Matsesta

MATSESTA is located 11¹/₂ km southeast of Sochi and 3¹/₂ km from the shore of the Black Sea in the valley of the mountain river Matsesta, surrounded by forested mountains. The springs appear on the earth's surface at a distance of 150 m from the left bank of the Matsesta River, rising 28 m above sea level. The mountain rocks at the spring outlet consist of strong grayish-brown limestone and greenish, rather soft marl. The springs are of volcanic (tectonic) origin (Ogilvy). The formation of hydrogen sulfide also involves microbiological processes (Microspira aestuarii and others) (Ushinsky, Fanaeva-Kester). The climate of Matsesta is maritime, warm, humid; the average annual temperature is about +15°. Atmospheric pressure ranges from 751.4 to 757.7 mm at 0°, averaging 755.2 mm. History. The first references to Matsesta springs are found in the descriptions of English traveler Bell (1837). In Russian literature, the Matsesta springs were first described in 1870 by Vereshchagin. Chemical analyses of the Matsesta springs were carried out by Struve (1886), Zalessky (1897), Fomin (1898) and Karstens (1927). The springs were captured in 1910 (Mikhailov). The local population had used the springs since ancient times in a primitive way, bathing in pits dug in the soil along the course of mineral water or in caves. The beginning of the development of M. as a resort dates back to 1912, when a small bathhouse and hotel were built near the springs (since 1924, clinical sanatorium No. 5). Its further rapid development is owed to Dr. Podgursky, who widely publicized its healing properties and organized the study of the Matsesta springs. Scientific and clinical study of M. began in 1912 (Podgursky, Pravdin, Slovtsov and others). The development of the resort proceeded in two ways. The settlement at the spring outlet is called Old Matsesta. In 1914, a new bathhouse was built 3 km from M. and near the sea shore, on the Sukhumi highway (New Matsesta). The wide development of the resort (in terms of construction and organization) began under Soviet power after it was included among resorts of national importance (in the union 'Sochi-Matsesta'). In New Matsesta, new sanatoriums were built and bathhouses were expanded. In recent years, a major reconstruction of the resort has been carried out: a direct highway connecting Sochi with M. and the Sochi-Matsesta seaside promenade have been created. A new bathhouse (with 50 cabins) is being built in Old Matsesta. In the bathhouse in Old Matsesta there are 26 baths, in New Matsesta - 98 baths, cabins for inhalations, rooms for gynecological procedures and for mineral enemas. The capacity of the bathhouses is up to 6,000-7,000 baths per day (in the entire year 1912, 1,000 baths were administered). For outpatients, there is a well-equipped polyclinic with offices in all specialties, as well as physiotherapy and electrocardiography offices. The attendance of the resort for the season is 44,000 people. The resort operates year-round. The course of treatment is 4-6-8 weeks; on average, patients receive 12-18 baths. The housing fund in Old Matsesta is insignificant - 1 sanatorium with 80 beds, but most sanatoriums and departmental rest houses are located in Sochi, in the mountainous area (Frunze district), and in New Matsesta, where in 1929 two sanatoriums of Kurupra were built according to the latest technology. Kurupra has 11 sanatoriums with 1,770 beds under its management; departmental sanatoriums and rest houses - 27 with 2,200 beds. Most outpatients live in Sochi and in Khosta. Communication between New and Old Matsesta with Sochi is by railway and bus. At 2 km in a straight line from the Matsesta springs and 1.2 km from the sea in the valley of the Agura River, there are Agura springs, which are very similar in composition to the Matsesta springs. The Agura springs have been studied by Ogilvy and Karstens, but are not exploited. Chemical composition and properties of Matsesta springs. The water of Matsesta springs is transparent, greenish in color, strongly salty, slightly bitter in taste, with a sharp smell of hydrogen sulfide. Matsesta springs are warm, strongly hydrogen sulfide, saline waters (Tables 1-3; analyses carried out by Karstens in 1927); the water temperature ranges from 21° to 27°. In terms of hydrogen sulfide content, Matsesta springs occupy one of the first places in the world, yielding only to Talgin springs in the USSR. The mineralization of the water, like the hydrogen sulfide content, varies in different springs and wells: mineralization ranges from 8 g to 12.5 g per 1 liter, hydrogen sulfide from 60 mg to 250 mg per 1 liter, which depends on the degree of dilution with fresh water. The water from spring No. 6 and well No. 60 has the most constant composition. With the help of a special distributor, it is possible to obtain baths with a relatively constant hydrogen sulfide content within 150-170 mg per 1 liter. There are 8 natural outlets. Of the wells (drilled by Ogilvy), 4 are in operation (Nos. 2, 3, 4, 7). The total flow is 1,000,000 liters per day (varies depending on the amount of atmospheric precipitation, reaching a maximum in spring months and a minimum in autumn months). Physiological action. Matsesta waters are used mainly externally for general and local baths, douches, inhalations, enemas and compresses. The action of Matsesta baths is similar to many other balneological procedures to therapy by irritation (Reiztherapie). The essence of this phenomenon, according to Ettinger and Rabinovich, who used Lewis' methodology for analyzing this reaction, is that under the influence of hydrogen sulfide (the main physiologically active principle of Matsesta springs, absorbed through the skin and through the lungs), histamine-like substances are formed in the skin as a result of its irritation. The action of these substances is twofold: 1) general - entering the general circulation, they act as protein therapy and 2) local - the effect of these substances on the walls of the smallest vessels of the skin (arterioles, capillaries, venules), manifested in their sharp dilation. The specific Matsesta 'skin redness' reaction of the skin and mucous membranes is sharply limited by the so-called demarcation line at the points of contact with water and is observed even in cool baths at 21°; it is caused mainly by the action of the mentioned histamine-like substances. The redness reaction consists of at least two sequential processes: 1) active dilation of capillaries, not associated with any nervous mechanisms, and 2) reflex dilation of peripheral arteries, the first process giving the demarcation line prevailing sharply in humans or rather, under ordinary conditions, being the only visible part of the reaction. The redness reaction is observed with a hydrogen sulfide content of at least 60 mg per 1 liter and is sharply expressed with a hydrogen sulfide content of 150-170 mg per 1 liter. The redness reaction appears 1-2 minutes after immersion in the bath and remains in the form of spots on different areas of the skin for 3-4 minutes after the bath. In different individuals, it is expressed to varying degrees. Matsesta baths most favorably affect all kinds of chronic inflammatory processes, as well as diseases of the cardiovascular system, disorders of general metabolism and skin lesions.

The mechanism of action on the cardiovascular system is as follows: dilation of the skin capillaries and precapillaries (subpapillary system) with acceleration of blood flow in them (while simultaneously narrowing the capillaries of the internal organs innervated by the splanchnic nerves), improvement of venous circulation, slowing of the pulse (by 10-15 beats), lowering of systolic and diastolic blood pressure (in most cases) by 5-10 mm Hg, in essential hypertensives by 30-40 mm (vagal action), slowing and deepening of breathing, which also contributes to the improvement of venous circulation (Valuedinsky); simultaneously, the blood supply to the heart muscle is increased and improved (the result of all this is the lengthening of the diastolic phase of cardiac activity) and metabolism in it. When taken orally, Matsesta water acts as a mild irritant to the secretory-motor functions of the gastrointestinal tract; internal use of the waters is limited and in its action it is inferior to other sources (Essentuki, etc.). Indications. Matsesta sources are mainly indicated in the following cases. 1) Patients with degenerative changes in the heart muscle and the conductive neuromuscular apparatus, with valvular defects of various origins, with regular or disturbed rhythm (except for atrial fibrillation) in the stage of subcompensation. 2) Initial forms of general and localized arteriosclerosis, mild forms of angina pectoris, essential hypertension (without kidney damage), obliterative endarteritis without gangrenous phenomena, chronic phlebitis and thrombophlebitis. Treatment is mainly indicated for cardiovascular diseases, mainly with heart muscle disease of the cardiosclerosis type (Valuedinsky and Kabakov), combined with metabolic disorders (gout, obesity), with diseases of the motor organs, female and nervous diseases, which due to damage to the cardiovascular system cannot be sent to other resorts (mud, etc.). 3) Chronic arthropathies, myositis (of various origins), periostitis, osteitis, unstable contractures of various origins (except central), fibrous ankyloses, osteomyelitis with recurrent fistulas after surgical intervention, residues of inflammatory processes of the abdominal cavity as a result of infections, injuries, as well as after operations. 4) Chronic female diseases (of the genital organs, peritoneum and pelvic cellular tissue). 5) Chronic nervous diseases: radiculitis, plexitis, neuralgia, neuritis, polyneuritis (without damage to the vagus nerve) of various origins; syphilis of the nervous system of equal forms; non-luetic encephalitis (except epidemic).- From other diseases, the following are indicated: 1) skin diseases: seborrheic eczema, chronic eczema, psoriasis, atrophic and professional dermatitis, skin itching, pruritus, etc.; 2) chronic catarrhs of the nose and throat in combination with cardiovascular diseases; 3) professional poisonings with lead, mercury, etc., especially in combination with cardiovascular diseases. Contraindications: acute and iodine-acute inflammatory processes of the heart, blood vessels, female organs (due to the sharply exacerbating effect of Matsesta baths); endocarditis and acute articular rheumatism, etc.; severe manifestations of decompensation of the cardiovascular system, aneurysms, angina pectoris in the presence of signs of heart failure and increased excitability of the nervous system, hypertension with signs of nephrosclerosis and pronounced cardiac weakness; increased nervous excitability; tuberculosis of various organs; completed atrophic degenerative processes: complete bony ankylosis, muscle atrophies, spondylosis in a developed form; neoplasms of the female organs, subacute processes and chronic suppurations in the small pelvis; organic diseases of the nervous system with persistent manifestations, compression myelitis on the basis of tuberculous spondylitis; furunculosis and all pyodermic skin diseases.