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Spas in

Dr, Nikola Jelepov-specialist of Internal disease and Balneology, Professor in the Medical Institute for Medical Assistants-, Bulgaria

Bulgaria is famous all over the world with its resorts.Besides mountain and sea resorts, the country is dotted with hundreds of mineral hot springs, known for their curative properties since time immemorial. Now they are used both for bathing and drinking.The spas for bathing are 34, for drinking 11 and combined 19. 80% of them have temperature about 37℃, the others about 40°-50℃, and some even obtain 100℃.

Until 1944, their utilization was empirical i, e, not haled on scientific data. Now

in Sofia there is a special Research Institute on spa treatment and physical therapy

based on the famous Spa Ovcha kupel. Hcre a wide range of problems are treated:

prophylactics, therapy-rchabi-itation, mmedial gym, dieting, massage as well as studying

the climatological factors in the different spas. The Institute performs scientific appraisals, gives definite prescriptions and recommendations to the different sanatoria in the spas.

The must famous spa in Bulgaria is Hissar. It is situated adout 30 miles north from

Plovdiv City.The history of that Spa dates back to antiquity. Thousands of years ago the

Thracians, the burial mounds of whom are stil1 to be seen in the vi℃inity,lived here.

But the place flourished mostly during the Roman Empire and was considered as foremost spa and emperors resort place. During that period of time thousands of slaves built

here a powerfull fortress, the ruins of which still arise admiration. The Spa has 24 mineral

pools for swimming and combined aero hclia therapy,The waters are hypotonic/abont 200 mgr. of dissolved solid suUstance in 1 Itr of water/hyperthermal/49℃/, Radioactive/168 em/ltr/with high alkaline reaction/pH up to 9/, contains mnnv trace elements/Copper,

Manganese, Wolfram, Cobalt, Molibdenum etc./ions and other elements. The flow of the

water is above 2000 Itr/mn.

The curative properties of the Hissar mineral waters are: lithiasis/nephro and

cholclithiasis/chronic inflammation of the renal and urinary organs/pyelitis, cystitis,

urethritis/inf-ammations of the livcr and gall bladder/cholangitis, cholecvstitis chronica/

chronic parenchymatous inflammation of the kidney and liver/nephritis, hepatitis/as

well as metabolic diseases/dialxnes, gout/, stomach and intestinal diseases/chronic

gastlitis, colitis, stomach and duodenal ulcers/gynaecological diseases.

Hissar has been established as a urolological center not only for Bulgaria but also

for patients tram abroad,

The second famour spa in Bulgaria is -atown in the extreme west of

Bulgaria, near the Yougoslavian border. It has 40 mineral springs and is one of the oldest

resorts not only in Bulgaria but in the whole world.The minral water is acratothermic,

hyperthermal/73℃/Hvdro-carbonate.Sulphatc-sodium, containing fluor sihcon and a

weak concentration of hydrogen sulphide . It IS alkaline/pH8.93/and has a flow of

3000°Itr/min and gives a remarkable effect on the following diseases:the atter effects of 63 acute articular rheumatism, rheuma, arthrosis/ rheumatic arthritis, Bechterew disease, arthrosis, traumatic arthritis, conditions clue to bone fractures, diseases of the vertebra column / not TBC / myositis, bursitis, tendovaginitis, radiculoneuritis, chronic gynaecological diseases. Similar to these waters arc those of the Spa and many others in Bulgaria . At the Spas of and Pavel Banja are organized specialized sanatoria for treatment of the after effect of infantile paralysis and conditions due to bone fractures. Most promising results are obtained from the treatment of the after effects of infantile paralysis in Momin Prohocl, where a Bulgarian School has been established / bathing, remedial gymm, massage, combined with the application of Nivalin - the world famous Bulgarian drug for this purpose. In north Bulgaria is found the only famous in that region Varshetz Spa. It is situated 400m above the sea level in the north western spurs of the Balkan Range. The average annual temperature is 10.2℃.There arc 3 natural mineral springs-36.2℃ 38℃ 29℃ The latter is tapped in a fountain for drinking, The waters contain small amount of mineral salts / 200mg / It/ they are hypothermal, hydrocarbonic and sulphobiosodic. Prolonged studies of the effect of the mineral waters and the climate have shown that Varshetz successfully treats: Cardio-vascular diseses and hypertensive diseases in stage of compensation, neurosis, diseases of the peripheral nervous system, rheumatism in chronic stadium, infectious arthritis at the stage of desensibilisation, thvreotoxicosis, menopause, the after-effects of thrombophlebitis, diabetes. Sofia is not only the capital of Bulgaria, but a Balneological center as well. It is almost the only capital in the world/together with Budapest Hungary, that has many mineral hot springs: Sofia mineral baths, Bankja, Ovcha Kupel, Gorna Banja and others, The characteristics of the mineral water are the same as Hisasr/Gorna Banja/and Varshetz,/Ovcha Kupel, Bankja/. Every trade union in Bulgaria / everybody is a member of an union/and the Ministry of Public Health have rest houses and sanatoria in the Spas. There are specialized sanatoria with different departments for slight mental and nervous diseases / Varshetz, Bankja, Narechen, Sofia etc / for cardio vascular diseases/ Bankja, Varshetz/ for gastro-intestinal diseases / Hissar, Gorna Ban ja/ for diseases of the kidneys/ Hissar, Gorna Ban ja/ for rheumatic diseases/ Kyustendil, Hissar Velungrad etc/. The Sanatoria function throughout the year and are supplied with equipment for physical therapy, remedial gym. massage etc. , varied dietetic food is prepared. For those who are not members of the union there are enough beds in the private houses and the polyclinic of the resort takes care of their medical treatment in specialized cabinets for internal, cardiovascular, nervous, gynecological diseases. They are supplied with modern apparatus for physical therapy, labolatories etc. The service of the polyclinic is free of charge. The members of trade unions pay about 25% of the board and lodging costs with a 64 government, or union subsidy paying the rest. Waters for drinking purposes used in Bulgaria vary in composition, properties, purposes. They are near to the world' s famous waters as those of Vichy, Karlovy Vary etc. The slightly mineralised drinking waters of Hissar, Gorna Banja have won great reputation in Bulgaria and abroad owing to their fine taste and curative properties in kidney, liver and gastro-intestinal diseases . The natural aerated and rich in mineral salts Michalkowo Water is also in great demand and so is Merichleri / very near to that of Karlovy Vary-Checkoslovakia/The drinking mineral water is rich in iron , In Bulgaria there are also resorts where peloids are applied. Comparison with Balneology in Japan As far as the author has read in the journal of the Jap. Ass. of Ph. Med ., there are some differences in applying the halneological factors for treatment of the patients . In

Bulgaria we give not so warm haths-usually we apply them at t°from 37-38°and rarely

45-45℃,and the duration time is 5-15 min . The bath is taken only once daily, 2 baths in 2 days and the third day-rest . In 14 days the patient usually takes 10 baths, for 20 days 10-14 baths. Every patient, if sanatoria or in private house is under the control of a physician- usually he is examined 2-3 times while taking the baths: at the beginning, at the 7th- 10 th day, when the bath reaction is expected and before he leaves the Spa. The special cases have everyday control. If the patient drinks the mineral water it is done according to his illness 3 times daily before or after meal, 15 min to 60 min at a quantity of 1000-300 ml. Japan and Bulgaria are very rich in mineral hot springs with old tradition in Balneology and it will be very useful for the specialists of both countries to exchange more often information and friendly contact among.