Massage for hypertension. Massage for hypertension Self-study materials for students

12.09.2021 Treatment

Valentin Nikolaevich Moshkov (July 18, 1903 - February 18, 1997) - Soviet scientist-doctor, one of the founders of physical therapy (exercise therapy) as an independent discipline of clinical medicine. Professor (1945), Corresponding Member of the Academy of Medical Sciences of the USSR (1957), Honored Scientist of the RSFSR (1974).

In 1927 he graduated from the State Institute of Physical Education, in 1931 - the 2nd Moscow Medical Institute. After graduating from the medical institute, he worked as head of the exercise therapy department at the State Institute of Physiotherapy (until 1941) and the Central Research Institute of Balneology and Physiotherapy (1943-1959).

In 1945 he defended his doctoral dissertation on "Therapeutic physical culture as a method of rehabilitation therapy after spinal cord injuries."

In the 1940s, at the Central Institute for Advanced Medical Studies, V.N. Moshkov begins his teaching career, works as an assistant professor of the Department of Therapy in the course "Medical control and exercise therapy", head (1943-1977) and scientific consultant (1977-1987) of the Department of Medical Control and Exercise therapy. He has trained many specialists in physiotherapy exercises.

In the hospital of the Central Research Institute of Balneology and Physiotherapy, V.N. Moshkov conducted a number of studies on the effectiveness of exercise therapy in the treatment of patients with diseases of the cardiovascular and nervous systems, respiratory organs, and the musculoskeletal system. Developed a massage technique for hypertension.

Books (3)

When you are over forty

How often we do not value health when we have it. Irrational wasting our strength, not attaching importance to the importance of the alternation of work and rest, full Sioux, regular nutrition, physical education, we finally experience the first signs of various functional disorders in the body. And they gradually begin to manifest themselves more sharply: fatigue develops faster, efficiency decreases, the heart begins to "feel".

Despite the fact that health is too expensive for us, we sometimes waste it carelessly, not noticing how we cut the branch on which we are sitting. Immediately, out of necessity, you have to pay great attention to yourself, your health, and you start going to doctors and absorbing various drugs. And it is good if a person realizes himself in time, when painful disorders have just begun to develop. Then timely therapeutic measures, and most importantly, adherence to the correct regimen and regular physical education, will be able to successfully prevent further dysfunction of the main body systems.

Therapeutic physical training in the clinic of nervous diseases

The monograph contains theoretical and practical material on the use of physical therapy in the complex therapy of persons with diseases and injuries of the nervous system.

In the general part of the book, materials are systematized, which are the basis for the correct construction of any particular method of medical physical culture. They include the general provisions of the method, fundamental questions of the methodological order, the content and role of therapeutic exercises in water, mechanotherapy, occupational therapy and massage in the treatment of patients with diseases and injuries of the nervous system. The data on the mechanism of the physiological therapeutic action of physical exercises are also generalized.

In the special part of the book, particular methods of using physical therapy for diseases and injuries of the brain (in the early and late periods of hemiparesis), lesions of the spinal cord, as well as the peripheral nervous system (radiculitis, polyradiculoneuritis, neuritis of the facial nerve and trauma of peripheral nerves) are considered.

Under the influence of massage in patients with diseases of the cardiovascular system, the indicators and state of vascular tone, the value of blood pressure change. With adequate influences and the use of special massage techniques in accordance with the pathogenetic and clinical characteristics of the disease, favorable changes occur.

Massage technique (V.N.Moshkova) for hypertensive patients.

Under the influence of the course of treatment with massage: head, occiput, there were favorable shifts in clinical indicators: decreased severity in the occipital region, in the forehead, eye sockets; decreased or disappeared headache, dizziness.

The procedure should be carried out in a separate room in silence.

  • The starting position is sitting, leaning against the back of a chair and relaxing the muscles. The masseur stands behind the patient's back. Two basic techniques are used, "stroking" and "kneading", alternating between them.

The massage begins with stroking and kneading the muscles of the interscapular region with the palm of your hand along the spine and from top to bottom.

  • Massage the shoulder girdle from the neck and spine to the shoulders, shoulder blades.
  • Then knead the II and III fingers of the mastoid and occipital region. All these techniques alternate with stroking the back of the neck and shoulder girdle from top to bottom and outward to the shoulder joint and axillary fossa.
  • When massaging the scalp, kneading I II, IV with fingers is performed from the occipital protuberance to the crown.
  • After that, the patient throws his head back, leaning on the chest of the masseur. In this position, the frontal and temporal regions are massaged; start by stroking with one or two fingers along the midline of the forehead to the scalp, then to the temples with four fingers or palms. Knead the forehead, supraorbital and infraorbital arches up and to the sides with all fingers.
  • Then the temporal areas are massaged with the base of the palm from the eyes to the back of the head. The circumference of the eye sockets at the top is kneaded with fingertips, and on the lower arch they are punctured.
  • Then again stroking with rake-like techniques and in the same sequence knead the forehead, scalp towards the back of the head with divorced II, III, IV, V fingers.
  • In conclusion, the neck, shoulder girdle and interscapular region are again massaged. Especially painful are the areas of the mastoid processes between the eyebrows and the midline of the parietal region. Apply light stroking and vibration.

The duration of the procedure is from 10 to 15 minutes. The course of treatment is 20 - 24 procedures.

Abdominal massage for obesity helps to improve blood circulation in the abdominal cavity, reduce congestion and a reflexive decrease in blood pressure. In addition, massage improves digestive and motor function.

  • The initial position during the procedure, the patient lies on his back. The impact on the muscles is carried out by stroking and kneading according to the technique generally accepted for this area.
  • Then the patient bends his knees, rests his feet on the couch, after which he begins to massage the intestines. Apply shallow kneading with four fingers (pressing them from above with the other hand) on the left half of the abdomen from top to bottom (along the colon), 6 - 8 times.
  • After that, the right half of the abdomen is massaged from the bottom up towards the ascending and transverse colon and the reception is completed with the massage of the left half of the abdomen. Kneading alternates with stroking, vibration. After vibration, stroking is applied clockwise.
  • Then, bringing the hands under the lumbar region, shaking is performed 3-5 times and the procedure is completed by stroking the abdomen. The duration of the procedure is 15 minutes.

There is a beneficial effect of massage according to the Mashkov method in combination with

    What is hypodynamia and hypokinesia? What is the effect of insufficient activity on the human body?

    List the mechanisms of the therapeutic effect of physical exercises on the body of a sick person.

    What are the general contraindications to the appointment of physiotherapy exercises?

    What means and forms of physiotherapy exercises do you know?

    General material and methodological support of the lecture

The lecture is held in room number 31 during the lecture, the lecturer uses slides that are demonstrated by a slideoscope.

    Self-study materials for students

a) On the topic of the lecture presented

Literature.

    1. Dobrovolsky V.A. A textbook on medical physical culture. M .: Fis, 1974. - p. 129 -130.

    (2) Zhuravleva A.I., Graevskaya N.D. Sports medicine and exercise therapy: A guide for physicians. - M .: Medicine, 1993 - S. 235 - 260

    Textbook / edited by V.A. Epifanova, G.A. Apanasenko Physiotherapy and medical supervision M. 6 Medicine, 1990 - 114 - 147.

    Types of rehabilitation.

    Modes of motor activity in a therapeutic clinic.

    Indications and contraindications for the use of exercise therapy for diseases of the cardiovascular and respiratory systems.

    Clinical and physiological substantiation of exercise therapy in cardiovascular pathology.

    Clinical and physiological substantiation of exercise therapy for respiratory diseases.

    Extracardiac factors of blood circulation

    basic principles of exercise therapy technique for circulatory failure

    features of the exercise therapy technique for ischemic heart disease, hypertension.

    Features of exercise therapy for pneumonia, bronchial asthma, pleurisy.

b) on the topic of the next lecture Physical therapy in surgery and traumatology and orthopedics "

    Physiotherapy and medical control: Textbook / Ed. V.A. Epifanova, G.L. Apanasenko. M .: Medicine, 1990. Pp. 104 - 111.

    Chernavsky V.A. Diagnostics and treatment of fractures and dislocations. - Tashkent "Medicine" 1977. - 201p.

    Yumashev G.T. Epifanov V.A. Operative traumatology and rehabilitation of patients with damage to the musculoskeletal system. M .: Medicine, 1983 .-- 283

    Kaptelin A.F. Rehabilitation treatment for injuries and deformities of the musculoskeletal system - M. Medicine, 1979. - 404.

          Modes of motor activity in a surgical clinic.

          Early and late, general and local postoperative complications.

          The principles of rehabilitation of patients with injuries of the musculoskeletal system

          Basics of exercise therapy technique after operations on the abdominal and thoracic cavity.

8. Literature used by the lecturer in preparation for the lecture

  1. Moshkov V.N. Physiotherapy exercises in the clinic of internal diseases. - Moscow: Medicine, 1977 .-- 375s.

  2. Mogendovich M.R. The current state of the issue of motor - visceral regulation. - M .: Medicine, 1973 .-- 221p.

    Dzyak V.N., Kryzhanovskaya I.I. Medical rehabilitation of patients with cardiovascular diseases. - K .: Healthy, I, 1971. - 136s.

    Temkin I.B. Isometric exercises for diseases of the circulatory system. - M .: Medicine, 1975-235s.

    Therapeutic physical culture: Handbook / ed. V.A. Epifanova - M .: Medicine, 1987 .-- 528s.

The lecture was prepared by Associate Professor I. I. Bondarev

... “We are on the cusp of the greatest golden age, when science, reason and even religion will triumph in search of truth. The Hindus call it Krita Yuga, astronomers call it the era of Aquarius, the Jews call it the coming of the Messiah, theosophists call it the New Age, and cosmologists call it the Harmonic Convergence. And the ancients even indicate the date: December 21, 2012, according to the Mayan calendar "... (Dan BROWN. The Lost Symbol.)

Doctor of Historical Sciences Gennady Aiplatov studied the works of a little-known Russian prophet who accurately predicted the fate of Russia in 1910

BOOK OF FATE

- The name of General Valentin Moshkov, a full member of the Russian Geographical Society, coordinator of the Society of Archeology, History and Ethnography at the Imperial Kazan University, was not included in modern encyclopedic dictionaries and reference books, but his last work can truly be called prophetic,

- says Doctor of Historical Sciences, Professor of the Department of National History of the Mari State University, Honored Worker of the Higher School of the Russian Federation Gennady Aiplatov.

- We are talking about a two-volume fundamental study published in 1907-1910 in Warsaw "A new theory of the origin of man and his degeneration, compiled on the basis of data from zoology, geology, archeology, anthropology, ethnography, history and statistics"

(T. 1. The origin of man. - Warsaw. 1907; T. 2. Mechanics of degenerations. 1912 - the beginning of the "Iron Age". - Warsaw, 1910). This study is a real book of the fate of our Fatherland, because in it Moshkov acts as a “Russian Nostradamus” who predicted the main course of Russian history until 2062.

As can be seen from the title of the book, in his forecast Moshkov did not proceed from "revelations" received from nowhere, but relied on a solid scientific foundation.

According to the general's theory, all states and all societies, from the largest to the smallest, complete a "continuous series of turns", which he called "historical cycles." Each cycle, without exception, for all peoples lasts exactly 400 years. “One gets the impression,” writes Moshkov, “that every 400 years of its history, the people return to the same place where they started. The cycle is a year of history. "

General Moshkov, following the Hebrew, Ancient Greek and other traditions, calls the four centuries of the cycle, respectively, gold, silver, copper and iron. Each cycle is divided into two equal halves - 200 years each: the first is ascending, the second is descending.

In the first half of the cycle “the state is growing and gaining strength and exactly at the end of the year 200 it reaches its maximum decline.

Then the first ascending half of the new four-century cycle begins. " Each of the halves of the cycle, consisting of 200 years, in turn, is divided into two centuries, differing in "its own character", and each century - into two half centuries (50 years). The first half of each century signifies decline, and the second - rise, with the exception of the last (fourth) century, which represents “continuous decline”. In a word, according to Moshkov's scheme, ups and downs in the entire historical cycle do not last more than 50 years.

THE CHARACTER OF TIME

- Why did Moshkov name the centuries after the name of the metals?

“He used legends about four centuries of history found among the Greeks, Hindus and ancient Jews,” explains Gennady Nikolaevich.

- So, the 1st century, called the golden one by the Greeks, in India called the century of perfection. According to the Hindu tradition, "a person in this age is virtuous, happy and lives a long time."

The Greeks called the II century the silver one, and according to the Hindu legend, "life in this century was shortened, vices and misfortunes appeared."

The Greeks call the 3rd century Bronze, because the "terrible generation" commits grief and violence.

And the IV century was called the iron century by the Greeks, and the age of sin by the Hindus. This is a deplorable period. Morality has degenerated, life expectancy has decreased, there is no truth anywhere. And in biblical prophecies, in particular in Daniel, we see not centuries, but kingdoms: Gold, Silver, Copper and Iron.

Now let us correlate Moshkov's theoretical scheme with the concrete history of Russia.

For the beginning of the first historical cycle, he took the year 812, when the leaders of the Glades, Ilmen Slavs, Radimichs, Krivichs and other tribes entered into an alliance, uniting their lands into the first ancient Slavic state - Kievan Rus. It turns out that in 1612 Russia began the third 400-year cycle, which will last until 2012.

A clear table of the history of Russia looks like this:

First cycle (812 - 1212)


Second cycle (1212 - 1612)


Third cycle (1612 - 2012)


INCREDIBLE MATCHES

- Do historical facts coincide with Moshkov's predictions?

- And you judge for yourself, - offers professor Aiplatov. - The last section of Moshkov's book is titled “The Coming Iron Age. Decline (1912 - 2012) ".

Here is what he writes in 1910 (!):

“Two years later, that is, in 1912, we are entering the Iron Age. The constant rise in prices for all basic necessities will increase every year. As a result, it will be followed by the breakdown of the financial system and the indebtedness of all sectors of society. Many people will die of hunger and epidemics. The people will find the alleged perpetrators of their misfortune in government agencies, in the wealthy classes of the population. Riots will begin, beatings of wealthy and powerful people ”. And in reality, the October Revolution took place, followed by a civil war, which Moshkov also predicted!

- Judging by his table, the second half of the Iron Age - since 1962 - promises continuous decline instead of rise. Why?

- Firstly, because this century completes a 400-year historical cycle. And secondly, this is the philosophy of decline according to Moshkov and the ancient treatises on which he relied in his research.

He writes: “With the onset of decline in the state, all ties are weakening, starting with the highest ones. First of all, love for the government disappears, followed by love for the motherland, then for one's fellow tribesmen, and, finally, even attachment to members of one's family disappears.

This is followed by hatred of the government in general, combined with an irresistible desire to destroy it. " Remember the late 1980s and early 1990s, when our country was the leader in the number of divorces, abortions, alcoholism, drug addiction, and the government was enemy number one for the people.

ANATOMY OF DECLINE

Further, General Moshkov describes in detail the behavior of the government and the masses during the period of decline, at the beginning of which "the main means of struggle are objectively congresses and seimas, debates and fights", and at the end of it "riots, revolutions and endless internecine wars, accompanied by the ruin of the country and beating its inhabitants ".

(Remember the fights even in parliament, political infantilism, Afghanistan, the Georgian-Abkhaz conflict, Chechnya. - Ed.)

(A clear prediction of the collapse of the USSR. - Ed.)

“At this time, treason reigns in all its forms. The Fatherland is sold both wholesale and retail, if only there are buyers for it. "

(Indeed, large domestic enterprises were sold to foreign firms. - Ed.)

Culture and art are degrading: "The study of sciences is reduced to cramming and the pursuit of diplomas that give advantages in the struggle for existence."

(In the 1990s, Russia ranked last in the world in terms of education. - Ed.)

"In the literary field, decadence and pornography are bursting as something new."

(Oh! We had enough of this stuff over the edge in the mid-1990s. - Ed.)

"People become addicted to all kinds of games, especially gambling, indulge in drunkenness, drug use, revelry and debauchery."

(What an accurate description of the pastime of the majority of the inhabitants of Russia in the late XX and early XXI centuries. - Ed.).

“I think that these extracts from Moshkov’s book mercilessly reveal the anatomy of recent decline in our country,” the professor sums up. - And remember that all this was described in 1910! But it looks as if the author of the forecast is our contemporary.

O WONDERFUL WORLD!

- According to Moshkov's forecasts, in 2012 a new Golden Age will begin in Russia. Will it be better than the previous one?

- Remember that the first half of the Golden Age of 1612-1662 began with a decline. And the current new century will come from its worst half, so the real rise will be only in 2062.

But it is better to live in the decline of the Golden Age than the Iron Age.

Here are the changes awaiting us:

“Enmity between people disappears and is replaced by consent and love. Parties no longer have any meaning and therefore cease to exist.

Civil strife and revolution recede into the realm of legends, since the uprising man is peaceful. Agriculture, cattle breeding, industry and trade begin to flourish. In science, the people is in a hurry to catch up with their civilized neighbors, from whom they lagged far behind during the decline.

Officials are being made honest. The army is being reformed and acquiring invaluable qualities. The citizens of the country are linked by common patriotism. The government communicates with the people with sincere love. "

... Some kind of communism!

QUOTE IN THE TOPIC

“We are on the cusp of the greatest golden age, when science, reason and even religion will triumph in search of truth. The Hindus call it Krita Yuga, astronomers call it the era of Aquarius, the Jews call it the coming of the Messiah, theosophists call it the New Age, and cosmologists call it the Harmonic Convergence. And the ancients even indicate the date: December 21, 2012, according to the Mayan calendar. "

Valentin Moshkov was born on March 25 (April 6), 1852. Descended from the nobility of the Kostroma province. After graduating from the Second St. Petersburg Military Gymnasium on August 5, 1868, he entered the service as a cadet at the Second Military Konstantinovsky School. On August 24 of the same year, he was transferred to the Mikhailovsky Artillery School, after which on August 11, 1871, V. Moshkov was promoted to second lieutenant and enlisted to continue serving in the 37th artillery brigade. In the service, he showed zeal and great interest. Less than 3 months later he was promoted to lieutenant. On June 17, 1873, Valentin Moshkov was assigned to the St. Petersburg fortress artillery to attend lectures at the Imperial Mining Institute. On December 28 of the same year he was promoted to staff captain.

On July 17, 1875 V.A.Moshkov was appointed to the post of junior artillery receiver at the Olonets mining plants. Valentin Moshkov took part in the Russian-Turkish War of 1877-1878. On December 26, 1877, he was promoted to captain.

On January 27, 1880, V.A.Moshkov was promoted to junior artillery receiver of the Main Artillery Directorate, leaving him at the Olonets mining factories.

Later V.A.Moshkov was transferred to the Volga-Kama region. On June 12, 1888, he became the senior artillery receiver of the Main Artillery Directorate. Presumably, in 1892 Moshkov was transferred from Kazan to Warsaw. On November 12, 1894, he was awarded the rank of lieutenant colonel, on May 14, 1896 - colonel. On December 6, 1905, he became a major general.

On August 22, 1913, V. A. Moshkov submitted his resignation letter "for domestic reasons." As evidenced by the materials of the report on the General Staff on September 19, 1913, he was promoted to lieutenant general "With dismissal from service, with a uniform and a pension"... After 1913, the traces of V.A.Moshkov are lost.

In 1921 V. A. Moshkov emigrated to Bulgaria. He died on November 19, 1922 in Sofia.

He was married to the daughter of a Petrozavodsk merchant Alexandra Ilyina, had children: sons Dmitry and Vladimir, daughters Julia and Zinaida.


Valentin Mashkov prediction to the world




source- http://kp.ru/daily/24428/597417/ Svetlana KUZINA — 22.01.2010

(1997-02-18 ) (93 years old)

Valentin Nikolaevich Moshkov(1903-1997) - Soviet scientist-doctor, one of the founders of physical therapy (exercise therapy) as an independent discipline of clinical medicine. Professor (1945), Corresponding Member of the Academy of Medical Sciences of the USSR (1957), Honored Scientist of the RSFSR (1974).

Biography

In 1945 he defended his doctoral dissertation on the topic "Therapeutic physical culture as a method of rehabilitation therapy after spinal cord injuries."

Bibliography

  • Moshkov V.N. Therapeutic physical training in the clinic of nervous diseases. - 3rd ed., Rev. and add. - M .: Medicine, 1982 .-- 224 p.
  • Moshkov V.N. Therapeutic physical training in the clinic of internal diseases. - 3rd ed. - M .: Medicine, 1977 .-- 375 p.
  • Moshkov V.N. General foundations of physiotherapy exercises. - 3rd ed., Rev. and add. - M .: Medgiz, 1963 .-- 356 p.
  • Moshkov V.N. When you are over forty .... - M .: Knowledge, 1965. - 32 p.

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Literature

  • Moshkov Valentin Nikolaevich: at the origins of the specialty // Massage. Body Aesthetics: Journal. - 2012. - No. 2 (28). - S. 10-12.
  • [bme.org / index.php /% D0% 9C% D0% 9E% D0% A8% D0% 9A% D0% 9E% D0% 92_% D0% 92% D0% B0% D0% BB% D0% B5% D0% BD% D1% 82% D0% B8% D0% BD_% D0% 9D% D0% B8% D0% BA% D0% BE% D0% BB% D0% B0% D0% B5% D0% B2% D0% B8% D1% 87 Moshkov Valentin Nikolaevich] // Great Medical Encyclopedia / Ed. B.V. Petrovsky. - 3rd ed. - M .: Soviet Encyclopedia, 1974-1988.

An excerpt characterizing Moshkov, Valentin Nikolaevich

- Yes, I just saw him.
She was obviously unable to speak and made signs with her hands to leave her.

Pierre did not stay for dinner, but immediately left the room and left. He went to look for Anatol Kuragin in the city, at the thought of which now all the blood rushed to his heart and he had difficulty catching his breath. On the mountains, at the gypsies, at the Comoneno - it was not. Pierre went to the club.
In the club everything went on as usual: the guests who had gathered for dinner sat in groups and greeted Pierre and talked about the city news. The footman, having greeted him, informed him, knowing his acquaintance and habits, that a place had been left for him in a small dining room, that Prince Mikhail Zakharych was in the library, and Pavel Timofeich had not yet arrived. One of Pierre's acquaintances, between talking about the weather, asked him if he had heard about Kuragin's abduction of Rostova, which they talk about in the city, is it true? Pierre, laughing, said that this was nonsense, because he was now only from the Rostovs. He asked everyone about Anatole; he was told by one that he had not come yet, the other that he would dine today. Pierre found it strange to look at this calm, indifferent crowd of people who did not know what was going on in his soul. He walked around the hall, waited until everyone had gathered, and without waiting for Anatole, did not dine and went home.
Anatole, whom he was looking for, dined at Dolokhov's that day and consulted with him about how to fix the spoiled business. It seemed to him necessary to see Rostova. In the evening he went to his sister to talk to her about the means to arrange this date. When Pierre, having traveled all over Moscow in vain, returned home, the valet reported to him that Prince Anatol Vasilich was with the Countess. The Countess's drawing-room was full of guests.
Pierre, without greeting his wife, whom he had not seen since his arrival (she was more than ever hated by him at that moment), entered the living room and, seeing Anatole, approached him.
“Ah, Pierre,” said the Countess, going up to her husband. “You don’t know in what position our Anatole…” She stopped, seeing in her husband’s lowered head, in his shining eyes, in his determined gait, that terrible expression of fury and strength that she knew and experienced after the duel with Dolokhov.
- Where you are - there is debauchery, evil, - said Pierre to his wife. “Anatole, come on, I need to talk to you,” he said in French.
Anatole looked back at his sister and obediently got up, ready to follow Pierre.
Pierre, taking his hand, pulled him towards him and walked out of the room.
- Si vous vous permettez dans mon salon, [If you allow yourself in my living room,] - Helen said in a whisper; but Pierre left the room without answering her.
Anatole followed him with his usual, dashing gait. But there was concern on his face.
Entering his office, Pierre closed the door and turned to Anatol without looking at him.
- You promised Countess Rostova to marry her and wanted to take her away?
- My dear, - Anatole answered in French (as was the whole conversation), I do not consider myself obliged to answer interrogations done in such a tone.
Pierre's face, which had been pale before, was contorted with fury. He grabbed Anatole by the collar of his uniform with his big hand and began to shake it from side to side until Anatole's face took on a sufficient expression of fright.
- When I say that I need to talk to you ... - Pierre repeated.
- Well, that's stupid. A? - Anatole said, feeling the collar button torn off from the cloth.
“You are a scoundrel and a scoundrel, and I don’t know what is holding me back from the pleasure of crushing your head with this,” said Pierre, “speaking so artificially because he spoke French. He took the heavy press in his hand and lifted it menacingly, and at once hastily put it in its place.
- Did you promise to marry her?
- I, I, I didn't think; however, I never promised, because ...
Pierre interrupted him. - Do you have her letters? Do you have any letters? - Pierre repeated, moving towards Anatol.