Treatment by means of mechanical therapeutics at the Edgar Allen Institute, Sheffield / by Rodolph Abercrombie.

Abercrombie, Rodolph.

Date:: [1912]

Credit: Treatment by means of mechanical therapeutics at the Edgar Allen Institute, Sheffield / by Rodolph Abercrombie. Source: Wellcome Collection.

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$1076 THE LANCET,} [APRIL 20, 1912. employment in any Government, public, or parochial service, or to attendance at, or employment or service in, ‘‘any public institution, charity, hospital, or school.’”’ Mr. Black’s suggestions for legislation are short and silly. A UNIVERSAL GAZETTE OF MEDICAL LITERATURE. ' WE have received from the Claudius- Verlag Amandus M. F. Martens, of Wandsbeck, the preliminary announcement of the bibliographische Monatsschrift, an international gazette of universal medical literature, under the editorship of H. Albert- Hellmers, which will appear in 12 parts yearly at an annual price of 30 marks (or 20 marks cash). Each issue will appear about the middle of the month and will contain a list of (a2) all newly issued books, and (2) all important articles appearing in the technical journals, indexed by titles and by “authors. There is no periodical publication covering the same ground and keeping pace with current literature. The splendid index-catalogue of the Surgeon-General’s Library at Washington appears only at long intervals andin book form. It is questionable whether indexing by title is as good as indexing by subject with frequent cross references. For instance, to take a case from the sample pages submitted with the circular :— ** Effects, the, upon the heart of soluble digitoxin, an isolated glucoside of the digitalis group,” would be of little service when indexed under ‘‘E” as ‘‘ Effects” to one seeking informa- tion about the heart or about digitoxin, both of which would easily be found in a subject-index. We note also that out of eight columns of title references only 16 references, or half a -olumn, are to English literature. This is a defect that would have to be remedied if it were desired to attract an English-speaking clientele. There can be no doubt, however, - that there is room for a satisfactory periodical publication on A fairer judgment, can be made of the enter- prise when the first part is available for inspection. WE regret to announce the death, on April 12th, at the advanced age of 84, of Dr. William Ogle, who was for 23 years superintendent of statistics in the General Register ‘Office, and made many important contributions to the science of medical statistics. We hope to publish an obituary notice of Dr. Ogle in an early issue. INTERNATIONAL Morat Epucation Conariss.— Under the patronage of the Queen Mother of the Netherlands and with Prince Henry of the Netherlands as Honorary President the Second International Moral Education Congress will be held at the Hague from July 29th to August 3rd. Great Britain, India, the principal countries of Europe, Japan, and the United States will be represented, and according to the preliminary programme the first aim of ‘the Congress will be to cultivate the codperation of men and women representing different schools of thought in matters of education and the formation of character. Mr. F. “Charles, 22, Park-crescent, Church End, Finchley, London, is the honorary secretary for Great Britain. Literary INTELLIGENCE.—Mr. Stephen Paget, ~~ the honorary secretary of the Research Defence Association, has written a book summarising in ten chapters the evidence given before the recent Royal Commission on Vivisection, as » well as the inspector’s report for 1910. The volume contains in a final chapter ‘a brief account of the report of that Com- mission, and an introduction by Lord Cromer. The book will be published by Mr. H. K. Lewis.—New editions of Hutchison and Rainy’s ‘‘ Clinical Methods’’ and Mitchell Bruce’s *‘ Materia Medica” are announced for publica- tion early in May by Messrs. Cassell and Co. In the revision of ‘‘ Materia Medica” Dr. Mitchell Bruce has had the collaboration of Dr. Walter J. Dilling, lecturer on pharmacology in the University of Aberdeen. ea TREATMENT BY MEANS OF MECHANICAL THERAPEUTICS AT THE EDGAR | ALLEN INSTITUTE, SHEFFIELD. By RopOLPH ABERCROMBIE, M.D. OAMB., MEDICAL DIRECTOR, EDGAR ALLEN INSTITUTE FOR MEDICO- MECHANICAL TREATMENT, SHEFFIELD. THE Edgar Allen Institute has been established for the purpose of carrying out, as a charitable institution, various - forms of physical treatment, more particularly treatment by — means of mechanical therapeutics. apparatus used is that designed by Dr. Zander, of Stockholm, who is justly regarded as the originator of this method of treatment. In general terms, it may be said that the apparatus is designed to carry out by mechanical means the various movements and manipulations which make up the Swedish system of physical treatment. The apparatus consists of three groups. In the first for active movements the patient performs the particular movement against the resistance of a weight and lever; in the second for passive movements the movement (e.g., flexion and extension or circumduction of a joint) is carried out by a power driven apparatus, without the aid of the patient’s muscles ; and the third group is for mechanical operations, as per- cussions or vibrations. All the apparatus are exactly graduated, so that the physician can regulate the force and range of the movement, and can prescribe the dosage of his treatment, instead of leaving it (as he must do when manual treatment is employed) to the judgment of the masseur. This exact graduation is of especial service in dealing with such conditions as impaired joint mobility or muscular paresis, for it enables the force of the treatment to be increased, step by step, as the patient’s condition improves. Economic considerations constitute one of the advantages of mechanical treatment; for after the initial expenditure for apparatus mechanical treatment can be carried ouf much more cheaply than similar treatment performed by hand, especially when large numbers of patients are dealt witb. Although the apparatus can do much, in certain of the manceuvres of massage proper, nothing can replace the human hand. At the Sheffield Institute the treatment is supple- mented in certain cases by massage given by trained Swedish masseurs. The number of patients treated at present is about 100 a day. Injuries. Owing to the industrial nature of the population the results of fractures, dislocations, and other severe injuries of the limbs form a large proportion of the cases. Such cases do not usually come under treatment until a period measured in months has elapsed after the time of accident. Much of the residual disability depends on adhesions about joints or tendons and on muscular paresis. In such conditions the Zander treatment has been found an effective method of restoring the patient’s working capacity. Considerable improvement has even been obtained in cases in which the disability has lasted for several years. Adhesions are treated by passive movements of the affected joint, the range of movement being gradually advanced as the condition improves. In treating painful joints mechanical treatment possesses the following advantage: when such a joint is being moved by hand the manipulator, actuated by a desire for the patient’s good, is tempted occasionally to summon up a vicarious heroism, and make a sudden increase in the excursion of the movement. The patient is always on the watch for acts of benevolence of this nature, and keeps his muscles in a state of contraction in order to frustrate them. Thus the manceuvre is rendered less effective and more painful. On the other hand, when the movement is performed by a machine, the patient knows that the range of movement is definite ; he therefore confides himself to the apparatus and relaxes his muscles, and the movement is often performed with remarkably little pain. For weakened muscles, active movements are used against the resistance provided by a weight and lever. An ingenious use is made of the principles of the lever in the Zander apparatus. At the beginning of a movement, when the muscle is fully elongated and therefore weak, the lever is inclined downwards from the horizontal, so that the resist- ance is small; half way through the movement, when the muscle is half contracted, and therefore strongest, the lever Lit i, Pa TGl ul Nit get ol OLN ee$

Treatment by means of mechanical therapeutics at the Edgar Allen Institute, Sheffield / by Rodolph Abercrombie.

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