Hernia. Fractures.
HERNIA.
Many cases of recent hernia have been successfully treated by massage.
The patient is placed flat on his back without headrest, so as to relax the muscles of the
abdomen. We massage the muscles in a general way at first and afterwards locally, the
object being to so strengthen the muscular parts around the ring that the normal retentive
power is established. I have used with great satisfaction the Iodine Petrogen 10 per cent,
with this treatment. There is no use of trying manual treatment for this trouble unless
the patient can be made to fully understand that he is not to stand up without his truss
on. In a severe case a surgical operation is of course necessary for a complete cure. The
patient should be instructed in the useful hernia-movements recommended by Dr. George H.
Taylor, of New York.
FIG. 114. Forcing a
Stiff Elbow-joint. FIG.
115. Forcing a Knee-joint.
FRACTURES.
Since the ambulatory treatment of fractures has been described by
Krause in Germany and by Hood and Sir William Bennett, of England, the American surgeons
seem to begin to take to it more in a few selected cases. Every simple fracture of the
extremities should be treated by massage before being reduced; we can, by gentle
manipulations above and around the fracture, draw the effusions away. The nearer a joint
the fracture,, the more important the massage becomes. The operator should of course be
very careful in handling the injured member and it is necessary to have someone to assist
in supporting it.
In fracture of the patella we must take special care of the quadriceps extensor femoris
and we must prevent adhesions of the fragments above and below. In giving the massage
around the knee we hold the fragments together with the thumb and index finger of one hand
and work with the other hand. In severe fractures with complications treated by the old
method the masseur is often called upon to deal with some difficult conditions.
Where there is impaired motion from faulty nerve or muscle action the operator should
carefully find out which muscles are the weaker and massage them; he should also overcome
contractions of the antagonists by movements or splints, even if necessary. Strokings of
the inside of the whole extremity affected are necessary to restore the circulation.
Anyone interested in the treatment of fractures should read the two following books : "
Massage in Recent Fractures," by Sir William Bennett, and "The Treatment of Injuries,"
by Dr. Wharton P. Hood. The active movements are sometimes indicated. In Figs. 114 and 115
we have represented two different ways of forcing contracted limbs and stiff joints. The
practical operator will see at a glance the great benefit obtained from the positions
given.
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