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What is ozone?
Ozone (/ˈoʊzoʊn/) (or trioxygen) is an inorganic molecule with the chemical formula O₃. It is a pale blue gas with a distinctively pungent smell. Ozone is a powerful oxidant  and has many industrial and consumer applications related to oxidation (including in Medicine).

What is ozone therapy?

Ozone therapy is a complementary treatment in medicine for various pathological processes through the use of established systemic, oral and local methods of applying ozone according to the appropriate treatment regimens, doses and concentrations, produced by a specially designed medical ozone generator in the form of an oxygen-ozone mixture with varying ratios of 99.95-95% oxygen to 0.05-5% ozone and based on the powerful oxidizing properties of ozone and its ability to cause controlled oxidative stress in living organism.

History

In 1785, Dutch chemist Martinus van Marum was conducting experiments involving electrical sparking above water when he noticed an unusual smell, which he attributed to the electrical reactions, failing to realize that he had in fact created ozone.

A half century later, Christian Friedrich Schönbein noticed the same pungent odour and recognized it as the smell often following a bolt of lightning. In 1840, he succeeded in isolating the gaseous chemical and named it “ozone”, from the Greek word ozein (ὄζειν) meaning “smelly”.

For this reason, Schönbein is generally credited with the discovery of ozone. He also noted the similarity of ozone smell to the smell of phosphorus, and in 1844 proved that the product of reaction of white phosphorus with air is identical. 

After 1840, many studies on the mechanism of disinfection of ozone were elaborated. But it was not until almost twenty years later that the new substance was revealed to be a triatom allotropic form of oxygen: in 1856 Thomas Andrews showed that ozone was formed only by oxygen, and in 1863 Soret established the relationship between oxygen and ozone by finding that three volumes of oxygen produce two volumes of ozone.

The first ozone generator was manufactured in Berlin, by the German inventor Ernst Werner von Siemens, who also wrote a book on the application of ozone in water, which gave rise to a series of pilot projects, during which the ozone disinfection mechanism was researched. In 1857 Werner von Siemens built the first superior induction tube with which Kleinmann made the first attempt to destroy microorganisms and also performed the first gas insufflations in animals and humans.

The formula for ozone, O₃, was not determined until 1865 by Jacques-Louis Soret and confirmed by Schönbein in 1867.

In 1896 Nikola Tesla patented the first ozone generator – a corona discharge ozone generator using charged metal plates to act on ambient air, and in 1900 founded Nikola Tesla “Tesla Ozone Co.”, manufacturer of generators for medical use.

The entry of ozone more widely into clinical practice is considered to have come from Germany. During the First World War 1914-1918 , German doctors noticed that the wounds of soldiers in a field hospital that was located near a power plant healed faster. It turned out that the effect was due to the large amount of ozone in the air. Dr. Anton Wolff already in 1915 began mass application of ozone as an antiseptic. German doctors used ozone to treat hard-to-heal and decubitus wounds, gangrene, severe burns and to stop bleeding in wounds. During this time, the Australian surgeon Erwin Payr (1871-1946) and the Swiss dental surgeon E.A. Fisch (1899-1966) actively created, worked and published valuable manuals on ozone therapy, the latter of whom wrote a dissertation in 1950 on ozone in medicine and created the CYTOZON generator, which is still present in the equipment for ozone therapy in dentistry. Scientific studies in dentistry after E.A. Fisch appeared only in the 80s thanks to the developments of H. Kirschner and A. Filippi.

            1936 the French doctor P. Aubourg introduced the method of rectal ozone insufflation in the treatment of fistulas and chronic colitis with good success and later for systemic application and thus opened the way for the use of ozone therapy in pediatrics as well. Later, after the second half of the twentieth century, the handbooks of the surgeon Hans-Georg Knoch on proctology and rectal insufflation were published, which elaborated this method in detail.

            During the Second World War 1939-1945, the study of the healing effect of ozone was actively continued in Germany, where it was successfully used for local treatment of wounds, burns, after surgical interventions and amputations, other severe traumas received at the front.

            After the war, however, practically for twenty-thirty years, the research was stopped, due to the appearance of antibiotics, the absence of reliable compact ozone generators and ozone-resistant materials. It was only in the 1970s that specialists again remembered the healing properties of ozone and included it in international scientific research programs.

            Hans Wolff (1927-1980), Joachim Hänsler (1908-1981) and Siegfried Rilling founded in 1972 German Medical Society of Ozone Therapists. All of Hans Wolff’s medical and research work has been devoted to ozone, and through his numerous publications and practice he has had an enormous share in the spread of ozone therapy throughout the world. In November 1973, the International Institute for the Study of Ozone was founded as a public-scientific and educational organization.

            Hans Wolff 1968 is also credited with putting the major autochemotherapy (MAH) method into practice  in collaboration with Joachim Hänsler and his company then for the production of medical ozone generators with accurate dosing in the 60-70s of the XX century.

            The development and dissemination of the bag gasification method is due to H. Werkmeister and O. Rokitansky in the second half of the past century.

            In Italy, the orthopedic doctor Cesare Verga developed in the 1980s the discolysis method for the intradiscal treatment of hernias with ozone and the local paravertebral application of ozone using the discosan method for spinal degenerative and inflammatory diseases. His student – Italian physiologist from Siena Prof. Velio Bocci (1928 – 2019) later took over the development of ozone therapy in Italy under the auspices of the national association of Italian ozone therapists, developing key manuals and textbooks on the practice and theory of ozone therapy, rooted in modern understandings of the application and mechanisms of action of ozone.

            A serious impetus for the development of ozone therapy, as we know it today, was given by the ozone therapy school of Russia. It is also due to the accumulated large database of scientific studies in the field, incl. and the introduction and demonstration of the benefits of the use of ozonated saline intravenously in practice. The State Medical Institute of Nizhny Novgorod in 1977 developed under the leadership of an academician cardiac surgeon from the Russian Academy of Medical Sciences ( RAMN ) – Boris Al. Korolev (1909-2010): ozonated saline as a systemic method of administration. The subsequent extensive studies and the specially published works of Prof. Stanislav Dm. Razumovsky (1974 – “Ozone and its reactions with organic compounds”) are the impetus for the accumulation of modern scientific data on all known mechanisms of ozone therapy. In April 1979, for the first time in the world, an ozonated cardioplegic solution was administered in the coronary bloodstream of a patient during surgery for a congenital heart defect in Russia. In 1986, the same institute conducted the first extracorporeal ozonation of blood during cardiac surgery for prosthetic mitral valve. Many more avant-garde methods of ozone therapy have been developed and applied in practice by the Russian school, which are studied and used all over the world, for which Russian researchers such as Klavdia N. Kontorshchikova, Gennady A. Boyarinov and Sergey P. Peretyagin played a significant role. The latter is also the current chairman of the Russian Ozone Association and a member of the International Scientific Division ISCO3 of IMEOF.

            The credit for the accumulation of a scientific database and practical manuals of the Cuban medical school is not small, especially after the establishment in Cuba in 1994 of the National Center for Scientific Research in the Field of Ozone Therapy. Biochemical studies of the mechanisms of ozone therapy are partly the merit of the long-term work of the Cuban institute in question, and its scientists such as Silvia Menendez Cepero and Olga Sonia Leon Fernandez stand out among them.

            In 1979, the International Medical Association of Ozone Therapists was founded.

            Formed in April 2005 in New Delhi, India and actively operating on the initiative of the Italian ozone therapy school with headquarters in Brescia, Italy is also the World Federation of Oxygen-Ozone Therapy (WFOOT). The chairmanship in WFOOT was handed over by the Romanian orthopedist Stefan Tiron, who has been holding it until recently, to Brazil in the person of Prof. Antonio Teixeira (president of ABOZ – the Brazilian Association of Ozone Therapy) at the organization’s 7th World Congress held in Bucharest, Romania, May 5-7. 2022.

            2009, the International Medical Ozone Federation (IMEOF) was founded in Pontevedra, Spain, with headquarters in Madrid, on the initiative and under the auspices of the Spanish Ozone Medical School (AEPROMO). Today, IMEOF works actively under the guidance of Adriana Schwartz and Frank Shallenberger and collects all scientific articles and research results in the field of ozone therapy. Doctors from various specialties from the countries of the European Union, USA, Canada, Russia, Brazil, Cuba, Japan, China, Israel, South Africa and others participate in its international congresses.

            The main international medical document and the first international consensus in working with ozone as methods and ways of application, indications, treatment schemes, doses and concentrations is the Madrid Declaration on Ozone Therapy. It was issued June 2010 by the IMEOF Scientific Council,  known as ISCO ₃ – International Scientific Committee of Ozonetherapy and with the assistance of the Royal Spanish Academy of Medicine. Currently, the Madrid Declaration on Ozone Therapy has two revised and supplemented editions (2nd edition June 2015 and 3rd edition May 2020) and is the main recommended and consensus document at a globally recognized level. Behind this successful project are the efforts of the Spanish association of ozone therapists (AEPROMO) under the leadership and with the special assistance of Spanish obstetrician-gynecologist Adriana Schwartz and a large international team, among which the merit of names such as Velio Bocci, the current president of ISCO ₃ – Gregorio Martinez Sanchez, Nabil Mawsouf and many others.

            To date, in over 50 countries around the world there are active ozone practices in the fields of medicine, cosmetics, dentistry and veterinary medicine. An international ozone therapy library with a vast number of published scientific materials, manuals, research results and articles already in excess of 3300 documents as of May 2020 is now available to ozone therapists.

How do we produce ozone?

Ozone is produced from medical /pure/ oxygen in a special apparatus under the influence of an extremely high charge of electrical energy.

A medical ozone generator is a special apparatus with the technical ability to produce an oxygen-ozone mixture in appropriate ratios, concentrations, flow rate and volume, based on the passage of pressurized oxygen from a container through an electric high-voltage arc in an insulated tube.

Ozone therapists are certified doctors, additionally qualified and certified to work with ozone in medicine, who, with the help of the relevant equipment and trained medical specialists, perform ozone therapy in the fields and specialties in which they are the only ones competent.

Effects of ozone on the human body:

1. Antiviral, antibacterial and fungicidal action /kills various types of viruses, bacteria and fungi and prevents their reappearance/
2. Activates the body’s antioxidant systems, helps break down free radicals.
3. Immunomodulatory effect – depending on the dose, it can have a stimulating or suppressing effect on immunity, therefore it can be used both in secondary immunodeficiency conditions /after prolonged illness/ and in autoimmune diseases.
4. Direct effect on the respiratory and cardiovascular system: it improves microcirculation, reduces peripheral vascular resistance, increases the elasticity of erythrocyte membranes and, as a final result, reduces oxygen hunger in the cells – therefore, hypertensive disease and ischemic heart disease are affected with ozone therapy.
5. It increases the amount of oxygen delivered to the tissues and thus leads to its better absorption.
6. Ozone therapy affects lipid metabolism. Ozone oxidizes fatty acids, which leads to a decrease in cholesterol, total lipids and triglycerides in the blood – favorable conditions are formed to protect vessels from sclerosis.
7. Ozone has a powerful analgesic and anti- inflammatory effect, potentiated mutually each other.
8. Detoxifying effect: for the prevention and treatment of diseases caused by metabolic disorders – obesity, diabetes /proven to lower blood sugar/, improves liver function.
9. Reduces the level of uric acid /which is the cause of gout/

Methods of ozone therapy:

• Intravenous, intramuscular, subcutaneous, intra-articular, injections in painful areas, injections in biologically active points
• In special sacks for effects on the skin (for diabetic foot, hard-to-heal wounds, skin diseases); rinsing or drainage with ozonated solutions of skin and mucosa
• Massage with ozonated oil, rectal and vaginal insufflations