Deformities Of The Feet. Affections Of The Eye, Ear

DEFORMITIES OF THE FEET.
In cases of club-foot use massage on the foot and on the leg up to the knee. A few turnings and flexions are very beneficial. In cases of "pigeon-toes" use similar treatment as for club-foot, but with the massage extended up to the hip. Also the following movements:
1. St. turning of the leg outward.
2. St. rotation of ext. leg (semicircle).
3. L. separating and closing of knees.
4. Feet at more than right angle, deep knee-bend, operator supporting chest and back.
5. Depression and elevation of legs, the operator turning the feet out as much as possible.
6. L. separating and closing of legs, feet turned out as much as possible.
In cases of flat foot we can, by the new Gefvert splint and our massage and movements, cure the deformity in a comparatively short time, if the patient will only persevere and be willing to stand a little pain. Apply careful massage to the whole foot and leg up to the knee.

The following movements are very effective:
1. Turning of the foot inward.
2. Rotation of the foot.
3. Flexion and extension of the foot.
4. Walking on tiptoe.
5. Walking on the outside border of the foot.
6. Feet closed; deep knee-bend.
Try to teach the patient to practice walking on his tiptoes five or six times daily. Massage is a valuable remedy in the complicated local nervetroubles, so frequently caused by a condition of talipes valgus. In other deformities of the feet the aim of the treatment must be to work the affected part back to its proper position by turning, rotation, flexion and extension, etc. Local massage is used to invigorate the muscles and to relax contracted tendons. All the deformities arising from infantile paralysis have been successfully treated by massage.

In talipes calcaneus, where the heel only touches the floor, we massage the posterior part of the leg to strengthen the soleus and gastrocnemius. We extend the foot by movements so as to overcome the contraction of the stronger flexor muscles. In talipes equino-varus where the toes come to the floor and the heel is drawn up and the foot inverted we massage the tibialis anticus, peroneus tertius and peroneus longus principally. We flex, evert and abduct the foot. In talipes equino-valgus where the toes touch the floor and the heel is drawn up and the foot is everted, we treat the tibialis anticus and the peroneus tertius principally. Our movements should be selected so as to adduct and invert the foot. When you have reached the safe limit of a movement hold the foot in that extreme position for some time to overcome tendinous contraction. With a good brace and intelligent massage there is rarely any real need for operating on the tendoAchillis.

AFFECTIONS OF THE EYE.
Massage is used for several chronic inflammations of the eye. By local massage we increase the circulation around the eye, and act directly upon the cornea. When we desire to see more clearly we rub the eyes, instinct telling us to remove from the cornea such particles as are stagnated. Certain swellings of the eyelids have been treated with great success by massage in the clinics of Schmidt, Rimpler, Rossander and Pagenstecher. Cases oimaculce cornecz (granules on the cornea) have been very successfully treated.

In some cases it is wise to apply massage on the whole front part of the affected side, and also on the same side of the neck. General massage is frequently used to strengthen the nervous system, thus giving effect upon the optic nerve. Manual treatment must never be applied to the eye without an order from a physician.

AFFECTIONS OF THE EAR.
Some authors (Politzer, Eitelberg) recommend massage for certain affections of the ear, and in my practice I have often been able to relieve severe pain, in cases of otitis, by massage only, in the form of centripetal strokings over the mastoid process and the corresponding side of the neck, as recommended by Gerst. In a few cases local massage has been applied to the ear with good results (Meyer and Lautenbach).