patients, once realize the clear-cut efficacy of AHT, do not hesitate to continue the maintenance treatments for years. Obviously the ozonetherapist must have a perfect competence for performing AHT in the smoothest possible way. Indeed some ozonetherapists do not feel skilled enough and prefer to perform other more rewarding tasks. The second problem is that medical personnel working in infectious disease wards are somewhat reluctant to deal continuously with infected blood and needles and the third is the occasional lack of venous access. These are not trivial problems: one can be frequently solved by the use of an idoneous blood substitute, that can be slowly injected into small veins; in the case of a difficult venous access, we can propose three options: a) cannulation of a central vein, keeping in mind some risks (Renaud and Brun-Buisson, 2001; Castagnola et al., 2003),

- b) quasi-total body exposure to oxygen-ozone in a cabin, c) rectal

insufflation of gas.

- 2. MINOR OZONE AUTOHAEMOTHERAPY

In the 1950, when I was a medical student, we used to do IM injections of either autologous freshly drawn blood or sterile milk as unspecific immunomodulators. This practice is then very old and continues to be used also without ozone (Olwin et al., 1997). Wolff may have had the idea of ozonating blood in the hope of activating its components. The technical procedure is empirical and simple: firstly, I collect the blood (5 ml) in a 10 ml syringe, and secondly, via a two-way stopcock, I add an equal volume of filtered oxygen-ozone at ozone concentrations between 40-80 mcg/ml depending upon the scope of the treatment and the disease. One can, more simply, first collect the 5 ml of gas and then withdraw, less precisely, about 5 ml of blood. In both cases, the blood, vigorously mixed with the gas, develops abundant foaming and certainly in this case the whole ozone dose reacts in less than one minute. After disinfecting the buttock skin and checking to not have penetrated a vessel, I inject, either in the subcutis or in the muscle, blood and foam in one site, usually without causing pain. We can do multiple injections or repeat them 2-3 times weekly. We do not know whether the IM or SC administration in multiple sites is more effective. Under an ozonetherapist guidance, a nurse’s help and the availability of an ozone generator, the patient can easily do her/his own therapy at home. What is the rationale of this sort of unspecific proteintherapy coupled to ozone remains conjectural and a scientific investigation will be useful. At the moment I can only speculate that blood, without anticoagulant, will infiltrate into the muscle tissue or the subcutis and will undergo 42 The Actual Six Therapeutic Modalities coagulation due to platelet and prothrombin activation. If we delay IM injection, this can happen already in the syringe! Several processes, such as fibrinolysis, serum reabsorption via lymphatic vessels and a mild sterile inflammatory reaction, are likely to take place as occasionally suggested by a slight swelling at the injection site reported by some patients during the next few days. Chemotactic compounds released at the site may stimulate the local infiltration of monocytes and neutrophils, which take up haemolysed erythrocytes and denatured proteins. Activated monocytes and lymphocytes may release interferons and interleukins either in loco or along the lymphatic system, upregulating the physiological cytokine response (Bocci, 1981c; 1988). Thus it would be quite interesting to evaluate some immunological parameters and ascertain if there is a simultaneous induction of HO-1 and some other heat shock proteins (Tamura et al., 1997) that may enhance immune reactivity and explain the