure) gastric acid -reducing effect and the function of the gastric acid -reducing effect and the function of the

cells is accelerated.(drinking cure) cells is accelerated.(drinking cure)

Cardiovascular and haematological Cardiovascular and haematological changeschanges

CardiovascularCardiovascular The superficial veins are being squashed The superficial veins are being squashed The venous regurgitation intensifies The venous regurgitation intensifies he central venous pressure increases he central venous pressure increases The blood pressure and the heart frequency The blood pressure and the heart frequency

decreasedecreaseHaematologicalHaematological haemodilutiohaemodilutio Hbg and htc decreasedHbg and htc decreased

Renal and pulmonal changesRenal and pulmonal changes

Renal changesRenal changes The The diuresis is growingdiuresis is growing on the road of different on the road of different

mechanisms mechanisms

Pulmonal changesPulmonal changes The circumference of the chest decreases The circumference of the chest decreases

because of the pressure weighing heavily on the because of the pressure weighing heavily on the chest chest The The vital capacity and the functional residuary vital capacity and the functional residuary

capacity decreasecapacity decrease

TemperatureTemperature

Under 28 °C cold (hideg)Under 28 °C cold (hideg)

28-33 °C cool ( hűvös)28-33 °C cool ( hűvös)34-35 °C indifferens34-35 °C indifferens36-39 °C warm (meleg)36-39 °C warm (meleg)Above 40 °C hot, boiling (forró)Above 40 °C hot, boiling (forró)

The effects of water with a warm and The effects of water with a warm and boiling (hot) temperatureboiling (hot) temperature

lasting vasodilatatio, blood pressure decrease lasting vasodilatatio, blood pressure decrease The blood supply of the fabrics improves, the The blood supply of the fabrics improves, the

metabolism intensifies metabolism intensifies musclerelaxing, spasmolytics and analgetics, musclerelaxing, spasmolytics and analgetics,

painkiller effectpainkiller effect The breathing turns slower one and more The breathing turns slower one and more

superficial one's superficial one's

Consensual reactionConsensual reaction

One mean a limb by the other limb due to One mean a limb by the other limb due to warmstimulus the vasodilatatios ensues warmstimulus the vasodilatatios ensues effect. effect.

Hydrotherapy proceduresHydrotherapy procedures I.I.

Whole, half- and part bathsWhole, half- and part baths With a cold, cool, warm and alternate temperature With a cold, cool, warm and alternate temperature

Hydromechanics proceduresHydromechanics procedures Súlyfürdő (weight bath), víz alatti vízsugármasszázs Súlyfürdő (weight bath), víz alatti vízsugármasszázs

(tangentor), zuhanyok (showers), leöntések (pouring (tangentor), zuhanyok (showers), leöntések (pouring off ), hydromassage tubeoff ), hydromassage tube

Borogatások, pakolások Borogatások, pakolások (packings(packings) ) sauna, heat air chamber, steam room (sauna, heat air chamber, steam room (szauna, szauna,

hőlégkamra, gőzkamrahőlégkamra, gőzkamra Underwater remedial gymnasticsUnderwater remedial gymnastics (víz alatti (víz alatti

gyógytorna)gyógytorna)

Víz alatti vízsugármasszázsVíz alatti vízsugármasszázs(Underwater massage jets) (Underwater massage jets)

(tangentor)(tangentor) It is made in 600-700 litres of medical tub with It is made in 600-700 litres of medical tub with

water capacity tangentor with an apparatus .water capacity tangentor with an apparatus .

Víz alatti vízsugármasszázsVíz alatti vízsugármasszázs(Underwater massage jets)(Underwater massage jets)

(tangentor) (tangentor) Biological effects:Biological effects:

Repairs the peripheral circulation, increases the Repairs the peripheral circulation, increases the metabolism.metabolism.

It repairs the tone of musculature .It repairs the tone of musculature . Indication:Indication:

A joint, the correction of the strength of musculature A joint, the correction of the strength of musculature beside a spine, his circulation got sick.beside a spine, his circulation got sick.

Accident, operative after treatment.Accident, operative after treatment. the correction of the condition the correction of the condition

Weight bath (Súlyfürdő)Weight bath (Súlyfürdő)

The suspension may be :The suspension may be : One point ( egypontos)One point ( egypontos) Two-point (kétpontos)Two-point (kétpontos) Three ponter (hárompontos)Three ponter (hárompontos)

Weight bath (Súlyfürdő)Weight bath (Súlyfürdő) Indication:Indication:

DiscopathyDiscopathy Spondylosis, spondylarthrosisSpondylosis, spondylarthrosis Paravertebral myalgiaParavertebral myalgia Cervicobrachialgia, lumboischialgiaCervicobrachialgia, lumboischialgia Intercostalis neuralgiaIntercostalis neuralgia Occipital neuralgiaOccipital neuralgia Cervicalis migrénCervicalis migrén Morbus Scheuermann Morbus Scheuermann SPASPA Hip and knee-joint contractura Hip and knee-joint contractura

Weight bath (Súlyfürdő)Weight bath (Súlyfürdő) Contraindication:Contraindication:

Acut radiculitisAcut radiculitis Spondylolysis, spondylolisthesisSpondylolysis, spondylolisthesis Spondylitis Spondylitis inflammation diseasesinflammation diseases Osteoporosis with a new compression fractureOsteoporosis with a new compression fracture postoperative states (laminectomia, spondylodesis, postoperative states (laminectomia, spondylodesis,

csavaros osteosynthesis)csavaros osteosynthesis) Tu. vertebraeTu. vertebrae Hip -and knee joints acut inflammationHip -and knee joints acut inflammation Balneotherapy general contraindicationsBalneotherapy general contraindications

Iszapkezelés (peloid therapy)Iszapkezelés (peloid therapy)

The forms of a mud cureThe forms of a mud cure • IszaptóIszaptó• IszapmedenceIszapmedence• Iszap-kádfürdőIszap-kádfürdő• Iszappakolás vagy Iszappakolás vagy

göngyölésgöngyölés• Iszap kompresszekIszap kompresszek• Iszappaszta vagy krémIszappaszta vagy krém• ParafangóParafangó

Packing (Pakolások)Packing (Pakolások) The basis of their expansion (kiterjedésük The basis of their expansion (kiterjedésük

alapján)alapján) :: Body packingBody packing: with the exception of a head and a neck : with the exception of a head and a neck

all of the body.all of the body.Three-quarter packing: the two upper limbs are left Three-quarter packing: the two upper limbs are left out.out.Half body packingHalf body packing: from a navel down: from a navel downTribe packingTribe packing: only onto the tribe : only onto the tribe Limb packingLimb packing: only onto the limbs : only onto the limbs

The basis of their moisture contentThe basis of their moisture content (nedvességtartalom alapján)(nedvességtartalom alapján):: Dry packingDry packing: warm bedsheet, rug: warm bedsheet, rug

Wet packingWet packing: cold wet dresses, dry dresses : cold wet dresses, dry dresses

Organ of locomotion rehabilitation Organ of locomotion rehabilitation class class

Gróf Tisza István Kórház, BerettyóújfaluGróf Tisza István Kórház, Berettyóújfalu

Inpatient classInpatient class 67 bed (cca: 1200-1500 patients/year)67 bed (cca: 1200-1500 patients/year)

Outdoor patient class (Daytime Outdoor patient class (Daytime sanatorium) sanatorium) 21 patients/day (cca: 4000 patients/year)21 patients/day (cca: 4000 patients/year)

Thank you for the Thank you for the attention! attention!