Treatment of internal diseases : for physicians and students / by Norbert Ortner ; ed., with additions, by Nathaniel Bowditch Potter ; tr. by Frederic H. Bartlett.

  • Ortner, Norbert, 1865-1935.
Date:
[1913], [©1913]
Catalogue details

Licence: Public Domain Mark

Credit: Treatment of internal diseases : for physicians and students / by Norbert Ortner ; ed., with additions, by Nathaniel Bowditch Potter ; tr. by Frederic H. Bartlett. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    able deprived of all exercise, that it is wiser to allow such, sports as golf, canoeing, rowing, doubles in tennis, and sometimes even foot-ball, provided, of course, that he can be examined by a competent physician after such exercise and from time to time to see that no mis- chief is being accomplished. We must remember that at this age the patient will naturally exceed our permission. With reasonable care such a plan keeps a growing boy's nutrition and digestion in much better condition and often prevents his becoming introspective and later a timid, morbid invalid. The practical point is to avoid over- fatigue, i.e., fatigue not readily overcome in a few minutes by rest in the horizontal position. Patton does not prohibit bicycle riding; he gives the following in- structions to cardiopaths who ride wheels: Do not ride over six miles an hour; confine riding to a boulevard or smooth gravel road, if possible; do not ride steep grades; do not ride against a strong wind; adjust the saddle well forward so that the weight of the body can be utilized in propelling the wheel; raise saddle so that the rider's leg is almost straight when pedal is low; use wide handle bars. He does not allow wheel riding in cases of mitral stenosis or marked aortic regurgitation.] •Oertel's Terraincur.—Oertel has a special method of treatment by systematic exercise, called a terraincur. It will be discussed more fully in the chapter on diseases of the heart muscle. Suffice it to say here that in general it is not suited to valvular lesions, even in the stage of complete compensation. Zander's Gymnastic Method.—Proper gymnastics are most warmly to be recommended for many patients. Zander has devised a suitable method, consisting of active and passive movements and mechanical massage, all three carried out by means of special machines run by steam or a motor, and carefully supervised by the physician. The amount of muscular work demanded can be exactly measured. Swedish Movements.—The Swedish movements, introduced by Ling, also consist of active and passive movements and of a kind of massage, and aim at an exact measurement of the muscular work in- volved; but they differ from Zander's method in needing no special room or apparatus, the gymnasium director or physician taking the place of the machine in the passive and active movements. The effect of both these methods can be explained only by the fact that by the movements of the muscles, especially the active movements, the blood current at the periphery through the veins towards the right heart is lightened, the peripheral blood pressure is reduced, the work of the heart lessened, and the heart therefore relieved. At the same time, thanks to the increased activity of the respiratory muscles, the blood stream from the right heart through the lungs to the left heart and the arteries is increased, the heart muscle receives a reflex impulse, and is stimulated to stronger contractions. The heart is thereby strengthened and, possibly, its muscular volume increased. It must be added that