A study of six hundred and thirty-five cases of infantile paralysis : with especial reference to treatment : from the Children's Hospital, Boston / Robert W. Lovett and W.P. Lucas.

  • Robert W. Lovett
Date:
1908
Catalogue details

Licence: In copyright

Credit: A study of six hundred and thirty-five cases of infantile paralysis : with especial reference to treatment : from the Children's Hospital, Boston / Robert W. Lovett and W.P. Lucas. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    t 19 weight-bearing induces a deformed position in tiie foot or knee, because such deformity not only leads to ])ei- manent distortion of the bones, but is necessarily ac- companied by prolonged muscular stretching and may lead to coiitraction deformity of the antagonistic, not stretched muscles. (h) and (c) The prevention of muscular disuse and the stimulation of nervous centers in the cord in par- tially destroyed groups are accomplished together by the' same measures. For a muscle to lie idle and not to con- tract is bad for it Avhether it is parah’zed, or partially paral}’zed, or not paralyzed at all. It will deteriorate locally and its functional cord center will not be stimu- lated to establish new associations or develop any latent power. But as a prerequisite to all treatment of this kind it must be assumed that the foot is properly supported by apparatus in walking, if without it it falls into a position of deformity. (The use and function of sup- porting apparatus is discussed in text-books on ortho- pedic surgery.) Having thus supported and held the paralyzed limb in a position fit for functional use, massage and elec- tricity are to be regarded as measures to improve the condition of the muscles and to lead toward functional use of partially paralyzed, stretched or disused muscles. Of themselves they are not curative or especially help- ful, except in so far as they promote muscular well- being and lead to muscular contractibility. Active muscidar contraction or muscle training is, in general, the most universally applicable therapeutic measure at our command and one insufficiently appre- ciated. Having worked with massage or electricity or both, for the development of the muscle or muscles an attempt should be made as soon as it becomes possible, to get the partly affected muscular group to contract in response to a voluntary impulse, at first being satisfied with only a quiver in the fibers at the attempted move- ment, but later affording aid in the attempted move- ment by the hand, by some improvised apparatus, such as a strap or bandage, or by the use of some mechan- ical apparatus, such as those of the Zander system, those used so extensively in German}^ or by some sim- pler form. In short, the effort is to bo made to make
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