Hyperemic TREATMENT IN MEDICINE....-.-- 006.0200 5 154

CHAPTER V

Hyperemic TREATMENT IN MEDICINE....-.-- 006.0200 5 154

CHAPTER VI

Hyreremic TREATMENT IN GYNECOLOGY AND OpsTETRICS 166

CHAPTER VIL

Hyreremic TREATMENT IN GeENITO-URINARY SurGERY 170

CHAPTER VIII

Hyperemic TREATMENT IN OTOLOGY.............. .. 176

CONTENTS u

CHAPTER IX PAGE Hyreremic TREATMENT IN OPHTHALMOLOGY......... - 181

CHAPTER X IN RHINOLOG

Hyveremic TREATME)

AND LARYNGOLOGY .......0 0000000 c cece eee eee eee 184 CHAPTER XI Hyreremic TREATMENT IN Nevro.ocy, IxcLupinc PSYCHIATRY eee ni pew; REE AE & 18S CHAPTER NII Hyperemic TREATMENT IN DERMATOLOGY......... --. 192 CONCHUSTON . wiscnsesectsasrezae semmveneunieune cinzecsedbansnete -. 193

INDEX ager cesy ass SERRE ERE 20 joka yee 199

LIST OF ILLUSTRATIONS

ra.

1. Application of Bier’s elastic bandage around arm...
2. Application of Bier’s elastic bandage around arm.
3. Application of Bier’s elastic bandage around arm.
4. Dressing during treatment.
5. Technique for obstructive hyperemia at shoulder- 6

joint. . Elastic neck-band. . Rubber bandage used for neck-band. . Neck-band made of black rubber. . . Application of elastic bandage for emia of head.. scree cereanaueneneis 10. Obstructive hyperemia, for testicles 11. Rubber tube for testicles. . 12. Rubber tube for testicles 13-16. Suction glasses. 17-20. Suction glasses. 21-22. Suction pumps. ag 23. Suction glass for puerperal mastitis . Suction glass for puerperal mastitis 25-29. Vacuum glasses. . 2. Vacuum glasses. 33. Patients treated with suction cups for suppuration and fistulous tuberculosis. . 34. Suction apparatus for finger (felon, ‘ete. 35. Suction apparatus for hand. ... . ‘ F 36. Medium position for moving wi rist in vacuum glass. 37. Dorsal flexion of wrist Produced by the vacuum. 38. Volar flexion of hand.. su eae 39. Strongest volar flexion...... 40. Passive stretching of the finger 41. Fingers pressed into flexion by vacuum 42. Foot-piece in place without supports. . 43. Cushion under heel for treatment of talipes caleaneus 44. Cushion under the fore part of the foot for treatment. of pes equinus....... 45. Large laterally slanting cushion in place 46. Apparatus for finger-stretching..... . paratus for finger-stretching. . Fingers successfully stretched . 49. Suction apparatus for elbow-joint. 13

14 LIST OF ILLUSTRATIONS

Suction apparatus for knee-joint.... 62 51. Suction apparatus for knee-stretching. 63 52. Contracted knee stretched by suction apparatus. . 63 53. Wooden hot-air box for hand...................05 66 54. Hot-air box for elbow....... : ore 88 woe OF 55. 68 56. 69 57. 70 58. 71 59. ir chamber for whole leg. 72 60. Hot-air chamber for both hips. .... 73 61. Hot-air douche for trigeminal neuralgia 74 62. Hot-air douche for sciatica........... 75 63. Small size elastic band for the finger 79

64. Klapp’s suction cup in case of carbuncle ..... oo 84

65. Suction glass applied to breast... 91

66. Suction cup applied to breast 92

67. Anatomy of palm of hand...... 103

68. Incisions in case of suppuration within tendor

of volar flexors ........... ie 105 69. Phlegmon of hand and forearm. . 107

70. Deep and large soiled wound of volar aspect of forearm 115
71. Elastic bandage in fistulous tuberculosis of elbow- joint ‘ . Suction glass in tuberculosis of elbow... -
72. Plaster-of-paris support in tuberculosis of the knee.. 127
73. Same as Fig. 73 as carried out by instrument-1 maker 127
74. Combined treatment of contracted tuberculous knee- joint. _— -
75. Tuberculous affection of metatarsus.
76. Producing local hy] rperemie in case of tuberculosis of the os sacrum. ara
77. Suction cup in u: ame case as figure 77...
78. Elastic tube in position in double tuberculous epidid MULES, « crcwnegas same vemneme dian pemmeeenes . Tuberculous epididymitis treated with suction-glass . . Tuberculous epididymitis treated with suction-glass .

. Kuhn’s lung suction mask i in 1 position. . ‘5. Hot-air box treatment of lumbago Suction glasses for cervix uteri. n glass for pars pendula penis . Suction apparatus for prostate Suction glass for sty.......

2. Suction apparatus for no: 93-95. Suction glasses for tonsils

in gonorrhea... 170

BIER’S HYPEREMIC TREATMENT

WILLY MEYER-SCHMIEDEN

BIER’S HYPEREMIC TREATMENT.

INTRODUCTION.

The physician who intends to make use of artificial hyperemia must first have a clear idea as to what he wishes to accomplish with it. To employ artificial hyperemia means to increase the quantity of blood in a given diseased part of the body, hoping thereby to obtain beneficial results.

The task of the blood is to circulate through ali the differ- ent tissues of the body, with few exceptions, and to main- tain therein the various physiologic functions.

But the blood current accomplishes this not only under normal conditions, but tries to adapt itself also to abnormal states. As soon as the body is invaded by disease or disturbing external influences, requiring an increase or decrease of the blood current, the circulatory conditions become changed.

Everyone who gives this matter some reflection, must come to recognize that the body in such instances, in prop- erly regulating the blood current, does a definite, deli- cate work, thereby often preventing, or even curing serious disease.

Physicians must learn to recognize in the circulatory blood one of the most powerful factors in the human and

2 wv

Definition of the Word In- flammation.

18 BIER’S HYPEREMIC TREATMENT.

animal system in bringing about the so-called ‘spontaneous cures.”

To explain, a burn may be cited as an example: A hot iron is brought close to the surface of the body. Immedi- ately the skin turns red. We call this the first degree of a burn. This reddening of the skin represents, according to Bier, the body’s attempt at protecting the injured part, the accelerated blood current cooling off the heated part and, at the same time, furnishing increased nutrition in the hour of danger.

With the cause persisting, the redness becomes more and more marked, while the sensitive nerves, through the production of pain, bring the imminent danger to the atten- tion of the brain. Soon the cooling blood current proves insufficient. A large accumulation of serum, a blister, developing between the layers of the skin, is furnished by the blood as a further protection against the injurious effect of the heat. To accomplish this, the body has to give up the external layer of the epidermis. We call this appearance of a blister the second stage of a burn.

With the appearance of the eschar, the body throws up the gauntlet, being no longer able to successfully employ the curative reactive inflammation. Necrosis sets in. This is the third stage of a burn.

Analogous work is done by the blood current in infectious ,—although with reduced rapidity in the con- spicuousness of the various phases,—when bacterial toxins take the place of the red-hot iron, as shown, for instance, in the inflammatory redness and the edema of a

proces:

furuncle, a phlegmon, an insect bite, ete. We have the same elemental fight of the system against an invading

INTRODUCTION. 19

foe. The spontaneous disappearance of an inflammation means no less and no more than the victorious fight of the increased blood current against the bacteria.

He who has followed this train of thought will coincide with Bier, that an inflammation—from the physiologic point of view—does not in itself represent a diseased condi- tion, but is a phenomenon indicating the body’s attempt to resist a deleterious invasion.

To increase this beneficent inflammatory hyperemia result- Aim of Bier's ing from the fight of the living body against invasion, is the beater aim of Bier’s hyperemic treatment.

By deduction from this simple reasoning we are able to discern the first and most important principle under- lying Bier’s hyperemic treatment, namely:

The blood must continue to circulate, there must never be _ Principle a stasis of the blood. This point is of such paramount eal Tete, importance that it must be stated ahead of and apart from ment. the rules that will be given later for the proper applica- tion of the treatment.

Bier’s teachings are of equal importance in explanation Artificial In- of inflammatory processes, as they are in the treatment Sanmanec. an of the same. If they be correct, we shall have to part with a number of time-honored views, up to the present time accepted as pathologie truths.

Hitherto it was considered the physician’s first duty to fight every kind of inflammation, since inflammations were looked upon as detrimental.

Bier teaches just the opposite: namely, to artificially increase the redness, swelling and heat, three of the four

cardinal symptoms of acute inflammation.

20 BIER'S HYPEREMIC TREATMENT.

Hence, all means that tend to subdue an inflammation are to be discarded.

To cite an example: According to Bier, it is a direct mistake if the physician orders the use of an ice-bag at the time of a beginning inflammation. By so doing he resists the healthy reaction of the body

he suppresses the salubrious effect of the inflammation and favors the deleterious influence of the bacteria. The fact that the ice-bag often brings comfort to the patient and reduces the pain, at least temporarily, does not invalidate the truth of the above dictum any more than the fact that an ice-cold drink momentarily comforts a feverish patient. The same rule obtains here as is generally applied in the case of infectious disease. There are very few physi- cians today who would attempt to reduce the fever in such

cases. We have learned to look upon this fever as one of

the weapons of the organism in its fight against the intruder.

It would lead too far, to consider here the many theories advanced in explanation of the effect of hyperemia. This book is to deal with the practical application of the latter. Suffice it to say, that the artificial increase of all the symp- toms and attributes of the complicated phenomenon, which we call inflammation, evidently is necessary, in order to succeed in conquering the acute inflammation.

The practical results obtained with the hyperemic treat- ment have proved beyond the shadow of a doubt the abso- lute correctness of the theories advanced by Bier.

GENERAL Part.