Aerotherapy

AEROTHERAPY (from the Greek aer—air and therapeia—treatment), the use of air for therapeutic and prophylactic purposes. Among other methods of treatment using natural forces, aerotherapy constitutes a part of meteorotherapy, since it utilizes the properties of open, clean air, whereas meteorotherapy relies on all meteorological phenomena. The connection between aerotherapy and climatotherapy is expressed in the use of aeraria at southern seaside resorts, air treatment in sanatoriums, and the widespread hygienic use of air in physical culture. For aerotherapy, clean air is necessary, with constant exchange, moderately humid, without sharp temperature and barometric fluctuations, and with a sufficient amount of reflected, diffused light; it is best to conduct aerotherapy in the "open, free air." The air environment is highly variable, and this variability cannot be regulated; therefore, aerotherapy requires the adaptation (training) of the patient. The purity of air for aerotherapy is not practically defined by figures; optimal humidity is 70–80%, barometric pressure is close to the usual (for example, 760 mm for residents of plains), and temperature ranges are: from 6 to 14° (cold baths), from 14 to 20° (cool, moderate), from 20 to 30° (warm). The physiological effect of aerotherapy is based, mainly, on the irritating effect of air—thermal and mechanical (Reiztherapie). Air baths remove vapors and gases emitted by the skin; furthermore, the effect of cold and cool baths consists of 1) direct and reflex irritation of peripheral nerves, 2) constriction and reactive dilation of vessels, 3) direct and reflex toning of nervous, muscular (and possibly glandular) tissue, 4) increasing and deepening of respiratory movements, 5) exercising and improving the work of thermoregulatory devices, and 6) increasing the basal metabolic rate. Particularly noteworthy is the influence on the work of the cardiovascular system and on the composition of the blood: a) due to the direct effect on vasomotor nerves and the reflex effect on the heart muscle, as well as due to the activity of skin capillaries, aerotherapy provides strong gymnastics for the organs of circulation, and this gymnastics in the correct dose strengthens them, but in excess can cause harm; b) the composition of the blood changes during long-term treatment of certain diseases (chlorosis, etc.) from a course of air baths as follows: hemoglobin increases by approximately 20%, the number of erythrocytes increases by 5%, and leukocytes by 21%. The technique of aerotherapy is simple: full or the greatest possible exposure of the entire body, a convenient place with protection from direct sunlight and sharp wind, and well-organized movements, activities, or games as an important auxiliary method for the majority of patients. Diverse forms of aerotherapy are illustrated by the following examples: 1) an extensive wooden terrace, open to the south and glazed on other sides, at a tuberculosis sanatorium in the central belt of the USSR; patients lie on this terrace in any weather for specific hours, if necessary in warm fur bags (Liegekur); 2) an aerarium at a children's seaside bone-tuberculosis sanatorium—a stone terrace completely open on the southern side; children (bedridden patients) use it in bad weather in summer or around the clock in transitional months (November, December); 3) the English system of treatment in the open air in special light-type dwellings; 4) constant walks, games, and activities for tuberculous and pre-tuberculous children in a park at a forest school, in only shorts or light undershirts all summer and in ordinary clothing in winter; 5) constant stay in the open air ("constant aeration") in the lightest clothing, either in the open or in semi-open canvas tents in sanatorium camps (see). Treatment and hardening on open grounds at physiotherapy sanatoriums in connection with physical exercises. As a preparatory method, aerotherapy is used in Rollier's sanatoriums (Leysin) before prescribing a course of heliotherapy (see). The duration of one air bath is from 15 minutes to 2–3 hours or more. The minimum duration of a course is 1½–2 months. The time of day is in accordance with the general regimen (best of all from 10 o'clock in the morning to 5 o'clock in the afternoon). Sometimes, after air baths, water procedures are prescribed; often aerotherapy is combined with heliotherapy. Indications for aerotherapy: pulmonary tuberculosis (in certain forms), glandular and bone tuberculosis, catarrhs of the upper respiratory tract, anemia, functional diseases of the nervous and cardiovascular systems, and conditions in which it is necessary to raise a lowered metabolic rate and weakened tone of the organism (for example, convalescents). In all these diseases, aerotherapy sometimes takes first place among therapeutic procedures, and sometimes serves only as an auxiliary method. Especially serious importance is attached to aerotherapy in sanatoriums for pulmonary tuberculosis. A practical physician often has to regulate the use of clean air in abundant quantities for patients, and here he moves to the prophylactic prescription of aerotherapy. Prophylaxis makes wide use of the properties of clean air in the norms of school hygiene and in the rules of physical culture. In the latter case, it is a matter of so-called hardening (see), where aerotherapy is included along with the use of water and sun. On the agenda is the question of the precise study of the therapeutic and prophylactic effect of air in the conditions of district medical activity.