CHAPTER II. METHODS OF INDUCING HYPEREMIA.
There are three methods by which hyperemia may be produced:
By means of an elastic bandage or band;
By means of cupping glasses;
By means of hot air.
1 and 2 produce a passive or venous hyperemia, 3 an active or arterial hyperemia.
Retarding the return of the blood to the heart by com- The Elastic pressing the veins at the most convenient place between i. the focus of inflammation and the heart with the help of an elastic bandage or band represents the oldest and typical method of producing artificial hyperemia.
The Germans call this “ Stauungs-hyperaemie,”’ a term describing cause as well as effect.
A word, covering the principle of the procedure as this does, is not to be found in the English language. ‘‘Ob- structive hyperemia’ might be suggested, but the word represents the cause only, not the effect. “Stasis hyper- emia’’ would be an absolutely false interpretation of the process. What pathologists call a stasis is exactly what must be prevented in applying artificial hyperemia.
“Congestive,” “induced,” “‘artificial-active’’ and “ artifi- cial-passive” or “‘artificial-arterial”’ and “‘artificial-venous”’ hyperemia also express but poorly the mechanical cause and
physiologic effect of the procedure. We think, therefore, 23
Cupping Glasses.
24 BIER'S HYPEREMIC TREATMENT.
that it would probably be best to take over bodily the word “‘Stauungs-hyperaemie”’ into the English language. Every physician, here and abroad, would then at once under- stand which kind of artificial hyperemia was referred to; viz., the venous one, which can be produced either by the elastic bandage or by suction glasses. The arterial hyper- emia, brought on by hot air, is, of course, not a “Stauungs- hyperaemie.” It would be best called :“ hot-air-hy peremia.””
Inasmuch as the word “Stauungs-hyperaemie” has not as yet been adopted, the term “obstructive hyperemia’”’ will be used in place of it in the following pages.
This obstructive hyperemia when produced by means of the elastic bandage can be employed only in diseases of the head, scrotum and testicles, and the extremities. That is to say, in the case of the former the compressing bandage is applied around the neck or the base of the scrotum; in the latter, around the extremity above the inflammatory focus.
In the upper extremities it can be used for affections from the shoulder-joint (inclusive) down to the finger tips. As to the lower extremities, while all portions below the hip can be readily made to profit by the method, it has been found imposs
ble so far, for anatomic reasons, to apply the treatment to the hip-joint itself.
Where hyperemia by means of elastic compression is not feasible, it can be produced by suction. This method is used upon the breast, back, spine, pelvis, and the surface of the whole body whenever a localized acute infection or an open wound (sinus, granulation, ete.) is present. For this purpose cupping glasses of various size and shape are employed.
METHODS OF INDUCING HYPEREMIA.
As has been said already, the hyperemia produced 1 the cupping glasses is also principally an obstructive hyperemia.
Hot air is generated in wooden or metal boxes especially Hot Air. constructed to suit the respective case. This represents an arterial hyperemia.
Elastic Ban- dage.