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History of halotherapy

A short excursion into the history of speleotherapy 

From 'Speleotherapy in Russia'  by Lidia Verihova, Candidate of Medical Sciences (Perm, 2000)

The history of speleotherapy goes back to the ancient times. There is not enough available information about this kind of treatment in modern literature. Miocene gypsum caves in Tana-dei-Re-Tiberius (Ravenna, Italy) were used in the Neolithic Age. People who lived underground dug several pools to collect calcium sulfate (gypsum) water and used it for therapeutic purpose. Caves, especially warm ones, attracted the sacrificers-healers in Ancient Greece.

There are well-known thermae in the mount of Crown in Sicily. Researches carried out by speleologists from Trieste in 1942, 1957 and 1958 showed that even in ancient times (6-5 century BC) a part of the cave was used for therapeutic purpose. Thus, the history of speleotherapy is nearly 2500 years old.

The ancient Indian epic poem "Ramayana" (2 century AD) describes how soldiers exhausted after chasing the kidnappers of Rama's wife Sita found a refuge in a mountain cave. Having tried some crystal pure water from underground springs and breathing healthy air in caves, they quickly regained their strength and overtook enemies. This is probably the earliest information about the effects of caves microclimate which reached our days.

In the works by Dr. Horvat there is an evidence that caves in Hungary have been used for therapeutic purpose since the Middle Ages. It is not a coincidence. In Hungary, there are more than 720 caves. The name of the Hungarian capital Budapest, according to the toponymic data consists of two words. 'Pest' has Slavic roots and comes from the word 'peshtera'. 'Buda' is still called "ofen" by Germans, which is translated as 'oven"and 'cave'.  

The first mention of speleotherapy in Russia dates back to the early 1st century. In the Piatihorsk canyon patients were put down into the baskets on a depth of 41 meters and bathed in the lake water that was considered to be curative. In 1858 the tunnel was dug to the underground lake and a wooden floating pool for swimming in 'warm seltzer' was built (t 28- 42' C). On the peninsula a well was dug the water of which has been used for medicinal purposes. 

Speleotherapy was widespread in Italy. Since 1870 patients with diseases of musculoskeletal system have been cured by hydrotherapy in the underground lake with hot water of karst cave Monsumao. The cave of Akvazanta in the province of Ascoli Piceno is used for treating arthritis, rheumatism, asthma, hypertension, gout, metabolism and gynecological disorders. Patients bathe in pools containing sulfuric water (t 38.6 'C), and the air in caves containing sulfurous gas.

In the cave of San Martino (Sondrio province) there is also a sulfate thermal spring of t 40 'C. Its water is radioactive bicarbonate-sulphate-alkaline water. The steam bath in the cave Giusto in Tuscany (temperature of the pool 37 'C) is used for treating patients with gout, obesity, dermatitis, uremia, chronic nephritis, arthritis and rheumatism, neuralgia and neuritis. In the artificial cave Perlanti the water is chloride-sulphate-alkaline with the temperature of 32 'C, treating the same diseases.

Sicily steam baths S. Kolodzhero near Mount Kronio (t 41 'C) are used for the treatment of rheumatism, neuralgia, neuritis, respiratory diseases, diseases of the lymphatic system, chronic otitis, skin diseases and metabolism.

In Germany since 1942 there are Bad Gastein thermal tunnels, located at a depth of 1600 m, with the air temperature up to 46 'C, humidity about 80% and radium emanation. Diseases of musculoskeletal and respiratory systems are cured there. 

There is also an evidence of positive therapeutic effect on patients with asthma diseases in the microclimate of karst caves in Klyutert located in Germany, in North Rhine-Westphalia. During World War II, this cave was used as a bomb shelter. The patients with asthma who had been in the shelter were noticed to have less asthma attacks, and cough; their breathing became easier. Since 1945, the cave Klyutert has been used medicinally for treating respiratory diseases. In 1949, German physician, Dr. K.H.Spannahel proposed to build an impatient department in the cave Klyutert in order to conduct systematic climatological and medical observations to confirm the effectiveness of speleotherapy. The results of the research and teamwork of Dr. K.H.Spannahel and the Hungarian geologist, famous Dr. H. Kessler set up the foundation of modern speleotherapy. The cave Klyutert was used to treat patients with diseases of the respiratory system later on.

In Zaafelde (Thuringia, Germany), in the Fairies' grotto patients with pertussis are treated. In Shenebek (near Magdeburg) respiratory and skin diseases are treated in a salt mine of depth of 400 m. The medical factors here are clean salt air of the constant temperature and high atmospheric pressure.

In Hungary, the Peace cave (in Ioshvafe near Miskolc) was used in 1954 to treat patients with respiratory system diseases. The Tawas cave (near Miskolc) treated patients with circulatory and respiratory system diseases. Since 1969 speleotherapy has been officially recognized as a method of treatment in Hungary. Studying medical factors of the caves, including their thorough bacteriological examination, evaluation and research speleotherapy mechanisms of therapeutic action of this type of treatment were performed by the Hungarian scientists, thus, approaching the scientific basis of the term 'therapeutic cave'. It is extremely important for the theory and practical speleotherapy.

In Austria the Solbad-Soltselman salt mine has been used since 1955 to treat patients with respiratory diseases.

In the Hombasetsky caves in Slovakia ('Slovenian karst') since 1955 the patients with pathology of the respiratory tract have been treated. Studying medical factors of these caves contributed to decoding mechanism of speleotherapy impact on human health.

In Poland in 1958 in the King salt mines (city of Krakow in Wieliczka Province) the patients (both adults and children) with respiratory diseases were treated. Thus, the effect of treatment among children reaches 100%, among adults - 80%.

In Bulgaria speleotherapy has been also used from the 50s of the 20th century. The beneficial effects of medical factors in the Magura cave soften bronchial asthma. It was mentioned by M. Kirhknopf, H.Ikonomov, H.Kirilov, and other authors.

In Romania speleotherapy has been developed from the mid-twentieth century. Patients are treated in the salt mines of Praid County Harghita, Tirgu County Vesau, and mine "Unirea" Prahov District.

In karst caves in Russia the employees of Adler climatic station while working in caves (1959 - 1962) noticed a significant improvement in their health during and after staying in the underground area. People suffering from asthma, had no asthma attacks during several weeks after staying in the caves. The similar effect was observed in Transcarpathia: nobody of 300 workers in Solotvyno salt mines suffered from asthma during 25 years.

These observations by foreign and domestic scholars of caves attracted the members of the Uzhgorod Department of Odessa Institute of Balneology. The founder of speleotherapy in Ukraine and the USSR was the Professor M.D. Torohtin; under his leadership and with his direct participation in October 1968 in Solotvyno salt mine number 8 (the village Solotvyno, Tyachiv district, Transcarpathian region of Ukraine) clinical and experimental hospital for the treatment of patients with allergic respiratory diseases was established. In 1976 (in mine 9) and in 1980 - the first and the second stage of the Ukrainian Republican Hospital was commissioned.

The first sylvinite speleohospital in Russia and the whole world was built in potash mine in 1975 (Berezniki, Perm region); and in 1977 it started working on Verhnokamsky deposits of potassium salts.

In 1994 there was a positive experience of speleo treatment for patients with bronchial asthma and chronic bronchitis in the southern Urals in the Sol-Iletska salt mine; in 1997 in the Shulgan-Tash cave (Ufa) there was information about treatment of bronchial asthma. 

There is also an evidence of the use of the Kapova cave for speleotherapy. Since 1971 the external factors of environment in the underground karst caves in Georgia were studied to assess the possibility of being treated in them. First the White cave near Tskhaltubo was studied, and in 1977 the study of therapeutic factors of the Novoafonska cave was started too. Since 1978, the inparient department in the White cave started to work. There the influence of microclimate on the patients' health with respiratory and cardiovascular diseases, as well as the health of the elderly people was studied. Later on the Novoafonska Cave was used. The effectiveness of treatment in this cave is higher than in the White cave.

In Azerbaijan (Nakhchivan City) since 1980 the hospital that has an underground compartment for 100 beds has been working. It is located in some large halls and galleries after salt extraction of salt mines Duz-Dag. It has successfully been used for treatment patients with respiratory diseases.

Since 1981 speleotherapy has been held in Kyrgyzstan. In the Chon-Tuz village Kochkorsky district of the Naryn region the underground hospital 'Cholpon' was built up in salt mine tunnels, located at an altitude of 2100 m. It is prescribed for the treatment of asthma, chronic bronchitis and hay fever.

In the 80s of the XX century there were studies of the microclimate in Soligorsk potash mines in Belarus. It was noticed that people working in Salihorsk pool, had no asthma attacks; the cases of hypertension were 0.4 per 100 workers (although their working conditions included vibration, noise, dust and fever); it was milder, with prolonged remission, and did not influence the working process. This information and experience of the therapy in the sylvinite Berezniki speleohospital contributed to the development of speleotherapy in Soligorsk. Since 1990, the speleocomplex built in halite sylvinite layers of the salt mine has been operating, allowing the comparative effective research of speleotherapy in different microclimatic conditions. A high therapeutic effect on patients with asthma in this speleoclimatic complex has been noticed too. Since 1981 speleotherapy has been held in the Czech Republic, and since the 90s it has been developing in Slovenia and Uzbekistan.

Medical therapy of broncho-obstructive diseases which is applied nowadays does not always give the maximum positive effect, so important is the development of non-medical treatment of chronic obstructive pulmonary diseases.

One of the promising methods of the drug therapy is halotherapy which has been based on speleotherapy - treatment in the microclimate of salt mines.

The progenitor of halotherapy are salt mines that are more than 2500 years. This is one of the oldest aerotherapeutic methods of treatment used in ancient Greece and Rome.

Using the artificial cavities in salt formations started in 1976 in our country. In 1968 Solotvyno town (Transcarpathian region) based on salt mine number 8, the first speleohospital was opened.

An hour of operating salt mines in speleohospital conclusively proved that salt in speleotherapy has a great therapeutic effect: all the physiological functions of the human body clearly improved while staying in the salt mine. It reaffirmed the histological analysis of all vital organs and tissues.

But as bandwidth of speleostationary is negligible, it made it necessary to create artificial cells that modulate key parameters of microclimate in the underground department of Allergic Hospital town of Solotvyno.

The first information about the technical means to create artificial microclimate of salt caves "appeared in the late twentieth century, when scientists of the Uzhgorod Branch of Odessa Institute of Balneology and the Solotvyno hospital released information on terrestrial medical facilities in which they recreated the microclimatic conditions of Solotvyno salt mine, creating ionized atmosphere, containing finely disseminated aerosol salt.

Simulations were reproduced by lining with the natural mineral halite, the filter with crushed mineral ventilation system and special equipment for spraying salt with the establishment of different modes factional-dispersed composition and concentration of aerosol. This therapeutic method was called halotherapy and was approved in 1990 by the Ministry of Health, and a year later was approved in methodical letter "Halotherapy in treatment of allergic respiratory illnesses for children."

Since that time halotherapy method has been widespread in the CIS, Baltic countries, Europe and Asia.

Halotherapy can be conducted in hospitals, but also in residential areas using a variety of halotherapeutic surface, from various small forms (halogen lamps lining the small fragments of space) to building the halochambers in separate rooms.

The first salt rooms in Lutsk appeared in 1985 based on children and adult regional hospitals. To reproduce the salt mine treatment parameters a special apparatus was designed by the cavers of the Uzhgorod allergy center and the Odessa Institute of Balneology. The treatment was conducted with moist fine aerosol of sodium chloride (Artyomsol). Withing 20 years the methods of reproduction parameters have been improved in salt rooms. Experts tried to approximate them to the parameters of Solotvyno salt mine known for its unique healing properties not only in Ukraine, but also abroad. Salt rooms altered their appearance by changing duration of the procedure, its methodology during and after the session, but did remain highly effective  in the treatment of both prolonged diseases and during the remission of chronic diseases to prevent exacerbation.

The halotherapy room in the hospital number 1 for adults was opened in autumn 2005. Visitors are mainly the patients of all ages of bronchopulmonary and ENT pathology. Procedures are usually tolerated well. There is a positive effect of the treatment. Many patients from other areas come to us for treating in halochambers, having noticed much improvement.

Climate conditions in the salt room:

air temperature  ....................................................................22-24 0C

average relative humidity ........................................................35-50%

average concentration of light electronegative ions ....33*103/cm3

aerosol dispersion ....................................................0.5 - 10 microns

concentration of salt spray .................................................5 mg/m3