Reference:  

1)      Groven MD, Pizzorno JE, Murray MT. Textbook of Natural Medicine, Churchill Livingstone
Second Edition 1999, Volume 1; 45: 381-387

Peat therapeutics and balneotherapy

                Mark D. Groven, ND

Skin response

The skin is a reflex, metabolic and immune organ. It affects the autonomic, immune and cirulatory sytems and participates in the biosynthesis of not only vitamin D, but acetylcholine, histamine, and serotonin as well. 2,4,10,15   With baths, significantly higher concentrations of minerals and medicaments can be reached in the epidermis than with systemic flooding via the vascular system.

                The primary effects of bath components take place within the skin.  For instance hydrogen sulfide acts as a radical trap for oxygen radicals. This functions to reduce inflammation. It is thought that the action comes from the effect of sulfur on the Langerhans cells which play a role in immune presentation and inflammation modulation. In this way, skin responses can act as transmitter activating helping functions.  Sulfur-containing peat baths show a pain-reducing and healing effect on rheumatic and degenerative disease. One reason may be because of the reduction in Langerhans cell activity which results from the combination of the components within peat and thermal radiation. 7,15,20,24

PEAT THERAPEUTICS

History

Peat is a substance that has been used as a medicinal preparation in baths and peloid packs extensively in Europe for the past 200 years. This unique substance contains many chemical constituents which can interact with organic and inorganic compounds. The scientific basis for the physical, chemical and pharmacological effects of peat baths has been long known and used extensively in balneotherapeutic applications in Europe and other parts of the world to treat rheumatic diseases, gynecological disorders, osteoarthritis, lumbago, sciatica, skin diseases, trauma and its sequelae and many other ailments and afflictions. The many substances in peat offer a vast possibility of medicinal cure applications.6,8-11,17,18,20,23-26,29,31-35

                It is important to consider the region and origin of the peat being used for medicinal purposes. Low moor peat has been shown to contain higher concentrations of nitrous substances, which are thought to contain a higher content of biologically active substances than the high moor peats or peats taken from a shallower depth. It is not just high nitrous content that makes a certain peat more medically useful, b t the quality, type and amount of the biologically active substances it contains that is the determining factor on medicinal effect. In Germany these types of peats are now a national resource. 15,16

Physiological effects

Peat has a structure containing micropores, which accounts for its sponge-like water carrying capacity and its ability to maintain either hot or cold temperatures. When applied, peat produces a gradient rise or fall in temperature which is especially desirable in a therapeutic bath. A peat bath influences the neuromuscular, endocrinological, blood in pulmonary and kidney hemodynamics depending on the consistency volume, partial or full bath. 4,10

                Peat has well documented effects such as tissue dilation, increase in stroke volume and metabolism and immunological stimulation. Peat bath may be preferable to water bath if one considers the gradient rise and fall of temperature, increased buoyancy and prevention of heat loss during a bath and the possible positive chemical and pharmacological effects of the constituents of peat. 1-4,6,8,15,19,21,25,26,32,33

                Peat substances are able to permeate the skin. Their absorption and action has been documented by the comparison of placebo, water, and pat bath using Doppler ultrasound measurement. One study which measured circulation in the uterine artery after bath therapy showed that only the peat bath achieves the physiological effect of prolonged vasodilation and circulation. This effect lasts several hours after the treatment and is only achieved with the peat bath. It is thought that absorption of peat substances takes place through the hair follicles and apocrine glands by diffusion and partial pinocytosis.10

                The functions of peat in medicinal applications are antimicrobial, antiviral, anti-inflammatory, and anti-neoplastic, to name a few.6,9-11,21  Many biochemical effects have been demonstrated in humans and animals. These include elevation of protein synthesis, estrogen stimulation, reduction of arachidonic acid, and inhibition of inflammatory mediators such as leukotrienes, prostaglandins, and thromboxane. Biological activity is ascribed to peat ingredients such as sulfur compounds, magnesium, manganese, iron and humic acids. 6,7,10,11,16,20,26,33

CLINICAL APPLICATIONS

Peat has many beneficial applications.

Human papilloma virus

Antiviral effects of peat have been demonstrated on several viruses, including the human papilloma virus. Remission and prevention of implantation of the virus has been described. This is a measure which prevents cancer. The antiviral and antineoplastic effects are thought to be associated with the ability of peat constituents such as humate to bind on lectin binding junctions blocking viral entry into cells.9,10

Infertility

A study on infertility due to immature follicle maturation syndrome demonstrated good results with peat therapy in comparison to the group receiving pharmacotherapy. In the peat therapy group, the rate of pregnancy was very good, along with a practically non-existent spontaneous abortion rate, while in the pharmaceutical group the rate of spontaneous abortions was very high. 36 

Ankylosing spondylitis

In the treatment of ankylosing spondylitis, peat therapy has shown a decrease in the level of C-reactive protein and an elevation of hemoglobin with a series of treatments. This coincided with a significant decrease in pain and an increase in function. 26,28

Hematoma

Organic peat with its intense vasodilating and anti-inflammatory effects, and interactions of its ions and mineral properties, including free iron not transported by macrophages, is an efficient therapy for the treatment of hematomas. Hematomas treated with thermal peat application were resolved 50% faster, with no hemosiderin residue, as compared with treatment with only heat applications which often left residues.23

Immune stimulation

Peat bath in combination with hyperthermia shows leukocyte elevation. The immune-stimulating effects of peat bath seen clinically correspond to hematological changes after baths.33    

PROCEDURE

The following procedures should be applied with care and forethought as to diagnosis and the skillful administration of the treatment. These procedures are stimulations to the body and the thermal effects should not be taken lightly. Patients must be thoroughly screened for contraindications to treatment before doing full-body immersion hyperthermia.

Hyperthermic medicinal peat bath

The indications and contraindications of the procedure are given in Table 45.1

Materials

·         Peat bath material – the author uses Dr. Schirmer’s formula

·         Tub with water thermometer and safety features like handrails and non-slip floor mats

·         Room with table for perspiration time

·         Gown or loose-fitting bating suit

·         Two sheets

·         Three wool blankets

·         Two large towels (one for patient to dry off after treatment and one for head wrap)

·         Basin with ice water and a face cloth

·         Basin with ice water and a face cloth

·         Digital thermometer or otothermometer for patient monitoring (no glass mercury thermometers)

·         Exhaust fan or room air filter

·         Foot stool for entering and leaving tub

Table 45.1 Indications and contraindications for hyperthermic medicinal peat bath

The design of the bath area should take into consideration getting patients in and out of the tub and then as directly as possible to a treatment table.

Procedure

1.        Patients should be ruled out for cardiovascular risk or any other conditions which do not respond to or are aggravated by thermal therapy before treatments begin.

2.        Make sure the tank is clean without a ring. Check log book on last treatment and cleaning. If any evidence of an unclean tank is seen, it must be cleaned and disinfected before use. This is done by using rubber gloves with a scouring sponge and scrubbing tank with disinfectant soap followed by a rinse of first hot and then cold water. Follow this by spraying the surface with 10% bleach solution and wait 10 minutes before rinsing with very hot water.

3.        Fill the tank 10 inches from the top with water at a temperature of 105-113 F (41-45C).

4.        The starting temperature and possible duration of treatment are determined by the condition.

5.        Straight water bath should not exceed 110F. With peat additive do not exceed 113F.

6.        Add peat to the bath.

7.        Close monitoring during treatment by periodic recording of the patient’s pulse, oral temperature, duration of treatment and tank temperature is necessary. A quick spike in pulse above initial pulse within the first minute or minutes is a contraindication to treatment. Any adverse reaction such as fingers and toes tingling, nausea, headache, light-headedness or dizziness should be evaluated closely and treatment terminated. For some patients they may only be able to tolerate a low temperature and a short duration for the first treatment. When doing a series of treatments, the first treatment is of shorter duration and lower temperature to see how the patients responds. The ability to tolerate treatments should improve as patients acclimatize through their series of treatments.

8.        The patient should enter extremely still water slowly. It will not feel as hot if the water is still.

9.        Have them remain still as they become fully immersed to help decrease the sensation of intense heat.

10.     To treat the pelvis utilize a sitz bath rather than a full bath to concentrate the effects of the treatment.

11.     The water will cool as time passes, although the peat material will help maintain the temperature. If the starting temperature was 105F, hot water may need to be added.

12.     Bath duration is 8-20 minutes and should not exceed 20 minutes.

13.     If the patient becomes fatigued or distressed, they should exit the bath to awaiting sheet and wool blankets.  Do not wait.

14.     AS the patient exits the tub, they must have help from two people who provide lifting support from under the arms bilaterally. This is a time to be very careful.

15.     Encourage the patient to concentrate on walking on their own.

16.     Have them lie down on a fresh sheet and wrap them in both sheets and two or three wool blankets.  Cover the head with a towel.

17.     Continue to monitor pulse and oral temperature for the duration of the 20 minute perspiration time.

18.     Rinse a face cloth in cold water and wipe perspiration from patients face frequently during both bath and perspiration time. This is done every 1 or 2 minutes and is extremely important.

19.     Encourage the patient to relax and help them keep their mind on pleasant matters during the bath.

20.     After the patient has been wrapped from head to foot in sheet and wool blankets, allow them to go through hydrotherapy reaction of rise and fall in temperature, pulse and diaphoresis three times before they are removed from sheet and allowed to return to normal activities.

21.     Have the patient rest and replace electrolytes after treatment.

22.     During the perspiration time, manual traction can be applied to the spine. This is done by grasping the patient’s ankles when they are supine and pulling for 30-45 seconds with enough traction that they almost slide on the table. Indications for manual traction are disc problems, scoliosis, impingement.

23.     Advise the patient not to shower with soap for up to 12 hours after peat bath as absorption rates continue post-bath if peat additives have been used.

24.     Patients should dry thoroughly and remain covered, warm and out of draft for 3 hours post-treatment.

25.     Clean the tank and room thoroughly after use. Log out time of bath and tank cleaning.

Medicinal peat peloid

The indications and contraindications of this procedure are given in Table 45.2

Materials

·         Peat pulp

·         Large towel

·         Small towel

·         Face cloth

·         Small blanket to cover hydrocollator

·         Two small stainless basins

·         One small paper cup

·         Hydrocollator (hot water bottle can alternately be used).

Table 45.2 Indications and contraindications for medicinal peat peloid

Procedure

This is a thermal peat pack and utilizes Dr. Schirmer’s technique and medicinal peat formula.

The procedure is as follows:

1.        Make a square layer of peat material about 0.25 inches thick, 2 inches bilateral of the spine and 6-8 inches long over the spine. If you are not treating the spinal area, cover the area to be treated. Try to make the area of application flat and level.

2.        Cover the peat directly with a warm wet face cloth. Remember borders of peloid exactly by ridging the facecloth around the margins of the peat.

3.        Border the wet face cloth-covered peloid with a rolled bath towel, making a quarter turn while folding the towel to match the margin of the peat.

4.        Apply one layer of towel over the face cloth and peat material.

5.       Put a fresh hydrocollator pack directly over the towel. The hydrocollator should be heated at a gentle boil for 1 hour prior to using. Do not allow any exposed skin to come in contact with the hot pack.

6.        Cover the hydrocollator pack with a towel or small blanket to insulate and prevent heat loss.

7.        Have a cup of cold water ready to pour on the wet face cloth-covered peloid if it gets too hot. In a good treatment the peloid pack should get hot enough to require two to three dowsings of water.

8.        As soon as the patient tells you that the pack is getting too hot, lift up the hydrocollator pack and towel and pour the water directly over the face cloth-covered peloid until cool. Then replace the hydrocollator and coverings.

9.       Never leave the patient unattended!

10.     Treatment time is approximately 25 minutes.

11.     To remove the peat from the skin after treatment, slide a small basin along the skin under the peat, scraping the peat into a bowl. Wipe with a full face cloth wetted with warm water in a gentle twisting motion back and forth to remove peat residue from the skin.

12.     Cover the treated are after treatment to maintain warmth for 3 hours.

Partial immersion medicinal peat bath

The indications and contraindications of this procedure are given in Table 45.3

Table 45.3  Indications and contraindications of partial immersion medicinal peat bath

Materials

·         Deep well basin – the tall plastic waste basket size works well for the leg

·         Medicinal peat bath

·         Water thermometer

·         Small towel

Procedure

1.        Fill basin to three-quarters full with 108-114 F water.

2.        Add peat to the bath.

3.        Have the patient immerse their wrist, ankle, or elbow slowly into the water. Try to immerse the forearm and leg if treating the hand or foot.

4.        Keep the body part immersed for 25 minutes.

5.        After the treatment, cover the area with a wool sock or clothing and keep covered for 3 hours post-treatment.

6.        Often peat material will be sent home with the patient to do home treatments.

7.        Clean up the basin by washing with antimicrobial soap. Then disinfect with 10% bleach solution and rinse after 10 minutes.

CONCLUSION

As a physician using Dr. Schirmer’s technique and peat formula, I have seen accelerated results that would not be achieved with any other method. I have seen excellent results for:

·         Arthritis

·         Tenosynovitis

·         Strains and sprains

·         Plantar fascitis

·         Low back pain including sciatica

·         Scoliosis

·         Fractures

·         Gout

·         Muscle pain

·         Dermatologic conditions such as eczema.

The combination of medical sophistication in diagnosis and application of various balneological methods provides an excellent tool for the physician to treat in a natural way to the great benefit of their patients.

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