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Lectures ON DISEASES OF THE MALE URETHRA

1917; BMJ; Volume: 1; Issue: 2926 Linguagem: Inglês

10.1136/bmj.1.2926.114

0959-8138

Frank Kidd,

Bladder and Urothelial Cancer Treatments

The splint shouild then be removed, the hand should be heated, and active-anid-passive movetmleilts of tlle joints carried out.The actual gain fronm day to day may be very small, but excellent results can generally be achiieved if thie treatment is persisted in.For tlle treatment of contracted conditions of the flexors of the forearmn several methods of applying continuous traction are available.Spl)ints with springs or elastic accumulators applied to the posterior aspect of the limb are, on the whole, rather unsatisfactory.The plan of tying weights to the forearmn mjay be of some effect, but it does not commend itself to the patient.TThe best results are obtained by placing the patient on hie back on an ordinary muassage t oucl.His shoulder and -clest are fixed to tihe couclh by adjiustable strappings.A-firm pad-is pladed tinder the flexed elbow, and traction is.applied in the line of the armi by attaclhing a strong cord to the wrist, passing it over a pulley at the bottom of the couch, and fasteniing it below.After five or ten minutes the cord becomes noticeably slack as tlle flexion yields, aind it r-equires to be tighltenied up at intervals.Cases steadily-iwptove if tlis-treatibeit is 6arried out tor periods of an hour twice a day.The pectoral mtuscles cani bd stretchled in simlilar faslhion by tyijng the exteiided arm- back to some object in the room, the weialgt of the limib being sustained by a small table placed under thie forearm.TThe Zander nystemprovides an excellent imietlhod for the exercise of both passive and active movements.The macllines can be adjusted, either passively to stretch con- tracted tissues or to provi(le a resistance against which the muscles are encouraged to contract.The action is a rhytlhmical one, and its value lies in the fact tlhat the force is evenly exerted without sudden jar or strain; tlhin is.effected by :an adjustable syst4m of counterpoise, the action of which resembles in ome measure thie steadying and controlling effect-exercise'I by antagonistic.muwles drring the eositrvation of their opponents.-The Zander pInehia6s aee expesiaive;-but where iarge -umbers of.-esesare tieatedtey very soon repay their cost.Whatever line of treatment.is.oopted-restoration of function, and voluntary exercise of the affected -iulb slhould bb encouraged from the earliest possible momenit; and interference with the function of the muscies con- cerned should be as limited as is-consistent with the treatment being carred out.1 am obliged-to Colonel T. Lucas, C.B., for his kind permission to publislh this paper.