The Chianciano Spa Water Cure

The traditional cure of Chianciano involves the use of natural mineral waters emerging from deep underground springs.

The cure is aimed principally at treatment of the liver, the biliary ducts and certain illnesses and disturbances of the metabolism.

The cure is effected using the waters from three separate springs: SANTA, FUCOLI and SILLENE.

These three springs today lend their names to the three locations where the cures are carried out and which together form the Company of TERME DI CHIANCIANO S.p.A.

It must be said that the possibility of curing hepatobiliary diseases (whether caused or symptomatic) is limited. It is, however, possible to intervene using appropriate treatments to correct functional defects that are associated with them or result from them.

The CHIANCIANO CURE is one of these appropriate treatments.
This affirmation is based on the results of a large number of clinical observations carried out in Chianciano.

In order to determine the type and prevalence of pathological features that motivate a decision to take the Chianciano cure, a clinical-statistical survey was recently undertaken on a random sample of 3,766 patients. The study revealed that:

  about 70% of subjects presented a range of digestive disorders, often accompanied by typical or atypical abdominal pains, whose symptoms pointed to primary hepatobiliary functional defects either arising from:

•     acute illnesses (hepatitis, cholecystitis);

•     intensive or prolonged treatment with pharmaceuticals (oral contraceptives, antibiotics, chemotherapeutic agents, etc.);

•     surgical operations on the bile ducts.

or due to:

•     biliary calculosis;

•     nutritional or metabolic hepatopathy (diabetes, obesity, hyperlipidemia);

•     non-progressive chronic hepatopathy (persistent chronic hepatitis)

For the overwhelming majority in this first and most important group of patients, the Chianciano cure proves to be effective in correcting the hepatobiliary functional imbalance and in eliminating or reducing the digestive disturbance as well as the associated pain.

•     a substantial proportion complain of digestive and/or secondary intestinal disturbances of psychological origin on the mechanisms that regulate hormonal and enzymatic secretion as well as motor activity of the digestive apparatus.

In these cases results of treatment using the Chancing cure are found to be good.

•     a small number manifest a variety of conditions (rashes, eczema, psoriasis, migraine, etc.) that have nothing to do with the liver.

Theoretically, there is no advantage to be gained from taking the Chianciano cure, and yet, surprisingly, some benefit is obtained.

ACQUA SANTA

The principal cure available in Chianciano, and the one that attracts most visitors, is Acqua Santa water.

It has a constant temperature at the source of 33 ⁰C and so is classified primarily as a thermal water. It has a fixed residue, at 180⁰C, of 3.280 grams/litre, which means that the total amount of substances dissolved in one litre of Acqua Santa is equal to 3.28 grams. For this reason it is also classified as a mineral water. The main chemical components are bicarbonate, sulphate and calcium. The water is taken as a drink.

CHEMICAL                   COMPOSITION
g/l
Suiphates                     1.8940
Sodium carbonate          0.8724
Calcium                        0.7200
Magnesium                   0.1600
Sodium                         0.03 70
Chlorine                        0.0269
Strontium                      0.0100 
Potassium                    0.0067 
Fluorine                        0.0020 
Iron                              0.0015 
Bromine                       0.0002 
Free carbon dioxide 455       cc/litre.

The various constituent parts are listed according to quantity present.
The first four must be considered the most significant. The table does not include trace elements.
The ions in the water combine to produce the corresponding salts:

•     calcium sulphate

•     calcium bicarbonate

•     magnesium sulphate

•     magnesium bicarbonate

Acqua Santa emerges at its source in the form of a complex mixture of numerous substances a with a chemical make-up that exhibits a well-defined and inalterable chemical/physical equilibrium. It is, therefore, a compound which in a pharmacological and therapeutic sense acts as a single entity.

•     Quality, quantity, chemical combination of its constituent minerals.

•     State of chemical/physical equilibrium attained during its flow through the ground.

It is impossible to reconstitute Acqua Santa (with its own salts after evaporation).
It cannot be reproduced artificially in a laboratory (with salts prepared and dissolved in ordinary water).

ACQUA SANTA AND ITS MODE OF ACTION

The action of Acqua Santa occurs principally on three levels:
On the biliary ducts
On the hepatoenteric cycle of the biliary acids
On the hepatic cell.
1. The effects of Acqua Santa water on the biliary tract

CHOLECYSTOKINETJC ACTION

When taken on an empty stomach, in fractional doses, Acqua Santa water stimulates secretion, in the duodenum, of cholecystochin in, a hormone that provokes:

• Contraction of the cholecyst

•     Passage of the concentrated bile in the choledochus

•     Opening of the duodenal sphincter muscle

•     Arrival of the bile in the duodenum.

CHOLERETIC ACTIQN

Acqua Santa water, when taken in suitable doses, causes an increase in the production of bile. The choleretic action of Acqua Santa is principally hydrocholeretic: that is, the bile produced contains a higher proportion of water and is therefore more abundant and more fluid. It is probable that the choleretic action of Acqua Santa has an effect on the bile in the biliary ductules.. The bile ductules follow the bile channels that emerge from the hepatic cell and are capable of diluting the bile by secreting an electrolitic solution rich in water and bicarbonates. This action is promoted by secretin (another hormone produced by the duodenal glands), that is liberated when partially digested food passes from the stomach into the duodenum. Using blood as a medium, the secretin hormone then acts upon the ductules, increasing choleresis without changing the biliary fraction produced by the hepatocyte. Acqua Santa water, therefore, acts on the duodenal glands to provoke the liberation of secretin which subsequently stimulates a choleretic action at the level of the biliary ductules.

2. The effects of Acqua Santa water on the hepatoenteric cycle of the biliary acids The bile acids are produced by the liver using cholesterol and include cholic and chenodeoxycholic acids.
Here in the liver they are combined with two amino-acids (glycine and taurine) before being injected into the bile and then carried along as bile salts (sodium and potassium).
Together with the phosolipids, also present in the bile, they form the so-called mycelia, the miniature cages that trap the cholesterol which, being a fat, cannot stay in solution in the bile, which is an aqueous liquid.
These primary bile acids (or salts) undergo a cyclical journey from intestine to liver, the hepatoenteric cycle. Once they arrive with the bile in the intestine .(what function?... they are reabsorbed in the last section of the small intestine to be retuned to the liver in the blood of the portal vein. This is an example of how the organism works to recycle useful substances and to eliminate only the useless or harmful ones.
The cholecystokinetic action of Acqua Santa water described above increases the frequency of the hepatoenteric cycle of the biliary acids so that:

•    more bile acids rectum to the liver to be re-used

•    the liver needs to produce less cholesterol to be transformed into biliary acids.

Since the synthesis of cholesterol and its transformation into biliary acids are processes that require the consumption of energy, Acqua Santa water a/so makes its own contribution to energy-saving in the body.

About 10% of the primary biliary acids(cholic and chenodeoxycholic) escape reabsorption in the intestines and undergoes, thanks to the microflora present in the colon, enzymatic transformations that lead to the creation of secondary biliary acids: deoxycholic acid from the cholic acid and lithocholic acid from the chenodeoxycholic acid.
About 20% of these are eliminated with the faeces and 80% is reabsorbed by the colon mucous and is brought back to the liver along the portal vein. When they reach the liver the secondary biliary acids are captured by the liver cells, united with the glycine and the taurine, and then re-emitted into the bile, in exactly the same way as the primary biliary acids.

Thanks to the partial capture of the bacterial flora in the intestines by certain constituents of Acqua Santa, the process of de-conjugation and de-hydroxyilation of the biliary acids is reduced; so that:

•    more conjugated primary biliary acids return to the liver for immediate r-use, and

•    production of secondary biliary acids is reduced.

Lithocholic acid (a secondary biliary acid) has been shown to be toxic for the liver. In normal conditions, however, the liver protects itself against the toxic effects of the lithocholate, neutralising it by a process known as sulphur conjugation. The same cannot be said for an unhealthy liver.

Free sulphur, coming from the sulphates present in Acqua Santa water, is made available by means of sulphur conjugation (neutralisation) of the /lithocholic acid.

The combination of actions exerted by Acqua Santa water on the hepatoenteric cycle of the biliary acids promotes subsaturation of the bile.
The bile is said to be supersaturated when the production of biliary acids in the liver falls below a certain limit or when secretion of cholesterol is greater than what the biliary acids, including the phospholipids, can hold in solution. Excessive cholesterol, therefore, precipitates in the form of minute crystals which attach themselves together to lead to the formation of stones.

treatment with Acqua Santa water can afford a useful contribution to the prevention of cholesterol-induced gallstones (cholelithiasis).

3.  The effects of Acqua Santa water on the hepatic cell

It is not possible to say very much about the action of Acqua Santa on the hepatic cell since there is so little data available to satisfactorily explain the biochemical processes in the liver. We can, however, formulate certain hypotheses. Some of the components of Acqua Santa water (sulphur, selenium) are found in:

•     enzymes (sulfokinase, glutathione-peroxidase)

•     sulphurated amino acids (methionine)

•     lipotrophic factors (cysteine, cystine)

These components of Acqua Santa, after absorption in the intestines, are offered to the hepatic cell in the more natural form and with elective affinity to carry out biochemical reactions.
In conclusion we can say that:
Acqua Santa water helps to activate the enzymatic systems that are at the very basis of the life of the hepatic cells and the functions carried out by the.

ACQUA FUCOLI

The water has a temperature of  16.5^°C at the source and is therefore a cold spring water. It is a mineral water with a fixed residue, at 180^°C, of2.600g/1.
The most important elements, in terms of quantity, are the first four, as in the case of Acqua Santa water. Each of these elements is present to a lesser extent than in Acqua Santa water. In particular, there is a lower content of sodium carbonate and free carbon dioxide which points to the original source being less deep compared to Acqua Santa. The water is classified as bicarbonate-sulphate-calcium. The spring emerges at an altitude of 434 metres.

CHEMICAL COMPOSITION

Sulphates                     1.6100
Calcium                        0.6530
Sodium carbonate         0.5200
Magnesium                   0.0980
Chlorine                        0.0240
Sodium                         0.0199
Potassium                     0.0042
Fluorine                        0.0017
Lithium                         0.0002

Free carbon dioxide 60.4 cc/litre

Like Acqua Santa, Acqua Fucoli has a hydrocholeretic action.
It modulates intestinal secretion and motor activity.
It exerts an antiphlogistic action on the gastric and duodenal mucous.
It has a rather marked diuretic effect.
It is taken as a drink.

Acqua Sillene belongs to the same hydrological basin as Acqua Santa and emerges at an altitude of 505 metres. It is a thermal spring water, emerging from the ground at 38.5⁰C, warmer than Acqua Santa, indicating that it originates from a greater depth. Lt is also a mineral water, with a fixed residual value at 180^°C of 2.956 g/l, slightly less than Acqua Santa.

CHEMICAL COMPOSITION

                                    g/l
Sulphates                     1.6480
Sodium carbonate          0.8160
Calcium                        0.6800
Magnesium                   0.1500
Sodium                         0.0403
Chlorine                        0.0130
Iron                              0.0010
Lithium                         0.0003

Free carbon dioxide 172 cc/litre

Given its high temperature and content in free carbon dioxide, Acqua Sillene is best employed for:

•     preparation (maturing) of Sillene Fango muds

•     Carbon dioxide balneotherapy.

Hydrotherapy treatments with Acqua Sillene concern:

1.    THE LIVER AND BILIARY DUCTS

Fango therapy of the hepatic region and

Balneotherapy to complete the water cure treatment with Acqua Santa.

2. THE CARDIOVASCULAR APPARATUS

Carbon dioxide balneotherapy

The use of Acqua Sillene in the treatment of hepatobiliary diseases is made possible by means of:

APPLICATIONS OF MUD TO THE HEPATIC REGION which:

reinforces the choleretic and cholecystokinetic action of the water cure treatment,

exercises an antispasmodic action.

Drainage of the biliary ducts

Temperature about 50^°C

            Duration 15 -20 minutes

CARBON DIOXIDE-RICH BATH   causing:

vasoconstriction of the abdominal viscera;
peripheral vasodilatation;

The carbon dioxide-rich Sillene water are:

• activation of the liver cell functions .
  This always follows the mud application

• Temperature about 38⁰C (natural temp.) Duration 10 minutes

• vasodilatation in the region of the skin and muscle with subsequent increase in blood folw.

• deep vasoconstriction with expression of the abdominal viscera.

• Determining factors are the carbonic acid, temperature and hydrostatic pressure.

• Temperature about 3 8⁰C (natural temp.) Duration 20-30 minutes

Indications for the use of Sillene water

1.    Arterial hypertension

• Immediate action:
  Lowering of systolic and diastolic pressure values;

• Medium to long term:
  Persistent reduction in pressure
  Values after a cycle of 10 baths.

2.    Peripheral vasculopathy of the limbs

• Increase in arterial flow in the concerned limbs.

• Consequent improvement in venous cycle

Results:

Mild cases: good or satisfactory
Medium-serious cases: results are useful in supporting pharmacological therapy.

Increased walking autonomy

Reduction in concomitant symptoms