Electrical Treatment,

Dominion, Volume 12, Issue 175, 19 April 1919, Page 8

Electrical Treatment,

Tlio muselcs aro there, but tho owner might not bo able to control them. . If lie went'out into tho world at this stage iie woukl be helpless. He has ;to be shown that these muscles are still capable of movement, and hero electrical treatment and massage has lo be adopted. A good many falso, ideas prevail as to tho uss of electricity as a curative medium. It has limitations, and the orthopaedist pretends to no "black magic" in his use of the curront. Normally muscle movement is controlled by the nerves, but lesion of these sensitive' "controls destroys the power of conveying to them, the impulses from the brain. A patient in this condition goes to the massage room for attention nt tho hnuds of the trained New Zealand women who have been selected because of their experience of the latest English methods. They use the British War Office standard elcctrical table, which is splendidly designed to secure simplicity and thorough control. The patient lies in the massago couch, his injured limb bared, and resting on a. wet pad—a good conductor of electricity. The masseuse tests the extent of his muscle control, and from her intimate knowledge, reinforced with the data provided by the surgeon, "picks up" tho muscles uncontrollable anil dormant. At her aide a metronome ticks quietly, plunging an electrical contact, into a mercury bath at each swing, sending a current to two pads manipulated by the operator. In rythmic succession the current is alternately applied and released. The effect on the muscle is remarkable to tho layuian'e eyo. The patient cannot movo it, but he feels the faradaic current, and he also ]nds that the musclo he caiiuot'eontrol is contracted when the current: is on. As the, metronome releases the .current tho muscle relaxes; and so the process of contraction and relaxation goes on, demonstrating that when the nerve conies again into action (and this is helping to. that, end), the muscle will once more come under tho control of its ownor's brain. The whole process is stimulating to'muscle and norve, and though it may take some months, normal control comes back at length, and the soldier blesses tho resources which science provides to lift him out of his helplessness. Ordinary massage is also given where required, "and another interesting feature of this department is the musclo reeducation conducted by the stall'. Perhaps a mail's right arm is not functioning properly, though his left is normal. So the masseuse handles the right arm, get? the soldier lo slowly exercise the muscles of tho left, while, with her aid, tho deficient limb is made to follow the same movements. And gradually the defective muscles commence to resume their functions under this practical educative process. Tho wide range of cases and the excellence of the equipment at Chalmers Hospital affords a good opportunity for training masseuses, 25 of whom aro undergoing a course of instruction by a s(<iff which has had experience in English orthopaeaic hospitals. Thus the requirements of other hospitals of_ tho kind in New Zealand will be maintained.

Special Baths. A valuable adjunct to tho massage department is the specially equipped bathroom, where many of the patients have a preliminary cour.sc of treatment in whirlpool and aerated baths. legs or arms are immersed in specially designed .baths, while an electrically-driven turbine in the bottom stirs up an artificial whirlpool, and »9 an additional resource, tho attenn'ant can set the whole bath bubbling violently with compressed air. This treatment has n valuable effect in softening the skin and improving the circulatory system before massage.' The masseuse often has to do her work at the bath, as more movement of an injured limb is ofteii possible under water, with the stimulating effect of aeration, and the whirlpool. ' • Orthopaedic Gymnastics. But orthopaedic treatment does not end with these things. It has many phases, all hearing on the one great object, the restoration 011 junction of the injured parts of the, body. The soldier cannot lie constantly in the bath, nor can lie get continuous massage. Something more than spasmodic. treatment is necessary, consequently tho orthopaedic gymnasium and the curative workshops form an essential part of the system. In the gymnasium carefully designed exercises are carried out by small squads of men with similar disabilities, inducing them to use their deficient muscles and restore full control. Many .of them, as a result of long disability, arc very chary of activity, but the knowledge that their' instructor is trained in this branch of gymnastics, and that behind him is (he advice of tho surgeon, gives Hie men confidence. Thii.v attempt movements which they impossibleami they succeed. "When the set oxer-, cises are over the class plays a round gams well within physical capacity, and in the excitement of competition the caulious ones do things they would not coldbloodedly essav—and another step has been made in tho restoration of function. A mirror facing a walking track is one of the fittings. This, enables a man (0 correct mistakes in his gait which have been brought on by injury. Tie sees his awkwardness, is told how to correct it. and gradually gets back Hi" poise and balance which vijl reduce the outward signs of his disability. The Workshops. It is in the workshops that tho most constant development of deficient functions can take place. Massage, baths,and gymnastics call necessarily fill only a part of the day, but in the workshops tho soldier may put in some hours of useful work—doubly useful for' the reason thai: the output lias an economic value, and in securing it the soldier helps to cure himself. Thirty men attend tho carpenters' shop f daily. Their principal work just now is tlio making of massage couches for the New Zea-

land orthoepaedic hospitals. The knowledge that they are doing useful work stimulates their interest, and tho task set for ihein, steadily pursued, helps them to regain control of tho limbs and facility in their use. Men who were onco right-handed are sometimes obliged to I rain tho left hand to a wider range of duty so as to make up for deficiencies. Then they find the canientery an interesting means to that end. it is tho same in the leather-work and basket-making shops, which are very useful in the numerous cases of hand injuries. Stiffmoving fingers nro applied to these delicate hand operations, and under tho direction of skilled and sympathetic women instructors, the patients are encouraged to persist in work which helps to bring back their old facility of movement and strength of fingers. Improvement in Splints. Tho making of splints and surgical appliances is an important activity at Chalmers Hospital, and it is evident that this art has developed enormously during the last few years. AVe see nothing of cumbrous wooden splints, because sheetiron and aluminium nro now tho principal materials. Splints can be shaped to lit. and to gently correct almost any deformity. The iron-workers, who have :in airy, well-equipped shop, include specially trained men, who were selected by Colonel AVvlie from among the Now Zealanders who gained Experience in England. Men are being trained here for splint work in other New Zealand orthopaedic hospitals, and a number of the patients also gain benefit Iroiu the.handling of the tools and machines. The finisned splints aro faced with soft lint, making them very comfortable and neat. Their variety is infinite, corresponding to the unfortunately large range of injuries which are received in modern warfare. "Drop foot" and "drop hands" Sire familiar 6igns of t':e cripple, and it is pleasant to nolo how the splint designer gives improved appliances to help men suffering from these troubles. For the "drop-foot" patient there is a splint with spring attachments to the leg, which gives tho foot strong hit clastic support, encouraging the patient to use the foot ■until, with tho help of tho splint and other orthopaedic treatment he can regain tho use of the lower muscles aim walk without a crutch. A more elaborate splint on, tho same principle, with tho fingers attached to spring loops working from the forearm, gives an artificial grip to an otherwise helploss hand, thus assisting to pave the way to normal muscular control. Plaster splints have also to bo used; as this is the most suitable medium for some deformities which aro the result of nerve lesion. These splints, ir.ade by English trained experts, aro particularly fine pieces of work in which strength and fconomy of material (for tho sake of the patient's comfort) are cleverly This department makes plaster cast of deformed limbs, ns a record of the patient's original condition. _ A collection of these casts already constitutes a "war museum." which will preserve for posterity vivid evidence of what war means to the men who risk their lives for their countrv. As it is often impossible to get a limb .back to its original shape, the art of tho bootmaker, lias to be applied to surgical boots. This is another department in the busy hospital. A shortening of the leg up to one inch can. usually be concealed by a well-made surgical boot, but some of tho shortening are three inches, which iiPccFsitutcs building up tlio sole in visible fashion. Many books hav; been written on tho subject of orthopaedic surgery, and the Chalmers Hospital embodies all its features. What is to be seen* there is n development of surgery which will be of the utmost value to civilians as well as soldiers, because these .modern appliances imported by the Defence Department for its own purposes will demonstrate (heir value in .general hospital practice, and wiil lend to become part of tlio standard equipment of every public hospital.