There are mineral waters of different types in Ukraine. Anyway any emphasized in “Mineral water inventory of USSR” (1987) group of mineral waters included deposits or sources of mineral waters of Ukraine. Hydro-mineral resources of Ukraine are determined by such mineral waters as acidulous, sulfide, radon, chalybeate and arsenical, iodide, bromine and iodide - bromine, boric, silicic waters with high concentration of organic substances and water without specific components and properties. Its supply is practically inexhaustible reasoning from the level of its contemporary usage.

Hydro-mineral resources of the country create favourable conditions for investment in sanatorium-and-spa industry and construction of bottling mineral waters plants.

Up to 50 different chemical elements were discovered in mineral waters. However, 7 ions are essential in mineral waters. They determine their curative properties to a great extent. The following ones belong to them:

• cations Na⁺, K⁺, Ca²⁺, Mg ²⁺;

• anions HCO^3-, Cl^-, SO₄^2-.

In the process of medicine water analysis their main ionic structure is characterized by these dominating anions and cations which biological and therapeutic actions differ.

 

Hydrocarbonate anion (HCO^3-) in the structure of mineral waters influences carbohydrate and protein metabolisms, has anti-inflammatory action, normalizes cholepoietic and biliary excretory functions of biliary system. Mineral waters with prevalent content of hydrocarbonate anions have clear acid neutralizing action in stomach, leaching effect in duodenum. Hydrocarbonates improve fixation of micro- and macroelements, raise the intensity of redox processes; intensify diuresis (favour excreting).

Hydrocarbonates also determine the effect on interstitial growth of pancreas that is connected with disorder of outflow of pancreatic secretion in consequence of inflammation changes in duodenum mucous membrane which appear due to disorder of physiological balance of acid and alkaline digestive secretions with predominance of acid secretion.

 

There are sulphate anions (SO₄^2-) in the structure of suplhate of calcium, natrium, magnesium in mineral waters. It is proved by experiments that sulphate - ions have the leading role in mechanism of action of sulphate-containing drinking mineral waters. Mechanism of action of sulphate-containing mineral waters consists in stimulation of: 1) inhibitory reflex by Serdyukov ( as a result of that the intensity of gastric secretion reduces; 2) secretin synthesis ( as a result of that formation of gastric and pancreatic secretions are inhibited); cholecystokinin – pancreozymin (as a result of that cholekinez and cholesecretion are intensified and also formation of pancreas ferments and their dislocation to intestines are intensified); motion activity of intestines.

There are chloride – ions (Cl^-) in the structure of practically all kinds of mineral waters. They are initial substrate for formation of muriatic acid of gastric juice. Promoting effect on primarily low secretion function of stomach, motion activity of unstriated muscles of digestive apparatus are typical for it. During drinking treatment chloride – ions make secretory

and motive function of stomach, biliary excretion and pancreatic secretion more active.

It determines the expediency of use of mineral waters, which contain chloride – ions in cases that are accompanied by hyposecretion of digestive glands.

Cations of natrium, magnesium, potassium play significant role in the vital functions of organism. Even slight deviation of their concentration in tissues or blood disturbs greatly all physiological processes and need urgent management.

 

Sodions (Na⁺) are one of the main cations of mineral waters, they play an important role in water-salt exchange, stimulate functional status of biliary ducts and gall-bladder, influence hepatobiliary system and secretory function of glands of digestive tract, intensify laxation.

 

Potassium ions (K⁺) are often in the structure of mineral waters together with sodion, that takes part in carbohydrate synthesis in liver and deposits in it. Potassium intensifies tone and motion activity of unstriated muscles of digestive apparatus – stomach, intestines, gall-bladder, regulates secretion of hydrochloric acid in stomach, acid-base balance of blood, takes part in nerve impulse transmission. It livens up the work of heart and a range of ferments, effects favourably on the work of skin and kidney. Potassium has protective function against unfavourable effect of natrium overstock and normalizes blood pressure. Lowering of potassium content in organism is accompanied by disorder of digestive apparatus – anorexia, vomiting, hypoperistalsis of bowels. The well-known changes of cardiovascular system are heart rhythm disorder, myocardial contractility disorder.

Sodium and potassium salts in structure of mineral waters promote regulation of water-salt exchange in tissues, stimulate cholepoietic and especially biliary excretory function of liver and gall-bladder and also secretory function of digestive glands, intensify peristalsis of bowels. Mainly they are in hydrocarbonate and sodium chloride waters and also in waters of complex anion structure.

Under conditions of ecocatastrophe caused by Chernobyl disaster the fact, that potassium and natrium are similar to caesium by their chemical properties, is very essential. Icreasing their content and quantitaty of drank water in dietary intake in two times faster radionuclide washout from the organism are observed, 90 % of caesium is excreted urinarily and only 10 % is excreted in fecal.

 

Calcium ions (Ca²⁺) in mineral water have antiseptic actions and cementing properties, they are capable to activate ferments, improve lipid exchange due to increase of formation of hepatic phospholipids, decrease permeability of cell membranes ( including permeability of hepatocytes), intensify excretive function of kidney, stimulate diuresis that makes the use of mineral waters, which contain calcium for patients with kidney and urinary system pathology appropriate. Calcium has high antiseptic actions.

Mineral waters that has calcium in concentration from 50 to 200 mg–equiv. % have antiinflammatory, antineoplastic and dehydrating actions, decrease formation of exudation, effect favourably on diseases of digestive tract, biliary system, liver and intestines. This kind of waters is recommended to patients with pathology of locomotor apparatus, for preventive measures against osteoporosis and also to people with liability to allergic reactions.

The waters that have calcium ions improve lipid exchange as a result of intensification of phospholipids  formation influenced by them that promote recovery of integration of hepatocytes with people who have liver disease.

 

Magnesium ions (Mg ²⁺) that come to the organism together with mineral water have choleretic action and ability to decrease level of cholesterin in bile and blood, have antispasmodic and analgesic effects. Magnesium takes part in all metabolism enzymatic processes important for cell (setting in muscles it activates anaerobic metabolism of carbohydrate), takes part in protein metabolism, influences sympathoadrenal system, catalyses action of pancreas ferments – trypsin and erypsin. Magnesium is also necessary for synthesis of cholinesterase, cholinacetilasa, adenasitryphosphotasa. Magnesium ions are absorbed in stomach and primary divisions of small intestine, come into liver where they often deposit.

Mineral waters that contain magnesium have a favourable effect on functional state of liver and biliary system, have choleretic, cholecinetic and spasmolytic actions, promote normalization of tone of gall-bladder, stomach and intestines and have debilitant action.

Besides, magnesium ion takes part in processes of intracellular metabolism, activates anaerobic metabolism of carbohydrate, intensifies action of some ferments of pancreas that obviously determines stimulatory effect of sodium chloride waters of light mineralization on pancreatic secretion. Magnesium ions promote neurility of central nervous system, have sedative action.

Mineral waters besides main structure of salts have many microelements. In spite of the fact that there are no many microelements in mineral waters, their physiological action is shown very clear that determines indications in several cases.

Application of natural mineral waters is one of the main methods of balneotherapy. Together with inner mineral water use this method became widespread not only at balneotherapeutic health resorts but also in non-resort conditions.

Integration of different by intensity temperature, mechanical and chemical irritants is the basis of balneotherapy effect with application of mineral waters.

 

Chemical agent is the leading one among great range of agents that account for physiological and therapeutic actions of mineral waters. It determines the specificity of balneotherapy in the process of application of mineral waters with curative purposes. In any mineral water one of the chemical ingredients in its structure is, as a rule, determinant in physiological and therapeutic effect that influences organism.

Natural mineral waters of the same physicochemical structure differ by great range of chemical agents that depend most of all on conditions of water formation and territorial allocation of sources or wells.

By application mineral waters contact directly with skin that has a complicated structure and performs numerous functions (protective, thermoregulating, receptor, secretory, resorption, respiratory and exchange). Skin is a big receptor field which nerve receptors (thermo-, mechano-, chemoreceptors and others) perceive irritations which are caused by mineral water and pass the information in form of impulses to appropriate nerve centers, determining the formation of neuroreflectory reactions in response.

Under the influence of bathes structure changes appear in skin; their character depends on physicochemical structure of mineral water. Nowadays it is exactly determined that gases (carbonic, nitrogen, radon, hydrogen sulphide, oxygen and etc.) and ions of some biologically active microelements (iodine, bromine, arsenic and etc.) that are in mineral water penetrate into

inner environment of organism through undamaged skin covering during the process of taking bath.

In practice of balneotherapy it is necessary to take into account the fact that natural mineral waters have a wide range of concentration of chemical agents ( especially sodium chloride, sulphide, radon ones).

That’s why in individual prescription of balneotreatment the doctor should be conversant in the fact what concentration of chemical agents separately for each mineral water is threshold, optimal and maximum allowable.

 

One should understand threshold valuation for every mineral water as its such minimal concentration that under the action of the following water on organism already determines physiological changes that are observed at least from some organs and systems.

Optimal concentration is its widest range without which boundaries the organism of majority of patients responds to physiological reactions from different organs and systems.

 

Maximum allowable concentration is the one that determines desirable expressive physiological changes from different organs and systems causing no damaging action.

In every mineral water any of chemical ingredients, which is its parts, as a rule, is leading in the influence that is exerted on the organism by this mineral water being used in each specific case in optimal dosage. This chemical stimulus in its conjugate with other chemical components of this water determines specificity of its effect on the organism.

Evocation of organism on hydropathic treatment is shown in so called balneoreaction. The last can be expressed in three forms: 1) physiological reaction by which changes in index of functional state of different organs and systems, which don’t go beyond physiological fluctuations, are observed; 2) adverse reaction by which physiological changes exceed a little physiological level but they are short; 3) reaction of recrudescence is shown by very expressive and steady at the same time changes in index of physiological systems of organism that speaks for failure of physiological mechanism of protection as a result of inadequate stimulus effect. Reaction of recrudescence takes the clearest symptom complex by chronic inflammatory diseases.

By adverse reaction one should decrease the intensity of effect of hydropathic treatment ( to decrease concentration of mineral water, temperature, duration of treatment and etc.). If adverse reaction appears in the beginning of the course it is expedient to cancel it at all and to change to another treatment mode in order to bring the patient out of recrudescence.

Chemical agents, which get inside the organism from mineral water during balneotreatment, arouse irritation of interoreceptors of vessels and internals. Together with other irritations, which cause thermal and mechanical agents by outer action of mineral water, they cause complex generalized response of the whole organism.

Thermal factor influences organism differently and plays the leading role in mechanism of therapeutic action of mineral waters. Skin is the main place of action of thermal factor. Being a poikilothermic membrane it prevents heat conduction inside the organism and promotes keeping of stationary temperature by internals. Besides, skin is rich in nerve terminals that perceive thermal irritation. Rufinum bodies, situated in subcutaneous fat, perceive heat. Krause's bulbs are situated more skin-deep in reticular layer; they perceive cold stimuli. Water itself has high thermal conduction that exceeds thermal conduction of air in 28 times. Specific heat of water is considered to be 1.0. In order to understand, is it much or less, one can state that heat capacity of iron is 0,11, heat capacity of mule peloids is 0,5, heat capacity of paraffin is 0.77, heat capacity of ozocerite is 0.8. Such heat capacity and thermal conduction determine the fact that by temperatures close to body temperature water can give or take a great quantity of heat during balneotreatment, in that way it promotes warming up or cooling of organism. Heat sensitivities  of people are individual and depend on temperature of the skin areas with which water contacts. The temperature of planta skin of healthy person is about 29-30 °C and patient’s one can be lower. The temperature of skin of body is 33 – 36 °C and that’s why the same temperature is taken differently by skin of planta and body. It is established that border between temperatures of warming – up and cooling in general fresh bath is 35.0 – 35.5 °C. By the temperature of water higher than 35.5 °C heat transfer from water to organism happens and if it is lower than 35 °C it works vice versa.

 

Thermal factor allows to affect greatly on organism during balneotreatments, first of all bathes. Depending on temperature all hydropathic treatments are accepted to be divide into: cold (lower than 20 °C); tepid ( 20 -33 °C); indifferent ( 34-36 °C); warm ( 37 – 39 °C) and hot ( 40 °C and higher).

The mentioned boundaries are relative because temperature sensitivity depends on many factors, mainly on individual peculiarities of organism and conditions of environment during undertaking the treatment.

The treatments with mineral water of indifferent or close to it temperature are undertaken more often. By indifferent temperature it is accepted to mean temperature of water that doesn’t differ greatly from body temperature or “core” temperature as foreign authors name it.Not only bath temperature and chemistry are important but also initial state of organism – cutaneous temperature, performance level of main systems, setting up to temperature effects and etc. The same temperature irritator can cause ambiguous reaction.

One can have different reactions from different organs and systems of organism by changing the intensity of temperature irritator, effect area (bath, half-bath), duration of treatment. Adequate usage of bathes of different gas, salt structure, taking into consideration thermal and hydrostatic factor allows to interfere actively with pathologic processes. For all that, in one case balneotherapy can replace medicine, in other cases it can intensify its action, in other cases it can create favourable background on which medicine usage would be more effective.

 

Mechanical agent is determined by hydrostatic pressure of water mass, decrease of body mass according to Archimedean principle, movement of gas bubbles. The influence of mechanical agents of bath is identified right away by submergence. According to Archimedean principle the submerged body of person loses around 9/10 of its weigh, that is, conditions close to weightlessness are created, person feels body weight loss, for all that the necessity of equilibrium control appears. The higher water mineralization is the bigger its repulsive force. At the same time the influence of hydrostatic pressure appears. As a result of these mechanical effects a range of correlated reactions appear, which support normal level of vital activity of organism. Receptors of skin, veins, and lymphatic vessels are the most sensitive to hydrostatic pressure. Blood pressure increase in vessels and right auricle was established in the experiment of animals’ vertical submergence. By taking carbonic acid gas bathes man has decrease of lung volume, increase of cardiac output. Increase of intrapleural pressure is noted, at that there is high position of diaphragm and decrease of lung capacity in 1 – 3 dm³. It has been proved that there is a direct dependence of venous pressure on water level in thoracic and abdominal cavities. It is discovered that blood pressure changes from hydrostatic factor in many fewer times than venous pressure.

Gas bubbles have some mechanical effect. Touching continuously, forming and creating typical feelings gas bubbles play a role of weak tactile stimulators. In such a way mechanical agent by application of mineral waters, on the one hand, is the source of irritation of dermalmechanoreceptors and influences in reflex on formation of generalized reaction of body response. On the other hand causing pressing of venous vessels mechanical agent influences microcirculation and haemodynamics, blood distribution in organism, heart work and chylopoiesis. Bathes change many indexes of respiratory function, this effect is realized due to water pressure on thoracic and abdominal cavities.

First of all mineral waters have specific organoleptic characteristics by which one can determine their type. It is flavour, taste, gassing, temperature, presence of proper deposits near the source.

It is very easy to distinguish sulphide waters by flavour. Their searches become easier because of the fact that smell of hydrogen sulphide (addle eggs) often covers long distances from the source. Light slight smell of hydrogen sulphide is also peculiar to mineral waters with high concentration of organic matters.

By salty taste one can distinguish waters with high mineralization. Acidulous waters usually have sour taste (“alum”). When these waters are coming out to the surface as a result of

drastic changes of physicochemical conditions carbonic acid begins to effervesce from water. Deposits of white and grey calcareous tuffs and travertines are also often observed near the source.

Ochre deposits of foxy colour are found near the sources of chalybeate waters and deposits of black or whitish gelatinous coating are found near sources of hydrogen sulfide and hydrosulfide waters.

Thermal waters are easily distinguished by touch and one can even approximately determine their temperature taking into account constant temperature of human body.

For well-grounded determination of water as mineral one it is necessary that it should correspond to classification characteristics or evaluation criteria.

 

Nowadays in Ukraine the classification of mineral waters of  Ivanov V.V. and Nevraeva G.O. is in common use. According to it the following main balneal groups of mineral waters are distinguished:

1. Group of acidulous waters with content of CO₂ no less than 0.5 g/dm³.

2. Group of sulfide waters, which contain H₂S+HS^- no less that 10 mg/ dm³.

3. Group of chalybeate waters, arsenical and polymetal mineral waters: chalybeate waters that have minimal iron content 10 mg/ dm³, arsenical waters with minimal arsenic conent 0.7 mg/ dm³, polymetal mineral waters with high content of some metals simultaneously– iron, aluminium, arsenic, manganese, copper and etc.

4. Group of bromine, iodide-bromine, iodide waters with minimal content of bromine 25 mg/dm3 and iodide 5.0 mg/ dm³. Such content of iodide and bromine was considered by authors of “Mineral water inventory” (1987) conditioned by water mineralization up to 10 g/ dm³, by higher mineralization the content of bromine and iodide should be transferred to waters with mineralization 10 g/ dm³. Such viewpoint  consisted in the fact that iodide and bromine belonged to therapeutically active microelements of inner application.

5. Group of radon waters with minimal content of radon 50 eman (5 nKi/ dm³, 185 Bk/ dm³).

6. Group of silicic mineral waters with minimal content of metasilicic acid not less than 50 mg/ dm³.

7. Group of mineral waters with content of organic substances – C _org not less than 8 mg/ dm³.

8. Group of boric waters with minimal concentration of orthoboric acid (H₃Bo₃)not less than 35 mg/ dm³.

9. Group of waters without specific components and properties of different ionic composition with general mineralization not less than 1 mg/ dm³.

Taking into account the aforecited the following standards of mineral waters of Ukraine are accepted:
Acidulous mineral waters

Except for Carpathian region acidulous waters in Ukraine are known on the east of Kerch peninsula (Sent-Elinske, Sultanivske, Kayali-Sart, Bulganacke sources and etc.) but they are local manifestations among general field of nitric and nitromethane waters, they are determined by little discharges and that’s why they are essentially of no practical importance.

The chemistry of acidulous waters is various enough and depends mainly on initial chemistry of groundwaters, which got to carbonation area, the gas saturation level of water and also on composition of aqueous rocks. As a result of this, acidulous waters can be of  atmogenic, magmatogene, sedimentogene and compound origin. Thus, chemistry and gas composition of acidulous waters reflect peculiarities of geological history of the region and the contemporary hydrochemical zoning of acidulous waters denotes directions and intensity of physicochemical processes at the present stage of geological development of Transcarpathians.

For the purpose of valuable usage of medicinal properties of mineral waters in sanatoriums the primary task is preservation of natural composition of mineral water at all stages of its way to customer: extraction of groundwaters, taking them out to the surface, transportation from water-catchment plant to well-room (bath section), conservation in reservoirs (in case of need), water delivery to balneological treatments.

Monitoring of mineral water composition and quality is for this purpose.

Ukrainian scientific research institute of rehabilitation and balneology in 2005 monitored acidulous waters (carbon dioxide, hydrogen carbonates, metasilicic and orthoboric acids) that are used in sanatoriums by inner and outer application in line: well – well-room, well- bath before treatment – bath after treatment. The results of researches show that component concentration in water from the well and in well-room doesn’t differ greatly but the one in water in bathes is nearly three times less. These researches will become validity for optimization of delivery technology of treatment procedures.

 

Table 3.2.1 Standards of mineral waters of Ukraine

Mineral waters	Active component	Concentration, mg/dm3
1. Natural table	General mineralization	to 1000. 0
2. Medicinal without specific components or peculiarities	General mineralization	above 1000.0
2.1. Of low mineralization		1000.0 – 5000.0
2.2 Of intermediate mineralization		5000.0 – 8000.0
2.3 Of high mineralization		10000.0 – 35000.0
2.4. Salt		35000.0 – 150000.0
2.5. Hard salt		Above 150000.0
3. Medicinal with specific components
3.1.Acidulous	Dissoluble(free) carbon dioxide (CO2)	Above 500.0 (1500 for outer application)
3.1.1 Low acidulous		500.0 – 1500.0
3.1.2. Acidulous of intermediate concentration (mediumacidulous)		1500.0 – 2500.0
3.1.3. High acidulous with spontaneous CO2		Above 2500.0
3.2 Sulfide Waters have additional name depending on PH value By pH <6,5 pH un. - sulfide, by pH 6,5 – 7,5 pH un. – sulphide - hydrosulfide, by pH>7,5 pH un. - hydrosulfide	General hydrogen sulphide	10.0
3.2.1. Low sulfide		10.0 – 50.0
3.2.2. Sulfide of intermediate concentration (intermediate sulfide)		50.0 – 100.0
3.2.3. High sulfide		Above 100.0
3.3. Radon	Radon (Rn), activity in Bq/ dm3	Above 185 Bq/ dm3
3.3.1 Very low radon		185 -740 Bq/ dm3
3.3.2 Low radon		740 - 1480 Bq/ dm3
3.3.3. Radon of intermediate concentration (intermediate radon)		1480 – 7400 Bq/ dm3 (1.48 – 7.4 K Bq/ dm3)
3.3.4 High radon		Above 7400 Bq/ dm3 (7.4 K Bq/ dm3)
3.4. Arsenical	Arsenic (As)	Above 0.7
3.4.1 Arsenical		0.7 – 5.0
3.4.2. High arsenical		Above 5.0
3.5 Chalybeate	Iron, sum of bivalent and trivalent (Fe2++ Fe3+)	Above 10.0
3.5.1 Chalybeate		10.0 – 40.0
3.5.2 High Chalybeate		Above 40.0
3.6. with increased composition of organic substances	Organic substances with recalculation on organic carbon (C org)	Above 5.0
3.7. Boric	Orthoboric acid (H3BO3)	Above 35.0
3.8. Bromine	Bromine (Br)	Above 25.0
3.9. Iodide	Iodine (I)	Above 5.0
3.10 Silicic	Metasilicic acid (H2SiO3)	Above 50.0

 

 

Sulfide mineral waters

Compounds of sulfur and hydrogen in groundwaters can be found in H₂S- hydrogen sulphide or in HS^- –hydrosulfide. It depends on acidity level of water (pH value). In neutral and subacid waters hydrogen sulphide prevails, in alkaline waters – hydrosulfide. Correlation of these compounds depending on pH is characterized by the next indexes: by pH 4 od. pH hydrogen sulphide makes 99.91 % in water, by pH 5 pH un. – 92.1 %, by pH 6 pH un.– 91.66 %, by pH 7 pH un.– 52.35 %, by pH 8 pH un. waters grade into the category of hydrosulfide and hydrosulfide already makes 90.2 %. In other words content of hydrogen sulphide and hydrosulfide in neutral waters is approximately the same. Taking into account the fact that for prevalent majority of sulfide mineral waters typical pH is about 7 pH un.,  it would be more well-founded to name them hydrosulfide hydrogen sulphide or hydrogen sulphide – hydrosulfide ones. But we use the traditional name – sulfide mineral waters. Waters with content of compounds H2S + HS^- more than 1- mg/ dm³ belong to them.

Sulfide waters are widespread in Ukraine. Deposits and manifestations of these waters are known in the Mountainous Crimea, on Kerch peninsula, in Transcarpathians and Pre-Carpathians and also in the boundaries of Volhynia and Podillya. One of the most well-known deposits in Transcarpathian region is Sinyacke deposit of sulphide waters which hydromineral source is used by state resort. Many sources of sulphide waters with unconditioned content of hydrogen sulphide (3-7mg/dm³) are known in Carpathians. But the biggest deposits in Ukraine are situated in junction outer zone of Pre-Carpathian Trough and south-west edge of Russian platform that stretches from North West to south east parallel to Carpathian Mountains and in which boundaries Lyubin’ Velykyi and Shklo in Lviv region, Cherche in Ivano-Frankivsk region and sanatoriums in villages Shcherbyci and Brusnyca in Chernivtsi region are situated.

Chokratcke deposit of sulfide waters that is situated in north east part of Kerch peninsula in 20 km from town Kerch, has the greatest potential for usage.

Data analysis proves sulfide waters in the boundaries of Ukraine aren’t investigated enough.

The most well-known resorts, where sulfide mineral waters are used, are Syniak (Transcarpathian region), Nemyriv, Liubin Velykyi (Lviv region), Cherche (Ivano-Frankivsk region).

Ukrainian scientific research institute of rehabilitation and balneology in 2005 monitored

hydrogen sulphide of sulfide waters No. 1-K ( sanatorium “Nemyriv”, Lviv region) that is used for outer application in form of general baths and also determined sulfur forms in mineral water.

Results of researches show that one should make recommendations concerning prescription of baths of different hydrogen sulphide content to patients with different indexes reasoning from real hydrogen sulphide content in bath water that is based on medicobiological quality rating of mineral waters (medical balneal conclusion). 

Chalybeate and arsenical mineral waters
Waters that contain dissolved iron in quantity more than 10 mg/ dm³ belong to chalybeate mineral waters. Iron is an element that is enough widespread in groundwaters of Transcarpathians, Donbas, Polissya and Ukrainian crystalline core-area. Mostly it is in dissolved condition in oxygen-containing waters in the absence of organic substances in bivalent form - Fe²⁺ Waters of Skhidnytcke deposit of mineral waters timed to hornfels horizon situated at the turn of menilite and bystruck formation belong to waters of the first group. The depth of horizon deposit of mineral waters is 30-100 m. Chemical composition of waters is hydrocarbonate sodium with mineralization 0.3 – 0.5 g/ dm³ and iron content up to 45 mg/ dm³. Chalybeate waters are also discovered in sources in region of the village Sheshory and Yaremcha town in Carpathians, where they are connected with menilite shales and have iron in quantity of 20-30 mg/ dm³. Mineralization of these waters is 0.2 – 0.25 g/ dm³. The only explored deposit of chalybeate waters of the first group is situated in region of Slovianohirsk town in Donbas, where these waters are connected with sandstones of protpopivsk formation of Karnic stage on the depth of 30-40 m. Available inventory of the deposit is 43 m³ /day and night. Waters are calcium hydrocarbonate-sulfate by chemical composition with mineralization of  0.2 g/ dm³and iron content up to 32 mg/ dm³. Except for Kelechynske deposit acidulous waters with conditioned content of iron are in sources of Kvasovecke, Uzhotske, Bilinske, Girsko-Tysenske, Verkhniobystrynske and Uzhgorod deposits. Iron concentration is mainly within the limits 20-30 mg/ dm³. These waters are mainly hydrocarbonate calcium, calcium magnesium, calcium sodium, sodium by chemical composition with mineralization from 1.0 to 2.5 g/ dm³. Poorly explored manifestations of acidulous chalybeate waters are also known in Transcarpathians especially in villages Tarasivka and Zanka where iron content in waters reaches 60 mg/ dm³, in region of village Solochyn and  urban-type settlement Vyshkove iron content is 20-40 mg/ dm³. Scientists of the Ukrainian scientific research institute of rehabilitation and balneology analyzed the state of usage of waters with increased iron content by production prepackaging. Nowadays only one chalybeate water – “Nastusia” (Transcarpathian region) is packed and also some waters with high iron content – “Syla Dovbusha” (Lviv region) and “Drahivska” (Transcarpathian region)An example of bottling of these waters may be well-known mineral waters “Poliana kupel’” and “Svaliava” (Transcarpathian region) that are bottled by a range of plants and firms. Waters with arsenic content more than 0.7 mg/ dm³ relate to arsenical mineral waters.

Arsenical waters are known in Transcarpathia as well. Particularly conditioned arsenic content was determined in acidulous waters of Girsko-Tysenske and Verkhniobystrynske deposits of acidulous mineral waters. By chemical composition  waters of Tysenske and Verkhniobystrynske deposits are chloride hydrocarbonate and hydrocarbonate chloride sodium and calcium sodium with mineralization from 3 to 32 g/ dm³and arsenic content 10 – 20 mg/ dm³.

There are data, which prove presence of arsenical waters on Kerch peninsula. Thus in one of the sources on the bank of Chokrak Lake that flows out chokrak limestones they determined arsenic content 3.5mg/ dm³ by mineralization 5.6 g/ dm³ and chloride calcium content of water. In the region of Tobechyk lake at a depth of 250 m they discovered horizon with chloride hydrocarbonate sodium water with mineralization 16 g/ dm³and high content of arsenic – 57 mg/ dm³and also of bromine - 320 mg/ dm³and fluorine - 58 mg/ dm³.

Scanty information about arsenical water proves that they are not adequately explored within the boundaries of Ukraine. Hence main discoveries in this sphere may be forecasted in future.

The most popular resorts, where chalybeate waters are used are Soimy, Shayan (Transcarpathian

 region), Slovianogirsk (Donetsk region).

          

Transcarpathian region of Ukraine is situated on the south west slopes of Ukrainian Carpathians and in the north-east part of Seredniodunayska lowland (so called Transcarpathian lowland). Mountain ridges take about 4/5 of the territory and in the eastern part there are detached massifs. Spa sources of Transcarpathia are mainly mineral waters (620 water inflows consisting of 69 main desorts), salt-mines and salt-pans, climate. 11 sanatorium-and-spa institutions, 6 rehabilitation departments, 30 hydropathical establishments are at mineral water centre. 31 medicinal table waters are bottled there. The biggest amount of deposits is situated in mountain regions – Svalyava (10), Khystske (9), Mizhgirske (9), Tyachivske (9), Rakhivske (9). There are also 70 tourist centres, on – season recreation centres, health improvement camps, hotel complexes.

Taking into account different approaches to division of MW that are explored by nowadays into groups and subgroups 69 deposits of MW of Transcarpathia may be conditionally divided into 8 main groups, which determine first of all tendencies of their therapeutic application. Quantitative characteristic of these groups is:

• acidulous hydrocarbonate sodium (14 deposits) ;

• acidulous chloride - hydrocarbonate and hydrocarbonate – chloride (14 deposits) ;

• acidulous hydrocarbonate calcium, calcium sodium, calcium-magnesium-sodium (13 deposits), including chalybeate (10 deposits);

• acidulous hydrocarbonate nitromethane chloride sodium (13 deposits);

• nitric, acidulous silicic(5 deposits);

• nitromethane sulfide (4 deposits);

• acidulous arsenical (4 deposits);

• thermal (20 deposits);

Acidulous hydrocarbonate sodium waters and hydrocarbonate waters of other types including chalybeate and arsenical ones are the most typical for Transcarpathia. At the same time sulfate waters are rare for Transcarpathia.

By gas composition the major part of MW of Transcarpathia are acidulous (75.0 %); nitric and nitromethane (18.0 %), sulfide (7.0 %).

 

Silicic mineral waters

 

Silicic mineral waters are of different chemical composition but the presence of conditionally essential microelement – silicon, unites them.

Silicic mineral waters are divided into nitric and acidulous ones with content of metasilicic acid (H₂SiO₃) not less than 50.0 mg/ dm³.

Reasoning from content three zones of distribution of these waters within the boundaries of Ukraine can be chosen: Transcarpathian, Podilska and Dnistrovska.

The most promising silicic waters in Transcarpathia are thermal and subthermal acidulous ones in which concentration of metasilicic acid reaches 60-24 mg/ dm³, deep waters which deposits are 100-250 m and their mineralization – 1.5 – 3.0 mg/ dm³.

Silicic waters are known in Solotvynske artesian downfold as well where they are operated on resort “Shayan”. Their composition is hydrocarbonate sodium, mineralization – 4.0 g/ dm³, content of metasilicic acid – 60.0 mg/ dm³, and content of carbonic acid – 20.0 g/ dm³.

The content proves that zone of Dnieper artesian basin is the most promising for searches of silicic mineral waters. Even know in Kharkiv region in sanatoriums “Rai-Olenivka” and “Berezivski mineral waters” mineral waters with conditioned content of metasilicic acid up to 60.0 mg/ dm³ are used for balneal treatment.

Waters from the sources “Kharkivske -1” and “Kharkivske-2” situated in the suburbs of Kharkiv were also determined as silicic ones. Silicic waters were discovered by wells in the village Pyatykhatky, at the cottage of region executive committee, in pioneer camps “Lisova stezhka” and “Svitlo zhovtnya”. Hydrocarbonate and sulfate anions and cations of calcium and magnesium prevail in the chemical composition of water. Mineralization doesn’t exceed 2.0 g/ dm³, content of metasilicic acid changes from 50 to 70.0 mg/ dm³.

Waters with limited concentration of metasilicic acid, i.e. those which concentration of this element varies about 50.0 mg/ dm³(up to and more), take a special place. On temporary requirements the status of drinking or medicinal water can be given only after research operations on animals in case of determination of biological activity after preclinical trials and clinical researches.

Berezivski mineral waters, Rai-Olenivka (Kharkiv region) are the most well-known resorts where silicic waters are used.

Bromine, iodide-bromine and iodide mineral waters

The waters are subdivided into: a) bromine – with bromine content not less than 25.0 mg/ dm³; b) iodide-bromine – with bromine content not less than 25.0 mg/ dm³, iodide content not less than 5.0 mg/ dm³; c) iodide – with iodide content not less than 5.0 mg/ dm³. These groundwaters of course lie down at high depths that is determined by the conditions of their formation.

Mineral iodide, bromine and iodide-bromine waters accompany gas, oil and condensate pools and that’s why are usually taken to the surface by prospect drilling and production wells. And even outside the hydrocarbon deposits on the territories of Dniprovsk-Donetsk, pre-Black Sea  and Transcarpathian downfolds, the Crimea and fold region of the Carpathians at depth of hundreds and thousands meters one can find waters of high mineralization, enriched with iodide and bromine up to the level that provides balneal conditions.

There are enough data about distribution of iodide bromine waters in Northern pre-Black Sea and pre-Azov regions. Waters with bromine content 38 – 138 mg/ dm³ and iodide content – 4-11mg/ dm³ with chloride sodium composition and mineralization 11-60 g/ dm³ were found particularly in region of Berdyansk town in Transcarpathian region in over chalky sands. In the village Koblevo (Mykolaiv region) waters of the same composition were found in Miocene deposits. Mineralization of waters is 24.4g/ dm³, bromine content is 48.8 – 56.6 mg/ dm³ . Bromine waters are widespread in pre-Azov and are found in regions of Melekino, Sedove villages (Donetsk region). In Odesa region bromine waters were found at depth of 550 m in sands of upper palaeogene. Mineralization of water is 23g/ dm³, bromine content at the same time is 52 mg/ dm³ . Moreover, chloride sodium waters with mineralization 90 - 105 g/ dm³ and bromine content 170 mg/ dm³ and temperature of water at outflow 35-45 °C were discovered in Archean Proterozoic granite near Odesa in the well No.1 – OT.

The Crimea, where unique sources are known, is very rich in mineral waters of this type. With full authority one should place among them well No. 905 near Feodosiya town that at the depth of 71 m in limestone of low palaeogene opened water bearing stratum of chloride sodium waters with mineralization 7.8 g/ dm³ and with extremely high content of iodide 239 mg/ dm³ and bromine content only is 57 mg/ dm³. The source Sarty-Su, that flows out from chokra limestones near urban-type settlement Lenino, stands in the same line. Water of this source is of low mineralization (3.2 g/ dm³) and bromine content in it is 79 mg/dm³. Berdyansk (Transcarpathian region) is the most well-know resort, where iodide-bromine waters are used. 

Radioactive (radon) waters
Waters that contain radon in amount less than 50 eman (5 nKi/ dm³, 185 Bq/ dm³) belong to radon waters. Ukraine is very rich in radon mineral waters which in spatial relation, in general, are connected with Ukrainian crystalline shield that stretches from north west to south east of our country on the territories of Rivne, Zhytomyr, Kyiv, Khmelnytsk, Vinnyca, Kirovograd, Cherkasy, Dnipropetrovsk, Zaporizhia, Donetsk, Odesa, Mykolaiv and Kherson regions. In nature radon is formed as a result of radioactive decay of radium. At the same time hydrogeologists and balneologists more often deal with radon-222 with half-value period 3,8 of days. This isotope is a result of decay of radium-226 with half-value period of 602 years that belongs to family of uranium-238. Except for deposit in Khmilnyk within the boundaries of Ukrainian shield there were discovered and explored Zhytomyr, Denishevske, Shepetivske, Korecke, Polonske, Bilocerkivske, Myronivske, Zvenygorodske,Znamenske, Kryvorizhske, Oleksandriyske, Velyko-Anadolske and Berdyanske deposits of radon waters with total active reserves of about 10 thousand m³/day and night. Well depth of mineral waters of these deposits doesn’t exceed 100 m, mineralization is within limits 0.5 – 3.5 g/ dm³, chemical composition of waters changes from hydrocarbonate to sulfate chloride calcium and calcium sodium. Discharges of wells change in wide diapason of meanings – from 0.5 to 10 dm³ /c. Except for Ukrainian crystalline shield radon waters were also discovered in other regions. Particularly the sources in mountain region of Carpathians are known, which have radon content in water reaching 200 – 250 eman. These waters are apparently connected with radioactive mineralization that is discovered in some areas enriched with organic substances of menilite slate. Khmilnyk (Vinnytsia region) is the most popular resort, where radon mineral waters are used.
Mineral waters with high concentration of organic substances

These are waters that contain organic substances in amount not less than 5.0 mg/ dm³. Worldwide known “Naftusia” , that provides a basis for hydromineral centre of the most famous in our country Truskavets resort, and waters of numerous deposits belong to this group. “Naftusia” was for sure known only in Resort gully of Truskavets before 60s of the last century.

Exploratory experience of Skhidnytske deposit to some extent contributed to discovery of Zbruchanske deposit of mineral waters that is situated at Podillya near urban-type settlement Sataniv of Khmelnytskyi region and later on – Makivske, Volochyske and Zaichyvske deposits in Khmelnytskyi region and Novo–Zbruchanske deposit in Ternopil region. All of them are connected with the limestone of Silurian. The bank of reserves is noticeably bigger than in “Naftusia” deposits. In Lviv region there were also discovered waters of this type in Verkhnyosynyovydske deposit (Verkhnyosynyovydsk area), where they are connected with waterbearing stratum in mudstones and Oligocene sands.

Thus, in the middle of 80s mineral waters with high concentration of organic substances were discovered at Podillya and in Carpathians.

Truskavets (Lviv region) and Sataniv (Khmelnytskyi region) are the most famous resorts where mneral waters with high concentration of organic substances are used.

Boric mineral waters

Waters that contain not less than 35 mg/dm³ of orthoboric acid H₃Bo₃ belong to boric mineral waters. Boron has expressive biological, pharmacological and poisonous action, antimicrobic action, promotes treatment of skin diseases. But the usage of large quantity of boron with water namely – 3 g/day and night can cause gastrointestinal and lung diseases.

These waters are spread in boundaries of the Carpathians, Transcarpathians and the Black Sea hollow. They belong to terygenic and volcanogenic sedimentary deposits of Neogene, palaeogene and chalk.

Mineral waters without specific components and properties
Waters, which balneal effect on human organism is determined by their main ionic composition and general mineralization, belong to mineral medicinal waters of this type. At the same time all main salifiable ions of water solution have their balneal usage. That’s why this group includes waters of various chemical composition by mineralization that varies from 1 to 250 g/ dm³ and more. Mineral waters without specific components and properties are spread practically over the whole territory of Ukraine. Myrhorod (Poltava region), Feodosiya (the AR Crimea), Kuyalnik (Odesa) are the most famous resorts, where mineral waters without specific components and properties are used.

Transcarpathians as well as the Crimea is region with the highest subsoil temperature in comparison to Pre-Carpathians and Donbas. Nowadays there are 20 deposits of subthermal, thermal and high thermal waters in Transcarpathians. 16 deposits of thermal and high thermal waters are of extrinsic value.

Group of acidulous hydrocarbonate sodium waters of Transcarpathians (AHSMW) is represented by 14 deposits: Shayanske, Chornogolovo-Pastilske, Kvasne, Golubynske, Ploskivske, Nelipynske, Svalyavske, Polyanske, Novo-Polyanske, Vedmezhyi, Olenivske, Ploskivske, Pasicke, Ruski Komarivci.

On the basis of these waters sanatorium “Poliana”, “Sonyachne Zakarpattya”, “Kvitka Polonyny”, sanatorium-preventorium “Kryshtaleve dzherelo” of Poliana resort, “Shayan” of Shayan resort are at work. Their main part is bottled - “Poliana Kupel”, “Poliana Kvasova”, “Luzhanska”, “Ploskivska”, “Nelipynska”, “Svaliava”, “Shayanska”, “Luzhanska -7” (“Golubynska”). There was developed a technique of dry salt production from “Pasika” MW, its artificial analogue “Gastroduopan”.

Unlike to thermal MW Vichy, Caucasian Borjomi, their Transcarpathians’ analogues are cold ones. Waters of this group are characterized by high background content of boron ( from 80 to 500 mg/ dm³), that is explained by their geochemical origin and metamorphism of water-containing rocks, especially sands of Lyutska formation in Duklyansko- Chornogorska tectonic zone is the reason of quasi-high content of boron in natural waters. AHSMW even highly mineralized, as a rule, are alkalescent (pH 6.3 – 6.9 pH unit), however they have expressive alkali – effect on metabolic processes in human body by drinking usage. First of all, it is important in neutralizing stomach acid (antacidic action), in resuming of acid-base balance of oral cavity, blood and urine.

14 deposits – Chornogolovo-Pastilske, Kolochavske, Komsomolske, Goverlyanske, Kobylecko-Polyanske, Dragivske, Zarichivske, Simerske, Pakhivske, Soimynske, Dragivske, Ugolske, Solske belong to the group of acidulous chloride - hydrocarbonate and hydrocarbonate – chloride waters of Transcarpathians.

On the basis of these MW sanatorium “Verkhovyna” (Soimynske deposit), tourist centre “Trembita”, recreation centre “Kvasnyi” (Kobylecko-Polyanske deposit) are at work, three of them – “Dragivske”, “Yavornytcka”, “Soimy” MW were bottled.

Quasi-high content of microelements especially arsenic (Rakhivska zone) is typical for waters of this group.

Hence, group of acidulous arsenical waters of Transcarpathians also belongs to this group of waters by main ionic content: low arsenical (arsenic content 0.7 – 5.0 mg/ dm³) ( Girsko-Tysyanske, Goverlyanske, Popytnyk, Verkhne-Bystryanske deposits) and high arsenical ( arsenic content 5.0 – 10.0 mg/ dm³) (Popytnyk deposit).

The majority of acidulous arsenical MW(AMW) are situated in rock masses – the Carpathians, the Caucasus, Alps, Mont Dore, Kamchatka, Sakhalin. Thus, arsenic content in AMW in some resorts is: Recoaro (Italy) – 2.0; Levico (Italy) – 6.2; La Bourboule (France) – 7.0; Dürckheim (Germany) – 14.0; Darridag (Azerbaijan) – 21.0; Sinegorskiy (Russia) – up to 102; Girska Tysa – 5.0 – 20.0 5.0 mg/ dm³.

Nowadays AMW are used mainly in form of baths in sanatorium “Girska Tysa” of Kvasy resort, sanatorium-preventorium “Menchul” (Bystryanske deposit). Scientific researches in medicinal usage of Kvasy-1 and Kvasy-2 MW determine the ability of their inner application, have need of continuation of their investigation.

Group of acidulous low mineralized hydrocarbonate - calcium and magnesium – calcium mineral waters in Transcarpathians is represented by 14 deposits: Vuchkivske, Golyatynske, Kvasovecke, Kosivske, Bogdanske, Stroinynske, Krasne, Bilyn, Kelechynske, Uzhocke, Richkivske, Kvasovecke, Chornogolovo-Pastilske, Tarasivske.

For all classical Narzans presence of some quantity of iron is typical, however chalybeate Narzans are the most valuable natural iron sources. At the same time there is no sulphate Narzan

of Kyslovodsk type in Transcarpathians. Narzans of Darasunsk and Kyslovodsk types are the most widely represented in the world. Thanks to wonderful taste properties which are given by high concentration of carbonic acid, Narzans are not only used at resorts but are also widely bottled. These are Nelenchuv, Zhegestov, Pivnichna, Polyanycya-Zdrui resorts, “Pivnichanka”, “Nalenchovyanka”, “Polyanycya”, “Kudovyanka”, “Staropolyanka” MW (Poland), Borsec, Buzias, Vatra Dornei resorts, “Borsek”, “Poyana” WM (Rumania), Rajecké Teplice, Beloves resorts (Czechia), Sliač resort (Slovakia), Balatonfüred resort (Hungary) and etc.

Acidulous waters of carbonate type (about 70 % MW of Transcarpathians) are mainly spread in fold Carpathians and are known by local name “burkuty”. All deposits of the mentioned MW are of high flow rate, spring waters are widely used by population but only three of them are used with curative purpose: Stroinynske in sanatorium-preventorium “Kvasnyi potik”, Tarasivske in sanatorium-preventorium “Plai” and Kelechynske in hematologic rehabilitation department of sanatorium “Verkhovyna”.

The majority of MW of this group are acid by their active reaction, their pH is lower 6,5 pH unit. It is explained by high concentration of free carbonic acid with low quantity of hydrocarbonates. In other hydrocarbonate acidulous waters with higher mineralization, as for example, in Poliana Kvasova, Luzhanska, absolute amount of carbonic acid is also considerable, they have at the same time more hydrocarbonate sodium. Correlation value of free carbonic acid to its bicarbonate salts is less in medium-salt water than in Narzans, hence their pH value is bigger. Narzans of Tarasivske deposit (5.6); Krasne deposit(6.0); Kelechenske deposit (6.0) have the lowest pH, that is the biggest acidity.

Group of chloride sodium waters is widely represented in Transcarpathians. There are acidulous MW of Solske, Maidanske, Vuchkivske, Ust-Chornyanske, Tysyanske deposits, thermal iodide-bromine chloride sodium salt brines of Velyatynske, Rozivske, Shaynske deposits are among them. Others are thermal nitromethane: Lazivske, Irshavske, Mukachiske, Ivanivske, Borchavske, Narcys, Beregivske, Garazdivske deposits and methane cold brines of Latorycke, Tereblyanske deposits, iodide-bromine brines of Zaluzhske deposit. These waters are the most widely represented in Ukraine as well as in the world.

 

Nowadays 9 deposits of the following group are developed in Transcarpathians. Their main application is outer – in form of baths in sanatorium “Perlyna Karpat” (Latorycke deposit), sanatorium-preventorium “Ust-Chorna” (Ust-Chornyanske), “Thermal waters” (Velyatynske), “Edelweiß”(Solske), tourist centres “Narcys” (Narcys), LOC “Latorycya” (Mukachivske), swimming pools of sanitary complex “Transcarpathians” (Beregivske), recreation centre “Borzhava” (Borzhavske). Nowadays, bottling of “Narcys” low-mineralized chloride sodium-calcium silicic MW is put in order.

One may use all low and medium-mineralized chloride sodium waters for drinking treatment (Narcys, Ivanivske, Borzhavske deposits), medium-mineralized MW(Irshavske, Mukachivske, Maidanske, Vuchkivske deposits) and also iodide-bromine waters and brines on chloride sodium basis (Zaluzhske, Velyatynske, Ivanivske, Rozivske, Garazdivske). Brines are diluted with fresh water for drinking usage. However, this dilution causes a sharp decrease of iodide and bromine content. According to the existing criteria for medicinal iodide-bromine water, for outer usage in form of baths iodide content - not less 5 mg/ dm³and bromine content – not less 25 mg/ dm³after dilution to optimal concentration for chloride sodium baths – 10 – 40 mg/ dm³. At the same time one should take into consideration that therapeutic action of bromine develops more expressively by less quantity of chlorides that is present in less mineralized waters. Taking it into account, MW of Garazdivske deposit is conditional by bromine and iodide for drinking usage, by bromine, even in dilution 1:1, 1:2 by the least quantity of chlorides – Irshavske deposit; other deposits (Zaluzhske, Velyatynske, Ivanivske) are conditional only for outer application.

 

Group of silicic thermal mineral waters. There are increased concentrations of silicon in MW of many types and the highest concentrations are in thermal, especially high-thermal waters. In all cases accumulation of silicic acid is predetermined by lixiviation processes of rocks, which contain H₂SiO ₃, high temperature, high pressure, acid or alkaline reaction of waters and also appropriate rock composition. It explains the fact that silicic waters are more often found among acidulous and also nitric thermae (which have alkaline reaction) connected preferably with alkaline igneous rock.

Nitric silicic thermaes are the most widespread in the world. They are represented by 4 deposits in Transcarpathians – Derenivske, Uzhgorodske (Uzhgorodska -2 MW: well No. 597, park of children's hospital), Lisarnya, Karpatske.

Acidulous silicic thermaes, which are widely presented in the world especially in zones of Quaternary volcanism, are represented in Transcarpathians by Uzhgorodske deposit of two types of water – Uzhgorodska -1 MW well No. 8 – Uzh, 13 – H (“Vozzyednannya” park), well No. 2, 5 (microrayon “Radvanka”) and well No. 5-T ( park in Krylova street) (Uzhgorodska -3).

There is peculiar type of nitric- acidulous “overheated” thermaes in regions of contemporary volcanism (New Zealand, Kamchatka). By outpouring to the surface they lose nearly all gases and become gas-free alkaline ones. Beregivske deposit in Transcarpathians, which is situated in the region of Beregivske fine mountain of volcanic origin, approaches these waters.

Silicic waters are found more often in the first group (50 – 100 mg/ dm³ H₂SiO ₃) (Derenivske, Lisarnya, Carpathian deposits), highsilic ones are found in other (100 – 150 mg/ dm³ H₂SiO ₃) (Uzhgorodske,Ivanivske deposits).

On the basis of nitric thermae of Derenivske deposit sanatorium “Kooperator”, sanatorium-preventorium “Promin’” of Uzhgorodske deposit (well No. 597) - rehabilitation department of local children’s clinical hospital, well-room in Uzhgorod town are at work. Acidulous silicic thermaes of Uzhgorodske deposit (well No. 8 – Uzh, 13H, 5, 15T) are also used by the citizens (well-room in Krylova Street, “Vozzyednannya” park), bottled as “Radvanka” MW. Low mineralized alkaline MW of Carpathian deposit is used in sanatoriums “Carpathians”, “Carpathians’ Pearl” of the resort Carpathians. Pools on the banks of Carpathian, Ivanivske, Derenivske deposits are built.

Silicic thermal waters of all genotypes are widely used with curative purpose for outer as well for inner drinking usage.

Among them fresh and low-mineralized MW of Derenivske, Uzhgorodske, Carpathian deposits attract special attraction as in the whole world.

Silicon can be found in three forms in MW: molecular silicic acid (metasilicic - H₂SiO ₃ and orthosilicic - H₄SiO ₄ ), ion hydrosilicate (H₂SiO ₃) and colloid form ( in form of fine gel).

According to the data of Bilak S.P. (1967, 1986) silicic acid was discovered in all MW of Transcarpathians. Its hydrochemical background is 31,7%. In cold MW content of  silicic acid is within the limits of hydrochemical background of the region, its quasi-high concentrations are discovered in thermal waters of all chemical types. Thus, its content is 56-66 mg/ dm³ by pH 6.3 pH unit in MW of Shayanske deposit. There is 96 % in monomolecular form and 3.5 % of its general content in colloid one.

The fact of existence of autochtonous microflora that also plays an appropriate role in the mechanism of their therapeutic action in MW in general, as well as in fresh ones, is of no less importance. First of all this is antimicrobic actions towards conditionally pathogenic and pathogenic microorganisms owing to microorganism – antagonists. It means that MW to some extent can act as biological medications like colibacterin, lactobacterin, in which antagonist action of microorganism is used that is caused by production of different ferments (colicin), which act as a brake on vital functions of pathogenic flora.

It is not inconceivable that biologically active components of hyposmotic MW contain complexes of organic and non - organic compounds, particularly, compounds of microelements

with organic ligands in organo-mineral complexes, which promote absorption processes of micro- and macroelements in parietal and membrane digestion. It is also known that silicon except for non-organic form can be in conjunction with organic substances, for example, with cholesterol, however it is not enough to make convincing conclusions.

Group of sulfide MW is represented in Transcarpathians by 4 deposits: Cynyatcke, Lazivske, Vilkhovecke and Tereblyanske with content of general hydrogen sulphide more than 10 mg/ dm³.

Low sulfide waters predominate in Transcarpathians taking into consideration division of sulfide waters into groups by concentration of general hydrogen sulphide (H₂S+HS^-) into low – sulfide (10 -50 mg/ dm³ ), medium – sulfide (50- 100 mg/ dm³) and high sulfide (100 – 250 mg/ dm³).

The biggest amount of hydrogen sulphide appears in deposits of Vygorlat- Gutynskiy volcanic mountain ridge – Synyacke ( up to 68 mg/ dm³). Its amount is noticeably less – 15 – 27 mg/ dm³ in MW of Solotvynska hollow.

Low sulfide low-mineralized hydrocarbonate-sulphate calcium waters of Synyacke deposit represent the only ones sulphate waters in Transcarpathians.

It is of vital importance by compound gas composition of sulfide waters because of the fact that CO₂ decreases pH value and in that way increases relative level of free hydrogen sulphide. It has been established that sulfide water is immediately active near the source because even short time conservation disturbs hydrodynamical balance of its ingredients which precipitates that complicates bottling.

Over recent years views on usage of sulfide waters change, especially concerning drinking usage and in form of irrigation. Their usage in stomatology, otolaryngology, gastroenterology especially spreads. New aspects of their therapeutic action appear that are particularly connected with forms of sulphur discovery, role of sulphoid in excretion of heavy metals by industrial chronic poisoning, of metabolites by toxic hepatitis. They obtain more specific information about bactericidal actions of sulphur, role of thiol compounds in treatment of immune – complex pathology. Bulitko G.G. and others (1991) studied forms of sulphur existence in sulfide waters of Carpathian region.

The most valuable from the represented mineral waters of Transcarpathians, which are not or mostly are not found in other regions of Ukraine:

• acidulous hydrocarbonate sodium waters with wide range of mineralization from 3 up to 10 mg/ dm³) and the highest content of hydrocarbonate (Poliana Kupel, Poliana Kvasova, Luzhanska -4,7, Shayanska, Ploskivska, Pasika nad etc.);

• acidulous chloride - hydrocarbonate calcium with the highest level of calcium up to 500 mg/ dm³ among MW of Ukraine (Soimy);

• acidulous chalybeate waters with the highest in Ukraine content of carbonate iron up to 56 mg/ dm³ (Kelechynska, Tarasivska);

• acidulous high silicic MW with the highest content of methasilic acid in Ukraine (up to 200 mg/ dm³) (Uzhgorodska-1, Nastusya); nitric silicic low-mineralized waters (Derenivske);

• low sulphide sulfate calcium waters (Synyatcka);

• arsenical waters (Kvasy);

• iodide-bromine waters (Gutynska);

These waters are of great value for drinking as well as for outer application in different technologies of balneotherapy with the purpose of primary, secondary balneoprophylaxis and balneo rehabilitation. It is needed to take a range of steps for efficient use of available hydromineral potential:

• working out of new and renovation of the existing therapeutic technologies, bringing them up to international standards;

• enlargement of service range taking into account development and new trends in therapeutic and sanitary tourism, Fitness, Wellness- programs;

• high-quality improvement and enlargement of infrastructure of sanatorium treatment and sanitary establishments.

Possibilities of balneotherapy and balneoprophylaxis on the basis of resorts of Transcarpathians

1. Integration of modern medical and preventive technologies with an opportunity of active rest, efficient use of tourist constituent – elements of entertainment and rest. This trend is considered to be the most perspective and actually means rapprochement of sanatorium-and-spa treatment and health and leisure tourism.

2. Working out of varied programs of balneotherapy and balneoprophylaxis different by therapeutic and recreation profile, duration, main therapeutic factor (factors), ability of integration with different methods of apparatus physiotherapy, traditional and alternative medicine, which are oriented on different age, social groups of recreants.

3. Creation and rationale of undurable (7-14 days) programs of balneoprophylaxis and balneotherapy for different pathological states, achieving high enough rehabilitation effect.

4. Wide use of balneotherapy methods in the net of sanatorium-and-spa institutions, patient care institutions of practical health protection, institutions of recreation sanitary type.

5. Working out and implementation of optimal diagnostic blocks that are necessary for choice of therapy tactics as well as by way of evaluation  criteria of functional organism reserves and state of adaptative processes and also their changes under the influence of therapy with purpose of providing demonstrative base of reproduction  therapy success.

6. Intensification of medical constituent in institutions of recreation sanitary profile.

7. Taking into account variety of balneal resources of Transcarpathians there is a real possibility of integration of different methods and mineral waters in therapeutic and sanitary technologies in different regions of Transcarpathians. At the same time every region has its own specific character that determines potential trends and perspectives of balneal resources application.

The basic balneoresources of Beregivska resort – recreation zone (RRZ):

• 6 MW deposits, 52 artificial water inflows (wells).

Peculiarities of composition of MW main groups:

• Nitric acidulous, nitromethane, acidulous silicic chloride sodium of different mineralization – from low-mineralized to brines.

4 deposits from 6 ones are explored.
The basic balneoresources of Velykobereznyansko-Perechynska RRZ:

• 7 MW deposits (66 water inflows – 28 wells, 38 springs).

Peculiarities of composition of MW main groups:

• acidulous hydrocarbonate – chloride sodium ( and sodium calcium), including with content of micro- and macroelements (boron, bromine, iron, silicon), from fresh to brines;

•  low – sulfide fresh and low-mineralized chloride hydrocarbonate calcium sodium including with arsenic content.

4 MW deposits from 7 are explored.
The basic balneoresources of Mizhgirsko-Volovecka RRZ:

• 9 MW deposits (121 water inflows – 27 wells, 94 springs).

Peculiarities of composition of MW main groups:

• acidulous fresh hydrocarbonate magnesium – sodium - calcium);

• acidulous chloride – hydrocarbonate medium – mineralized sodium – calcium with high content of calcium, presence of iron and hydrogen sulphide.

5 MW deposits from 9 are explored.
The basic balneoresources of Irshavska RRZ:

• Irshavsk deposit of thermal MW (27 water inflows – 17 wells, 10 springs).

Peculiarities of composition of MW main groups:

• thermal methane iodide-bromine hydrocarbonate – chloride sodium MW.

They are practically unexplored.
The basic balneoresources of Mukachivska RRZ:

• 7 MW main deposits (31 water inflows – 23 wells and 8 springs).

Peculiarities of composition of MW main groups:

• thermal chloride sodium, iodide-bromine and boric brines;

• sulphide waters;

• nitric silicic thermae.

5 deposits from 7 are explored.
The basic balneoresources of Rakhivska RRZ:

• 9 main deposits (142 water inflows – 38 wells and 104 springs).

Peculiarities of composition of MW main groups:

• acidulous hydrocarbonate medium – mineralized and fresh chloride – hydrocarbonate sodium (calcium - sodium), including with high content of arsenic, iron, boron;

• acidulous fresh hydrocarbonate calcium, magnesium MW, including chalybeate ones;

• low – sulfide waters.

3 deposits from 9 are explored.
The basic balneoresources of Svalyavska RRZ:

• 10 deposits (94 water inflows – 77 wells and 17 springs).

Peculiarities of composition of MW main groups:

• Preferably acidulous hydrocarbonate sodium of different composition and mineralization (from 5 up to 25 g/ dm³), including with content of boron and fluorine.

9 deposits from 10 are explored.
The basic balneoresources of Tyachivska RRZ:

• 9 MW deposits (67 water inflows – 21 wells and 46 springs).

Peculiarities of composition of MW main groups:

• acidulous high chalybeate (including strongly chalybeate – 73 mg/ dm³, fresh hydrocarbonate sodium (sodium – calcium);

• nitric- methane low-sulfide;

• chloride sodium brines of Solotvynska hollow and Solotvynsk salines

3 deposits from 9 are explored.
The basic balneoresources of Uzhgorodska RRZ:

• 6 MW deposits (38 water inflows – 29 wells and 9 springs).

Peculiarities of composition of MW main groups:

• low mineralization of the majority of waters;

• high and very high content of metasilicic acid;

• presence of biologically significant content of iron, calcium, other micro- and macroelements;

• high mineralized thermal MW.

3 deposits from 6 are explored.
The basic balneoresources of Khustsko-Vynogradivska RRZ:

• 4 MW deposits (91 water inflows – 49 wells, 42 springs).

Peculiarities of composition of MW main groups:

• acidulous silicic fresh hydrocarbonate sodium, including ones with increased content of sulphates;

• acidulous low-mineralized chloride- hydrocarbonate sodium;

• acidulous, including silicic, boric and iodide-bromine chloride sodium thermal brines;

• nitric silicic thermae.

All MW deposits are partially explored.
Carried out analysis proves the fact that great potential of all types of MW of Ukraine remains unused. That’s why the usage of hydromineral base of Ukraine in health improvement and treatment is one of the main aspects of recreation activity. MW resources of every region of Ukraine have their own specific characters and can determine individual balneal profile of every resort-recreation zone. 
INNER USE OF MINERAL WATERS
Complex medicinal effects are the main in influence of drinking mineral waters, which appear as a result of controlling effect of medicinal mineral waters on organs of gastrointestinal tract, urinary excretion, metabolic processes; neurohumoral gastritis effects ( I phase) become apparent as a result of antrum irritation by influence of mineral water on duodenal mucosa - secretin, cholecystokinin, pancreozymin, motilin (II phase); the second group of effects is connected with interaction reaction of physical-chemical composition of mineral water and gastric contents. Treatment option:

1. mineralization – low (2-5 g/l), medium(5-10 g/l), high 910-15 g/l); mineral waters of high mineralization dilute with fresh water to appropriate concentration;

2. temperature – in order to have spasmolytic effect mineral waters are heated up to 40-45 °C, they are used cold (18-20 °C) to tone up neurosecretory apparatus of gastric or preserve volatile, in other cases the temperature of mineral water is 25-30 °C;

3. volume of single portion – from 150 up to 200ml; in order to intensify the effect of mineral water single use is reached to 300-400ml, to soften its action it is prescribed in little portions in 50-100 ml at single use or several times in an hour interval;

4. tempo of use – mineral waters are sipped slowly to intensify digestive, gastric action; in other cases tempo of use is free;

5. presence of carbon dioxide – one uses mineral waters with carbon dioxide or waters are additionally aerated to intensify stimulating effect of water on neurohumoral digestive apparatus; to decrease the action mineral waters are previously degassed.

6. correlation of time of water use with meals – water is used 30-40 min before meals to have a stimulating effect on neurosecretory gastric apparatus, to decrease activity of gastric glands –1- 1.5 hours before meals; by the absence of inhibitory duodenal reflex (duodenal ulcer), presence of dyspeptic syndrome in between meals (reflux esophagitis) – following meals in 1-1.5 hours; to influence organs of hetobiliary system, pancreas, intestines – 1 hour before meals; in cases of pain or dyspeptic syndromes following meals, at night mineral water use is prescribed additionally in the period of digestion; in case of need to influence metabolic processes or urinary excretion organs waters are drank 1 hour before meals;

7. use periodicity – usually three times a day; in case of need additional use is prescribed during digestion period, before going to bed; course of treatment is 3-4 weeks;

8. peculiarities of use – predominant composition of some anions (hydrocarbonate, sulphate or chloride), significant content of microelements (iron, silicon, boron and etc) or organic substances (nephtene carbohydrates, humic or carboxylic acids and etc.), which allow to gain purposeful effects. It is the ground for choice of drinking mineral water.

Gastric lavage by mineral waters is carried out with the help of thick stomach pump, patient is in sitting position. Mechanism of action: mineral water inserted into stomach influences mechanoreceptors, thermoreceptors, chemoreceptors, causes appropriate reflex phenomena. Some amount of mineral water is absorbed, influencing the whole body. Action features: cleaning out the contents of the stomach, stimulation of motion activity of stomach, removal of “acidism syndrome”, improvement of reparative processes of mucous coat of stomach. Indications: food poisoning, inflammatory processes in stomach, deceleration of gastric emptying – atony, pylorostenosis, heartburn. Contraindications: stomach ulcer with inclination to hemorrhage, penetration of gastric ulcer, disorder of gullet patency, cirrhosis, hypertension.
Duodenal insertion of mineral waters. By this method mineral water comes directly to duodenum passing by stomach. Mechanism of action: process of excretion of duodenal content with increased content of pancreatic ferments increases in response to insertion of mineral water to duodenum, gall-bladder emptying takes place, motion function of duodenum, small and large intestine normalizes, inflammatory processes in them decrease. Action features: cleaning out the contents of duodenum, stimulation of motion activity of duodenum, liquidation of duodenostasis, reflex stimulation of digestion apparatus which has neurohumoral feedbacks with duodenum (secretin, cholecystokinin, pancreozymin, motilin effects). Indications: chronic cholecystitis and cholangitis, biliary dyskinesia, chronic hepatitis that proceeds with biliary pathology, chronic duodenitis, chronic dyspepsia. Contraindications: recrudescence of chronic hepatitis, cholecystitis, vascular heart diseases with circulatory inefficiency.
Bowel lavage with mineral waters. Water is injected directly per rectum directly to large intensine. Mechanism of action: warm mineral water washes away and dissolves mucus from intestines walls, effects anti-inflammatory, and decreases spastic phenomena. A part of injected mineral water is absorbed and influences the whole organism. Action features: cleaning out the contents of large intensine, microscopic flora, endotoxin; abolition of colostasis; stimulation of digestion apparatus which has neurohumoral feedbacks with large intensine. Indications: chronic colitis, constipation, chronic cholecystitis. Contraindications: peritoneal commissures, colonic polyposis, anal fissures, hemorrhoid. 

HYDROTHERAPY

 

General wet pack is method by which undressed patient is laid on couch covered by woolen blanket and cotton sheet that is wetted in water of temperature 30 -25 °C and squeezed very well. The patient is packed in sheet and then in blanket and is left for 40 - 60 min. Mechanism of action: stimulant and antipyretic actions on the first phase (10 -15 min); calming action on the second phase (30-40 min); expressed thermal and diaphoretic action on the third phase of reaction (40-60 min). Action features: phase character of action depending on treatment duration (antipyretic, sedative, diaphoretic, stimulating action).

Indications: patients, who have fever, astenization of organism, period of recovery, hypersthenic form of nervous prostration, primary manifestation of hypertension, insomnia, adiposity, podagra, toxic poisoning.

Contraindications: benign and malignant tumour, inclination to hemorrhage, hypertensive disease of II stage, thyrotoxicosis.

 

Rubbing wet is general rubbing done by patient himself or a nurse, rubbing separate parts of the body in definite order. Mechanism of action: treatment influences the patient in refreshing or restorative way. Action features: restorative, training, increases specific resistance of the body.

Indications: defatigation, neurasthenia, asthenic states, body training, hypometabolism, interictal period of rheumatism.

Contraindications: general to hydropathic treatments.

 

Dousing. It is accepted to use general and local dousing. Mechanism of action: water effect on  undressed patient or separate parts of his body is stimulating and restorative. Action features: stimulating, restorative, training, increases nonspecific body resistance.

Indications: dousing of upper and lower extremities in case of excessive sweating, vasomotor disorders, varicose veins, asthmatic attack, of back in case of neurasthenic states.

Contraindications: general to hydropathic treatments.

 

Therapeutic showers are hydropathic treatments by which body is influenced by water in the form of stream of particular temperature and pressure. Mechanism of action: mechanical irritation of receptor apparatus of coverlets. Action features: mainly reflex mechanisms owing to mechanical, thermal and psychoemotional factors; effects depending on methods and types of showers. Kinds of showers – raining douche, needle-shower, circular, fan, Charcot’s (stream), contrast douche.

Indications: functional disturbance of nervous system – hyposthenic form of neurasthenia, asthenic depression, essential arterial hypotension, adiposity, hemorrhoid, neuralgia, myositis, traumatic joint injury, contractures.

Contraindications: general to hydropathic treatments.

 

Therapeutic baths. There are hyperthermic effects in mechanism of bath action followed by body cooling, which stimulate thermoregulating receptors, promote decrease of body weigh, blood pressure level, and lead to coronary vasodilating activity, relaxation of muscles of respiration, increase of vital lung capacity and improvement of alveolar gas exchange.Sauna(dry air Finnish bath) is a medical and preventive treatment that is characterized by influence of air high temperature and low relative humidity. Action features: thermoregulating, adaptogenic, anti-inflammatory, broncholytic, vascular, stimulation of metabolic processes, antistress, sedative.

 

Table 3.2.2. Parameters of different baths types

 

Baths type	Air temperature	Humidity	Principles
Dry air Finnish bath	Up to 90-100 °C	10- 15 %	One should take shower with soap and wipe the body dry before going to sauna. Treatment consists in cyclic being in heat-chamber – 5-10 min followed by body cooling ( shower at a temperature of 33- 28°C, swimming-pool at a temperature 33-30 °C) during 3-5 min accompanied by 15-20 min of relaxation. Altogether there are 1-3 cycles. During the rest it is recommended to drink fluid – mineral water ( like Luzhanska, Poliana Kupil) or have tea. One shouldn’t soap or stay outside for a long time after having sauna, rest-time is 40-60 min. Periodicity is 2-3 times a week, 8-12 seances - a course.
Russian bath	Up to 60-70 °C	90-100%	It is recommended to visit sweating-room 2-3 times, visit duration is 5-10 min; during the breaks – cooling at shower (temperature 33-28 °C) and 10-15 min of relaxation. At normal adaptation of patients it is possible to apply hydrokinesitherapy.
Turkish dry air bath	Up to 70 and 90 °C	10-15%	Treatment cycles include successional being in heat-chamber 70 °C, and then 90°C or their alternate. The cycles are similar to the above mentioned.
Japanese water bath	40 or 50°C		1-3 persons are put in large tubs with water, exposition is 5-15 min, and then 10-15 min of air cooling, 2-3 seances. Treatment is carried out twice a week; there are 10-12 treatments a course.

 

Russian bath –rooms specially equipped for carrying out of sanitary, preventive and therapeutic actions. Action features: improvemet of dermal respiration, thermoregulation, lung ventilation, central and peripheral circulation, metabolism.

Turkish dry air bath (hamam). Action features: thermoregulating, adaptogenic, anti-inflammatory, broncholytic, vascular, stimulation of metabolic processes; it is noted the presence of two heat-chambers.

Japanese water bath (ofuro). Action features: thermoregulating, adaptogenic, anti-inflammatory, broncholytic, vascular, stimulation of metabolic processes.

Indications: nonspecific upper airway infections, inactive form of chronic rheumatism, disturbance of peripheral circulation, hypertension, adiposity, hepatitis, exudative diathesis, diseases of locomotor system.

Contraindications: malignant tumours; epilepsy; acute phase of inflammatory processes; all levels of decompensate cardiac failure, heart disease with angina decubitus; endocarditis; arterial hypertension with renal irritation.

BATHS

General baths by Walinski is a treatment by which they set a patient into bath at water temperature of 36 - 37°C and add little by little hot water up to temperature of 40-42°C. Mechanism of action: treatment is superpotent thermic irritant as a result of this it causes expressed physiologic changes in organism. Action features: anti-inflammatory in subacute and chronic phases of inflammation, by torpid passing; stmulative of metabolic processes, sudorific.

Indications: neuropathy, chronic rheumatism, Bechterew's disease, adiposity, upper airway infections, bronchial asthma, chronic diseases of female breeding organs, chronic prostatitis, urine acid diathesis.

Contraindications: cardiovascular disease, kidney disease, drastic nervous break-down.

Baths by Gauff are local water baths with the temperature that rises gradually. Mechanism of action: small peripheral vessels, that lie deep, widen by slow rise in temperature of water in bath, microcirculation processes improve. The treatment causes large blood redistribution in organism, influences favourably heart activity and cerebral circulation. Action features: spasmolytic, improving microcirculation, stimulating metabolism processes, sudorific.

Indications: essential hypertension, diseases of cardiac muscle on the background of atherosclerosis, functional disturbance of cardiovascular system, urine acid diathesis, cerebral circulation disturbance, insomnia.

Contraindications: general to hydrotherapy.

General contrast bath. Two neighboring swimming-pools of small size with different water temperature are used for general contrast baths. Mechanism of action: contrast baths by attenuated method with water temperature difference of 5 °C influence blood circulation in a similar way as fresh warm baths. By temperature difference of 10 °C baths promote decrease of peripheric resistance due to decrease of vascular tone of non-crushing type that determines compensatory increase of systolic and minute volume. Action features: having tonic-training effects, stimulation of metabolic processes.

Indications: functional disturbance of nervous and cardiovascular systems, essential arterial hypotension, myocardiodystonia with circulatory inefficiency not higher that 1 st., simpatico-adrenalovicrysydiencephal character with neurotic reactions, adiposity of the 1^st-3^rd degree by assident arterial hypertension of 1^st-2^nd stage, after athletic overexertion and mental strain, for body training.

Contraindications: general to hydrotherapy; adiposity of the 4^th degree; chronic adnexitis, prostatitis in subacute phase; diseases of locomotor system and peripheral nervous system in acute condition.

Local contrast bath. One or two small baths are used for the treatment. The first one is filled with hot water and the second – with cold one. Mechanism of action: local and reflex. Action features: training, trophic, vascular, sedative.

Indications: varicose veins, crus ulcer, dermal diseases, dying down and hyperhidrosis of extremities, insomnia.

Contraindications: general to hydrotherapy; kidney diseases.

Underwater shower-massage is a treatment during which a patient is massaged by sheet of water from special device directed at patient’s body under water. Mechanism of action: thermal and mechanical irritations cause dermahemia that is determined by a great blood redistribution; blood circulation and lymphokinesia, microcirculation processes, lymphotrophy improve; tissue metabolism is stimulated and resolution of inflammation source is accelerated. Action features: spasmolytic, myorelaxing, stimulating metabolic processes, improving blood circulation and lymphotrophy, absorbing.

Indications: postoperative intervention diseases and orthopedic trauma (spine, joints, muscles, tendons), disturbance and diseases of peripheral nervous system, final poliomyelitis, sluggish wounds, varicose ulcers (in the absence of trombophlebitis), pathologic climax ( in the stage of peripheral circulation compensation), disturbance of metabolism of fats, spinal osteochondrosis.

Contraindications to hydrotherapy: coronary heart disease of all functional classes, that are shown by stenocardia, rhythm disturbance, circulatory inefficiency; essential hypertension of 2^nd and 3^rd stages.

Fresh bath is a treatment by which patient is set in bath with tap water. Mechanism of action: thermal and hydrostatic factors stimulate non-specific effect on the organism. Action features: different effect depending on temperature of water – spasmolytic or restorative effect on vasculature, sedative or stimulating effect on central nervous system, stimulation of metabolic processes.

Indications: 10 -15 min - restorative effect on cardiovascular system, central nervous system; 15 – 25 min – calming effect – all states that are accompanied with irritation.

Contraindications: general to hydrotherapy.

Vibrating bath is an effect on the organism of general or local bath and vibration of water waves directed at definite part of the body of patient. Mechanism of action: effects on patient’s organism of stable mechanical, thermal, hydrostatic irritants determine neurohumoral regulations which are passing with the assistance of hypothalamo-pituitary-adrenal axis. Action features: integration of mechanical factor with thermal and hydrostatic, in the result of it resolving, neurohumoral, anti-inflammatory, restorative actions are shown and developed.

Indications: diseases of respiratory apparatus (bronchial asthma, chronic pneumonia), diseases of digestive apparatus (chronic gastritis, gall-bladder dyskinesia, chronic cholecystitis, dyskinetic constipation), arthropathy, neuropathy (osteochondrosis of cervical vertebra and sacral vertebra), diseases of female genital sphere.

Contraindications: general to phisiobalneotherapy, greatly expressed atherosclerosis, stenocardia with frequent attacks, expressed dysfunction of endocrine system, neurosis, trombophlebitis.

Vortical bath is a treatment by which thermal and hydrostatic irritants of water are intensified by its monotonous movements in the bath – turbulence. Mechanism of action: single vertical bath influences geodynamics, increases tone of dermal veins. Course treatment normalizes microcirculation dermal processes, decrease of increased index level of sympatico adrenal system and serotonin. Action features: integration of mechanical factor in the form of vortical sheet of water with thermal and hydrostatic bath effects; vascular, anti-inflammatory, analgesic, stimulating, resolving actions.

Indications: diseases of respiratory apparatus (bronchial asthma, chronic pneumonia), diseases of digestive apparatus (chronic gastritis, gall-bladder dyskinesia, chronic cholecystitis, dyskinetic constipation), arthropathy, neuropathy (vegetative polyneuropathy).

Contraindications: general to phisiobalneotherapy, expressed atherosclerosis, stenocardia with frequent attacks, dysfunctional disturbance of endocrine system, neurosis, trombophlebitis.

Mustard bath is a treatment by which patient is effected by thermal factor of water and aromatic substance – mustard. Mechanism of action: expressed dilatation of peripheral vessels that is shown in dermal hyperemia, one feels pleasant warmth, pulse slows down, respiration

becomes deep and infrequent, decrease of blood pressure is shown. Action features: vasodilating, spasmolytic, anti-inflammatory, analgesic, sudorific.

General indications: chronic pneumonia, bronchitis and other catarrhal diseases. Local for legs – ARD, essential hypertension with headache, neurosis, IHD, asthmatic attacks)

Contraindications: general to hydrotherapy.

Alkaline (soda) bath is a treatment by which patient is effected by thermal factor of water and sodium bicarbonate. Mechanism of action: the presence in water dissolved soda softens, fluffs up epidermis and also there is anti-inflammatory action. Action features: anti-inflammatory, desensitizing, fluffing epidermis.

Indications: dermal diseases, giperkeratoz, intertrigo, skin itch.

Contraindications: general to hydrotherapy.

Starch(sifting) bath is a treatment by which patient is effected by water temperature and dissolved starch or siftings(dunst). Mechanism of action: the presence in water dissolved starch or dunst has coating action, calms down skin itch, changes skin pH. Action features: coating, anti-inflammatory, antipruritic.

Indications: dermal diseases, pancreatic diabetes, hydradenitis.

Contraindications: general to hydrotherapy.

Manganic bath is a treatment by which patient is effected by thermal factor and dissolved in water potassium permanganat. Mechanism of action: the presence in water dissolved potassium permanganat has anti-inflammatory and bacteriostatic effect. Action features: anti-inflammatory, astringent, bacteriostatic, antifungal.

Indications: inflammatory diseases of skin and hypoderm, mycosis, moist eczema.

Contraindications: general to hydrotherapy.

Pine bath isa treatment by which patient is effected by thermal factor and dissolved pine extract. Mechanism of action: by dissolving in water pine extract there is a pleasant pine aroma in the bathroom that has positive influence on the patient via scent centre irritation, causes emotional lift, increases patient’s reactivity. Action features: sedative, hypotensive, anti-inflammatory, desensitizing, vascular.

Indications: diseases of cardiovascular system, diseases of nervous system, diseases of gastrointestinal tract, functional psychosomatic disturbance, primary hypertension.

Contraindications: general to hydrotherapy.

Sage bath isa treatment by which patient is effected by thermal factor and dissolved sage condensate. Mechanism of action: the presence in bath sage condensate has anti-inflammatory, resolving, irritating effect.

Indications: diseases of locomotor system, diseases of cardiovascular system, diseases of nervous system, diseases of female breeding organs, etc.

Contraindications: general to hydrotherapy.

Bath from nut leaves isa treatment by which patient is effected by thermal factor and tincture of nut leaves. Mechanism of action: is used as astringent, antibacterial agent for healing of wounds, eczemas, inflammatory processes, psoriasis, exudative diathesis.

Indications: inflammatory processes of female genital sphere, trophic ulcers, wounds, haemorrhoids, dermal diseases – psoriasis, eczema, exudative diathesis.

Contraindications: general to hydrotherapy.

Bath from dried lime-blossoms isa treatment by which patient is effected by thermal factor and tincture of dried lime-blossoms. Mechanism of action: inflammatory, antibacterial, sedative. Action features: influence on coverlets has anti-inflammatory, analgesic effects, inhalation of lime-blossom aroma causes sedative and broncholytic effects.

Indications: bronchitis, bronchial asthma, osteochondrosis, inflammatory processes, trophic ulcers, varicose veins.

Contraindications: general to hydrotherapy.

Lavender bath isa treatment by which patient is effected by thermal factor and lavandin oil. Mechanism of action: improves blood circulation, functioning of cardiovascular system, nervous system. Action features: anti-inflammatory, desensitizing, analgesic, sedative.

Indications: neurasthenia, vegetative-vascular dystonia, inflammatory processes, climacteric neurosis, radiculitis, osteochondrosis, varicose veins, trophic ulcers.

Contraindications: general to hydrotherapy.

Bubble bath isa treatment by which patient is effected by thermal factor and lather of aromatic soap powder with saponin. Mechanism of action: as a result of less volume of water in the bath (50l) hydrostatic pressure is absent, mechanical effect on peripheral cblood circulation is off, that’s why it is used as less loading treatment. Action features: sedative, hypotensive, desensitizing; they are more desirable with aged people, weak patients and children.

Indications: diseases of cardiovascular system, vascular diseases, neurosis, hypertension.

Contraindications: general to hydrotherapy.

Sodium chloride (chlorhydric) bath isa treatment by which patient is effected by thermal factor and dissolved in water salts. Mechanism of action: regulating effect on functional state of central nervous system, causes immunological transformation in organism, changes passing of metabolic processes, improves catch properties of venous wall, promotes improvement of blood outflow from extremities by passive venous congestion. Action features: anti-inflammatory, desensitizing, analgesic, microcirculation stimulating, antitumor, restorative effect on CNS and endocrine organs.

Indications: diseases of cardiovascular system, obliterating disease of extremity vessels, varicose veins and postthomboplebitis syndrome, diseases of locomotor system, spine, diseases of central and peripheral nervous systems, dermal diseases, chronic inflammatory processes of female genital sphere.

Contraindications: general to hydrotherapy.

Flux bath are used withcurative purpose in the regions with metal manufacture. Flux formed by cast iron production is gathered hot in granulating pit for its “extinguishing” with cold water. Sulphuric compounds tin from flux in water that pass into solution forming flux waters of expressed sulphuric reaction. Mechanism of action: thiosulfates and calcium ions are the main components of flux waters. Bisulfate ions, that improve metabolic and oxidation-reduction processes in tissues, have the dominant role in effect of flux waters on skin. Action features: anti-inflammatory, analgesic, hyposensitizating, sedative.

Indications: diseases of locomotor system (joints, muscles, tendons), affection of peripheral nervous system (radiculitis, neuritis, neuralgia, polyneuritis, plexitis), functional disorders of nervous system, diseases of cardiovascular system, metabolic diseases, dermal diseases.

Contraindications: general to hydrotherapy.

Alum bath isa treatment by which patient is effected by thermal factor and dissolved in water potassium alum. Mechanism of action: alum presence in bath has astringent and anti-inflammatory and antipruritic effect. Action features: anti-inflammatory, astringent, antipruritic.

Indications: dermal diseases, pancreatic diabetes, inflammatory diseases of female genital sphere.

Contraindications: general to hydrotherapy.

Turpentine bath isa treatment by which patient is effected by thermal factor and “white emulsion” or “yellow solution” made from turpentine. Mechanism of action: turpentine is refined terpene oil that is got from tarry liquid of pine trees and is known as substance that has antiseptic, local irritating and analgesic action. White turpentinous emulsion dilates and rhythmically narrows capillaries, increases blood pressure, improves excretory function of kidney. Yellow turpentinous solution in bath improves volume blood index, decreases venous vascular tone, has normalizing effect on indexes of serotonin, catecholamines, blood lipids. Action features: vascular, anti-inflammatory, analgesic, lipotropic, stimulating of metabolic processes.

Indications: diseases of locomotor system, diseases of cardiovascular system, diseases of nervous system, essential hypertension of the 1^st-2^nd degrees, alimentary obesity.

Contraindications: general to hydrotherapy, congestive heart failure with stenocardia phenomena, cardiac failure higher than the 1^st degree, hypertension of the 2^ndB-3^rd degrees, chronic nephritis, nephrosis, chronic hepatitis, cirrhosis.

Iodide-bromine bath isa treatment by which patient is effected by thermal factor and salts, iodide, bromine that are in water. Mechanism of action: penetration of bromine ions through undamaged skin from bath water has biological effect on organism, influence on the leading physiological systems of organism (nervous, cardiovascular, sympathoadrenal and hypophysial suprarenal). Iodide-bromine baths often cause expressed hypodynamic changes, improve capillary blood flow, normalize blood velocity and vascular tone, decrease blood pressure, normalize action of endocrine organs, arouse metabolic processes. Action features: sedative, anti-inflammatory, lipotropic, hypotensive, decreasing thyroid gland function, arousing hypophysis function.

Indications: diseases of cardiovascular system – mitral, aortal valvular disease, myocardiodystrophy, cardiosclerosis, hypertension, atherosclerosis of extremity vessels, endocrine metabolic diseases, diseases of nervous system, thyrotoxicosis, allergic dermatitis, eczema, neurodermatitis, alphos, diseases of locomotor system of inflammatory and degenerate character, inflammatory processes of female genital sphere and ovarian dysfunction, diseases of digestive apparatus (chronic gastritis, incalculary cholecystitis).

Contraindications: general to hydrotherapy.

Oxygen bath isa treatment by which patient is effected by thermal factor and oxygen that is dissolved in water. Mechanism of action: dissolved in water oxygen gets to blood, saturates organism, stimulates liquidation of oxygen debt, normalizes blood pressure, improves hemodynamics, stimulates metabolic processes. Action features: sedative, hypotensive, vascular.

Indications: hypertension, heart diseases, cardiosclerosis, endarteritis, phlebit, trombophlebitis, neurasthenia, asthenic feeling, stimulation of metabolic processes.

Contraindications: general to hydrotherapy, thyrotoxicosis with the predominance of stimulant processes, high index of general exchange, general secripitude.

Carbonic acid gas bath isa treatment by which patient is effected by thermal and hydrostatic factors and carbonic acid gas that is dissolved in water. Mechanism of action: dilate vessels of skin, cause changes in hemodynamics; intensify systole, elongate diastole, slow down heart rate, rise blood velocity and the amount of circulating blood, normalize blood pressure. Action features: vagotonic, digitalis, stimulating metabolic processes, setting up, vascular (influence on central and peripheral hemodynamics), training; is differentiated by three-phase vascular effect.

Indications: hypertension and essential arterial hypotension, diseases of cardiovascular system (heart disease, chronic myocarditis, myocardiodystrophy, heart rate disturbance), diseases of nervous system, respiratory diseases, adiposity, pancreatic diabetes, podagra, stomatological diseases, CHF of the I functional class, for patients of the 2^nd functional class without hear rate disturbances.

Contraindications: CHF of IX functional class, general to hydrotherapy.

Dry carbonic acid gas bath isa treatment by which patient is effected carbonic acid gas that is isolated from water in bath. Mechanism of action: blood circulation in muscles, brain and heart vessels improve, tone of unstrained muscles decreases, cardiac work improves, decrease blood pressure level, oxygen uptake by myocardium improves. Action features: water absence in bath does away with overwork of cardiovascular system by water level pressure and expressed thermal effect. Sedative, hypotensive, digitalis, vagotonic, vascular actions are observed.

Indications: CHF, hypertension, disturbance of peripheral blood circulation, spastic diseases of peripheral vessels, endarteritis, thropic disorders of skin because of sclerosis, trombophlebitis, pancreatic diabetes, adiposity, chronic nonspecific lung diseases.

Contraindications: chronic myocardial infarction, cardiac aneurysm, cardiac failure higher than II degree, essential hypertension of the 3^rd degree, multiple bronchiectasis, pulmonary tuberculosis.

Nitric bath isa treatment by which patient is effected by thermal and hydrostatic factors and rare nitric gas that is dissolved in water. Mechanism of action: by nitric bath effect capillary bore is narrowed, especially in venous channel; it causes affection of cardiac beats, decreases blood pressure, slows down deepening of breathing, influences calmingly nervous system, analgesic, hyposensitizating. Action features: sedative, hypotensive, anti-inflammatory, desensitizing.

Indications: essential hypertension of the 1^st-2^nd degrees, endarteritis in the primary stage, neurasthenia, diseases of peripheral nervous system, infection-allergic affection of joints, thyrotoxicosis.

Contraindications: general to hydrotherapy.

Pearl bath isa treatment by which patient is effected by thermal factor and air that is boosted by compressor under pressure 0.5 – 1.5 atm. Mechanism of action: has sedative effect on CNS. Action features: restorative, general stimulating.

Indications: heart diseases, cardiosclerosis, essential hypertension of the 1^st-2^nd degrees, functional disorders of nervous system, climacteric psychosis.

Contraindications: general to hydrotherapy.

Hydrogen sulfide (sulfide) bath isa treatment by which patient is effected by hydrostatic pressure, thermal factor and sulfides dissolved in water. Mechanism of action: normalizes corticosubcortical relations, normalizes functions of involuntary nervous system, increases abstract processes, has anti-inflammatory, resolving, trophic action. Action features: expressed vasorelaxant, desensitizing, neurohumoral, stimulating of metabolic processes, lipotropic, improving blood flow characteristics and microcirculation, anti-inflammatory. It is distinguished by three phase vascular effect.

Indications: diseases of cardiovascular system, essential hypertension of the 1^st-2^nd degrees, endarteritis, Raynaud's disease, varicose veins, diseases of locomotor apparatus, diseases of nervous system.

Contraindications: general to hydrotherapy, cerebral atherosclerosis, after recurrent myocardial infarction, chronic diseases of kidney and biliary diseases, bad tolerance to sulfide bath.

Radon bath is a method of balneotherapy with the usage of radioactive tracer of radon and its daughter products. Mechanism of action: the starter of radon bath action is its effect on cutaneous receptor, direct effect of radioactive emanation on blood, tissue architecture and functional clinical activity of protein molecules, it normalizes activity of cardiovascular system, carbohydrate metabolism, fat, nitrogenous metabolisms, intensifies oxidizing processes, increases uric acid excretion from the organism. Action features: anti-inflammatory, regenerative, analgesic, resolving, lipotropic, exchange.

Indications: diseases of cardiovascular system, diseases of locomotor apparatus (non tuberculous arthritis, chronic spondylarthritis, radiculitis, polyarthritis, chronic inflammatory processes of pelvis minor organs), diseases of digestive apparatus, diseases of endocrine system, metabolic diseases, diseases of nervous system.

Contraindications: general to hydrotherapy, pregnancy, oncological diseases, suppurative processes, tuberculosis.

Dry radon bath is a treatment by which patient is affected by air-radon mixture in bath without water. Mechanism of action: the character of organism irradiation of patient by taking “dry” radon bath differs by variety of different temperature, water mechanical factor if off. Action features: anti-inflammatory, regenerative, analgesic, lipotropic.

Indications: dermal diseases (psoriasis, eczema, neurodermatitis), joint diseases, diseases of cardiovascular system, adiposity, rheumatoid joint inflammation, systemic scleroderma.

Contraindications: general to hydrotherapy.

Mud bath isa treatment by which patient is effected by thermal, hydrostatic factors and mud dissolved in water. Action features: thermal, chemical and mechanical effects. Expressed influence thanks to organic macromolecular complexes and inorganic compounds of thin phase of mud, thermal factor eases resorption processes. Action features: expressed anti-inflammatory, analgesic, hyposensitizating effects, increase of irnmunoreaction.

Indications: joint and spine diseases, affection of peripheral nervous system, adiposity, diseases of bronchopulmonary of nonspecific aetiology.

Contraindications: general to hydrotherapy.

Nikipelova O.M., Lemko I.S., Dragomyretska N.V., Gaisak M.O.