Carbonic acid bath

Carbonic acid baths are a form of balneotherapy treatment and describe baths whose carbonic acid source has a carbon dioxide content of at least one gram per kilogram of water. The carbonic acid source used therapeutically can be of natural or artificial origin. The bath additives used for balneotherapy are often referred to as carbonic acid baths themselves.

The process is not fully scientifically recognized.

Natural carbon dioxide baths

In Germany there are many natural springs, some of which are cold and some of which are warm, which have a high carbon dioxide content for carbon dioxide baths : Bad Ems , Bad Nauheim , Bad Salzuflen , Bad Wildungen , Bad Pyrmont and the like. a.

Historically, for example, Friedrich Wilhelm Beneke became Bad Nauheim's first well doctor in 1857, who published the first paper on the treatment of heart disease with carbonated brine baths.

Artificial carbon dioxide baths

Artificial carbon dioxide baths can be prepared in two different ways, either mechanically or chemically.

The mechanical preparation takes place by saturating water with gaseous carbonic acid from a steel bottle under an overpressure of about three bar in a so-called impregnation apparatus (impregnation process). The cold water impregnated in this way is then added to the warm bath water in the appropriate amount, and the full bath is adjusted to the usage temperature with hot water at the end.

It is easier to create carbon dioxide baths by mixing chemicals that are added to the bath water. Only sodium hydrogen carbonate is used as the carbonic acid-supplying preparation (carbonic acid carrier) . This sets by adding a weak acid or an acidic salt such. B. aluminum sulfate (carbonic acid generator) releases the corresponding amount of carbonic acid.

Carbon dioxide dry bath / gas bath

The carbonic acid dry bath, also known as a carbon dioxide gas bath, can be carried out as a partial or full bath.

For partial baths, an electrically heated box with a hole with an elastic sleeve is used; for full baths, appropriate seating cubicles or special tubs are used. The seating cabins contain a chair and the special tubs are equipped with loungers. Carbon dioxide is introduced for treatment, which causes the temperature to drop sharply. This is why constant post-heating is required to maintain the treatment temperature. This leads to the formation of the skin moisture required for the absorption of the gas.

Indications

The carbon dioxide baths approved as medicinal products in Germany have the following indications:

• For supportive treatment in mild forms of high blood pressure (arterial hypertension) and
• for supportive treatment in mild forms of peripheral circulatory disorders in the arms and legs

The following indications are generally considered to be certain:

• Mild arterial hypertension (stage 1 WHO)
• Peripheral arterial occlusive diseases up to stage II
• Functional arterial circulatory disorders
• Microcirculation disorders of the skin
• Neurovegetative and psychosomatic cardiac and circulatory problems
• Venous circulatory disorders

In addition, the following medical indications can be found:

• Arterial hypertension (stage 2 WHO)
• Peripheral arterial disease at any stage
• Trophic ulcers of the skin, venous ulcers
• Chronic venous insufficiency
• Supportive treatment for inflammatory and non-inflammatory rheumatic diseases in the subacute and chronic stage

Effects

Due to the assumed effect of carbon dioxide on skin receptors, the sensitivity to itching and pain should decrease in the carbonic acid bath. Therefore, carbonic acid baths should be used in some diseases such as B. Ulcus and gangrene relieve pain and often have a calming effect on the nerves.

The positive influence of peripheral vasodilation on poorly healing wounds will also continue to be discussed and investigated.

For use in ischemia , it has been shown that treatment with carbonic acid baths induces VEGF synthesis, which leads to the formation of new blood vessels from endothelial progenitor cells .

A possible positive influence of carbon dioxide baths on the performance of athletes was also examined. Differences between a treated and an untreated group of swimmers could be shown. However, it is still unclear to what extent a possible benefit could result from these differences.

By influencing the thermal receptors, carbon dioxide inhibits the sensitivity of the cold receptors and stimulates the warm receptors, so that carbonic acid baths are felt to be around 2 ° C warmer than they actually are. The indifference temperature is lower than in tap water baths without triggering the temperature counter-regulation. Therefore, carbonic acid baths can also be used at lower temperatures of up to approx. 31 ° C without feeling cold.

Instructions for use and contraindications

The patient should not move much in the bath water in order to keep the separation of the aqueous solution of carbon dioxide as low as possible.

The patient's head should always be held above the edge of the bathtub so that the gas above the water level cannot be inhaled. Particular care is required with children.

After the bath, the body should be showered and a rest period of at least 30 minutes should be observed. The bath room should be sufficiently ventilated after each carbon dioxide bath.

Contraindications that are generally indicated for full baths include febrile illnesses and infections, heart failure (stage III and IV, NYHA ), high-grade coronary insufficiency and high blood pressure (stage IV, WHO). On the other hand, the carbonic acid bath is especially contraindicated in the case of respiratory insufficiency , weeping, widespread eczema , recent heart attacks and dry gangrene .

literature

• Josef Kowarschik: Physical Therapy , Springer Verlag, Vienna 1957
• Helmut G. Pratzel, Wolfgang Schnizer: Handbook of Medical Baths , Karl F. Haug Verlag GmbH & Co., Heidelberg 1992, ISBN 3-7760-1228-5
• Otto Gillert, Walther Rulffs: Hydrotherapy and Balneotherapy , Pflaum Verlag, Munich 1990, ISBN 3-7905-0586-2
• JH Kaiser: Kneipp hydrotherapy - general and special balneotherapy , Sanitas Verlag, Bad Wörishofen 1968

Individual evidence

1. ^ ABDA database, accessed March 20, 2015
2. ↑ C. u. U. Brüderlin: The physical therapy a guide for doctors and users , Verlag Jungjohann, Neckarsulm 1985
3. ↑ M. Finžgar, Z. Melik, K. Cankar: Effect of transcutaneous application of gaseous carbon dioxide on cutaneous microcirculation , Clin Hemorheol Microcirc. 2014 Sep 26.
4. ↑ H. Irie, T. Tatsumi, M. Takamiya, K. Zen, T. Takahashi, A. Azuma, K. Tateishi, T. Nomura, H. Hayashi, N. Nakajima, M. Okigaki, H. Matsubara: Carbon dioxide-rich water bathing enhances collateral blood flow in ischemic hindlimb via mobilization of endothelial progenitor cells and activation of NO-cGMP system , Circulation. 2005 Mar 29; 111 (12): 1523-9.
5. ↑ T. Akamine, N. Taguchi: Effects of an artificially carbonated bath on athletic warm-up , J Hum Ergol (Tokyo). 1998 Dec; 27 (1-2): 22-9.

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