INFANTILE PARALYSIS

Dominion, Volume 9, Issue 2870, 7 September 1916, Page 3

INFANTILE PARALYSIS

WHAT IS THE TREATMENT? OPINIONS OF A NURSE Some public attention has been diiected lately to the treatment of infantile paralysis,' or rather to that portion of rhe treatment of tha disease which has for its object tho restoration to /little sufferers of tho use of. their powerless limbs. Medical treatment suffices only •to arrest and cure the disease; it "does not remove altogether tho effects of the disease. Theso effects must be removed by other means. To instruct qualified peoplo in the use of these other methods of treatment the Public Health authorities encaged Nurse Bevilaqua, of Melbourne, who has achieved some success with a treatment devised by one Dr. MaoKenzio. Nurse Bevilaqua made a tour of tho principal centres of Now Zealand, and gave demonstrations in the treatment, and it is reported that her methods are being followed with tome sucocas, in other centres. About Wellington Hospital there seems to be some Joubt. Nurse Bovilaqua's treatment does not seem to have been carried out successfully here, and 'the public is not yet in full information of all the facts of the case.

Some account of how infantile paralysis and other muscular defects are treated in other countries was given to ;\ Dominion reporter yesterday by Miss' Helmfelt, a lady whoua namn has been mentioned onco or twice in tho recent controversy. Miss Helmfelt comes.from Denmark; she wis trained in Sn'edcn, and for two years she was in charge of a hospital for the treatmont of paralysed children in ' the South-East of London. This position sho held until she came to New Zealand some months ago, and 6lio came to New Zealand for privato reasons. Miss Helmfelt explains that_ tho treatment fof infantile paralysis is alternating rest and exercise oi paralysed muscles. This sounds very simple, but in Sweden the course of training was until recently three years. It lias recently been shortened to two years. Tho masseuses or nurses are all trained at the Royal Central Institute for Remedial Exercises and Massage. They take a very complete courso in anatomy, and they are taught and examined wholly by doctors. No person other than a doctor may give instruction in this treatment, which, as most people know,' is more highly developed, and moro widoly used in Sweden than in any country in the world. When Nurse Bovilaqua came here, Miss Helmfelt went to her demonstrations, and found that Miss Bevilaqua's system, was tho same in all but a' few details as that which she had learned and practised. The now modifications she has in practise found to 'bo effective. First and foremost the treatment requires that the paralysed muscles must bo rested, and this is done by splinting tho paralysed limb with special splints. If a limb ia wholly paralysed it should be splinted in a position which is best for easy movement, supposing that were possible. If only one muscle or set of muscles is' : paralysed the work of splinting is not so easy. In a healthy limb nature arranges that opposing sets of muscles balance, one another. | If one set is powerless, the. involuntary contraction of its opponent stretches and strains it. The splints must be so applied as to relieve the diseased muscles from this unnatural tension. Correct splinting can. bo made to give the musclo perfect rest. But tho splints alone do no good. If the limb is not exercised,. the only result is that tho muscles tend to bo-, come atrophied. _ Rest • must be combined - with exercise, and the exercise must be frequent. The exercise is tho most difficult of al! tho treatment to apply. Tho child must be assisted, coaxed, persuaded, encouraged somehow or other to try to movo the helpless limb in a particular way. Sometimes movement can be obtained, in a few weeks, even after months of paralysis, but complete cure,is not to bo speedily secured. In aggravated eases of long standing it may not be possible to get complete recovery, but it is always possible to restore some power of movement. In recent cases complete recovery is possible. ' These exercises must be varied to meet the changing needs of the case and the growing power of movement. Above all things, they must be the right exercises, and no one without, a complete knowledge of anatomy and some training can knows whether exercises are right or not. Mothers can help, but Miss Helmfelt considers that they ought to follow directions implicitly, and to bring their children regularly to be seen by the doctor or the masseuse, oven after recovery seems to bo in sight. Usually this would mean going regularly to the hospital! From an institution cases must be discharged before tho children are quite recovered, but. they arc in a state to make as complete a recovery as could ever be possible if treatment is continued'by iho parents under direction. So that, in addition to tho hospital ward for infantile paralysis, there should be :i well-supervised out-patients' clinic. "You need heaps of patience and; courage and optimism for this work," said Miss Helmfelt. "Recovery may bo so very slow. I had cases in London which continued to improve for two years.. But I have never.had cases to improve so quickly as here in Wellr ingtou, and I think tho reason is that they arc recent. The longer a case has remained untended the more slow and difficult the recovery. How do I get children to try? Oh, you must make a game of it with them. Pet them, play with them, get their confidence somehow, and, above all, encourage them. Tell them that if they try.they will he able to do so and so *ti a certain time. But I do not believe in giving any child false hopes never to be realised. Onco disheartened their interest is gone. Properly led on, they get very much interested in th'oir own recovery. You go in to see a little patient, and he will say excitedly, 'Oh, I can do so arid so to-day, nurse.' So you lead them on from effort to effort until voluntary move'ment is achieved. After this, you must keep on the exercise to get the muscles strong again. When strength as well a 3 movement is restored recovery is complete. But although recovery, and complete recovery, in all but the worst eaoos may be confidently looked for, it is very often a long business. You need heaps of patience."