Joint Movements.—Under this procedure we may mention flexion, extension, abduction, adduction, pronation, supination, circumduction, and stretching. The movements may be passive or resistive. In passive movements the exercise is almost entirely confined to the joint, the patient offering no muscular resistance. With the resistive movements a certain degree of muscular activity is enforced by the patient, thus not only exercising the joints, but the muscles connected with the joints. The physiologic effect of joint movements is to markedly stimulate all the parts about the joint, and is indicated in various joint disorders which may have resulted in the lessening of the normal movements of the part, as in rheumatism, gout, chronic synovitis, and the stiffness that follows immobilization of the joint in the treatment of sprains, fractures, etc. Care should be exercised in the beginning not to use too much force in the manipulation, otherwise the existing condition may be aggravated, and more harm result than good. Increased force may be exercised with each treatment, always bearing in mind the necessities of each case.
ELECTRICITY.
By Dr. James C. Gill,
Rush Medical College, Chicago, Ill.
Electricity is a useful and important therapeutic agent, and an understanding of its effect when applied to the human body is as essential as a knowledge of any other therapeutic measure. Too often the therapeutic use of electricity is committed to those having very little knowledge of it, and consequently good results are not obtained.
It is a great mistake to allow or advise patients to use electricity themselves; no greater mistake would be made or more harmful results follow if they were advised to go to the drug store, and help themselves to any drugs they might choose. Electricity should be administered by a physician, or under the directions of a physician by a nurse who has been thoroughly taught its use.
In medicine we have usually considered three different forms of electricity: First, Galvanism or Chemical Electricity; Second, Faradism or Induced Electricity; Third, Franklinic or Static Electricity. Now, we add a fourth and a very important one—namely, X-ray. A nurse should have a general knowledge of these different manifestations of electricity and their effect when applied to the body.
In electricity we have units of measurements as we do in weights and measures. For instance, the force that drives the current of electricity along, as we might express it, is called the electromotive force, and its unit of measurement is a volt. The resistance which the current must overcome is measured in ohms, and the strength of the current is measured in amperes, or, as we measure it in medical electricity, the thousandth part of an ampere, a milliampere.
Galvanic or chemic electricity has certain properties not obtainable in the other forms. Comparatively speaking, it is a current of considerable quantity, but low electromotive force. The galvanic current passes always from the positive to the negative pole. It possesses the power to decompose various compounds, such as water, the tissues of the body, etc. This is called the electrolytic action, and may be used to destroy certain tumors, for the removal of superfluous hair, etc. Again this current has the power to convey certain substances in solution into the tissues. This is called cataphoresis, and is used to produce local anesthesia by the use of cocain applied to the positive pole. This is one of the best methods we possess of obtaining local anesthesia.
The effect of iodin may be obtained by the use of a solution of potassium iodid, and the negative pole may be used to affect local swellings, etc. Muscular tissue may be made to contract by the application of the current, either when applied to the motor nerve supplying the muscle or when applied directly to the muscle. Upon sensory nerves the positive pole is sedative, and may be used to relieve pain in cases of neuralgias, etc. The negative pole is stimulating, and may be used in conditions requiring increased nutrition, etc.