Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
Four distinct varieties of manipulation are found to be most generally
useful:
1. rubbing, or stroking
2. kneading
3. tapping, or percussion.
4. passive and active moments.
_Stroking_ consists in gentle rubbing directed from the periphery
upward, commencing the process above the inflamed part and continuing
it over the diseased area; the pressure, at first light but finally
firmer, will force the exudates into the tissues above, which have
been emptied by the preparatory rubbing.
_Kneading_ means rubbing the part circularly with the pulps of the
fingers and the thumb or the palm of the hand, and is best combined
with pinching up of the skin or muscles singly or together, and gently
rolling them between the fingers and palms.
_Percussion_ is effected by tapping the surface over the diseased part
with the tips of all the fingers held on a level, or with the ulnar
side of the hands, or, after covering the part with a towel, three
parallel pieces of stiff rubber tubing, fixed in a handle (a muscle
beater), may be employed, gently striking the part transversely to its
long axis.
_Passive movements_ should be made at the close of each sitting if a
joint is concerned.
Massage is sometimes advisable twice daily, but often once a day or
every other day is better; each sitting may last from fifteen minutes
to one hour.
+EXAMINATION BY RADIOGRAPHY+
+X-Ray Examination.+ This method of examination depends on the property
of penetration of matter possessed by a radiation from an electrically
excited Crookes’ tube. This radiation has been proved to lie outside
the spectrum, and has been named X-ray.
It may, for purposes other than those required by the expert, be
looked upon as a source of light which has the property of penetrating
the tissues to a greater or less extent according to their density,
and the shadows cast by it can be recorded on a photographic plate, or
may be viewed with the naked eye by means of a screen composed of a
thin layer of barium platinocyanide, a substance which becomes highly
fluorescent in the presence of this radiation.
One or the other of these methods is used for the recognition of
pathologic conditions existing in the human tissues.
The fluorescent screen appears at first sight to be an easy way of
recognizing abnormalities. Its value in the examination of the thorax,
where the movements of the heart, lungs, and diaphragm have to be
observed, is undoubtedly very great; but as an accurate means of
recognizing any abnormality, it is untrustworthy. For instance, it is
possible to fail to recognize simple transverse fracture of the tibia
by its means. Its use is therefore to be deprecated in cases where
great accuracy is necessary, and it is safer and better to make use of
the more certain method, the photographic plate.
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