University of Pennsylvania Medical Bulletin Volume 23 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1911 Excerpt: ...many months, but under proper treatment the intensity of the pain usually subsides in a few days, and in long-standing cases a few weeks may be required for the removal of the indurated area. The best plan of treatment is that giving temporary relief, which is to be followed by the removal of the cause. The acute cases should be given a saline purge at once and kept at rest in bed until there is an amelioration of the symptoms; this usually occurs soon, but atmospheric conditions sometimes act unfavorably. The part may be immobilized: however, there is no absolute need for this unless it affords relief to the patient. The drug of choice for internal use is aspirin, and a dram and a half or even more in twenty-four hours may be necessary; the usual doses given are entirely inadequate. Locally, mesotan or spirosal may be used. The most valuable means at our command for a permanent cure is massage; and just at this point it is worthy of note that the reason this condition is regarded a more hopeful one abroad is because of the different way in which the manipulation is carried out; there, the treatments are much more vigorous and are for the most part given with the thumbs; after a few treatments the amount of pressure required in some cases would astonish one not familiar with this work. Owing to the pain produced, it is desirable that the first few treatments be given gently. It is interesting to notice the gradual disappearance of resistance and the lessening of pain in these indurated areas as the patient improves. The treatments should be continued as long as the area is tender and the induration is palpable, or until it is determined that no further improvement can be accomplished, for it occasionally happens that the induration is of so long standing an...